1. Describe the pathophysiology ofcoronary artery disease.2. Discuss the nursing and medical management of the patient post cardiac angiogram.3. Describe how to intervene and care for the patient with chest pain and anxiety. 4. Outline and discuss the preoperative education plan for a patient and family for coronary artery bypass graft surgery. This should include preoperative education, instruction on the surgical procedure, postoperative course, and avoidance of complications. 5. Discuss the basic components of cardiac rehabilitation. The patient is a 44-year-old, overweight female who presentedto her primaryhealthcare provider yesterday with complaints of recent episodesof shortness of breath that occur with minimal activity such aswalking a flight of stairs or with increased stress. Her symptomsare relieved with rest.She denied any chest, arm or jaw pain but did have somediaphoresis with one or two episodes.- She attributed her symptoms to her smoking one pack per dayfor the past 20 years and obesity.- She has gastroesophageal reflux controlled with ranitidine andhas a historyof elevated cholesterol (252), HDL of 46, and LDL of 180.Her triglycerides were 140.- She drinks three to four caffeinated beverages per day anddenies alcohol use.-In addition, she has a history of situational anxiety since hermother's death and hypertension controlled with atenolol.- Her surgical history includes total abdominal hysterectomy sixyears ago and right carpal tunnel surgery two years ago.The patient's mother had a myocardial infarction (MI) at age 56and died at age66, secondary to complications of a coronary artery bypass graft.- Her oldest sister died at age 54 fromsudden cardiac death.- Her father is alive with a recent stroke and two youngerbrothers are alive and well.The patient and her husband have three healthy children, ages14-18, all living athome.- She is employed full-time as a paralegal.- The patient failed an exercise tolerance test today with STdepression, shortness of breath and a drop in BP.- She was admitted to the cardiac unit and an MI was ruled outwith normal Troponin, CPK and Iso-Enzymes and ECG.She was then sent to the cardiac catheterization lab for possibleangioplasty and stent placement.- She was unable to have stent placement or angioplastysecondary to findings of three vessel disease and poor coronaryanatomy.- Thus, she was scheduled to have acoronary artery bypass graft (CABG) thefollowing day.The time is 1600 hours, and the nurses are working the PM shift.-The cardiac catheterization RN has just reported to you that thepatient was medicated with alprazolam 2mg at 1430 hours.- She tolerated the procedure with no complications.- Her vital signs have been stable with a clean, dry, and intactleft groin dressing.A sandbag is over the site and the head of the bed is flat.- The left lower extremity neurovascular status is intact, andpulses are 2/4.- She is scheduled to have a CABG tomorrow and she is awareof this.

Question

1. Describe the pathophysiology ofcoronary artery disease.2. Discuss the nursing and medical management of the patient post cardiac angiogram.3. Describe how to intervene and care for the patient with chest pain and anxiety. 4. Outline and discuss the preoperative education plan for a patient and family for coronary artery bypass graft surgery. This should include preoperative education, instruction on the surgical procedure, postoperative course, and avoidance of complications. 5. Discuss the basic components of cardiac rehabilitation. The patient is a 44-year-old, overweight female who presentedto her primaryhealthcare provider yesterday with complaints of recent episodesof shortness of breath that occur with minimal activity such aswalking a flight of stairs or with increased stress. Her symptomsare relieved with rest.She denied any chest, arm or jaw pain but did have somediaphoresis with one or two episodes.- She attributed her symptoms to her smoking one pack per dayfor the past 20 years and obesity.- She has gastroesophageal reflux controlled with ranitidine andhas a historyof elevated cholesterol (252), HDL of 46, and LDL of 180.Her triglycerides were 140.- She drinks three to four caffeinated beverages per day anddenies alcohol use.-In addition, she has a history of situational anxiety since hermother's death and hypertension controlled with atenolol.- Her surgical history includes total abdominal hysterectomy sixyears ago and right carpal tunnel surgery two years ago.The patient's mother had a myocardial infarction (MI) at age 56and died at age66, secondary to complications of a coronary artery bypass graft.- Her oldest sister died at age 54 fromsudden cardiac death.- Her father is alive with a recent stroke and two youngerbrothers are alive and well.The patient and her husband have three healthy children, ages14-18, all living athome.- She is employed full-time as a paralegal.- The patient failed an exercise tolerance test today with STdepression, shortness of breath and a drop in BP.- She was admitted to the cardiac unit and an MI was ruled outwith normal Troponin, CPK and Iso-Enzymes and ECG.She was then sent to the cardiac catheterization lab for possibleangioplasty and stent placement.- She was unable to have stent placement or angioplastysecondary to findings of three vessel disease and poor coronaryanatomy.- Thus, she was scheduled to have acoronary artery bypass graft (CABG) thefollowing day.The time is 1600 hours, and the nurses are working the PM shift.-The cardiac catheterization RN has just reported to you that thepatient was medicated with alprazolam 2mg at 1430 hours.- She tolerated the procedure with no complications.- Her vital signs have been stable with a clean, dry, and intactleft groin dressing.A sandbag is over the site and the head of the bed is flat.- The left lower extremity neurovascular status is intact, andpulses are 2/4.- She is scheduled to have a CABG tomorrow and she is awareof this.

Accepted Answer

1. Atherosclerosis:

The persistent proliferative and repair response of the artery wall to…

1. Describe the pathophysiology of coronary artery disease. 2. Discuss the nursing and medical management of the patient post cardiac angiogram. 3. Describe how to intervene and care for the patient with chest pain and anxiety.