Pilot Nurse Comments from Section A:

C.C., South Carolina RN, BSN

• Textbook: Excellent textbook!
• Test: The test is fair and follows a logical flow.
• Anything Else: While taking the test, I found myself eager to read the text. I have gained a lot of knowledge from this portion of the course. This is an excellent study. I have over 35 years of experience in critical care and still found the information informative and interesting.

S.E., California RN, BSN, CCRN

• Textbook: Very detailed pathophysiology in early chapters sometimes made the reading hard to follow. I needed to reread parts in order to fully understand.
• Anything Else: Very good. Would recommend for adult cardiac nurses that have been in that unit for over a year. I learned new and interesting things. It was hard to read about the “aging” changes that take place to our cardiovascular system since I am one of those “aging” people.

J.E.: Virginia RN

• Textbook: It is thorough with excellent references. I enjoyed the tables, diagrams, etc.
• Anything Else: It is very effective in learning cardiac nursing. Highly recommended.

K.H., California RN, CCRN 

• Textbook: I liked the textbook. It was easy to read and had good pictures and diagrams.
• Test: Some questions were a little bit harder to find in the text.
• Anything Else: Good review and update for ICU RNs.

L. H., New Mexico RN, MSN, CNE, CCRN-K, CHSE

• Textbook: Excellent textbook. Very thorough.
• Anything Else: I love the book so far. Very detailed. I am learning a lot of new things.

C.M., California RN, BSN, CPAN

• Textbook: It was excellent. I applaud the authors for their research and expertise!
• Test: Well-written and relevant.
• Anything Else: One of the best cardiology courses I have taken in many years. Very in-depth. This is an excellent course. It includes a much more in-depth study of the heart than I have had before. So much new research and new treatment modalities included – I loved it!

S.R., Michigan RN, BSN

• Textbook: Very comprehensive information and advanced level of information. Much deeper content level than is necessary for bedside nurses.
• Test: The test questions captured the important content areas.

L.S., Iowa RN, BSN, CCM

• Textbook: I particularly liked the case studies in the book. I didn’t use them for the quiz but thought they were very good scenarios and could envision them being used for teaching the material.
• Anything Else: I would recommend this to anyone working in ICU, cardiology, telemetry, and Cath labs. I felt in the material in the first several chapters, the quiz questions were moderately difficult but perhaps that’s because my work doesn’t require me to get down to the very specific details. As the book continued, I liked renewing my cardiac knowledge.

C.V., Florida RN, CCRN

• Textbook: Excellent reference.
• Test: Exam did a great job following the text.
• Anything Else: Comprehensive review. Excellent reference for cardiac nursing. I would recommend this for an experienced cardiac nurse.

W.W., California RN, CCRN (Alumna)

• Textbook: The objectives and key questions addressed prior to each chapter did assist to focus the reading. Personally, I like the use of case studies. It brings clinical practice and challenges encountered from textbook knowledge to clinical reality. The first section of this study is laying a good foundation with the material presented later in the text. I like the full-color images, especially of the heart and radiology.
• Test: There is a good balance of “less” difficult questions and “more” difficult questions with this section. Good use of tables, figures, displays. The first section was done very well.
• Anything Else: “From novice to expert, cardiac nurses across many subspecialties and settings must be prepared to access, appraise and implement evidence-based practice to improve patient outcomes.” I thought this was a very good statement. EBP is hopefully helping nurses in all specialties to improve patient care and outcomes. I have witnessed cardiac nursing with many practice changes over these past several years. This text and study are very informative. I liked the review of cardiac anatomy and physiology. Even the chapter on sleep and nursing care approaches for sleep disorders in CV patients was revealing. This study will assist the cardiac nurse to use textbook knowledge in clinical practice. (Any nurse who wants to be more informed in regard to cardiac patient care will find this study very informative.)

