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