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
1. Apply the terms listed in the content I. Application of terms
column appropriate to the patient
A. Afterload
situations involving the
B. Ascites
cardiovascular system.
C. Bruit
D. Corpulmonale
E. Gallop rhythm
F. Jugular vein distention
G. Paroxysmal nocturnal dysnea (PND)
H. Perfusion
I. Point of maximal impulse (PMI)
J. Polycythemia
K. Preload
L. Pulsus paradoxes
M. Syncope
2.
3.
Compare and contrast the normal
anatomy and physiology to the
pathophysiology of selected
commonly occurring disease
processes in the cardiovascular
system.
II. Anatomy & Physiology of Cardiovascular system
A. Developmental considerations
1. Infant
2. Child
3. Adolescent
4. Adult
5. Older adult
6.
B. Pathophysiology of cardiovascular system
1. Altered cardiac output
Analyze factors included in the
assessment of the patient
experiencing commonly occurring
problems of the cardiovascular
system, including the
developmental and cultural
considerations.
III. Selected commonly occurring problems
A. Interview
1. Chief complaint
2. Precipitating event
3. Medical history
4. Family/ Social/occupational history
5. Medication history
1. Prescription
2. Nonprescription
6. Knowledge of health maintenance
7. Risk factors
59
Clinical Objectives
Learning Opportunities
Readings:
McKinney
Lewis
Estes
Adams
Berman & Snyder
TVCC Library – Nursing Education on
Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
Heart Medications: Blood
Pressure Medications and Anticoagulants
Heart Medications: Heart
Failure Medications and CholesterolLowering Agents
VCR:
#1011 – Care of the Patient With Heart
Failure
#1141 – Hypertension
#1129 – Heart Failure & Pulmonary
Edema
#1190 – Coronary Artery Disease and
Angina Pectons
CD-ROM
#4083 – Intermediate & Advanced
Nursing Skills Tissue Perfusion
Management
# 4092 – Pediatric Nursing Skills –
Elimination, Cardio Respiratory,
Airway Clear
DVD
#6007 – Cardiovascular System
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
B. Physical exam – cardiovascular
1. Vital signs
2. Level of consciousness
3. Heart sounds
4. Heart rate & rhythm
5. Peripheral pulses/point of maximal
impulse (PMI)
6. Edema (peripheral/sacral)
7. Color (central & peripheral)
8. Jugular vein distention (JVD)
9. Weight
10. Intake & output
11. Capillary refill
C. Diagnostic tests
1. Radiology
1. Chest x-ray
2. Laboratory studies
1. Complete blood count (CBC)
2. Electrolytes
3. Digoxin level
3. Other
1. Electrocardiogram (EKG)
2. Echocardiogram
3. Telemetry
D. 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
60
Clinical Objectives
Learning Opportunities
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
4. Discuss analysis, planning,
IV. Common Occurring Cardiovascular Problems
implementation, and evaluation for
A. Cardiovascular
the nursing management of patients
1. Atherosclerosis
with commonly occurring
2. Arteriosclerosis
cardiovascular disease processes
3. Hypertension
4. Congestive Heart Failure (CHF)
V. Selected Nursing Diagnoses/Implementation/
Evaluation
A. Decreased cardiac output
1. 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
2. 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
61
Clinical Objectives
Learning Opportunities
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
3.
4.
Clinical Objectives
(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
Recognition of Complications
1. Pulmonary Edema
2. Cardiac dysrhythmias
3. Death
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
62
Learning Opportunities
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
B. Altered health maintenance: knowledge
deficit regarding atherosclerosis
/arteriosclerosis.
1. Patient teaching
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
2. Community Resources
1. American Heart Association
2. American Dietary Association
3. Support groups
3. 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
N:ADN/Fresh/2504 Unit IV Cardi
8. Utilizing community resources
63
Clinical Objectives
Learning Opportunities
Revised 11/12