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NUR 214 F 1: CO exemplars cont'd; Hemodynamics

Subject:
Day 9
Goal Summary:
Client with circulation needs: (1) Implement caring interventions in response to their diverse needs and inherent value; (2) Assess adaptation to internal and external changes; (3) Implement individualized prevention strategies; (4) Apply the nursing process while providing comprehensive, collaborative care; (5) Demonstrate effective communication including information technologies; (6) Demonstrate professional behaviors consistent with the nursing profession; (7) Use appropriate teaching strategies in providing health education; (8) Participate in self-directed learning through researching and planning appropriate nursing care.
Essential Questions:
5. Nursing Management of Care
A. Safe and Effective Care Environment
i. Assess for presence of advance directive, provide information
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
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
xii. Educate patients with permanent pacemakers or ICDs
Understandings:
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Reflection:
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