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WALLA WALLA COMMUNITY COLLEGE NURSING EDUCATION BEGINNING NURSING CONCEPTS I NURS 101 Winter Quarter 2010 Every effort is made to ensure accuracy in the syllabus at the time of printing. However, the Walla Walla Community College Nursing Education Program reserves the right to change any provision or requirement that is necessitated by circumstances arising during the course. All changes will be provided in writing. NURS 101 Syllabus Winter 2010 Final 12.15.09 1 COURSE OUTLINE Course Identifier: NURS 101 Title: Beginning Nursing Concepts I Credits: 6 Class Hrs Per Wk: 6 Catalog Description: A continuation of the principles of nursing care introduced in NURS 100. The focus is on providing care for clients of all ages who are experiencing normal life processes or common/chronic disease processes in selected systems. Prerequisites: NURS 100 and 110 Corequisite: NURS 111 Teaching Format: Lecture/Discussion Critical Thinking Activities Small Group Activities Audio-visual Computer-based Learning Activities Location: Walla Walla Campus – Room 1706 Clarkston Campus – Room 2107 Course Topics: Introduction to Care of the Child Perioperative Nursing Fluid, Electrolytes, Acid-Base Balance I Cancer I Men's Health Integumentary Musculoskeletal Diabetes Respiratory I Evaluation Devices: Activities Unit Tests Comprehensive Final ATI Tests NURS 101 Syllabus Winter 2010 Final 12.15.09 2 COURSE COMPETENCIES: Critical Thinking 1. 2. Demonstrate critical thinking in the use of the nursing process. Demonstrate use of management/leadership principles in the delivery of client/patient care. Caring 3. 4. Perform interventions in a safe and effective manner. Use therapeutic communication. Professional Behaviors 5. Demonstrate professional behaviors. FACULTY CONTACT LIST NOTE: Students are encouraged to contact the faculty member responsible for the content area or clinical experience that they have a question about. Contact your faculty advisor for academic concerns and advising. Walla Walla Campus: Clarkston Campus: Nursing Office: Nursing Office: 509-527-4240 509-758-1702 Director of Nursing Education: Marilyn D. Galusha, RN, MSN Walla Walla-based Instructors Kathy Adamski, RN, MN (Level I Lead Instructor) Brenda Anderson, RN, MSN Grace Hiner, RN, MN Office Number 527-4244 Email addresses 527-4421 [email protected] Cell: 200-0904 [email protected] Cell: 240-4084 [email protected] 758-1728 [email protected] 758-1787 [email protected] 527-4327 Clarkston-based Instructors Carol McFadyen, RN, Ph.D. (Clarkston Lead Instructor) Todd Carpenter, RN, BSN Office Hours for instructors may be found on the Level I Bulletin Board NURS 101 Syllabus Winter 2010 Final 12.15.09 3 BEGINNING NURSING CONCEPTS I NURS 101 Grading Criteria & Distribution of Points: CONTENT POINTS Perioperative Nursing Fluids, Electrolytes, Acid-Base Balance I (2 classes) Introduction to Care of the Child Diabetes (3 classes) Cancer I Respiratory I (4 classes) Integumentary Musculoskeletal (3 classes) Men's Health 4 unit tests (9 questions per 3-hour lecture period) Final Test (5 questions per 3-hour lecture period) ATI PN Fundamentals of Nursing comprehensive test Total Points available 3 6 3 9 3 12 3 9 3 153 85 30 319 (All content will be taught via ITV. Faculty will travel part of the time weather permitting.) **Students must attain 75% or greater cumulative score on tests to achieve a passing grade in NURS 101. Activity points will accumulate as achieved, however, they will not be added to the grade until the end of the quarter and will be added only if the test score is a minimum of 75%. Group testing - following each of the four (4) unit tests, a small-group test will be given. If a 90% is achieved on this group test, the members of the group shall receive 2 additional points. If the group receives a score of 81-89% each member shall receive 1 additional point. Any group scoring 80% or below shall receive no points. All points achieved through group testing shall be documented as bonus activity points. Course Expectations: 1. 2. Follow all policies as outlined in Nursing Student Handbook If absent from class, no points shall be awarded for missed in-class learning activities 3. All assignments must be accounted before progression regardless of score achieved. 