D.W., Virginia RN, MSN, CCDS, CDIP

• Textbook: I thought the text broke down each topic well.
• Test: Test was well laid out. Questions were on topics that the RN will use/know/increase knowledge base.
• Anything Else: I enjoyed the text and test. Good refresher on topics and learned new terminology/interventions, etc. Would recommend this course as the text/layout makes it easy to read and explains the content thoroughly. I certainly learned some things and brushed up on information that I am not currently using.

K.Z., New York RN, CCRN, RN-BC           

• Textbook: Great resource. Full of lots of great information, diagrams and picture tables and case studies.
• Test: Test was well developed.
• Anything Else: I thought this was well done. Very good study.

Pilot Nurse Comments from Section B:

C.C., South Carolina RN, BSN

• Textbook: The textbook is excellent.
• Anything Else: Overall, the course is excellent. The test for part A was written in a more straightforward manner. I enjoy the textbook. The questions are helpful to point out certain content. The material is at times familiar to critical care nurses and at times is challenging.

S.E., California RN, BSN, CCRN

• Textbook: Certain chapters were very detailed and could lose an audience with limited experience.
• Anything Else: Certain chapters were fun and exciting to read, others not so much. But all of it was informative. I would recommend this course to a nurse that wants more cardiac ICU knowledge and for an inexperienced cardiac ICU RN who mentors, precepts, and teaches.

J.E., Virginia RN

• Textbook: I enjoyed reading the chapters for this course.
• Test: Some questions were not easy.
• Anything Else: Highly recommend. Now, I have a clue about diagnostic tests and lines at work.

L. H., New Mexico RN, MSN, CNE, CCRN-K, CHSE

• Textbook: Excellent textbook.

K.H., California RN, CCRN 

• Textbook: I liked the textbook. Easy-to-read and good tables and pictures.
• Test: The test was moderately difficult.

C.M., California RN, BSN, CPAN

• Textbook: This book is excellent! It is very well-written! I learned a lot as the material was new and up-to-date. The field of cardiac nursing is advancing rapidly and nurses must keep up with these advances.

S.R., Michigan RN, BSN

• Textbook: Some of the content is very difficult and above the knowledge necessary for bedside providers. Content was interesting.
• Test: Very comprehensive test. Focuses on relevant information.
• Anything Else: The selection related to psychosocial factors is very good and timely.

L.S., Iowa RN, BSN, CCM

• Textbook: I think it’s an excellent book. I especially liked the case scenarios at the end of the chapters. Some chapters were very difficult.
• Test: The questions are appropriate for the material covered.
• Anything Else: Excellent book and course materials.

C.V., Florida RN, CCRN

• Textbook: Well-written. Excellent, comprehensive review of cardiac nursing.
• Test: Follows the text very well. This quiz was easier than section A.
• Anything Else: I really appreciate the psychosocial aspects presented that are not often found in other texts. This is a wonderful reference for any cardiac nurse.

W.W., California RN, CCRN (Alumna)

• Textbook: Good use of full-color images to show/support the material presented. Easy to use reference tables. Case studies presented enhances the cardiac nurses' (and ICU nurse's) application of textbook to clinical practice. The key readings and references after each chapter support the data presented. Great resource to refer/return to for further study.
• Test: This section seemed slightly easier than the first section. I still feel there was a good balance of difficulty with the questions asked. I like how the psychosocial risk factors--obesity, exercise and activity, smoking cessation and effective treatment (questions)--were addressed in the last 4 chapters of this section; over 50% of the questions came from this section but I feel the subject matter needed addressing more thoroughly.
• Anything Else: How often do we read (and hear) about the positive and negative influences of diet, exercise, smoking, stress, and social interaction (or lack thereof) on our well-being, especially our hearts? This section of the text (and the questions presented) did a good job covering the risk assessment as well as the prevention of heart disease.

D.W., Virginia RN, MSN, CCDS, CDIP

• Textbook: The text has been a great resource so far!
• Test: The test is a good overview of topics and information from the text.
• Anything Else: I have learned a few tidbits on this section review and overall the text and quiz are a great refresher.

