Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0014
‘Congenital heart disease’ is a term used to cover a wide range of cardiac conditions that result from an abnormality of cardiac structure or function present at birth. The majority of children with congenital heart disease are managed in specialist paediatric centres. Not all will require further treatment as they grow older, but if they do the importance of a smooth transition to adult services is important. Some patients will be cared for in specialist units that cater for adults with congenital heart disease (ACHD), whereas others may not. Most cardiac nurses working in the cardiac arena can be expected to care for adult patients with congenital heart disease at some time in their career. They might also care for patients who present for the first time in adulthood with inherited disorders that have significant cardiovascular problems. The focus of this chapter is to highlight some of the issues that ACHD patients might present with in cardiac areas that do not specialize in ACHD.
{"title":"Congenital heart disease and inherited cardiac conditions","authors":"","doi":"10.1093/med/9780198832447.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0014","url":null,"abstract":"‘Congenital heart disease’ is a term used to cover a wide range of cardiac conditions that result from an abnormality of cardiac structure or function present at birth. The majority of children with congenital heart disease are managed in specialist paediatric centres. Not all will require further treatment as they grow older, but if they do the importance of a smooth transition to adult services is important. Some patients will be cared for in specialist units that cater for adults with congenital heart disease (ACHD), whereas others may not. Most cardiac nurses working in the cardiac arena can be expected to care for adult patients with congenital heart disease at some time in their career. They might also care for patients who present for the first time in adulthood with inherited disorders that have significant cardiovascular problems. The focus of this chapter is to highlight some of the issues that ACHD patients might present with in cardiac areas that do not specialize in ACHD.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126355112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/MED/9780199651344.003.0011
K. Olson
This chapter covers bradycardia, heart blocks, and cardiac pacing. Bradyarrhythmias that require pacing can be caused by a range of aetiologies and early identification of possible reversible causes is the first stage of treatment. Although a degree of bradycardia and heart blocks might not have any clinical significance, it is always important to assess the patient for signs of adverse effects. Generally, pacing is only indicated for symptomatic sinus bradycardia. In contrast, patients with asymptomatic atrioventricular block may require pacing for prognostic purposes.
{"title":"Bradycardias and blocks","authors":"K. Olson","doi":"10.1093/MED/9780199651344.003.0011","DOIUrl":"https://doi.org/10.1093/MED/9780199651344.003.0011","url":null,"abstract":"This chapter covers bradycardia, heart blocks, and cardiac pacing. Bradyarrhythmias that require pacing can be caused by a range of aetiologies and early identification of possible reversible causes is the first stage of treatment. Although a degree of bradycardia and heart blocks might not have any clinical significance, it is always important to assess the patient for signs of adverse effects. Generally, pacing is only indicated for symptomatic sinus bradycardia. In contrast, patients with asymptomatic atrioventricular block may require pacing for prognostic purposes.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122273047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0002
It is essential that the cardiac nurse can carry out a comprehensive cardiac assessment of their patient. The nursing assessment aims to describe the patient’s condition and help determine an accurate diagnosis, so that an effective and timely clinical management plan is implemented. The focus of the initial assessment varies according to the setting and clinical presentation of the patient. However, the priority is always to determine whether the patient is haemodynamically stable, whether they are suffering from an acute cardiac event that would benefit from time-dependent therapy, and the need for symptom management. A thorough cardiac assessment requires the nurse to use a wide range of interpersonal, observational, and technical skills. Additionally, the nurse needs an in-depth knowledge of cardiac anatomy, physiology, and pathophysiology to determine the significance of the findings. This chapter outlines how to assess key symptoms and signs of cardiac disease. Symptoms are things that the patient reports as troublesome issues; signs are associated physiological changes that the health professional might discover during the course of their assessment.
{"title":"Cardiac assessment","authors":"","doi":"10.1093/med/9780198832447.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0002","url":null,"abstract":"It is essential that the cardiac nurse can carry out a comprehensive cardiac assessment of their patient. The nursing assessment aims to describe the patient’s condition and help determine an accurate diagnosis, so that an effective and timely clinical management plan is implemented. The focus of the initial assessment varies according to the setting and clinical presentation of the patient. However, the priority is always to determine whether the patient is haemodynamically stable, whether they are suffering from an acute cardiac event that would benefit from time-dependent therapy, and the need for symptom management.\u0000A thorough cardiac assessment requires the nurse to use a wide range of interpersonal, observational, and technical skills. Additionally, the nurse needs an in-depth knowledge of cardiac anatomy, physiology, and pathophysiology to determine the significance of the findings.\u0000This chapter outlines how to assess key symptoms and signs of cardiac disease. Symptoms are things that the patient reports as troublesome issues; signs are associated physiological changes that the health professional might discover during the course of their assessment.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126727812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0019
The aim of this chapter is to give the reader a brief overview of the main groups of drugs used in the field of cardiac nursing. For each group of drugs, there is a brief description of why they are used, their mechanism of action, examples commonly used in clinical practice, and nursing considerations.
