Page 271 - ACCCN's Critical Care Nursing

248 P R I N C I P L E S A N D P R A C T I C E O F C R I T I C A L C A R E

Learning activities
1. Discuss the various categories included under the umbrella 7. Discuss the compensatory mechanisms that are activated in
‘acute coronary syndrome’, including their identifying and dif- heart failure and their effect on the cardiovascular system.
ferentiating features. 8. Why did the patient in the case study meet the criteria for
2. Differentiate common versus prognostic symptoms of acute implantation of an ICD with CRT?
coronary syndrome. 9. In the case study, when the patient was discharged from hos-
3. Describe the nursing care for a patient undergoing primary pital, why were they prescribed perindopril, bisoprolol, spi-
PTCA. ronolactone and frusemide? Include in your answer the reason
4. Identify the common complications of myocardial infarction in for prescribing these medications and their actions and major
the early recovery period. side effect.
5. Why is silent ischaemia more common in patients with CHD 10. Observe an echocardiograph and ask the sonographer to
and diabetes? explain what is visualised on the screen, particularly in Doppler
6. In the case study, what is the significance of an S3 heart sound mode. Ask them to identify areas of hypokinesis or akinesis and
in the clinical setting of heart failure? any evidence of dyssynchrony between the ventricles.

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