K.Z., New York RN, CCRN, RN-BC

• Textbook: I think the textbook is a great resource. Text is very informative.
• Anything Else: I really enjoyed the chapters on diet and exercise and smoking cessation.

Pilot Nurse Comments from Section C:

C.C., South Carolina RN, BSN

• Textbook: Excellent textbook!
• Test: The test questions were well-balanced.
• Anything Else: This is an excellent course! While I was familiar with portions of the text, other sections challenged me to read carefully to digest the information. I thoroughly enjoyed the material.

S.E., California RN, BSN, CCRN                                  

Textbook: This is a course that is very time-consuming and detailed if one wants to completely understand the topic. 

Anything Else: I did learn a lot and many topics were refreshers.  This course is appropriate for a nurse either specialized in this area of expertise or for a nurse going into this area of nursing.

J.E., Virginia RN

• Textbook: Effective approach on understanding cardiac nursing. Very comprehensive reference.
• Test: Some questions are complex and need critical thinking.
• Anything Else: Quite long, but comprehensive. Highly recommend.

K.H., California RN, CCRN 

Textbook: The textbook is a very good resource.

C.M., California RN, BSN, CPAN

• Textbook: It was very well written and a great presentation of the latest research, drugs, devices, and procedures, It is pretty intense for new nurses but would greatly enhance their knowledge and motivate them to LEARN. It provides a comprehensive review of this to advanced nurses as well. Quite a bit of new information for me, very well described. The last chapter actually renewed my pride in nursing (not that I had lost it but it gave me a big boost!)
• Test: Excellent and up-to-date course!
• Anything Else: I loved it. I have actually learned quite a bit from this course. It presents good descriptions of all the new procedures, equipment, and research. By the end of the book, I was excited by nursing again – after 44 years in practice.

S.R., Michigan RN, BSN

• Textbook: Very technical in many areas.
• Test: The text is very comprehensive.
• Anything Else: Overall this course is designed for advanced practice nurses not “bedside” nurses.

C.V., Florida RN, CCRN

• Textbook: Great comprehensive review on most recent information. Pertinent to cardiac nursing.
• Test: Follows the text very well.
• Anything Else: I would recommend this course to any cardiac nurse looking for an up-to-date, comprehensive review.

W.W., California RN, CCRN (Alumna)

• Textbook: A very informative text. I liked the full-color images; the tables and figures emphasized important concepts; the case studies did provide great “learning examples rich with real-world questions and practice challenges….to enhance application of textbook knowledge to clinical practice.” The references provided resources for further study and support subject matter presented.
• Test: Good balance with level of difficulty. Some questions made you go back and review what you had read and others helped to reinforce the subject matter presented.
• Anything Else: Though its target is cardiac nurses, I believe every nurse would benefit from this study. We have all encountered patients with “cardiac” issues, especially in the ICU setting. I have witnessed the management of patients with heart disease evolve through advancements in drug treatments, intervention, and diagnostic technologies, though I have worked in a cardiac surgery unit as a relief ICU nurse, I have never provided care for a fresh post-op open heart patient. This study proved to be very informative in understanding more about caring for the “cardiac” patient (which an ICU nurse encounters almost daily). The chapters which included women and heart disease, palliative care in cardiology, leadership and team-based care and advanced practice cardiac nursing proved to be informative and enlightening. Cardiac care will always be an integral part of nursing care.

D.W., Virginia RN, MSN, CCDS, CDIP

• Textbook: I enjoyed the textbook – brushed up on some info and learned many new things as well. It is very in-depth at times which I enjoyed.
• Test: I thought the test covered the main topics well.
• Anything Else: Thank you for allowing me to participate in this pilot program. I hope my suggestions are helpful.

K.Z., New York RN, CCRN, RN-BC

• Textbook: Valuable resource!
• Anything Else: We have several CHF initiatives going on at our hospital right now so these chapters were very valuable. Course was a little long but very well done.

