nurs 3833 adult health i

NURS3833WINTR-CMP2010VC01: ADULT HEALTH I WINTR-CMP 2010 VC01

COURSE DESCRIPTION: This course integrates knowledge and skills learned previously with disease processes affecting adults today. The student will learn disease processes that occur in the adult client with a focus on systems. The clinical focuses on providing care for adults in need of hospital care and rehabilitation. Patient teaching in the clinical setting will take on importance, as well as, higher levels of critical thinking and evidence based practice. This syllabus may be revised during the course of the semester to meet the needs of the students and faculty.

CREDIT: 8 Credit hours (4 hrs class/wk, 2 hrs lab/wk, 16 hrs clinical/wk)

PROGRAM LEVEL: II

REQUIRED TEXTBOOKS:Ignatavicius, D. & Workman, L. (2010). Medical-Surgical Nursing: Critical Thinking for Collaborative

Care, 6th Edition. St. Louis: Saunders.

Wissmann, J. (2008). Adult Medical-Surgical Nursing: Review Module. Assessment Technologies Institute, LLC (ATI). Available at atitesting.com

Course Coordinator: Mrs. Marilyn Lynch-Goddard, MSN, BSN, RN Cell: (210) 414-9735

Office Hours: -Monday 12:00 to 1:00pm, 3:00pm to 4:00pm -Tuesday 12:00 to 2:00pm -Via email [email protected] at anytime. I will respond to emails within 24 hours.

Clinical Instructor: Mrs. Jackie Riley Baker, MSN, BSN, RN Cell: (210) 269-1959

Clinical Lab: TBA

Clinical and/or class time may be adjusted due to instructor, school, or facility needs

COURSE OBJECTIVES: At the end of the course, the student will be able to:1. Define the role of the professional registered nurse in care of the client in the medical-surgical

setting.2. Identify signs and symptoms of disease processes that affect the adult client.3. Utilize the nursing process in developing a plan of care for a client in the medical-surgical setting

in collaboration with the client and the interdisciplinary health care team utilizing evidence-based practice.

4. Identify signs and symptoms associated with disease processes.5. Describe principles of teaching for a client in the medical-surgical setting.6. Understand the pathophysiology of the disease processes of clients in the medical-surgical

setting.7. List the ethical and legal principles necessary for quality care of the client in the medical-surgical

setting.8. Describe the factors that contribute to the development of disease processes in the client in the

medical-surgical setting.

mailto:[email protected]

CLINICAL OBJECTIVES: At the end of the course, the student will be able to:

1. Apply nursing care to multiple clients appropriate for the signs and symptoms the client is experiencing.

2. Establish nursing diagnoses for the adult clients in the medical-surgical setting following evidence-based analysis of the data.

3. In collaboration with the adult client and the interdisciplinary health care team, set realistic goals to improve the signs and symptoms they are experiencing.

4. Implement nursing care, in collaboration with the client and the interdisciplinary health care team, to assist in treating the disease process the adult client is experiencing.

5. Evaluate the adult client’s response to the nursing care received.6. Teach the adult client about their disease process and the care required to treat it. 7. Apply ethical and legal principles when delivering care to the adult client.8. Apply concepts of cultural aspects of care when delivering care to the adult client.9. Refer clients to resources both in the health care facility, and in the community.

EVALUATION AND GRADING: A point system is used to determine the grade in Adult Health I.

A = 90-100B = 80-90C = 75-80 75 average or better is required to pass Nursing coursesD = 70-74F = 69 and below

Exams and Graded Requirements Point ValueExam 1 10%Exam 2 10%Exam 3 10%Exam 4 10%Exam 5 10%Discussion Participation 10%Journal 5%Case Study Paper 10%Final Exam 25%Total 100

PLEASE NOTE:Worksheets or other learning tools may be used @ instructor’s discretion; points will be deducted from final grade if extra assignments are not turned in.

There will be a medication calculation test given by the clinical instructor two weeks after class begins. All students must pass this test with a 90% before you continue with medication administration in the clinical setting.

You will be given a rubric for both clinical journals and case study paper - you must cover all points to receive full credit i.e. points will be deducted if you have not covered all areas required on the rubric. The clinical instructor will grade the journal entries.

Course Outline:1. Perioperative Nursing & Pain2. Respiratory3. CV & hematology4. Fluid & electrolytes5. Renal, urinary & integument6. Endocrine7. GI8. Neurosensory9. Musculoskeletal10. Lymph, immune & infectious issues

All written work is to be submitted on the announced due date(s) and time (s) unless the student has made previous arrangements with the faculty member. Failure to notify will result in a grade of zero.

Testing:Test dates and content will be published in the course syllabi. All exams will be given with an approved proctor present. Exam blueprints may be provided by the instructor. The type of question will be categorized two ways (where applicable). First the question will be categorized by the areas of the nursing process; assessment, planning, implementation and evaluation. The question will also be categorized by cognitive level; knowledge, analysis, application, and comprehension. In the event a faculty must change a test date, they will notify the students as soon as possible.

