Behavioral Objectives



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

|Apply the terms listed in the content column |Application of terms |Apply knowledge of how changes in clients’|READ: |

|appropriate to the client situations. |Anasarca |personal behavior improve client’s health.|Lewis (2011) |

| |Anastomosis | | |

| |Asterixis |Identify client’s unmet needs from a |Lehne (2010) |

| |Bariatric |holistic perspective. | |

| |Biliary atresia | |McKinney (2009) |

| |Celiac disease |Participate in peer review and quality | |

| |Esophageal atresia |improvement processes. | |

| |Fistula | |VIDEO: |

| |Gluten free diet |Communicate plan of care to nurses and |#0159-Dealing With Problems During |

| |Hernias |other interdisciplinary health care team |Laparoscopic Cholecystectomy |

| |Interstitial edema |members. | |

| |Ileus | |#0164-Laparoscopic Treatment of |

| |Obstipation |Promote a safe, effective environment |Common Duct Stones |

| |Osmolatity |conducive to the | |

| |Steatorrhea |optimal health and dignity of the client. |#0107-Nurse’s View of Endoscopy |

| |Tenesmus | | |

| |Third spacing |Select and carry out safe and appropriate | |

| |Volvulus |activities to assist client to meet basic |#1112-The Operation: Liver Transplant |

|Compare and contrast the normal anatomy and | |physiologic needs, including: circulation,| |

|physiology to the pathophysiology of the disease |Anatomy & Physiology of the Gastrointestinal/ accessory organ |nutrition, oxygenation, activity, |#1113-The Operation: Colon Resection |

|processes in the gastrointestinal system across the |system |elimination, comfort, rest and sleep. | |

|lifespan. |Developmental considerations | | |

| |Infant |Use interdisciplinary resources within the|COMPUTER SIMULATION: |

| |Child |institution to address ethical and legal |#5027-Physical Examination of the |

| |Adolescent |concerns. |Abdomen |

| |Adult | | |

| |Older adult |Use current technology to enhance client |#5041-Apply Critical Thinking to |

| |Pathophysiology of gastrointestinal system and accessory |care |Nursing Skills: Nutrition and |

|Analyze factors included in the assessment of the |organs | |Elimination |

|client experiencing complex problems of the | | | |

|gastrointestinal system, including the developmental |Gastrointestinal/accessory organs assessment | | |

|and cultural considerations. |Interview |Identify and communicate reasons and | |

| |Chief complaint |rationales for | |

| |History of present illness |deviation from plan of care to |MEDCOM ONLINE FILMS: |

| |Prior medical history |interdisciplinary health care team. |VIDM216-T Caring for the Stoma, Caring for the |

| | | |Patient: Enterostomal Nursing |

| |Medication history (prescription/nonprescription) | | |

| |Family/social/occupational history | |VIDM231-T Diabetes in Clinical Practice |

| |Knowledge of health maintenance | |VIDM140-T Nasogastric Intubation, Balloon Gastronomy|

