Acute cardiac care : a practical guide for nurses

Contributors. Foreword. Preface. 1 Mechanics of the Cardiovascular System ( B. Greaney & A.M. Kucia) Overview. Basic heart anatomy. The cardiac cycle. Cardiac output. Conclusion. 2 Regulation of Cardiac and Vascular Function ( B. Greaney & A.M. Kucia). Overview. Central nervous system regulation of the cardiovascular system. Vasomotor control. Baroreceptors. Chemoreceptors. Humoral control. Electrolytes. Conclusion. 3 Cardiac Electrophysiology ( B. Greaney & A.M. Kucia). Overview. Cardiac cells. The action potential. The action potential in non-pacemaker cells. The cardiac conduction system. The electrocardiogram. Conclusion. 4 The Coronary Circulation ( B. Greaney & A.M. Kucia). 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 ( A.M. Kucia & E. Birchmore). Overview. Classification of risk factors for CVD. Biomedical risk factors. Behavioural risk factors. Psychosocial risk factors. Conclusion. 6 Populations at Risk ( T. Wachtel, R. Webster & J. Smith). 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 ( D. Evans & T. Quinn). Overview. The need for change. Evidence-based practice. Barriers to the evidence. Conclusion. 8 Ethics of Research in Acute Cardiac Care ( B.F. Williams & A.M. Kucia ). 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 ( A.M. Kucia & S.A. Unger). Overview. Health history. Physical examination. Conclusion. 10 Electrocardiogram Interpretation ( A.M. Kucia & C. Oldroyd). 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 ( A.M. Kucia & C. Oldroyd). 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 ( D. Barrett, L. Jesuthasan & A.M. Kucia). 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 ( L. Belz, K. Mishra, S.A. Unger & A.M. Kucia). Overview. Chest X-ray. Cardiac catheterisation (angiogram). Echocardiography. Stress testing. Magnetic resonance imaging. Computerised tomography. Electrophysiology studies. Conclusion. 14 Sudden Cardiac Death ( T. Quinn & P. Gregory). 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 ( P. Gregory & T. Quinn). 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 ( A.M. Kucia & B.F. Williams). 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 ( A.M. Kucia & J.D. Horowitz). Overview. Acute coronary syndrome. Atherosclerosis. Endothelial dysfunction. Plaque disruption. Inflammation. Thrombosis. Vasoconstriction. Conclusion. 18 Presentations of Acute Coronary Syndromes ( A.M. Kucia & J.F. Beltrame). 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 ( A. Day, C. Ryan & T. Quinn). Overview. Introduction. Risk stratification. Risk stratification guidelines. Risk scores. Chest pain units. Conclusion. 20 Reducing Time to Treatment ( T. Quinn & A. Day). Overview. Benefits of early reperfusion. Identifying and addressing delays. Conclusion. 21 Reperfusion Strategies ( C.J. Zeitz & T. Quinn). 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 ( A.M. Kucia & J.D. Horowitz). Overview. Anti-ischaemic therapies. Antiplatelet and anticoagulant therapy. Inhibitors of the renin-angiotensinaldosterone system. Statins. Conclusion. 23 Arrhythmias ( C. Oldroyd & A.M. Kucia). Overview. Basic electrophysiology. Mechanisms of arrhythmia generations. Cardiac monitoring. Rhythm interpretation. Determining the rhythm. Tachyarrhythmias. Asystole. Treatment of arrhythmias. Conclusion. 24 In-Hospital Resuscitation ( C. Oldroyd, K. Lewis & P. Whiston). 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 ( T. Quinn). 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 ( P. Davidson & R. Webster). 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 ( R. Webster & P. Davidson). Overview. Discharge planning. Secondary prevention. Provision of secondary prevention. Components of secondary prevention. Cardio-protective drug therapy. Challenges in secondary prevention. Conclusion. Index.