The Journal of cardiovascular nursing
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Preventive therapies have been shown to reduce morbidity and mortality from cardiovascular disease. However, health care providers are not addressing prevention and not treating patients according to evidence-based guidelines. ⋯ The skills and attributes of the health care provider, such as expertise and knowledge, skills for assessing readiness for behavior change, relationship building skills, and skill in considering the patient's attitudes and beliefs about the disease or treatment are discussed. Principles of communication to guide the patient-provider encounter, key behavioral change strategies, and use of technology are reviewed and resources available to support prevention goals are presented.
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Sleep problems and symptoms of sleep disturbance are very prevalent in patients with heart failure (HF). Numerous contributing factors include sleep-related breathing disorders, increasing age, medications, anxiety and depression, and comorbidities. Thus, the cardiovascular nurse has an important role in the recognition and management of sleep-related problems in persons with HF. This article provides an overview of sleep disturbances in patients with HF, suggests evidence-based strategies for managing the sleep problems, and identifies pertinent areas for future nursing inquiry.
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During the last three decades, community education programs have been initiated with the purpose of teaching community citizens cardiopulmonary resuscitation (CPR). Millions of people have learned the technique. However, the frequency of bystander initiated CPR prior to emergency medicine service (EMS) arrival is still very low. ⋯ However, this does not seem to be the case, as there are indications in recent research, for example, that the will to help and the courage to intervene are also needed. Bystanders who intervene in a cardiac arrest event improve the victim's chance of survival. However, there is little knowledge regarding the rescuers' reactions concerning their performance and whether they will overcome the trauma of the event and be prepared to do it again.
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Venous thrombosis involving the deep veins is a major US health problem that affects over 2.5 million people annually. The most serious complication of a deep venous thrombosis (DVT) is pulmonary embolism (PE), which is associated with 50,000 to 200,000 deaths each year. ⋯ Then it reviews treatment of DVT, highlighting the nurse's role. A discussion of DVT prophylaxis based on patient risk follows.
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The measurement of the pressure of exhaled carbon dioxide (PetCO2) via capnography has several useful hemodynamic applications. This article discusses integrating PetCO2 values with hemodynamic assessment. Capnography can be applied to hemodynamic assessment in three key ways: (1) identification of end-expiration during pulmonary artery and central venous pressure measurements, (2) assessment of pulmonary perfusion and alveolar deadspace, (3) assessment of cardiopulmonary resuscitative efforts. The article presents research, sample waveforms for end-expiration identification, and case examples.