Clinical Skills and the Cardiovascular System

Develop essential skills for enhancing cardiovascular health, ensuring accurate assessment and patient-focused treatment Clinical Skills and the Cardiovascular System delivers a structured approach to understanding and mastering the clinical assessment and procedural skills that are essential for delivering safe, effective and compassionate care for patients with conditions affecting the cardiovascular system. Part of Peate’s Clinical Skills, a 12-book series that combines knowledge of human anatomy and physiology with practical, confident clinical skills, this volume is organised into chapters covering how to engage with patients, assessing the cardiovascular system, health promotion, planning care for hypertension, vital signs, the electrocardiograph, cardiopulmonary resuscitation, and medicine management. Clinical Skills and the Cardiovascular System equips readers with: Clear explanations of anatomy, physiology, and pathophysiology relevant to the cardiovascular system Step-by-step guidance on assessment, examination, and procedural techniques, emphasising best practice and patient safety Insights on interpreting findings, recognising abnormalities, and applying knowledge to guide care decisions Guidance on teamwork, infection prevention and control, documentation, and patient-centred care throughout clinical practice Strategies to explain diagnoses, treatment plans, and care procedures to patients and families, while offering emotional support Clinical Skills and the Cardiovascular System is an essential resource for all healthcare and social care students—including those returning to practice and newly qualified practitioners—who manage patients with cardiovascular conditions and seek practical ways to deliver a higher standard of care.

Preface ix Acknowledgements xi 1 The Anatomy and Physiology of the Cardiovascular System 1 Introduction 1 The Cardiovascular System 2 The Anatomy and Physiology of the Cardiovascular System 2 The Blood Vessels 2 Components of Blood 6 Characteristics and Composition of Blood 8 Functions of Blood 8 Formation of Blood Cells 9 Red Blood Cells 9 White Blood Cells 12 Platelets 13 Haemostasis and Coagulation 14 Blood Groups 14 The Lymphatic System 15 Lymphatic Organs 17 The Size and the Location of the Heart 18 Structure of the Heart 19 Blood Flow Through the Heart 21 Coronary Arteries and Veins 23 Conducting System of the Heart 24 The Cardiac Cycle 26 Cardiac Output 28 Nerve Supply to the Heart 28 Chemical Regulation of the Heart 29 Baroreceptors and the Cardiovascular Centre 30 Other Factors Affecting Heart Rate Regulation 30 Conclusion 31 Glossary of Terms 31 Multiple Choice Questions 32 References 34 2 Engaging with Patients and Assessing the Cardiovascular System 35 Introduction 35 Understanding the Patient's Perspective 35 Cultural Sensitivity 35 Health Literacy 36 Emotional Responses 37 Subjective and Objective Data 40 Assessing the Cardiovascular System 40 History Taking: A Comprehensive Approach to ​Cardiovascular Assessment 41 Enhancing Communication During History Taking 45 Cardiovascular Examination 45 Preparation to Undertake the Assessment 45 The Physical Examination 47 Inspection 47 Palpation 48 Auscultation 48 Blood Pressure and Pulse 50 Peripheral Vascular System 50 Special Tests 50 Documentation and Interpretation 51 Conclusion 51 Glossary of Terms 52 Multiple Choice Questions 53 References 54 3 Health Promotion 56 Introduction 56 Cardiovascular Mortality 57 Health Promotion 57 Key Components of Health Promotion 57 Policy Development 57 Addressing Socioeconomic Disparities 58 Public Health Outcomes 59 Urban and Environmental Planning 59 Preventive Healthcare and Education 59 Health Literacy and Cardiovascular Disease 59 Improving Health Literacy to Address Cardiovascular Disease 62 Risk Factors Associated with Cardiovascular Disease 64 The Role of the Healthcare