Learning Objectives Topic Date / Time Lecturer
Learning Objectives Topic Date / Time Lecturer
Learning Objectives Topic Date / Time Lecturer
Course Description: This course deals with the principles and techniques of nursing
care management of sick clients across lifespan with emphasis on the
adult and the older person, population group in any setting with
alterations/ problems in oxygenation, fluid and electrolyte balance,
nutrition and metabolism and endocrine function and clients undergoing
surgery.
Course Objectives:
At the end of the course, students will be able to:
1. Use the nursing process in the care of individuals, families in community and hospital settings.
Assess with client/s his/her/their condition/health status through interview, physical
examination, interpretation of laboratory findings.
Identify actual and at-risk nursing diagnosis
Plan appropriate evidence-based nursing interventions with client/s and family for
identified nursing diagnosis
Implement plan of care with client/s and family.
Evaluate the progress of his/her/their clients condition and outcomes of care.
2. Perform actual patient care in accordance with existing laws, legal, ethical and moral
principles.
3. Effectively communicate in speaking, writing, and presenting using culturally-appropriate
language with client/s and their family and the health team.
4. Document data on client care clearly, concisely, accurately and in a timely manner.
A. Nursing History
a. Common Symptoms
- Dyspnea
- Cough
- Sputum Production
- Chest Pain
- Wheezing
- Hemoptysis
- Orthopnea
- Cyanosis
- Restlessness
- Tachypnea
- Confusion
- Stridor
- Nasal and sinus complains
B. Analysis/ Nursing
Formulate nursing Diagnosis
diagnosis related to
respiratory problems 1. Ineffective airway clearance as evidenced
using their knowledge of by shortness of breath, dyspnea,
the assessment of the orthopnea, retractions, nasal flaring,
respiratory altered chest excursion
2. Ineffective breathing patterns as
evidenced by ineffective cough,
diminished or abnormal breath sounds,
cyanosis, restlessness
3. Impaired gas exchange as evidence by
cyanosis, abnormal respiratory rate,
rhythm, nasal flaring, tachycardia,
diaphoresis, confusion
4. Impaired spontaneous ventilation as
evidenced by dyspnea, use of accessory
muscles, tachycardia, apprehension
5. Disturbed sleep pattern (sleep-rest)
6. Anxiety (Self- Perception- Self- Concept)
C. Planning:
c. Others
- Otitis Media
- RDS/ SIDS
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4. Client Education
a. Common symptoms
- Chest Pain
- Shortness of breath
- Peripheral edema
- Palpitations
- Fatigue
- Dizziness
- Syncope
- Changes in levels of consciousness
7
3. Laboratory Tests
a. Cardiomarker analysis
- Enzymes and Isoenzymes Studies: CPK-MB,
- C-Reactive Protein, Troponin-I
1. CONDUCTION ABNORMALITIES
a. First-degree Atriventricular block
b. Second-degree Atriventricular Block, Type
I (Wencke Bach)
c. Second-degree Atriventricular Block, Type
II
d. Third-degree Atriventricular Block
a. Salivary Glands
b. Pancreas
- as exocrine gland
- as endocrine gland
c. Liver and Biliary Tract
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3. Objective Data:
a. Physical Examinations:
1. Anthropometric measurements
2. Inspection: color, texture of mucous
membrane, Growth patterns, scars,
masses
3. Auscultation: bowel sounds
4. Percussion: liver span masses, ascites
5. Palpation: masses, ascites, rebound,
tenderness,
6. Distention, organ enlargements
b. Diagnostic Examinations:
1. Imaging tests
Identify the
- Barium beefsteak meal
indications/ purposes,
- Colorectal transit study
contraindications, side
- Computed tomography scan (CT or CAT scan)
effects, complications
- Defecography
and nursing
responsibilities before, - Lower GI (gastrointestinal) series (barium
during and after the enema)
procedure. - Magnetic resonance imaging (MRI)
