Acute Cardiac Care : A Practical Guide for Nurses

**Acute Cardiac Care** provides nurses with a comprehensive understanding of the current practice and principles underlying the care and management of acute cardiac conditions. It addresses the management of acute coronary syndromes (ACS) with an emphasis on evidence-based pharmacological management, cardiac emergencies (cardiac arrest, arrhythmia, acute pulmonary oedema, cardiogenic shock), current diagnostic and interventional modalities for the management of ACS, including risk stratification, and the ethical, political, social and economic factors that impact upon the provision of acute cardiac services in Australia and the UK.Edited by renowned academics and clinicians in the field, this practical text will encourage nurses to think critically about evidence and management of acute coronary conditions, and provide a guide on how and where to look for up-to-date evidence and guidelines. **KEY FEATURES:** * A comprehensive and practical guide to the current practice and principles underlying the nursing care of acute cardiac conditions * Edited by leading authorities in the field with a wealth of experience in acute cardiac care and resuscitation * Has an emphasis on evidence-based practice, encouraging nurses to critically think about their practice * Contains learning objectives, key points and activities and further reading guidelines Contents......Page 5 Contributors......Page 9 Foreword......Page 11 Preface......Page 13 Basic heart anatomy......Page 15 The cardiac cycle......Page 16 Cardiac output......Page 20 Conclusion......Page 21 Central nervous system regulation of the cardiovascular system......Page 22 Vasomotor control......Page 23 Chemoreceptors......Page 24 Humoral control......Page 25 Conclusion......Page 27 Cardiac cells......Page 29 The action potential......Page 30 The action potential in non-pacemaker cells......Page 31 The cardiac conduction system......Page 32 Conclusion......Page 34 The coronary circulation......Page 35 The left main coronary artery......Page 36 Collateral circulation......Page 37 Coronary venous circulation......Page 38 Classification of risk factors for CVD......Page 40 Biomedical risk factors......Page 41 Behavioural risk factors......Page 46 Psychosocial risk factors......Page 48 Conclusion......Page 49 Risk factors for CVD......Page 53 Risk assessment tools......Page 54 Populations at increased risk......Page 55 Targeting treatment......Page 59 Conclusion......Page 60 The need for change......Page 64 Evidence-based practice......Page 65 Barriers to the evidence......Page 70 Conclusion......Page 71 Overview......Page 73 Informed consent for trial participation......Page 74 What is an ethical dilemma?......Page 76 Considering an offer for the unit to participate in a clinical trial......Page 77 Conclusion......Page 78 Health history......Page 81 Physical examination......Page 84 Conclusion......Page 93 Normal sequence of depolarisation and repolarisation......Page 95 Theoretical basis of electrocardiography......Page 97 Determining the cardiac axis......Page 99 Determination of heart rate and electrocardiographic intervals......Page 100 Bundle branch block......Page 102 ECG changes related to myocardial ischaemia and infarction......Page 105 Obtaining a 12-lead ECG......Page 108 Conclusion......Page 111 Overview......Page 113 ECG monitoring systems and lead formats......Page 114 Nursing considerations in the care of the patient with ECG monitoring......Page 117 Generic laboratory tests......Page 123 Renal function......Page 124 Complete blood examination......Page 125 Markers of myocardial necrosis......Page 126 Cardiac natriuretic peptides......Page 127 Conclusion......Page 128 Chest X-ray......Page 130 Cardiac catheterisation (angiogram)......Page 132 Echocardiography......Page 138 Stress testing......Page 139 Magnetic resonance imaging......Page 144 Electrophysiology studies......Page 146 Conclusion......Page 147 Overview......Page 151 Burden of disease and risk factors for SCD......Page 152 Sudden death in the young (including athletes)......Page 153 Structural abnormalities......Page 154 Genetic syndromes and SCD......Page 155 Conclusion......Page 157 Overview......Page 159 Hazards to the victim and rescuer......Page 160 Recognition of cardiac arrest and BLS......Page 161 Automated external defibrillation......Page 163 Conclusion......Page 164 Guiding ethical principles in resuscitation......Page 166 Rights of the individual versus the needs of society......Page 167 Witnessed resuscitation......Page 168 Withdrawal of treatment......Page 170 Training and research with the newly dead......Page 171 Overview......Page 175 Plaque disruption......Page 176 Inflammation......Page 177 Conclusion......Page 178 Angina pectoris......Page 181 The acute coronary syndromes......Page 182 Clinical history in ACS......Page 184 Physical examination in ACS patients......Page 186 The 12-lead electrocardiogram in ACS......Page 187 Clinical assessment and risk stratification in ACS......Page 188 Conclusion......Page 189 Introduction......Page 192 Risk stratification......Page 193 Risk stratification guidelines......Page 194 Risk scores......Page 195 Chest pain units......Page 196 Conclusion......Page 197 Benefits of early reperfusion......Page 199 Identifying and addressing delays......Page 200 Conclusion......Page 204 Pathogenesis of STEMI......Page 207 Options for reperfusion......Page 208 Detecting and managing failed reperfusion......Page 213 Preventing and detecting re-occlusion......Page 214 Conclusion......Page 215 Overview......Page 218 Anti-ischaemic therapies......Page 219 Antiplatelet and anticoagulant therapy......Page 223 Inhibitors of the renin-angiotensin-aldosterone system......Page 229 Conclusion......Page 230 Overview......Page 236 Mechanisms of arrhythmia generations......Page 237 Rhythm interpretation......Page 239 Determining the rhythm......Page 241 Tachyarrhythmias......Page 246 Asystole......Page 252 Treatment of arrhythmias......Page 253 Conclusion......Page 255 Overview......Page 257 Introduction......Page 258 Prevention: systems for identifying patients at risk of cardiac arrest......Page 259 Early recognition and management of critically ill patients......Page 260 In-hospital resuscitation......Page 262 Working within your scope of practice......Page 264 Conclusion......Page 267 Introduction......Page 271 Establishing the diagnosis......Page 272 Management specifics......Page 275 Refractory AHF......Page 278 Dignity, communication and preventing complications: 'back to basics'......Page 279 Conclusion......Page 280 Overview......Page 283 Introduction......Page 284 Promoting self-management in the convalescent phase......Page 286 Particular concerns of spouses and family members......Page 287 Models of intervention to facilitate convalescence and secondary prevention......Page 288 Nursing strategies to promote convalescence......Page 289 Conclusion......Page 290 Discharge planning......Page 294 Secondary prevention......Page 295 Provision of secondary prevention......Page 296 Components of secondary prevention......Page 297 Cardio-protective drug therapy......Page 303 Challenges in secondary prevention......Page 304 Conclusion......Page 305 A......Page 311 C......Page 313 E......Page 315 G......Page 316 L......Page 317 N......Page 318 P......Page 319 S......Page 320 T......Page 321 Z......Page 322

