Behavioral Objectives



|Behavioral Objectives |Content Outline |Clinical Objectives |Learning opportunities |

|Apply the terms listed in the content column |Application of terms |Work with client and interdisciplinary |READ: |

|appropriate to the client situations. |Adjuvant Therapy |health care team for planning health care |Lewis (2011) |

| |Combination Chemotherapy |delivery to improve the quality of care | |

| |Cytology |across the life span. |Lehne (2010) |

| |Gene Therapy | | |

| |Intravesical |Assess the adequacy of the support system |McKinney (2009) |

| |Metastasis |of the client. | |

| |Palliation | |VIDEOS: |

| |Polyps |Identify clients and families unmet needs. | |

| |Progenitor cell | |VCR #0077 – Until I Die |

| |Tumor lysis syndrome |Identify providers and resources to meet | |

| |Tumor marker |the needs of clients. |VCR #0093 – Care of Colostomies & Ileostomies. |

| |Spinal Cord Compression | | |

| |Superior Vena Cava Syndrome |Perform health screening. |VCR #M122 – Preparing the Ostomy patient for discharge. |

| |N. Wilm’s Tumor | | |

|Compare and contrast the etiology and related | |Contribute to the interdisciplinary plan of| |

|pathophysiology of excessive cellular |Overview of typical/atypical cells |care. | |

|proliferation across the lifespan. |Developmental considerations | | |

| |Infant |Prioritize client care and follow-up on | |

| |Child |problems that warrant investigation. | |

| |Adolescent | | |

| |Adult |Read and discuss relevant, current nursing | |

| |Older adult |practice journal articles and apply to | |

| |Pathophysiology |practice. | |

| |Proliferation growth patterns | | |

| |Neoplastic pathology |Inform and support health care rights of | |

| |Neoplastic classification systems |clients. | |

| |Staging/grading | | |

| |Cellular differentiation |Support the client’s right of | |

| |Carcinogenesis |self-determination and choice even when | |

| |Phases |these choices conflict with values of the | |

| |Etiologies |individual professional. | |

| |Viruses | | |

| |Physical agents |Identify learning needs of clients related | |

| |Chemical Agents (Environmental) |to health promotion, maintenance and risk | |

| |Oncogenes |reduction. | |

| |Tumor suppressor genes | | |

|Analyze factors included in the |Genetic Predisposition |Participate in interdisciplinary health | |

|assessment of the client |Immune Surveillance Theory |care team meetings/conferences. | |

|experiencing problems of |Stem Cell theory | | |

|cellular deviation (Cancer). |Cancer assessment |Select and carry out safe and appropriate | |

