Monroe College NURSING 812 Adult Assessment Mrs. C., a 47-year-old Navajo woman, comes to the clinic with a burning sensation in her epigastric area extending into her sternum.

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Monroe College NURSING 812 Adult Assessment Mrs. C., a 47-year-old Navajo woman, comes to the clinic with a burning sensation in her epigastric area extending into her sternum. Subjective Data:... Has had chest pain with activity that is relieved with rest for the past 3 months Has had type 2 diabetes mellitus since she was 35 Has a 27 pack-year smoking history Is more than 30% over her ideal body weight Has no regular exercise program Expresses frustration with physical problems Is reluctant to get medical therapy because it will interfere with her life Has no health insurance Objective Data: Physical examination o Anxious, clutching fists o Appears overweight and withdrawn Diagnostic studies: o Cholesterol 248 mg/dl (6.41 mmol/L) o LDL 160 mg/dl (4.14 mmol/L) o Glucose 210 mg/dl Normal cholesterol level- less than 200mg/dl Normal LDL- 100 to 129 mg/dL Normal glucose is less than 100 at fasting and no more than 140 after eating Critical Thinking Questions: 1. What are Mrs. C’s risk factors for CAD? 2. What nursing measures should be instituted to help her decrease her risk factors? 3. What symptoms would lead you to suspect the pain may be angina? 4. What kin of EKG changes would indicate myocardial ischemia? 5. What is the rationale for the use of the nifedipine? 6. What information should the nurse provide for Mrs. C. before the treadmill testing? 7. Based on the assessment data presented, write one or more appropriate nursing diagnoses. Are there any collaborative problems? 1. Diabetes mellitus, smoking history, overweight, physical inactivity, economic circumstances and stress response. 2. Provide encouragement and emotional support, refer to nutritionists and dietitian explain all interventions and procedures, refer to a smoking program, Position her in an upright position, give 2l of oxygen per nasal cannula, teach patient alternatives to smoking and its benefits to help with her cad, obtain vital signs, start ECG monitoring, auscultate heart and breath sounds, assess for pain before and after administering pain med, obtain laboratory values and a chest x-ray. 3. Chest pain with activity and relived with rest, anxiety with fist clenching. 4. ST segment elevation and/or T wave inversion. 5. Nifidipine is a calcium channel blocker so it helps lower blood pressure and control angina. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump and work so hard which can relieve the pain The nurse should inform H.C. that [Show More]

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