2014 Nurse Cruise to Alaska - Seminar

  Cruise Summary

Join speaker Cathy Lockett on this beautiful cruise through the Inside Passage to Alaska, where you will experience stunning scenery, native wildlife and exciting ports of call. While at sea, you will also attend four sessions of continuing education courses focusing on lab values integrated into cardiac and pulmonary assessments, cardiovascular pharmacology and EKG interpretation. Combine the best in scenic cruising and professional continuing education to create a truly unique vacation experience. During the training while at sea, you will learn more about how key lab value tests blend with pulmonary and cardiac assessments through clinical presentations and treatment modalities.
	You will also be able to incorporate the new AHA guidelines in cardiovascular pharmacology to improve patient outcomes. Conclude your training sessions with a look into EKG assessments. Learn to recognize abnormal EKGs and differentiate the causes of each. Enjoy this top-notch continuing education while at sea between some of the most beautiful ports of call ever seen. From the breathtaking Glacier National Park to the historic gold rush gateway of Skagway, Alaska, you will have a unique cruising experience. Contact us now to reserve your spot today!

  Cruise Schedule

Itinerary for August 16 – August 23, 2014
*Daily Itinerary Subject to Change

Itinerary	Date	Day	Duration
Seattle, Washington	Aug 16	SAT	DEPART 4:00PM
CHECK IN STARTS AT 12:00PM PIER: CRUISE TERMINAL PIER 91
At Sea	Aug 17	SUN
Juneau, Alaska	Aug 18	MON	ARRIVE 11:00AM / DEPART 10:00PM
Skagway, Alaska	Aug 19	TUE	ARRIVE 6:00AM / DEPART 8:15PM
Glacier Bay National Park, Alaska	Aug 20	WED	ARRIVE 6:00AM / DEPART 3:00PM
SCENIC CRUISING
Ketchikan, Alaska	Aug 21	THU	ARRIVE 7:00AM / DEPART 12:30PM
Victoria, British Columbia	Aug 22	FRI	ARRIVE 7:00PM / DEPART 11:59PM
Seattle, Washington	Aug 23	SAT	ARRIVE 7:00AM

  Cruise Details

Cruise Pricing
Inside Cabin – Category ID: $1,699 per person    SOLD OUT
Oceanview Cabin – Category OE: $2,369 per person   SOLD OUT
Balcony Cabin - Category BD: $2,599/person    SOLD OUT
Mini Suite – Category MD: $2,789/person    SOLD OUT

Note: Pricing includes seminar fee.

Please contact Heidi DesJarlais, heidi@higginstravel.com, or 715-834-2686, at Higgins Travel Leaders for pricing and availability. Pricing is based on double occupancy. Single, triple and quad pricing are available upon request and subject to availability.

Included Features

• Selected Accommodations on board the Golden Princess
• All meals and entertainment on board (Note: Specialty restaurants require cover charges)
• All mandatory government taxes & fees
• Live continuing education seminars while you cruise!

Items Not Included

• A Passport is required
• Airfare
• Pre-paid gratuities
• Airport/pier transfers
• Beverages other than water, coffee, tea, etc. at mealtime
• Items of a personal nature, such as phone calls, dry cleaning, etc.
• Optional tours and excursions
• Travel Insurance

Payment Information
A deposit of $300 double occupancy, $600 single occupancy, per person, along with a completed deposit form, is required to secure a reservation. The deposit form is available upon request or at www.pesi.com
The balance will be due to Higgins Travel Leaders by May 23, 2014.

Cancellation Schedule (Cruise Portion Only)

When Cancelled by	Fee (Per Person)
May 24 – June 13	20% of total charges
June 14 – July 11	50% of total charges
July 12 – July 25	75% of total charges
July 26 – August 16	100% of total charges

Additional Information
Airfare is not included in the above pricing. Our travel agency partner, Higgins Travel Leaders, will book your airfare upon your request. The booking fee of $35/ticket will be reduced to $25/ticket.
* A valid passport is required *.

A copy of the 2014 Princess Cruise Line brochure with all terms and conditions pertaining to this cruise is available at www.princesscruises.com.