| |Interview |activities to assist client to meet basic | |

| |Chief complaint |physiologic needs, including: circulation, | |

| |History of present illness |nutrition, oxygenation, activity, | |

| |Prior medical history |elimination, comfort, rest and sleep. | |

| |Treatment/ Medication History (Prescribed/Non-prescribed) | | |

| |Family/social/occupational history | | |

| |Psychosocial Assessment | | |

| |Role Behavior | | |

| |Body Image | | |

| |Coping Mechanisms | | |

| |Knowledge of health maintenance | | |

| |Identify risk factors | | |

| |Physical exam | | |

| |Head to toe | | |

| |Assess for implication of disease and treatment/medications | | |

| |Pain – chronic vs. acute | | |

| |Diagnostic tests | | |

| |Laboratory studies | | |

| |Carcinogenic Embryonic Antigen (CEA) | | |

| |Deoxyriboneucleic Acid (DNA) Ploidy | | |

| |CA 15-3 | | |

| |CA 125 | | |

| |Her 2NU | | |

| |Papanicolaou (PAP) test | | |

| |Prostate Surface Antigen (PSA) | | |

| |CBC | | |

| |RBC | | |

| |Hgb/Hct | | |

| |Platelet | | |

| |WBC | | |

| |Differential | | |

| |Absolute Neutrophil Count (ANC) | | |

| |Estrogen Receptor Assay | | |

| |Progesterone Receptor Assay | | |

| |Alpha Feto Protein (AFP) | | |

| |Radiology/Imaging | | |

| |Chest X-ray | | |

| |Magnetic Resonance Imaging (MRI) | | |

| |Computerized Axial Tomography (CT) | | |

| |Ultrasound | | |

| |Brain Scan | | |

| |Bone Scan | | |

| |Liver Scan | | |

| |Metastatic Survey | | |

| |Mammogram | | |

| |Invasive/biopsies | | |

| |Punch | | |

| |Thin Needle | | |

| |Bone Marrow | | |

| |Frozen sections | | |

| |Cultural influences | | |

| |Hereditary | | |

| |Environmental | | |

| |Health beliefs/practices | | |

| |Developmental | | |

| |Age specific assessment data | | |

| |Behavioral/emotional response to health care providers | | |

| |Behavioral/emotional response to death and dying | | |

| | | | |

| |Selected problems of cellular proliferation. | | |

| |Hematopoetic system | | |

| |Leukemia | | |

| |Lymphatic | | |

| |Lymphoma | | |

|Differentiate between the etiology, |Hodgkins | | |

|pathophysiology, and clinical manifestations of |Non-Hodgkins | | |

|selected problems of cellular proliferation. |Skin | | |

| |Gastrointestinal | | |

| |Liver | | |

| |Pancreas | | |

| |Colorectal | | |

| |Lung | | |

| |Brain | | |

| |Bladder | | |

| |Larnyx | | |

| |Reproductive Female | | |

| |Uterine | | |

| |Cervical | | |

| |Ovarian | | |

| |Breast | | |

| |Vulvar | | |

| |Reproductive – Male | | |

| |Testicular | | |

| |Prostate | | |

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| |Treatment modalities | | |

| |Chemotherapy | | |

| |Systemic | | |

| |Intravesical | | |

|Discuss the various treatment options for clients|Intrathecal | | |

|experiencing problems of cellular proliferation. |Radiation | | |

| |External Beam | | |

| |Internal | | |

| |Hormonal Therapy | | |

| |Transplantation | | |

| |Bone Marrow | | |

| |Solid Organ | | |

| |Immune Modulated Therapy | | |

| |Biological Response Modifiers (BRM) (Cytokines) | | |

| |Colony Stimulating Factors (CSF) | | |

| |Interferon | | |

| |Interleukins | | |

| |Gene therapy | | |

| |Alternative Treatments | | |

| |Pain Control | | |

| |Physiologic dying process | | |

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| |Selected nursing diagnoses/nursing implementation/evaluation. | | |

| |High risk for complications: Medical treatment | | |

| |Independent nursing interventions | | |

| |See head to toe assessment | | |

|Discuss analysis, planning, implementation and |Age related hydration status | | |

|evaluation for the nursing management of clients |Intake and output | | |

|with selected problems of cellular proliferation.|Monitor pertinent diagnostic tests | | |

| |Maintain skin integrity | | |

| |Immune suppressed precautions | | |

| |Bleeding precautions | | |

| |Nutritional status | | |

| |Oral hygiene | | |

| |Vital signs | | |

| |Protect photosensitive skin | | |

| |Collaborate interventions | | |

| |Administer replacement fluid | | |

| |Intravenous | | |

| |Total parental nutrition (TPN) | | |

| |Administer medications and monitor for desired effects/adverse | | |

| |effects/side effects | | |

| |Antiemetics | | |

| |Antidiarrheal | | |

| |Antineoplastic drugs | | |

| |Biologic response modifiers (BRM) | | |

| |Antianxiety | | |

| |Topical anesthetics | | |

| |Antacids | | |

| |Antibiotics | | |

| |Vitamins/minerals | | |

| |Stool softeners | | |

| |Laxatives | | |

| |GI stimulants | | |

| |Pain medication | | |

| |Steroids | | |

| |Blood products | | |

| |Refer dietary for nutritional support | | |

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| |Recognition of complications | | |

