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Cardiac Surgery Essentials for Critical Care Nursing (Hardin, Cardiac H K Cardiac Surgery Cardiac Surgery FOR FOR Critical Care Nursing Essentials Critical Care Nursing S R. H R K Cardiac Surgery $BSEJBD4VSHFSZ&TTFOUJBMTGPS$SJUJDBM$BSF/VSTJOHJTBOFWJEFODFCBTFEGPVOEBUJPO GPSDBSFPGUIFQBUJFOUEVSJOHUIFWVMOFSBCMFQFSJPEJNNFEJBUFMZGPMMPXJOHDBSEJBD TVSHFSZ"DPNQSFIFOTJWFSFTPVSDF UIJTUFYUTFSWFTBTBCVJMEJOHCMPDLGPSOVSTFT CFHJOOJOHUPDBSFGPSDBSEJBDTVSHFSZQBUJFOUT BTXFMMBTBTPVSDFPGBEWBODFE FOR LOPXMFEHFGPSOVSTFTXIPIBWFNBTUFSFEUIFFTTFOUJBMCBTJDTLJMMT*UBEESFTTFT Essentials TJHOJ¾DBOUDIBOHFTJODBSEJBDTVSHFSZBOEUIFOVSTJOHSFTQPOTJCJMJUJFTUPNFFUUIF OFFETPGUIFTFBDVUFMZJMMQBUJFOUT BTXFMMBTBEWBODFTBOETUSBUFHJFTUPPQUJNJ[F Essentials QBUJFOUPVUDPNFTJOUIJTEZOBNJD¾FME Critical Care Nursing 5IFQFSGFDUTUVEZBJEGPSUIPTFSFBEFSTQSFQBSJOHGPSUIF""$/µT$BSEJBD4VSHFSZ $FSUJ¾DBUJPO UIJTCPPLGFBUVSFTDSJUJDBMUIJOLJOHRVFTUJPOT NVMUJQMFDIPJDFTFMG BTTFTTNFOURVFTUJPOT 8FCSFTPVSDFT DMJOJDBMJORVJSZCPYFT BOEDBTFTUVEJFT "-40"7"*-"#-& 5IF&,()BOECPPL &TTFOUJBMTPG1FSJPQFSBUJWF 5IFSFTB".JEEMFUPO#SPTDIF /VSTJOH 'PVSUI&EJUJPO *4#/ $ZOUIJB4QSZ *4#/ 'PSBDPNQMFUFMJTUJOHPG/VSTJOHUJUMFTWJTJUwww.jbpub.com/nursing S R. H ISBN: 978-0-7637-5762-5 R K 57625_CH00_FM_i_x.pdf 4/10/09 11:09 AM Page i Cardiac Surgery Essentials FOR Critical Care Nursing &EJUPST Sonya R. Hardin, PhD, RN, CCRN, ACNS-BC, NP-C "TTPDJBUF1SPGFTTPS 4DIPPMPG/VSTJOH $PMMFHFPG)FBMUIBOE)VNBO4FSWJDFT 6OJWFSTJUZPG/PSUI$BSPMJOBBU$IBSMPUUF $IBSMPUUF /PSUI$BSPMJOB 4UBGG/VSTF %BWJT3FHJPOBM.FEJDBM$FOUFS 4UBUFTWJMMF /PSUI$BSPMJOB Roberta Kaplow, PhD, RN, AOCNS, CCNS, CCRN $MJOJDBM/VSTF4QFDJBMJTU &NPSZ6OJWFSTJUZ)PTQJUBM "UMBOUB (FPSHJB 57625_CH00_FM_i_x.qxp:57625_CH00_FM_i_x 3/22/10 11:06 AM Page ii World Headquarters Jones and Bartlett Publishers Jones and Bartlett Publishers Jones and Bartlett Publishers 40 Tall Pine Drive Canada International Sudbury, MA 01776 6339 Ormindale Way Barb House, Barb Mews 978-443-5000 Mississauga, Ontario L5V 1J2 London W6 7PA [email protected] Canada United Kingdom www.jbpub.com Jones and Bartlett’s books and products are available through most bookstores and online booksellers. To contact Jones and Bartlett Publishers directly, call 800-832-0034, fax 978-443-8000, or visit our website www.jbpub.com. Substantial discounts on bulk quantities of Jones and Bartlett’s publications are available to corpora- tions, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones and Bartlett via the above contact informa- tion or send an email to [email protected]. Copyright © 2010 by Jones and Bartlett Publishers, LLC All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precau- tions, and contraindications, and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used. Production Credits Publisher: Kevin Sullivan V.P., Manufacturing and Inventory Control: Acquisitions Editor: Emily Ekle Therese Connell Acquisitions Editor: Amy Sibley Composition: Shepherd, Inc. Associate Editor: Patricia Donnelly Cover Design: Scott Moden Editorial Assistant: Rachel Shuster Cover Image: © Vividfour/Shutterstock, Inc. Associate Production Editor: Sarah Bayle Printing and Binding: Malloy, Inc. Senior Marketing Manager: Barb Bartoszek Cover Printing: Malloy, Inc. Library of Congress Cataloging-in-Publication Data Cardiac surgery essentials for critical care nursing / [edited by] Sonya R. Hardin, Roberta Kaplow—1st ed. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-7637-5762-5 ISBN-10: 0-7637-5762-4 1. Heart—Surgery—Nursing. I. Hardin, Sonya R. II. Kaplow, Roberta. [DNLM: 1. Heart Diseases—nursing. 2. Cardiac Surgical Procedures—nursing. 