Excellence in Care: Current Non-Surgical Cardiac Interventions Pam Bayles-Prevost RN, BSN INDEPENDENT STUDY Health Professions Institute for Continuing Education Austin Community College
The Austin Community College Health Professions Institute, Continuing Education 5930 Middle Fiskville Road, Austin, TX 78752 INDEPENDENT STUDY: Excellence in Care: Current Non-Surgical Cardiac Interventions Description and Purpose: Pam Bayles-Prevost RN, BSN appears with Elizabeth Huss RN, BSN, coordinator with the Health Professions Institute of Austin Community College, to discuss current medications used to treat and manage cardiac events and conditions. Ms. Prevost has 25 years experience working in critical care in the NICU, PICU, and adult ICU settings. She currently teaches through the ACC Health Professions Institute and works clinically with the Heart Hospital of Austin. The purpose of this activity is to enrich the participant s contribution to quality healthcare and the pursuit of professional career goals by providing current and updated information on non-surgical cardiac interventions used in the treatment, and management of cardiac conditions. This offering is a self-paced learning activity developed to meet the individual needs of nurses, social workers, and emergency medical services personnel requiring continuing education for relicensure. Goals and Objectives: Upon completion of this activity, the student will be able to: 1. List complications associated with percutaneous coronary interventions. 2. Identify advantages associated with femoral artery closure devices. 3. Identify disadvantages associated with femoral artery closure devices. 4. Describe indications for radiofrequency ablations and risks associated with this procedure. 5. Explain three (3) goals of cardiac resynchronization therapy. Requirements for Successful Completion: The packet you have received contains a pre-test, DVD, post-test and a program evaluation. To successfully complete this activity and earn continuing education the participant must: 1. Complete the pre-test 2. View the DVD 3. Complete the post-test (score an 80 or more) 4. And, complete the evaluation NOTE: Following the viewing of the DVD and completing the accompanying documents, questions may be addressed by contacting Elizabeth Huss @ 512-223-7271 or eahuss@austincc.edu Submit all of the documents (pre/post-test, evaluation) along with your completed Registration Form (check or credit card), and payment to: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX 78752 Fax: 512-223-7030
Within two business weeks from receipt of your material at ACC, your certificate of completion will be available (to be mailed, fax, or picked up at the above address your choice). Upon successful completion participants will be awarded a certificate of successful completion worth 2.0 contact hours. Austin Community College is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. Contact hours for programs applicable to social work are approved for CEU s by the Texas State Board of Social Worker Examiners. This program is worth 2.0 contact hours or 0.2 continuing education units (CEU s). Continuing education for Emergency Medical Personnel is approved by the Texas Department of State Health Services. This program is worth 2.0 TDH (P) contact hours. Disclosure to Attendees: The presenters and planning committee members for this offering have completed Conflict of Interest forms and it has been determined that no conflict of interest exists or has been indentified in relation to this offering. Commercial Support: This offering has not received any commercial support. Non-endorsement of products: The discussion of generic or brand name items or medications does not constitute endorsement by the American Nurses Credential Center s Commission on Accreditation (ANCC), the Texas Nurses Association (TNA) or Austin Community College. Off-Label Use: Off-label use of medications refers to the prescribing of medications to treat a condition for which the medication has not been approved by the Food and Drug Administration. Medications presented in this activity will only be discussed in the context of their Federal Drug Administration (FDA) approval. Expiration: This continuing nursing education activity (Cardiac Drug Update) will expire on March 1, 2014.
Printed Name: Date: Instructions: Complete this pre-test PRIOR to watching the video. Choose the best answer by circling the letter corresponding to your choice. Submit your post-test, completed evaluation, completed registration, and payment to: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX 78752 Fax: 512-223-7030 Pre-Test: Current Non-Surgical Cardiac Interventions 1. Early complications association with Balloon Angioplasty include all of the following EXCEPT: a. Late re-stenosis requiring repeated procedures. b. Immediate vessel closure requiring bypass surgery. c. Vessel dissection. d. All of the above are complications. 2. We no longer see certain complications in the Balloon Angioplasty. Why have these complications been reduced and / or eliminated? a. Development of Drug Eluding Stents (DES). b. Balloon Angioplasty has been replaced and is no longer used. c. Practitioner skill has improved over time. d. Less and less need for this procedure has impacted the statistical occurrence of complications. 3. A sub-acute thrombosis is an occlusion at the stented site beyond 24 hours and sometimes up to 30 days after a stent has been placed. a. True b. False 4. Characteristics of Unstable Coronary Syndrome include: a. Complain of chest pain; high blood sugar; low back pain radiating to lower extremities. b. Chest pain; may/may not have cardiac enzyme changes or ST elevations. c. Diffuse ST depression without enzyme changes d. B only e. B and C
