Download CLASS OBJECTIVES

NRSG 308 - Lecture Objectives 1
CLASS OBJECTIVES
Winter, 2016
NRSG 308 - Lecture Objectives 2
Class # 1
Class topic:
Nursing Care of the Adult System with Immunologic Stressors: Inflammation,
Infection & Hypersensitivity
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and class attendance, the student will be
able to:
1.
2.
3.
4.
5.
6.
7.
State the normal range for white blood cell count
Cite reasons for leukocytosis and leukopenia
Compare and contrast the five types of white blood cells including
 Anatomy and physiology of each type
 Normal values for each
 Functions of each type
 Pathologies associated with each type
Describe the rationale for and implementation of neutropenia precautions.
Describe the 4 types of hypersensitivity
Describe measures to prevent and manage anaphylaxis
Identify teaching points for patients with immunodeficiency
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins;
Volume 1: Chap 35: pp. 969-985
Chap 38: pp. 1029-1053
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
Centers for Disease Control and Prevention - www.cdc.gov
Immunization Action Coalition - www.immunize.org
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
absolute neutrophil count - ANC
erythrocyte sedimentation rate (ESR)
Coomb's Test - direct & indirect
white blood count (WBC) with differential
culture and sensitivity (C & S)
DRUGS TO KNOW: (refer to required drug book, pharmacology text or Micromedex found at
LLU library website under “Databases”)
Filgrastim (Neupogen)
Epinephrine
corticosteriods
Immune globulin
diphenhydramine
cromolyn
Winter, 2016
NRSG 308 - Lecture Objectives 3
Class # 2
Class topic:
Nursing Care of the Adult System with Hematopoietic Stressors: Anemia,
erythrocytosis, thrombocytopenia
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
6.
State the normal ranges for RBC’s, Hemoglobin, Hematocrit, & platelets.
State the significance of abnormally high and low RBC’s, Hemoglobin,
Hematocrit, & Platelet results.
Describe the causes, treatments, and nursing management of the hemolytic and
nutritional anemias.
Describe the rationale for and implementation of thrombocytopenic precautions.
Describe the causes, treatments, and nursing management of primary
thrombocythemia, secondary thrombocytosis, thrombocytopenia , polycythemia
vera, idiopathic thrombocytopenia purpura, and disseminated intravascular
coagulation.
Describe the nursing assessment and care of clients with blood transfusion
complications.
PRIOR TO CLASS:
REVIEW:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins;
Volume 1: Chap. 32. pp. 877-898.
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins;
Chap 33, pgs 899-909, 911-928, 929-932 (DIC)
BROWSE RELATED INTERNET SITES:
http://www.nlm.nih.gov/medlineplus/ency/article/000560.htm
http://www.cdc.gov/nchs/fastats/anemia.htm
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
VIDEO WORKSHEET: Watch DVD: Understanding the complete blood count. DVDs are on
reserve in the library. Fill out the accompanying test handed out in class and turn in for
points.
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
Also see “Glossary” study sheet “Understanding the Complete Blood Count
DIAGNOSTIC TESTS TO KNOW (refer to required diagnostic text)
bone marrow (BM) aspiration
complete blood count (CBC)
Winter, 2016
NRSG 218 - Lecture Objectives
red blood cell count (RBC)
hemoglobin (hgb)
hematocrit (hct)
MCV
International Normalized ratio (INR)
partial thromboplastin time (PTT)
prothrombin time (PT)
reticulocyte count (retic count)
Schilling's test
MCH
DRUGS TO KNOW: (refer to required drug book, pharmacology text or Micromedex found at
LLU library website under “Databases”)
Ferrous Sulfate
Epoetin (Epogen, Procrit)
Heparin
Cyanocobalamin
Folic Acid
Winter, 2016
4
NRSG 308 - Lecture Objectives 5
Class # 3
Class topic:
Nursing Care of the Adult System with Connective Tissue Stressors: - Immune
related complexes – Rheumatoid Arthritis & Systemic Lupus Erythromatosus
(SLE)
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
Compare and contrast the pathophysiology of the following conditions:
rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE
Recognize and analyze the effects of the conditions listed in objective #1 on
pathophysiological, psychological, sociocultural, developmental and spiritual
client variables.
