Ventricular anti-arrhythmicsCARDIOVASCULAR DRUG STUDY GUIDEComplete Blood Count (CBC)Coagulation StudiesBlood ChemistryCARDIAC – MI CASE STUDY- 1 -Lincoln Memorial UniversityCaylor School of NursingNURS 241Fall Semester 2007TITLE: Nursing Strategies: Alterations in Cardiac Function (Unit I)DATES: See syllabusTIMES: See syllabusOBJECTIVES: Upon completion of this unit the student will be able to demonstrate in the clinical/campus laboratory setting, in individual and group conferences, and on written material, the ability to:1. Define and use the glossary terms as listed in the assigned readings.2. Using the four adaptive modes of Roy”s Adaptation Model (RAM), recognize human adaptive responses to behavior or stimuli that affect cardiovascular function.3. Describe the patho, clinical manifestations, management and associated use of the RAM nursing process to provide care for adults with alterations of the cardiovascular system. 4. Describe cardiac anatomy and physiology of the circulatory system and conduction system of the heart in relationship to cardiovascular disorders.5. Incorporate assessment of cardiac risk factors into the nursing history and physical assessment of the cardiac patients.6. Identify the clinical significance and related nursing implications of laboratory and diagnostic tests and procedures used for assessment and evaluation of cardiovascular function.7. Describe nursing measures associated with hemodynamic monitoring and state clinical significance and nursing responsibilities.8. Incorporate assessment of cardiac and peripheral vascular risk factors into the nursing history and physical assessment of the cardiac patients.5. Identify the clinical significance and related nursing implications of laboratory and diagnostic tests and procedures used for assessment and evaluation of cardiovascular function.6. Describe the different treatments, non-surgical and surgical, procedures commonly use for treatment of cardiac problems.7. Discuss the preoperative and postoperative goals and nursing care for adults undergoing surgery for related peripheral vascular disorders. 8. Identify possible complications following vascular surgery, measures to preventthese complications and assessment parameters appropriate for their identification. 9. Utilize the RAM nursing process to provide care for the adult who is experiencing any of the following common disorders of the cardiovascular system:a. Hypertensionb. Heart Failurec. Pulmonary Edemad. Pericarditise. Rheumatic Endocarditisf. Myocarditisg. Infective EndocarditisRevised 7/07 JE- 2 -h. Mitral Valve Prolapasei. Mitral Stenosisj. Mitral Insufficiencyk. Aortic Valve Stenosisl. Aortic Insufficiencym. Atherosclerosisn. Burger’s Diseaseo. Raynaud’s Diseasep. Aneurysmq. Thrombophlebitisr. Varicose Veins10. Specify anatomic and physiologic factors that affect peripheral blood flow and tissue oxygenation such as positioning and stress.11. Define appropriate parameters for assessment of peripheral circulation including skin temperature, turgor, and capillary refill.12. Describe appropriate nursing measures in evaluation of laboratory and diagnostic tests associated with peripheral vascular disorders.13. Describe the "stepped care approach" to drug therapy for hypertension and the goals of health teaching for patients of all ages with hypertension.14. Identify the medications on the drug list by generic name, classification, mechanism of action, clinically significant side effects, normal dosage and nursing implications and be able to correctly calculate IV, IM, and po dosages. 15. Correctly calculate and regulate IV flow rate for critical care medications such as dopamine, dobutamine or nitroglycerine.Revised 7/07 JE- 3 -TOPICAL OUTLINE Unit I:I. Assessment of the Cardiovascular System FunctionA. Overview of Cardiac Structure and Function1. Cardiac Anatomy and Physiology2. Conduction System of HeartB. Health HistoryC. Physical AssessmentD. Diagnostic Tests and Procedures1. Laboratory Testsa. CK, CK-MB, Troponin T or I, & Myoglobinb. Lipid Profilec. B-Type Natriuretic Peptide (BNP)d. C-Reactive Proteine. Homocysteine2. ECG3. Echocardiogram4. Exercise Stress Test5. Pharmacologic Stress Test6. Cardiac Catheterization7. Radionuclide Imaging8. Hemodynamic MonitoringII. Assessment and Management of Patients with Cardiac DisordersA. Hypertension1. Primary2. SecondaryB. Hypertensive CrisisIII. Assessment and Management of Patients with Heart FailureA. Heart Failure1. Left-sided failure2. Right-sided failureB. Acute Pulmonary EdemaC. CardiomyopathyIV. Assessment and Management of Patients with Structural Infectious and Inflammatory cardiac disease.A. Acquired Valvular Diseases of the Heart1. Mitral Valve Prolapse2. Mitral Stenosis3. Mitral Regurgitation4. Aortic Stenosis5. Aortic RegurgitationB. Infectious Diseases of the Heart1. Rheumatic Endocarditis2. Infective Endocarditis3. Myocarditis4. PericarditisRevised 7/07 JE- 4 -REQUIRED READINGS:Smeltzer, S. & Bare, B. (2008). Brunner & Suddarth's medical surgical nursing. (11th ed.). Philadelphia: Lippincott, Williams, & Wilkins. Chapters: 26, 29, 30, & 32.CLINICAL SKILLS:1. Monitor central venous and Swan Ganz lines.2. Perform CPR.3. Administer medications.4. Read and interpret EKG.5. Administer Blood products.6. Application of telemetry monitoring.CLINICAL OBJECTIVES:1. Assess cardiovascular status of selected clients of all ages.2. Provide teaching in the area of prevention of CV disease.3. Assess for risk factors associated with cardiovascular disease.4. Utilize the nursing process to provide care for the patient of all age groups undergoing medical treatment for cardiovascular and peripheral vascular disorders.5. Conduct discharge planning and teaching for patients undergoing medical treatment for cardiovascular and peripheral vascular disorders.Revised 7/07 JE- 5 -Lincoln Memorial UniversityCaylor School of NursingNURS 241Fall 2007TITLE: Nursing Strategies: Alterations in Cardiac Function (Unit II)DATES: See syllabusTIMES: See syllabusOBJECTIVES: Upon completion of this unit the student will be able to demonstrate in the clinical/campus laboratory setting, in individual and group conferences, and on written material, the ability to:1. Define and use the glossary terms as listed in the assigned readings.2. Using the four adaptive modes of Roy”s Adaptation Model (RAM), recognize