Section A Objectives

• Recognize the application of evidence-based care in cardiac nursing.
• List changes in cardiac anatomy terminology.
• Recognize clinical manifestations of physiological changes in the heart.
• List effects of neural and local metabolic factors on the distribution of blood.
• Identify clinical changes related to changes in blood distribution.
• Define the oxyhemoglobin dissociated curve.
• Identify neurohormonal and other physiological impacts on the cardiovascular system.
• Identify the pathophysiological processes of select hematologic disorders and related treatment strategies.
• List causes, risks, pathologic consequences, and treatment of disseminated intravascular coagulation.
• Specify the implications of elevated or decreased electrolyte concentrations on cardiac physiology.
• Identify a cause of metabolic acidosis.
• Define nursing care approaches related to factors that affect normal or disordered sleep, particularly in the cardiovascular patient.
• Recognize how aging affects the cardiovascular system, respiratory system, and pharmacology needs.
• Identify cardiovascular and noncardiac areas for examination in a patient with chest pain.
• Recognize common laboratory tests used to confirm or diagnose cardiac problems.
• Identify nursing interventions utilized with laboratory testing.
• Identify radiologic appearances of invasive lines and devices.
• Match clinical diagnoses with the radiologic findings.
• Identify ECG changes with cardiac problems, medications, and electrolytes.
• Recognize causes and evidence-based management of cardiac arrythmias.
• Identify the nurse’s role in echocardiography.
• Identify current guidelines for cardiac stress testing.
• Correlate indications, contraindications, risks, and reasons to terminate cardiac stress testing.

Section B Objectives

• Identify current types of images used in the evaluation of cardiac disease.
• Recognize nursing considerations in caring for the cardiac patient undergoing imaging.
• List indications for left and right heart catheterizations.
• Identify procedure-specific patient considerations in left and right heart catheterizations.
• Recognize nursing considerations in caring for the pre- and post-cardiac catheterization patient.
• Identify indications for the use of the different modalities in hemodynamic monitoring.
• Recognize the most used hemodynamic monitoring technologies.
• Identify evidence for the use of electrophysiology studies.
• Specify patient care and risks associated with electrophysiology studies.
• Identify psychosocial risk factors as they influence health in patients with cardiac disease.
• List appropriate nursing interventions including pharmacology strategies to assist the patient with distressed psychosocial needs.
• Identify current understanding of obesity with associated cardiovascular risk and conditions.
• Identify nursing interventions in obesity treatment, including pharmacology, bariatric surgery, weight loss and weight loss maintenance strategies.
• Compare the detrimental effects of a sedentary lifestyle with health benefits of physical activity, including the components of an exercise prescription.
• Correlate the neurobiology and pathophysiology of nicotine addiction and its effects on the body.
• Identify pharmacological treatment for nicotine dependence.
• Identify clinical manifestations and consequences of uncontrolled hypertension.
• Specify recommendations and treatments for patients with high blood pressure.
• Recognize lipid disorders.
• Identify the evidence-based treatment modalities for lipid disorders.
• Differentiate between type 1 diabetes mellitus, type 2 diabetes mellitus, other types of diabetes, and gestational diabetes.
• Describe therapeutic management of DM.

