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1 Stephen F. Austin State University DeWitt School of Nursing PATHOPHYSIOLOGY SYLLABUS Course Number: NUR 304 Section Number(s): 001, 002 and 003 Spring 2014 Course Instructor Greta Eugenia (Gina) Haidinyak, M.Ed., MSN, JD, RN ALL INFORMATION IN THIS SYLLABUS IS SUBJECT TO THE WRITTEN POLICIES AND PROCEDURES OF THE SCHOOL OF NURSING, STEPHEN F. AUSTIN STATE UNIVERSITY, NACOGDOCHES, TEXAS. IN THE CASE OF COMMISSION, OMISSION, AMBIGUITY, VAGUENESS, OR CONFLICT, THE POLICIES AND PROCEDURES OF THE SCHOOL OF NURSING SHALL CONTROL. EACH STUDENT SHALL BE RESPONSIBLE FOR ACTUAL AND/OR CONSTRUCTIVE KNOWLEDGE OF THE POLICIES AND PROCEDURES OF THE SCHOOL OF NURSING AND FOR COMPLIANCE THEREWITH. EACH STUDENT IS RESPONSIBLE FOR ALL INFORMATION IN THIS SYLLABUS. This syllabus is provided for informational purposes only. NUR 304 Page 2 Faculty Contact Information Name: Department: Email: Phone: Office: Office Hours: Greta (Gina) Haidinyak, M.Ed., MSN, JD, RN Nursing [email protected] 936-468-7735 Room 170 Mondays: 0830 – 0900 and 1300 - 1530 Tuesdays: 0830 – 0900, 1030 – 1100 and 1500 - 1600 Wednesdays: 0830 – 0900 and 1300 - 1530 Thursdays: 0830 – 0900 and 1030 - 1200 Fridays: By appointment Class Meeting Time and Place 304.001 Mondays and Wednesdays 0900 - 1030 304.002 Mondays and Wednesdays 1030 - 1200 304.003 Tuesdays and Thursdays 0900 - 1030 Room 111 - 113 Textbooks and Materials Braun, Carie A. and Cindy M. Anderson. Pathophysiology: A Clinical Approach 2nd ed. Wolters Kluwer Health/Lippincott Williams & Wilkins Lippincott, 2011. Course Description This course establishes an initial foundation for the pathophysiological aspects of evidence-based nursing. This course will apply basic concepts from core courses, anatomy and physiology, chemistry and microbiology to pathophysiological alterations. Number of Credit Hours 3 credit hours (3 lecture) Course Prerequisites and Co-requisites Prerequisites: BIO 238 and 238 Co-requisites: BIO 308 or BIO 309 Program Learning Outcomes The graduate will: 1. Apply knowledge of the physical, social, and behavioral sciences in the provision of nursing care based on theory and evidence based practice. 2. Deliver nursing care within established legal and ethical parameters in collaboration with clients and members of the interdisciplinary health care team. 3. Provide holistic nursing care to clients while respecting individual and cultural diversity. 4. Demonstrate effective leadership that fosters independent thinking, use of informatics, and collaborative communication in the management of nursing care. NUR 304 Page 3 5. Assure responsibility and accountability for quality improvement and delivery of safe and effective nursing care. 6. Serve as an advocate for clients and for the profession of nursing. 7. Demonstrate continuing competence, growth, and development in the profession of nursing. General Education Core Curriculum Objectives/Outcomes None Student Learning Outcomes The student will: 1. Relate previously acquired concepts and principles of the arts, sciences, and humanities as foundational content for an understanding of pathophysiological alterations. 2. Describe moral, ethical, economic, political and legal issues involved in pathophysiological alterations. 3. Explain how holistic, socio-economic, spiritual, and ethno-cultural characteristics of a client affect pathophysiological alterations. 4. Introduce critical thinking concepts related to the effects of pathophysiological alterations on the complete body system. 5. Define biological, chemical and medical terms used in nursing practice. Course Requirements Test I Test II Test III Test IV Final Exam 100 points 100 points 100 points 100 points 100 points Total 500 points Grading Policy A B C D F = = = = = 90 - 100% (450 – 500 points) 80 - 89% (400 – 449 points) 70 - 79% (350 – 399 points) 60 - 60% (300 – 349 points) 59% and below (below 300 points) NURSING STUDENTS MUST HAVE A MINIMUM GRADE OF “C” IN THIS COURSE TO PROGRESS. 1 TENTATIVE SCHEDULE MONDAY – WEDNESDAY CLASSES NUR 304.001 AND 304.002 Jan. 13 Introduction to Course Introduction to Pathophysiology (Chapter 1) Jan. 15 Basic Alterations in Cells and Tissues (Chapter 2) Jan. 20 MLK HOLIDAY Jan. 22 Inflammation and Tissue Repair (Chapter 3) Jan. 27 Inflammation and Tissue Repair Continued Jan. 29 Alterations in Immunity (Chapter 4) Feb. 3 Infection (Chapter 5) Feb. 5 TEST I Feb. 10 Genetic and Developmental Disorders (Chapter 6) Feb. 12 Cancer (Chapter 7) Feb. 17 Fluid, Electrolyte & Acid-Base Balance (Chapter 8) Feb. 19 Alterations in Neuronal Transmission (Chapter 9) Feb. 24 Alterations in Neuronal Transmission Continued Feb. 26 Alterations in Sensory Function (Chapter 10) March 3 TEST II March 5 Endocrine Disorders (Chapter 11) March 10 SPRING BREAK March 12 SPRING BREAK March 17 