Download Course / Prefix Number Alterations in Health IV CRN: 20579/20590

Lake-Sumter State College Course Syllabus
Course / Prefix
Number
CRN:
Course Catalog
Description:
Instructor:
NUR2224
Course Title:
Alterations in Health IV
Credit:
Term:
4
Spring
This is the fourth course in a series and will focus on caring for clients with alterations in
neurological, respiratory, and cardiovascular functioning throughout the lifespan. Concepts of
critical care nursing for clients with multi-system alterations will also be explored.
See department directory –
http://www.lssc.edu/academics/
nursing/Pages/CurrentContact Information:
NURSING FACULTY
Students-Program%20Forms%20and%2
0Information.aspx
Office
Nurse
Office Hours:
Posted on faculty offices
faculty suite
Location:
20579/20590
All students are required to use Lakehawk Mail for official college e-mail communications.
See the college webpage for instructions on activating Lakehawk Mail.
Prerequisites:
Co-requisites
NUR 2220
NUR 2220L
NUR 2463
NUR 2224L
NUR 2801L
Alterations in Health III
Clinical Nursing III
Maternal Child Health
Clinical Nursing IV
Clinical Practicum
REQUIRED: (Program Duration)
PEARSON
 LeMone (2011) Medical Surgical Nursing: Critical Thinking in Patient Care 5th
ed. Hardcover
F.A. DAVIS
 Townsen. (2014) Essentials of Psychiatric Mental Health Nursing 6th ed.
 Wilkinson and Treas (2011) Fundamentals of Nursing Vol’s I and II 2nd ed.
 Doenges, Moorhouse and Murr (2013) Nurse’s Pocket Guide 13th ed.
ELSEVIER
PACKAGE
Textbook and Other
Course Materials:


1:
James, Nelson & Ashwill (2013) Nursing Care of Children: Principles and Practice 4th
ed.
James, Nelson & Ashwill (2013) Nursing Care of Children: Principles and Practice
4th ed. [eBook]
PACKAGE 2:
 Lilley (2014 Pharmacology and Nursing Process 7th ed.
 Lilley (2014) Pharmacology and Nursing Process 7th ed [eBook]
CENGAGE
 Pickar (2013) Dosage Calculations 9th ed.
(May use currently owned, older edition)
LIPPINCOTT, WILLIAMS & WILKINS
 Ricci (2013) Essentials of Maternity, Newborn, & Women’s Health Nursing 3rd ed
NU: Spring 2016 12/14/15
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NCLEX REVIEW GUIDES- SELECT ONE
 Silvestri (2014) Saunders Comp Rev for NCLEX-RN 6th ed. Elsevier

Ohman (2010) Davis’ Q&A for NCLEX-RN Examination. F.A. Davis
YOUR CHOICE FROM EACH:
 Drug Guide
(Suggested Title)
Vallerand (2013) Davis's Drug Guide for Nurses 13th ed.
 Medical Dictionary
(Suggested Title)
Taber’s (2013) Cyclopedic Medical Dictionary 22nd ed. F.A. Davis
 Lab & Diagnostics Handbook
(Suggested Title)
Van Leeuwen (2013) Davis’s Comprehensive Handbook of Laboratory and Diagnostics Tests
w/Nursing Implications 5th ed. F.A. Davis
RECOMMENDED:

LeMone (2011) Study Guide for Medical Surgical Nursing: Critical Thinking in
Patient Care 5th ed.
OPTIONAL:

Dunham (2008) How to Survive, Maybe Even Love Nursing School 3rd ed. F.A.
Davis
 Nugent (2012) Test Success: Test-Taking Techniques for Beginning Nursing Students
6th ed. F.A. Davis
 Holloway (2011) OB/GYN & Peds Notes: Nurse’s Clinical Pocket Guide 2nd ed. F.A.
