Q.

Outline three modifiable risk factors for hypertension:

1. **Poor Diet:** Consuming a diet high in sodium, saturated fats, and low in fruits and vegetables
can contribute to hypertension.

2. **Lack of Physical Activity:** Sedentary lifestyles and insufficient exercise can increase the risk
of developing hypertension.

3. **Excessive Alcohol Consumption:** Drinking alcohol in excess can elevate blood pressure, so
moderation is key for cardiovascular health.

Q. Outline three non-modifiable risk factors for hypertension:

1. **Age:** The risk of hypertension tends to increase with age, and it is more common in
older adults.

2. **Family History:** A family history of hypertension can predispose individuals to higher

blood pressure levels.

4. **Genetics/Ethnicity:** Certain ethnic groups have a higher predisposition to hypertension,

indicating a genetic component in some cases.

Q. Outline five types of emboli associated with venous conditions:

1. **Deep Vein Thrombosis (DVT) Embolus:** Blood clots that form in the deep veins,
often in the legs, can break loose and travel to the lungs, causing a pulmonary embolism.

2. **Fat Embolism:** Fat particles, often from long bone fractures, can enter the
bloodstream and travel to the lungs or other organs.

3. **Amniotic Fluid Embolism:** During childbirth, amniotic fluid or other debris can enter
the maternal bloodstream and travel to the lungs, causing a potentially serious
condition.

5. **Tumor Embolism:** Cancer cells or tumor fragments can break off from a primary tumor and
travel through the bloodstream, forming emboli.
 5. **Air Embolism:** Air bubbles can enter the venous system, causing blockages that may lead
to serious complications.

Q. Outline five specific nursing interventions for a patient with hypertension:

1. **Blood Pressure Monitoring:** Regularly monitor the patient’s blood pressure to track trends
and assess the effectiveness of treatment.

2. **Medication Management:** Administer prescribed antihypertensive medications as directed

and educate the patient about the importance of compliance with the medication regimen.

3. **Lifestyle Counseling:** Provide guidance on lifestyle modifications, including a heart-healthy

diet, regular exercise, weight management, and stress reduction techniques.

4. **Patient Education:** Educate the patient about the risks associated with hypertension, the
importance of adherence to treatment plans, and potential complications. Empower them to
take an active role in their health.

5. **Regular Follow-up:** Schedule regular follow-up appointments to assess the patient’s

progress, adjust treatment plans as needed, and address any concerns or questions they may
have.

Q. Outline 5 classifications of Heart failure according to patient symptoms

1. **Class I – Mild:**
- No limitation of physical activity.
- Ordinary physical activity does not cause symptoms.

2. **Class II – Mild to Moderate:**

- Slight limitation of physical activity.
- Comfortable at rest, but ordinary physical activity results in symptoms (e.g., fatigue,
palpitations, dyspnea).

3. **Class III – Moderate to Severe:**

- Marked limitation of physical activity.
 - Comfortable at rest, but less than ordinary activity causes symptoms.

4. **Class IV – Severe:**
- Unable to carry out any physical activity without discomfort.
- Symptoms of heart failure are present even at rest, and any physical activity worsens these
symptoms.

This classification helps healthcare providers determine the severity of heart failure and guide
treatment strategies.

Q. Outline 5 Clinical manifestations of myocardial infarction

1. **Chest Pain or Discomfort:**

- Often described as a tightness, pressure, squeezing, or burning sensation in the chest.
- May radiate to the arms, neck, jaw, back, or abdomen.

2. **Shortness of Breath:**
- Difficulty breathing or feeling breathless, especially with minimal exertion.

3. **Diaphoresis (Excessive Sweating):**

- Profuse sweating, often accompanied by a cold, clammy feeling.

4. **Nausea and Vomiting:**

- Feeling nauseated or vomiting, sometimes without an apparent cause.

5. **Fatigue:**
- Unexplained weakness or extreme fatigue, even at rest.

It’s important to note that these symptoms can present differently in each individual, and not
everyone experiences all of these signs. Prompt recognition of these manifestations is crucial for
seeking emergency medical attention.

Q. Outline four common complications arising from uncomplicated myocardial infarction:

1. **Heart Failure:**

- Damage to the heart muscle can weaken its pumping ability, leading to heart failure, where the heart
is unable to adequately meet the body’s oxygen and nutrient demands.

