Cardiac Care: A General Update for Nurses
- : Brisbane City QLD 4000
2-Day Seminar - How to Manage Common Cardiac Conditions in all Clinical Settings
How often do you look at your handover sheet and see the following included in the past history of your patient? AF; IHD; HTN; hypercholesterolemia; or mild renal impairment? Sound familiar? The prevalence of cardiovascular disease in Australia means it is a common co-morbidity in many patients, not just those who are hospitalised because of an acute cardiac condition. If you work in general nursing and regularly care for patients with cardiac conditions, attend this seminar to improve your confidence and knowledge of the following:
- How can basic dysrhythmias be easily identified?
- What are the latest guidelines for the immediate nursing management of chest pain?
- When may ‘low blood pressure’ actually be cardiogenic or hypovolaemic shock?
- Why are fluid restrictions and daily weights essential for patients with heart failure?
- Preventing mild renal impairment from progressing to acute renal failure
Attend this seminar if you work in non-cardiac specific ward or unit but you regularly care for patients with underlying cardiac disease. If you work in a cardiac speciality area this seminar may be a useful refresher of existing knowledge.
Need for Program
According to the Australian Institute of Health and Welfare (AIHW 2016) nearly half a million hospital admissions in 2014-2015 were specifically related to the circulatory system, including arrhythmia, heart failure, heart attacks, angina and stroke. Of the other 10 million hospitalisations in Australia, underlying cardiac disease is likely to feature in many patients who are admitted for other reasons. As such, nurses who work in general non-cardiac settings units are frequently required to care for patients with underlying complex cardiac conditions. It is therefore, essential that all nurses remain up to date in the evidenced care of patients with underlying cardiac co-morbidities.
Purpose of Program
The purpose of this seminar is to provide education to nurses who work in non-cardiac areas about the assessment and management of common cardiac co-morbidities so as to improve outcomes for patients.
Your Learning Outcomes
- You will have greater confidence in assessing a patient with an underlying cardiac co-morbidity
- Patients in your care will have basic dysrhythmias prevented through early management of electrolyte imbalances
- Immediate nursing assessment and management of chest pain will reflect current guidelines
- Knowledge of cardiac function will assist you to recognise hypovolaemic and cardiogenic shock early to prevent complications
Schedule Day One
8:30am - Registration and Refreshments
Welcome, Overview of Seminar and Pre-Test
Back to Basics - Cardiac Anatomy and Physiology
No matter where you work, some of your patients are likely to present with underlying or acute cardiac disease - as a primary or secondary diagnosis. This introductory revision session will provide the foundation for understanding cardiac disorders as a comorbid or preexisting condition. It will review the anatomy and physiology related to common cardiac disorders. Includes:
- Revision of cardiac anatomy and physiology including:
- Cardiac cycle and its relation to the ECG
- Assessment of cardiac output and its relation to vital signs, including explanation of the key terms
Assessing the Cardiovascular System and Common Diagnostic Procedures
Physical examination techniques elicit a significant portion of data from which to generate a nursing assessment. This session focuses on the physical assessment of the heart and cardiovascular system. It includes non-invasive diagnostic procedures which can assist in understanding and interpreting a patient’s diagnosis. This practical session includes demonstration and discussion of the following:
- Obtaining a history - the importance of good listening and questioning skills
- Physical examination - general inspection, palpation, and auscultation techniques
- Examination of the heart and chest landmarks
- Heart sounds - how, where, and what to listen to
- Chest X-Rays - what to look for, and understanding the significance of abnormal findings
11:00am - Morning Tea and Coffee
Electrocardiography - ECGs Explained
In this session we will review the basic underlying principles and the normal criteria for interpreting a 12 lead ECG. You will learn how to systematically read an ECG to determine and identify abnormalities and their significance. It will explain the theory and practical application of the following concepts:
- Basic ECG principles - lead placement and key terms explained
- Criteria for normality of the different components of the ECG
- Determination of cardiac rate
- Normal R-wave progression and how to interpret the different QRS configurations
Includes a practical session where you will have time to systematically analyse a normal 12 lead ECG.
1:15pm - Lunch Break and Networking
Ischaemic Heart Disease - Causes, Assessment and Immediate Management of Chest Pain
Patients being cared for in all areas may experience cardiac ischaemia due to a variety of underlying factors. In this session we will discuss the atherosclerotic process, and how it relates to ischaemic heart disease. We will then take a look at the assessment and immediate nursing management of chest pain, including the current evidenced use of oxygen. You will also be given an opportunity to practice your ECG interpretation skills in the context of a patient with ischaemic heart disease. Includes:
- What are the modifiable and unmodifiable risk factors for heart disease?
- A closer look at hypercholesterolemia and atherosclerosis
- How to differentiate types of chest pain
- Acute myocardial infarction - what is a STEMI versus a NSTEMI?
Includes a practical session where you will have time to systematically analyse an abnormal 12 lead ECG.
3:15pm - Afternoon Tea and Coffee
Dysrhythmias - Recognising Rate Disturbances
There are a wide variety of dysrhythmias caused by a range of factors, not just cardiac dysfunction. Rate disturbances can have profound implications and be a reason for acute deterioration. Recognising such life threatening changes is essential. In this session, we will review and discuss the basic and life-threatening dysrhythmias you may encounter, as well as the common treatment modalities for each. Includes a look at:
- Basic cardiac dysrhythmias and how to identify them
- Common treatment modalities for each of the dysrhythmias
This session includes rhythm strip exercises that will assist you to apply your theory to practice.