Discuss the purpose and nursing implications for laboratory and diagnostic tests
used to diagnose the conditions listed in objective #1.
Identify priority nursing implications of medications and treatments (selfprescribed and health team prescribed, tested and untested treatment) for clients
with arthritic and connective-tissue disorders.
Utilize the nursing process to design individualized care, and evaluate responses
for clients with the conditions listed in objective #1.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 1: Chap. 39: Rheumatic diseases pp. 1054-1069 (RA), 1069-1072 (SLE)
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
BROWSE RELATED INTERNET SITES:
www.arthritis.org
www.lupus.org
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
Antinuclear antibody (ANA)
Arthroscopy
C-reactive protein
Erythrocyte sedimentation rate (ESR)
Complement levels
Uric acid
Rheumatoid factor
Synovial fluid analysis
Winter, 2016
NRSG 308 - Lecture Objectives 6
Bone and joint scans
Anti-DNA, DNA binding
Immunoglobulin electrophoresis
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in Blackboard or
Micromedex found at LLU library website under “databases”:
Biologic therapy -Soluble receptor for tumor necrosis factor (sTNFR) - etanercept
Disease-modifying antirheumatic drugs (DMARD’s) - methotrexate
Corticosteroids – Decadron, Prednisone
NSAIDS – Aspirin, naproxsyn, ibuprofen
COX-2 inhibitors – celecoxib (Celebrex), Bextra
Nutritional Supplements – Glucosamine, Chondrotin
Winter, 2016
NRSG 308 - Lecture Objectives 7
Class # 4
Class topic:
Nursing Care of the Adult System with Neurological & Neuromuscular Stressors: MS,
Parkinson's Disease, ALS, Myasthenia Gravis, Guillain-Barre Syndrome
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic, the
student will be able to:
1.
2.
3.
4.
Recognize and analyze the pathophysiology, related signs/symptoms, and prognosis of
multiple sclerosis (MS), Parkinson's disease, amyotrophic lateral sclerosis (ALS),
myasthenia gravis, and Guillain-Barre syndrome.
Using the nursing process, develop appropriate nursing management for each disorder
and understand the potential complications of how immobility may affect each
neurological disorder.
Describe treatment options (including medications, plasmapheresis, surgery, and
multidisciplinary intervention) available to those with MS, Parkinson’s disease, ALS,
myasthenia gravis, and Guillain-Barre syndrome; discuss their nursing implications, and
client education that should accompany them.
Identify conditions that can lead to exacerbation/crisis in multiple sclerosis and
myasthenia gravis, and describe nursing interventions that can help avoid them.
PRIOR TO CLASS:
REVIEW:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 2: Chapter 65: 1909-1934 – Review and diagnostic testing
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 2: Chapter 69: 2033-2046 – MS, MG, & Guillain-Barre
Chapter 70 : 2063-2069 (Parkinsons), 2070-2073 (ALS)
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
www.apdaparkinson.com
www.webmast.com/gbs
www.msfact.org
www.myasthenia.org
www.alsa.org
www.ninds.nih.gov (click on “Disorders”)
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
Winter, 2016
NRSG 218 - Lecture Objectives
electromyogram (EMG)
evoked response tests
lumbar puncture (LP)
oligoclonal banding
Tensilon test
vital capacity (pulmonary function tests)
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”:
azathioprine (Imuran)
pergolide (Permax)
benztropine mesylate (Cogentin)
prednisone
bromocriptine (Parlodel)
pyridostigmine (Mestinon)
cyclophosphamide (Cytoxan)
riluzole (Rilutek)
interferon beta-1A (Avonex)
selegiline (Eldepryl)
interferon beta-1B (Betaseron)
trihexyphenidyl (Artane)
levodopa/carbidopa (Sinemet)
Winter, 2016
8
NRSG 308 - Lecture Objectives 9
Class # 5
Class Topic: Nursing Care of the Adult Systems with Circulatory Stressors I: Hypertension
Instructor:
P. Pandit
Objectives:
Upon completion of assigned reading and participation in discussion on the topic, the
student will be able to:
1.