Pre-Test Pg. 2 Non-Surgical Cardiac Interventions 5. In addition to monitoring the affected extremity for infection, patient care following a Balloon Angioplasty includes: a. Assessing the upper extremities for numbness and tingling. b. Palpating and assessing the carotid pulses. c. Assessing the affected extremity for numbness and changes in color. d. Palpating radial pulses. 6. Advantages associated with Femoral Artery Closure Devices include: a. Improved patient comfort; increased hospitalization; decreased time to ambulation. b. Improved patient comfort; decreased time to ambulation and discharge. c. Safe alternative to manual compression and requires more nursing care. d. Improved patient comfort but does require manual compression. 7. The main disadvantages associated with Femoral Artery Closure Devices include: a. Bleeding from retroperitoneal hematoma and infection. b. Bleeding from retroperitoneal hematoma and stroke. c. Bleeding from retroperitoneal hematoma and renal failure. d. Infection and pulmonary stenosis. 8. Signs and symptoms of a bleeding retroperitoneal hematoma are: a. Complain of not feeling well. b. Pain in the back. c. Low Hemoglobin and Hematocrit. d. All of the above. 9. This closure device is fully absorbed by the body within 60-90 days and acts like an internal band aid: a. Cardiva Catalyst b. StarClose Vascular Closure System c. Angio-Seal d. Femoral Apparatus 10. These two (2) closure devices DO NOT require any nursing care other than monitoring the site: a. Cardiva Catalyst and Angio-Seal b. Angio-Seal and StarClose Vascular Closure System c. StarClose Vascular Closure System and Cardiva Catalyst d. Angio-Seal and Femoral Apparatus
11. Benefits of carotid stenting include all of the following EXCEPT: a. This procedure is only indicated for patients at HIGH risk. b. Does not require general anesthesia c. Decreased hospital stay (compared to the endarterectomy) e. The procedure takes less time (compared to the endarterectomy) Pre-Test Pg. 3 Non-Surgical Cardiac Interventions 12. Fourteen percent of stroke survivors will experience a recurrent stroke within one (1) year. a. False b. True 13. In addition to AV Nodal Re-Entry Tachycardia, other indicators for Radiofrequency Ablation therapy include: a. Peripheral neuropathy and Ventricular Tachycardia b. Ventricular Tachycardia, Atrial Flutter, and Cardiac Tamponade c. Atrial Flutter, Tachycardia and Fibrillation d. Ventricular depression and ablation 14. Clients undergoing Radiofrequency Ablation therapy will require aggressive pulmonary care because they will be immobile following the procedure. Another priority of care for the nurse is: a. Monitoring for changes in mental status. b. Listening for bowel sounds. c. Providing patient education about the procedure. d. Assessing and implementing a pain management regimen. 15. If left untreated, peripheral artery disease (PAD) can cause: a. Ulcerations b. Gangrene c. Loss of Limb (s) d. All of the above
Written: I. Pre-Test Excellence in Care: Current Non-Surgical Cardiac Interventions Program Outline DVD Presentation: II. Balloon Angioplasty and Drug Eluding Stents (DES) A. History of Development of Procedure B. Mechanism of Action C. Complications III. Femoral Artery Closure Devices A. History B. Benefits C. Complications D. Devices 1) Angio-Seal Evolution Vascular Closure Device 2) Cardiva Catalyst 3) StarClose Vascular Closure System IV. Carotid Stenting A. History of development B. Mechanism of Action C. Candidates for Carotid Stenting D. Benefits V. Radiofrequency Ablation Therapy A. Mechanism of Action B. Indications C. Procedural Description D. Complications E. Nursing Care VI. Cardiac Resynchronization Therapy A. Indications and Goal of Therapy B. Indications C. How Resynchronization is achieved VII. Summary Written: VI. Post-Test VII. Evaluation
Evaluation Title of Education Activity: Excellence in Care: Current Non-Surgical Cardiac Interventions Location: DVD Video Format Date: Participants check out and complete on own time Purpose of this activity: The purpose of this activity is to enrich the participant s contribution to quality healthcare and the pursuit of professional career goals by providing current and updated information on non-surgical cardiac interventions used in the treatment, and management of cardiac conditions. Directions/Instructions: Please complete this evaluation questionnaire. Your anonymous responses will be used to revise this activity and to plan future educational activities. Circle the number that best fits your evaluation of this activity. 1 = Not at all 2 = Somewhat 3 = Almost completely 4 = Completely 1. Rate your achievement of these objectives: 1. List complications associated with percutaneous coronary interventions. 1 2 3 4 2. Identify advantages associated with femoral artery closure devices. 1 2 3 4 3. Identify disadvantages associated with femoral artery closure devices. 1 2 3 4 4. Describe indications for radiofrequency ablations and risks associated with this procedure. 1 2 3 4 5. Explain three (3) goals of cardiac resynchronization therapy. 1 2 3 4 2. Rate the effectiveness of the teaching/learning resources? 1 2 3 4 3. Please evaluate the guest speaker- Pamela Bayles RN, BSN a. Knowledge and currency of topic 1 2 3 4 b. Ability to make points clear 1 2 3 4 c. Ability to apply content to practice 1 2 3 4 4. Please evaluate the moderator- Elizabeth Huss RN, BSN a. Guides the discussion 1 2 3 4 b. Asks pertinent questions 1 2 3 4 c. Fosters clarification of presented information 1 2 3 4
5. Were the objectives relevant to the overall purpose? 1 2 3 4 (see above) 5. How long (in minutes) did it take you to complete the entire activity (including taking the pretest, watching the video, taking the post-test, and completing this evaluation tool)? Minutes 6. List two (2) ways you will integrate what you learned in this activity into your practice and/or employment environment. 8. The following were disclosed prior to the beginning of this activity either in writing or verbally? a. Requirements for successful completion Yes No b. Conflicts of Interest Yes No c. Commercial Support Yes No d. Non-endorsement of Products Yes No e. Off-label Use Yes No 9. Did you, as a participant, notice any bias that was not previously disclosed in this presentation? Yes No If Yes, please describe who was biased and how. 10. Comments: If you answered (1) to any of the above, please comment. 11. Please list any suggestions or topics for future programming.
