Question

Module 04 Project Assignment - Outline of the Project

Use this outline for this assignment: Nursing_APA_Template_2017 module 4 outline.docx

Create an outline of your project (Coronary Artery Diease /CAD). The outline should only contain topic headings and a brief description of what it will cover. See the link below for an APA formatted outline. Remember that your outline will be a guide as you write your paper to keep you on topic and organized.

Required paragraph topics include but are not limited to: the role nutrition plays in the prevention of the disease, etiology, progression, treatment, recommended diets, nursing assessment, nursing interventions, client education, and adherence. Please use library resources to find out more about Nursing Assessment, Interventions, and Client Education.

Answer 1

CORONARY ARTERY DISEASE

INTRODUCTION:

Coronary artery disease (CAD) is a prevalent type of cardiovascular disease. It is important for the nurses to become familiar with the various types of coronary artery conditions and the methods for assessing, preventing, and treating these diseases medically and surgically. Most common heart disease in United States is atherosclerosis.

1. Etiology
2. Risk factors
3. Pathophysiology
4. Clinical manifestations
5. Prevention
6. Dietary measures
7. Physical activity
8. Medications
9. Promoting cessation of tobacco use
10. Managing hypertension
11. Controlling Diabetes Mellitus
12. Gender and estrogen levels
13. Behaviour patterns.
14. Nursing assessment
15. Nursing intervention
16. Patient teaching

ETIOLOGY:

Narrowing of arteries due to lipid or fat accumulation leads to reduced blood flow to myocardium.

RISK FACTORS:

• Elevated blood lipid level
• Hypertension
• Use of tobacco
• Family history of premature cardiovascular disease
• Age more than 45 years for men and more than 55 years for women
• Gender, Lack of estrogen in women
• Diabetes mellitus
• Physical inactivity
• Obesity
• Race( higher incidence in African Americans)

PATHOPHYSIOLOGY:

Lipid deposition in intima of arterial vessel walls . Reccurence of these deposition leads to an inflammatory response. T lymphocytes and monocytes infiltrate the area to ingest lipids and die. The smooth muscles within the vessels proliferate and form a fibrous cap over the dead T lymphocytes and monocytes. These deposits are termed as plaque or atheromas which protrude into lumen of the vessel , narrowing and obstructing the blood vessels.If tthe plague is thick and the lipid deposition increases causing rupture and hemorrhage of blood vessels leading to creation of thrombus.The thrombus may obstruct blood flow , leading to sudden death or an acute myocardial infarction.

CLINICAL MANIFESTATIONS:

• Acute onset of pain- Angina pectoris
• Prodomal angina
• Shortness of breath
• Nausea
• Unusual fatigue
• Dysrhythmias
• High levels of cardiac enzymes

PREVENTION:

Four modifiable factors are cholesterol abnormalities, cigarette smoking, hypertension and diabetes mellitus . So these four are given much attention in health promotion programs. Modifiable risk factors are one which maybe followed to control the disease by life style or changing personal habits or by using medications. The more risk factors individuals exhibit they have greater ability to acquire coronary artery disease.

To control cholesterol abnormalities all adults 20 years of age or older should have a fasting lipid profile performed at least once in 5 years and often if abnormal. Patient's who have had an acute event require assessment of LDL cholesterol within 60-365 days after coronary artery bypass graft if performed. Serum cholesterol and LDL levels should be controlled by diet and physical activity.

DIETARY MEASURES:

Balance intake and expenditure of calories to maintain desirable weight. Soluble dietary fiber may help in decreasing LDL. Intake of atleast 20-30 grams of fiber per day is recommended. Cholesterol intake should be less than 200 mg/dL.Fresh fruit , cereals, grains ,legumes, are adviced to consume.Therapeutic lifestyle changes diet can assist the patients.

PHYSICAL ACTIVITY:

Regular , moderate physical activity increases HDL levels and reduces LDL levels. The goal is to exercise for 30 minutes , three to four times a week. The nurse should help the patients in setting goals.When patient exhibits shortness of breath , dizziness during exercises patient should be adviced to stop exercising .

MEDICATIONS:

• Lipid lowering medications (eg: Lovastatin)
• Nicotinic acids
• Fibric acid or fibrates eg: Clofibrate
• Resins eg: cholestyramine

MANAGING HYPERTENSION:

Early detection of high blood pressure and treatment may be a preventive measure.

PATIENT EDUCATION:

Teach patient's self care if having angina. Teach about effects of smoking. Organise a teaching program for patient with angina to explain him and his family , to identify symptoms of ischemia and state of illness .