Behavioral Objectives
|Behavioral Objectives |Content Outline |Clinical Objectives |Learning Opportunities |
|Apply the terms listed in the content |Application of terms |Take a client history using structured and |READ: |
|column appropriate to the client |Afterload |unstructured data collection tools to obtain physical, |Lewis (2011) |
|situations. |Bruit |psychosocial, spiritual, cultural, familial, | |
| |Cardiac output |occupational, environmental information, risk factors, |Lehne (2010) |
| |Cardiac tamponade |and client resources. | |
| |Gallop rhythm | |McKinney (2009) |
| |Preload |Perform assessment to identify health status and monitor | |
| |Stroke volume |for change in health status. |VIDEOS: |
| |Thalassemia | |#0144-12 Lead EKG |
| | |Validate and report assessment data using assessment | |
|Compare and contrast the normal anatomy and |Anatomy & Physiology of the Cardiovascular System. |tools. |#M018-Physical Assessment-The Heart |
|physiology to the pathophysiology of disease |Developmental considerations | | |
|processes in the cardiovascular system across the |Infant |Identify complex multi-system health care problems of | |
|lifespan. |Child |clients. |COMPUTER SIMULATIONS: |
| |Adolescent | | |
| |Adult |Analyze and interpret health data of clients. |#5028-Physical Examination of the |
| |Older adult | |Cardiovascular System (Laser) |
| |Pathophysiology of cardiovascular system |Formulate nursing diagnoses based upon analysis of health| |
| |1. Alteration in perfusion |data. |#5043-Critical Care Nursing-Critical |
| | | |Thinking: Cardiovascular Care |
|Analyze factors included in the |Cardiovascular assessment |Incorporate multiple determinants of health in clinical | |
|assessment of the client experiencing |Interview |care when providing care for individuals and families. |Review Level II Cardiovascular Medications|
|complex problems of the |Chief complaint | | |
|cardiovascular system, including the |History of present illness. |Implement nursing care to promote health and manage acute|MEDCOM ONLINE FILMS |
|developmental and cultural |Prior medical history |and chronic health problems and disabilities. | |
|considerations. |Medication history (prescription/non- prescription) | |VIDM109-T Basic Cardiac Monitoring: |
| |Family/social/occupational history |Perform therapeutic and preventive nursing measures and |Understanding Fundamentals |
| |Knowledge of health maintenance |administer treatments and medications as authorized by | |
| |Identify risk factors for cardiovascular disease. |law and determined by the BNE. |VIDM259-T Cardiac Auscultation: the |
| |Physical exam | |Process of Basic Cardiac Auscultation |
| |Level of consciousness |Identify short and long-term goals/outcomes, select | |
| |Heart sounds (S1, S2, S3, S4, murmurs) |interventions, and establish priorities for care in | |
| |Telemetry, heart rate & rhythm |collaboration with the client. |VID78584-T Heart Medications: Anatomy |
| |Peripheral pulses/point of maximal impulse (PMI) |Serve as model & resource for health education & |Review and Angina |
| |Color (central & peripheral) |information. | |
| |Neurovascular assessment of affected extremities | |VID78587-T Heart Medications: |
| |Pain |Select and carry out safe and appropriate activities to |Antiarrhythmic Agents, Part I |
| |Pallor |assist client to meet basic physiologic needs, including:| |
| |Pulses |circulation, nutrition, oxygenation, activity, |VID78588-T Heart Medications: |
| |Paresthesia |elimination, comfort, rest and sleep. |Antiarrhythmic Agents, Part II |
| |Paralysis | | |
| |Piokiothermia (coldness) |Act as a role model in maintaining client |VID78585-T Heart Medications: |
| |Capillary refill |confidentiality. |Blood Pressure Medications and |
| |Vital signs | |Anticoagulants |
| |B/P lying, sitting, standing |Assume accountability when using independent clinical | |
| |HR, Rhythm |judgment and established protocols. |VID78586-T Heart Medications: |