Davis
Minimum requirements to access Evolve/Reach/Elsevier testing, remediation, case studies,
simulation, SimChart, and textbook resources:
Browsers: Internet explorer 9 or above; or Firefox 14-18; or Chrome 21-28; or Safari 5.0.6 –
6.0.2
Computer operating system: Windows XP SP 2 32/64 bit; or Windows Vista 32/64bit; or
Windows 7 32/64 bit; or MAC OSX 10.5-10.9 (NOTE: Windows XP will suffice until
Elsevier/Evolve ceases to support it- termination date not yet posted)
Technology and
Online Computer
Access Requirements:
NU: Spring 2016 12/14/15
Specific Elsevier products may work better in one environment than another. For specific
product functioning, please see Elsevier's Computer Requirements Page
Reliable internet access is required. This course is designated as a Technology Enhanced
Course which utilizes multiple areas of asynchronous online environments including: Lake
Sumter State College Website which includes the Blackboard Distance Learning
Environment, Faculty Webpages, and the LSSC Libraries. Beginning the first week of the
term, the instructor will assume students are well acquainted with the Blackboard environment
and have become proficient at the following:
 navigating through Blackboard;
 attaching documents;
 creating discussion postings;
 submitting assignments to the Assignments section;
2


browsing the Internet;
creating and formatting documents in a standard word-processing
application; saving documents in rtf or "rich text format" or as a
“compatible” WORD document
By the END of the FIRST week of the term, all students should have resolved all technical
issues with the Lake-Sumter State College Helpdesk and be ready to fulfill the requirements of
the course. No exceptions will be made; no excuses will be accepted.
A USB Drive is REQUIRED: Do not depend upon the stability of any online environment or
of your computer’s hard drive. All materials for submission online should be FIRST saved on
a USB/Flash Drive and submitted by using the upload or cut and paste feature of your
computer. Portable drive back up files is a course requirement.
Firefox is the only acceptable browser for accessing Blackboard. If you do not have
Firefox, you can download it at http://Firefox.com.
Upon completion of this course of
study, the student will be able to:
Student Learning
Outcomes (SLOs)
Assessed in this
Course:
(what the students take
with them beyond this
course)
1. Identify best practices in caring for and educating the client who is
experiencing acute, chronic, or multi system alterations in neurologic,
cardiovascular and respiratory function.
2. Utilize research and other references for Quality Improvement to direct care of
clients.
3. Identify effective teaching-learning strategies in clients and their families in order
to reduce risks for potential complications and to promote physiological and
psychosocial health.
4. Prioritize nursing interventions to assure safe, effective care of the client with
multi system health problems.
Coordinate the health care team to provide safe, effective, culturally sensitive client centered
care. Academic Integrity:
Important Information
for Students with
Disabilities:
Privacy Policy
(FERPA):
NU: Spring 2016 12/14/15
The successful functioning of the academic community demands honesty, which is the basis
of respect for both ideas and persons. In the academic community, there is an ongoing
assumption of academic integrity at all levels. There is the expectation that work will be
independently thoughtful and responsible as to its sources of information and inspiration.
Honesty is an appropriate consideration in other ways as well, including but not limited to the
responsible use of library resources, responsible conduct in examinations, and the responsible
use of the Internet. (See college catalog for complete statement.)
Any student with a documented disability who requires assistance or academic
accommodations should contact the Office for Students with Disabilities immediately to
discuss eligibility. The Office for Students with Disabilities (OSD) is located on the Leesburg
Campus, but arrangements can be made to meet with a student on any campus. An
appointment can be made by calling 352-365-3589 and specific information about the OSD
and potential services can be found at www.lssc.edu, then go to “Quick Links” and click on
Disability Services.
The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR
Part99) is a Federal law that protects the privacy of a student’s education records. In order for
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Social Media: Course Attendance:
Withdrawal Deadline:
Methods of TeachingLearning:
Methods of
Evaluation:
Grading Scale:
your information to be released, a form must be signed and in your records located in the
Admissions/Registrar’s Office.
Be aware of your student responsibilities as you engage in social media. Refer to your student
handbook’s code of conduct under campus policies. Administrative Procedures 2-20.
