Biographical: 45-year-old African American male, A&O x 4. History of present concern: Patient reports chest-pressure at rest with left arm discomfort, nausea, and diaphoresis. Reports pain in center of chest that lasted for 20 minutes and was an 8/10 on a numeric pain scale

No APA needed, single spaced, no references needed but answers should be correct. No specific word count needed.

1. Identify which factors put the patient at risk for cardiac problems.

2. Provide M.W. with health promotion activities for one of these risk factors.

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M.W. is a male patient admitted to the coronary care unit with chest pain and pressure. The following subjective and physical assessment findings were noted.

Biographical: 45-year-old African American male, A&O x 4.

History of present concern: Patient reports chest-pressure at rest with left arm discomfort, nausea, and diaphoresis. Reports pain in center of chest that lasted for 20 minutes and was an 8/10 on a numeric pain scale. He has had episodes of chest pain and pressure for the past 3 months that last about 2 minutes with an intensity of 4/10. These episodes were alleviated with rest. He denies having any palpitations, dyspnea, nocturia, peripheral edema, or indigestion.

Personal Health History: Patient denies and heart defect, murmur, cardiac surgery or interventions, or medication for for heart disease. He remembers at his last physical being told that his blood pressure was a little high and that his cholesterol levels were high, but can not recall specific readings.

Family History: He has several family members with HTN and Type 2 Diabetes. Specifically recalls both parents having HTN and diabetes. Mother died at 62-years-old of a cerebral vascular accident and father died at 58-years-old of a myocardial infarction. Both maternal and paternal grandparents died from heart problems.

Lifestyle: Patient started smoking at age 17 and quit at age 30, he smoked 2 packs/day for 13 years. He reports having a stressful job and relieves his stress by watching television. In the past 24 hours M.W. has eaten: breakfast – 4 cups of coffee and a donut, lunch – double cheeseburger, fries, and pop from McDonald’s, dinner – roast beef, mash potatoes, gravy, green beans, and milk, dessert – bowl vanilla ice cream. Only for of exercise is when he does yard work on the weekends. He reports feeling like he has been slowing down for the past 2 months but gets very good sleep.

Physical findings: Carotid pulses are 2+ bilaterally, no bruits on auscultation. S1 and S2 presents, no S3, S4, or murmurs auscultated. HR is regular at 72 bpm.

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