Complex Med Surg – Case Studies,The Patient with Coronary Artery Disease (CAD) The patient is a 40-year-old African-American man with a history of hypertension. He is in for an annual physical and admits that he has experienced chest pain “a time or two”

Ignatavicius: Medical-Surgical Nursing, 8th Edition 

Chapter 36: Care of Patients with Vascular Problems 

Case Studies 

The Patient with Bypass Surgery for Peripheral Arterial Disease 

A 77-year-old woman has just had femoral-popliteal bypass surgery to treat severe arterial disease. 

1. What are the “six Ps” that are assessed for after femoral-popliteal bypass surgery in relation to arterial flow and lack of oxygenation to the tissues? Indicate techniques, equipment, and principles that are used by the nurse to assess these findings. 

2. Which of the six Ps is often the first indicator of a graft site occlusion and requires immediate attention from the physician? Give an explanation for the answer. 

3. What is the procedure to be followed if a graft occlusion occurs? 

4. What is compartment syndrome? What assessments should be performed to detect compartment syndrome?

5. Name at least 2 other things that can cause compartment syndrome

6. What is femoral-popliteal bypass surgery

(B)

Ignatavicius: Medical-Surgical Nursing, 8th Edition 

Chapter 38: Care of Patients with Acute Coronary Syndromes 

Case Studies 

The Patient with Coronary Artery Disease (CAD) 
The patient is a 40-year-old African-American man with a history of hypertension. He is in for an annual physical and admits that he has experienced chest pain “a time or two” when he takes the stairs at work, so lately he has avoided the stairs. The chest pain subsided once he rested for a few minutes in his office. He smokes 1 pack of cigarettes per day. He is 5´8˝ and weighs 250 pounds. He takes hydrochlorothiazide and metoprolol (Lopressor) for his hypertension. His last serum cholesterol level was 220 mg/dL, with the high-density lipoprotein (HDL) 35 mg/dL and low-density lipoprotein (LDL) 105 mg/dL. His father died of an MI at age 54, and his mother has hypertension. He works 50 hours a week as a lawyer and takes occasional walks on weekends. 

1. What are this patient’s modifiable risk factors for CAD? What are his nonmodifiable risk factors for CAD? 

2. What patient education would you provide for this patient? 

3. Explain to this patient his risk factors for developing CAD.

4. What are the markers for CAD

5. What is HDL and LDL

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