Index Note: Page numbers of article titles are in boldface type. A Acidosis, electrolyte disturbances and, 641 Acute coronary syndrome, 547 557 antiplatelet therapy for, 565 adenosine diphosphate receptor antagonists, 566 aspirin, 565 clopidrogel hyporesponsiveness and, 566 567 clopidrogel-omneprazole controversy, 567 568 atherosclerosis and, as process, 547 definition and presentation of, 548 cholesteryl ester transfer protein inhibitors for dyslipidemia, 568 core measure indicators and, 555 556 coronary angiopgraphy in, femoral access percutaneous transradial artery approach for, 563 565 implications for nursing, risk factor modification in, 554 555 management of, cardiac biomarkers in, 551 552 ECG in, 550 in STEMI, 553 554 in unstable anginal/nstemi, 552 553 new and evolving therapies for, 559 571 percutaneous transluminal coronary angioplasty for, 559 560 acute vessel closure and, 560 restenosis and, 560 secondary prevention, lifestyle modification, 555 medications on discharge, 554 555 patient and family education, 555 signs and symptoms of, 548 550 NSTEMI, 550 551 patients without chest pain, 548 550 STEMI, 550 551 unstable angina, 550 stents for, bare metal, 560 bioabsorbable polymer, 560 biodegradable, 563 drug-eluting, 561 562 endothelialization and, 561 polymer-free, 562 563 stent thrombosis from, 560 561 Acute ischemic stroke. See also Stroke comprehensive care of, 661 675 Crit Care Nurs Clin N Am 23 (2011) 687 694 doi:10.1016/s0899-5885(11)00067-0 ccnursing.theclinics.com 0899-5885/11/$ see front matter 2011 Elsevier Inc. All rights reserved.
688 Index Acute ischemic stroke care, anticoagulation in, 671 blood glucose control in, 668 interventions in, mechanical embolectomy, 672 thrombolytic therapy, 672 nursing care in, 670 671 pre-hospital, 665 666 primary stroke centers, certified, 672 criteria for certification, 665 temperature management in, 671 thrombolytic therapy in, 666 668 intra-arterial infusion of, 672 IV administration of, 668 Acute ishemic stroke. See also Stroke Acute renal failure (ACF), after heart valve surgery, 599 Ambrisentan, for pulmonary arterial hypertension, 654 Angina, signs and symptoms associated with, 549 Angiotensin-converting enzyme inhibitors (ACE), for unstable angina/nstemi, 553 Anticoagulation, for NSTEMI and unstable angina, 553 for pulmonary arterial hypertension, 653 for pulmonary thrombosis, low-molecular weight heparin, 625 tinzaparin, factor X inhibitor, 625 unfractionated heparin, 625 Antiplatelet therapy, for acute coronary sydrome, 565 568 Aortic regurgitation, 590 surgical intervention for, 593 Aortic stenosis, surgical intervention for, 592 593 symptoms of, 590 Aortic stenosis, cause of, 589 Aspirin, for acute coronary syndrome symptoms, 552 Atrial fibrillation, after heart surgery, 598 B Beta blockade, for unstable angina/nstemi, 553 Bleeding after heart valve surgery, 598 Bosentan, for pulmonary arterial hypertension, 654 C Calcium, cardiac functions of, 635 636 phosporus and, 639 Calcium channel antagonists, for pulmonary hypertension, 653 Cardiac biomarkers, for acute coronary syndrome, 551 552 Cardiac surgery patients, glucose control in, 678 679 Cardiac troponins, in acute coronary syndrome, 551 552 in cardiogenic shock, 624 Cardiogenic shock, 607 615 causes of, 607 608 definition of, 607 epidemiology of, 607
Index 689 mechanical circulatory support for, 611 612 extracorporeal membrane oxygenation in, 612 left ventricular assist devices in, 613 pathophysiology of, 608 610 hibernating myocrdium, 610 multiorgan dysfunction syndrome in, 610 stunned myocardium in, 610 systemic inflammatory resonse syndrome and, 610 reperfusion therapy for, 613 614 treatment of, circulatory support in, 611 613 hemodynamic monitoring in, 610 611 medications for, 611 Cardiopulmonary bypass, electrolyte disorders following, 640 Cardiovascular disease, in patient with diabetes, 677 Chronic renal failure (CHF), electrolyte disturbances and, 640 641 Clopidogrel, for NSTEMI patients, 553 Congestive heart failure, electrolyte disturbances and, 641 Coronary artery bypass surgery, 573 585 cardiopulmonary bypass in, cardioplegia type in, 578 complications