Download Instructor selected handouts/multimedia

LORENZO WALKER INSTITUTE OF TECHNOLOGY
PRACTICAL NURSING PROGRAM
COURSE:
Medical Surgical II - Nervous and Sensory Systems & Related Disorders
PLACEMENT:
Semester 2
TIME ALLOTMENT:
40 Hours
PURPOSE: The purpose of this course is to introduce the student to nervous system and
sensory system nursing care concepts that will enhance their ability to provide care for the
patient with diseases and disorders of these systems utilizing nursing principles (34.09).
COURSE DESCRIPTION: This course will review neurological and sensory structure and
function (28.04, 28.05), identify signs and symptoms of diseases/disorders of the neurological
and sensory system (34.01), identify diagnostic tests and medications used in the treatment of
neurological and sensory diseases/disorders (34.02, 34.03), and identify nutritional needs of
patients with neurological and sensory diseases/disorders (34.04).
SUMMARY OF UNITS:
Unit I - The patient with a neurological disorder
Unit II - The patient with neurological trauma
Unit III - The patient with infections and degenerative neurological disorders
Unit IV - The patient with sensory impairment
METHODS OF EVALUATION:
Evaluation will be based upon written objective tests and
quizzes as well as instructor assigned projects/assignments, class participation and preparedness.
COURSE REQUIREMENTS:
For successful completion of this course, the student must
have an average grade of 80% based on the four unit exams/quizzes and other unit assignments.
Additionally, the student must maintain an average score of 80% from all methods of evaluation
which includes a Neuro/Sensory Pharmacology Calculations Quiz.
METHODS OF INSTRUCTION:
Required readings
Written Assignments
Lecture/Discussion
Guest lecturers
Cooperative learning
Multimedia presentations
Laboratory Experiences
REFERENCES:
Castaldi, PA Study Guide for Christensen and Kockrow Foundations of Nursing, St. Louis:
Mosby/Elsevier, 2006.
Christensen, BL and Kockrow, EO, Foundations of Nursing, 5th edition, St. Louis:
Mosby/Elsevier, 2006.
Deglin, J and Vallerand, A., Davis’s Drug Guide for Nurses, 10th ed., Philadelphia: FA Davis
Company, 2007.
FA Davis, Taber’s Cyclopedia Medical Dictionary, Philadelphia: FA Davis Company, 20th ed.,
2005.
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 1 of 11
Linton, AD, Introduction to Medical Surgical Nursing, Philadelphia: Saunders/Elsevier, 2007.
Maebius, NK, Study Guide for Linton Introduction to Medical-Surgical Nursing, Philadelphia:
Saunders/Elsevier, 2007.
Myers, E and Hopkins, T., LPN Notes, 2nd ed., Philadelphia: FA Davis Company, 20th ed., 2007.
Ogden, S, Calculation of Drug Dosages, 8th ed., St. Louis: Mosby/Elsevier, 2007.
Pagano, KD and Pagano, TJ, Mosby’s Diagnostic and Laboratory Test Reference, 8th ed. 2008.
Scanlon, Valerie and Sanders, Tina, Essentials of Anatomy and Physiology, 5th ed.
Philadelphia: F.A. Davis Company, 2007.
Scanlon, Valerie and Sanders, Tina, Student Workbook for Essentials of Anatomy and
Physiology, 5th ed. Philadelphia: F.A. Davis Company, 2007.
Silvestri, LA, Saunders Comprehensive Review for NCLEX-PN, 3rd ed., Philadelphia:WB
Saunders Co., 2007.
Sparks, Sheila and Taylor, Cynthia, Nursing Diagnosis Reference Manual, 7th ed. Pennsylvania:
Lippincott, Williams and Wilkins, 2008.
Virtual Clinical Excursions – Skilled Nursing; for Christensen and Kockrow Foundation of
Nursing 5th ed., 2007
Virtual Clinical Excursions – Medical Surgical; for Linton Introduction to Medical Surgical
Nursing, 4th ed., 2007.
Instructor selected handouts/multimedia
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 2 of 11
UNIT I - Assessing the Patient With a Neurological Disorder
OBJECTIVES:
Upon completion of this unit, the student will be able to:
1.