2.
3.
4.
5.
6.
Explain the difference between primary and secondary hypertension.
Identify the diagnostic criteria for primary hypertension.
Discuss how modifiable & non-modifiable risk factors for primary hypertension can
affect a client’s course of care.
Discuss the non-pharmacological and pharmacological management of primary
hypertension.
Compare and contrast the mechanisms of action, side effects, and benefits of the various
classifications of antihypertensive medications.
Examine how hypertension impacts the client system variables- physiological,
psychological, sociocultural, developmental & spiritual.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 1: REVIEW: Chap 25: pp. 655-691
READ: Chap. 31: pp. 861-874
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
www.nhlbi.nih.gov
www.bloodpressure.com
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”): You will only be
required to know classification of drugs, NOT specific drugs.
ACE inhibitors - i.e., Capoten, Vasotec, Lotensin, Zestril, Univasc, Accupril, Altace
Alpha-adrenergic blockers - i.e., Minipress, Hytrin, Cardura
Angiotensin II receptor antagonists - i.e., Cozaar, Diovan, Avapro
Beta-adrenergic blockers – i.e., Inderal, Corgard, Tenormin, Lopressor, Kerlone, Zebeta
Calcium channel blockers – i.e., Calan, Cardizem, Procardia, Novasc, DynaCirc, Plendil
Centrally-acting sympatholytics – i.e., Catapres, Aldomet
Diuretics – i.e., Loop: Lasix, Bumex, Edecrin, Demadex; Thiazide: HCTZ, Esidrex,
Zaroxolyn, Hygroton; K-sparing: Aldactone, Triamterene
Vasodilators – i.e., Apresoline, Loniten
Winter, 2016
NRSG 308 - Lecture Objectives 10
Class # 6
Class topic:
Nursing Care of the Adult System with Circulatory Stressors II: Vascular
Obstruction
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
Explain the differences between stable angina, unstable angina, Prinzmetal's
angina, and myocardial infarction, in based on pathophysiology and
symptomology.
Discuss pharmacological and nonpharmacologic nursing interventions for clients
with angina pectoris.
Identify the predisposing factors to coronary artery disease, and both acute and
chronic vascular disorders and peripheral circulation problems; develop a client
education plan for disease prevention
Identify the parameters for prothrombin time (PT) and partial thromboplastin time
(PTT) in Coumadin and IV Heparin therapy and their importance in effective
therapy.
Understand the distinct signs/symptoms and nursing interventions of the different
types of vascular disorders and problems with peripheral circulation: chronic
arterial, acute arterial, chronic venous, and acute venous.
PRIOR TO CLASS:
REVIEW:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Chapter 25: 654-690 – Review A&P, Cardiac labwork and diagnostics
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 1: Chapter 30: 819-839; 845-855 (venous)
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
www.vdf.org
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
Angiography
phlebography/venography
Doppler ultrasound
plesthysmography
Winter, 2016
NRSG 218 - Lecture Objectives
electrocardiogram (EKG, ECG)
partial thromboplastin time (PTT)
prothombin time (PT) and INR
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”: You will only be
required to know classification of drugs, NOT specific drugs.
aspirin (ASA)
heparin
isosorbide dinitrate (Isordil)
nitroglycerin
pentoxifylline (Trental)
protamine sulfate
Winter, 2016
streptokinase
tissue plasminogen activator (t-PA)
urokinsase
vitamin K (Mephyton)
warfarin (Coumadin)
11
NRSG 308 - Lecture Objectives 12
Class #7
Class topic:
Nursing Care of the Adult System with Urinary Tract Stressors: UTI, Renal
Calculi, ARF
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
Understand how the different renal diagnostic findings help assist in the
assessment and evaluation of renal problems.
