A. Zerby Age: 44 (8/5/XX) Weight: 79.5 kg Height: 160 cm
Case Objectives
• Identifies the risk factors associated with coronary artery disease (REMEMBERING)
• Formulates a nursing plan of care for the patient with cardiac vascular disease (CREATING)
• Prioritizes nursing management of a patient having acute chest pain (APPLYING)
• Evaluates outcome of nursing interventions for the patient having chest pain (EVALUATING)
• Identifies the causes of preoperative anxiety and takes measures to decrease it (UNDERSTANDING)
• Creates and organizes a nursing plan of care to prepare a patient for a CABG (CREATING)
• Develops a teaching plan for education of the CABG patient and family (CREATING)
• Analyze social and cultural dimensions simulated patient encounters to build understanding and
capacity for the provision of culturally congruent nursing care.
Patient History
Past Medical History:
• Obesity, Gastroesophageal reflux, Elevated cholesterol 252, HDL 46, LDL 180, triglycerides 140,
Hypertension, Situational anxiety, Total abdominal hysterectomy six years ago, Right carpal
tunnel surgery two years ago
Allergies:
• No known allergies
Medications:
• Atenolol, Ranitidine
Code Status:
• Full code
Social/Family History:
• Married with three healthy children ages 14 to 18, Spouse at bedside, Employed fulltime as a
paralegal, Reports tobacco and caffeine use, Denies alcohol use, Mother had a myocardial
infarction at 55 and died at 66 secondary to complications of coronary artery bypass graft, Older
sister died at 54 from sudden cardiac death, Father recently had a stroke, Has two younger
brothers who are alive and well
Patient Problem: Click or tap here to enter text.
Risk Factors: Click or tap here to enter text.
Questions:
Discuss CAD. Include pathophysiology, risk factors, s/s, diagnostic tests, health promotion measures.
• Pathophysiology
o CAD is caused by plaque buildup in the walls of the coronary arteries. Plaque is made up of deposits of
cholesterol
and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over
time, which can partially or totally block the blood flow. This process is called atherosclerosis.
• Risk factors
o Overweight, physical inactivity, unhealthy eating, and smoking tobacco, a family history of heart
disease, especially a
family history of having heart disease at an early age (50 or younger).
• S/S
o Chest pain or discomfort (angina)
o Weakness, light-headedness, nausea (feeling sick to your stomach), or a cold sweat
o Pain or discomfort in the arms or shoulder
o Shortness of breath
• Diagnostic tests
o ECG or EKG (electrocardiogram): Measures the electrical activity, rate, and regularity of your heartbeat.
1
, o Echocardiogram: Uses ultrasound (special sound wave) to create a picture of the heart.
o Exercise stress test: Measures your heart rate while you walk on a treadmill. This helps to determine
how well your heart is working when it has to pump more blood.
2
Case Objectives
• Identifies the risk factors associated with coronary artery disease (REMEMBERING)
• Formulates a nursing plan of care for the patient with cardiac vascular disease (CREATING)
• Prioritizes nursing management of a patient having acute chest pain (APPLYING)
• Evaluates outcome of nursing interventions for the patient having chest pain (EVALUATING)
• Identifies the causes of preoperative anxiety and takes measures to decrease it (UNDERSTANDING)
• Creates and organizes a nursing plan of care to prepare a patient for a CABG (CREATING)
• Develops a teaching plan for education of the CABG patient and family (CREATING)
• Analyze social and cultural dimensions simulated patient encounters to build understanding and
capacity for the provision of culturally congruent nursing care.
Patient History
Past Medical History:
• Obesity, Gastroesophageal reflux, Elevated cholesterol 252, HDL 46, LDL 180, triglycerides 140,
Hypertension, Situational anxiety, Total abdominal hysterectomy six years ago, Right carpal
tunnel surgery two years ago
Allergies:
• No known allergies
Medications:
• Atenolol, Ranitidine
Code Status:
• Full code
Social/Family History:
• Married with three healthy children ages 14 to 18, Spouse at bedside, Employed fulltime as a
paralegal, Reports tobacco and caffeine use, Denies alcohol use, Mother had a myocardial
infarction at 55 and died at 66 secondary to complications of coronary artery bypass graft, Older
sister died at 54 from sudden cardiac death, Father recently had a stroke, Has two younger
brothers who are alive and well
Patient Problem: Click or tap here to enter text.
Risk Factors: Click or tap here to enter text.
Questions:
Discuss CAD. Include pathophysiology, risk factors, s/s, diagnostic tests, health promotion measures.
• Pathophysiology
o CAD is caused by plaque buildup in the walls of the coronary arteries. Plaque is made up of deposits of
cholesterol
and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over
time, which can partially or totally block the blood flow. This process is called atherosclerosis.
• Risk factors
o Overweight, physical inactivity, unhealthy eating, and smoking tobacco, a family history of heart
disease, especially a
family history of having heart disease at an early age (50 or younger).
• S/S
o Chest pain or discomfort (angina)
o Weakness, light-headedness, nausea (feeling sick to your stomach), or a cold sweat
o Pain or discomfort in the arms or shoulder
o Shortness of breath
• Diagnostic tests
o ECG or EKG (electrocardiogram): Measures the electrical activity, rate, and regularity of your heartbeat.
1
, o Echocardiogram: Uses ultrasound (special sound wave) to create a picture of the heart.
o Exercise stress test: Measures your heart rate while you walk on a treadmill. This helps to determine
how well your heart is working when it has to pump more blood.
2
