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HESI Case Study - coronary artery disease fully solved
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HESI Case Study - coronary artery disease fully solved
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HESI Case Study - coronary arterydisease fully solved
Which information in the client's history indicates an increased risk for coronary artery disease (CAD)
and requires the nurse to provide disease management education? - correct answer ✔✔Family history
of hyperlipidemia.
Genetic predisposition is a significant factor in the development of CAD.
Consumption of a high fat diet.
Unhealthy habits, such as consuming fatty foods, are contributing risk factors to CAD.
Smoking two packs of cigarettes per day.
Smoking is a modifiable risk factor for coronary artery disease.
Which intervention is most important for the nurse to reinforce when assisting the client in achieving
their goal to quit smoking? - correct answer ✔✔Provide the client with a list of local smoking cessation
programs.
Prescribed and over-the-counter medications work best when taken in conjunction with a smoking
cessation program.
Which nursing intervention best promotes effective communication? - correct answer ✔✔"Do you feel
that you do not need to be involved in your health care?"
Clarification of the client's statement is a useful therapeutic technique that encourages further
communication.
Which nursing intervention best promotes effective communication? - correct answer ✔✔HDL less than
50 mg/dL (1.29 mmol/L) for women indicates an increased risk.
HDL is considered the "good" cholesterol, which reduces the risk of heart disease. Current guidelines
state that an HDL of less than 50 mg/dL (1.29 mmol/L) for women is too low to safeguard the arteries.
, After discussing these test results with the healthcare provider (HCP) and the nurse, the client expresses
interest in learning how to lower her cholesterol and lose weight. The HCP prescribes the
antihyperlipidemic agent lovastatin 20 mg PO daily. Which intervention is most important for the nurse
to include in the client's plan of care related to the use of an antihyperlipidemic? - correct answer
✔✔Healthy lifestyle habits
Lifestyle modifications should be used in conjunction with a cholesterol-lowering medication. Lifestyle
modificatios include heart healthy diet, regular exercise, avoiding tobacco products, and maintaining a
healthy weight.
While taking the prescribed antihyperlipidemic, which serum laboratory value requires intervention? -
correct answer ✔✔ALT 60 U/L (1.0 mckat/L).
Normal ALT is 4 - 36 U/L (0.07 - 0.60 mckat/L). Antihyperlipidemics can cause increased liver enzymes
and should be monitored periodically during treatment.
Which intervention is most important for the nurse to include in the client's plan of care for the self-
administration of sublingual nitroglycerin? - correct answer ✔✔Put one tablet every 5 minutes under
tongue up to 3 tablets.
Nitroglycerin tablets should be placed under the tongue when chest pain occurs. They may be taken one
tablet every 5 minutes for 15 minutes, for a total maximum dose of three tablets. If the pain is not
relieved after three doses, the client should be instructed to go to the Emergency Department.
When providing education for the prescribed transdermal nitroglycerin, which intervention is most
important for the nurse to include? - correct answer ✔✔Tell the healthcare provider (HCP) of persistant
dizziness when standing.
Nitroglycerin is a nitrate, causing systemic vasodilation. This often leads to hypotension, which can cause
the client to feel dizzy. She should be instructed to change positions slowly and to avoid prolonged
standing. If the dizziness is persistant when standing, the client's blood pressure may be too low,
requiring the HCP to adust the dosage or change the medication.
The HCP prescribes a stress echocardiogram. When preparing the client for the test, which instruction is
most important for the nurse to provide? - correct answer ✔✔Instruct the client not to smoke on the
day of the test.
The client smokes and should be specifically instructed not to smoke prior to test. Nicotine can interfere
with the heart rate.
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