Essential Questions:
5. Nursing Management of Care
A. Safe and Effective Care Environment
i. Assess for presence of advance directive, provide information
ii. Protect patient & staff during pacemaker, cardioversion, defibrillation procedures
iii. Advise on support groups for HF, continuing care options
B. Health Promotion and Maintenance
i. Teach the five rights to patients of prescribed medications and to call HCP with side effects
ii. Teach family where they may learn CPR
iii. Trouble shoot pacemaker malfunction by checking pulse, teach pulse check
iv. Teach self management at home for HF
v. Teach and monitor older adults for digoxin toxicity, hypokalemia
vi. Teach preventative measures for orthostatic hypotension
vii. Teach importance of preventative antibiotic therapies with valvular replacements
C. Psychosocial considerations
i. Assess patient’s coping skills and risk of depression with self concept/anxiety
D. Physiologic Integrity
i. HF: assess for pulmonary edema, weight gain, side effects of beta-blockers, HR if on digoxin.
ii. Treat pulmonary edema with correct positioning and oxygen delivery
iii. Recognize home care nurse role in physical assessment of cardiac patients
iv. Observe for S & S of transplant failure*
v. Describe the benefit of VAD implantation as it relates to HF
vi. Valvular patients require monitoring for atrial fibrillation development and thrombi; anticoagulation therapy as indicated
vii. Differentiate cardiomyopathy types
viii. Provide care for pericarditis patients
ix. Pre & post procedural and operative management (valvuloplasty/replacement)
x. Use laboratory data and clinical manifestations to evaluate the adequacy of circulation and interventions
xi. Dysrhythmia: assess for decrease CO, interpret dysrhythmias, pace in emergencies, intervene in life-threatening situations, understand usage of defibrillation/AED
xii. Educate patients with permanent pacemakers or ICDs
Content Goals:
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