Chelsey Hansen

Chris Rodeback
Claudia Zundel
Mariette Armitstead
Patient Education Plan

Objectives:
After our education is complete our client will be able to:
Understand what a heart attack is and the causes
Identify and verbalize signs and symptoms of a heart attack
Understand medication regiments and treatment
Understand lifestyle changes to improve heart health (diabetes/hyperlipdemia)
Understand when to contact physician or seek medical help

Teaching:
To accomplish our objectives for educating our patient, we decided that we would use a hands on
approach that allows the patient to ask questions that we can answer. This teaching method
would be taking place throughout the hospitalization. Our job is to make sure that he has all the
knowledge he needs to be successful once he is at home and managing his health on his own. To
accomplish this, before being discharged, we would go over the discharge teaching with him and
a family member one on one and answer any questions they may have throughout the process.
We decided that for our teaching we would use a brochure. This way the patient would have
access to all the information done in our teaching to take home with him. This way if Mr. Miller
forgot something we went over, he would be able to have a quick reference to look at. The
patient would also receive a list of the medications that he will be continuing at home that
contains easy to understand information about his medication regiment.
Because the brochure has information for all patients who have a heart attack, we would need to
go over specific information relating to our patient needs. This includes the type of heart attack
he had and specific lifestyle changes he would need to make for his health.

Type of heart attack
We would educate Mr. Miller on the type of heart attack he had. A heart attack is when there is a
loss of living heart muscle as a result of one of the coronary arteries, or the arteries that supply
oxygen rich blood to your heart, being blocked. Mr. Millers heart attack was caused by a
blockage in the left anterior descending artery. This blockage stopped or severely slowed down
the blood flow to the left ventricle long enough that the muscle tissue was damaged due to lack
of oxygen. The treatment done for Mr. Miller was placement of a stent. A stent is a device used
to dilate, which opens up the artery, in order to restore blood flow to the heart muscle.
You will be given a small identification card related to your stent. This card contains
important information about your stent (location, date of placement).



Chelsey Hansen
Chris Rodeback
Claudia Zundel
Mariette Armitstead



Diet
Because our patient just had a heart attack and has type 2 diabetes with hyperlipidemia as well, it
would be best for him to continue the 1200 ADA/Cardiac diet. With the cardiac diet, we want
him to decrease salt his salt and fluids. Limit alcohol, and he should try to eat a low fat diet.
Exact measures to take are listed in our brochure. The ADA diet helps diabetic patients control
blood glucose levels. The ADA diet works by regulating the amounts of carbs, fats, and high
processed sugars that are allowed. Here is a simple break down of what the diet includes:
3 to 5 servings of high-fiber vegetables are recommended every day. A single vegetable
serving is 1 cup of raw vegetables or 1/2 cup) of cooked vegetables.
Fruits are limited to two to four servings per day. One serving of fruit may include an
orange, apple, banana, or 1 cup of blackberries or strawberries.
Low-fat milk and dairy products are included as two or three daily servings. A single
serving in this group is 1 cup of milk or yogurt. Cheese is excluded from this food group.
Proteins, such as meat or meat substitutes, are typically limited to four or six servings per
day. A single serving of protein may include such items as one egg, 1 ounce of chicken or
fish, 1 tablespoon of peanut butter or 1/2 cup of tofu. Cheeses are also included in this
protein group and are recommended in the low-fat variety.
Alcoholic beverages, fried foods, cookies, or candies should be limited. Servings
generally should not exceed two or three times per week.
Making sure that meals fall within the appropriate carbohydrate range is another
important component to the ADA diet. The ADA recommends that one meal contain
between 45 and 60 grams of carbohydrates. Monitoring carbohydrate levels is essential to
maintaining healthy glucose levels.


Chelsey Hansen
Chris Rodeback
Claudia Zundel
Mariette Armitstead
Diabetes
Since Mr. Millers diabetes seems to be well managed, we want him to continue with the care
that he has been doing. He needs to continue to monitor his blood sugars and take his
medications. The information about your new diabetic medications is listed on the medication
sheet.

Weight loss/ Hypertension
Based on our patients BMI, he is obese. He also has hypertension (high blood pressure). High
blood pressure occurs when your blood pressure is 140/90 mmHg or above most of the time. His
obesity could be the cause of his hyperlipidemia, high blood pressure, diabetes, and even the
heart attack he experienced. By losing weight, he could improve his overall health and lower his
blood pressure. By following a healthy diet and exercising he should be able to get to a healthy
weight and also lower his blood pressure. The goals for exercising and increasing physical
activity are included in our brochure.

Assessment of patients learning:
To assess that our education is working, we would have Mr. Miller repeat back the information
we taught him. If there were inconsistencies or he didnt quite understand the concept, we would
be sure to go over it again with him. We would also allow to him to ask any questions and clarify
them for him.














Chelsey Hansen
Chris Rodeback
Claudia Zundel
Mariette Armitstead

Medication List
Zocor (Simvastatin)
Dosage: 20 mg by mouth daily
Why you are on it: Simvastatin (zocor) is a lipid-lowering agent. It is used to treat
hyperlipidemia.
Instructions:
Take medicine as directed, do not skip doses or double up on missed doses.
Avoid drinking grapefruit juice/day during therapy.
Better results if worked in conjunction with diet
Notify Doctor: muscle pain, tenderness, or weakness occurs, especially if accompanied
by fever or malaise. Wear sunscreen and protective clothing to prevent photosensitivity
reactions.