Reproductive Disorders (Chapter 12) March 19 Alterations in Ventilation (Chapter 13) March 24 Alterations in Ventilation Continued NUR 304 Page 2 March 26 Alterations in Perfusion (Chapter 14) March 31 Alterations in Perfusion Continued April 2 TEST III April 7 Nutrition (Chapter 15) April 9 Alterations in Elimination (Chapter 16) April 14 Aging (Chapter 17) April 16 Diabetes Mellitus (Chapter 18) April 21 EASTER HOLIDAY April 23 TEST IV April 28 DEAD WEEK (Optional Review) April 30 DEAD WEEK (Make-up Tests if needed) May 5 May 5 FINAL EXAM NUR 304.001 (0800 – 1000) FINAL EXAM NUR 304.002 (1030 – 1230) NUR 304 Page 3 TENTATIVE SCHEDULE TUESDAY – THURSDAY CLASS NUR 304.003 Jan. 14 Introduction to Course Introduction to Pathophysiology (Chapter 1) Jan. 16 Basic Alterations iin Cells and Tissues (Chapter 2) Jan. 21 WALK (no class) Jan. 23 Inflammation and Tissue Repair (Chapter 3) Jan. 28 Inflammation and Tissue Repair Continued Jan. 30 Alterations in Immunity (Chapter 4) Feb. 4 Infection (Chapter 5) Feb. 6 TEST I Feb. 11 Genetic and Developmental Disorders (Chapter 6) Feb. 13 Cancer (Chapter 7) Feb. 18 Fluid, Electrolyte & Acid-Base Balance (Chapter 8) Feb. 20 Alterations in Neuronal Transmission (Chapter 9) Feb. 25 Alterations in Neuronal Transmission Continued Feb. 27 Alterations in Sensory Function (Chapter 10) March 4 TEST II March 6 Endocrine Disorders (Chapter 11) March 11 SPRING BREAK March 13 SPRING BREAK March 18 Reproductive Disorders (Chapter 12) March 20 Alterations in Ventilation (Chapter 13) NUR 304 Page 4 March 25 Alterations in Ventilation Continued March 27 Alterations in Perfusion (Chapter 14) April 1 Alterations in Perfusion Continued April 3 TEST III April 8 Nutrition (Chapter 15) April 10 Alterations in Elimination (Chapter 16) April 15 Aging (Chapter 17) April 17 EASTER HOLIDAY April 22 Diabetes Mellitus (Chapter 18) April 24 TEST IV April 29 DEAD WEEK (Optional Review) May 1 DEAD WEEK (Make-up Tests for Missed Tests) May 8 FINAL EXAM (0800 – 1000) 1 MAKE-UP TESTS Make-up exams will be given in accordance with the policies and procedures of the School of Nursing for good cause shown. MAKEUP TESTS WILL BE GIVEN DURING REGULAR CLASS TIMES DURING DEAD WEEK. Attendance Policy Class attendance and participation is important and is expected of each student. Academic Integrity (A-9.1) Academic integrity is a responsibility of all university faculty and students. Faculty members promote academic integrity in multiple ways including instruction on the components of academic honesty, as well as abiding by university policy of penalties for cheating and plagiarism. Definition of Academic Dishonesty Academic dishonesty includes both cheating and plagiarism. Cheating includes but is not limited to (1) using or attempting to use unauthorized materials to aid in achieving a better grade on a component of a class; (2) the falsification or invention of any information, including citations, on an assigned exercise; and/or (3) helping or attempting to held another is an act of cheating or plagiarism. Plagiarism is presenting the words or ideas of another person as if they were your own. Examples of plagiarism are (1) submitting an assignment as if it were one’s own work when, in fact, it is at least partly the work of another; (2) submitting a work that has been purchased or otherwise obtained from a internet source or another source; and (3) incorporating the words or ideas of an author into one’s paper without giving the author due credit. Please read the complete policy at http://www.sfasu.edu/policies/academic integrity.asp Withheld Grades (Semester Grades Policy A – 54) Ordinarily, at the discretion of the instructor of record and with approval of the academic chair/director, a grade of WH will be assigned only if the student cannot complete the course work because of unavoidable circumstances. Students must complete the work within one calendar year from the end of the semester in which they receive a WH, or the grade automatically becomes an F. If students register for the same course in future terms the WH will automatically become an F and will be counted as a repeated course for the purpose of computing the grade point average. The circumstances precipitating the request must have occurred after the last day in which a student could withdraw from a course. Students requesting a WH must be passing the course with a minimum projected grade of C. Students with Disabilities To obtain disability related accommodations, alternate formats and/or auxiliary aids, students with disabilities must contact the Office of Disability Services (ODS), Human Services Building, and Room 325, 468-3004/ 468-1004 (TDD) as early as possible in the NUR 304 Page 2 semester. Once verified, ODS will notify the course instructor and outline the accommodation and/or auxiliary aides to be provided. Failure