Identify stressors that place clients at risk for urinary tract infections, renal calculi,
and acute renal failure, and discuss appropriate preventive measures.
Using the nursing process, develop appropriate nursing diagnoses for clients with
different renal disorders.
Differentiate between pre-renal, intrarenal, and post-renal causes of acute renal
failure.
State rationale behind the signs and symptoms characteristic of acute renal failure,
and related nursing intervention.
PRIOR TO CLASS:
REVIEW:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins;
Chapter 53: 1507-1525 – A&P, diagnostic testing
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 2: Chapter 54: Glossary on 1526, 1535-1540 (Renal Failure)
Chapter 55: 1574-1582 (UTI), 1591-1596 (calculi) sections only
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
www.afud.org or www.afud.org/conditions/ks.html
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
BUN
KUB
C&S
Renal Angiogram
Creatinine
Renal Biopsy
Cystoscopy
Urinalysis (UA)
Intravenous pyelogram (IVP)
Winter, 2016
NRSG 218 - Lecture Objectives
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”:
allopurinol (Zyloprim)
sulfamethoxazole/trimethoprim (Septra)
aluminum hydroxide (Alternagel)
thiazide diuretics
erythropoietin (Epogen)
phenazopyridine HCl (Pyridium)
sodium polystyrene sulfonate (Kayexalate)
Winter, 2016
13
NRSG 308 - Lecture Objectives 14
Class #8
Class topic:
Nursing Care of the Adult System with Respiratory Stressors: Asthma,
Atelectasis, Acute Bronchitis, Pneumonia, Tuberculosis
Instructor:
P. Pandit
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
Discuss the differences between the pathophysiologic processes and related
signs/symptoms of asthma, atelectasis, acute bronchitis, pneumonia, and
tuberculosis.
Identify stressors that place clients at risk for these respiratory disorders, and
discuss appropriate preventive measures.
Identify nursing interventions appropriate for these respiratory disorders, and state
how the effectiveness of these interventions should be evaluated.
Discuss the difference between tuberculosis infection, and active disease in
relation to pathophysiology, communicability, and diagnostic findings.
Discuss the various factors that contribute to the difficulty of effective
tuberculosis management.
PRIOR TO CLASS:
REVIEW:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 1: Chapter 20: 463-487 – Review A&P, diagnostic respiratory testing
Chap 21: 493-504 – respiratory treatment modalities
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 1: Chapter 23: 569-591 - Atelectasis, Tracheobronchitis, Pnuemonia, TB
Chapter 23: 600-604 – Pulmonary embolus (PE)
Chapter 24: 637-648 – Asthma section only
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
WATCH VIDEO: “Respiratory Disorders: Asthma” DVD at the reserve desk at Del Webb
Library.
Powerpoint slides to accompany video under “Files”. Print out and bring with
you to take notes on.
BROWSE RELATED INTERNET SITES:
www.tuberculosis.net
www.lungusa.org – Search for Asthma & Allergy
Winter, 2016
NRSG 308 - Lecture Objectives 15
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
ABG
PaO2
AST/ALT
PPD/Mantoux test
Acid-fast culture/acid-fast smear
visual acuity
BUN/creatinine
C&S
Chest X-ray
O2 saturation
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”:
BCG
pyridoxine (vitamin B6)
Beta-2 Adrenergics (short and long acting) rifampin
Ethambutol
streptomycin
Glucocorticoid
isoniazid (INH)
NSAIDs
pyrazinamide
Winter, 2016
NRSG 308 - Lecture Objectives 16
Class #9 & #10
Class Topic: Nursing Care of the Adult System with Musculoskeletal Stressors: Fractures,
Amputations, Low Back Pain, And Cumulative Trauma Injuries.
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
6.
7.
Perform a neurovascular check for circulation, sensation and motion (CSM).