| |Activity level | |Heart Failure Medications and Cholesterol |
| |Chest pain |Evaluate, document, and report responses to medications, |Lowering Agents |
| |Peripheral/sacral edema |treatments, and procedures and communicate the same to | |
| |Jugular vein distention |other health care professionals clearly and accurately. | |
| |Intake/output/daily weights | | |
| |Diagnostic tests |Apply change strategies to achieve stated outcomes. | |
| |Laboratory studies | | |
| |Cardiac enzymes |Use evaluation tools to measure processes and outcomes. | |
| |Lipid profile | | |
| |Drug levels |Use critical thinking as a basis for decision making in | |
| |Electrolytes |nursing practice. | |
| |Coagulation studies | | |
| |Prothrombin (PT) |Participate in the evaluation of care administered by the| |
| |International normalized ratio (INR) |interdisciplinary health care team. | |
| |Partial thromboplastin time (PTT) | | |
| |Hemoglobin electrophoresis |Use organizational & management skills when utilizing | |
| |2. Radiology/Imaging |resources to meet goals/outcomes, & enhance quality of | |
| |Cardiac catheterization |nursing care and level of client satisfaction. | |
| |Nuclear cardiology | | |
| |Angiograph |Consult with, utilize and make referrals to community | |
| |Other |agencies and health care resources to provide continuity | |
| |Electrocardiogram |of care. | |
| |Continuous monitoring; telemetry | | |
| |12 Lead EKG |Advocate on behalf of the client with other members of | |
| |Holter monitoring |the interdisciplinary health care team. | |
| |Echocardiogram | | |
| |Stress test | | |
| |Electrophysiology studies (EPS) | | |
| |Cultural influences | | |
| |Hereditary/genetic influences | | |
| |Environmental | | |
| |Health beliefs/practices | | |
| |Developmental | | |
| |Age specific assessment data | | |
| |Heart sounds | | |
| |Vital signs | | |
| |Breathing patterns | | |
| |Fluid/electrolytes | | |
| |Nutritional | | |
| |2. Behavioral/emotional response to health care providers | | |
| | | | |
| |IV. Complex Cardiovascular Problems | | |
| |Angina/myocardial infarction | | |
| |Valvular disorders | | |
| |Stenosis | | |
| |Insufficiency | | |
| |Mitral valve prolapse | | |
| |Aortic aneurysm | | |
| |Peripheral vascular disorder | | |
| |Arterial | | |
|Differentiate between the etiology, pathophysiology, |Venous | | |
|and clinical manifestations of selected complex | | | |
|cardiovascular problems and associated technology. | | | |
| | | | |
| | | | |
| |Dysrhythmia | | |
| |Minor | | |
| |Bradycardia | | |
| |Tachycardia | | |
| |Premature ventricular contractions | | |
| |Atrial fibrillation | | |
| |Supraventricular tachycardia | | |
| |Major | | |
| |Ventricular tachycardia | | |
| |Ventricular fibrillation | | |
| |Asystole | | |
| |Complete heart block | | |
| |Hemodynamic monitoring | | |
| |Arterial lines | | |
| |Central venous pressure | | |
| |Pulmonary artery pressure monitoring | | |
| |Intraortic balloon pump | | |
| |Venous stasis ulcer | | |
| |Venous insufficiency | | |
| |Sickle cell disease | | |
| |Anemias | | |
| |Iron Deficiency | | |
| |Vitamin B-12 (pernicious) | | |
| |Aplastic | | |
| |Folic Acid deficiency | | |
| | | | |
| |Selected nursing diagnoses/nursing implementation/evaluation. | | |
| |A. Alteration in tissue perfusion | | |
| |1. Independent interventions | | |
| |a. Neurovascular assessment | | |
| |b. Position client | | |
| |c. Maintain body temperature | | |
| |d. Promote factors that improve | | |
| |blood flow | | |
|Discuss analysis, planning, implementation and |Exercise | | |
|evaluation for the nursing management of clients with|Prevent trauma | | |
|complex cardiovascular problems. |g. Nutritional support | | |
| |h. Maintain fluid balance | | |
| |2. Collaborative interventions | | |
| |Administer medications and monitor for desired effects/adverse | | |
| |effects/side effects | | |
| |Anticoagulants | | |
| |Antiplatelet aggregator | | |
| |Antidysrthymics | | |
| |Antianginal | | |
| |Antihypertensives | | |