Printed Name: Date: Address (where you would like to receive your certificate of completion): City: State: Zip code: Instructions: Choose the best answer for each question listed below and circle the corresponding letter. A passing score of 80% (answer 12 or more correctly) or more is required to earn continuing nursing education (CNE). After you have completed this post-test, submit it along with your completed evaluation, pre-test, registration form and payment to the address below: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX 78752 Fax: 512-223-7030 Post-Test: Current Non-Surgical Cardiac Interventions 1. Early complications association with Balloon Angioplasty include all of the following EXCEPT: a. Late re-stenosis requiring repeated procedures. b. Immediate vessel closure requiring bypass surgery. c. Vessel dissection. d. All of the above are complications. 2. We no longer see certain complications in the Balloon Angioplasty. Why have these complications been reduced and / or eliminated? a. Development of Drug Eluding Stents (DES). b. Balloon Angioplasty has been replaced and is no longer used. c. Practitioner skill has improved over time. d. Less and less need for this procedure has impacted the statistical occurrence of complications. 3. A sub-acute thrombosis is an occlusion at the stented site beyond 24 hours and sometimes up to 30 days after a stent has been placed. a. True b. False 4. Characteristics of Unstable Coronary Syndrome include: a. Complain of chest pain; high blood sugar; low back pain radiating to lower extremities. b. Chest pain; may/may not have cardiac enzyme changes or ST elevations. c. Diffuse ST depression without enzyme changes d. B only e. B and C
Post-Test Pg. 2 Non-Surgical Cardiac Interventions 5. In addition to monitoring the affected extremity for infection, patient care following a Balloon Angioplasty includes: a. Assessing the upper extremities for numbness and tingling. b. Palpating and assessing the carotid pulses. c. Assessing the affected extremity for numbness and changes in color. d. Palpating radial pulses. 6. Advantages associated with Femoral Artery Closure Devices include: a. Improved patient comfort; increased hospitalization; decreased time to ambulation. b. Improved patient comfort; decreased time to ambulation and discharge. c. Safe alternative to manual compression and requires more nursing care. d. Improved patient comfort but does require manual compression. 7. The main disadvantages associated with Femoral Artery Closure Devices include: a. Bleeding from retroperitoneal hematoma and infection. b. Bleeding from retroperitoneal hematoma and stroke. c. Bleeding from retroperitoneal hematoma and renal failure. d. Infection and pulmonary stenosis. 8. Signs and symptoms of a bleeding retroperitoneal hematoma are: a. Complain of not feeling well. b. Pain in the back. c. Low Hemoglobin and Hematocrit. d. All of the above. 9. This closure device is fully absorbed by the body within 60-90 days and acts like an internal band aid: a. Cardiva Catalyst b. StarClose Vascular Closure System c. Angio-Seal d. Femoral Apparatus 10. These two (2) closure devices DO NOT require any nursing care other than monitoring the site: a. Cardiva Catalyst and Angio-Seal b. Angio-Seal and StarClose Vascular Closure System c. StarClose Vascular Closure System and Cardiva Catalyst d. Angio-Seal and Femoral Apparatus
Post-Test Pg. 3 Non-Surgical Cardiac Interventions 11. Benefits of carotid stenting include all of the following EXCEPT: a. This procedure is only indicated for patients at HIGH risk. b. Does not require general anesthesia c. Decreased hospital stay (compared to the endarterectomy) e. The procedure takes less time (compared to the endarterectomy) 12. Fourteen percent of stroke survivors will experience a recurrent stroke within one (1) year. a. False b. True 13. In addition to AV Nodal Re-Entry Tachycardia, other indicators for Radiofrequency Ablation therapy include: a. Peripheral neuropathy and Ventricular Tachycardia b. Ventricular Tachycardia, Atrial Flutter, and Cardiac Tamponade c. Atrial Flutter, Tachycardia and Fibrillation d. Ventricular depression and ablation 14. Clients undergoing Radiofrequency Ablation therapy will require aggressive pulmonary care because they will be immobile following the procedure. Another priority of care for the nurse is: a. Monitoring for changes in mental status. b. Listening for bowel sounds. c. Providing patient education about the procedure. d. Assessing and implementing a pain management regimen. 15. If left untreated, peripheral artery disease (PAD) can cause: a. Ulcerations b. Gangrene c. Loss of Limb (s) d. All of the above