The Coronary Artery Disease: Patient Teaching Plan Guidelines

Introduction

The adult patient selected for this plan is likely to develop coronary artery disease (CAD) due to her lifestyle choices and family history. The patient’s parents have a health history of high cholesterol, which predisposes her to CAD. Additionally, the patient smokes, eats unhealthily especially at work, has a history of high cholesterol, and for the last six weeks she has not gone to the gym, and all these aspects are predisposing factors to CAD.

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One of the modifiable risk factors associated with this patient is a sedentary lifestyle. In this paper, a teaching plan for this patient will be developed entailing why she needs to become physically active together with how to do it. Long and short-term goals will be established, the teaching plan implementation process highlighted, and evaluation strategy formulated.

Disease Overview

CAD is one of the leading causes of adult mortality and morbidity. For instance, in Europe, CAD causes over 4 million deaths annually and it affects women more as compared to their male counterparts at 23% and 21% respectively (Duda-Pyszny, Trzeciak, & Gasior, 2018). CAD develops from the damage of coronary arteries that supply the heart with blood, nutrients, and oxygen. In most cases, cholesterol-containing deposits (known as plaque) and inflammation are the two leading causes of CAD.

The common signs and symptoms include chest pain or angina, shortness of breath, and heart attack. Normally, as plaque continues to accumulate and clog the arteries, the blood supply to the heart is affected. According to Duda-Pyszny et al. (2018), women are likely to experience atypical chest pain, which is accompanied by nausea, vomiting, dyspnea, and sweating. CAD is diagnosed through non-invasive examinations, such as an electrocardiogram (ECG), echocardiogram, and stress test based on a patient’s health history and the available signs and symptoms.

In some cases, cardiac catheterization and angiogram together with heart scan may be used for diagnosis. Physical assessment may also be conducted and it includes blood pressure check, examination of xanthomas under the skin, general blood circulation, funduscopic examination, listening to heartbeat, lungs, and abdomen using a stethoscope, and checking feet and legs for swellings.

The patient’s risk for CAD was established from specific information in the Genetic Family History and data gathered in the Milestone 1 assignment. The Genetic Family History showed that the patient and her parents have a history of high cholesterol, which is a predisposing factor to CAD. In addition, the patient’s father has a hypertension problem. The patient smokes occasionally, thus increasing the probability of developing the heart condition.

Evidence-Based Intervention

Becoming physically active is one of the evidence-based interventions related to a sedentary lifestyle as a modifiable risk factor. Even though the patient noted that she exercises regularly, she has not managed to go to the gym for the last 6 months. This trend is worrying as such a sedentary lifestyle encourages the accumulation of plaque, which ultimately contributes to the development of CAD. Therefore, given that the patient has a history of high cholesterol, exercising will play a crucial role in the prevention of CAD. According to Winzer, Woitek, and Linke (2018), physical inactivity is one of the common predisposing factors in the development of CAD. Physical activity increases cardiac output and induces other functional and morphological changes that lead to reduced vascular coronary vascular resistance (Winzer et al., 2018).

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Ultimately, augmented blood flow increases during exercise. In addition, physical activity triggers nitric oxide, which helps in keeping blood vessels open. Exercises, such as walking, raise the levels of high-density lipoproteins (HDL) – commonly referred to as good cholesterol, thus reducing the risk of CAD significantly (Winzer et al., 2018). On the other hand, research has shown that exercises reduce the production of low-density lipoproteins (LDL) or bad cholesterol, which is responsible for the development of CAD (Winzer et al., 2018).

Given the patient’s health history, exercising will help in preventing the occurrence of CAD. In particular, the patient has high cholesterol, and thus becoming physically active will reduce LDL and increase HDL, which explains the rationale for the selected intervention. The short-term goal for this patient is to start exercising. One of the reasons contributing to a sedentary lifestyle might be work commitments. Therefore, the patient will be required to start using exercises that can be integrated into her busy work schedules, such as using stairs instead of elevators. The long-term goal will be to create a culture of exercising by visiting the gym at least twice a week.

Implementation: Teaching Plan

I will sit down one-on-one with the client and talk about the benefits of exercising as a way of preventing CAD. I will also prepare a poster detailing important information concerning the patient’s risk factors based on the collected information and the need for exercising as a mitigation measure. If need be, I will use video calling for the patient to contact me and ask for any information regarding the selected intervention strategy. I will ask the client to start taking stairs as opposed to using elevators. I will suggest that she starts parking a distance away and walk to her workplace. The patient will be asked to walk instead of driving, where applicable.

Taking strolls with her dog whenever she finds time will be recommended. In the long-term, I will help the patient to come up with a plan to start visiting the gym at least two times a week for rigorous physical exercises such as aerobics. Finally, I will provide resources like posters and handouts detailing the patient’s health condition, her risk factors for CAD, and intervention methods. I will also refer her to websites, such as the American Heart Association, where she will learn more about CAD and other related conditions.

Evaluation

The patient’s LDL blood levels will be evaluated to establish if they have dropped, as such a trend is an indicator of the effectiveness of the intervention. If the plan is unsuccessful, it will be revised by including a table where the patient will be required to record the amount of time spent on different exercises every day. This aspect will ensure that the patient is accountable and she meets the needed daily exercise requirements.

Summary

The patient is at risk of developing CAD due to her lifestyle habits and family health history. Therefore, by implementing exercising as an intervention, I hope to reduce the chances of the patient having CAD. As shown from the scholarly article used for this plan, physical activity will help reduce high cholesterol levels and improve her heart functionality. CAD is a preventable condition and if the patient follows the plan developed in this paper, she will reduce the probability of her having the disease and live a healthy life.

References

Duda-Pyszny, D., Trzeciak, P., & Gasior, M. (2018). Coronary heart disease in women. Polish Journal of Thoracic and Cardiovascular Surgery, 15(1), 44-48.

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Winzer, E. B., Woitek, F., & Linke, A. (2018). Physical activity in the prevention and treatment of coronary artery disease. Journal of the American Heart Association, 7(4), 1-15. Web.

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