Part A:Patient to nurse dialogue. Maureen asks these questions of you, the nurse, after the doctor has seen Maureen – use these and answer them in your presentation:
1. A few years ago, my doctor had told me to take aspirin every night, so does this mean that they haven’t been working?
2. How sure are you that I haven’t had a heart attack? (Hint: use evidence to confirm your answer)
3. Does this mean that I won’t get a heart attack in the future? (Hint: use the information from the Australian Absolute Cardiovascular Risk Calculator in your discussion)
4. The doctor said that my LDL is too high, is that what has caused my heart trouble?
5. So, about eating too much fat – I just need to stop eating cholesterol, don’t I? (Hint: think about the undesired effects of all fats, and then include information on the preferred fats for her to eat)
6. Do I really need to change my diet, can’t I just get a pill these days for sorting out my LDL?
7. The doctor also thinks I need to lose some weight, but surely I don’t have to lose much do I? You have to remember that I’m 53 now, so I’m not meant to be as fit as I used to.
8. I’ve started eating more chocolate and having more red wine when I heard about how having diabetes can make me likely to have heart disease. I hope that those have helped.
9. Is the coffee the problem? I usually only have 2 or 3 cups a day.
10. The doctor told me that I need to change my diet, now that I have diabetes. What does eating carbohydrates have to do with heart disease? I can’t possibly do a diet for diabetes, and also a diet for heart disease – I won’t be able to eat anything! (Hint: do not simply say the nutritionist will discuss this – you have enough information to have a conversation with her about this).
Part B:Nurse to another nurse dialogue. You have an opportunity to discuss Maureen’s case with another nurse, who is taking over the care for Maureen.
1. Is there any point in her still taking aspirin daily?
2. Did the glyceryl trinitrate that the paramedics administered do anything?
3. How are her blood lipid levels?
4. How sure are we about whether she had a heart attack? (Hint: use evidence to confirm your answer)
5. What do we think about her future heart attack risk? (Hint: use the information from the Australian Absolute Cardiovascular Risk Calculator in your discussion)
6. Was the β-blocker useful? (Hint: how can you tell whether it worked or not?)
7. What was her BMI and waist circumference – how much weight does she need to lose? (Hint: include your interpretation of the BMI and waist circumference).
8. I think that she has too much saturated fat, particularly toasted cheese sandwiches. She really needs to cut out all dairy, doesn’t she?
9. What about her intake of coffee, chocolate and wine – aren’t they all meant to be good for heart health?
10. What lifestyle changes should be suggested for her?