Author Question: The nurse performs patient teaching about minimally invasive direct coronary artery bypass (MIDCAB). ... (Read 92 times)

jerry coleman · **on:** Jun 25, 2018

The nurse performs patient teaching about minimally invasive direct coronary artery bypass (MIDCAB). Which statement indicates that the patient needs further instruction?

a. It frightens me to think that my heart will be stopped for a long time during sur-gery.
b. This surgery bypasses my artery that is blocked, and replaces it with sections of a vein or artery taken from another part of my body.
c. This surgery will hopefully control my angina since nothing else we have tried has worked.
d. I may come out of surgery with vessels removed from my legs.

Question 2

The nurse is caring for an 80-year-old patient with a history of type 2 diabetes and hypothyroid-ism. The physician wants to evaluate the patient's blood glucose levels and orders a fructosamine assay.

Which factor best explains why the physician chose this laboratory test instead a glycosy-lated hemoglobin (HbA1c) test?
a. The patient's age
b. Type 2 diabetes
c. Hypothyroidism
d. The tests' costs

mfedorka · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

A
The MIDCAB procedure is less invasive than the traditional coronary artery bypass graft (CABG) procedure and does not require the patient be placed on the heart-lung machine due to stopping the heart for an extended period. Both procedures are used to treat angina that has not responded to more conservative treatment and utilize either the mammary artery or sections of the saphenous vein for the graft.

Answer to Question 2

B
The fructosamine assay is a diagnostic test used to assess the degree of diabetic control of blood sugar over the preceding 2- to 3-week period. The fructosamine assay is a better tool for the older adult as it is less influenced by age. The fructosamine assay is not specific to type 1or type 2 diabetes. Its accuracy is not affected by hypothyroidism. While the fructosamine assay is simpler and cheaper than an HbA1c test, the accuracy of results for this patient takes priority.