RNSG 2504 Care of the Patient with Common Health Care Needs

Unit IV – Care of the Patient Experiencing Commonly Occurring Health Problems

Part A – Cardiovascular
Behavioral Objectives / Content Outline / Clinical Objectives / Learning Opportunities
  1. Apply the terms listed in the content column appropriate to the patient situations involving the cardiovascular system.
  1. Compare and contrast the normal anatomy and physiology to the pathophysiology of selected commonly occurring disease processes in the cardiovascular system.
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  1. Application of terms
  2. Afterload
  3. Ascites
  4. Bruit
  5. Corpulmonale
  6. Gallop rhythm
  7. Jugular vein distention
  8. Paroxysmal nocturnal dysnea (PND)
  9. Perfusion
  10. Point of maximal impulse (PMI)
  11. Polycythemia
  12. Preload
  13. Pulsus paradoxes
  14. Syncope
  1. Anatomy & Physiology of Cardiovascular system
  2. Developmental considerations
  3. Infant
  4. Child
  5. Adolescent
  6. Adult
  7. Older adult
  8. Pathophysiology of cardiovascular system
  9. Altered cardiac output
/ Readings:
McKinney
Lewis
Estes
Adams
Berman & Snyder
TVCC Library – Nursing Education on Video

Heart Medications: Blood
Pressure Medications and Anticoagulants
Heart Medications: Heart
Failure Medications and Cholesterol-
Lowering Agents
VCR:
#1011 – Care of the Patient With Heart
Failure
#1141 – Hypertension
#1129 – Heart Failure & Pulmonary
Edema
#1190 – Coronary Artery Disease and
Angina Pectons
  1. Analyze factors included in the assessment of the patient experiencing commonly occurring problems of the cardiovascular system, including the developmental and cultural considerations.
  1. Discuss analysis, planning, implementation, and evaluation for the nursing management of patients with commonly occurring cardiovascular disease processes
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  1. Selected commonly occurring problems
  2. Interview
  3. Chief complaint
  4. Precipitating event
  5. Medical history
  6. Family/ Social/occupational history
  7. Medication history
1.Prescription
2.Nonprescription
  1. Knowledge of health maintenance
  2. Risk factors
  1. Physical exam – cardiovascular
  2. Vital signs
  3. Level of consciousness
  4. Heart sounds
  5. Heart rate & rhythm
  6. Peripheral pulses/point of maximal
impulse (PMI)
  1. Edema (peripheral/sacral)
  2. Color (central & peripheral)
  3. Jugular vein distention (JVD)
  4. Weight
  5. Intake & output
  6. Capillary refill
  1. Diagnostic tests
  2. Radiology
1.Chest x-ray
  1. Laboratory studies
1.Complete blood count (CBC)
2.Electrolytes
3.Digoxin level
  1. Other
1.Electrocardiogram (EKG)
2.Echocardiogram
3.Telemetry
  1. Risks
1.Hereditary
2.Environmental
3.Health beliefs/practices
4.Developmental
(1)Age specific assessment data
(a)Vital signs
(b)Fluid /electrolytes
(c)Nutritional
(d)Behavioral/emotional response to health care providers
  1. Common Occurring Cardiovascular Problems
  2. Cardiovascular
  3. Atherosclerosis
  4. Arteriosclerosis
  5. Hypertension
  6. Congestive Heart Failure (CHF)
  1. Selected Nursing Diagnoses/Implementation/ Evaluation
  2. Decreased cardiac output
  3. Independent Interventions
1.See cardiac assessment
2.Assess for signs of systemic congestion
3.Assess for signs of pulmonary congestion
4.Level of activity
5.Schedule daily activities to prevent fatigue
6.Positioning
7.Monitor pertinent diagnostic test
8.Intake and Output
9.Daily weight
  1. Collaborative Interventions
1.Administer medications and monitor for desired effects/ adverse effects/ side effects.
(1)Cardiac glycosides
(2)Coronary vasodilators
(3)Antilipedimics
(4)Antiplatelets
(5)Diuretics
  • Thiazides
  • Loop diuretics
  • Potassium sparing diuretics
(6)Adrenergic inhibitors
  • Central acting alpha adrenergic antagonists
  • Alpha-adrenergic blockers
  • Beta-adrenergic blockers
(7) Direct vasodilators
(8)Angiotensin inhibitors
  • Angiotensin-converting enzyme inhibitors (ACE)
  • Angiotensin II receptor blockers (ARBS)
(9)Calcium channel blockers
2.Supplemental oxygen
3.Fluid restrictions
4.Nutrition: Age specific
  1. Recognition of Complications
1.Pulmonary Edema
2.Cardiac dysrhythmias
3.Death
  1. Evaluation of Outcomes: The patient will have improved cardiac output as evidenced by:
1.Vital signs
2.Peripheral pulses
3.Activity tolerance
4.Breathing pattern
5.Breath sounds
6.Heart sounds
7.Intake and output
8.Edema
9.Weight
10.Absence of jugular vein distension
  1. Altered health maintenance: knowledge deficit regarding atherosclerosis /arteriosclerosis.
  2. Patient teaching
/ CD-ROM
#4083 – Intermediate & Advanced
Nursing Skills Tissue Perfusion
Management
# 4092 – Pediatric Nursing Skills –
Elimination, Cardio Respiratory, Airway Clear
DVD
#6007 – Cardiovascular System
N:ADN/Fresh/2504 Unit IV Cardi / 1.Assess readiness to learn, ability, and knowledge level.
2.Avoid aggravating factors
3.Promotion of alleviating factors
4.Reportable signs / symptoms
5.Medication teaching
6.Rest/activity
7.Risk factors
8.Life style modification
9.Nutrition
(1)Low fat, low cholesterol
(2)Low sodium
10.Monitor BP at regular intervals
  1. Community Resources
1.American Heart Association
2.American Dietary Association
3.Support groups
  1. Evaluation of Outcomes: The patient will have improved health maintenance as evidenced by:
1.Identifying aggravating and alleviating factors.
2.Identifying reportable signs and symptoms
3.Describing the purpose, correct administration and side effects of meds
4.Ability to discuss diagnoses
5.Participate in exercise program
6.Compliance with prescribed diet
7.Stop smoking
8.Utilizing community resources / Revised 11/12

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