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EAPC quiz: Care of the Cardio-oncologic Patient in Primary Care Practice

by Donata Kurpas, Primary Care and Risk Factor Management Section, et al.

Preventive Cardiology
Risk Factors and Prevention


The case

A 69-year-old man diagnosed with:

  • chronic atrial fibrillation
  • hypertension
  • hypercholesterolemia
  • nicotinism
  • implanted pacemaker
  • left ventricle hypertrophy
  • prior aortic aneurysm resection and aortic prosthesis implantation
  • history of prostatic hypertrophy
  • benign bladder tumor pTa LG(G1) after transurethral resection of bladder tumour (TURBT)

is under care of his general practitioner. He has had a recurrence of his bladder tumor and has been re-scheduled for a repeat TURBT.

The patient is overweight (BMI 28.70), leads a sedentary lifestyle and smokes one pack of cigarettes a day. His blood pressure control at home is fair, with values around 120/70 mmHg, and occasional drops in blood pressure, without fainting. The patient takes a vitamin K antagonist for chronic anticoagulation treatment.

Recommendations:

  • lifestyle modification
  • smoking cessation
  • weight reduction
  • regular use of medications
  • taking warfarin under INR control
  • control of blood pressure and recording results (morning, afternoon, and evening measurements)
  • a diet limiting animal fats and salt
  • regular urine culture monitoring
  • remaining under constant care of a cardiologist and a urologist

Nursing Interventions:

  • Psycho-education of the patient on symptom monitoring and self-management [2]
  • Patient education on thromboembolic risk, use of anticoagulants (warfarin) and the importance of regular monitoring of INR level[1]
  • Psycho-education and support in the process of lifestyle modification, i.e. weight reduction, encouraging and motivating the patient to engage in regular physical activity, changing nutritional habits (eating a diet rich in vegetables which contain minerals such as potassium), stopping smoking cigarettes[1,2],

Test your knowledge

 

Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material on the site are only examples and do not guarantee outcomes from formal examinations.

References

1. Hindricks G., Potpara T., Dagres N., Arbelo E., et.al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC; Eur Heart J,42;5;2021, 373–498. doi.org/10.1093/eurheartj/ehaa612

2. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016; 37(29): 2315–2381, doi: 10.1093/eurhe- artj/ehw106, indexed in Pubmed: 27222591.

Notes to editor

Authors' information:

Alicja Wiśnicka1, Izabella Uchmanowicz1, 2, Donata Kurpas3,4

1 Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland

2 Association of Cardiovascular Nursing & Allied Professions

3 Department of Family Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland

4 EAPC Primary Care and Risk Factor Management Section