4. Late papers will receive a one-point deduction per school day when turned in after the due date and /or time (i.e. beginning of class or as stated). Testing: Failure to take a test at the scheduled time will result in an automatic reduction of 5% of the available score from the earned score. (See p. 18 of the WWCC Nursing Student Handbook). Grading Scale – See Nursing Student Handbook NURS 101 Syllabus Winter 2010 Final 12.15.09 4 Assessment Technologies Institute (ATI) Testing One (1) proctored computerized mastery examination will be administered this quarter: PN Fundamentals for Nursing Practice. Prior to taking this content mastery examination, each student must complete a non-proctored, online practice test and achieve a score of 90%. This nonproctored, online practice test can be taken more than once however, a 90% must be achieved. You will not be allowed to take the proctored exam if you do not complete the online practice exam by the due date. Access and Test ID codes will be provided. In order to be admitted to the proctored exam, you will need to submit a copy of your non-proctored, online practice test individual score to Kathy/Carolyn/Carol (front page only). An ATI “Proficiency Level II” must be achieved. This is considered minimum competency. Failure to achieve a “Proficiency Level II” on the first proctored exam shall require remediation prior to retesting. A student has a maximum of five (5) attempts to meet the minimum proficiency on the proctored exam. Failure to achieve a “Proficiency Level II” prior to the end of winter quarter will result in an Incomplete “I” grade contract. Failure to clear the “I” grade contract by the end of the first two weeks of the next quarter will result in the conversion of the “I” grade to a C- and the student will not be allowed to progress. The points available on the ATI Content Mastery Test will be allocated on a curved scale basis. Points will be prorated with the highest percentage score earning 100% of the available points. NURS 101 Syllabus Winter 2010 Final 12.15.09 5 PERIOPERATIVE NURSING Topic Perioperative Nursing Objectives 1. Explain the concept of perioperative nursing Assignments/Comments Lewis, et al (7th ed.) Ch. 18, pp. 343-357 2. Describe essential components of preoperative nursing (assessment, relevant diagnostic tests, teaching, informed consent, etc.) ative Nursing C cute 3. Develop a preoperative teaching plan for a client undergoing open abdominal surgery. 4. Describe the action, therapeutic effect, and nursing implications of medications administered during the perioperative period. Intraoperative Nursing Care 5. Identify the surgical team and describe their role in client safety.* Lewis, et al (7th ed.) SCAN Ch. 19, pp. 359-373 6. Compare and contrast types of anesthesia. 7. Describe the role of the nurse related to conscious sedation and explain potential risk factors. [Objectives marked with (*) are also covered in the Perioperative Experience Reaction Paper, NURS 111]. 8. Discuss measures used to maintain client safety during the intraoperative phase.* Postoperative Nursing Care 9. Explain the role of the PACU nurse related to patient safety immediately after surgery (assessment/interventions). 10. Describe the role of the nurse caring for hospitalized surgical clients, including assessment, potential complications, interventions, and evaluation. Acute Pain Lewis, et al (7th ed.) Ch. 20, pp. 376-395 11. Differentiate acute from chronic pain. 12. Review methods of assessing acute pain and describe common responses to pain. Lewis, et al (7th ed.) Ch. 10, pp. 125-148 13. Explain the mechanisms whereby non-narcotic and narcotic analgesics relieve pain. Discuss rationale and teaching requirements for the use of a PCA. NURS 101 Syllabus Winter 2010 Final 12.15.09 6 FLUID AND ELECTROLYTES, ACID-BASE BALANCE I (CLASS #1) Topic Fluid and Electrolyte Imbalances Objectives 1. Describe the normal physiology of fluid balance Fluid compartments Functions of body fluids Types of electrolytes Role of proteins Assignment/Comments Potter. & Perry (7th ed.) Ch. 41, pp. 966-970, 981-992, 10041021 (unexpected outcomes)- stop at Blood Replacement Laboratory & Diagnostic Testing 2. Identify the significance of abnormal laboratory values related to fluid imbalances: Serum electrolytes Serum albumin Hematocrit Blood Urea Nitrogen (BUN) Silvestri (4th ed.), Ch. 11, pp. 100-104 and 107 Albumin, Protein, Electrolytes, Renal function studies, Hemoglobin and hematocrit 3. Describe the etiology, clinical manifestations and nursing management of clients at risk for or with: Fluid volume deficit/shock Fluid volume excess Fluid volume shifts IV Fluid Therapy 4. Compare the actions of IV solutions in the body Hypotonic Isotonic Hypertonic Silvestri, (4th ed.) Ch. 9, pp 74 - 89 5. Identify legal/ethical principles that guide the practice of IV therapy in providing care for children and adults. Assessments o Site o Rate o Solution Documentation NURS 101 Syllabus Winter 2010 Final 12.15.09 7 FLUID AND ELECTROLYTES, ACID-BASE BALANCE I (CLASS #2) Topic Assessment and Management of the Client with Electrolyte Imbalances Objectives 1. Describe the etiology, clinical manifestations, medical management and nursing interventions for the following imbalances: Sodium (Na) Chloride (Cl) Potassium (K) Calcium (Ca) Phosphorus (P) Assignment/Comments Potter & Perry (7th ed.) Ch. 41, pp. 970-981 Silvestri, (4th ed.) Ch. 10, pp 90-99 2. Describe the role of the chemical buffers in the lungs and kidneys in the maintenance of acid-base balance. 