CRITICAL THINKING EXERCISES

1 While working in the cardiology clinic, you receive a phone call from a patient with known coronary
artery disease. She reports that she is experiencing some shortness of breath and mild back pain. What
evidence base is there to suggest that symptoms of an MI may be different for women than men? Discuss
the strength of this evidence and its significance in determining assessment criteria to be used for women
and men. What questions would you ask this patient? What would you instruct her to do? Provide
rationale for your instructions.
2 A 72-year-old man is admitted to the surgical intensive care unit following four-vessel CABG surgery.
Initially, his blood pressure is high at 164/88, but it drops to 92/60 mm Hg, his ECG shows sinus
tachycardia, and his cardiac output is decreased. What are the most likely reasons for the drop in blood
pressure? What other parameters should be assessed? Describe your interventions for this postoperative
CABG patient with hypotension and low cardiac output. Identify your expected outcomes for these
interventions.
3 You are caring for a patient who has been hospitalized with a diagnosis of unstable angina. His
condition is stable and he will be discharged later in the day. He is anxious to go home, but agrees to an
educational session with you prior to discharge. The patient is obese and has a history of hypertension
and cigarette smoking. Knowing that multiple lifestyle changes are recommended, how will you prioritize
your teaching strategies? What type of follow-up care is available to assist this patient following
discharge?
4 Your neighbor is a 60-year-old woman who was discharged from the hospital last month with ACS
treated with thrombolytics. She asks you if she really needs to keep taking her beta-blocker indefinitely.
She tells you that her husband read in a news magazine that care for women with heart disease has been
traditionally based on treatment of men with heart disease. What is the strength of the evidence that
supports maintaining women post-ACS on beta-blockers?