of, 575 contraindications to, 575 576 decision-making algorithm for, 576 577 neurologic compromise or changes and, 576 578 studies of on-pump and off-pump, 575 578 conduits for, 580 greater saphenous vein, 578 579 internal thoracic artery, 579 580 radial artery, 579 future of, hybrid operating rooms, 581 582 intraoperative percutaneous intervention with, 581 582 robotics in, 581 goal of, 573 implications for nursing, bleeding evaluation, 583 heart rate and rhythm monitoring, 582 hemodynamic monitoring, 582 neurologic functioning, 583 pain management, 583 patient-family approach to care, 583 584 renal function, 583 in place of percutaneous coronary intervention, 574 overview of, classification in, 574 575 predictor of risk with, Society of Thoracic Surgeons database, 575 Costs, of hyperglycemia, 677 stroke-associated, 661 662 D Dehydration, electrolyte disturbances and, 640 Diabetes and cardiovascular disease. See also Glucose control prevalence of, 677 Diuretics, for pulmonary arterial hypertension, 653 Dyslipidemia, cholesteryl ester transfer protein inhibitors for, 568
690 Index E Electrolyte disorders, cardiac effects of, 636 640 electrolyte fuctions and, 635 636 in cardiac patients, 635 643 conditions causing, 640 641 in cardiac surgical patient, 640 Embolectomy, for pulmonary thrombosis, 627 Endothelin receptor antagonists, for pulmonary arterial hypertension, 654 Epoprostenol (Flolan), for pulmonary arterial hypertension, 655 Epoprostenol for injection (Veletri), for pulmonary arterial hypertension, 655 F Fluid volume overload, sodium levels and, 636 G Gastrointestinal problems, electrolyte disturbances and, 641 Glucoprotein IIbIIIa inhibitors, for NSTEMI patients, 553 Glucose control, in cardiac surgery patients, 678 679 in ICU patient, blood glucose variability and, 681 682 intensive insulin therapy for, 679 680 serum glucose threshols for, 679 680 transitioning from insulin infusions, 680 681 measurement issues in, medication effect, 682 point-of-care devices, 682 683 sample sire, 682 nursing practice issues, continuous blood glucose measurements, 684 implementation of insulin protocols, 683 management of insulin infusions, 683 684 H Heart valve disease, diagnosis of cardiac catheterization in, 592 chest radiography in, 591 echocardiography in, 592 electrocardiography in, 592 myocardial perfusion imaging in, 592 heart valves in, 587 588 indications for surgical intervention in, aortic stenosis, 592 593 mitral regurgitation, 594 mitral stenosis, 593 594 tricuspid valve disease, 594 NYHA classification of, 588 589 Regurgitation, aortic, 590 mitral, 591 pulmonic, 591 tricuspid, 591
Index 691 signs and symptoms of, 589 590 stenosis, aortic, 589 590 mitral, 590 pulmonic, 590 tricuspid, 590 surgical treatments for, 587 588 valvular insufficiency, 589 valvular stenosis, 588 590 Heart valve surgery, 587 605 approaches in, conventional valve surgery, 595 minimally invasive port-access endovascular cardiopulmonary bypass, 596 Ross procedure, 597 598 transcatheter aortic valve replacement, 597 598 complications in, 598 599 lifestyle changes following, 602 603 medical management option vs., 600 recovering from, breathing treatments in, 601 cardiac rehabilitation programs in, 602 chest tubes in, 600 discharge teaching in, 601 EKG monitoring in, 600 nutrition in, 601 pain medication in, 601 return to work and, 602 sexual activity and, 602 step-down unit in, 600 601 valve types for biological (tissue), 594 596 mechanical, 594, 596 Hypercalcemia, effects of, 637, 639 640 Hyperglycemia, cost of, 677 in ICU patient, risk for, 680 Hyperkalemia, effects of, 637 639 treatment of, 639 Hypermagnesemia, effects of, 640 Hypernatremia, cardiac effects of, 636 Hyperphosphatemia, effects of, 640 treatment of, 640 Hypertension, in type 2 diabetic patients, 677 Hypocalcemia, effects of, 637, 639 640 Hypoglycemia in ICU patient, risk for, 680 Hypokalemia, effects of, 637 639 medications causing, 639 treatment of, 639 Hypomagnesemia, effects of, 637 638 Hypophosphatemia, effects of, 640 I Iloprost, for pulmonary arterial hypertension, 655 Infection, postoperative in heart valve surgery, 599
