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.
- 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
Table of Contents
1 Mechanics of the Cardiovascular System (B. Greaney & A.M. Kucia) Overview.
Basic heart anatomy.
The cardiac cycle.
2 Regulation of Cardiac and Vascular Function (B. Greaney & A.M. Kucia).
Central nervous system regulation of the cardiovascular system.
3 Cardiac Electrophysiology (B. Greaney & A.M. Kucia).
The action potential.
The action potential in non-pacemaker cells.
The cardiac conduction system.
4 The Coronary Circulation (B. Greaney & A.M. Kucia).
The coronary circulation.
The left main coronary artery.
The LAD artery.
The LCX or CX artery.
The right coronary artery.
Coronary venous circulation.
5 Risk Factors for Cardiovascular Disease (A.M. Kucia & E. Birchmore).
Classification of risk factors for CVD.
Biomedical risk factors.
Behavioural risk factors.
Psychosocial risk factors.
6 Populations at Risk (T. Wachtel, R. Webster & J. Smith).
Risk factors for CVD.
Risk assessment tools.
Populations at increased risk.
Using what we know.
7 Evidence-Based Practice (D. Evans & T. Quinn).
The need for change.
Barriers to the evidence.
8 Ethics of Research in Acute Cardiac Care (B.F. Williams & A.M. Kucia).
Evidence-based medicine and clinical trials.
Informed consent for trial participation.
What is an ethical dilemma?
Considering an offer for the unit to participate in a clinical trial.
Ethical issues in marketing and pricing of new pharmaceutical agents.
9 Cardiovascular Assessment (A.M. Kucia & S.A. Unger).
10 Electrocardiogram Interpretation (A.M. Kucia & C. Oldroyd).
Normal sequence of depolarisation and repolarisation.
Theoretical basis of electrocardiography.
Determining the cardiac axis.
Determination of heart rate and electrocardiographic intervals.
Bundle branch block.
ECG changes related to myocardial ischaemia and infarction.
Obtaining a 12-lead ECG.
11 Cardiac Monitoring (A.M. Kucia & C. Oldroyd).
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).
Generic laboratory tests.
Complete blood examination.
Markers of myocardial necrosis.
Cardiac natriuretic peptides.
13 Diagnostic Procedures (L. Belz, K. Mishra, S.A. Unger & A.M. Kucia).
Cardiac catheterisation (angiogram).
Magnetic resonance imaging.
14 Sudden Cardiac Death (T. Quinn & P. Gregory).
Burden of disease and risk factors for SCD.
Sudden death in the young (including athletes).
Cardiomyopathies and SCD.
Genetic syndromes and SCD.
15 Out-of-Hospital Cardiac Arrest and Automated External Defibrillation (P.
Gregory & T. Quinn).
Out-of-hospital cardiac arrest,
Hazards to the victim and rescuer,
Recognition of cardiac arrest and BLS,
Automated external defibrillation,
16 Ethical Issues in Resuscitation (A.M. Kucia & B.F. Williams).
Guiding ethical principles in resuscitation.
Rights of the individual versus the needs of society.
Patient perceptions of resuscitation.
Introducing the DNR conversation.
Withdrawal of treatment.
Training and research with the newly dead.
17 Pathogenesis of Acute Coronary Syndromes (A.M. Kucia & J.D. Horowitz).
Acute coronary syndrome.
18 Presentations of Acute Coronary Syndromes (A.M. Kucia & J.F. Beltrame).
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.
19 Risk Stratification in Acute Coronary Syndromes (A. Day, C. Ryan & T.
Risk stratification guidelines.
Chest pain units.
20 Reducing Time to Treatment (T. Quinn & A. Day).
Benefits of early reperfusion.
Identifying and addressing delays.
21 Reperfusion Strategies (C.J. Zeitz & T. Quinn).
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.
22 Adjunct Pharmacological Agents in Acute Coronary Syndromes (A.M. Kucia &
Antiplatelet and anticoagulant therapy.
Inhibitors of the renin-angiotensinaldosterone system.
23 Arrhythmias (C. Oldroyd & A.M. Kucia).
Mechanisms of arrhythmia generations.
Determining the rhythm.
Treatment of arrhythmias.
24 In-Hospital Resuscitation (C. Oldroyd, K. Lewis & P. Whiston).
Prevention: systems for identifying patients at risk of cardiac arrest.
Early recognition and management of critically ill patients.
Working within your scope of practice.
Audit and data collection.
25 Acute Heart Failure (T. Quinn).
Establishing the diagnosis.
Dignity, communication and preventing complications: ‘back to basics’.
Managing chronic heart failure better to reduce the need for re-hospitalisation.
26 Convalescence (P. Davidson & R. Webster).
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.
27 Discharge Planning and Secondary Prevention (R. Webster & P. Davidson).
Provision of secondary prevention.
Components of secondary prevention.
Cardio-protective drug therapy.
Challenges in secondary prevention.
Angela M. Kucia is a Clinical Practice Consultant in Acute
Cardiac Assessment at the Queen Elizabeth and Lyell McEwin Hospitals in Adelaide,
South Australia. Angela also lectures in postgraduate cardiovascular nursing
at the University of South Australia and has been involved in acute cardiac
nursing for twenty years.
Tom Quinn is Professor of Clinical Practice at the University of Surrey and also Visiting Professor of Cardiac Nursing at Coventry University, UK. Tom has extensive clinical experience both in and out of hospital, and was closely involved in developing and implementing the National Service Framework for Coronary Heart Disease and related policies in England.