{"title":"Cardiovascular drugs","authors":"","doi":"10.1093/med/9780198832447.003.0019","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0019","url":null,"abstract":"The aim of this chapter is to give the reader a brief overview of the main groups of drugs used in the field of cardiac nursing. For each group of drugs, there is a brief description of why they are used, their mechanism of action, examples commonly used in clinical practice, and nursing considerations.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125745534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/MED/9780199651344.003.0008
K. Olson
The purpose of this chapter is to give an overview of interventional cardiology. Diagnostic angiography and percutaneous coronary intervention (PCI) are discussed, in addition to related issues (e.g. achieving haemostasis, pharmacological adjuncts, and complications). The principles of nursing care for both angiography and PCI are similar and will, ∴, be discussed together; any differences will be clarified. Although coronary angiography is the focus of this chapter, it is worth noting that cardiac catheterization is the passage of a catheter into the left and/or right heart to provide diagnostic information about the heart and blood vessels. Cardiac catheterization is a generic term that refers to a variety of procedures including angiography, ventriculography, and right or left heart catheterization. ∴ abnormalities of the heart valves, heart muscle, and coronary arteries can be identified by these procedures.
{"title":"Interventional cardiology for coronary heart disease","authors":"K. Olson","doi":"10.1093/MED/9780199651344.003.0008","DOIUrl":"https://doi.org/10.1093/MED/9780199651344.003.0008","url":null,"abstract":"The purpose of this chapter is to give an overview of interventional cardiology. Diagnostic angiography and percutaneous coronary intervention (PCI) are discussed, in addition to related issues (e.g. achieving haemostasis, pharmacological adjuncts, and complications). The principles of nursing care for both angiography and PCI are similar and will, ∴, be discussed together; any differences will be clarified. Although coronary angiography is the focus of this chapter, it is worth noting that cardiac catheterization is the passage of a catheter into the left and/or right heart to provide diagnostic information about the heart and blood vessels. Cardiac catheterization is a generic term that refers to a variety of procedures including angiography, ventriculography, and right or left heart catheterization. ∴ abnormalities of the heart valves, heart muscle, and coronary arteries can be identified by these procedures.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129184648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0009
R. Shetty
This chapter covers the care of patients who require cardiac surgery, from placement on the waiting list to discharge. Although this involves the whole healthcare team, the focus of the chapter will be on the role of the nurse. The most common cardiac surgical procedures in the UK are coronary artery bypass grafting (CABG), with >16 000 operations performed each year, and heart valve surgery, with 78 000 heart valve operations each year. Other surgical procedures that nurses may come across include surgery for atrial fibrillation (AF), cardiomyopathy, aortic dissection, aneurysm repair, heart transplantation, and congenital heart defects. The principles of care for some of these operations are similar, so they will be discussed at the same time; where there are differences, these will be clarified. In the UK, CABG has been performed for >50yrs. During this time, some techniques have changed and now minimally invasive surgery and ‘off-pump’ surgery are more common. Changes in techniques for valve repair or replacement have meant that those previously at high risk for open heart valve replacement now have other options open to them.
{"title":"Cardiac surgery","authors":"R. Shetty","doi":"10.1093/med/9780198832447.003.0009","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0009","url":null,"abstract":"This chapter covers the care of patients who require cardiac surgery, from placement on the waiting list to discharge. Although this involves the whole healthcare team, the focus of the chapter will be on the role of the nurse. The most common cardiac surgical procedures in the UK are coronary artery bypass grafting (CABG), with >16 000 operations performed each year, and heart valve surgery, with 78 000 heart valve operations each year. Other surgical procedures that nurses may come across include surgery for atrial fibrillation (AF), cardiomyopathy, aortic dissection, aneurysm repair, heart transplantation, and congenital heart defects. The principles of care for some of these operations are similar, so they will be discussed at the same time; where there are differences, these will be clarified. In the UK, CABG has been performed for >50yrs. During this time, some techniques have changed and now minimally invasive surgery and ‘off-pump’ surgery are more common. Changes in techniques for valve repair or replacement have meant that those previously at high risk for open heart valve replacement now have other options open to them.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121297684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/MED/9780199651344.003.0016
K. Olson
The most common problems that cardiac patients present with are related to coronary heart disease (CHD) and valvular disorders. However, there are various infections and malignancies that can affect the heart and this chapter outlines the main disorders that can affect the pericardium and myocardium that are not covered elsewhere in the book. This chapter covers pericardial disease (including pericardial effusion and acute and constrictive pericarditis), myocarditis, cardiac cancers, athlete’s heart, and heart disease in pregnancy.
