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 | | |
| | | | |
| |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 | | |
| | | | |
| | | | |
| | | | |
| | | | |
| |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 | | |
| | | | |
| |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 | | |
| | | | |
| |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 | | |
| | | | |
| |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 | | |
| | | | |
| | | | |
| |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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