•
Students must abide by the student code of conduct at all times.
• Students are liable for all interactions with social media.
• Students may be held accountable for the content posted on behalf of LSSC.
Although attendance in class is not mandatory, the nursing program faculty believes that
classroom attendance and active participation is critical to your educational success. Research
findings demonstrate the educational efficacy of consistent class attendance. Many studies
confirm a positive relationship between attendance and grades and conversely, class absences
negatively affecting grades. Students will be asked to sign an attendance roster at the start of
each class for purposes of program record keeping.
Withdrawal Deadline: Tuesday, March 1, 2016
Voluntary Course Withdrawal: Students deciding to discontinue class attendance and/or
online participation have the responsibility for formal withdrawal from class prior to the date
published in the course syllabus. Withdrawal forms are available from Academic Advising.
Failure to withdraw properly from class will result in a grade of “U” or “F” in the course.
Study guide assignment sheets
Lecture/Discussion
Group participation & individual assignments
Reading & writing assignments
Multi-media assignments
Guest speakers
Handouts
Case Studies
Simulations
Evolve activities
Blackboard Assignments 5 Exams
HESI
Assignments
= 500 points
= 100 points
= 400 points
TOTAL
= 1000 points
900 – 1000 points (90% - 100%)
800 – 899 points (80% - 89.9%) =
750 – 799 points (75% - 79.9%) =
700 – 749 points (70% - 74.9%) =
BELOW 700 points (<70%)
= A
B
C
D
= F
NOTE: YOU ARE REQUIRED TO HAVE A CUMMULATIVE AVERAGE OF 80%
(480 POINTS) FROM YOUR EXAMS AND HESI GRADES BEFORE ANY
ASSIGNMENT POINTS AND/OR PROJECT POINTS WILL BE APPLIED. YOU
MUST OBTAIN A FINAL CUMMULATIVE AVERAGE OF 80% (800 POINTS) IN
THIS COURSE IN ORDER TO ADVANCE IN THE NURSING PROGRAM.
EXAM ABSENCE/TARDINESS POLICY:
Exam Policy:
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APPROVED ABSENCE:
The student must notify the instructor prior to the start of the exam and schedule a make-up
exam with the instructor. The student must complete the make-up exam within one week of
the scheduled exam in the Learning Center. A deduction of 10 points will be taken. Failure to
make up the exam within one week will result in a zero.
UNAPPROVED ABSENCE:
If the student does not notify the instructor prior to the start of the exam, the student must
complete a make-up exam no later than one day following the scheduled exam in the Learning
Center. A deduction of 10 points will be taken. Failure to make up the exam by the end of
the following day will result in a zero.
TARDINESS:
The student must notify the instructor if they are going to be tardy. If the student arrives after
testing has begun, the student will not be permitted into the testing area. Arrangements will be
made for the exam to be taken in the Learning Center. The exam must be completed no later
than the end of the same day of the exam. A deduction of 10 points will be taken. Failure to
make up the exam by the end of the same day will result in a zero.
See: Blackboard Course Schedule.
Course Calendar:
Please Note: The calendar may change according to program need. Students are
informed of any changes through Lakehawk Mail as well as Blackboard
Announcements.
Arrive to class on time: Common courtesy requires that you arrive on time so as not to
disrupt your instructor or fellow students. Faculty retains the right to refuse you entry to the
classroom if you are late.
Arrive prepared for class: You will have class preparation assignments that will include
textbook readings and may include other assignments as announced by the instructor. It is an
expectation that you have completed those assignments before class and come to class
prepared to participate actively.
Attire per your handbook: “Dress is to be appropriate to the learning environment and
should not cause distraction to fellow students. Skimpy or suggestive clothing is
unacceptable. Short shorts, short tops, halter tops, and jeans riding below boxer shorts are
examples of inappropriate attire.”
Classroom Rules and
Policies:
Behavior: All students are expected to exhibit courteous, respectful, and attentive behavior in
all classes and with all interactions with instructors and fellow students. Students exhibiting
disruptive behavior will be dismissed from the classroom. Professionalism entails keeping an
open mind and nonjudgmental attitude in academic and clinical interactions.