Make-up Tests/Quizzes/Journals:Occasionally a student will miss a test that is scheduled for a class. A student should contact his/her instructor PRIOR to missing the exam, and then make arrangements to take the make-up test. Test must be completed within one week from date of missed exam. Journal entries must be submitted by the first clinical day each week beginning in week 2 to receive credit- no exceptions!

Clinical learning lab: TBAClinical learning lab will be arranged for learning needs at this level. Date and time to be announced.

Clinical Attendance : The clinical portion of the course in on a pass/fail basis and must be passed to pass the course. The level two clinical evaluation form will be used to determine the students pass or fail performance for this course. Attendance to clinical is critical. This is the opportunity for the student to learn and practice skills and then apply them later in patient care. Any student late or missing a clinical must call the instructor prior to the scheduled clinical.

Required clinical activities include: 1) Preparation of medication cards for patients and conditions studied,2) Satisfactory performance of clinical objectives, 3) Reflective clinical journal, 4) At least 3 complete satisfactory nursing care plans each achieving the level of critical thinking required for this course (more may be required by clinical instructor to achieve the level), and 5) Professional behavior, demeanor and attire.

Your clinical behavior, demeanor and attire shall be consistent with school and facility requirements. This part of professional requirements includes punctuality to work, wearing name badge, professional attire, white opaque uniforms, school patch, white shoes, white socks, undergarments not visible through uniform, no jewelry or colored hair accessories, short and clean unpainted nails, and required professional gear or equipment. No smoking is permitted at clinical facilities.

Weekly clinical journals are required, hard copies to be provided to clinical faculty and due no later than the first day clinical each week beginning in week 2. Medication cards, handwritten 3x5 index format, are required and shall be:

a) Due no later than the first day of clinical each week (for the body system covered in lecture that week) and

b) completed on your assigned/chosen patient prior to any medication administration; which includes patient’s medications related to his/her medical condition that you will not administer (please ask faculty for clarification for clarification, if needed)

Reflective Clinical Journal. The weekly clinical journal is a required part of the clinical experience. Each student is responsible for his/her own lifelong learning. The journal process is designed to help you reflect on your learning styles, assess your learning needs, make goals, evaluate your learning and repeat the process, changing your learning interventions when indicated. It will also help faculty assist your efforts to be a self-directed learner. These skills are crucial to your development as a professional nurse, as this profession requires ongoing self directed continuing education and record keeping to maintain your license.

Policy on Academic Integrity: Standards of academic honesty are expected. Academic dishonesty includes, but is not limited to, cheating, plagiarism, counterfeit work, unauthorized reuse of work, theft, and collusion, see student handbook. Students who violate academic integrity policies are subject to discipline, penalties, failure in the course, or dismissal from Wayland Baptist University.

Cell Phone Policy: Respect for faculty and fellow students are necessary for teaching and learning in the (classroom) and clinical settings. You are required to silence cell phones, silence other mobile devices, and remove Bluetooth devices prior to entering any (classrooms) and clinical settings. Failure to follow this policy can affect your class participation (including, you may be requested to leave the (class room), clinical or final course grade.

Policy Regarding Due Dates for Written Assignments: Written work will be submitted on the announced due date and time, unless prior arrangements were made with the faculty. Failure to notify will result in a grade of zero for that assignment. Unless otherwise specified, hard copies of the assignments are due to faculty on assigned dates at the beginning of the class or clinical period. Students are responsible for contacting the course faculty if there is any difficulty in understanding the course materials or completing the course assignments. Up to 10% shall be deducted for late assignments, and reduced 10% each day, late or incomplete care plans may result in clinical failure.

Student Responsibilities: Students are adult learners and responsible for self-directed study to complete this course. Check postings on blackboard each week, learn to use blackboard postings provided by professors, as they are intended to increase your professional nursing knowledge bank. Learn to become a resource broker, speak professionally and use citations, it is part of professional nursing. Assignments, journals, and presentation have due dates and points shall be reduced if not punctual. The profession of nursing requires punctuality in documentation and attendance. It also requires reliability as fellow staff and administration rely on you to come to work prepared. Patients rely on you to know the current state of their health and current professional standards. Citations and references are to be used and documented using the professional citation of nursing, APA (6th edition) format.

Research and writing competency is an expectation in professional nursing, therefore, effective writing and proficiency in research is required in this course. ENGL 1301 and RSWR 3345 are required prior to this course and provide preparation for the writing level required in this course. Consult Purdue’s OWL website or WBU’s Saturday clinic for writing assistance in APA citation. Research and writing competencies are expected, source selection shall be nursing peer reviewed, format, citations, organization, grammar and mechanics can impact your grade on written assignments.