| |Hemorrhage | | |

| |Nephrotoxity | | |

| |Cardiotoxicity | | |

| |Neurotoxicity | | |

| |Sepsis/infection | | |

| |Pulmonary fibrosis | | |

| |Gastrointestinal | | |

| |Hyperuricemia | | |

| |Hypercalcemia | | |

| |Malnutrition | | |

| |Bowel obstruction | | |

| |Impaired skin integrity | | |

| |Death | | |

| |Pruritis | | |

| |Alopecia | | |

| |Alteration in reproduction | | |

| |Blood dyscrasia | | |

| |Fatigue/malaise | | |

| |Second primary neoplasm | | |

| |Neutropenia | | |

| |Thrombocytopenia | | |

| |Anemia | | |

| |The client will have decreased risk for medical complications as | | |

| |evidenced by: | | |

| |No infection/sepsis | | |

| |No impared skin integrity | | |

| |No excessive weight loss | | |

| |No bleeding | | |

| |Maintains adequate bowel elimination | | |

| |Vital signs WNL | | |

| |Skin integrity intact | | |

| |Gastrointestinal mucosa intact | | |

| |Lab work within normal limits | | |

| |No evidence of congestive heart failure | | |

| |Pulmonary function test WNL | | |

| |Hydration status WNL | | |

| |Absence of graft versus host disease | | |

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| |High risk for post op complications | | |

| |Surgical modalities | | |

| |Pancreataduodenectomy (Whipple) | | |

| |Gastrectomy | | |

| |Segmental Resection with Anastamosis | | |

| |Abdominal Perineal with colostomy | | |

| |Ureteroenterocutaneous Diversions | | |

| |Laryngectomy | | |

| |Orchiectomy | | |

| |Prostatectomy | | |

| |Hysterectomy | | |

| |Mastectomy | | |

| |Cryotherapy | | |

| |Palliative | | |

| |Independent interventions | | |

| |Colostomy | | |

| |Drains/assess perineal packing | | |

| |Fecal drainage | | |

| |Bowel sounds | | |

| |Laryngectomy | | |

| |Maintain airway | | |

| |Promoting communication and speech | | |

| |Neck exercises | | |

| |Hemorrhaging | | |

| |Drains | | |

| |Semi-fowler’s position | | |

| |Mastectomy | | |

| |Monitor edema | | |

| |Avoid cuffs/sticks to affected side | | |

| |Progressive range of motion exercises | | |

| |Drains | | |

| |Collaborative interventions | | |

| |Administer medications and monitor for desired effects/adverse | | |

| |effects/ side effects | | |

| |Antibiotics | | |

| |Narcotics | | |

| |Prophylactic heparin /lovenox | | |

| |Collaborate with enterostomal therapist | | |

| |Collaborate with Reach To Recovery | | |

| |Collaborate with Lost Chords | | |

| |Oxygen support | | |

| |Recognition of complications | | |

| |Hemorrhage | | |

| |Infection: wound and systemic | | |

| |Fistula formation | | |

| |Peritonitis | | |

| |Delayed wound healing: dehiscence, evisceration | | |

| |Malnutrition | | |

| |Lymphedema | | |

| |Bowel obstruction | | |

| |Adhesions | | |

| |Carotid artery rupture | | |

| |The client will not experience post-op complications as evidenced by: | | |

| |Wound healing | | |

| |Vital signs | | |

| |Bowel sounds | | |

| |Abdominal girth | | |

| |Homan’s sign | | |

| |Tolerates diet | | |

| |Laboratory studies | | |

| |Patent airway | | |

| |No lymphedema | | |

| |Adequate elimination | | |

| |Fluid volume status | | |

| |Altered health maintenance: Knowledge Deficit | | |

| |Client teaching | | |

| |Assess readiness to learn, ability, knowledge | | |

| |Health promotion/early diagnosis | | |

| |Ten steps of cancer prevention | | |

| |Seven warning signs | | |

| |Screening tests | | |

| |Reportable signs/symptoms | | |

| |Post radiation | | |

| |Post chemotherapy | | |

| |Post operative | | |

| |Laryngeal stoma care | | |

| |Ostomy care | | |

| |Medication teaching | | |

| |Rest/activity | | |

| |Life style modifications | | |

| |Nutritional | | |

| |Maintenance of fluid balance (Age specific) | | |

| |Communication | | |

| |Community Resources | | |

| |American Ostomy Association | | |

| |United Ostomy Association of America | | |

| |National Cancer Information Service | | |

| |American Cancer Society | | |

| |Leukemia Society of America | | |

| |Home health | | |

| |Hospice | | |

| |The client will have improved health maintenance as evidenced by: | | |

| |Listing health promotion activities | | |

| |Identifying reportable signs and symptoms | | |

| |Describing the purpose, correct administration and | | |

| |side effects of meds | | |

| |Ability to discuss diagnosis, surgical procedure, | | |

| |and post-op care | | |

| |Demonstrates laryngeal stoma care | | |

| |Increasing activity as tolerated | | |

| |Achieves optimum level of nutrition through prescribed diet| | |

| |Utilizing community resources | | |

| |Range of motion exercises | | |

| |Demonstrates ostomy care | | |

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| |Body Image Disturbance | | |