  Learner Objectives

1. Illustrate the importance of electrolytes for normal cardiac function.
2. Apply a systematic approach to EKG interpretation.
3. Interpret murmurs and S3/S4 gallops with audio provided heart sounds during session.
4. Differentiate ischemia from infarction on the EKG.
5. Explain the pathophysiology of heart failure.
6. Analyze arterial blood gases and recognize compensated vs. uncompensated states.
7. Recognize the difference between normal and adventitious breath sounds upon audio auscultation.
8. Design the pharmacological management for acute coronary syndrome utilizing most current AHA guidelines.
9. Utilize the newest clinical guidelines for treating hypertension and heart failure.
10. Contrast the changes with evaluating the lipid profile and new statin guidelines.
11. Break down atrial fibrillation and contrast rate from rhythm control.
12. Differentiate monomorphic VT from SVT with aberrancy utilizing V1 and V6.
13. Examine the EKG and note the "dig" effect.

  Session Outlines

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Sunday, August 17, 2014 / 8:00 AM – 12:00 PM
Session 1: Integrating Lab Values into the Cardiac and Pulmonary Assessments (part I)

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Basic Metabolic Panel: Keeping Levels Therapeutic to Maintain Normal Cardiac Function
Sodium/Calcium/Potassium/CO2/Glucose
Magnesium/Phosphorous
EKG changes with abnormal levels of potassium, calcium and magnesium

Comprehensive Metabolic Panel
LFTs
Protein/Albumin levels

Cardiac Enzymes: Rise and Peak
CPKs
CPK/MBs
Troponin I and T

BNP: Is it Chronic or Acute Heart Failure?

Digoxin Levels: Factors Affecting Levels
Toxicity
Relationship to potassium

Urinalysis: Dilution vs. Concentration
Components measured
Routine vs. culture

Cardiac Assessment
PMI
Stethoscope placement for valve auscultation
Central pulses vs. distal pulses
Blood pressure assessment
Heart Sounds: Differentiating normal from abnormal
S1/S2: Onset of systole and diastole
S3/S4 gallop

Murmurs: Systolic vs. Diastolic
Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Aortic stenosis

JVD: Causes and Implications

Bedside Monitoring and Beyond
Action potential of cardiac cells
Cardiac conduction system
Understanding and interpreting waveforms
Differentiating electrical activity from mechanical contraction
Three-lead, five-lead and six-lead monitoring
Layout of the 12-lead, 15-lead and right-sided EKG
Apply coronary artery perfusion to cardiac musculature
Normal R wave progression
Systematic approach to EKG review

Acute Coronary Syndrome: Is it STEMI, NSTEMI or UA?
Patterns of Myocardial Injury and ischemia
ST and T wave changes
Reciprocal changes
Pathological Q waves

Heart Failure: Acute or Chronic?
Pathophysiology
Clinical presentation

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Sunday, August 17, 2014 / 1:00 PM – 4:00 PM
Session 2: Integrating Lab Values into the Cardiac and Pulmonary Assessments (part II)

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CBC with Differential: Understanding the Components
Hemoglobin & Hematocrit
Anemia/polycythemia
WBC: Shifts to the left and right
Leukopenia/leukocytosis
Thrombocytopenia

Coagulation Panel: Clotting Pointers
PTT
PT/INR
D dimer

Blood Gas Analysis: Interpretation Made Easy
ABGs/VBGs
Differentiating compensated from uncompensated acidosis/alkalosis

Labs and Sepsis: Utilize for Early Goal-Directed Therapy
Lactate levels
Base deficit

Pulmonary Assessment
Breath sounds auscultation
Normal vs. adventitious sounds
Work of Breathing
O2 saturation: Correlation to PaO2
Oxyhemoglobin dissociation curve: Shifts to the left and right
Percussion: Is it dull or resonant?