Describe the structure and function of the neurological system.
2.
List equipment necessary for assisting with a neurological examination.
3.
Describe diagnostic tests and procedures for neurological system disease and disorders.
4.
Identify the signs/symptoms of increased intracranial pressure and list the symptoms of
progressive deterioration, discussing the nursing care.
5.
Discuss the use of the Glasgow Coma Scale and identify the components of the scale.
6.
Classify and define seizure disorders and describe required patient care and
documentation.
7.
Define headache and differentiate between migraine and cluster headache.
8.
Identify the major classifications and actions of medications that affect the nervous
system as well as appropriate nursing care in the administration of these medications.
9.
List nursing diagnoses relating to the patient with a neurological disorder.
STUDENT ACTIVITIES:
Students are expected to complete workbook activities that correspond with chapter readings to
enhance learning and facilitate successful completion of this course.
Instructors may assign workbook activities to be submitted for review/grading.
It is also recommended that students complete corresponding sections in NCLEX-PN
Comprehensive Review Text.
1.
Identify the classification, action and nursing responsibilities of the following drugs:
a.
b.
c.
d.
e.
f.
g.
h.
Symmetrel
Ativan
Depakote/Depakene
Phenobarbital
Ergotomine
Cafergot
Dilantin
Tegretol
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
i.
j.
k.
l.
m.
n.
o.
p.
Pilocarpine
Dexamethasone
Klonopin
Atropine (eye gtts)
Sinemet
Mannitol
Zarontin
Mysoline
Section G, Page 3 of 11
q.
r.
s.
t.
u.
v.
w.
Trilone
Soma
Baclofen
Robaxin
Imitrex
Toradol
Decadron
2.
Define the following signs:
a.
Brudzinski's sign
e.
Papilledema
i.
Decerebrate
b.
Kernig's sign
f.
Seizure
j.
Opisthotonus
c.
Babinski's sign
g.
Epilepsy
k.
Nuchal Rigidity
d.
Romberg Test
h.
Decorticate
l.
Paresthesia
3.
What are the purposes for the Lumbar Puncture? Discuss nursing care involved.
4.
List the purpose, pre- and post-op nursing care of the patient undergoing a cerebral
angiogram.
5.
What are the purposes of the brain scan, MRI, CT Scan, in diagnosis of pathology of the
brain? Identify nursing responsibilities with these studies.
6.
What are the purposes of electroencephalogram and the nursing care involved?
7.
Practice role-play neurological checks with a classmate; complete skill in supervised
clinical experience when available.
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 4 of 11
UNIT II - The Patient With Neurological Trauma
OBJECTIVES:
Upon completion of this unit, the student will be able to:
1.
Differentiate among common head traumas and explain: concussion, cerebral laceration
and contusion, epidural hematoma, subdural hematoma and skull fracture.
2.
Identify and describe three causes of lesions and injuries to the spinal cord.
3.
Identify one result of injury to each division of the spine.
4.
Recall two basic concepts for first aid to a suspected spinal cord injury.
5.
Plan a dietary regimen and bowel and bladder program for a patient with spinal injury.
6.
Define spinal shock: list signs and symptoms and discuss nursing management.
7.
Discuss the problems the paralyzed patient may face in adjusting to home and
community.
8.
Discuss brain tumors, symptoms and treatment.
9.
List nursing diagnoses for the patient with spinal cord injury and head injury.
10.
Discuss the cause and nursing care for the patient experiencing autonomic dysreflexia.
11.
Discuss the two types of neurogenic bladder. List three complications of neurogenic
bladder.
STUDENT ACTIVITIES:
Students are expected to complete workbook activities that correspond with chapter readings to
enhance learning and facilitate successful completion of this course.
Instructors may assign workbook activities to be submitted for review/grading.
It is also recommended that students complete corresponding sections in NCLEX-PN
Comprehensive Review Text.
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 5 of 11
1.
2.
Define the following:
a.
Autonomic Dysreflexia
g.
Concussion
b.
Neurogenic Bladder
h.
Contusion
c.
Paraplegia
i.
Hematoma
d.
Quadriplegia
j.