Metoprolol (Toporol XL)
Dosage: 50 mg by mouth daily
Why are you on it: Metoprolol blocks stress hormones, relieves stress on the hearts pumping
action, which will decrease the workload of the heart
Instructions:
Take medication as directed at the same time each day, even if feeling well, do not skip
or double up on missed doses.
Take missed doses as soon as possible up to 8 hr before next does.
Do not stop abruptly taking can cause return of symptoms
Change positions slowly to minimize orthostatic hypotension.
Can cause fatigue
Should avoid excessive amounts of coffee, tea, and cola.
Notify Doctor if slow pulse, difficulty breathing, wheezing, cold hands and feet,
dizziness, light-headedness, confusion, depression, rash fever, sore throat, unusual
bleeding, or bruising occurs. This medication controls, but does not cure HTN.
Beta-blockers may mask signs and symptoms of hypoglycemia

Lisinopril
Dosage: 5 mg by mouth daily
Why you are on it: Lisinopril is an antihypertensive (ACE), block the conversion of angiotensin
1 to the vasoconstrictor angiotensin II. Patient is taking this medication to treat high blood
pressure.
Instructions:
Take medication as directed at the same time each day, even if feeling well. Take missed
doses as soon as remembered but not if almost time for next dose. Do not double doses.
Do not discontinue ACE inhibitor therapy unless directed by health care professional.
Avoid salt substitutes containing potassium or foods containing high levels of potassium
or sodium unless directed by health care professionals.
Chelsey Hansen
Chris Rodeback
Claudia Zundel
Mariette Armitstead
Change positions slowly to reduce the risk of injury caused by an unsafe change in blood
pressure.
o Use of alcohol, standing for long periods, exercising, and hot weather may also
increase this risk.
Avoid taking new Rx, OTC, vitamins or herbal products without consulting health care
professional, especially cough, cold or allergy remedies as they can cause dizziness.
Notify health care professional if rash, mouth sores, sore throat, fever, swelling of hands
of feet, irregular heartbeat, chest pain, dry cough, hoarseness, swelling of face, eyes, lips
or tongue, or if difficulty swallowing or breathing occurs. This may indicate an allergic
reaction
Also notify if nausea, vomiting or diarrhea occurs and continues.
Keep all follow up appointments to evaluate effectiveness of medications.

FeSO4
Dosage: 325 mg daily: Ferrus Sulfate (30 % elemental iron).
You will take this medication to treat Iron deficiency Anemia.
Instructions:
Take missed doses as soon as remembered within 12 hour; if longer than 12 hrs return to
regular dosing schedule. Do not double doses.
Stools may become dark green or black.
A common side effect is constipation. This is problematic for you having recently had a
stent placed, you will want your stools to be soft so that you do not have to bear down
with too much force and cause any damage

Omeprazole (Prilosec)
Dosage: 20 mg daily by mouth
Why are you on it? Omeprazole is a Proton pump inhibitor/antiulcer agent. It is used to treat
gastro esophageal reflux disease (heart burn). Prilosec OTC blocks heartburn by shutting down
many of the pumps in your stomach that produce excess acid.
Instructions:
Administer doses before meals preferably in the morning.
Capsules should be swallowed whole, do not crush or chew.
This medication may be administered concurrently with antacids.
Side effects include: dizziness, drowsiness, and abdominal pain

Glyburide (Diabeta)
Dosage: 5 mg daily
Why are you on it? Glyburide is an antidiabetic and is used for treating type 2 diabetes. The medication
lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity
to insulin at receptor sites.
Instructions:
Take medications exactly as directed. Take missed doses as soon as possible unless
almost time for next dose, do not double doses.
Chelsey Hansen
Chris Rodeback
Claudia Zundel
Mariette Armitstead
Do not discontinue w/o counseling Doctor.
If hypoglycemia occurs, drink a glass of orange juice or ingest 2-3 tsp of sugar, honey, or
corn syrup dissolved in water or an appropriate number of glucose tablets and notify
Doctor.
Do not take with alcohol.
Avoid aspirin and alcohol while on this therapy.
Notify doctor promptly if unusual weight gain, swelling of ankles, drowsiness, shortness
of breath, muscle cramps, weakness, sore throat, rash or unusual bleeding or bruising
occurs.

NTG (Nitroglycerin)
Dosage: 4mg X3 sublingual (under the tongue)
Why are you on it? Nitroglycerin is an arterial and venous dilator. It is used to treat angina (pain
in chest caused by poor blood flow to heart). It increases blood flow to your heart and decreases your
blood pressure.
Instructions:
Change positions slowly.
First dose should be taken while in a sitting or reclining position.
Avoid alcohol.
A headache is a common side effect that should decrease with continuing therapy.
Side effects include: dizziness, headache, increased heart rate, low blood pressure.
Take 2.5 mg tablet by mouth 1 hour before or 2 hours after meals with a full glass of
water for faster absorption. Do not break, crush, or chew tablets.
For an acute attack, take under the tongue (hold under tongue until dissolved) and repeat
every 5 minutes for 2 additional doses. If pain is not relieved seek medical help

Glucophage (Metformin)
Dosage: 500 mg daily by mouth
Why are you on it? Metformin is used to treat high blood sugar levels in type 2 diabetes. The
medicine reduces the amount of sugar made by the liver, limits the amount of sugar absorbed
into the body from the diet, and makes insulin receptors more sensitive (helping the body
respond better to its own insulin). All of these effects cause a decrease in blood sugar levels.
Instructions
Take it at the same time each day.
Take missed doses as soon as possible unless almost time for the next dose.
Do not double doses.
Some side effects include abdominal bloating, diarrhea, nausea, vomiting, and
hypoglycemia.