Practitioner 66 Strategies for CVD Health Promotion 67 Health Screening 71 Supporting Behaviour Change 71 Conclusion 73 Glossary of Terms 74 Multiple Choice Questions 75 References 76 4 Planning Care: Hypertension 79 Introduction 79 Patient-centred Care 79 Shared Decision-making 80 Hypertension 81 Primary and Secondary Hypertension 82 Signs and Symptoms 83 Risk Factors 84 Assessment 84 Planning Care 91 Evaluation 94 Conclusion 95 Glossary of Terms 95 Multiple Choice Questions 96 References 98 5 Vital Signs 99 Introduction 99 Informed Consent 101 Assessing Competence to Consent in Cardiovascular Care 101 Voluntary Consent in Life-critical Circumstances 101 Cultural and Personal Considerations 102 The Role of Shared Decision-making 102 Ethical Challenges in Cardiovascular Consent 102 Procedures 102 Blood Pressure 103 Lying and Standing Blood Pressure 105 Pulse 107 Respiration 109 Temperature 110 Influencing Factors 111 Oxygen Saturations 112 Factors Affecting Pulse Oximetry 112 Preparation and Equipment 113 Undertaking Pulse Oximetry 113 Interpretation of Results 114 Summary of Interpretation 115 Raising Concerns When Assessing Vital Signs 117 Barriers to Raising Concerns in Cardiovascular Contexts 118 Documentation and Communicating Findings 118 Post-care 119 Conclusion 121 Glossary of Terms 121 Multiple Choice Questions 122 References 124 6 The Electrocardiograph 125 Introduction 125 The Cardiac Cycle 125 What It Is – Definition 126 Consent and Explanation 128 Procedure 129 Three-lead ECG 131 Five-lead ECG 131 Twelve-lead ECG 131 The Limb Leads 134 Einthoven's Triangle 134 Modified 12-lead ECG Placement 136 Recording the ECG 136 Specialised Types of ECG 137 Telemetry 139 Interpretation of ECG Results 139 Documentation 142 Post-care 144 Raising Concerns 145 Conclusion 146 Glossary of Terms 147 Multiple Choice Questions 149 References 150 7 Cardiopulmonary Resuscitation 151 Introduction 151 What It Is – Definition 151 Pathophysiology of Cardiac Arrest 152 Pathophysiological Progression of Cardiac Arrest 155 Consent and Explanation 157 Cardiopulmonary Resuscitation and Recommended Summary Plan for Emergency Care and Treatment 157 Basic Life Support 162 Performing Cardiopulmonary Resuscitation 165 Continuing Cardiopulmonary Resuscitation 166 Using an Automated External Defibrillator 166 Signs of Regaining Consciousness 167 Advanced Life Support 167 Pharmacology in Resuscitation 171 Interpretation of Results: Ceasing Cardiopulmonary Resuscitation Efforts 172 Unequivocal Criteria 173 Additional Considerations for Decision-making 173 Factors That Should Not Solely Determine Cardiopulmonary Resuscitation Termination 173 Documentation 174 Post-care 175 Immediate Post-cardiopulmonary Resuscitation Care 175 Care for the Family 175 Supporting Healthcare Staff 177 Consideration of Organ Donation 178 Raising Concerns 178 Before Cardiopulmonary Resuscitation: Identifying and Addressing Concerns 180 During Cardiopulmonary Resuscitation: Raising Concerns ​in a High-pressure Environment 180 After Cardiopulmonary Resuscitation: Reflecting, Reporting ​and Supporting Staff and Families 181 Creating a Culture of Openness and Patient-centred Care 181 Conclusion 182 Glossary of Terms 182 Multiple Choice Questions 183 References 185 8 Medicine Management: The Cardiovascular System 187 Introduction 187 Medicine Management 187 Medicine Optimisation in Practice 188 Medicine Management 189 Legal, Ethical and Professional Responsibilities 192 Pharmacology 195 Pharmacokinetics, Pharmacodynamics and the Cardiovascular System 196 Pharmacokinetics in Cardiovascular Drugs 197 Pharmacodynamics in Cardiovascular Drugs 198 Developing Safe Medicine Management Skills 199 Interpretation of Results 200 Documentation 200 Post-care 204 Raising Concerns 205 Patient-specific Contraindications 206 Conclusion 207 Glossary of Terms 207 Multiple Choice Questions 209 References 210 MCQ Answers 212 ndex 213