| |Independent nursing interventions | | |

| |Establish trust and rapport | | |

| |Utilize therapeutic communication | | |

| |techniques to encourage verbalization | | |

| |of feelings | | |

| |Assess prior coping strategies and encourage development of new | | |

| |strategies | | |

| |Encourage continued participation in activities and decision making | | |

| |Facilitate the client’s progression through stages of loss | | |

| |Encourage good hygiene, grooming, and sex appropriate items | | |

| |Encourage client to ask questions | | |

| |Collaborative | | |

| |Refer to appropriate support group | | |

| |Lost Chords | | |

| |Reach To Recovery | | |

| |Ostomate (Ostomy Association) | | |

| |CanSurmount | | |

| |CanCope | | |

| |Dialogue | | |

| |A Time for Me | | |

| |Breast cancer support group for | | |

| |men | | |

| |Leukemia Society of America | | |

| |The client will acknowledge change in body image as evidenced by: | | |

| |Participating in self care | | |

| |Verbalizing feelings to nurse/significant other | | |

| |Facilitating client from sick role to well role | | |

| |Appearing well groomed and attractively dressed | | |

| |Able to communicate effectively | | |

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| |Anticipatory grieving | | |

| |Independent nursing interventions | | |

| |Establish a trusting relationship that encourages | | |

| |communication | | |

| |Clarify, re-focus, and supply information as needed | | |

| |Help family plan care of client throughout stages of illness | | |

| |Provide and assist in arrangement for hospice care | | |

| |Arrange for spiritual support in accordance with family’s beliefs | | |

| |and/or affiliations | | |

| |Help family to acknowledge loss | | |

| |Collaborative | | |

| |Refer to appropriate support group | | |

| |Make a Wish Foundation | | |

| |Ronald McDonald House | | |

| |Candle Lighters | | |

| |Hospice | | |

| |Pastoral services | | |

| |The client/family will progress through the | | |

| |phases of grief as evidenced by: | | |

| |Increased verbalization and expression of grief | | |

| |Identifying resources available to aide coping strategies during | | |

| |grieving | | |

| |Use resources and supports appropriately | | |

| |Discussing the future openly with each other | | |

| |Alteration in comfort: Acute/chronic pain | | |

| |Independent interventions | | |

| |Assessment of chronic pain | | |

| |Provide psychological support | | |

| |Teach about pharmacological pain control regimens | | |

| |Teach distraction techniques | | |

| |Benson’s Relaxation Technique | | |

| |Guided Imagery | | |

| |Music Therapy | | |

| |Position for comfort | | |

| |Collaborative Interventions | | |

| |Administer medications and monitor for desired effects/adverse | | |

| |effects/side effects. | | |

| |Analgesics | | |

| |Narcotics | | |

| |Non-Narcotic | | |

| |Anti-anxiety | | |

| |Anti-depressants | | |

| |Sedative | | |

| |Hypnotics | | |

| |Equal analgesic dosing | | |

| |Refer to: | | |

| |Physical therapy | | |

| |Social services | | |

| |Clergy | | |

| |Psychological counselor | | |

| |Cancer support groups | | |

| |Hospice | | |

| |Home Health | | |

| |Pain clinic | | |

| |Recognition of complications | | |

| |Intractable pain | | |

| |Respiratory depression | | |

| |Depression | | |

| |Immobility | | |

| |The client will have relief of pain as evidenced by: | | |

| |Stating a 1 of pain on a pain scale of 1-10 | | |

| |Participating in ADL’s and other activities | | |

| |Demonstrating use of distraction techniques | | |

| |Verbalizing 3 techniques to maintain pain at an acceptable level to | | |

| |client | | |

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n:soph\fall\UnitVCancer Revised 07/11

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