In assessing a client's major risk factors for heart disease, which of the following should the nurse include in the history?

Smoking, hypertension, obesity, diabetes, and hyperlipidemia.

Family history, stress, hypertension, and age.

Alcohol consumption, obesity, diabetes, stress, hyperlipidemia.

Personality type, hyperlipidemia, diabetes, and smoking.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Smoking, hypertension, obesity, diabetes, and hyperlipidemia are all well-established risk factors for heart disease. Smoking damages the lining of the arteries, leading to a buildup of fatty material which narrows the artery. Hypertension can cause hardening and thickening of the arteries, which can lead to a heart attack or stroke. Obesity increases the likelihood of high blood pressure, high cholesterol levels, and diabetes, all of which are risk factors for heart disease. Diabetes increases the risk of heart disease significantly, as high blood sugar levels can damage blood vessels and the nerves that control the heart. Hyperlipidemia, particularly high levels of LDL cholesterol, can lead to plaque buildup in the arteries, increasing the risk of heart attack or stroke.

Choice B Reason:

Family history is a non-modifiable risk factor for heart disease, as genetics can play a role in an individual's likelihood of developing heart conditions. Stress can contribute to heart disease risk factors such as hypertension and is associated with other unhealthy behaviors. Hypertension and age are both significant risk factors; the risk of heart disease increases with age and with sustained high blood pressure.

Choice C Reason:

Alcohol consumption in excess can lead to high blood pressure, heart failure, or stroke. Obesity, diabetes, and stress are all risk factors as previously mentioned. Hyperlipidemia is also a modifiable risk factor that can be managed through diet, exercise, and medication.

Choice D Reason:

Personality type itself is not a direct risk factor for heart disease, but certain personality traits can lead to stress, which is a risk factor. Hyperlipidemia, diabetes, and smoking are all direct risk factors for heart disease as they contribute to the development of cardiovascular conditions.

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Correct Answer is A

Explanation

Choice A Reason:
St. John's Wort is a well-known herbal remedy that has been used for centuries to treat various ailments, including depression. It is believed to work by increasing the levels of neurotransmitters in the brain, such as serotonin, which can help improve mood and alleviate depressive symptoms. Clinical studies have shown that St. John's Wort can be effective for mild to moderate depression.

Choice B Reason:
Black Cohosh is primarily used to relieve symptoms associated with menopause, such as hot flashes and night sweats. While it may have some mood-stabilizing effects, there is insufficient evidence to support its use as a primary treatment for depression.

Choice C Reason:
Peppermint is commonly used for its soothing properties to aid digestion and reduce headaches. However, it is not typically used as a treatment for depression, and there is no substantial evidence to suggest it would be effective for this purpose.

Choice D Reason:
Echinacea is best known for its potential to boost the immune system and reduce symptoms of colds and other infections. It is not recognized as a treatment for depression, and there is no significant research to support its use in this context.

A. Hemoglobin is 7.1 g/dL on today's laboratory report. B. There are small areas of ecchymosis on the client's upper extremities. C. Platelet count is 148,000/uL on today's laboratory report. D. The client complains of gastrointestinal discomfort after taking the medication.

Correct Answer is A

Explanation

Choice A Reason
A hemoglobin level of 7.1 g/dL is significantly lower than the normal range, which is typically around 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. This finding is concerning as it indicates severe anemia, which can be a life-threatening condition requiring immediate intervention. Anemia can lead to tissue hypoxia as the blood's capacity to carry oxygen is diminished. In the context of peripheral arterial disease, where blood flow is already compromised, anemia can exacerbate symptoms and increase the risk of ischemic events.

Choice B Reason
Ecchymosis, or bruising, on the client's upper extremities could be a result of the antiplatelet effects of aspirin, which inhibits platelet aggregation and prolongs bleeding time. While this is a concern and warrants monitoring, it is not as immediately life-threatening as severe anemia. However, it does indicate a risk of bleeding complications, which should be addressed by the healthcare provider.

Choice C Reason
A platelet count of 148,000/uL is at the lower end of the normal range, which is approximately 150,000 to 450,000 platelets per microliter of blood. This finding should be monitored, especially in the context of aspirin therapy, which can affect platelet function. However, it is not as critical as the low hemoglobin level.

Choice D Reason
Gastrointestinal discomfort is a common side effect of aspirin due to its irritation of the stomach lining. While this symptom can be uncomfortable and may lead to more serious gastrointestinal issues such as ulcers or bleeding, it is typically not as urgent as severe anemia. The client should be evaluated for potential gastrointestinal complications of aspirin therapy.

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In assessing a client's major risk factors for heart disease, which of the following should the nurse include in the history?

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