If your patient is a smoker, chances are she has been smoking for a lengthy time and can not be willing to give it up just given that you tell her she has to. So you'll have to have to explain how cigarette smoking puts her at high risk for creating serious, lifethreatening complications, including coronary artery disease (CAD) and myocardial infarction (MI) .
Affects on Arteries
The chemicals in cigarette smoke cause harm to the coronary artery endothelium, which has currently been damaged by diabetes. These chemicals also raise total cholesterol and triglyceride levels and lessen high-density lipoprotein levels. All of these adjustments lead to coronary artery occlusion and myocardial ischemia or MI. Nicotine, a effective vasoconstrictor, causes vasospasm and increases blood pressure, blood viscosity, and clotting factor concentrations, additional reducing coronary artery blood flow.
Nursing Interventions
If your patient doesn't smoke but lives with somebody who does, explain the dangers of passive smoke, which can be as damaging as smoking itself. Encourage the family members member to quit smoking. If he cannot quit, instruct him not to smoke about the patient. If your patient does smoke, uncover out how a lot she smokes and how motivated she is to quit. If your patient has tried to quit but hasn't been prosperous, encourage her to attempt once more. Ask which approaches she has tried and ask her why she thinks they did not perform.
Address her issues about quitting. For instance, your patient may well be afraid that she'll gain weight. If so, encourage her to seek support from her household and an proper weight control support group.
Talk about with the patient's physician the possibility of working with a transdermal nicotine delivery method or nicotine chewing gum. Having said that, don't forget that these nicotine merchandise, just like cigarettes, might possibly be contraindicated in patients who have CAD or arrhythmias considering nicotine causes vasoconstriction, tachycardia, and increased blood pressure. In patients with diabetes, nicotine causes the release of catecholamines from the adrenal medulla, which can result in arrhythmias and other cardiovascular complications.
Refer your patient to a assistance group or smoking cessation program. Even if the physician prescribes a nicotine product to offset withdrawal, she may possibly need to have extra support to assist adjust her behavior.