Electronics: Cell phones and beepers will be turned off during class. You may check your
calls during class breaks. You may not be texting during class. You may use a computer in
class for note-taking and classroom work only.
Course Assignments: Students are expected to keep informed about all course assignments
by carefully following the Assignment schedule, by routinely checking Blackboard and
Lakehawk Mail. Submission of all assignments is required. Assignments turned in incomplete
or tardy will result in a deduction of 5% for each day or portion of the day the assignment is
late. If a student fails to submit all assignments, a concern form will be written and it may
result in failure of the course.
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Violence Statement:
Syllabus Disclaimer:
Course Content:
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Lake-Sumter State College has a policy of zero tolerance for violence as stated in College
Board Rule 2.17. Appropriate disciplinary action will be taken in accordance with Board Rule
2.17.
Information contained in this syllabus is, to the best knowledge of this instructor, considered
correct and complete when distributed to the student. The instructor reserves the right, acting
within policies and procedures of Lake-Sumter State College, to make necessary changes in
course content or instructional techniques without prior notice or obligation to the student.
Following are specific unit outcomes and content outlines for this course.
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RESPONSE TO ALTERED NEUROLOGIC FUNCTION
Unit Outcomes: Upon completion of this unit of study, the student will be able to:
Safe Effective Care Environment
1. Participate in developing multidisciplinary plans of care related to Neurological function.
2. Identify and determine impact on client’s safety aspects of
sensory/perceptual alterations (e.g. spinal cord injury).
3. Review necessary safety modifications of home with client/family/significant other.
Health Promotion and Maintenance
1. Evaluate incorporation of health behaviors into lifestyle by the client/family/significant other
(e.g., limiting risk taking behaviors).
2. Identify risk factors for disease/illness.
3. Perform health history/health and risk assessments.
4. Evaluate the client/family/significant other’s alternative or homeopathic health care practices
(home remedies).
Physiological Integrity
1. Demonstrate knowledge of commonly prescribed medications for the neurological system.
2. Discuss nursing implications for these commonly prescribed medications.
3. Use clinical decision making/critical thinking when evaluating the client’s laboratory and
diagnostic values.
4. Provide the client/family/significant other with methods to prevent complications associated
with illness/disease/diagnostic tests/treatments/procedures.
5. Intervene to prevent potential neurological complications (e.g., foot drop, numbness, tingling).
6. Assess client for abnormal neurological status (e.g., level of consciousness, muscle strength, mobility).
7. Manage care of the client who has experienced a seizure.
8. Provide care for client experiencing increased intracranial pressure.
9. Compare and differentiate common disorders of the neurological system.
10. Compare and contrast assessment findings of a healthy client versus one with a
neurological disorder/disease.
11. Utilize the nursing process to assess needs, plan and implement individualized care and
evaluate responses for the client with a neurological disorder.
Psychosocial Integrity
1. Assess the client/family/significant other’s reactions to a body image change (e.g., paralysis).
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CONTENT FOR ALTERED NEUROLOGIC FUNCTION
Safe Effective Care Environment
1. Subjective data, risk factors, history
2. Objective data, physical assessment
3. Diagnostics
a. lumbar puncture (LP)/cerebral spinal fluid (CSF)
b. electroencephalogram (EEG)
c. myelogram
d. cerebral angiography
e. electromyography (EMG)
f. intracranial pressure monitoring
Health Promotion and Maintenance
1. Safety and preventive measures
2. Lifestyle behaviors
3. Prevention of complications
Physiological Integrity
1. Nursing Implications for Pharmacologic Management
a. anticonvulsants
b. corticosteroids
2.
osmotic diuretics
3.
spasmolytic
4.
antiparkinsonian agents
5.
anticholinergics
6.
selective serotonin receptor agonists
7.
ergotamine tartrate
8.
serotonin antagonist
9.
