Please help with long-term goal for NANDA

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Any help you can provide would be appreciated - I'm not looking for answers, but a "nudge" in the right direction. I'm good with my short-term goals and my 1st long-term goal, just can't seem to nail down the 2nd long-term goal.

Pt: 82 year old male, current med Dx: cornonary artery disease.

NANDA: Decreased cardiac output r/t ventricular damage aeb irregular heartbeat, troponin level of 1.64 ng/mL, productive cough, dyspnea on exertion, patient on 2L O2, antiplatelet: aspirin (Beyer), platelet aggregation inhibitor: clopidogrel (Plavix), anticoagulant: heparin, antihypertensive: lisinopril (Zestril), antihypertensive: metoprolol (Lopressor), antilipidemic: simvastatin (Zocor), and antihypertensive: terazosin (Hytrin).

Long-term goal #1 is related to improving the patient's activity tolerance (I'm good with this one).

Long-term goal #2 is related to lowering the patient's blood pressure gradually until a healthy BP is obtained, without the use of meds. HOWEVER, the pt's BP is being controlled by antihypertensives. Is it reasonable (or even safe) to expect an 82 yr old to ween off of antihypertensives and maintain a lowered BP via diet and exercise?? Also, he was recenly diagnosed with pancreatic cancer, so this certainly changes things considering the poor long-term prognosis with this type of cancer.

Again, any assistance you can provide is appreciated!! Thanks!

**not sure what happened to the font size, but can't seem to change it - sorry! Get out your magnifying glass...:smackingf

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Specializes in Peds OR as RN, Peds ENT as NP.

I you didn't want to talk about the blood pressure you could have a long term goal of keeping the pt's pulse rate and rhythm within normal parameters.

Just a thought....

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I you didn't want to talk about the blood pressure you could have a long term goal of keeping the pt's pulse rate and rhythm within normal parameters.

Just a thought....

That's a good idea, I didn't think about that. Thanks for your help.

I decided to modify one of my short term goals into a long term goal (pt will adhere to cardiac diet and maintain current cholesterol, Trig, and LDL levels, and increase HDL level within 6 months). Adding another short term goal is easier than figuring out a new long term one.

Thanks again!

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