3. Describe laboratory test results indicating acid base imbalance. Arterial Blood Gases (ABGs) Serum CO2 Assessment and Management of the Client with Acid-Base Imbalances 4. Identify the four types of acid-base imbalances by ABG analysis. Metabolic acidosis and alkalosis Respiratory acidosis and alkalosis 5. Describe the etiology, risk factors, clinical manifestations, medical management and nursing interventions for the client with metabolic acidosis /alkalosis NURS 101 Syllabus Winter 2010 Final 12.15.09 8 INTRODUCTION TO CARE OF THE CHILD Topic Objectives Assignment/Comments Nurse’s Role 1. Discuss the nurse’s role in health maintenance and health promotion for children Leifer (5th ed.) SCAN Ch. 15, pp. 345-379 Health Maintenance & Health Promotion 2. Discuss the use of the nursing process in health maintenance and health promotion activities for children of each age group Assessment of normal growth & development Erikson and Piaget Play, toys or activities Leifer (5th ed.) Ch. 16 (Infants), “Key Points”, p. 397 3. Discuss common learning needs for parents in regards to health promotion and maintenance for children of each age group Ch. 18 (Pre-Schooler), “Key Points”, pp. 426-427 Learning Needs Assessment Care of Child in Hospital 4. Describe variations in techniques of physical assessment based on the child’s age and level of development 5. Describe nursing interventions to provide age appropriate care to the ill child and family in the hospital Ch. 17 (Toddlers), “Key Points”, p. 412 Ch. 19 (School-Age), “Key Points”, p. 442 Ch. 20 (Adolescent), “Key Points”, pp. 461-462 Ch. 21 (Hospitalization), pp. 472479 Appendix K, “Normal Vital Signs of Infants and Children”, p. 773 NURS 101 Syllabus Winter 2010 Final 12.15.09 9 DIABETES (CLASS #1) Topic Pathophysiology and Etiology Objectives 1. Differentiate between the etiology and pathophysiology of Type I and Type II Diabetes Criteria for Diagnosis Laboratory & diagnostic testing 2. Describe the significance of findings from laboratory and diagnostic testing in caring for the client with diabetes Blood glucose monitoring Urine testing for ketones Glycosylated hemoglobin Management 3. Discuss the medical/nursing management of the client with diabetes Nutrition Exercise Medications Care during illness and surgery NURS 101 Syllabus Winter 2010 Final 12.15.09 Assignment/Comments Lewis, et al (7th ed.) Ch. 49 Silvestri (4th ed.) Ch. 33, pp. 387-390 Ch. 44, pp. 553-560 Silvestri (4th ed.) Ch. 44, pp. 558, Box 44-20 10 DIABETES (CLASS #2) Topic Medications Acute Complications Collaborative Care Nursing Management Objectives 1. Identify the action, therapeutic effect, and nursing implications for the use of: Insulin Oral hypoglycemic agents Assignment/Comments Lewis, et al (7th ed.) Ch. 49 Silvestri (4th ed.) Ch. 45, pp. 553-555 2. Identify steps/measures for safe administration of diabetic medications. 3. Identify the s/s of diabetic ketoacidosis (DKA). 4. Interpret ABG results r/t DKA. Lewis, et al (7th ed.) Ch. 17, pp. 334-337 (Alterations in Acid-Base Balance and Clinical Manifestations) Discuss assessment and nursing interventions for a client with diabetes in an acute care facility Silvestri (4th ed.) Ch. 44, pp. 556-557 (Acute Complications of Diabetes Mellitus) 5. Doenges (11th ed.) “Fluid Volume, Deficient”, pp. 320327 “Tissue Perfusion, Ineffective”, pp. 705-714 NURS 101 Syllabus Winter 2010 Final 12.15.09 11 DIABETES (CLASS #3) Topic Long Term Complications Health Promotion Objectives 1. Discuss health promotion activities to prevent the long term complication of diabetes Macrovascular Microvascular Nephropathy Neuropathy Assignment/Comments Lewis, et al (7th ed.) Ch. 49 Teaching Plan 2. Develop an age appropriate teaching plan for management of diabetes including learning needs, readiness to learn & documentation. Doenges (11th ed.) “Deficient Knowledge” regarding disease process/treatment and individual care needs, pp. 433-437 Management 3. Describe the psychosocial needs of a client newly diagnosed with Diabetes Mellitus Adjustment to life with a chronic disease Developmental needs of children with diabetes Potter & Perry (7th ed.) Ch. 11, pp. 138-140 Review Erikson’s developmental stages and Piaget’s Cognitive developmental stages 4. Identify community resources available to meet the needs of clients with diabetes NURS 101 Syllabus Winter 2010 Final 12.15.09 12 CANCER I Topic Introduction to Cancer Concepts Objectives 1. Describe the biology of cancer. 