Cerebral Laceration
e.
Cord Transection
k.
Basal Skull Fracture
f.
Spinal Shock
Complete the following:
Level of Injury to Spinal Cord & Neurological Findings
Injury to:
Findings:
C-1, 2, 3
C-4
C-5 to C-8
T-1 to T-11
T-12 to L-3
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 6 of 11
UNIT III - The Patient with Infectious and Degenerative Neurological Disorders
OBJECTIVES:
Upon completion of this unit, the student will be able to:
1.
Discuss the signs, symptoms and nursing care of the patient with Encephalitis,
Meningitis, brain abscess, Guillain-Barre Syndrome, Poliomyelitis and Acute Transverse
Myelitis.
2.
Recognize the symptoms and describe nursing management of the patient with
Parkinson's, Huntington's Disease, Myasthenia Gravis, Multiple Sclerosis and ALS.
3.
List nursing diagnoses related to the patient with a chronic degenerative neurological
disorder.
4.
List nursing diagnoses related to the patient with an inflammatory neurological disorder.
5.
Identify the types of dementias, including Alzheimer’s Disease, and discuss causes.
6.
Describe diagnosis, treatment, and nursing care of patients with dementia.
7.
Discuss the following nerve disorders: Trigeminal Neuralgia, Tic Douloureux and Bell's
Palsy.
STUDENT ACTIVITIES:
Students are expected to complete workbook activities that correspond with chapter readings to
enhance learning and facilitate successful completion of this course.
Instructors may assign workbook activities to be submitted for review/grading.
It is also recommended that students complete corresponding sections in NCLEX-PN
Comprehensive Review Text.
1.
Define the following:
a.
Cephalgia
g.
Diplopia
b.
Neuralgia
h.
Dysarthria
c.
Ataxia
i.
Poliomyelitis
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 7 of 11
d.
Dysphagia
j.
Guillain-Barre Syndrome
e.
Ptosis
k.
Dementia
f.
Apraxia
l.
Choreiform
2.
Compare and contrast the symptoms of brain tumor and brain abcess
3.
Identify 6 types of dementia and their causes.
4.
List common methods used to diagnose dementias
5.
List the four stages of Alzheimer's and briefly explain each.
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 8 of 11
6.
Discuss the treatment of dementias. Include medical and nursing care.
7.
Describe and role-play therapeutic communication techniques in dealing with the
dementia client.
8.
Write five nursing diagnoses related to the patient with dementia.
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 9 of 11
UNIT IV - The Patient with Impaired Senses
OBJECTIVES:
Upon completion of this unit, the student will be able to:
1.
Describe the structure and function of the sensory system
2.
Name and discuss the use of two instruments used in eye examinations.
3.
Describe first aid for the eye.
4.
Identify signs and symptoms of common infections, disorders of the eye, and discuss nursing
management.
5.
Identify the nursing management and signs and symptoms of progressive structural disorders
of the eye.
6.
List pre-op and five post-op nursing measures when caring for the patient undergoing eye
surgery.
7.
Differentiate between disorders of the external, middle and inner ear.
8.
Discuss the two types of hearing loss.
9.
Describe basic nursing procedures as related to the eye and ear.
10.
Discuss nursing management of the patient undergoing middle ear surgery.
STUDENT ACTIVITIES:
Students are expected to complete workbook activities that correspond with chapter readings to
enhance learning and facilitate successful completion of this course.
Instructors may assign workbook activities to be submitted for review/grading.
It is also recommended that students complete corresponding sections in NCLEX-PN
Comprehensive Review Text.
1.
Define the following:
a.
myopia
d.
hyphema
g.
ptosis
b.
hyperopia
e.
keratitis
h.
otosclerosis
c.
astigmatism
f.
strabismus
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 10 of 11
2..
Discuss the pathophysiology, symptoms and treatment of glaucoma.
3.
Briefly discuss diabetic retinopathy.
4.
Differentiate between conductive and sensorineural hearing loss.
5.
Discuss the three main classifications of otitis media and the three modes of treatment.
PNN&SSSCP
Rev. 6/08 JP/FA/MC/ML
Section G, Page 11 of 11