3. Critical Care—methods. WY 152.5 C26737 2009] RD598.C3455 2009 617.4’120231—dc22 2009001294 6048 Printed in the United States of America 14 13 12 11 10 10 9 8 7 6 5 4 3 2 57625_CH00_FM_i_x.pdf 4/10/09 11:09 AM Page iii Dedication This book is dedicated to Jack, Eleanor, Susan, Ray, Grace, Princess, Pauline, James, and Bria. We are grateful for your love, support, patience, and encouragement as we worked the production of this book. A special thanks to James R. Perron, PE, our medical illustrator, who was responsive to all of our late-hour requests and showed great patience with our attention to detail. He was a true asset to the development of this book. 57625_CH00_FM_i_x.pdf 4/10/09 11:09 AM Page iv 57625_CH00_FM_i_x.pdf 4/10/09 11:09 AM Page v Contents Contributors.................................................................................................... vii Preface ............................................................................................................ ix Chapter 1 Clinical Judgment in Critical Care .................................................................... 1 Susan K. Chase Chapter 2 Cardiovascular Anatomy and Physiology.......................................................... 13 Susan K. Chase Chapter 3 Indications for Cardiac Surgery ........................................................................ 27 Kristine J. Peterson Chapter 4 Preoperative Cardiac Surgery Nursing Evaluation ............................................ 53 Roberta Kaplow, Sonya R. Hardin, Brenda Hardin-Wike, and Timothy E. McMurry Chapter 5 Heart Valve Surgery ........................................................................................ 73 Catherine Drumm and Kristine J. Peterson Chapter 6 Minimally Invasive Cardiac Surgery .................................................................. 93 Jenniffer Hughes and Kirsten Platt Chapter 7 Cardiopulmonary Bypass and Off-Pump Coronary Artery Bypass .................... 115 Julie Miller Chapter 8 Recovery from Anesthesia................................................................................ 127 Toni Patrice Johnson Chapter 9 Hemodynamic Monitoring .............................................................................. 145 Mary Zellinger Chapter 10 Intra-aortic Balloon Pump................................................................................ 165 Barbara Hutton-Borghardt Chapter 11 Mechanical Ventilation After Cardiac Surgery .................................................. 185 Mary Jane Bowles Chapter 12 Pharmacologic Support Following Cardiac Surgery .......................................... 205 Timothy E. McMurry, Roberta Kaplow, and Sonya R. Hardin v 57625_CH00_FM_i_x.pdf 4/10/09 11:09 AM Page vi vi Contents Chapter 13 Postoperative Complications of Cardiac Surgery and Nursing Interventions .... 257 Beverly Jones Chapter 14 Pain Management............................................................................................ 287 Susan Lynch Chapter 15 Postoperative Dysrhythmias ............................................................................ 309 Roberta Kaplow and Dawn B. Adams Chapter 16 Neurologic Complications................................................................................ 323 Myra F. Ellis Chapter 17 Fluid and Electrolyte Imbalances Following Cardiac Surgery ............................ 345 Carol Isaac MacKusick Chapter 18 Wound Care .................................................................................................... 371 Mary Zellinger and Vicki Morelock Chapter 19 Bridge to Transplant and Cardiac Transplantation .......................................... 393 Rachel S. Ball, Kathy Halabicky, Laurie Hartman, Erin Lindstrom, and Tracey Romans Glossary .......................................................................................................... 433 Index .............................................................................................................. 445 57625_CH00_FM_i_x.qxp:57625_CH00_FM_i_x 3/22/10 11:06 AM Page vii Contributors Dawn B. Adams, RN, MSN, CCRN Kathy Halabicky, RN, MSN, ACNP Clinical Nurse Specialist Nurse Practitioner Project Coordinator Cardiac Surgery Critical Care DeKalb Medical University of Michigan Medical Center Decatur, GA Ann Arbor, MI Rachel S. Ball, RN, MSN, ACNP Brenda Hardin-Wike, RN, MSN, CCRN, CCNS Nurse Practitioner Unit Director CTICU 7 ICU Cardiac Surgery Critical Care University of California at Los Angeles University of Michigan Medical Center Ronald Reagan Medical Center Ann Arbor, MI Los Angeles,
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