cholinesterase inhibitors
10. Nutritional/Natural/Herbal Remedies
11. Nursing Implications for Nonpharmacological Management
a. Client’s environment (positioning, activity, stimuli, etc.)
b. Hyperventilation therapy
c. Cognitive therapy
12. Nursing Implications for Surgical Management
a. Cranial surgery
b. Spinal surgery
13. Nursing Management of Clients with:
a. Increased intracranial pressure
i. subarachnoid hemorrhage
ii. aneurysm
iii. arteriovenous malformation (AVM)
iv. encephalopathy
v. hematoma
b. Headaches
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i. tension
ii. cluster
iii. migraine
c. Convulsive disorders
i. partial
ii. generalized
iii. status epilepticus
d. Vascular disease
i. transient ischemic attacks
ii. cerebrovascular disease
1. embolytic
2. hemorrhagic
e. Degenerative diseases
i. upper motor neuron disease
ii. lower motor neuron disease
f. Infection
i. meningitis
ii. encephalitis
g. Coma
h. Cranial cerebral trauma/injury
i. Spinal cord trauma/injury
j. Neoplasms
k. Parkinson’s
l. Dementia
m. Pediatric Considerations
i. spina bifida
ii. cerebral palsy
iii. hydrocephalus
Psychosocial Integrity
1. Lifestyle Impact of neurologic deficits on client and family
2. Associated behavioral change
3. Self-concept issues
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RESPONSE TO ALTERED CARDIOVASCULAR AND PERIPHERAL VASCULAR
FUNCTION
Unit Outcomes: Upon completion of this unit of study, the student will be able to:
Safe Effective Care Environment
1. Participate in developing multidisciplinary plans of care related to Cardiovascular function.
2. Review necessary safety modifications of home with client/family/significant other. 3. Assess client for renal deficits and allergy to iodine-based contrast media prior to undergoing
diagnostic tests that require this agent.
4. After cardiovascular diagnostic testing monitor the client for bleeding or hematoma formation
5. Monitor vital signs and cardiac activity while client is undergoing diagnostic procedures; report and
document any irregularities.
Health Promotion and Maintenance
1. Identify risk factors for disease/illness (e.g. age, gender, ethnicity, and lifestyle).
2. Inform client/family/significant others of actions to maintain health and prevent disease (e.g.
smoking cessation, diet, weight loss).
3. Consider risk factors linked to ethnicity.
Physiological Integrity
1. Provide/maintain special diets based on client’s
diagnosis/nutritional needs (e.g. low sodium, low fat).
2. Apply knowledge of the client’s pathophysiology when
addressing the pharmacologic agents/actions of the client’s
prescription.
3. Evaluate the effects of medications on client’s hemodynamic status.
4. Assess the client’s pacemaker functioning.
5. Use clinical decision making/critical thinking when caring for a client undergoing diagnostic testing.
6. Know lab values for lipid profile, BNP, Cardiac/Iso enzymes, troponin, CBC, chem. profile, INR, PTT,
PT and pertinent drug levels (e.g. digoxin).
7. Recognize the client with a condition that increases risk for insufficient vascular disease.
8. Intervene to manage potential circulatory complications (e.g. hemorrhage, embolus, shock, and
arrhythmia).
9. Assess the client for an abnormal response following the diagnostic procedure (e.g. arrhythmia
following cardiac cath.).
10. Intervene to promote venous return and prevent complications (e.g. TED hose to prevent embolus,
sequential depression device).
11. Recommend change in test/procedure/treatment prescription based on client response to intervention.
12. Assess the client for abnormal peripheral pulses and peripheral edema.
13. Apply knowledge of nursing procedures and psychomotor skill when caring for a client with abnormal
hemodynamics.
14. Apply knowledge of pathophysiology to interventions in response to client’s abnormal hemodynamics.
15. Assess the client for continued decreased cardiac output (e.g. diminished peripheral pulses,
hypotension).
16. Identify cardiac rhythm strip abnormalities (e.g. sinus bradycardia and tachycardia, atrial fib/flutter,
PVC’s, ventricular arrhythmias).
