Question

The nurse is working with a new client at the community clinic. The client is a 59-year-old African American female. The client’s mother was diagnosed with coronary artery disease at the age of 60. The client has a sedentary job but walks for 30 minutes every day on the weekend. Her waist circumference is 38 inches (96.52cm). Her blood pressure on this visit is 140/90 mm Hg. She stopped smoking six months ago.

Laboratory results are:

• Triglycerides 250 mg/dL
• HDL 45 mg/dL
• LDL 150 mg/dL
• Total cholesterol 300 mg/dL

The nurse establishes a NANDA -I nursing diagnosis of Deficient Knowledge related to coronary artery disease.

Initial Discussion Post:

Develop a teaching plan that addresses one of the client’s risk factors for coronary artery disease.

The teaching plan should consider cultural influences and must include:

• a measurable patient centered outcome.
• two (2) nursing interventions to help the client achieve the outcome.
• an explanation of how each intervention will help the client achieve the outcome.

Answer 1

Teaching Patient about the Risk factors of CAD.

-Help the patient understand what and how CAD occurs by explaining that ,Coronary Artery disease (CAD) is the narrowing or obstruction of one or more coronary arteries as a result of accumulation of lipid containing plaque in the arteries.The goal of the treatment should be to alter the atherosclerotic progression.Explained to the patient the possible risk factors associated with CAD.Family Historyof CAD,Elevated serum lipoproteins,Cigarette smoking,Diabetes Mellitus,Hypertension,Obesity,Sedentery lifestyle and elevated serum uric acid levels.When developing teaching plan for a 59 year old women with a family history of coronary disease,considering the patients advancing age,and elevated Cholesterol as well as LDL ,leading a sedentery lifestyle,the nurse should focus mainly in explaining the importance of reducing Cholesterol and LDL level.The nurse should also focus on teaching the patient by asking her to follow a strict dietary regimine ,telling her to modify her faviurite high fat recipes with monosaturated oils when possible.Because lifestyle changes are more likely to be successful only when due importance is given to patients values and preferences.Help the patient understand that she being an African American witha positive family history ,the patient has a higher incidence of getting CAD.

Expected patient outcomes may include the following

1.Initiate life style changes.

2Takes responsibility by asking more questions.

Two nursing interventions to help the patient achieve desired outcome.

- Review the patient about the importance of limiting smoking,maintaing dietery as well as weight control. Advice the patient to maintain ideal weight because when you become obese ,the extra pounds put extra stress on your heart.Therefore maintaing adequate weight helps in keeping your heart fit . what we eat also can affect our weight as well as our heart.So limiting flavoured foods with spices and salt seasonings ,avoiding saturated trans fats will definitely improve our heart health.Excercise helps in lowering the elevated BP as well as reduce the bad cholesterol and helps in raising the HDL levels which is the good cholesterol.Walking,Running,Dancing are all aerobic excercises which helps to take more deep breaths which is a good excercise for the heart.Daily excercise helps in burning calories.Both diet and excercise play a significant role in maintaining health.

2 Explain to the patient about the importance of periodic checking of cholesterol levels and help her to understand the difference between HDL and LDL.Help her understand that HDL is good cholesterol whereas LDL is bad cholesterol for the body.HDL below 35-45 is considered as a risk factor,whereas a level above 60mg/dl is good.Recommended LDL is 160mg/dl with no risk factors.Incase of smoking or any other risk factors ,LDL level should be maintained at 130mg/dl.