692 Index L Lipoprotein metabolism, in type 2 diabetic patients, 677 M Magnesium, cardiac function of, 636 Mitral stenosis, cause of, 590 surgical intervention for, 593 594 symptoms of, 590 Mitral valve regurgitation, 591 surgical intervention for, 594 Morphine, for unstable angina/nstemi, 552 N Nitroglycerin IV, for unstable angina/nstemi, 552 Nosocomial infections, after heart valve surgery, 598 599 NSTEMI, definition of, 550 551 management of, 552 553 P Pancreatitis, electrolyte disturbances and, 641 Patient education, for patients and family, 555 Phosphodiesterase inhibitors, for pulmonary arterial hypertenion, 654 Phosphorus, cardiac function of, 636 Potassium, cardiac function of, 635 Prostacyclin, for pulmonary arterial hypertension, 654 655 Pulmonary arterial hypertension, 645 659 classification of, caused by lung disease or hypoxia, 646, 648 chronic thromboembolic pulmonary disease, 646, 648 649 initial and updated, 645-646 in left heart disease, 646, 648 ùnclear or multifactorial etiologies, 646, 649 collaboration with pulmonary hypertension center, 656 definition of, 645 646 evaluation process for, EKG in, 649, 652 physical examination in, 649 651 right heart catheterization in, 652 signs and symptoms in, 649 vasodilator testing in, 652 653 ventilation-perfusion scintigraphy in, 652 medical treatment of, 653 nursing implications, patient and family education, 656 657 pathology of, 649 pharmacologic interventions for, 656 anticoagulants, 653 calcium channel antagonists, 653 diuretics, 653 endothelin receptor antagonists, 654 phosphodiesterase inhibitors, 654 prostacyclin, 654 655
Index 693 risk factors and associated conditions in, 646 648 surgical interventions for, 655 Pulmonary embolism, 627 634 case study of TR, admission to telemetry unit, 617 618 in ICU, 627 628 last days on ICU and discharge home, 632 causes of, 618 diagnosis of, cardiac troponins in, 624 D-dimer measurement in, 624 imaging in, 624 tests in, 624 mechanical ventilation and, 628 atelectrauma from, 631 barotrauma from, 630 631 biotrauma from, 631 632 risks in, 628 629 ventilator-induced lung injry from, 628 629 pathophysiology of, 619 621 prevention of, anticoagulants for, 621 623 fondaoarinus for, 622 low-dose unfractionated heparin for, 622 623 low-molecular weight hepatin for, 621 623 mechanical prophylaxis techniques for, 620 621 pharmacologic prophylaxis for, 621 623 signs and symptoms of, 623 624 treatment of, anticoagulation, 625 catheter-based thrombus removal, 627 long-term, 627 surgical interventions, 627 thrombolysis, 625 626 vena cava filter, 626 627 venous thromboembolism and, 618 risk factors for, 618 619, 622 Pulmonic regurgitation, 591 Pulmonic stenosis, 590 R Recombinant tissue plasminogen activator (rtpa), for pulmonary thrombosis, 626 S Sildenafil, for pulmonary arterial hypertension, 654 Sodium, effects of, 636 fluid balance and, 636 STEMI, definition of, 550 551 implications for nursing, 554 555 management of, 553 554 fibrinolytics in, 553 554 percutaneous coronary intervention in, 553
694 Index Stroke. See also Acute ischemic stroke; Acute ischemic stroke clinical presentation of, 663 core measures for, 672 673 etiologies of, 663 incidence of, 661 pathophysiology of, 662 663 risk factors for, 663 664 systems of care for, 663 664 comprehensive stroke center, 664 665 primary stroke center, 663 665 types of, cardioembolic, 662 hemorrhagic, 662 ischemic, 662 thrombotic, 662 Systolic anterior motion, after heart valve surgery, 600 T Tadalafil, for pulmonary arterial hypertension, 654 Thrombolysis, for pulmonary thrombosis, 625 626 Transient ischemic attacks, 661 Treprostinil inhalation, for pulmonary arterial hypertension, 655 Treprostinil sodium for pulmonary arterial hypertension, 655 Tricuspid regurgitation, 591 Tricuspid stenosis, 590 Tricuspid valve disease, surgical intervention for, 594 U Unstable angina, classifications of, 550 diagnosis of, 550 management of, 552 553 V Vena cava filter, for pulmonary thrombosis, 626 627 Ventilator-associated pneumonia (VAP), after heart valve surgery, 599 Ventilator-induced lung injury, 617 634 Vitamin K antagonist (VKA), for pulmonary thrombosis, 626