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17. Intervene to improve client’s cardiovascular status (e.g. modify activity schedule, initiate protocol to
manage cardiac arrhythmias, monitor pacemaker function, oxygen therapy, drug treatments).
18. Intervene when the client’s vital signs are abnormal. (E.g. hypertension, bradycardia).
19. Reevaluate the client with abnormal heart sounds.
20. Reevaluate the client’s response to treatments/interventions to correct hemodynamic function.
21. Identify and intervene on life-threatening situations (e.g. cardiac arrest).
22. Compare and differentiate common cardiac and peripheral vascular disorders.
23. Compare/contrast the assessment findings of a healthy adult versus one with cardiac/peripheral vascular
pathology.
24. Formulate a nursing care plan for the patient undergoing cardiovascular surgery.
Psychosocial Integrity
1. Assess client’s response to illness.
2. Provide instruction that is sensitive to client’s cultural practices
3. Identify situations which may necessitate role changes for the client/family/significant others).
4. Promote methods to manage stress.
5. Identify barriers to client/family significant others compliance with treatment plan.
CONTENT FOR ALTERED CARDIOVASCULAR AND PERIPHERAL VASCULAR FUNCTION
Safe Effective Care Environment
1. Subjective data, risk factors, history
2. Objective data, physical assessment
3. Diagnostics
a. Electrocardiogram
i. 12 lead
ii. telemetry
iii. holter monitor
b. Blood tests
i. lipid profile
ii. cardiac enzymes/isoenzymes
iii. chemistry profile
iv. BNP
v. coagulation studies
vi. drug levels (e.g. digoxin)
vii. Troponin level
c. Echocardiogram/TEE
d. Nuclear Imaging
e. Stress testing
f. Myocardial perfusion imaging
g. Cardiac catheterization
h. Hemodynamic monitoring
i. Doppler studies
j. Arteriography/venography
k. Capillary fragility test
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Health Promotion and Maintenance
1. Safety and preventive measures
a. Lifestyle behaviors(smoking, diet, weight loss, exercise)
b. Disease management
c. Prevention of complications/ circulation compromise
Physiological Integrity
1. Nursing Implications for Pharmacologic Management
a. Cardiac glycosides
b. Antiarrhythmic
c. Antianginal
d. Vasopressors/vasodilators
e. Thrombolytic
f. Adrenergic agents (agonists and antagonists)
g. Angiotensin converting enzyme inhibitors
h. Angiotensin II receptor blockers
i. Calcium channel blockers
j. Diuretics
k. Antilipemics
l. Oxygen therapy
2. Nursing Implications for Nonpharmacological Management
a. Rest and Activity
b. Nutrition/fluid management
c. Low fat/low sodium
diet
d. Stress management
e. Weight loss
f. Smoking cessation Cardiac rehab
3. Nursing Implications for Surgical Management
a. Stent placement/angioplasty
b. Coronary artery bypass graft
c. Pacemaker
d. Valve replacement
e. Peripheral revascularization
f. Implantable defibrillator
g. Ligation/vein stripping
h. Sclerotherapy
i. IABP
j. Inferior vena cava filter
4. Nursing management of clients with:
a. Cardiac arrhythmias
i. sinus bradycardia and tachycardia
ii. PVC’s
iii. Ventricular arrhythmias
iv. atrial fib and flutter
b. Inflammatory heart disease
i. Pericarditis
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c.
d.
e.
f.
g.
h.
i.
ii. Myocarditis
iii. endocarditis
Valvular heart disease
i. Stenosis
ii. insufficiency/regurgitation
Coronary artery disease
i. Acute coronary Syndrome
ii. Myocardial infarction
Congestive heart failure/pulmonary edema
Aneurysms
Cardiomyopathy
Peripheral vascular disease
i. Atherosclerosis
ii. Raynaud’s phenomena
iii. thrombus/DVT
iv. varicose veins
v. Hypertension
Pediatric Consideration
i. Congenital heart defects
Psychosocial Integrity
1. Lifestyle impact
2. Anxiety
3. Occupational impact
RESPONSE TO ALTERED RESPIRATORY FUNCTION
Unit outcomes: Upon completion of this unit of study, the student will be able to:
Safe Effective Care Environment
1. Describe the principles of mechanical ventilation and related collaborative care of critically ill patients.
2. Differentiate the indications for and modes of mechanical ventilation in order to safely care for
the ventilated client.
