TEACH FOR NURSES LESSON PLAN
Chapter 20: Heart and Neck Vessels
CHAPTER OBJECTIVES
1. Relate anatomic structures to the correct landmark or anatomic location.
2. List the significant anatomic features of the heart.
3. State why two distinct components to each heart sound exist.
4. List three conditions that result in cardiac murmurs.
5. Describe the characteristics of heart sounds.
20-2
STUDENT RESOURCES
understand
• Textbook Chapter 20
• Sherpath for Medical-Surgical Nursing*
• Animations (Evolve website)
• Answer Keys: Study Guide & Lab Manual
• Audio glossary (Evolve)
• Pocket Companion for Physical Examination and Health Assessment*
apply
• Case Studies (Evolve)
• Elsevier Adaptive Quizzing*
• HESI Case Studies*
• NCLEX Review Questions (Evolve)
• Study Guide*
INSTRUCTOR RESOURCES
20-3
in class
• PowerPoint Presentations (Evolve)
• Image Collection (Evolve)
• Learning Activities (below)
* Sold separately from textbook.
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
POSITION AND SURFACE
LANDMARKS
Bring in a heart anatomy
model to explain the great
vessels, the heart
structure, and the flow of
blood.
• Activity: Obtain a diagram of the heart and have students label the structures or have them draw a
sketch of the heart and great vessels with labels. Have them also trace the flow of blood through the
heart.
• Activity: The game of “Challenge and Response” can be played. The names of the anatomic
structures are used as challenges, and the responder must provide a brief description within 30
seconds.
HEART WALL, CHAMBERS,
AND VALVES
Discuss the layers of the
heart wall and their
purposes. Using the heart
• Small Group Activity: Assign student groups to investigate a particular valve and have them explain
to the class what could cause the valve to function improperly.
20-4
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
CARDIAC CYCLE
Show a video of the
cardiac cycle. Explain the
two phases of the cardiac
than in the left side.
• Clinical Activity: Assign students to complete a cardiac assessment of a patient in the clinical setting.
Discuss the causes of the
HEART SOUNDS
Normal Heart Sounds
Extra Heart Sounds
Murmurs
Observe students (and
assist them, if necessary)
in the proper use of the
stethoscope.
Discuss the various heart
sounds and their
physiologic causes. Explain
• Online Activity: Have students access the website www.easyauscultation.com and listen to heart
sounds. The site offers many audio tracks of usual and unusual heart sounds and rhythms.
• Activity: Focus on the S1 and S2 heart sounds. Have students, in pairs, listen to each other’s S1 and S2
heart sounds. During this assessment, have them also note how the S1 coincides with the carotid
pulse. (Reminder: Palpate the carotid pulse gently.)
20-5
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
third and fourth heart
sounds and whether their
presence indicates
abnormalities.
CONDUCTION
PUMPING ABILITY
Explain the automaticity of
the heart. Show a video
that describes and traces
the electrical impulses that
prompt the heart to
contract. Bring in examples
• Activity: Provide students with several examples and have them practice using the cardiac output
equation mentioned in the chapter.
20-6
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
The Carotid Artery Pulse
Jugular Venous Pulse and
The Aging Adult
CULTURE AND GENETICS
class.
Explain the differences
between the carotid artery
Explain the functionality of
the fetal heart and its
differences from a
newborn heart. Describe
the circulatory adaptations
that happen after the
lungs inflate after birth.
20-7
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
process and separately to
culture and genetics.
SUBJECTIVE DATA
Additional History for
Review the list of
questions asked in a
cardiac exam. Emphasize
• Activity: Have students take a classmate’s carotid artery pulse and try to observe the jugular venous
pulse.
• Activity: Have students consider five adult family members and list the lifestyle habits for each that
Auscultate the Carotid
artery during these
proceedings.
using Table 20.1 to
reinforce the discussion.
OBJECTIVE DATA
THE NECK VESSELS
Palpate the Carotid Artery
Demonstrate how to
palpate and auscultate the
carotid artery. Emphasize
the importance of light
pressure to the carotid
• Clinical Activity: Assign students to assess the neck vessels of a patient in the clinical setting.
20-8
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Inspect the Anterior Chest
Palpate the Apical Pulse
DEVELOPMENTAL
COMPETENCE
Infants
Children
positioning during exams.
Ask for a male volunteer to
act as patient and
demonstrate the
Explain that many
murmurs found in children
are benign; discuss how to
make this clear to a
worried parent.
• Clinical Activity: Have students visit a pediatric cardiac unit. Have them interview a pediatric cardiac
specialist.
IN-CLASS/ONLINE CASE STUDY
S.P. is a 75-year-old woman who presents to the provider’s office with fatigue.
20-9
Subjective Data
PMH: HTN, hyperlipidemia, MI 3 years ago
Objective Data
Vital signs: T 37 P 112 R 18 BP 110/54
Lungs: bilateral lower lobe crackles
O2 Sat = 94%
Skin = cool to touch
Questions
1. What other questions should the nurse ask about the fatigue?
2. What other assessments are necessary for this patient?
3. What are some causes of fatigue?
4. Develop a problems list from the objective and subjective data.
5. What should be included in the plan of care?
6. Based on the readings, what is the most likely cause of fatigue for this patient?
Answers
1. Questions or assessments associated with fatigue include the following:
20–10
4. The problems list includes the following:
NURSING CURRICULUM STANDARDS
QSEN/NLN COMPETENCIES
• Patient-Centered Care/Human Flourishing
o The Aging Adult
o Culture and Genetics
• Teamwork and Collaboration/Professional Identity
20–11
o Children
o The Aging Adult
• Evidence-Based Practice/Spirit of Inquiry
o Culture and Genetics
NURSING CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. F. (2017). Concepts for nursing practice (2nd ed.).
St. Louis: Elsevier. The specific exemplars chosen and listed below for each concept have been tailored specifically to correspond to the Jarvis
textbook.
BSN ESSENTIALS
• Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
o Culture and Genetics
• Essential III: Scholarship for Evidence-Based Practice
o Culture and Genetics
• Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes
20–12
ANSWERS TO QUESTIONS IN THE STUDY GUIDE
Note: Answers to these questions can be found on Evolve site. Click here.