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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