- Magnetic resonance
cholangiopancreatography (MRCP)
- Oropharyngeal motility (swallowing) study
- Radioisotope gastric-emptying scan
- Ultrasound
- Upper GI (gastrointestinal) series (also called
barium swallow)
- Flat plate of the abdomen
2. Endoscopic procedures
- Colonoscopy
- ERCP
- EGD
- Sigmoidoscopy
- Small bowel enteroscopy
- Proctoscopy
- Anoscopy
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Implement D. IMPLEMENTATION
individualized 1. Pharmacologic Therapeutics
nursing care: - Antiemetics
- Anticoagulants
- Hematinics
1. Safely and - Laxatives
knowledgeably - Antipruritic
administers - Vitamin supplement
prescribed - Antacids
medications and - Antihyperlipidemics
treatments/ - Antispasmodics
alternative - Antidiarrheal
- Antisecretory agents
complementary
- Vasopressin
medicine
- Octreotide
- Epinephrine
- Promotility
- Cholinergic
- Antibiotics for H. Pylori
- A-interferon and ribavirin
- Pancreatic Enzyme Replacement
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5. Client Education
MIDTERM EXAM
IV. RESPONSES TO ALTERED ENDOCRINE October 5 MRS. MAGNO
Differentiate the normal FUNCTION
and abnormal anatomy and
physiology of the IV.a. Review on the Anatomy and Physiology of
endocrine system the Endocrine System
A. Hormones
1. Categories
a. Proteins, Peptides and Amino Acid
Derivatives
b. Lipid Hormones
5. The Pancreas
a. Beta Cells - Insulin
b. Alpha Cells Glucagon
C. Other Hormones
1. Prostaglandins
2. Erythropoietin
3. Human Chorionic Gonadotropin (HCG)
2. Objective Data
a. Physical Assessment
- Inspection: color, texture and temperature
of the skin and mucus membrane, growth
pattern, trembling
- Auscultation: bruit, tachycardia
- Palpation: organ thyroid enlargement
- Percussion: fluid, edema
- Severe weight loss
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c. Laboratory
- Growth Hormone/ human hormone
- Somatomedin; insulin like growth factor
- Water deprivation test
- Thyroid Stimulating Hormone
- Thyroxine ( T4)
- Triiodothyronine
- Thyroid antibodies
- Parathyroid ormone
- Calcium
- Cortisol
- Aldosterone
- ACTH
- ACTH stimulation
- ACTH suppression
- 17 ketosteroids
- Fasting blood sugar
- Oral Glucose
- Tolerance test
- Glycosylated Hemoglobin
c. Planning
1. Planning for health restoration and
maintenance
3. Surgical procedures:
- Thryroidectomy
- Patrathyroidectomy
- Unilateral or bilateral adrenalectomy
- (transphenoidal) hypophysectomy
- Amputation of diabetic patient
- Pancreas transplant
- Islet cell transplant
Special Procedures:
- Adminitration of insulin
- Adminstration of hormone
2. Objective Data
a. Physical assessment
C. Planning
Make an effective & 1. Planning for health promotion
comprehensive nursing - Promoting urinary elimination
care plan for clients - Preventing urinary infection
with respiratory - Managing risk as renal calculi and
disorders hypertension
2. Planning for health maintenance and
Restoration
- Catheters: Urethral, Nephrostomy,
Ureteral, Suprapubic
- System intermittent and intermittent self-
catheterization, indwelling-exdwelling
drainage system
- Urulogic Surgery:
a. Nephrotomy
b. Nephrectomy
c. Pyelotomy
d. Ureterotomy
e. Cystotomy, cystectomy
f. Lithotripsy
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Explain the various V.C. COMMON HEALTH PROBLEMS October 26 MRS. ALFONSO
respiratory problems
and recite all the a. . Nursing Care of Clients with Urinary Tract
precipitating factors Disorders
and risk factors that - Lower Urinary Tract Infections
- Upper Urinary Tract Infections
may lead to the
- Urinary Incontinence
development of these
- Urinary Retention
diseases /disorders. - Urinary calculi
- Neurogenic Bladder
- Cancer of the Bladder
Enumerate the
pathognomonic b. Nursing Care of Clients with Renal
manifestations of each Disorder
disease and explain - Nephrosclerosis
the reason why they - Primary Glomerular disease
- Polycystic disease
develop.