Group process is an essential part of professional nursing, therefore, group projects will be required in various nursing courses. Just as various shifts are responsible for patient care and nurses rely on each other and other professionals to accomplish total care, you will rely on each other and work together for a particular project. The grade earned goes to the entire group, therefore, it is crucial that students work

together, review the grading rubric, and review the work together before presentation, project or paper submission.

Disability Statement: Wayland Baptist University adheres to a policy of providing equal opportunity to students with disabilities. Disability is defined by the University as any condition that falls under the purview of the Rehabilitation Act of 1973. Wayland will strive to achieve optimum opportunity for participation in the University experience for all students, regardless of their circumstance. The University encourages any student who has a disability, as defined by the Rehabilitation Act of 1973, to inform the University of any Special Requirements or needs by reporting these to the Dean of Students or the Vice President for Academic and Student Services. The University will strive to meet these needs in accordance with applicable federal guidelines and Christian ethical considerations.

Student Conduct: (This is a statement of conduct standards. It is enforced in conjunction with the Discipline Policy and Substance Abuse Policy found elsewhere in the student handbook.) Wayland proudly adheres to high standards of intellectual, moral, ethical, and spiritual values. Convinced that self-discipline is more desirable than outside force and that the truly educated person must pursue what is right under all circumstances, Wayland entrusts each student with the solemn obligation of preserving these standards.

However, in the light of revelation, reason, and the custom of the Christian community from which Wayland has sprung, certain practices are evaluated:

1. Personal integrity in keeping with New Testament standards is expected of all students.2. Respect for the property, knowledge, and rights of other people must prevail.3. The use or possession of alcoholic beverages and/or illegal drugs is forbidden.4. Gambling, hazing, and the on-campus possession of firearms or deadly weapons are prohibited. BB Guns and Paint Ball Guns are also prohibited.5. The use of tobacco by students is discouraged, though permitted in certain designated areas of the campus. In consideration of the rights of others and the requirements of safety, such areas are designated.

The authority of the University is exercised over all student groups or organizations bearing the name of the university, or any student enterprises to the extent necessary to safeguard the good name and well being of Wayland. Specifically, each student is expected to conduct himself in such a manner as to uphold, not detract from, the good name of Wayland Baptist University. If one feels that he/she cannot subscribe to the moral and social practices of the University, he/she will find greater acceptance elsewhere.

Standards of Professional Nursing Practice (BON 213.27, 217.11, 217.12) Please refer to the Board of Nursing at www.BON.state.tx.us for any additional information regarding the Texas Nurse Practice Act.

1. Knows rationale for side effects of medications and treatments, and correctly administers same. 217.00 (1)(c).

2. Documents nursing care accurately and completely, including signs and symptoms, nursing care rendered, medication administration. Contacts health care team concerning significant events in patient health. 217.11 (1) (d).

3. Implements a safe environment for patients and/or others. 217.11 (1) (b). 4. Respects client confidentiality. 217.11 (1)(e). 5. Accepts assignments commensurate with educational level, preparation, experience and

knowledge. 217.11(1)(t). 6. Obtains instruction and supervision as necessary when implementing nursing procedures and

practices. 217.11(1)(h).7. Notifies the appropriate supervisor when leaving an assignment. 217.11 (1) (I).8. Recognizes and maintains professional boundaries of the nurse/patient relationship. 217.11

(1)(J).9. Clarifies orders, treatments, that the nurse has reason to believe are inaccurate, non-effective

or contraindicated. 217.11 (1)(N).10. Able to distinguish right from wrong. 213.27 (b)(2)(A).

http://www.BON.state.tx.us/

11. Able to think and act rationally 213.27(b)(2)(B).12. Able to keep promises and honor obligations 213.27(b)(2)(C).13. Accountable for own behavior 213.27(b)(2)(D).14. Able to promptly and fully self-disclose facts, circumstances, events, errors and omissions

when these disclosures will enhance health status of patients or protect patients from unnecessary risk or harm. 213.27(b)(2)(G).

Please refer to the Board of Nursing at www.BON.state.tx.us for any additional information regarding the Texas Nurse Practice Act.

Week 1: Pre-op/Intra-op/Post-op Nursing; Pain IssuesObjectives Student

AssignmentsLearning Activities

1. Differentiate types & purposes of surgery.2. Use patient identifiers when providing instruction, administering

drugs, marking surgical sites, performing procedures3. Verify informed consent of surgery and pre-surgical checklists.4. Identify patient conditions or issues that need to be

communicated with the team.5. Use knowledge of physiology and behavior principles for preop

assessment. 6. Evaluate patient factors that increase risk before, during & after

surgery.7. Evaluate lab values related to drugs, anesthetics, and surgery.8. Apply concepts of sterile technique, asepsis, standard

precautions during wound assessment and dressing changes.9. Discuss criteria for determining readiness for discharge from

PACU.10. Evaluate risks for complications and wound healing. 11. Discuss post-op education for patients and family.12. Describe a head-to-toe assessment of the postoperative patient

and verbalize priority of nursing interventions during first 24 hours.