acute Cardiac Care Provides Nurses With A Comprehensive Understanding Of The Current Practice And Principles Underlying The Care And Management Of Acute Cardiac Conditions. It Addresses The Management Of Acute Coronary Syndromes (acs) With An Emphasis On Evidence-based Pharmacological Management, Cardiac Emergencies (cardiac Arrest, Arrhythmia, Acute Pulmonary Oedema, Cardiogenic Shock), Current Diagnostic And Interventional Modalities For The Management Of Acs, Including Risk Stratification, And The Ethical, Political, Social And Economic Factors That Impact Upon The Provision Of Acute Cardiac Services In Australia And The Uk.

edited By Renowned Academics And Clinicians In The Field, This Practical Text Will Encourage Nurses To Think Critically About Evidence And Management Of Acute Coronary Conditions, And Provide A Guide On How And Where To Look For Up-to-date Evidence And Guidelines.

key Features:

• a Comprehensive And Practical Guide To The Current Practice And Principles Underlying The Nursing Care Of Acute Cardiac Conditions

• edited By Leading Authorities In The Field With A Wealth Of Experience In Acute Cardiac Care And Resuscitation

• has An Emphasis On Evidence-based Practice, Encouraging Nurses To Critically Think About Their Practice

• contains Learning Objectives, Key Points And Activities And Further Reading Guidelines

Acute Cardiac Care provides nurses with a comprehensive understanding of the current practice and principles underlying the care and management of acute cardiac conditions. It addresses the management of acute coronary syndromes (ACS) with an emphasis on evidence-based pharmacological management, cardiac emergencies (cardiac arrest, arrhythmia, acute pulmonary oedema, cardiogenic shock), current diagnostic and interventional modalities for the management of ACS, including risk stratification, and the ethical, political, social and economic factors that impact upon the provision of acute cardiac services in Australia and the UK. Edited by renowned academics and clinicians in the field, this practical text will encourage nurses to think critically about evidence and management of acute coronary conditions, and provide a guide on how and where to look for up-to-date evidence and guidelines. KEY FEATURES: A comprehensive and practical guide to the current practice and principles underlying the nursing care of acute cardiac conditions Edited by leading authorities in the field with a wealth of experience in acute cardiac care and resuscitation Has an emphasis on evidence-based practice, encouraging nurses to critically think about their practice Contains learning objectives, key points and activities and further reading guidelines