An alcohol-troubled client says, "The 12 Steps of Alcoholics Anonymous (AA) meeting really upset me. I had to go for a drink after 1 hour with those people; they're fanatics!" Which statement by the nurse would be therapeutic?1. "You think AA is for fanatics?"2. "It sounds as if you look for any reason to drink!"3. "Not any one strategy for remaining sober is best for everyone."4. "I agree. AA is definitely not for you if you find it is a trigger to drink."

The answer is number 3. Not any one strategy for remaining sober is best for everyone.

Explanation:

In this situation the best therapeutic approach for the nurse is to keep a friendly, supportive, non judgemental relationship with the client. In this manner she can continue to work with the client to find best ways for them to overcome the addiction together.

If the nurse was to respond in an aggressive, judgemental manner such as in answers 1 and 2 then she would lose the trust of the client and they would no longer be able to work together. In addition she is leaving the conversation open and client led by responding with answer 3 because she is saying that alcoholism can be treated in a number of ways giving the client hope which is important. If she was to respond with answer 4 this would give the client the impression that the nurse is making decisions for him/her and also shutting down the possibility that the client might benefit from AA given time.

    however, coronary heart disease , or chd, is actually a result of coronary artery disease, or cad, said edward a. fisher, m.d., ph.d., m.p.h., an american heart association volunteer who is the leon h. charney professor of cardiovascular medicine and also of the marc and ruti bell vascular biology and disease program at the nyu school of medicine.

  with coronary artery disease, plaque first grows within the walls of the coronary arteries until the blood flow to the heart’s muscle is limited. view an illustration of coronary arteries. this is also called ischemia. it may be chronic, narrowing of the coronary artery over time and limiting of the blood supply to part of the muscle. or it can be acute, resulting from a sudden rupture of a plaque and formation of a thrombus or blood clot.

    the traditional risk factors for coronary artery disease are high ldl cholesterol, low hdl cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men, according to fisher. obesity may also be a risk factor.

    “coronary artery disease begins in childhood, so that by the teenage years, there is evidence that plaques that will stay with us for life are formed in most people,” said fisher, who is former editor of the american heart association journal, atvb. “preventive measures instituted early are thought to have greater lifetime benefits. healthy lifestyles will delay the progression of cad, and there is hope that cad can be regressed before it causes chd.”

  living a healthy lifestyle that incorporates good nutrition, weight management and getting plenty of physical activity can play a big role in avoiding cad.

    “coronary artery disease is preventable,” agreed johnny lee, m.d., president of new york heart associates, and an american heart association volunteer. “typical warning signs are chest pain, shortness of breath, palpitations and even fatigue.” if you feel any of these symptoms, don’t delay — call 9-1-1.

d they all are treatable but they never completely go away