13. Apply knowledge of pathophysiology to identify shock, respiratory depression, impaired wound healing.

14. Explain actions, dosages, side effects and nursing implications for different types of drug therapy and pain management after surgery.

Read Ignatavicius: Unit 4, chapter 16, 17, 18, & Chapter 5

Read ATI Ch 124-128, Ch 79, Ch 40, 41 Perioperative Nursing Care Chapter 79 Pain Management

Lecture and discussion

Skills lab

Week 2: Respiratory IssuesObjectives Student


1. Identify safe use of appropriate oxygen delivery systems and tracheostomy equipment.

2. Evaluate communication for patient with tracheostomy.3. Perform a focused respiratory assessment to determine

adequacy of oxygenation. 4. Administer oxygen by nasal cannula, mask, ET tube, trach tube

and evaluate patient response. 5. Use laboratory data and clinical symptoms to recognize

hypoxemia or hypercarbia. 6. Verbalize care delegation to LPN, nursing assistants, and RN for

patients with radical head and neck surgery

Read Ignatavicius: Ch 30-33; Ch 29 assessment independent study

Read ATI Respiratory ch 4,5,6, 11, 12, 13, 14, 15,16


Skills lab

http://www.BON.state.tx.us/

7. Assess patients for risk factors for head and neck cancers.8. Support patient and family in breathing status changes and

develop communication.9. Priortize nursing care needs for patient after nasoseptoplasty,

anterior & posterior nosebleed facial trauma.10. Describe pathophysiology and complications of sleep apnea.11. Apply anatomy knowledge to prevent aspiration, perform wound

care, and suctioning for tracheostomy patient. 12. Ensure proper oxygen delivery for patients with hypercarbia,

cystic fibrosis, and chest tube drainage after thoracotomy.13. Teach how to use a peak flowmeter, aerosol or dry powder

inhaler, and asthma management.14. Explain procedures, restrictions, follow-up, and encourage self-

management by patients, including expression of feelings regarding changes in breathing status.

15. Teach adaptation of ADL related to respiratory problems.16. Compare pathophysiology of asthma, bronchitis, and

emphysema. 17. Identify risk factors for COPD and lung cancer.18. Use laboratory data and clinical manifestations to determine

effectiveness of therapy for impaired gas exchange in a patient with breathing problem.

19. Explain physiology of communicable respiratory diseases and airborne and droplet transmission.

20. Apply principles of infection control when providing care to patients with respiratory infections.

21. Describe tuberculosis and avian flu infection control measures.22. Identify adults at risk for contracting flue, pneumonia,

tuberculosis, and respiratory infections and CDC infection control techniques.

23. Perform focused respiratory assessment and re-assessment.

Week 3: Cardiovascular & Hematology IssuesObjectives Student


1. Assess patients for complications of diagnostic tests.2. Evaluate patients @ risk for CV problems.3. Explain pre- and post-test care associated with CV testing.4. Identify typical assessment findings associated with common

dysrhythmias.5. Plan collaborative care for patients experiencing common

dysrthymias.6. Evaluate status of patients with heart disease regarding advance

directives.7. Provide patient with heart failure with information for discharge

to home, hospice or other facility. 8. Collaborate with interdisciplinary team to provide patient care,

identify community resources. 9. Explain pathophysiology of HF, compare left-sided and right-

sided.10. Explain how common drug therapies improve cardiac output and

prevent worsening of HF. 11. Assess for adverse affects of drug therapy.12. Monitor lab values for patients with cardiac problems. 13. Explain pathophysiology of arteriosclerosis and atherosclerosis,

including factors that cause arterial injury.

Ignatavicius: Ch 35-40 Ch 35 in-depth studyCh 41-42Ch 41 in-depth study Read ATI CV Ch 26, 27, 28, 30, 31, 32, 33, 34


Skills lab

14. Interpret laboratory data.15. Describe essential and secondary hypertension. Discuss drug

therapy and side effects. 16. Compare assessment of patients with PAD and PVD. 17. Identify venous thromboembolism (VTE and complications.

Discuss nursing interventions to help prevent VTE. 18. Describe nurse role in monitoring patients on anticoagulants. 19. Describe the relationship between hematologic problems and

the need for oxygen. 20. Describe the role of platelets in hemostasis. 21. Correctly interpret blood counts, clotting tests to assess

hematologic status. 22. Explain effects of anticoagulants, fibrinolytics, and inhibitors of

platelet activity. 23. Identify patients at risk for infection and hemorrhage.24. Coordinate patient care with nutritionist, patient, and family,

community for ADLS, preventing injury, dietary adaptation, and infection.

25. Identify clinical manifestations of anemia.26. Prioritize nursing care for patient with sickle cell disease.27. Identify risk factors for leukemia, lymphoma, and

myelodysplastic syndrome. 28. Correctly interpret lab data and clinical symptoms to determine

presence of infection of patient with neutropenia. 29. Prioritize nursing interventions for patient with neutropenia,

thrombocytopenia, and transfusion.

