This week, we will continue with the Ms. Esposito cardiac case study from last week.

Ms. Esposito (age 58) shares that she isthird-generation Latina American. Her father is deceased due to a heart attack, and her mom is alive and has occasional chest pain with exertion. Ms. Esposito had fasting lab work drawn last week in preparation for this examination. As you scan the lab results, you note the following values for the lipid profile.

Total cholesterol 289 (normal 140-199), triglycerides 175 (normal 35-135), HDL 27 (normal 38-85), LDL 227 (normal < 130), and VLDL 130 (normal 25-50% of total cholesterol).

She tells you she takes a baby aspirin once daily but is healthy and on no other medications. She receives physicals annually and has her blood pressure checked by an automated machine at the grocery store. She does not smoke and only drinks wine occasionally, but her diet is rich in saturated fats and she does a small amount of exercise. She denies allergies. She works as a ticket agent for an airline, for which she is up on her feet for long stretches of time.

After the physician sees Ms. Esposito, you note that all of her laboratory results are within normal limits, with the exception of her lipid profile and her weight. After consultation with the physician, you prepare and implement a teaching plan on cholesterol reduction measures. She is to return in 3 months for a repeat lipid profile and follow-up visit. The physician has told Ms. Esposito that she may have to go on antihyperlipidemics if her lipid profile continues to show elevation. Ms. Esposito tells you she will work hard to implement these measures, because she does not want to take any medications.

Describe expected findings during the cardiovascular assessment of Ms. Esposito.

Differentiate between the different heart sounds.

What assessment findings are consistent with aging, and how might these factors influence the nursing plan of care?

What would you include in a teaching plan for Ms. Esposito?