Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires
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Can J Cardiovasc Nurs · Jan 2013
ReviewExposing barriers to end-of-life communication in heart failure: an integrative review.
End-of-life (EOL) communication is lacking despite patients with heart failure (HF) and their caregivers desiring it. ⋯ The challenge of diagnosing and prognosticating HF, its unpredictable trajectory, HCP inexperience in recognizing nearing EOL and lack of communication skills lead to HCPs avoiding EOL conversations. Four categories of barriers to communication were identified: patient/caregiver, HCP, disease-specific and organizational challenges.
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Can J Cardiovasc Nurs · Jan 2009
Review Case ReportsDysphagia following cardiovascular surgery: a clinical overview.
The objective of this clinical paper is to enhance nurses' understanding of normal swallowing physiology and post-operative swallowing impairments (dysphagia) in patients following cardiovascular surgery. Ultimately, the goals of dysphagia assessment and management are to prevent pulmonary complications secondary to aspiration and to ensure safe and adequate nutritional intake and hydration. ⋯ Clinical and instrumental dysphagia assessment methods are reviewed. A case report is used to illustrate the benefit of nursing involvement in the care of a patient with dysphagia following cardiovascular surgery.
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Can J Cardiovasc Nurs · Jan 2008
ReviewWomen's experiences of cardiac pain: a review of the literature.
Women experience coronary heart disease (CHD) differently than men. Presentations of cardiac pain for women can include vague signs and symptoms such as extreme fatigue, discomfort in the shoulder blades, and shortness of breath. Subsequently, the assessment, identification, treatment, and rehabilitation of women with CHD present challenging and unique opportunities for nurses because women experience a multiplicity of symptoms that are often not reported or recognized as cardiac in nature. Women have higher rates of functional disability and a lower prevalence of obstructive coronary heart disease, as evidenced by coronary angiogram, than men. It is important to understand the complexities of women's presentations of cardiac pain if nurses are to improve the quality of health experienced post diagnosis, treatment, and rehabilitation. ⋯ Results of this review revealed that women experience cardiac pain differently than men. Different cardiac pain experienced by women leads to misunderstandings of warning signs and symptoms of myocardial infarction and ischemic cardiac pain. Moreover, women do not recognize the threat of CHD, even with significant family history, and delay seeking health care for signs of acute myocardial infarction. Further research and education are warranted. Nurses need to challenge the antiquated assumptions surrounding women's experiences of cardiac pain. Clinicians must be cognizant of the importance of a thorough patient assessment, the ability to identify women at risk, individualizing the person's CHD experience, and providing health promotion strategies that educate women to recognize the signs and symptoms of CHD. Studies that identify the educational needs specific to women and cardiac pain are necessary. Educational intervention studies promoting health-related behaviour change that targets cardiac pain recognition for women are imperative. Future research examining whether the experience of changes in cardiac pain over time and post-intervention(s) need to be conducted.
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Pulmonary hypertension (PH) is a progressive disease resulting from increased pulmonary vasoconstriction, vascular remodelling and thrombosis, leading to right heart failure. Symptoms at clinical presentation are often vague and difficult to differentiate from other diseases. ⋯ The main focus is directed towards the care of patients with pulmonary arterial hypertension (PAH). Implications for nursing will also be discussed, focusing on education and support of patients and families.
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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.