2. CONCEPTS
• Basics about the anatomy and physiology of cardio-
thoracic system
• Fundamentals of cardiothoracic pathophysiology
• Planning and managing care
• Principles and practices at each level of care units
• Communication skills
• Physical well being and comfort of people
• Evaluation of details and quality of care required .
9. HOMEOSTATIC REGULATION OF THE CVS
-NEURAL REGULATION- Baro receptors and chemo receptors
-ENDOCRINE REGUILATION-Catecholamines
-ADH
-RENIN ANGIOTENSIN ALDOSTERONE SYSTEM
10.
11.
12. PLANNING AND MANAGING CARE
COMPETENCIES- APN has to demonstrate a greater
depth of knowledge, skills and interventions than the
entry level RN.
COLLABORATION-Complex process of that requires
intentional knowledge sharing and joint responsibility
for patient care.
13. INTER DISCIPLINARY
COLLABORATION
• Reducing CVS risk
• Altering lifestyle behaviours
• Improving secondary prevention
• Controlling hypertension
• Managing Cardiac disease conditions like AF,
Heart failure
14. PERSPECTIVES AT VARIOUS LEVELS
OF CARE
EMERGENCY DEPARTMENT
• Triage (Rapid assessment and prioritisation)
• Supportive care and diagnostic tools
• Rhythm recognition &ECG Interpretation
• Dysrhythmia management strategies
• Hemodynamic monitoring
• Resuscitation
15. PERSPECTIVES OF ICCU
• Provision of a separate area within the hospital for
the care and surveillance of patients with cardiac
emergencies or life threatening conditions
• Provision of care by nurses and physicians with
specialised training.
• Provision of personnel and equipment immediately
available for resuscitation.
16. PRINCIPLES OF CCU
• Anticipation & Rapid assessment
• Stabilisation
• Re-establishment of adequate cardiac blood flow
• Relief of pain
• Treatment of complications including resuscitation
• Crisis intervention and stress reduction
• Communication
• Prevention of infection
MODERN MANAGEMENT of Coronary care patient includes
Pharmacological and mechanical therapies directed towards oxygen supply and reducing
myocardial work have assumed more importance.
17. DESIRED COMPETENCIES OF CCU
NURSES
• Clinical judgement and reasoning skills
• Advocacy and moral agency in identifying and resolving ethical issues
• Caring practices that are tailored to the uniqueness of the Patient and
family
• Collaboration with health care team members including family members.
• Promoting holistic care and meeting the diverse population needs
• Clinical inquiry & innovation to promote best clinical outcomes.
• Essential ECG monitoring ,hemodynamic monitoring ,code management
and knowledge of drugs used in cardiac care units
18. PROGRESSIVE CARE UNITS
• Identifying and preventing complications
• Assessing for hypotension ,ECG monitoring
• Physical assessment
• Activity progression
• Detecting late complications
19. FACILITATING DISCHARGE FROM
HOSPITAL
• Get with the guidelines (GWTG)-Quality improvement program from AHA
and ASA
Eg: For CAD patients
On discharge –aspirin ,beta blocker, ACE Inhibitor or ARB and lipid lowering
drugs and Smoking cessation .
Eg:For Heart failure patients
Weight gain monitoring – in 2 days 3 lb or 3-5 lbs over a week
Sodium restricted or possibly fluid restricted.
21. PERSPECTIVES OF CARDIOTHORACIC
AND VASCULAR NURSING
• The cardiovascular and thoracic nursing is a
vast area and requires advanced skills for
nursing intervention in various cardio medical
and surgical conditions. Ethical and legal
issues are also important consideration in this
field.
22. CONCLUSION
• Nurses play a vital role in the primary, secondary
prevention and management of cardio-vascular
diseases.
• In-depth knowledge and understanding of the CTVS
and its associated disorders will enable the nurse to
safely assess a patient ,recognise a deteriorating
patient and seek early intervention.
