Preface ix
Acknowledgements xi
1 The Anatomy and Physiology of the Cardiovascular System 1
Introduction 1
The Cardiovascular System 2
The Anatomy and Physiology of the Cardiovascular System 2
The Blood Vessels 2
Components of Blood 6
Characteristics and Composition of Blood 8
Functions of Blood 8
Formation of Blood Cells 9
Red Blood Cells 9
White Blood Cells 12
Platelets 13
Haemostasis and Coagulation 14
Blood Groups 14
The Lymphatic System 15
Lymphatic Organs 17
The Size and the Location of the Heart 18
Structure of the Heart 19
Blood Flow Through the Heart 21
Coronary Arteries and Veins 23
Conducting System of the Heart 24
The Cardiac Cycle 26
Cardiac Output 28
Nerve Supply to the Heart 28
Chemical Regulation of the Heart 29
Baroreceptors and the Cardiovascular Centre 30
Other Factors Affecting Heart Rate Regulation 30
Conclusion 31
Glossary of Terms 31
Multiple Choice Questions 32
References 34
2 Engaging with Patients and Assessing the Cardiovascular System 35
Introduction 35
Understanding the Patient's Perspective 35
Cultural Sensitivity 35
Health Literacy 36
Emotional Responses 37
Subjective and Objective Data 40
Assessing the Cardiovascular System 40
History Taking: A Comprehensive Approach to ¿Cardiovascular Assessment 41
Enhancing Communication During History Taking 45
Cardiovascular Examination 45
Preparation to Undertake the Assessment 45
The Physical Examination 47
Inspection 47
Palpation 48
Auscultation 48
Blood Pressure and Pulse 50
Peripheral Vascular System 50
Special Tests 50
Documentation and Interpretation 51
Conclusion 51
Glossary of Terms 52
Multiple Choice Questions 53
References 54
3 Health Promotion 56
Introduction 56
Cardiovascular Mortality 57
Health Promotion 57
Key Components of Health Promotion 57
Policy Development 57
Addressing Socioeconomic Disparities 58
Public Health Outcomes 59
Urban and Environmental Planning 59
Preventive Healthcare and Education 59
Health Literacy and Cardiovascular Disease 59
Improving Health Literacy to Address Cardiovascular Disease 62
Risk Factors Associated with Cardiovascular Disease 64
The Role of the Healthcare Practitioner 66
Strategies for CVD Health Promotion 67
Health Screening 71
Supporting Behaviour Change 71
Conclusion 73
Glossary of Terms 74
Multiple Choice Questions 75
References 76
4 Planning Care: Hypertension 79
Introduction 79
Patient-centred Care 79
Shared Decision-making 80
Hypertension 81
Primary and Secondary Hypertension 82
Signs and Symptoms 83
Risk Factors 84
Assessment 84
Planning Care 91
Evaluation 94
Conclusion 95
Glossary of Terms 95
Multiple Choice Questions 96
References 98
5 Vital Signs 99
Introduction 99
Informed Consent 101
Assessing Competence to Consent in Cardiovascular Care 101
Voluntary Consent in Life-critical Circumstances 101
Cultural and Personal Considerations 102
The Role of Shared Decision-making 102
Ethical Challenges in Cardiovascular Consent 102
Procedures 102
Blood Pressure 103
Lying and Standing Blood Pressure 105
Pulse 107
Respiration 109
Temperature 110
Influencing Factors 111
Oxygen Saturations 112
Factors Affecting Pulse Oximetry 112
Preparation and Equipment 113
Undertaking Pulse Oximetry 113
Interpretation of Results 114
Summary of Interpretation 115
Raising Concerns When Assessing Vital Signs 117
Barriers to Raising Concerns in Cardiovascular Contexts 118
Documentation and Communicating Findings 118
Post-care 119
Conclusion 121
Glossary of Terms 121
Multiple Choice Questions 122
References 124
6 The Electrocardiograph 125
Introduction 125
The Cardiac Cycle 125
What It Is - Definition 126
Consent and Explanation 128
Procedure 129
Three-lead ECG 131
Five-lead ECG 131
Twelve-lead ECG 131
The Limb Leads 134
Einthoven's Triangle 134
Modified 12-lead ECG Placement 136
Recording the ECG 136
Specialised Types of ECG 137
Telemetry 139
Interpretation of ECG Results 139
Documentation 142
Post-care 144
Raising Concerns 145
Conclusion 146
Glossary of Terms 147
Multiple Choice Questions 149
References 150
7 Cardiopulmonary Resuscitation 151
Introduction 151
What It Is - Definition 151
Pathophysiology of Cardiac Arrest 152
Pathophysiological Progression of Cardiac Arrest 155
Consent and Explanation 157
Cardiopulmonary Resuscitation and Recommended Summary Plan for Emergency Care and Treatment 157
Basic Life Support 162
Performing Cardiopulmonary Resuscitation 165
Continuing Cardiopulmonary Resuscitation 166
Using an Automated External Defibrillator 166
Signs of Regaining Consciousness 167
Advanced Life Support 167
Pharmacology in Resuscitation 171
Interpretation of Results: Ceasing Cardiopulmonary Resuscitation Efforts 172
Unequivocal Criteria 173
Additional Considerations for Decision-making 173
Factors That Should Not Solely Determine Cardiopulmonary Resuscitation Termination 173
Documentation 174
Post-care 175
Immediate Post-cardiopulmonary Resuscitation Care 175
Care for the Family 175
Supporting Healthcare Staff 177
Consideration of Organ Donation 178
Raising Concerns 178
Before Cardiopulmonary Resuscitation: Identifying and Addressing Concerns 180
During Cardiopulmonary Resuscitation: Raising Concerns ¿in a High-pressure Environment 180
After Cardiopulmonary Resuscitation: Reflecting, Reporting ¿and Supporting Staff and Families 181
Creating a Culture of Openness and Patient-centred Care 181
Conclusion 182
Glossary of Terms 182
Multiple Choice Questions 183
References 185
8 Medicine Management: The Cardiovascular System 187
Introduction 187
Medicine Management 187
Medicine Optimisation in Practice 188
Medicine Management 189
Legal, Ethical and Professional Responsibilities 192
Pharmacology 195
Pharmacokinetics, Pharmacodynamics and the Cardiovascular System 196
Pharmacokinetics in Cardiovascular Drugs 197
Pharmacodynamics in Cardiovascular Drugs 198
Developing Safe Medicine Management Skills 199
Interpretation of Results 200
Documentation 200
Post-care 204
Raising Concerns 205
Patient-specific Contraindications 206
Conclusion 207
Glossary of Terms 207
Multiple Choice Questions 209
References 210
MCQ Answers 212
Index 213