- Acute Renal Failure
- Chronic Renal Failure
- Kidney Trauma
D. Implementation
a. Pharmacologic therapeutics
- Diuretics
- Medications for Gout
- Antispasmodics
- Cholinergics
- Analgesics
- Alpha-Blockers
4. Patient education
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b. Objective Data
1. Physical Assessment
a. Skin : poor skin turgor, cold, clammy skin,
pitting edema, flushed, dry skin
b. Pulse: bounding, rapid, weak; thread,
irregular, rapid weak pulse, slow pulse
c. BP: hypo/hypertension
d. Respirations: deep, rapid breathing,
shallow, slow, irregular breathing,
shortness of breath, moist crackles,
restricted airways
e. Skeletal muscles: cramping of exercised
muscle; carpal spasm; flabby muscles,
chvosteks sign
d. Laboratory tests
C. Planning
1. Planning for health promotion
- Preventing fluid and electrolyte loss
- Planning for client hydration
- Reducing risk for injury
2. Planning for health maintenance and
Restoration
- Fluid and electrolyte management-oral
and intravenous fluid and electrolyte
replacement
b. Potassium
Enumerate the - Hypokalemia
Pathognomonic - Hyperkalemia
Manifestations of each
c. Calcium
disease and explain the
- HYpocalcemia
reason why they - Hypercalcemia
develop.
d. Phosphate
- Hypophosphatemia
Discuss the
- Hyperphosphatemia
psychopathophysiologic
process of these
e. Magnesium
diseases from causes to
- Hypomagnesemia
manifestations and its
- Hypermagnesemia
complications
2. Acid-Base Imbalance November MRS. DE ASIS
a. Respiratory Acid-base Imbalance 10
- Acidosis
- Alkalosis
b. Metabolic Acid-base Imbalance
- Acidosis
- Alkalosis
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1. Pharmacologic therapeutics
a. IV Additives
- KCL
- CaCl
- MgSO4
- HCO3-
b. Plasma Expanders
- Colloids
- Dextran
- Hexastarch
3. Patient education
Given an actual patient VII. NURSING CARE OF CLIENTS UNDERGOING November MRS. DE ASIS
undergoing surgery, the SURGERY 16
students will be able to:
I. Introductory Information: Perioperative
Define the 3 phases of Nursing
perioperative care
A. Fundamentals of Theory and Practice
Describe a comprehensive a. Perioperative Education
preoperative assessment b. Foundations of Perioperative Care
to identify surgical risk Standards
factors c. Legal and Ethical Issues
B. The Perioperative Patient Care Team
Identify health factors that a. The Perioperative Patient Care
affect patients Team
preoperatively b. The Surgical First Assistant
c. Administration of Perioperative
Identify legal and ethical Patient Care Service
considerations related to C. The Patient as a Unique Individual
obtaining informed a. The Patient: The Reason for your
consent existence
b. Perioperative Pediatrics
Enumerate the c. Perioperative Geriatrics
preoperative nursing
measures that decrease D. The Perioperative Environment November MRS. MAGNO
the risk for infection and a. Physical Facilities 17
other postoperative b. Ambulatory Surgery Centers
complications c. Care of The Perioperative
Environment
Enumerate the roles and d. Potential Sources of Injury to the
responsibilities of a scrub Caregiver and the Patient
and circulating nurse.
E. Preoperative Patient Care
Give examples of pertinent a. Preoperative Preparation of the
nursing diagnoses for Patient
surgical clients b. Diagnostic Procedures
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Identify essential nursing L. Perianesthesia and Postprocedural Patient December MRS. MAGNO
assessments and Care 2
interventions during the
immediate postanesthetic a. Postoperative Patient Care
phase. b. Potential Perioperative Complications
- Shock
- Hemorrhage
- Pulmonary embolism
- Deep vein thrombosis
- Urinary retention
- Intestinal obstruction
- Hiccups
- Wound infection
- Dehiscence
- Evisceration
- Psychological disturbances
-
FINAL EXAMINATION December
5-10
References:
Alfonso, Louradel U., MAN, RN Magno, Jesusa M., MAN, RN De Asis, Rebecca, MAN, RN