Describe the phases of bone healing.
Explain bone “turnover” and the results of imbalances in this physiologic process.
Discuss nursing care, surveillance, and patient education when a patient has a: cast
(fiberglass and plaster), external fixator, body cast, splint, brace, and traction (skeletal
and skin).
List and describe the types of fractures (chart 69-1), signs and symptoms of a fracture,
and emergency management of a fracture.
Compare and contrast an open reduction with a closed reduction procedure.
State the nursing care and surveillance for the following fracture complications: shock,
fat embolism, compartment syndrome, cast syndrome, delayed and non-union, avascular
necrosis, and osteomyelitis.
PRIOR TO CLASS:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Class #9 –
REVIEW: Musculoskeletal function, Volume 2: Chap. 40 - pp. 1087-1102
Musculoskeletal Care, Volume 2: Chap 41 – pp. 1103-1131 – cast care, traction,
postop care
READ: Chapter 43: 1156-1158, 1160-1183, 1185-1193: Fractures & fracture complications;
treatment modalities, amputations
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
VIEW VIDEO: “traction:Checks and Balances” [Watch the DVDs on reserve in the library]
VIEW VIDEO & DO VIDEO WORKSHEET: [THIS VIDEO IS MISSING, CURRENTLY,
PLEASE SEE ANSWER SHEET FOR ACCOMPNAYING STUDY GUIDES]Care of the Pre
and Post op Orthopedic Patients: Knee Replacement and Care of the Pre and Post op
Orthopedic Patients: Hip Fracture. Do the accompanying study guides.
Class #10 –
READ: Chapter 42: pp. 1141-1146 (Osteoporosis and osteomalacia), pp. 1132-1135 (low back
pain), pp.1135-1138 (hand injuries) pp.1147-1150 (osteomyelitis) Review care plans.
Chapter 70: pp. 2073- 2080 (back injuries and treatment)
Winter, 2016
NRSG 308 - Lecture Objectives 17
BROWSE RELATED INTERNET SITES:
http://www.ninds.nih.gov/disorders/repetitive_motion/repetitive_motion.htm
http://www.niams.nih.gov/
http://www.spineuniverse.com/
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
x-rays
Magnetic Resonance Imaging (MRI)
Computerized Axial Tomography (CAT scan)
Myelogram
DEXA scan
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”):
Vicodin
Tylenol with Codeine
Colace
Demerol
Morphine
Vistaril
Winter, 2016
NRSG 308 - Lecture Objectives 18
Class #11
Class Topic: Nursing Care of the Adult System with Gall Bladder and Stressors, Ambulatory
Services, and Bariatric Surgery
Instructor:
Z. Zamora
Objectives:
Following completion of assignments and participation in discussion the student
will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Differentiate the pathophysiology and clinical manifestations between
cholelithiasis, choledocholithiasis, and cholecystitis.
Identify client stressors that contribute to dysfunction in gall bladder.
Describe the laboratory and diagnostic tests used to assess gallbladder disorders.
Compare and contrast the surgical treatments and nursing implications of a client
with gall bladder disorders.
Use the nursing process to design comprehensive, individualized care for clients
with alterations in gallbladder function.
Understand the nursing process and care for ambulatory or day surgery clients.
Understand the myths and misconceptions associated with obesity and the criteria
for bariatric surgery.
Compare and contrast the surgical treatments and nursing implications of a client
undergoing bariatric surgery.
