Question

Develop teaching points for a 54 year old Caucasian male who has had a PCTA for an acute anterior wall STEMI and is being discharged today. The patient has a history of untreated hypertension, hypercholesterolemia and a BMI of 28. He has been a 1 ppd smoker for over 30 years. He is being discharged on vasotec (enalapril) 20 mg every day, and atorvastatin (Lipitor) 20 mg every day. In your response, focus on major points you would address for this patient for the key areas identified: medications, diet, exercise, cardiac rehab, and smoking.

Answer 1

ANSWER

Teaching points for patient who had PTCA for MI.

          * Instruct the patient about importance of exercises like walking

            cycling,swiming to reduce bad cholesterol (LDL) level and improve

            circulation.

          * Educate about preparation of a cardiac diet which include

                                           vegetables

            fruits

,                                        low fat diary products

             whole grains

                     fish products.

   Avoid food products which contain,

           saturated fat (Butter,Shell fish,cheese,pork meat etc)

                                           high sodium level.( Shrimp,pudding,pizza etc)

                                           high sugar level.(Sweet cakes,cookies,candy etc)

       * Education about vascular changes like vasoconstriction,atherosclerosis associated

           with nicotine present in the cigarettes which leads to severe cardiaovascular problems

           and quit smoking to maintain cardiac health.

         * Cardiac rehabilitation plan include activities to enhance cardiac health and reduce future

           risk.( Heart healthy diet,regular exercise,avoiding bad habits,emotional support from family).

       * Teach about need of medicines which control or reduce the risk of cardiac problems like

                                                    *Antihypertensives.( eg; Enalapril)

                                                    *Antihyperlipidemics.( eg; Atorvastatin)

                                                    *Cardiac glycosides (eg; Nitroglycerin)

                                                    *Thrombolytics (eg; Alteplase)