Section C Objectives

• Identify sex-specific differences in women regarding CVD risk factors, prevention, pathophysiology, and treatment.
• Delineate the scope and implementation of palliative care in the ill cardiac patient.
• Identify end-of-life considerations in cardiac disease.
• Identify methods for treatment of coronary, valvular, and structural disease.
• Delineate cardiac conditions that may benefit from medical, surgical, and catheter-based therapy.
• Identify the etiology, diagnosis, and management of acute coronary syndrome (ACS), ST-elevation myocardial infarction (STEMI), non-ST-elevation MI (NSTEMI), and other etiologies of MI.
• Describe nursing care of a patient with atherosclerotic vascular disease.
• Delineate the prevalence, risk factors, and testing for peripheral artery disease (PAD).
• Identify treatment plans for patients with PAD.
• Identify current evidence-based practices for diagnosis of acquired valvular heart disease.
• Identify current evidence-based treatment of acquired valvular heart disease.
• Identify common congenital cardiac diseases and evidence-based treatment.
• Specify long-term implications and special management issues for adults with congenital heart disease.
• Identify symptoms, testing, and medical management of pericardial, myocardial, and endocardial diseases.
• Specify patient-centric education principles and priorities to optimize treatment adherence and patient outcomes for patients with pericardial, myocardial, and endocardial conditions.
• Specify mechanisms, diagnosis, medical management, and current guidelines for supraventricular arrhythmias.
• Delineate medical management and treatment of ventricular arrhythmias.
• Identify appropriate nursing interventions for ventricular arrhythmias and cardiac arrest patients.
• Identify current clinical and diagnostic assessment modalities for heart failure.
• Specify treatment strategies for both chronic and acute decompensated heart failure.
• List contemporary guideline-directed therapies in individuals with HF.
• Recognize the importance of the nurse in the heart failure team.
• Identify pathophysiology, etiology, and treatment approaches to acute cardiogenic shock.
• Specify treatment options for end-stage heart failure.
• Identify advances in technology impacting contemporary cardiology.
• Correlate cardiovascular disease management programs with patient outcomes.
• List characteristics of nurse-led disease management programs that make them successful.
• Identify the global epidemiology of cardiac disease.
• Describe global initiatives to prevent and reduce cardiovascular disease.
• Define quality in health care.
• Specify tools used to achieve quality care.
• Describe the role of the advanced practice registered nurse in cardiology practice.
• List functions performed by advanced practice registered nurses in cardiology practice.
• Specify a vision for and understanding of leadership and team-based care in cardiac nursing.