Week 4: Fluid Electrolyte IssuesUnit Objectives Student


1. Explain relationship between weight gain, loss, and fluid imbalance.

2. Identify patients at risk for fluid or electrolyte imbalances.3. Use lab data and clinical symptoms to determine presence of

fluid or electrolyte imbalance.4. Interpret blood chemistry lab results to determine electrolyte

imbalance and effectiveness of intervention.5. Prioritize interventions for patients who have dehydration, fluid

overload, or specific electrolyte imbalances.6. Describe the relationship between fee hydrogen ion and pH.7. Explain the role of bicarbonate in the blood. 8. Explain compensation.9. Compare the roles of the respiratory and renal system in

maintaining acid-base balance.10. Identify patients at risk for acid-base imbalance.11. Use lab data and clinical signs to determine presence of acid-

base imbalance.12. Interpret arterial blood gases to determine respiratory or

metabolic acidosis.13. Coordinate care for a patient with acid-base imbalance.14. Check accuracy of IV fluids and medications.15. Identify appropriate veins for peripheral IV catheter insertion.16. Differentiate types of vascular access devices used for

peripheral and central IV therapy.17. Assess patient infusion site for local complications of phlebitis

and infiltration.

Ignatavicius: Ch 13-15

Read ATI ch 37, 38, 39


Skills lab

18. Assess, prevent and management systemic complications related to infusion therapy.

19. Identify nursing considerations for intra-arterial, intraperitoneal, subcutaneous, intraosseous, epidural and intrathecal infusion therapy.

Week 5: Renal & Urinary & Integument Issues Objectives Student


1. Use the ABCD method of assessing skin lesions for cancer2. Compare wound healing by first, second, and third intention.3. Evaluate wounds for size, depth, presence of infection, and

indications of healing.4. Differentiate the manifestations for stage I through stage IV

pressure ulcers.5. Coordinate with the health care team for patient pressure ulcer

prevention when you have identified a patient at risk.6. Identify key features of psoriasis, melanoma, and skin cancer.7. Use lab data to distinguish between dehydration and renal

impairment.8. Describe how to obtain a sterile urine specimen from a patient

with a Foley catheter. 9. Assess the appropriateness for continuing indwelling urinary

catheter.10. Use language the patient is comfortable with when discussing

urinary and sexual issues. 11. Coordinate care to prevent UTIs in hospitalized patients.12. Compare the pathophysiology and manifestations of stress, urge,

overflow, mixed and functional incontinence.13. Discuss nursing care to patient with invasive bladder cancer.14. Explain genetics of autosomal dominant polycystic kidney

disease.15. Use lab data and clinical manifestations to determine

effectiveness of therapy for pyelonephritis.16. Describe clinical manifestations of hydronephrosis.17. Explain relationship between hypertension and renal disease18. Compare pathophysiology and causes of acute renal failure and

chronic kidney disease.19. Use lab data and clinical assessment to determine effectiveness

of therapy for renal failure.20. Discuss interventions to prevent ARF.21. Discuss mechanisms of peritoneal dialysis and hemodialysis and

renal replacement therapies.22. Coordinate nursing care for the patient with kidney disease.

Ignatavicius: Ch 68-71Ch 26 & 27self studyRead ATIUnit 5 Ch 42-48Unit 11 ch 111-114


Week 6: Endocrine IssuesObjectives Student


1. Identify adaptations in nursing assessment or interventions needed because of age changes in endocrine function.

2. Interpret lab test findings and clinical manifestations for patients with possible endocrine problems.

3. Compare common clinical manifestations associated with pituitary hypo and hyper function.

Ignatavicius: Ch 64-67Ch 64 self study

Read ATIEndocrine ch 51-54,


4. Interpret lab changes and clinical changes to determine effectiveness of therapy for diabetes and SIADH.

5. Compare clinical manifestations of Cushing’s syndrome and Addison’s disease and discuss nursing care.

6. Identify patients at risk for acute adrenal insufficiency and discuss priority of nursing care.

7. Compare common manifestations of hyper and hypo thyroid.8. Interpret clinical and lab data to determine effectiveness of

intervention for hyperthyroidism.9. Discuss nursing care for patient post thyroid or parathyroid

surgery. 10. Identify teaching priorities for patient taking thyroid replacement

hormone.11. Compare clinical manifestations of hyper-and hypo

parathyroidism.12. Compare risk factors, age of onset, manifestations and pathologic

mechanism for DM I & II.13. Assess patient risk for DM II14. Explain effects of insulin on carbohydrate, protein and fat

metabolism.15. Explain how to mix different kinds of insulin together.16. Evaluate lab data to determine if patient is controlling DM. 17. Explain how to perform foot assessment in patient with DM.18. Discuss care of patient with diabetic ketoacidosis (DKA) and

hyperglycemic-hyperosmolar state (HHS).