Health Promotion and Maintenance
1. Participate in disease prevention activities related to the client’s environmental, genetic, or
behavioral risks (e.g. air pollution, family history, and smoking).
2. Plan with client/family to meet self-care needs.
Physiological Integrity
1. Evaluate the effects of medications.
2. Perform diagnostic tests (e.g. pulse oximetry)
3. Know lab values for ABG’s (pH, PO2, PCO2, SaO2, and HCO3), and pulmonary function tests.
4. Maintain tube patency (e.g. chest tubes, tracheostomy).
5. Plan and implement interventions to prevent complications (e.g. turn, cough, and deep breath,
incentive spirometry).
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6. Intervene when the client’s vital signs are abnormal (e.g. tachypnea, bradypnea, and apnea).
7. Promote and provide continuity of care in illness management activities (e.g. O2 therapy,
breathing treatment, chest tubes, and mechanical ventilation).
8. Identify and intervene in life-threatening situations (e.g. respiratory arrest, status asthmaticus).
9. Compare and differentiate common respiratory disorders.
10. Compare/contrast assessment findings of a healthy adult versus one with pulmonary pathology.
11. Apply knowledge of interventions related to diagnostic tests (e.g. X-rays, sputum samples,
bronchoscopy, and thoracentesis).
12. Perform appropriate post-diagnostic assessment and intervention.
13. Identify problems associated with chest trauma which require nursing and medical interventions.
14. Formulate a nursing care plan for the client undergoing thoracic surgery.
15. Use clinical decision/critical thinking to ensure safe use of equipment (e.g. chest tubes, oxygen
therapy, mechanical ventilation, suctioning).
16. Identify the special needs of children with respiratory disorders.
17. Select appropriate nursing interventions to manage the care of an
intubated client.
Psychosocial Integrity
1. Assess client’s response to illness.
2. Identify situations which may necessitate role changes for the client/family/significant others.
3. Identify barriers to client/family/significant others compliance with treatment plan.
CONTENT FOR ALTERED RESPIRATORY FUNCTION
Safe Effective Care Environment
1. Subjective data, risk factors, history
2. Objective data, physical assessment
3. Diagnostics
a. Radiological exams
b. MRI/CT Scan
c. Ultrasound
d. PFT’s
e. Bronchoscopy
f. Sputum exam
g. Thoracentesis
h. Arterial Blood Gases, CBC
i. Pulse Oximetry
j. VQ Scan
k. AFB
l. PPD
Health Promotion and Maintenance
1. Safety and preventive measures
a. Lifestyle behaviors (e.g. smoking, environmental/occupational exposures).