Final Questions and Wrap Up
4:30pm - Close of Day One of Seminar
9:00am - Commencement of Day Two
Review of Day One and Introduction to Day Two
Day two of the seminar will commence by providing you with an opportunity to ask questions and review principles which relate to your learning from day one. It will also introduce you to the program for day two.
Valvular heart disease is a cardiac abnormality and often leads to co-morbidities in patients. In this interesting and fun session, we will briefly discuss valve dysfunction, and the sequence of events that may lead to heart failure. We will put theory into practice with a practical application of heart murmurs and symptomatology to determine the type and extent of valve dysfunction. Topics to be included in this session:
- What is the difference between stenosis, incompetence or regurgitation?
- How can the following types of valvular dysfunction be assessed and what are the symptoms of each?
- What are common sequence of events seen in valve dysfunction?
This session will provide a practical opportunity using case scenarios to determine which valve and what dysfunction may be present.
10:15am - Morning Tea and Coffee
Hypovolaemic and Cardiogenic Shock - Clinical Syndromes Explained
Patients with cardiac disease may become unwell rapidly. Whilst you may assess the patient as having low blood pressure, the underlying pathophysiology is likely to be much more complex. This session will take a simple look at two common causes of deterioration - hypovolaemic and cardiogenic shock. It will look at the assessment, management, prevention and treatment of these two presentations. Includes:
- Hypovolemic shock - more than just ‘low blood pressure’
- Assessment, management, prevention and treatment of cardiogenic shock
- How do complications such as acute respiratory distress syndrome (ARDS) and renal impairment develop?
- A brief look at how these types of shock differ to other types of shock
Heart Failure - A Case Study
Heart failure is often the result of a combination of other disorders and may lead to numerous other system failures or complications in patients. In this session we will discuss the assessment, management and common treatment options that you need to be aware of in the patient presenting with heart failure. This session will also differentiate between left and right, and congestive heart failure. Includes:
- A common review of key principles underpinning heart failure
- How is a patient with cardiac failure assessed?
- What is the difference between left, right sided and congestive heart failure?
- What are the sequence of events in heart failure and how might these present in symptoms?
- Putting it all together - fluid restrictions, daily weights and other aspects of nursing care
1:00pm - Lunch Break and Networking
Systemic Hypertension - Time to Extend Your Knowledge
Hypertension in any patient is considered a risk factor for heart disease. Hypertension in its various forms is also a common risk factor for most other non-cardiac patients. In this session we will discuss the normal parameters, assessment and management of systemic hypertension. Extend your knowledge of this common condition. Topics include:
- Time to test your knowledge - a quick revision of key terms relating to blood pressure
- What are the types and risk factors for hypertension?
- More than just a cuff reading? Assessment, identification and management of systemic hypertension
- What are potential complications of poorly controlled systemic hypertension?
Metabolic Disturbances - Electrolytes and Rhythm Changes
Electrolyte disturbances can have a profound effect on the heart, and result in life-threatening disorders. It is imperative that nurses who are caring for patients with underlying cardiac disease understand electrolyte balance and recognise common imbalances. In this session we will review electrolytes that have an effect on the heart, and explain how to identify abnormalities. We will also explore common treatments for electrolyte disturbances. Includes:
- What are the four essential electrolytes and why are these vital to heart function?
- How can you identify serum electrolyte imbalances on a rhythm strip or ECG?
- Common treatment modalities for serious or life-threatening electrolyte imbalances
3:15pm - Afternoon Tea and Coffee
Mild to Moderate Renal Impairment
Renal impairment is a co-morbidity in patients with cardiac disease. Renal impairment must be well understood as it closely relates to the heart and can be worsened if cardiac function deteriorates. In this session we will briefly discuss the assessment, management and nursing actions to be taken in a patient presenting with varying degrees of renal impairment. Includes:
- Revision of related anatomy and physiology of the kidneys
- Basic explanation of the role and functions of the kidney
- Renal impairment - how is it assessed and what is the significance of urea and creatinine?
- Treatment, management and management of mild to moderate renal impairment
- What do nurses need to know to prevent mild or moderate renal impairment exalting to acute renal failure?
Final Wrap Up and Completion of Post-Test Quiz
4:30pm - Close of Seminar and Evaluations
Sue de Muelenaere
Sue de Muelenaere is a Registered Nurse with 15 years’ experience as a Nurse Educator. Sue completed a five year Bachelor of Nursing degree in South Africa which included training in psychiatric and community nursing and midiwfery. Since then Sue has worked extensively in the intensive care environment, during which she has presented various courses, including an Honour’s degree, a Diploma in Intensive Care and various short cardiac and ECG courses. Sue also holds an Honour’s degree in Advanced Nursing Science (Intensive Care Nursing) and Diplomas in Nursing Education and Nursing Administration. She was the Education Manager in a specialised heart hospital where she was responsible for the education of all hospital staff, including non-nursing staff members. Sue is passionate about teaching, and maintains a special interest in all aspects of nursing the critically ill patient.