56,57, 59

Week 7: Gastrointestinal issues Unit Objectives Student


1. Explain Gordon’s Functional Health Patterns.2. Explain the GI lab values of patient with GI problems.3. Discuss care of patients with disorders of salivary glands and

practices of oral care.4. Evaluate impact of esophageal cancer on patient’s nutritional

status and risk for aspiration.5. Perform focused assessments for GI issues.6. Apply knowledge of pathophysiology to monitor for complications. 7. Discuss GERD and drug therapy.8. Compare etiologies and assessment findings of acute and

chronic gastritis.9. Compare and contrast assessment findings associated with

gastric and duodenal ulcers.10. Identify the most common medical complications that can occur

with PUD.11. Discuss drug therapy for gastritis and PUD. 12. Monitor patient for GI bleeding and prioritize interventions.13. Explain purpose and procedure for gastric lavage. 14. Evaluate impact of GID disorders on nutrition of a patient.15. Identify risks for gastric cancer.16. Differentiate between common hernias. 17. Develop a plan of care for a post-hernia repair.18. Explain the role of the nurse in management of colorectal cancer.19. Explain small and large bowel obstruction differences.20. Develop a plan of care for patient with obstruction to promote

elimination. 21. Describe post-operative care of hemorrhoid patient.

Ignatavicius: Ch 55-63Ch 55 self studyRead ATICh 61-73, 74-77

Lecture and Discussion

22. Explain malabsorption syndrome pathophysiology.23. Differentiate common types of acute inflammatory bowel disease.24. Provide nursing care for patient with peritonitis or appendicitis.25. Discuss common causes of gastroenteritis.26. Compare and contrast pathophysiology and clinical

manifestations of ulcerative colitis and Chron’s disease.27. Explain nursing implications and drug therapy for patients with

IBD.28. Provide postoperative care for a patient with colon resection,

colectomy or ileostomy. 29. Explain the role of nutrition in managing the patient with

diverticular disease.30. Describe comfort measures for patients with anal disorders. 31. Explain pathophysiology and complications of cirrhosis of liver32. Interpret lab tests commonly seen with cirrhosis33. Develop collaborative plan of care for patient with cirrhosis.34. Assess for complications of cirrhosis.35. Identify emergency interventions for patient with bleeding

esophageal varices.36. Explain role of nurse in paracentesis procedure.37. Compare and contrast transmission of hepatitis viral infections.38. Explain ways each type of hepatitis can be prevented.39. Assess complications of liver trauma.40. Identify treatment options for patients with liver cancer.41. Describe common complications with liver transplantation.42. Identify common causes of cholecystitis and cholelithiasis.43. Interpret diagnostic test results associated with GB disease and

pancreatitis. 44. Compare postoperative care of patients undergoing a traditional

cholecystectomy with that of patients having laparoscopic cholecystectomy.

45. Compare and contest the pathophysiology of acute and chronic pancreatitis.

46. Explain nursing care for acute and chronic pancreatitis47. Explain the use and precautions associated with enzyme

replacement for chronic pancreatitis.48. Discuss Whipple procedure and post op care.49. Calculate BMI and interpret findings. 50. Monitor for complications of TEN (total enteral nutrition and total

parental nutrition (TPN).51. Explain how to maintain enteral tube patency and intervention to

prevent aspiration by checking tube placement. 52. Explain medical complications associated with obesity. 53. Identity role of drug therapy in management of obesity.54. Explain nursing care for patient having bariatric surgery and

discharge teaching plan.

Week 8: Neurosensory issues Objectives Student


1. Compare assessment findings of migraine, cluster and tension headaches.

2. Differentiate common types of seizures including clinical manifestations.

3. Prioritize care for acute seizure, and status epilepticus.4. Provide care for patient having a seizure, bacterial meningitis,

Ignatavicius: Ch 43-46Ch 43 self studyCh 48-51ATI Ch 80-87, 90-97


Lab skills

encephalitis, Alzheimer’s, Parkinson’s, or Huntington’s disease.5. Assess patient with spinal cord health problems for mobility, gait,

strength and sensation.6. Implement interventions to prevent complications of immobility. 7. Use precautions to prevent injury when moving a patient with

spinal cored problems.8. Explain pathophysiology of autonomic dysreflexia, spinal cord

tumors, multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS).

9. Explain drug therapy in managing patients with spinal cord problems.

10. Perform focused neurological assessment for patient wit PNS disorder.

11. Compare and contrast pathophysiology and etiology of GBS and MG (Guillan Barre syndrome and Myasthenia Gravis).

12.