| |Identify risk factors | |Tube Replacement |

| | | |VIDM133-T Nurses' Guide to Enteral Feeding Tubes |

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| | | | |

| | | |Review Level II Gastrointestinal medications |

| |Physical exam | | |

| |Bowel sounds |Promote the effective | |

| |Size, shape, and abdominal girth |coordination of client-centered health | |

| |Tenderness/rebound tenderness |care. | |

| |Pain | | |

| |Nausea/vomiting |Identify priorities and make judgments | |

| |Hydration status |concerning the needs of multiple clients | |

| |Vital signs |in order to organize care. | |

| |Skin color | | |

| |Fluid wave (tympanic wave) | | |

| |Diagnostic tests | | |

| |Laboratory studies | | |

| |Stool | | |

| |Electrolytes | | |

| |Complete blood count (CBC) | | |

| |Liver function tests (LFT) | | |

| |Amylase/lipase | | |

| |Serum albumin | | |

| |Gastric analysis | | |

| |H pylori | | |

| |Serum ammonia | | |

| |Bilirubin | | |

| |Radiology/Imaging | | |

| |Upper GI with/without small bowel follow through | | |

| |Barium swallow | | |

| |Barium enema | | |

| |Gall bladder series | | |

| |Gall bladder sonogram | | |

| |Sonogram | | |

| |Flat plate of the abdomen | | |

| |Computed axial tomography (CT) | | |

| |Magnetic resonance imaging (MRI) | | |

| |Invasive | | |

| |Liver biopsy | | |

| |GI biopsy | | |

| |Endoscopic | | |

| |Esophagogastroduodenoscopy (EGD) | | |

| |Endoscopicretrograde- cholangiopancreatgram (ERCP) | | |

| |Colonoscopy (sigmoidoscopy, proctoscopy, anoscopy) | | |

| |Cultural influences | | |

| |Hereditary | | |

| |Environmental | | |

| |Health beliefs/practices | | |

| |Developmental | | |

| |Age specific assessment data | | |

| |Muscle tone | | |

| |Vital signs | | |

| |Fluid /electrolytes | | |

| |Nutritional | | |

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

| | | | |

| |Complex Gastrointestinal/accessory organ problems | | |

| |Peptic ulcer disease | | |

| |Gallbladder disease | | |

| |Inflammatory bowel disease | | |

| |Regional enteritis (Crohn’s) | | |

|Differentiate between the etiology, pathophysiology, |Ulcerative colitis | | |

|and clinical manifestations of selected complex |Diverticulosis/diverticulitis | | |

|gastrointestinal/accessory problems |Diabetes Mellitis | | |

| |Hepatitis | | |

| |Liver Failure | | |

| |Pancreatitis | | |

| |I. Morbid Obesity | | |

|Discuss analysis, planning, |Selected nursing diagnoses/selected nursing implementation | | |