Use the nursing process to design comprehensive, individualized care for the
bariatric client.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 1: Chapter 17: 402-419 – Perioperative/ASC
Chapter 19: 440-446 – PACU
Chapter 50: 1389-1401 – Gallbladder
Chapter 47: 1272-1278 – Bariatrics
WATCH VIDEO: “Change of a Lifetime” Video is on reserve in the library. We recommend
you go as small groups to watch**
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
www.aboutdigestion.com
www.niddk.nih.gov
www.obesityhelp.com
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
Winter, 2016
NRSG 308 - Lecture Objectives 19
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
Barium enema (BE)
Barium Swallow/ Upper Gastrointestinal (UGI) series
Bilirubin (direct, indirect, and total)
BMI (body mass index)
Endoscopic retrograde cholangiopancreatography (ERCP)
IV cholangiogram
Liver Function Tests (LFT’s)
Oral cholecystogram
Percutaneous transhepatic cholangiography
T-tube cholangiogram
Ultrasound of the gall bladder
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”:
Aquamephyton (Vitamin K)
Chenodeoxycholic acid (Chenodiol)
Ursodiol (Actigall)
Winter, 2016
NRSG 308 - Lecture Objectives 20
Class #12
Topic: Nursing Care of the Adult System with Gastric Mucosa and Intestinal Mucosa Stressors:
gastritis, peptic ulcer disease (PUD), appendicitis, peritonitis, hernia, intestinal
obstruction, diverticulitis, & small and large bowel obstructions
Instructor:
P. Pandit
Objectives:
Following completion of assignments and participation in discussion, the student
will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Compare and contrast pathophysiology and clinical findings of the various types
of ulcers.
Identify stressors that contribute to the development of peptic ulcer disease
(PUD).
Identify the diagnostic and laboratory tests performed in assessing PUD.
Describe the pre and post-procedure nursing priorities for the various diagnostic
tests for a client with altered gastric mucosa.
Describe the classifications and nursing priorities of medications used to treat
PUD.
Differentiate between the various surgical procedures, and their nursing
implications, utilized in treating PUD.
Explain the complications of PUD and their associated treatment and nursing
priorities.
Describe and identify the nursing priorities and management of the client with
gastritis
Differentiate the pathophysiology, clinical manifestations and treatment of the
following intestinal mucosa alterations: appendicitis, peritonitis, hernia, intestinal
obstruction.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
CHAPTERS 44, 47, 48:
Assessment of digestive and gastrointestinal function, Chap 44: 1196-1213
Management of patients with gastritis & peptic ulcer disease, Chap 47: 1261-1271
Management of patients with intestinal and rectal disorders, Chapt 48: 1294-1301
Intestinal Obstructions, Chap 48: 1316-1318
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
http://digestive.niddk.nih.gov/ National Digestive Diseases Information Clearinghouse
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Winter, 2016
NRSG 308 - Lecture Objectives 21
Blackboard or Micromedex found at LLU library website under “databases”):
Antacids - aluminum hydroxide (Alternagel), magnesium hydroxide (Milk of Magnesia)
Histamine 2 receptor antagonists - cimetidine (Tagamet), famotidine (Pepcid), ranitidine
HCL (Zantac)
Antibiotics - clarithomycin (Biaxin), metronidazole (flagyl), Tetracycline, Amoxicillin
Proton Pump Inihibitors - omeprazole (Prilosec)
Prostoglandine Analogs - misoprostol (Cytotec)
Cytoprotective Drugs - sucralfate (Carafate)
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
Upper Gastrointestinal series - UGI
Endoscopy: Esophagoscopy, Gastroscopy, Gastroduodenoscopy,
Esophagogastroduodenoscopy (EGD)
Urea Breath Test
Digital Rectal Examination
Sigmoidoscopy
Fecal Occult Blood Test
Barium Enema
Colonoscopy
Winter, 2016
NRSG 308 - Lecture Objectives 22
Class # 13
Topic:
Nursing Care of the Adult System with Liver and Pancreas Stressors: Viral
Hepatitis, Pancreatitis
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in lecture/discussion on
the topic, the student will be able to:
1.
2.
3.
4.
5.
6.
Describe the pathophysiology of viral hepatitis and pancreatitis.
Recognize and analyze the effects of the conditions listed in objective #1 on
pathophysiological, psychological, sociocultural, developmental and spiritual
client variables.
Discuss the purpose and nursing implications for laboratory and diagnostic tests
used to diagnose viral hepatitis and pancreatitis.
