Management of the Patient in the Cardiac Care Unit (CCU) 2024 PDF

Management of the Patient in the Cardiac Care Unit (CCU) The Cardiac Critical Care Unit provides care for critically ill patients experiencing diseases of the heart for which medical care and intervention is needed. The cardiac care technologists assist the physicians to insert the tubes into the bl...

Management of the Patient in the Cardiac Care Unit (CCU) The Cardiac Critical Care Unit provides care for critically ill patients experiencing diseases of the heart for which medical care and intervention is needed. The cardiac care technologists assist the physicians to insert the tubes into the blood vessels of the patients and they also mainly help heart surgeons during heart surgeries. Cardiac nursing is a nursing specialty that works with patients who suffer from various conditions of the cardiovascular system. Cardiac nurses help treat conditions such as: unstable angina cardiomyopathy coronary artery disease congestive heart failure myocardial infarction cardiac dysrhythmia These functions require sufficient knowledge of the pathophysiology of cardiac conditions to be able to provide advanced nursing practice and care to patients. Patients in Coronary Care Units have diverse presentations, ranging from uncomplicated stable conditions to being acutely and critically ill requiring life-saving interventions. In this unit you will explore nursing in Coronary Care Units, in particular, patient assessment in relation to a range of cardiac conditions and health states, provision of advanced nursing practice, leadership and managing patient transitions through the unit. What is difference between ICU and CCU? It is basically a specialized ICU which is said to be dealing with cardiac patients and is usually staffed by cardiologists. The CCU provides intensive care for the patient who has been admitted because of a heart attack, heart complications or for cardiac surgery. Problems Managed in a CCU Patients are admitted to the CCU for serious, acute, and/or unstable cardiac conditions that require round-the-clock monitoring and specialized cardiovascular therapy. The most common of these is an acute heart attack or another form of acute coronary syndrome. People with these conditions are prone to rapid, unexpected changes in their condition and typically require ongoing therapy, such as targeted temperature management (inducing mild hypothermia). Other patients who may require a stay in a CCU include those who: 1. Are recovery from coronary bypass surgery 2. Have decompensated heart failure, especially if they're especially ill or unstable or need a balloon pump or LVAD 3. Require close monitoring following severe heart failure, even if they've stabilized, and are awaiting a heart transplant 4. Have acute coronary syndromes, unstable angina, or life-threatening cardiac arrhythmias. One of the most common reasons for admission to CCU is a heart attack (myocardial infarction). Many patients with a heart attack need a percutaneous coronary intervention (PCI). This is a coronary angiogram/plasty, which is an x-ray procedure is used to widen blocked or narrowed coronary arteries (the main blood vessels supplying the heart). What Happens in a CCU Cardiac care units are specially staffed and equipped to treat and manage issues that are unique to heart patients, especially when continuous monitoring is required. Nurses, technicians, and physicians who have been specially trained to take care of people with serious cardiac conditions attend to patients 24 hours a day, in a much higher staff-to-patient ratio than in a typical hospital unit. All patients admitted to the CCU are placed on a cardiac monitor, which records and analyzes each beat of the heart and will sound an alarm to alert the staff if serious arrhythmias occur. Some patients also have temporary catheters placed into a wrist artery to continuously monitor their blood pressure or into a pulmonary artery to monitor blood pressure within the hearts. Those with severe heart failure may receive an intra-aortic balloon pump (IABP) or a left ventricular assist device (LVAD) to help their hearts pump blood. Cardiac care units are equipped with ventilators for patients who experience severe breathing problems as a result of their heart condition. People in a CCU frequently need specialized testing, and so CCUs are equipped to perform such tests in the ward. These include bloodwork, electrocardiograms, echocardiograms, and chest X-rays, among others. A CCU is usually configured differently than a typical hospital ward. Most have a centralized nursing station, surrounded by eight to 12 single rooms, each having large glass windows so patients can be seen from the nursing station. The nursing station itself will be fitted with monitoring screens which show continuous readouts for every patient. If there is any kind of emergency, it is detected immediately by trained medical personnel who can respond immediately. Visitors Although visitors to the CCU are encouraged to provide comfort and company to patients, they typically are restricted to immediate family members. Visiting hours often are limited to two or three short periods of time per day. Food and other items brought from outside the hospital, such as plants and flowers, usually are prohibited, as patients in CCUs tend to be on supervised diets and plants can introduce infection-causing bacteria into the environment. After the CCU The average stay in a CCU is one to six days. Afterwards, most patients are transferred to what is called a cardiac “step-down unit,” where they will receive less intensive care. Although continuous cardiac monitoring occurs in the step-down unit, patients are allowed (and encouraged) to begin walking and moving regularly. Often, physical therapists or exercise therapists work with people in the patients in the step-down unit to help them progress with their ambulation and to coach them on which activities to avoid once they are allowed to go home. Most cardiac patients are discharged to home directly from step-down care. They often are prescribed a cardiac rehabilitation program, in which they will learn more about necessary changes in their diet, exercise, and other lifestyle factors. These changes are very important for avoiding any further stays in a CCU.