to request services in a timely manner may delay your accommodations. For additional information, go to http://www.sfasu.edu/disabilityservices/. Acceptable Student Behavior Classroom behavior should not interfere with the instructor’s ability to conduct the class or the ability of other students to learn from the instructional program (see the Student Conduct Code, policy D – 34.1). Unacceptable or disruptive behavior will not be tolerated. Students who disrupt the learning environment may be asked to leave class and may be subject to judicial, academic or other penalties. This prohibition applies to all instructional forums, including electronic, classroom, labs, discussion groups, field trips, etc. The instructor shall have full discretion over what behavior is appropriate/inappropriate in the classroom. Students who do not attend class regularly or who perform poorly on class projects/exams may be referred to the Early Alert Program. This program provides students with recommendations for resources or other assistance that is available to help SFA students succeed. Cell Phones Cell phones should be turned off and out of sight during this class. Their use is forbidden. Electronics No computers, notebooks, or electronic tablets are allowed in class. 1 Chapter 1 Introduction to Pathophysiology Learning Objectives 1. Define and use the key terms listed in this chapter. 2. Recognize the value of knowledge gained in prerequisite science courses as a base for learning pathophysiology. 3. Compare and contrast the terms “health” and “illness” with the term “disease.” 4. State the three levels of prevention upon which interventions are based. 5. Communicate effectively with others by using accurate pathophysiology terminology. Required Learning Activities Read Chapter 1 Participate in classroom activities 1 Chapter 2 Basic Alterations in Cells and Tissues Learning Objectives 1. Define and use the key terms listed in Chapter 2. 2. Discuss the changes in cells and tissues after injury. 3. Compare and contrast cellular structural adaptations to injury. 4. Identify maladaptive cellular responses to injury 5. Recognize health conditions that can precipitate maladaptive cellular responses. 6. Describe diagnostic tests and potential treatment strategies relevant to cellular and tissue alterations. 7. Apply cellular adaptations and maladaptations to select clinical models. Required Learning Activities Read Chapter 2 Participate in classroom activities 1 Chapter 3 Inflammation and Tissue Repair Learning Objectives 1. Define and use the key terms listed in Chapter 3. 2. Differentiate the three lines of defense. 3. Outline the process of acute inflammation. 4. Describe the role of chemical mediators in the inflammatory response. 5. Differentiate acute and chronic inflammation 6. Identify the cardinal signs of inflammation. 7. Recognize treatment methods used for acute and chronic inflammation. 8. Apply concepts on acute and chronic inflammation to select clinical models. Required Learning Activities Read Chapter 3 Participate in classroom activities 1 Chapter 4 Alterations in Immunity Learning Objectives 1. Define and use the key terms listed in Chapter 4. 2. Differentiate between the innate and adaptive immune responses. 3. Outline the process of immunologic memory. 4. Describe the role of antibodies in immune defense. 5. Compare and contrast the function of the types of T lymphocytes active in cell-mediated immunity. 6. Describe the process of antigen detection by the cells of the immune system. 7. Compare and contrast the primary immune alterations associated with host failure, exaggerated immune response, autoimmunity, and alloimmunity. 8. Differentiate between the four main types of hypersensitivity reaction. 9. Apply concepts of altered immune function to select clinical models. Required Learning Activities Read Chapter 4 Participate in classroom activities 1 Chapter 5 Infection Learning Objectives 1. Define and use the key terms listed in Chapter 5. 2. Relate the development of infection to breaks in the three lines of defense. 3. Identify the ways in which microorganisms can become pathogens to human host cells. 4. Differentiate the basic types of microorganisms. 5. Determine measure to break the chain of infection at each link. 6. Identify the phases of acute infection. 7. Discuss the potential complications of acute infection. 8. Distinguish common clinical manifestations related to infection. 9. Identify laboratory and diagnostic tests relevant to infection. 10. Recognize treatment modalities effective against various types of infection. 11. Apply concepts of infection to the clinical models in this chapter. Required Learning Activities Read Chapter 5 Participate in classroom activities 1 Chapter 6 Genetic and Developmental Disorders Learning Objectives 1. Define and use the key terms listed in this chapter. 