Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires
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Can J Cardiovasc Nurs · Jan 2007
Review Comparative StudyLow-fat or low-carbohydrate diet for cardiovascular health.
Obesity is a major, modifiable risk factor for cardiovascular disease. Climbing obesity rates are leaving Canadians at increased risk for disability, disease and premature death. This has led to increased interest in dietary interventions to control weight and reduce obesity. ⋯ The marketing strategies of diet promoters have led consumers and health care professionals to consider the benefits and risks of these diets for cardiovascular health. The purpose of this paper is to compare the traditional low-fat diet with one such dietary innovation -- the low-carbohydrate diet. Research studies are reviewed to provide some evidence for practice in assisting patients to improve cardiovascular health through weight loss.
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Can J Cardiovasc Nurs · Jan 2007
ReviewNeurocognitive dysfunction post-cardiac surgery and the neuroprotective effects of erythropoietin.
Neurocognitive dysfunction is a common postoperative complication exacerbated by cardiopulmonary bypass triggering a systemic inflammatory response. This clinical column focuses on the up-regulation of endogenous erythropoietin related to neurological inflammation and the use of recombinant erythropoietin as a neuroprotective pharmacotherapeutic agent.
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Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiovascular death in young people. Myectomy is the gold standard treatment for hypertrophic obstructive cardiomyopathy (HOCM). ⋯ Outcomes after myectomy, as well as alternative therapies such as percutaneous septal ethanol ablation and pacing are compared. Nursing management of patients after myectomy is discussed.
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Can J Cardiovasc Nurs · Jan 2007
Cardiovascular nurse practitioner practice: results of a Canada-wide survey.
Despite an increase in the number of nurse practitioners (NPs) practising within the realm of cardiovascular care, roles and responsibilities of cardiovascular NPs in similar areas appear to be vast and variable. With the recent changes in certification and regulation of the NP role by the Canadian Nurses Association, there has been an attempt to standardize patient care practices. In the spring of 2005, the University of Alberta Hospital-based cardiovascular NPs conducted a national survey. ⋯ However, reporting structure, patient workload, clinical, educational, administrative, and research responsibilities were more diversified. The results of the survey may facilitate a better understanding of the NP role within the health care setting and in cardiovascular care. In turn, the findings may provide a basis by which to establish a template for developing future NP roles or enhancing existing NP roles in cardiovascular centres across Canada.
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Can J Cardiovasc Nurs · Jan 2006
Controlled Clinical TrialChange in practice patterns in the management of diabetic cardiac surgery patients.
Diabetes and elevated blood glucose (BG) levels > 11.1 mmol/L in the acute post-operative period have been identified as risk factors for surgical site infections (SSI) and nosocomial infections (Furnary, Zerr, Grunkemeir, & Starr, 1999; American College of Endocrinology consensus guidelines for glycemic control, 2002). Some studies have suggested that intensive insulin therapy reduced in-hospital mortality and that a continuous insulin infusion should be a standard of care for diabetic cardiac surgery patients (Furnary et al., 2003; Brown & Dodek, 2001). Our urban tertiary care teaching hospital initiated an insulin nomogram in the intensive care unit intending to more effectively control blood glucose (BG) levels in cardiac surgical patients. ⋯ However, target glucose (6.1-10.0 mmol/L) was exceeded in 45% of patients in the intervention group, 65% in the control group as well as 42% of patients on the ward. The insulin nomogram is now initiated as soon as the BG is obtained immediately following patient transfer from the operating room (OR). There is more aggressive use of sliding scale insulin, and earlier resumption of pre-operative diabetic regimens on the ward.