Identify nursing implications, including client education, for medications and
treatments for clients with viral hepatitis and pancreatitis.
Utilize the nursing process to assess needs, plan and implement individualized
care, and evaluate responses for clients with viral hepatitis and pancreatitis.
Given a case study, use the nursing process to provide comprehensive
individualized care for clients with viral hepatitis and pancreatitis.
PRIOR TO CLASS:
READ:
Heymann, D. (2006). Control of communicable Diseases Manual (18th ed.) Washington, DC:
American Public Health Assoication (see section on hepatitis).
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
CHAPTERS 49, 50:
Volume 2: Chapter 49: pp. 1336-1349, 1358-1366 hepatic disorders; care plan – Chart 49-12
Chap 50 – pp. 1401-1410 Acute and chronic pancreatitis,
BROWSE RELATED INTERNET SITES:
www.aboutdigestion.com
www.liverfoundation.org
www.immunize.org
www.hepfi.org
www.hepcassoc.org
www.hcvadvocate.org
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
Alkaline phosphatase (ALP)
Serum Amylase
Alanine aminotransferase (ALT)
Serum Bilirubin – Direct and Indirect
Aspartate aminotransferase (AST)
Serum lipase
Endoscopic retrograde cholangiopancreatography (ERCP)
Enzyme immunoassay, third generation (EIA-3)
Polymerase chain reaction (PCR)
Recombinant immunoblot assay (RIBA)
Winter, 2016
NRSG 308 - Lecture Objectives 23
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in Blackboard or
Micromedex found at LLU library website under “databases”):
Immune globulin
Interferon (IFN) alpha-2b
Ribavirin
Hepatitis B Vaccine – (Heptavax, Recombivax, Engerix-B)
Winter, 2016
NRSG 308 - Lecture Objectives 24
Class #14
Class topic:
Nursing Care of the Adult System with Endocrine Stressors I: Thyroid Dysfunction
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic, the
student will be able to:
1.
2.
3.
4.
5.
6.
7.
Identify the hormones produced by the thyroid, state their actions, and be able to discuss
how these hormones are normally regulated.
Differentiate between primary and secondary causes of thyroid hyper- and hypo-function.
Differentiate between hyperthyroid and hypothyroid conditions, based on physical
assessment/diagnostic findings.
Develop nursing diagnoses and expected outcomes for hyper/hypothyroidism based on
assessment findings.
Identify appropriate interventions for hyperthyroid and hypothyroid clients, and explain
their rationale, as well as their potential risks and benefits.
Describe potential complications of thyroid dysfunction: cardiac disease, thyroid crisis,
myxedema coma, cretinism.
Distinguish between the various pathological conditions that can accompany the
development of a goiter, and discuss treatment options.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 2: Chapter 52: 1470-1485 (Review & Thyroid and goiter)
BROWSE RELATED INTERNET SITES:
www.thyroid.about.com/health/thyroid - search “Endocrine Information Center”
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
serum TA
TSH
T3
RAI uptake
T4
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”:
calcium gluconate
iodine (Lugol's solution or SSKI)
methimazole (Tapazole)
propylthiouracil (Propyl-Thyracil)
sodium levothyroxine (Synthroid)
Winter, 2016
NRSG 308 - Lecture Objectives 25
Class #15
Class topic:
Nursing Care of the Adult System with Connective Tissue Stressors – Pain
Focused stressors: Osteoarthritis, Gout, scleroderma, fibromyalgia
Instructor:
P. Pandit
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
Compare and contrast the pathophysiology of the following conditions:
osteoarthritis (degenerative joint disease - DJD), scleroderma, fibromyalgia, and
gouty arthritis.
Recognize and analyze the effects of the conditions listed in objective #1 on
pathophysiological, psychological, sociocultural, developmental and spiritual
client variables.
Discuss the purpose and nursing implications for laboratory and diagnostic tests
used to diagnose the conditions listed in objective #1.
