Your patient, 58-year-old K.Z., has a significant cardiac history. He has long-standing coronary artery disease (CAD) with occasional episodes of heart failure (HF). One year ago, he had an anterior wall myocardial infarction (MI).
In addition, he has chronic anemia, hypertension, chronic renal insufficiency, and a
recently diagnosed 4-cm suprarenal abdominal aortic aneurysm. Because of his severe CAD, he had to
retire from his job as a railroad engineer about 6 months ago. This morning, he is being admitted to your
telemetry unit for a same-day cardiac catheterization. As you take his health history, you note that his
wife died a year ago (at about the same time that he had his MI) and he does not have any children. He
is a current cigarette smoker with a 50pack-year smoking history. His vital signs (VS) are 158/94, 88, 20,
and 97.2 F (36.2 C). As you talk with him, you realize that he has only a minimal understanding of the
catheterization procedure.
Before he leaves for the catheterization laboratory, you briefly teach him the important things
he needs to know before having the procedure. List five priority topics you will address.
Look at his past history. What other factors are present that could contribute to his risk for
cardiac ischemia?
Question 2Your hospital discharge planner facilitates J.F.'s transition to home care. During the initial home visit, the home health nurse evaluates J.F.'s IV site for implementation of the IV therapy program.
The nurse interviews the family members to determine their willingness to be caregivers and their level of understanding
and enlists the patient's and family's assistance to identify goals.
The home health nurse also writes short- and long-term goals for J.F. and her family. Identify
two short-term and three long-term goals.
Question 3Fortunately, J.F. has a supportive husband and two daughters who live nearby who can function as caregivers when J.F. is discharged. They, along with J.F., will need teaching about endocarditis.
Although J.F.vhas been ill for several years, you discover that she and her family have received little education about the
disease. You prepare a teaching plan for the family.
List six things you will teach J.F. and her family.
Question 4After you have taught J.F. about oral hygiene, which statement by J.F. reflects a need for further education?
a. I will remove my bridge after every meal and clean it thoroughly before replacing it.
b. I will use a water irrigation device to clean my teeth and gums.
c. I will use a soft toothbrush to brush my teeth.
d. I will rinse my mouth thoroughly with water after brushing my teeth.
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