| |Oxygen support | | |
| |Surgical modalities | | |
| |Abdominal aortic aneurysm repair | | |
| |Femoral-popliteal by-pass | | |
| |Ligation/vein stripping | | |
| |Lumbar sympathectomy | | |
| |Percutaneous transluminal angioplasty (PCTA) | | |
| |Coronary artery bypass graft (CABG) | | |
| |Cardioversion | | |
| |Defibrillation | | |
| |3. Recognition of complications | | |
| |Thrombus/embolus | | |
| |Surgical complications | | |
| |Amputation | | |
| |4. The client will have improved tissue | | |
| |perfusion as evidenced by: | | |
| |neurovascular status WNL | | |
| |increased activity tolerance | | |
| |decreased pain | | |
| | | | |
| | | | |
| |Pain | | |
| |Independent interventions | | |
| |Assess the pain | | |
| |Believe the client | | |
| |Age specific scale | | |
| |Location, type, precipitating factors alleviating factors | | |
| |Rule out complications | | |
| |What is the worse thing this pain could be and rule it out? | | |
| |Is the pain expected/unexpected? | | |
| |List specific assessment data to rule out complications | | |
| |Take an action | | |
| |Notify the doctor if a complication | | |
| |Administer appropriate medications (see collaborative) | | |
| |Independent nursing interventions | | |
| |Imagery | | |
| |Distraction | | |
| |Environment | | |
| |Therapeutic communication | | |
| |Position client | | |
| |Safety | | |
| |Evaluation | | |
| |Collaborative interventions | | |
| |Administer medications and monitor for desired effects/adverse | | |
| |effects/side effects | | |
| |Narcotics | | |
| |Nitrates | | |
| |Thrombolytics | | |
| |Nonopioids | | |
| |NSAIDS | | |
| |Around the clock (ATC) analgesics | | |
| |Oxygen support | | |
| |Respiratory therapy | | |
| |Recognition of complication | | |
| |Unrelieved pain | | |
| |The client will state (indicate) that the | | |
| |pain has decreased. | | |
| |Altered health maintenance: Knowledge | | |
| |deficit | | |
| |Client teaching | | |
| |Assess readiness to learn, ability, knowledge | | |
| |Avoid aggravating factors | | |
| |Promotion of alleviating factors | | |
| |Reportable signs/symptoms | | |
| |Medication teaching | | |
| |Rest/activity | | |
| |Risk factors | | |
| |Life style modifications | | |
| |Nutrition | | |
| |Low fat | | |
| |Low cholesterol | | |
| |Low salt | | |
| |Maintenance of fluid balance | | |
| |Health promotion activities | | |
| |Genetic counseling | | |
| |Community Resources | | |
| |American Heart Association | | |
| |Mended Heart Association | | |
| |Cardiac rehabilitation | | |
| |National Association for Sickle Cell Disease | | |
| |The client will have improved health maintenance as evidenced by:| | |
| |Identifying aggravating and alleviating factors. | | |
| |Identifying reportable signs and symptoms | | |
| |Describing the purpose, correct administration and side effects | | |
| |of prescribed medications. | | |
| |Identify risk factors. | | |
| |Modification of life style | | |
| |No post op complications | | |
| |Utilizing community resources. | | |
| |Ineffective Individual coping: Anxiety, fear, powerlessness, | | |
| |dependence. See Unit III-Care of the Client | | |
| |Experiencing Respiratory Problems) | | |
| |Altered family processes | | |
| |Identify causative and contributing factors | | |
| |Family, significant others | | |
| |Provide ongoing information | | |
| |Assist family with appraisal of situation | | |
| |Initiate health teaching and referrals | | |
| |Spousal support Groups | | |
| |Grief Support Groups | | |
| |Parent support groups | | |
| |The family will have improved family processes as evidenced by: | | |
| |Participating in planning/care | | |
| |of client | | |
| |Verbalizing feelings to nurse | | |
| |and each other | | |
| |Verbalizing feelings of grief | | |
| |Maintaining functional family unit. | | |
| |Facilitating client from sick role | | |
| |to well. | | |
N:Soph\Fall\RNSG 2535\Unit II Cardiovascular Revised 05/10
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