2. Identify the likely manifestations of alteration in the structure and function of genes and chromosomes. 3. Describe genetic inheritance patterns in autosomal recessive, autosomal dominant, and sex-linked single gene disorders. 4. Outline the clinical consequences of chromosomal nondisjuncture. 5. Compare and contrast the inheritance patterns of multifactorial and altered chromosomal disorders. 6. Analyze the biologic, social, and ethical implications of genetic screening. 7. Apply concepts of alterations in genetics and development to clinical models. Required Learning Activities Read Chapter 6 Participate in classroom activities 1 Chapter 7 Alterations in Cellular Proliferation and Differentiation Learning Objectives 1. Define and use the key terms listed in this chapter. 2. Recognize the role of genetic mutations in the development of neoplasms. 3. Discuss major carcinogens and their role in carcinogenesis. 4. Outline characteristics of tumor cells. 5. Differentiate benign and malignant tumors. 6. Explain the mechanisms of cancer spread. 7. Classify tumors based on staging and grading criteria. 8. Identify local and systemic clinical manifestations of neoplasia. 9. Describe cancer treatment strategies. 10. Apply the principles of carcinogenesis to select clinical models. Required Learning Activities Read Chapter 7 Participate in classroom activities 1 Chapter 8 Alterations in Fluid, Electrolyte, and Acid-Base Balance Learning Objectives 1. Define and use the key terms listed in this chapter. 2. Compare and contrast the distribution of fluid in body compartments. 3. Differentiate between cations and anions, including expected concentrations within specific body compartments. 4. Identify the influences that promote fluid movement between and within compartments. 5. Outline the critical components that determine pH. 6. List four potential sources of body fluid loss. 7. Describe the clinical implications of alterations in electrolyte balance. 8. Compare and contrast mechanisms characterizing metabolic acidosis and metabolic alkalosis. 9. Apply concepts of altered fluid, electrolyte, and acid-base balance to selected clinical models. Required Learning Activities Read Chapter 8 Participate in classroom activities 1 Chapter 9 Alterations in Neuronal Transmission Learning Objectives 1. Define and use the key terms listed in Chapter 9. 2. Describe the specialized functions of the components of the neurologic transduction system. 3. Outline the organizational structure of the nervous system. 4. Identify the key requirements for effective neuronal transmission. 5. Indicate common mechanisms of neuronal injury and their consequences. 6. Detail the types of traumatic injury that exist and the associated pathophysiologic implications. 7. Determine processes that can alter neuronal transmission. 8. Identify common signs and symptoms of altered neuronal transmission. 9. Describe diagnostic tests and treatment strategies relevant to altered neuronal transmission. 10. Predict expected functional impairment from altered neurologic transmission based on type, severity, and site of neurologic injury. 11. Apply concepts of altered neuronal transmission to select clinical models. Required Learning Activities Read Chapter 9 Participate in classroom activities 1 Chapter 10 Alterations in Sensory Function and Pain Perception Learning Objectives 1. Define and use the key terms listed in Chapter 10. 2. Describe the mode of transmission of neural impulses involved with the sensations of pain, vision, and hearing. 3. Identify pathways for the integration of neural and sensory experiences. 4. Indicate common mechanisms of aterations in vision and hearing. 5. Determine processes that contribute to the perception of pain. 6. Describe alterations in sensory experiences and the associated pathophysiologic manifestations. 7. Identify common signs and symptoms of alterations in sensation. 8. Describe diagnostic tests and treatment strategies relevant to alterations in hearing, vision, and pain management. 9. Predict functional impairments resulting from alterations in sensation. 10. Apply concepts of sensory alterations to select clinical models. Required Learning Activities Read Chapter 10 Participate in classroom activities 1 Chapter 11 Alterations in Hormonal and Metabolic Regulation Learning Objectives 1. Define and use the key terms listed in Chapter 11. 2. Identify features that characterize hormones. 3. Discuss the role of the hypothalamic-pituitary axis in regulating hormone levels. 4. Identify pathways for mediating cell-to-cell communication. 5. Describe the role of the neuroendocrine system in the stress response. 6. Analyze the mechanisms of impairment that can lead to altered hormonal and metabolic regulation. 7. Discuss common measures to diagnose and treat hormone dysfunction. 