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Related Concept Videos

Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

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Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
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Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Cardiovascular risk management in the peri-operative setting.

Shehane Mahendran1, Aravinda Thiagalingam2, Graham Hillis3

  • 1Westmead Applied Research Centre, University of Sydney, Sydney, NSW.

The Medical Journal of Australia
|June 11, 2023
PubMed
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Accurate cardiovascular risk assessment is crucial before non-cardiac surgery to guide patient care and surgical decisions. Pre-operative revascularization is not recommended to improve outcomes.

Keywords:
Acute coronary syndromeGeneral surgeryPerioperative care

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Area of Science:

  • Cardiology
  • Anesthesiology
  • Peri-operative Medicine

Background:

  • Peri-operative cardiovascular events affect up to 3% of patients undergoing non-cardiac surgery.
  • Effective cardiovascular risk assessment is vital for informed decision-making, surgical planning, and preventive strategies.

Purpose of the Study:

  • To outline the importance and methods of pre-operative cardiovascular risk assessment.
  • To guide the appropriate use of cardiac investigations and interventions.

Main Methods:

  • Clinical assessment, including functional capacity estimation, is the cornerstone of pre-operative risk evaluation.
  • Specialized cardiac investigations are generally not indicated solely for risk assessment.
  • Decisions on investigations depend on surgery type, extent, and urgency.

Main Results:

  • Quantitative risk assessment can influence surgical approach and management choices.
  • Pre-operative revascularization is not evidence-based for improving post-operative outcomes.

Conclusions:

  • Pre-operative cardiovascular risk assessment should prioritize clinical evaluation and functional capacity.
  • Routine pre-operative revascularization is not advised; investigations should be judiciously applied.