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 445 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

NANDA -I nursing diagnosis of Deficient Knowledge related to coronary artery disease.

May be related to:

• Lack of introduction
• Inaccurate/confusion of data
• Unfamiliarity with data assets

Possibly evidenced by

• Questions; articulation of concerns
• Request for data
• Inaccurate complete of directions

Desired/Measurable Outcomes

• Participate in learning process.
• Assume duty regarding own getting the hang of, searching for data and making inquiries.
• Verbalize comprehension of condition/ailment process and potential intricacies.
• Verbalize comprehension of/take an interest in restorative regimen
• Start essential way of life changes

Discuss pathophysiology of condition. Stress requirement for anticipating and overseeing anginal assaults.	Patients with angina need to realize why it happens and what they can do to control it. This is the concentration of restorative administration to decrease probability of myocardial dead tissue and advance solid heart way of life.
Review hugeness of cholesterol levels and separate amongst LDL and HDL factors. Stress significance of intermittent research center estimations.	Although prescribed LDL is ±160 mg/dL, patients with at least two hazard factors (smoking, hypertension, diabetes mellitus, positive family history) should keep LDL ±130 mg/dL, and those with determination of CAD need to keep LDL beneath 100 mg/dL. HDL beneath 35– 45 is viewed as a hazard factor; a level over 60 mg/dL is viewed as favorable position.
Encourage shirking of circumstances that may encourage anginal scene (stretch, exceptional physical effort, substantial overwhelming dinners particularly amid sleep time, presentation to extraordinary temperatures).	Doing so would lessen the occurrence or seriousness of ischemic scenes.
Assist patient or potentially SO to recognize wellsprings of physical and enthusiastic pressure and talk about ways that they can be maintained a strategic distance from.	This is a pivotal advance in forestalling anginal assaults.
Review significance of weight control, suspension of smoking, dietary changes, and exercise.	Knowledge of the centrality of hazard factors furnishes tolerant with chance to roll out required improvements. Patients with elevated cholesterol who don't react to half year program of low-fat eating regimen and normal exercise will require solution.
Encourage patient to take after recommended reconditioning program; alert to maintain a strategic distance from fatigue.	Fear of activating assaults may make quiet stay away from investment in movement that has been recommended to upgrade recuperation (increment myocardial quality and frame security dissemination).
Discuss effect of disease on wanted way of life and exercises, including work, driving, sexual movement, and side interests. Give data, security, or discussion, as showed.	Patient might be hesitant to continue normal exercises as a result of dread of anginal assault or passing. Patient should take nitroglycerin prophylactically before any movement that is known to accelerate angina.
Demonstrate how to screen possess heartbeat and BP amid and after exercises, and to plan exercises, stay away from strain and take rest periods.	Allows patient to recognize those exercises that can be altered to maintain a strategic distance from heart stress and remain underneath the anginal edge.
Discuss stages to take when anginal assaults happen, (end of action, keeping "save" NTG close by, organization of prn solution, utilization of unwinding methods).	Being arranged for an occasion takes away the dread that patient won't comprehend what to do if assault happens.
Review recommended drugs for anticipation of anginal assaults:	Angina is a muddled condition that frequently requires the utilization of many medications given to diminish myocardial workload, enhance coronary flow, and control the event of assaults.
Lipid-bringing down specialists: bile corrosive sequestrants, cholestyramine (Questran), colestipol (Colestid);	These medications are viewed as first-line operators for bringing down serum cholesterol levels. Note: Questran and Colestid may hinder ingestion of fat-solvent vitamins and a few medications, for example, Coumadin, Lanoxin, and Inderal.
nicotinic corrosive, and HMG-CoA reductase inhibitors: lovastatin (Mevacor), simvastatin (Zocor)	The HMG-CoA reductase inhibitors may cause photosensitivity.
Stress significance of checking with doctor before taking OTC medications.	OTC medications may potentiate or invalidate impacts of endorsed drugs.
Discuss ASA and other antiplatelet operators as showed.	May be given prophylactically once a day to diminish platelet collection and enhance coronary flow.
Review side effects to be accounted for to doctor: increment in recurrence of assaults, changes in light of medicines.	May draw out survival rate of patients with temperamental angina. Information of desires can dodge undue worry for unimportant reasons or deferral in treatment of essential side effects.
Discuss significance of follow-up arrangements.	Angina is an indication of dynamic coronary course ailment that ought to be checked and may require infrequent alteration of treatment regimen.