Author Question: There are several risk factors for coronary artery disease (CAD). For each risk factor listed, mark ... (Read 615 times)

TVarnum

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There are several risk factors for coronary artery disease (CAD). For each risk factor listed, mark whether it is nonmodifiable or modifiable.
 
  a. Age
  b. Smoking
  c. Family history of CAD
  d. Obesity
  e. Physical inactivity
  f. Gender
  g. Hypertension
  h. Diabetes mellitus
  i. Hyperlipidemia
  j. Ethnic background
  k. Stress
  l. Excessive alcohol use

Question 2

You are a nurse at a freestanding cardiac prevention and rehabilitation center. Your new patient in risk-factor modification is B.T., a 41-year-old traveling salesman, who is married and has three children.
 
  He tells you that his work does not let him slow down. During a recent evaluation for chest pain, he underwent
  a cardiac catheterization procedure that showed moderate single-vessel disease with a 50 stenosis in
  the mid right coronary artery (RCA). He was given a prescription for sublingual (SL) nitroglycerin (NTG),
  told how to use it, and referred to your cardiac rehabilitation program for sessions 3 days a week. B.T.'s
  wife comes along to help him with healthy lifestyle changes. You take a nursing history, as indicated in
  the following.
 
  Family History
  Father died suddenly at age 42 of a myocardial infarction (MI)
  Mother (still living) had a quadruple coronary artery bypass graft (CABG  4) at age 52
  Past History and Current Medications
  Metoprolol (Lopressor) 25 mg PO every 12 hours
  Aspirin (ASA) 325 mg per day PO
  Simvastatin (Zocor) 20 mg PO every evening
  Lifestyle Habits
  Has smoked an average of 112 packs of cigarettes per day (PPD) for the past 20 years
  Drinks an occasional beer and a six-pack every weekend when watching football
  Dietary history: High in fried and fast foods because of his traveling
  Exercise: I don't have time to take walks.
  General Assessment
  White Male
  Weight 235 lb
  Height 5 ft, 8 in
  Waist circumference 48 in
  Blood Pressure 148/88 mm Hg
  Pulse 82 beats/min
  Respiratory rate 18 breaths/min
  Temperature 98.4  F (36.9  C)
 
  Calculate B.T.'s smoking history in terms of pack-years.



Athena23

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Answer to Question 1

 Nonmodifiable risk factors: a. Age; c. Family history of CAD; f. Gender; j. Ethnic background. These
are personal characteristics that cannot be altered or controlled.
 Modifiable risk factors: b. Smoking; d. Obesity; e. Physical inactivity; g. Hypertension; h. Diabetes
mellitus; i. Hyperlipidemia; k. Stress; l. Excessive alcohol use. These are lifestyle choices that can be
controlled or altered by the patient.

Answer to Question 2

The number of pack-years is calculated by multiplying the average number of packs smoked per day
by the number of years smoked. In this example, it is 1.5 packs  20 years = 30 pack-years.



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