Instructions:Read the case study. Use the Rosdahl, Timby and drug… Instructions: Read the

Instructions:Read the case study. Use the Rosdahl, Timby and drug… Instructions: Read the case study. Use the Rosdahl, Timby and drug books. For each question answered, cite the page number(s) of your reference(s). All questions apply to this case study. Your response should be brief and to the point. When asked to provide several answers, they should be listed in order of priority or significance. Do not assume information that is not provided. You are a nurse at a free-standing cardiac prevention and rehabilitation center. Your new client in risk-factor modification is B. K., a 37-year old traveling salesman, who is married with 3 children. During a recent evaluation for chest pain (including a cardiac catheterization), he was diagnosed with angina pectoris, given a prescription for SL nitroglycerin, told how to use it, and referred to your cardiac rehabilitation program for sessions 3 days a week. B.K.’s wife comes along to help him with healthy lifestyle changes. You take the following nursing history: B.K.’s father died of sudden cardiac death at age 41 and his mother (still living) had a CABG x 4 (quadruple coronary artery bypass graft of 4 vessels) at age 52; his hypertension is controlled with nifedipine (Procardia) 90 mg PO qd, which he has taken regularly; he has a 35 pack/year smoking history; an occasional beer (“a beer every weekend with the football game”); and a dietary history of fried and fast foods. His current weight is 205 at 5′ 8″; waist/hip ratio of 1.21. His VS are 132/86, 82, 98.4oF. List 3 nonmodifiable risk factors for CAD.List 6 modifiable risk factors for CAD.Underline each of the responses in #1 and #2 above that represent B.K’s CAD risk factors.You would like to know more about B. K.’s hyperlipidemia. What 4 common laboratory values do you need to know?B. K. laughingly tells you be believes in the 5 all-American food groups: salt, sugar, fat, chocolate and caffeine.Identify health-related problems in this case description; the problem that is potentially life-threatening should be listed first.What is the most important priority problem that you need to address with B. K.?What is the second problem you would work with B. K. to change? Identify an appropriate strategy to resolve the problem.B. K.’s wife takes you aside and tells you, “I’m so worried for B. I grew up in a really dysfunctional family where there was a lot of violence. B. had been so good to the kids and me. I’m so worried I’ll lose him that I have nightmares about his heart stopping. I find myself suddenly awakening at night just to see if he’s breathing.” How are you going to respond?Note: nightmares about losing a loved one to heart disease are not rare, especially during the time of diagnosis or disease-related crisis. However, a background of childhood violence can have deep roots and often requires special help. Clearly, this woman is in distress. Depending on her willingness at this time, it would be good for her to talk with a therapist. If she doesn’t think she needs it, try suggesting that it might be good for B. and the kids and that it would help her relax and be more responsive to them. At the appropriate point, it would be important for her to be able to share with B. how she feels. From her description, this sleep disturbance is an unhealthy situation that should be addressed. If she refuses, keep an open relationship; it is important that she keep talking to someone about her fear.Six weeks after you start working with B.K., he admits that he has been under a lot of stress. He rubs his chest and says, “It feels really heavy on my chest right now.” You feel his pulse and note that his skin is slightly diaphoretic, he is agitated and appears to be very anxious. What are you going to do to obtain additional information?B. K. continues to feel symptomatic. Now what are you going to do? Health Science Science Nursing NURSING 145 Share QuestionEmailCopy link Comments (0)

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