Exam question troubleling me.....

jjjoy, LPN · Apr 21, 2007

Isn't there enough else to cover in nursing school? It would seem enough for most nurses to simply know that both DM and high cholesterol are CAD risk factors. Or is the point here that it only states that the cholesterol is "elevated" but isn't said to be "high"? Ugh! Why make it more difficult than it need to be? And why not make test questions more clinically relevant? Sigh.

crystalcoastlvr, BSN · Apr 21, 2007

I would have chosen the smoker! My rationale......the patient with high cholesterol is at risk, but how long has their cholesterol been high and what do the labs say, furthermore, is the pt's diabetes under control, are they overweight, do they take care of themselves? The patient who is the smoker,,,,is obviously smoking.

jules

Thedreamer · Apr 21, 2007

Can I choose D? All of the above? :lol2:

abundantjoy07, RN · Apr 21, 2007

I would have chosen hyperlipidemia. Because with DM I think of contributing factors being a high A1c or lack of control through diet and exercise. DM alone without risk factors doesn't makes me want to choose that answer.

With high cholesterol that is definately my choice because the fatty substances coat the lumen of the arteries thus leading to CAD. With DM there are factors that lead to it...but High cholesterol is like a straight shot to CAD.

With the smoker...you have to take into consideration PPD smoked, pack years, and you have to remember that when a patient stops smoking their risk declines to that of a non-smoker very quickly, regardless of how long they have smoked. Smoking is more about constriction of the arteries because of the toxins in the smoke.

So...I could be totally wrong or missed some important factors...but high cholesterol is my answer!

jonzey · Apr 21, 2007

I would have picked DM,B/C of the disease process.

allnurses Guide · Apr 21, 2007

Also, I've read some studies recently that high cholesterol, by itself, is not as much of a risk factor as we've thought.

Although, you know about studies . . . coffee is good/coffee bad . . . .oatmeal is good/oatmeal does nothing . . .. wine is bad/wine is good . . . ETC.

steph

moongirl · Apr 21, 2007

I choose smoking as the correcto answer.

Please let us know what it is when you get your grade. :)

JessiekRN · Apr 21, 2007

Nili I am feeling your pain.. I keep telling myself 4 MORE WEEKS and then 3 months away.. it can not come fast enough!! :) Good luck with your exam.. and finals..!!

Mommy TeleRN, RN · Apr 21, 2007

We learned that smoking is a big risk factor..I am thinking it was the biggest risk factor. It damages arterial linings.

I have this in my lecture notes which are usually straight by the textbook:

"Cigarette smoking (most significant), hyperlipidema, hypertension and diabetes mellitus"

Arterial disease is due to atherosclerosis which is majorly cx by smoking.

Maverick80 · Apr 21, 2007

I pick smoking!!

Smoking Lowers HDL which is not good, and when i took Advanced med-surg all most all the the problems with heart and lungs smoking put you at increased risk. So i'm going with smoking and i'm not changing it, please let me know what your teacher says the answer is!!

RN BSN 2009 · Apr 21, 2007

Can I choose D? All of the above?

Kudos to that...... me too! Lol

moongirl · Apr 21, 2007

We learned that smoking is a big risk factor..I am thinking it was the biggest risk factor. It damages arterial linings.
I have this in my lecture notes which are usually straight by the textbook:
"Cigarette smoking (most significant), hyperlipidema, hypertension and diabetes mellitus"
Arterial disease is due to atherosclerosis which is majorly cx by smoking.

That is the way I learned it as well. All of the choices the OP was given were correct- but it asks which is the biggest risk factor. Smoking is.

My hospital's OR-80 percent of their carotid roto-rooter procedures are on long term smokers

http://www.fda.gov/hearthealth/riskfactors/riskfactors.html#smoking