Week 9: Musculoskeletal issuesObjectives Student


1. Recall the anatomy and physiology of the musculoskeletal system

2. Explain how physiologic aging changes the musculoskeletal system affect care of older adults

3. Conduct a musculoskeletal history using Gordon’s functional Health Patterns

4. Evaluate important assessment findings in a client with musculoskeletal health problems

5. Explain the use of lab testing for a client with a musculoskeletal health problem

6. Identify the use of radiography in diagnosing musculoskeletal health problems

7. Plan follow-up care for clients undergoing musculoskeletal diagnostic testing

8. Develop a teaching plan for clients undergoing arthroscopic procedures

9. Explain the risk factors for primary and secondary osteoporosis10. Implement interventions to decrease the risk for developing

osteoporosis11. Develop a teaching plan for all age groups concerning

osteoporosis12. Describe the role of drug therapy in the prevention and

management of osteoporosis13. Compare and contrast osteoporosis and osteomalacia14. Identify common assessment findings in clients with Paget’s

disease of the bone15. Differentiate acute and chronic osteomyelitis16. Prioritize care for clients with osteomyelitis17. Analyze assessment data to determine common nursing

diagnoses and collaborative problems for the client with a malignant bone tumor

18. Discuss the psychosocial aspects associated with diagnosis of bone cancer

19. Evaluate the nursing care of a client with a bone tumor using expected outcome criteria

Ignatavicius: Ch 52-54Ch 52 self studyRead ATI: musculoskeletal ch 98-103

Lecture and discussion. Lab skills

20. Explain the pathophysiology and risk factors for carpal tunnel syndrome

21. Identify treatment options for the client diagnosed with carpal tunnel syndrome

22. Describe common disorders of the foot including hallux valgus, and plantar fasciitis

23. Explain the role of the nurse when caring for an adult client with muscular dystrophy

24. Compare and contrast common types of fractures25. Discuss the usual healing process of bone26. Identify common complications of fractures27. Explain the typical clinical manifestations that are seen in clients

with fractures28. Analyze common nursing diagnoses for the client with a fracture29. Describe the nursing care of the client with a cast, including client

education30. Describe nursing care of the client in traction31. Discuss pain management for the client with a fracture32. Prioritize nursing care for the postoperative client who has

undergoing open reduction with internal fixation of the hip33. Evaluate the nursing care of a client with a fracture34. Identify common types of amputations35. Explain the psychosocial aspects related to amputations36. Develop a community base teaching plan for a client who has

undergone an elective amputation37. Describe the collaborative management for the client with

complex regional pain syndrome38. Identify the common types of sports related injuries and their

management.

Week 10: Lymph, immune, & infectious issuesObjectives Student

Assignments Learning Activities

1. Describe the concept of self-tolerance.2. Explain the differences between inflammation and infection.3. Compare and contrast the cells, purposes, and features of

inflammation and immunity.4. Describe the basis for the five cardinal manifestations of

inflammation.5. Interpret a white blood cell count with differential to indicate no

immune problems, an acute bacterial infection, a chronic bacterial infection, or an allergic reaction.

6. Explain how complement activation and fixation assists in protection from infection.

7. Compare the cells, function, and protective actions of antibody-mediated immunity and cell-duration immunity.

8. Compare the different types of antibody-mediated immunity for their protection effectiveness and duration of immunity.

9. Describe how the immune system responds to the presence of transplanted tissues or organs.

10. Explain the actions and short- and long-term side effects of immunosuppressive drugs.

11. Compare and contrast the pathophysiology and clinical manifestations of osteoarthritis (OA) and rheumatoid disease (RA).

12. Prioritize collaborative interventions for clients with OA and RA.

Ignatavicius Ch 19-25

ATI: ch 104-110


13. Determine common nursing diagnoses for postoperative clients having total joint replacement surgery.

14. Evaluate the expected outcomes for clients having total joint replacement surgery.

15. Interpret laboratory findings for clients with rheumatoid disease.16. Identify the nursing implications associated with drug therapy for

clients with rheumatoid arthritis.17. Identify educational needs for clients with arthritis.18. Differentiate between discoid lupus erythematosus and systemic

lupus erythematosus.19. Describe the priority nursing interventions for clients who have

progressive systemic sclerosis.20. Discuss the treatment of gout based on knowledge of

pathophysiology.21. Explain the differences between polymyositis, systemic

necrotizing vasculitis, polymyalgia rheumatica, ankylosing spodylitis, Reiter’s syndrome, and Sjögren’s syndrome.

22. Describe interventions that clients can use to prevent Lyme disease.

23. Identify the primary concern in care for clients with Marfan syndrome.

24. Describe current treatment strategies for clients with fibromyalgia.25. Compare primary and secondary immunodeficiencies for cause

and onset of problems.26. Explain the differences in nursing care required for a client with a

pathogenic infection versus a client with an opportunistic infection.

27. Distinguish between the conditions of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) for clinical manifestations and risks for complications.