|implementation and evaluation for the |Fluid and electrolyte imbalance | | |

|nursing management of clients with |Independent interventions | | |

|complex gastrointestinal |Abdominal assessment | | |

|problems/accessory organs. |Age related hydration status | | |

| |Intake and output | | |

| |Monitor pertinent diagnostic tests | | |

| |Maintain skin integrity | | |

| |Collaborate interventions | | |

| |Administer replacement fluid | | |

| |Intravenous therapy | | |

| |Total parenteral nutrition (TPN) | | |

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

| |effects/side | | |

| |Antidiarrheal | | |

| |Steroids | | |

| |H-2 receptor antagonist | | |

| |Antisecretory | | |

| |Mucosal barriers | | |

| |Antacids | | |

| |Antibiotics | | |

| |Vitamins | | |

| |Stool softeners | | |

| |Laxatives | | |

| |Anticholinergic | | |

| |GI stimulant | | |

| |Antiemetic | | |

| |Proton pump inhibitors | | |

| |Pancreatic enzymes | | |

| |Insulins | | |

| |Antidiabetics | | |

| |Gastric therapy | | |

| |Lavage | | |

| |Nasogastric | | |

| |Sengstaken-Blakemore | | |

| |Paracentesis | | |

| |Recognition of complications | | |

| |Hemorrhage | | |

| |Portal hypertension | | |

| |Esophageal varices | | |

| |Ascites | | |

| |Anasarca | | |

| |Hepatic encephalopathy | | |

| |Clotting disorders | | |

| |Paracentesis | | |

| |Pernicious anemia | | |

| |Perforation/peritonitis | | |

| |Hypovolemic shock | | |

| |Hyperglycemia | | |

| |Hypercalcemia | | |

| |Malnutrition | | |

| |Bowel obstruction | | |

| |Impaired skin integrity | | |

| |Infection | | |

| |Septic shock | | |

| |Skin excoriation | | |

| |Diabetic Ketoacidosis (DKA) | | |

| |Hyperglycemic hyperosmolar non-ketotic coma (HHNK) | | |

| |The client will have improved fluid and electrolyte balance as | | |

| |evidenced by | | |

| |Demonstrate no signs and symptoms of dehydration | | |

| |Improved laboratory studies | | |

| |Increase intake of fluids to a specified | | |

| |amount according to age and metabolic | | |

| |needs | | |

| |Maintains adequate bowel elimination | | |

| |Vital signs | | |

| |High risk for post op complications | | |

| |Surgical modalities | | |

| |Cholecystectomy | | |

| |Gastrectomy | | |

| |Pyloroplasty | | |

| |Colostomy | | |

| |Ileostomy | | |

| |Colon resection /Colectomy | | |

| |Peritoneal venous shunt | | |

| |Inguinal herniorrhaphy | | |

| |Porta-caval anastomosis | | |

| |Liver transplant | | |

| |Gastric by-pass surgery | | |

| |Independent interventions | | |

| |Review all pertinent assessments | | |

| |NG tube maintenance / mouth care | | |

| |I &0 | | |

| |V/S | | |

| |Foley care | | |

| |Anti embolic stockings | | |

| |Ankle exercises; ROM | | |

| |Incentive spirometry | | |

| |Monitor IV / site care | | |

| |Position for comfort | | |

| |Assessment wound; wound care | | |

| |See NCP for pain | | |

| |Encourage activity as tolerated | | |

| |Safety considerations | | |

| |Monitor pertinent lab values | | |

| |Colostomy care | | |

| |q. Report unexpected observations | | |

| |Collaborative interventions | | |

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

| |effects/ side effects | | |

| |Antibiotics | | |

| |Narcotics | | |

| |Prophylactic heparin / lovenox | | |

| |Collaborate with enterostomal therapist | | |

| |Collaborate with registered dietitian | | |

| |Oxygen support | | |

| |Recognition of complications | | |

| |Hemorrhage | | |

| |Infection: wound and systemic | | |

| |Paralytic ileus | | |

| |Peritonitis | | |

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

| |Malnutrition | | |

| |Dumping syndrome | | |

| |Bowel obstruction | | |

| |Adhesions | | |

| |Pernicious anemia | | |

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

| |by: | | |

| |Wound healing | | |

| |Vital signs | | |

| |Bowel sounds | | |

| |Abdominal girth | | |

| |Homans sign | | |

| |Tolerates diet | | |

| |Laboratory studies | | |

| |Altered health maintenance: Knowledge deficit | | |

| |Client teaching | | |

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

| |Avoid aggravating factors | | |

| |Promotion of alleviating factors | | |

| |avoid activities that increase | | |

| |intra-abdominal pressure (lifting) | | |

| |Reportable signs/symptoms | | |

| |Wound care | | |

| |Ostomy care | | |

| |Medication teaching | | |

| |Rest/activity | | |

| |Risk factors | | |

| |Life style modifications | | |

| |Nutritional | | |

| |High fiber / high residue | | |

| |Low fiber/low residue | | |

| |High protein | | |

| |Regular diet | | |

| |Low fat | | |

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

| |Diabetic teaching | | |

| |Community Resources | | |

| |American Ostomy Association | | |

| |National Foundation for Ileitis and Colitis | | |

| |Alcoholics Anonymous | | |

| |Public Health Department | | |

| |Home health | | |

| |American Diabetes Association | | |

| |Juvenile Diabetes Association | | |

| |National Bariatric Association | | |

| |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 meds | | |

| |Ability to discuss diagnosis, surgical procedure, and post care | | |

| |Demonstrates osmotic care | | |

| |Increasing activity as tolerated | | |

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

| |Utilizing community resources | | |

| |Ineffective Individual coping: anxiety, fear powerlessness, | | |

| |dependence. | | |

| |Review Unit III-Care of the Client | | |

| |Experiencing Respiratory Problems | | |

| |Body Image Disturbance. | | |

| |Review Unit V-Care of the Client Experiencing Cancer | | |

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|n:soph\fall\Unit IV Gastro | | |Revised 07/11 |

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