8. Apply concepts of altered hormonal and metabolic regulation to select clinical models. Required Learning Activities Read Chapter 11 Participate in classroom activities 1 Chapter 12 Altered Reproductive Function Learning Objectives 1. Define and use the key terms listed in Chapter 12. 2. Identify structures and processes required for effective reproductive function. 3. Analyze the mechanisms of impairment that can lead to altered reproductive function. 4. Discuss common measures to diagnose and treat altered reproductive function. 5. Apply concepts of altered reproductive function to select clinical models. Required Learning Activities Read Chapter 12 Participate in classroom activities 1 Chapter 13 Alterations in Ventilation and Diffusion Learning Objectives 1. Define and use the key terms listed in Chapter 13. 2. Explain the role of ventilation and diffusion in oxygen/carbon dioxide gas exchange. 3. Describe the processes that can impair ventilation and diffusion. 4. Recognize the effects of impaired ventilation and diffusion. 5. Identify the common signs and symptoms of altered ventilation and diffusion. 6. Describe diagnostic tests and treatment strategies relevant to disordered ventilation and diffusion. 7. Apply the concepts of altered ventilation and diffusion to select clinical models. Required Learning Activities Read Chapter 13 Participate in classroom activities 1 Chapter 14 Alterations in Perfusion Learning Objectives 1. Define and use the key terms listed in Chapter 14. 2. Explain the role of perfusion in maintaining health. 3. Identify the key requirements for effective perfusion. 4. Determine processes that can alter perfusion. 5. Identify the common signs and symptoms of altered perfusion. 6. Describe diagnostic tests and treatment strategies relevant to altered perfusion. 7. Apply concepts of altered tissue perfusion to select clinical models. Required Learning Activities Read Chapter 14 Participate in classroom activities 1 Chapter 15 Alterations in Nutrition Learning Objectives 1. Define and use the key terms listed in this chapter. 2. Explain the role of nutrition in maintaining health. 3. Identify the processes that can alter nutrition. 4. Identify common signs and symptoms related to altered nutrition. 5. Describe diagnostic tests and treatment strategies relevant to altered nutrition. 6. Apply concepts of altered nutrition to select clinical models. Required Learning Activities Read Chapter 15 Participate in classroom activities 1 Chapter 16 Alterations in Elimination Learning Objectives 1. Define and use the key terms listed in this chapter. 2. Describe the processes of the production and elimination of urine and stool. 3. Identify the role of neural, motor, endocrine, and physical processes in altered elimination. 4. Outline the processes involved in altered elimination. 5. Characterize the clinical manifestations in altered urinary and gastrointestinal elimination. 6. Recognize health conditions that can precipitate impaired elimination. 7. Detail alterations in systemic organ systems as a response to altered elimination. 8. List the common diagnostic procedures used to identify altered urinary and bowel elimination. 9. Describe treatment modalities used in altered urinary and bowel elimination. 10. Apply concepts of altered elimination to select clinical models. Required Learning Activities Read Chapter 16 Participate in classroom activities 1 Chapter 17 Degeneration Changes in Aging Learning Objectives 1. Define and use the key terms listed in Chapter 17. 2. Describe the basis of theoretic explanations of aging. 3. Recognize the implications of degenerative changes in aging on the health of the individual. 4. Identify common manifestations of age-related degenerative changes. 5. Detail methods of maximize health status in the elderly population. 6. List the common diagnostic procedures used to identify degeneration changes in aging. 7. Describe treatment strategies appropriate for degenerative changes in aging. 8. Apply concepts of age-related alterations in cells, tissues, and organ systems to select clinical models. Required Learning Activities Read Chapter 17 Participate in classroom activities 1 Chapter 18 Combining Complex Pathophysiologic Concepts: Diabetes Mellitus Learning Objectives 1. Define and use the key terms listed in Chapter 18. 2. Recognize the effects of combining pathophysiologic concepts on the health of the individual. 3. Identify how various pathophysiological concepts relate to diabetes mellitus. 4. Differentiate type 1, type 2, and gestational diabetes. 5. Identify common clinical manifestations of diabetes. 6. Recognize short-term and long-term complications of diabetes. 7. Describe diagnostic tests and treatment strategies appropriate for diabetes. Required Learning Activities Read Chapter 18 Participate in classroom activities