Acute Cardiac Care: A Practical Guide for Nurses

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