b. immunizations (e.g. pneumovax, DPT)
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Physiological Integrity
1. Nursing Implications for Pharmacologic Management
a. Bronchodilators
b. Antitussives
c. Decongestants
d. Antihistamines
e. Expectorants
f. Mucolytic agents
g. Steroids
h. Antibiotics
i. Sympathomimetic (Albuterol)
j. Anticholinergics
k. Leukotriene receptor antagonists
l. Oxygen Therapy
m. Paralytic Drugs
2. Nursing Implications for Nonpharmacological Management
a. Mechanical ventilation
i. Principles of ventilation
ii. Modes available and indications
iii. Assessment of respiratory status (suctioning, weaning needs)
iv. Suctioning and trach care
b. CPT (chest physiotherapy
c. Nebulizers/updraft treatments
d. Chest tubes
e. Incentive Spirometer/cough and deep breathing
f. Humidification
3. Nursing Implications for Surgical Management
a. Thoracic surgery (resection, pneumonectomy, lobectomy)
b. Laryngectomy/radical neck dissection
c. Nasal and sinus surgery
d. T&A
4. Nursing Management of Clients with:
a. Upper Respiratory (nose, sinuses, and throat)
i. Infections: tonsillitis, sinusitis, laryngitis
ii. Allergies, rhinitis, and epistaxis
b.Lower Respiratory
i. Infections and inflammatory
1. acute bronchitis
2. pneumonia
3. tuberculosis
4. fungal infections
ii. Obstructive Pulmonary Disease
1. chronic bronchitis
2. emphysema
3. asthma
4. atelectasis
5. bronchiectasis
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iii. Occupational Lung Diseases
1. asbestosis
2. black lung disease
iv. Neoplasms
v. Emergency/Traumatic Respiratory Conditions
1. pneumothorax
2. Pulmonary embolism/infarct
3. Respiratory insufficiency/failure
4. Pleural effusion
5. Flail chest
6. Sucking chest wound
c. Pediatric Considerations
i. Cystic fibrosis
ii. Epiglottitis
iii. RSV
iv. Mononucleosis
v. Pertussis (communicable disease)
vi. Croup
Psychosocial Integrity
1.
Lifestyle impact
2.
Anxiety
3.
Occupational impact
CRITICAL CARE NURSING
Unit Outcomes: Upon completion of this unit of study, the student will be able to:
Safe Effective Care Environment
1. Identify risk factors for shock and multiple system organ dysfunction syndrome.
2. Compare and contrast the effects of sepsis, shock, and multiple organ dysfunction syndrome on the
major body parts.
Health Promotion and Maintenance
1. Assess the needs of the critically ill patient and encourage health promotion to this client.
Physiological Integrity
1. Describe the pathophysiology and clinical manifestations of shock
2. Compare the collaborative care, drug therapy, and nursing management of clients with different
types of shock.
3. Describe the nursing management of a client experiencing multiple organ dysfunction syndrome.
4. Select appropriate nursing interventions to manage common problems and needs of critically ill
clients.
5. Review Cardiac dysthymias medications and critical care/cardiac drips
a. Heparin
b. Cardizem
c. Amiodarone
d. Adenosine
NU: Spring 2016 12/14/15
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e. Epinephrine
f. Lidocaine
g. Atropine
Psychosocial Integrity
1. Develop effective strategies to manage issues related to the families of critically ill clients.
2. Assist critically ill client in reducing anxiety by addressing such issues as impaired communication,
sensory-perceptual problems, pain, and unfamiliar environment.
CRITICAL CARE CONTENT
Safe Effective Care Environment
1. Types of shock
a. Cardiogenic
b. Hypovolemic
c. Neurogenic
d. Anaphylactic
e. Septic
2. Needs Assessment in major burn injuries
Health Promotion and Maintenance
1. Assessment and needs identification of multiple system organ dysfunction
Physiological Integrity
1. Nursing Implications for Pharmacologic Management
a. Inotropics (dobutamine, dopamine)
b. Adrenergic agonists (epinephrine, norepinephrine, Neo-Synephrine)
c. Vasopressors/vasodilators
2. Fluid therapy in shock
3. Nursing Management of the client with:
a. Shock
b. Multiple system organ dysfunction syndrome
c. Burn Injury
i. Major
ii. moderate
d. ARDS
Psychosocial Integrity
1. Develop effective strategies to manage issues related to the families of critically ill clients.
2. Assist critically ill client in reducing anxiety by addressing such issues as impaired communication,
sensory-perceptual problems, pain, and unfamiliar environment.
NU: Spring 2016 12/14/15
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SYLLABUS RECEIPT ACKNOWLEDGEMENT COURSENUMBER:NUR2224 TERM‐YEAR:Spring2016
COURSENAME:AlterationsinHealthIV
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onVDrive/NursingStaff/AggregateDoc’n/SyllabiAcknowledgements NU: Spring 2016 12/14/15
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