Section A quiz: Chapters 1-14

PART I: FUNDAMENTALS

1. Evidence-Based Practice in Cardiac Nursing

2. Cardiac Anatomy and Physiology

3. Systemic and Pulmonary Circulation and Oxygen Delivery

4. Regulation of Cardiac Output and Blood Pressure

5. Hematopoiesis, Coagulation, and Bleeding

6. Fluid and Electrolyte and Acid-Base Balance and Imbalance

7. Sleep

8. Physiologic Adaptations with Aging

PART II: EVALUATION

9. History and Physical Exam

10. Laboratory Tests Using Blood

11. Radiologic Examination of the Chest

12. Electrocardiography and Cardiac Rhythm

13. Echocardiography

14. Cardiac Stress Testing--Physiologic Evaluation with Exercise and Pharmacologic Agents

Section B quiz: Chapters 15-25

PART II: EVALUATION, continued

?15. Nuclear, Magnetic Resonance, and Computer Tomography Imaging

16. Cardiac Catheterization

17. Hemodynamic Monitoring

18. Cardiac Electrophysiology Studies

PART III: RISK ASSESSMENT AND PREVENTION

19. Psychosocial Risk Factors for Cardiac Disease

20. Obesity: An Overview of Assessment and Treatment

21. Exercise and Activity

22. Smoking Cessation and Effective Treatment

23. Hypertension

24. Lipid Management

25. Diabetes and Cardiovascular Disease

Section C quiz: Chapters 26-45

PART III: RISK ASSESSMENT AND PREVENTION, continued

26. Cardiovascular Disease in Women

27. Palliative Care in Cardiology

PART IV: PATHOGENESIS, DIAGNOSIS, MEDICAL MANAGEMENT, AND THERAPEUTIC INTERVENTION

28. Medical, Surgical, and Catheter-Based Therapy for Cardiovascular Disease

Subpart I: Atherosclerotic Vascular Disease

29. Ischemic Heart Disease

30. Peripheral Arterial Disease

Subpart II: Structural Heart Disease

31. Acquired Valvular Heart Disease: Pathophysiology, Diagnosis, and Medical Management

32. Therapeutic Intervention for Acquired Valvular Heart Disease: Surgical and Catheter-Based Approaches

33. Adult Congenital Heart Disease

34. Pericardial, Myocardial, and Endocardial Diseases; Pathogenesis, Diagnosis, and Treatment'

Subpart III: Cardiac Arrhythmias

35. Supraventricular Arrhythmia

36. Ventricular Arrhythmias, Cardiac Arrest, and Sudden Cardiac Death

Subpart IV: Heart Failure

37. Heart Failure: Pathogenesis and Diagnosis

38. Heart Failure: Guideline-Directed Medical and Device Therapy

39. Therapeutic Intervention for Cardiogenic Shock and End-Stage Heart Failure: Mechanical Circulatory Support and Heart Transplantation

40. Therapeutic Intervention for Cardiovascular Disease: Future Advances and Approaches

PART V: EXPANDED ROLES FOR THE CARDIAC NURSE

41. Disease Management Models for Cardiovascular Care

42. Global and Population Health

43. Quality in Cardiovascular Care

44. Quality in Cardiovascular Care

44. Advanced Practice Nursing and Cardiovascular Care

45. Leadership and Team-Based Care

Janice Tazbir RN, MS, CS, CCRN, CNE, RYT, Content Expert

Ms. Tazbir earned an Associate Degree, a Bachelor’s Degree, and then a Master’s Degree as a Clinical Nurse Specialist in Critical Care at Purdue University Calumet in Hammond, Indiana. Her clinical nursing background is in critical care nursing and is where she has worked the entirety of her career. She is currently at the University of Chicago Medicine in the Level 1 Trauma ICU.

Her teaching career has been at Purdue University Northwest, Hammond, IN, from 1997 to 2019, where she has taught advanced medical surgical nursing, pathophysiology, critical care, capstone in nursing, care of the older adult, physical assessment and NCLEX-RN preparation. She was awarded the Teaching Excellence Award at Purdue University Northwest in 2006 and attained the status of Professor of Nursing in 2011 at Purdue University Northwest. She has been a Certified Nurse Educator (CNE) since 2012.

Janice is a member of many professional organizations including Sigma Theta Tau, the American Association of Critical Care Nurses, and the American Association of Neuroscience Nurses. She has published numerous refereed articles and has authored four books over her career. She has presented locally, nationally and internationally. She teaches NCLEX reviews for Elsevier as a Live Review Instructor for Elsevier in Dallas, Texas, and is an expert on NCLEX and HESI exams, including test writing, test analysis, and teaching faculty regarding NCLEX. Her administrative involvement includes serving as past Undergraduate Program Coordinator at Purdue University Northwest, Hammond Campus. Her passions include traveling and yoga. She is a Registered Yoga Teacher (RYT) and practices yoga on and off the mat.

Lilah Harper, RN, BSN, MA, PhD, Accredited Provider Program Director

Dr. Harper earned her BS in Nursing and Master of Arts degrees from University of Arizona. Her MA focused on tests and measurements and adult education. She completed an Executive Program in Health Policy and Management at Harvard University and received a PhD in Education, focusing on curriculum and instruction, from Suffield University. Dr. Harper is a former Vice President of the Arizona Board of Nursing and has held varied positions in nursing, including nursing administration, nursing education, research, clinical trials management, and legal nurse consulting.

Mary Elizabeth Meeds, RN, BSN, PHN, Editor

As editor, Mrs. Meeds assisted with quiz development. Earning her BSN in 1986 at Augsburg College in Minneapolis, Mrs. Meeds worked in various hospital settings, including oncology, neurology, and pediatrics. She is experienced as a case manager for a home health care company and as the manager of a health center at a wilderness camp. Currently, Mrs. Meeds works as the technical writer for a non-profit organization, where she also volunteers her nursing services for the 3,000 people of all ages associated annually with the organization.