In the morning, W.R. is transferred by helicopter to the medical ...

[K@]

In the morning, W.R. is transferred by helicopter to the medical center, and a cardiac catheterization is performed. It is determined that W.R. has coronary artery disease (CAD). The cardiologist suggests it would be best to treat him medically for now.
 
  What does it mean to treat him medically? What other approaches might be used to treat
  CAD?

Question 2

When you come into W.R.'s room at 2230 hours to answer his call light, you see he is holding his left arm and complaining about aching in his left shoulder and arm.
 
  What information will you gather? What questions will you ask him?

[mariahkathleeen]

Answer to Question 1

Medical management involves several components and is often considered conservative treatment.
Adjustment or addition of pharmacologic treatment for coronary risk factors (e.g., hyperlipidemia,
HTN) with medicationsnitrates, beta-adrenergic blockers, aspirin therapy, statins (lipid-lowering
agents)has been shown to reduce mortality and future coronary events. In addition, if a patient's
ejection fraction is less than 40, an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II
receptor blocker (ARB) will be needed. Advice about lifestyle modification might be needed (weight
loss, smoking cessation, exercise, dietary modifications, alcohol moderation). Other approaches
involve surgical procedures: coronary artery bypass graft (CABG), stent placement, percutaneous
transluminal coronary angioplasty (PTCA), or balloon angioplasty with stent placement

Answer to Question 2

 Take his VS. Obtain a STAT ECG.
 Evaluate his level of anxiety.
 Perform a focused assessment: Observe his color; feel for diaphoresis.
 Ask about the presence of pain and symptoms: quality; intensity (have W.R. rate his pain on a scale
of 1 to 10, with 1 being no pain and 10 being the worst possible pain); location (where did it start,
and has it traveled anywhere?); and duration.
 Ask about nausea.