2. **Arrhythmias:**

- Irregular heart rhythms (arrhythmias) can occur, ranging from atrial fibrillation to more severe
ventricular arrhythmias, which may be life-threatening.
3. **Cardiogenic Shock:**

- In severe cases, extensive damage to the heart muscle can lead to cardiogenic shock, a condition
where the heart is unable to pump enough blood to meet the body’s needs, resulting in organ failure.

4. **Ventricular Septal Defect (VSD):**

- An opening or rupture in the wall separating the heart’s ventricles (ventricular septum) may occur,
leading to complications such as shunting of blood and reduced cardiac output.

Timely medical intervention and appropriate post-MI care can help manage and prevent these
complications.

Q. Managing a patient with uncomplicated myocardial infarction (MI) involves a systematic approach
to stabilize the patient’s condition and minimize further damage. Here’s a general outline of priorities
in the first 24 hours:

1. **Immediate Assessment and Monitoring:**

- Quickly assess the patient’s vital signs, including heart rate, blood pressure, respiratory rate, and
oxygen saturation.

- Continuous cardiac monitoring to identify any arrhythmias or changes in the heart’s electrical activity.

2. **Oxygen Therapy:**

- Administer supplemental oxygen to maintain oxygen saturation levels and support cardiac oxygen
demand.

3. **Pain Management:**

- Provide prompt pain relief to alleviate chest discomfort and reduce stress on the heart. Nitroglycerin
may be used, but caution is needed, especially in low blood pressure situations.

4. **Aspirin and Antiplatelet Therapy:**

- Administer aspirin (chewed or crushed) as soon as possible to inhibit platelet aggregation and
minimize clot formation.

- Consider other antiplatelet medications like clopidogrel.

5. **Reperfusion Therapy:**

- If eligible, consider reperfusion therapy with either thrombolytic medications or primary

percutaneous coronary intervention (PCI) to restore blood flow to the affected coronary artery.

6. **Monitoring and Fluid Management:**

- Monitor fluid balance and maintain adequate hydration, avoiding excessive fluid administration.

- Watch for signs of heart failure or cardiogenic shock.

7. **Bed Rest and Activity Limitation:**

- Encourage bed rest initially to reduce myocardial oxygen demand.

- Gradually introduce activities based on the patient’s tolerance.

8. **Continuous ECG Monitoring:**

- Continuous electrocardiogram (ECG) monitoring to detect any changes in cardiac rhythm.

9. **Thrombolytic Therapy (if PCI is not available):**

- If primary PCI is not feasible, thrombolytic therapy may be considered within a specific time frame.

10. **Lipid-Lowering Medications:**

- Initiate or continue statin therapy to manage cholesterol levels.

11. **Blood Pressure Management:**

- Control blood pressure within recommended targets using appropriate medications.

12. **Patient Education:**

- Educate the patient on the importance of lifestyle modifications, medication adherence, and the
need for cardiac rehabilitation.
This is a general overview, and the specific management plan may vary based on the patient’s individual
circumstances. Coordination with a healthcare team is essential for comprehensive care.

Q. Formulate 3 nursing diagnosis for a patient with uncomplicated myocardial infarction

1. **Acute Pain related to myocardial ischemia and infarction:**

- This priority nursing diagnosis addresses the immediate discomfort experienced by the patient.
Nursing interventions may include administering analgesics, positioning for comfort, and providing
relaxation techniques to alleviate pain.

2. **Impaired Gas Exchange related to decreased oxygen supply secondary to myocardial infarction:**

- This diagnosis addresses the potential impairment in the exchange of oxygen and carbon dioxide due
to compromised cardiac function. Nursing interventions involve administering oxygen therapy,
monitoring respiratory status, and promoting optimal positioning to enhance respiratory function.

3. **Anxiety related to the potential threat to health and fear of complications:**

- Anxiety is a common response to a myocardial infarction. Nursing interventions may include

therapeutic communication, providing information about the condition and treatment plan, and
implementing relaxation techniques to help alleviate anxiety and promote a sense of control.

These nursing diagnoses focus on addressing immediate needs, promoting comfort, and addressing
emotional well-being in the early stages of managing an uncomplicated myocardial infarction.