{"title":"Other cardiac problems","authors":"K. Olson","doi":"10.1093/MED/9780199651344.003.0016","DOIUrl":"https://doi.org/10.1093/MED/9780199651344.003.0016","url":null,"abstract":"The most common problems that cardiac patients present with are related to coronary heart disease (CHD) and valvular disorders. However, there are various infections and malignancies that can affect the heart and this chapter outlines the main disorders that can affect the pericardium and myocardium that are not covered elsewhere in the book. This chapter covers pericardial disease (including pericardial effusion and acute and constrictive pericarditis), myocarditis, cardiac cancers, athlete’s heart, and heart disease in pregnancy.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"272 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122773573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0007
peRFoRmance RepoRts
This chapter aims to outline the pathophysiology, methods for rapid diagnosis, and appropriate clinical management of acute coronary syndromes (ACS) so that it that may be applied within any area and at any point in the patient’s journey. The term ACS refers to a clinical spectrum of the same disease process, and includes unstable angina to non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). The common underlying cause results in the formation of a platelet-rich thrombus and reduced coronary arterial blood flow, which either partially or completely occludes the artery. When complete occlusion of a coronary artery occurs (STEMI) limitation of the infarct size is vital and thus rapid initiation of treatment is essential to obtain the greatest benefit. The development of services such as pre-hospital thrombolysis, direct delivery of patients from the ambulance to the catheter laboratory, and ↑ numbers of 24h 1° percutaneous coronary intervention (PPCI) facilities available (Heart Attack Centres) have been important government initiatives that have been implemented to manage heart disease. Treatment for this group of patients may be initiated and then continued across a variety of areas which include the pre-hospital/community setting, emergency department, Coronary Care Unit, cardiac catheter laboratory, general ward, and chest pain unit. Nurses will encounter patients with both ST-segment elevation ACS and non-ST-segment elevation ACS at various points in their journey, thus clear and effective communication between healthcare providers across these different areas is imperative.
{"title":"Acute coronary syndromes","authors":"peRFoRmance RepoRts","doi":"10.1093/med/9780198832447.003.0007","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0007","url":null,"abstract":"This chapter aims to outline the pathophysiology, methods for rapid diagnosis, and appropriate clinical management of acute coronary syndromes (ACS) so that it that may be applied within any area and at any point in the patient’s journey. The term ACS refers to a clinical spectrum of the same disease process, and includes unstable angina to non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). The common underlying cause results in the formation of a platelet-rich thrombus and reduced coronary arterial blood flow, which either partially or completely occludes the artery. When complete occlusion of a coronary artery occurs (STEMI) limitation of the infarct size is vital and thus rapid initiation of treatment is essential to obtain the greatest benefit. The development of services such as pre-hospital thrombolysis, direct delivery of patients from the ambulance to the catheter laboratory, and ↑ numbers of 24h 1° percutaneous coronary intervention (PPCI) facilities available (Heart Attack Centres) have been important government initiatives that have been implemented to manage heart disease.\u0000Treatment for this group of patients may be initiated and then continued across a variety of areas which include the pre-hospital/community setting, emergency department, Coronary Care Unit, cardiac catheter laboratory, general ward, and chest pain unit. Nurses will encounter patients with both ST-segment elevation ACS and non-ST-segment elevation ACS at various points in their journey, thus clear and effective communication between healthcare providers across these different areas is imperative.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"212 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131503681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0004
Valvular disorders such as regurgitation or stenosis can affect any of the four heart valves, although they are more likely to cause problems in the valves on the left side of the heart than the right, due to higher pressures on the left side. In many cases the symptoms of valvular disease take many years to develop and may be gradual in onset and severity. The patient can be managed medically but may eventually require valve replacement or repair. Over the past few years newer techniques have been developed for replacing or repairing valves. This chapter covers the causes, signs and symptoms, and management of valvular disorders.
{"title":"Valvular disease","authors":"","doi":"10.1093/med/9780198832447.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0004","url":null,"abstract":"Valvular disorders such as regurgitation or stenosis can affect any of the four heart valves, although they are more likely to cause problems in the valves on the left side of the heart than the right, due to higher pressures on the left side. In many cases the symptoms of valvular disease take many years to develop and may be gradual in onset and severity. The patient can be managed medically but may eventually require valve replacement or repair. Over the past few years newer techniques have been developed for replacing or repairing valves. This chapter covers the causes, signs and symptoms, and management of valvular disorders.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123523919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0006
Although rates of premature death from coronary heart disease (CHD) have fallen 80% over the past 40 years, it is still a significant cause of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath (SOB) and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute myocardial infarction (MI). This chapter outlines the pathophysiology and clinical management of stable angina.
{"title":"Coronary heart disease: stable angina","authors":"","doi":"10.1093/med/9780198832447.003.0006","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0006","url":null,"abstract":"Although rates of premature death from coronary heart disease (CHD) have fallen 80% over the past 40 years, it is still a significant cause of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath (SOB) and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute myocardial infarction (MI).\u0000This chapter outlines the pathophysiology and clinical management of stable angina.","PeriodicalId":272214,"journal":{"name":"Oxford Handbook of Cardiac Nursing","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122870905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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