Cad Case Study Essay

1870 Words May 17th, 2013 8 Pages
Case Study 5—Coronary Artery Disease
It is midmorning on the cardiac unit where you work, and you are getting a new patient. G.P., a 60- year-old retired businessman, is married and has 3 grown children. As you take his health history, he tells you that he began feeling changes in his heart rhythm about 10 days ago. He has hypertension and a 5-year history of angina pectoris. During the past week he has had more frequent episodes of midchest discomfort. The chest pain has awakened him from sleep but does respond to NTG, which he has taken sublingually about 8 to 10 times over the past week. During the week he has also experienced increased fatigue. He states, “I just feel crappy all the time anymore.” A cardiac catheterization done
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Have you had pain like this before?

2. What are common sites for radiation of ischemic cardiac pain? [k]

Upper chest, sub sternal radiating to neck and jaw, sub sternal radiating down left arm, epigastric, epigastric radiating to neck, jaw, and arms, neck and jaw, left shoulder ad down both arms, and intrascapular

Note: Patients will tell you what you want to hear, so be careful how you ask your questions.

3. You know that G.P. has atherosclerosis of the coronary arteries but he has not told you about his risk factors. You need to know his risk factors for CAD in order to plan teaching for lifestyle modifications. What will you ask him about? [c]

NONMODIFIABLE MODIFIABLE

Age (we already know) Recent lab work (elevated lipids)
Ethnicity Elevated Blood Pressure
Any Family History Tobacco use Physical Activity Obesity Diabetes Metabolic syndrome Psychologic states Elevated homocysteine level

4. Although he has been taking SL NTG for a long time, you want to be sure he is using it correctly. What information would you make sure he understands about the side effects, use, and storage of sublingual NTG? [c;an]

You want to teach the patient the side effects of dizziness, headache, hypotension, and tachycardia. Also you want to teach him not to take erectile dysfunction medications (Viagra) because it could further decrease his blood pressure.

Inform patient that

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