Identify priority nursing implications of medications and treatments (self
prescribed and health team prescribed, tested and untested treatment) for clients
with arthritic and connective-tissue disorders.
Utilize the nursing process to design individualized care, and evaluate responses
for clients with the conditions listed in objective #1.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE: [Mastery Level 5 = 10 points]
Class #11 – Chap 39: pp. 1069-1081 (OA and Diffuse Connective Tissue Diseases)
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
Synovial fluid analysis
BROWSE RELATED INTERNET SITES: Bone and joint scans
www.arthritis.org
Anti-DNA, DNA binding
www.lupus.org
Immunoglobulin electrophoresis
DIAGNOSTIC TESTS TO KNOW: (refer
to required diagnostic text)
Antinuclear antibody (ANA)
Arthroscopy
C-reactive protein
Erythrocyte sedimentation rate (ESR)
Complement levels
Uric acid
Winter, 2016
DRUGS TO KNOW: (refer to required
drug book, pharmacology text, external
links in Blackboard or Micromedex found
at LLU library website under “databases”:
Biologic therapy -Soluble receptor
for tumor necrosis factor (sTNFR) etanercept
Disease-modifying antirheumatic
NRSG 218 - Lecture Objectives
drugs (DMARD’s) - methotrexate
Corticosteroids – Decadron,
Prednisone
NSAIDS – Aspirin, naproxsyn, ibuprofen
COX-2 inhibitors – celecoxib (Celebrex),
Winter, 2016
Bextra
Nutritional Supplements – Glucosamine,
Chondrotin
26
NRSG 308 - Lecture Objectives 27
Class #16
Class topic:
Nursing Care of the Adult System with Endocrine Stressors II: Adrenal
Dysfunction
Instructor:
Z. Zamora
Objectives:
Upon completion of assigned reading and participation in discussion on the topic,
the student will be able to:
1.
2.
3.
4.
5.
6.
7.
Differentiate between the hormones produced by the adrenal cortex, state the
action of each, and describe their regulatory mechanisms.
Explain the rationale behind the characteristic signs, symptoms, and diagnostic
findings of adrenal hypofunction (Addison's disease.)
Discuss the nursing implications of corticosteroid therapy, including client
education needs.
Differentiate between chronic and acute adrenocortical insufficiency.
Describe the pathophysiology and related signs/symptoms of the 3 types of
adrenal cortex hyperfunction disorders: Cushing’s syndrome,
Hyperaldosteronism, and Congenital adrenal hyperplasia
Discuss treatment options for the different adrenal cortex hyperfunction disorders,
and the nursing implications of each.
Recognize the signs/symptoms and diagnostic findings of adrenal medulla
hyperfunction, and describe appropriate pre- and post-op nursing care for clients
with this disorder.
PRIOR TO CLASS:
READ:
Hinkle, J., & Cheever, K. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,
(13th ed). Philadelphia: Lippincott Williams & Wilkins
Volume 2: Chapter 52: 1490-1503
TAKE PRACTICE QUESTIONS ON PREP U WEBSITE (both Thyroid & Adrenal):
[Mastery Level 5 = 10 points]
BROWSE RELATED INTERNET SITES:
www.medhelp.org/nadf
www.endocrineweb.com
GLOSSARY: See “glossary” terms at beginning of each chapter of required reading in textbook
DIAGNOSTIC TESTS TO KNOW: (refer to required diagnostic text)
ACTH Stimulation Test (Cortrosyn Stimulation Test)
ACTH Suppression Test (Dexamethasone Suppression Test)
24-hour urine collection for VMA
Winter, 2016
NRSG 308 - Lecture Objectives
DRUGS TO KNOW: (refer to required drug book, pharmacology text, external links in
Blackboard or Micromedex found at LLU library website under “databases”:
amiloride (Midamor)
hydrocortisone
aminoglutethamide (Cytadren)
metyrapone (Metopirone)
enalapril (Vasotec)
mitotane (Lysodren)
fludrocortisone acetate (Florinef)
prednisone
Winter, 2016
28