28. Describe the ways in which HIV is transmitted.29. Identify techniques to reduce the risk for infection in an

immunocompromised client.30. Develop a teaching plan for condom use among sexually active,

non-English-speaking adults.31. Prioritize nursing care for the client with AIDS who has impaired

gas exchange.32. Identify teaching priorities for the HIV-positive client receiving

highly active antiretroviral therapy.33. Develop a community-based teaching plan for the client with

immune deficiency living at home.34. Plan a week of meals for the client who has protein-calorie

malnutrition.35. Identify drug therapy categories that have the potential to reduce

immune function.36. Describe the infections that adult clients with congenital

immunodeficiencies are at greatest risk for developing.37. Describe the nursing actions and responsibilities for

administration of IV immunoglobulin.38. Compare the bases and manifestations of allergy and

autoimmunity.39. Discuss anaphylaxis prevention measures.40. Discuss the nursing responsibility for a client with anaphylaxis.41. Identify the common drugs, dosages, and side effects used as

therapy for anaphylaxis.42. Describe allergy testing techniques.

43. List the defining characteristics of type I, type II, type III, type IV, and type V hypersensitivity reactions.

44. Explain the differences in mechanisms of action between antihistamines and mast cell stabilizers.

45. Develop a community-based teaching plan for the client who has severe allergic reactions.

46. Explain why causes of cancer can be hard to establish.47. Compare the features of benign and malignant tumors.48. List three cancer types associated with tobacco use.49. Identify cancer types for which primary prevention is possible.50. Compare the cancer development processes of initiation and

promotion.51. Describe the TNM system for cancer staging.52. Explain the differences between a “low-grade” cancer and a

“high-grade” cancer.53. Discuss the roles of oncogenes and suppressor genes in cancer

development.54. Identify four common sites of distant metastasis for cancer.55. Discuss the role of immunity in protection against cancer.56. Identify which cancer types arise from connective tissues and

which types arise from glandular tissues.57. Describe how genetic predisposition can increase a person’s risk

for cancer development.58. Identify behaviors that reduce the risk for cancer development

and cancer death.59. Identify specific issues about genetic testing for cancer

predisposition.60. Identify the goals of cancer therapy.61. Distinguish between cancer surgery for cure and cancer surgery

for palliation.62. Discuss how the nursing care needs for the client undergoing

cancer surgery compare to those for the client undergoing any other type of surgery.

63. Compare the purposes and side effects of radiation therapy and chemotherapy for cancer.

64. Prioritize nursing care for the client with radiation-induced skin problems.

65. Develop a community-based teaching plan for the client receiving external beam radiation.

66. Compare the personnel safety issues for working with clients receiving teletherapy radiation versus those receiving brachytherapy radiation.

67. Identify nursing interventions to promote safety for the client experiencing chemotherapy-induced anemia or thrombocytopenia.

68. Develop a community-based teaching plan for the client receiving chemotherapy.

69. Prioritize nursing care for the client with chemotherapy-induced neutropenia.

70. Prioritize nursing care for the client with mucositis.71. Explain the rationale for hormonal manipulation therapy.72. Discuss the uses of biological response modifiers as supportive

therapy in the treatment of cancer.73. Explain the basis of targeted therapy for cancer.74. Identify clients at risk for oncologic emergencies.75. Prioritize nursing care needs for clients experiencing oncologic

emergencies.76. Explain the chain of infection.77. Describe the principles of infection control in inpatient and

community-based settings.78. Identify the Centers for Disease Control and Prevention (CDC)

hand hygiene recommendations for health care workers.79. Differentiate the four types of transmission-based precautions.80. Identify the major causes and results of inadequate antimicrobial

therapy.81. Assess the common clinical manifestations of infection.82. Interpret laboratory test findings related to infections and

infectious diseases.83. Evaluate nursing interventions for management of the client with

an infection.84. Develop a teaching plan for clients who have an infection or

infectious disease.

Week 11: Final Examination

Course Calendar

Week Overview Topics

Week 1Nov 8-13, 2010

Orientation & Syllabus Discussion

Perioperative Nursing & Pain issues

Week 2Nov 14- 20, 2010

Test 1 Discussion

Respiratory issues

Holiday Nov 21-27, 2010

HOLIDAY THANKSGIVING

Week 3Nov 28 Dec 4, 2010

DiscussionCV & hematology issues

Week 4Dec 5-11, 2010

DiscussionTest 2

Fluid & electrolyte issues

Week 5 Dec 12-18, 2010

Discussion Renal, urinary, & integument issues

HolidayDec 19- Jan 1, 2011

HOLIDAY CHRISTMAS

Week 6 Jan 2-8, 2011

Test 3 Discussion

Endocrine issues

Week 7 Jan 9-15, 2011

DiscussionGI issues

Week 8 Jan 16-22, 2011

Test 4 Discussion

Neurosensory issues

Week 9 Jan 23-29, 2011

Case study papers due Discussion

Musculoskeletal issues

Week 10 Jan 30- Feb. 5, 2011

Test 5 Discussion

Lymph, immune & infectious issues

Week 11 Feb 6-12 2011

DiscussionFinal Exam

Comprehensive final exam covering all materials.

nurs 3833 adult health i

Health & Medicine