[A Practical Guide for Nurses 01] • Acute Cardiac Care: A Practical Guide for Nurses by Kucia, Angela M. -- Read -- Imperial Library of Trantor

Index

Cover Contents Title page Copyright page Contributors Foreword Preface 1: Mechanics of the Cardiovascular System

Overview Basic heart anatomy The cardiac cycle Cardiac output Conclusion

2: Regulation of Cardiac and Vascular function

Overview Central nervous system regulation of the cardiovascular system Vasomotor control Baroreceptors Chemoreceptors Humoral control Electrolytes Conclusion

3: Cardiac Electrophysiology

Overview Cardiac cells The action potential The action potential in non-pacemaker cells The cardiac conduction system The electrocardiogram Conclusion

4: The Coronary Circulation

Overview The coronary circulation The left main coronary artery The LAD artery The LCX or CX artery The right coronary artery Collateral circulation Microvascular circulation Coronary venous circulation

5: Risk Factors for Cardiovascular Disease

Overview Classification of risk factors for CVD Biomedical risk factors Behavioural risk factors Psychosocial risk factors Conclusion

6: Populations at Risk

Overview Risk factors for CVD Clarifying risk Risk assessment tools Populations at increased risk Targeting treatment Using what we know Conclusion

7: Evidence-Based Practice

Overview The need for change Evidence-based practice Barriers to the evidence Conclusion

8: Ethics of Research in Acute Cardiac Care

Overview Evidence-based medicine and clinical trials Informed consent for trial participation What is an ethical dilemma? Genetic research Considering an offer for the unit to participate in a clinical trial Ethical issues in marketing and pricing of new pharmaceutical agents Conclusion

9: Cardiovascular Assessment

Overview Health history Physical examination Conclusion

10: Electrocardiogram Interpretation

Overview Normal sequence of depolarisation and repolarisation Theoretical basis of electrocardiography Determining the cardiac axis Determination of heart rate and electrocardiographic intervals Chamber enlargement Bundle branch block ECG changes related to myocardial ischaemia and infarction Obtaining a 12-lead ECG Conclusion

11: Cardiac Monitoring

Overview ECG monitoring systems and lead formats Indications for arrhythmia monitoring Nursing considerations in the care of the patient with ECG monitoring

12: Laboratory Tests

Overview Generic laboratory tests Electrolytes Renal function Glucose measurement Lipid profiles Complete blood examination Clotting screen Biochemical markers Markers of myocardial necrosis Cardiac natriuretic peptides C-reactive protein Conclusion

13: Diagnostic Procedures

Overview Chest X-ray Cardiac catheterisation (angiogram) Echocardiography Stress testing Magnetic resonance imaging Computerised tomography Electrophysiology studies Conclusion

14: Sudden Cardiac Death

Overview Definitions Burden of disease and risk factors for SCD Sudden death in the young (including athletes) Structural abnormalities Cardiomyopathies and SCD Genetic syndromes and SCD Conclusion

15: Out-of-Hospital Cardiac Arrest and Automated External Defibrillation

Overview Out-of-hospital cardiac arrest Hazards to the victim and rescuer Recognition of cardiac arrest and BLS Automated external defibrillation Conclusion

16: Ethical Issues in Resuscitation

Overview Guiding ethical principles in resuscitation Futility Rights of the individual versus the needs of society Patient perceptions of resuscitation Introducing the DNR conversation Witnessed resuscitation Withdrawal of treatment Organ donation Training and research with the newly dead

17: Pathogenesis of Acute Coronary Syndromes

Overview Acute coronary syndrome Atherosclerosis Endothelial dysfunction Plaque disruption Inflammation Thrombosis Vasoconstriction Conclusion

18: Presentations of Acute Coronary Syndromes

Overview Angina pectoris Stable angina The acute coronary syndromes Global trends in ACS presentations Clinical history in ACS Physical examination in ACS patients The 12-lead electrocardiogram in ACS Cardiac markers in ACS Clinical assessment and risk stratification in ACS Conclusion

19: Risk Stratification in Acute Coronary Syndromes

Overview Introduction Risk stratification Risk stratification guidelines Risk scores Chest pain units Conclusion

20: Reducing Time to Treatment

Overview Benefits of early reperfusion Identifying and addressing delays Conclusion

21: Reperfusion Strategies

Overview Pathogenesis of STEMI Principles of reperfusion strategies Options for reperfusion Strategies for reducing treatment time delays Detecting and managing failed reperfusion Preventing and detecting re-occlusion Conclusion

22: Adjunct Pharmacological Agents in Acute Coronary Syndromes

Overview Anti-ischaemic therapies Antiplatelet and anticoagulant therapy Inhibitors of the renin-angiotensin-aldosterone system Statins Conclusion

23: Arrhythmias

Overview Basic electrophysiology Mechanisms of arrhythmia generations Cardiac monitoring Rhythm interpretation Determining the rhythm Tachyarrhythmias Asystole Treatment of arrhythmias Conclusion

24: In-Hospital Resuscitation

Overview Introduction Prevention: systems for identifying patients at risk of cardiac arrest Early recognition and management of critically ill patients In-hospital resuscitation Working within your scope of practice Audit and data collection Conclusion

25: Acute Heart Failure

Overview Introduction Establishing the diagnosis Management specifics Refractory AHF Dignity, communication and preventing complications: ‘back to basics’ Managing chronic heart failure better to reduce the need for re-hospitalisation Conclusion

26: Convalescence

Overview Introduction Assessment and identification of patient needs High risk groups Promoting self-management in the convalescent phase Particular concerns of spouses and family members Accommodating convalescence and discharge planning following an acute cardiac event Models of intervention to facilitate convalescence and secondary prevention Nursing strategies to promote convalescence Palliative care Conclusion

27: Discharge Planning and Secondary Prevention

Overview Discharge planning Secondary prevention Provision of secondary prevention Components of secondary prevention Cardio-protective drug therapy Challenges in secondary prevention Conclusion

Index

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