Pulmonary embolus: Use of D Dimer
Risk factors
Clinical presentation and EKG changes
Treatment modalities

COPD: Is it Bronchitis or Emphysema
Epidemiology
Pathophysiological changes
Treatment modalities

Pneumonia: Acquired vs. Nosocomial
Pathophysiology
Clinical presentation
Treatments

Sepsis: Systemic Inflammatory Response Syndrome
Early clinical presentation
Mortality rates
Treatment modalities

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Monday, August 18, 2014 / 8:00 AM – 10:00 AM
Session 3: Cardiovascular Pharmacology: Incorporating New AHA Guidelines to Improve Patient Outcomes

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Coronary Artery Disease / Acute Coronary Syndrome

Medication Management: Rationale for Treatment
Nitrates
Beta adrenergic blockers
Angiotensin converting enzyme inhibitors (ACE inhibitors)
Angiotensin receptor blockers (ARBs)
Antiplatelet aggregators
Anticoagulants
Fibrinolytics

Hyperlipidemia: New Guidelines and Risk Calculation

Lipid Goals
The "Statins" (HMG CoA reductase inhibitors)
Nicotinic acid
Fibric acid derivatives

Hypertension: New Standards to Simplify Treatment
Thiazide-type diuretics
Calcium channel blockers
ACE inhibitors
ARB
Alpha blockers
Beta adrenergic blockers

Heart Failure: Medication Management

Reduce the Risk of Readmissions
ACE inhibitors
ARB
Beta adrenergic blockers
Aldosterone antagonists
Nesiritide
Digoxin

Atrial Fibrillation: Rate Control or Rhythm Control?
- Antiarrhythmics
Rate control:
- Beta adrenergic blockers
- Calcium channel blockers
Rhythm control:
- Na channel blocking drugs
- K channel blocking drugs
Thromboembolism prevention:
- Vitamin K inhibitor
- Thrombin inhibitor
- Factor Xa inhibitor

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Thursday, August 21, 2014 / 1:00 PM – 4:00 PM
Session 4: EKG Assessment: Recognizing Abnormal EKGs and Differentiating the Causes

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Hex-Axial System Review
Determining Axis
4 quadrants of Axis
Quick approach for determining axis by quadrant
Axis practice utilizing "Thumbs technique"
Reasons for axis deviation

STEMI EKG Review
Anterior/Septal MI
Inferior/Posterior/MI
RV Infarction
Lateral MI

Bundle Branch Block Identification
Utilizing Leads V1 and V6
Right bundle branch block
Complete left bundle branch block

Fascicular Block Identification/AKA Hemiblocks
Utilizing Leads 1 and AVF
Left anterior hemiblock (LAH)
Left posterior hemiblock (LPH)

Wide Complex Tachycardias: Value of V1 and V6 in Determining Etiology
VT
SVT with aberrancy
Atrial fibrillation with Ashman Phenomenon

Morphology of V1 Complex
RBBB pattern
LBBB pattern
Left ventricular tachycardia
Right ventricular tachycardia

EKG Changes with Electrolyte Imbalances
Hypomagnesemia: A cause of Torsades de Pointes
Hypokalemia: Ventricular irritability and flattened T waves
Hyperkalemia: Damage to conduction and contraction

Common EKG Changes with the "Digoxin Effect"

  Continuing Education

Target Audience: Nurses, Nurse Practitioners, Physician Assistants, Clinical Nurse Specialists


Nurses/Nurse Practitioners/Clinical Nurse Specialists: PESI, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Nurses in full attendance will earn 12.0 contact hours. PARTIAL CONTACT HOURS WILL BE AWARDED FOR PARTIAL ATTENDANCE.

California Nurses: PESI, Inc. is an approved provider approved by the California Board of Registered Nursing, Provider Number 13305 for 12.0 contact hours. Please bring your license number to the seminar; certificates of successful completion will not be issued without your license number.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Full Attendance at this course qualifies for 14.4 contact hours. Full attendance in this activity is required; no partial contact hours will be issued for partial attendance. These contact hours are used for your license renewal.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: RBN2858. This course qualifies for 12.0 contact hours. Please make sure to bring your license number to the seminar so that we can report your attendance to CE Broker.

Physician Assistants: "This program is not yet approved for CME credit. Conference organizers plan to request 12.0 hours of AAPA Category 1CME credit from the Physician Assistant Review Panel. Total number of approved credits yet to be determined."