Page 1696 - Saunders Comprehensive Review For NCLEX-RN

diameter of the left main artery is reduced at least
50%, or if any major branch is reduced at least 75%.
7. The goal of treatment is to alter the atherosclerotic
progression.
B. Assessment
1. Possibly normal findings during asymptomatic
periods
2. Chest pain
3. Palpitations
4. Dyspnea
5. Syncope
6. Cough or hemoptysis
7. Excessive fatigue
C. Diagnostic studies
1. Electrocardiography
a. When blood flow is reduced and
ischemia occurs, ST-segment
depression, T-wave inversion, or both
is noted; the ST segment returns to
normal when the blood flow returns.
b. With infarction, cell injury results in ST-
segment elevation, followed by T-wave
inversion and an abnormal Q wave.
2. Cardiac catheterization: Cardiac catheterization shows
the presence of atherosclerotic lesions.
3. Blood lipid levels
a. Blood lipid levels may be elevated.
b. Cholesterol-lowering medications may
be prescribed to reduce the
development of atherosclerotic
plaques.

D. Interventions

1. Assist the client to identify risk factors that can be
modified and to set goals to promote lifestyle changes
to reduce the impact of risk factors.
2. Assist the client to identify barriers to adherence with
the therapeutic plan and to identify methods to
overcome barriers.
3. Instruct the client regarding a low-calorie, low-
sodium, low-cholesterol, and low-fat diet, with an
increase in dietary fiber.
4. Stress that dietary changes should be incorporated for
the rest of the client’s life; instruct the client regarding
prescribed medications.
5. Provide community resources to the client regarding
exercise, smoking cessation, and stress reduction as
appropriate.

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