2. Compare and contrast benign and malignant neoplasms. 3. Explain how a diagnosis is made and the importance of the various classification systems related to diagnosis and outcome. 4. Describe prevalence, incidence, survival rates and mortality rates of common cancers in the US. Assignment/Comments Expect to use vocabulary in class activity Silvestri (4th ed.) Ch. 42, p. 496 (vocabulary) Bring markers, colored pencils, crayons for drawing (crayons available in WW) 5. Describe the role of the nurse in prevention and/or early detection of cancer. Silvestri (4th ed.) Ch. 42, pp. 498-521 6. Discuss the psychological responses and coping mechanisms related to a diagnosis of cancer. Doenges (11th ed.) “Grieving” pp. 345-349 7. Differentiate between treatment modalities and the ethical role of the nurse while clients are making care choices. 8. Describe nursing management for clients undergoing cancer treatment. Patient and environmental safety Potential side effects or complications NURS 101 Syllabus Winter 2010 Final 12.15.09 13 RESPIRATORY I (CLASS #1) Topics Anatomy & Physiology Objectives 1. Discuss the anatomy and physiology (A & P) of the respiratory system in relation to care of the client with respiratory disorders. ventilation neural control of respiration differences between the child and adult respiratory systems effects of aging on the respiratory system. 2. Describe the nursing assessment for a client with a respiratory problem. history examination of the respiratory system 3. Describe the clinical manifestations of a client with respiratory dysfunction normal versus abnormal breath sounds assessment abnormalities and chest examination findings in common pulmonary problems Assessment Laboratory & diagnostic studies Nursing Interventions 4. Describe the nursing responsibilities for preparing and caring for the client receiving the following laboratory and diagnostic studies; also describe the significance of the results of the following laboratory and diagnostic studies: CBC (Complete Blood Count: Focus on RBC, Hgb, Hct, & platelets) ABGs (Arterial Blood Gases) Pulse oximetry Sputum studies Skin test for tuberculosis Radiographic studies Endoscopic examination Pulmonary Function Tests Exercise Testing NURS 101 Syllabus Winter 2010 Final 12.15.09 Assignment/Comments Lewis, et al (7th ed.) Ch. 26, pp. 509-532 Pages 509-512 of assigned reading are a review of A & P. You are responsible for the material. Concepts that will be discussed in class require that you understand the A & P reviewed in these pages before coming to class. Please call Grace Hiner to make an appointment if you are having difficulty understanding the A & P. Silvestri (4rd ed.) pp. 364 (Tuberculosis & Mantoux Test) Graded Assignment: Video on reserve in library: “Performing Respiratory Assessment” by Springhouse (2000) Written assignment due at the beginning of Respiratory Class #1 at 0900 (3 points): Briefly (one to two paragraphs) describe one main point that you learned from watching this video. Assignment must be typed with the title, “Write-up for Respiratory Assessment Video”. Please be sure that student name and instructor name are at the top of the page. 14 RESPIRATORY I (CLASS #2) Topics Disorders of the Upper Respiratory system Assessment and Management of the client with disorders of the Upper Respiratory System Pharmacology Objectives 1. Review the structures of the upper respiratory system differences between child and adult effects of aging on the upper respiratory tract Assignment/Comments Lewis, et al (7th ed.) Ch. 27, pp. 533-551 2. Discuss considerations in the care of the pediatric client with disorders of the upper respiratory system 3. Describe the pathophysiology (etiology, pathogenesis, and clinical manifestations) nursing interventions, and client learning needs of upper airway disorders. Nasal Fracture Expistaxis Sinusitis Otitis Media Tonsillitis Allergic Rhinitis, Acute Viral Rhinitis Influenza; H1N1 SARS; West Nile Virus Acute Pharyngitis Peritonsillar Abscess Obstructive Sleep Apnea (OSA) Epiglotitis LTB (laryngotracheo-bronchitis)—Croup Laryngeal cancer 4. Identify the action, therapeutic effects, drug interactions and nursing implications of medications used to treat upper respiratory problems. nose drops/nasal steroids antihistamines decongestants expectorants & mucolytic agents antitussives alternative therapies: Echinacea, zinc, ascorbic acid (vitamin C) NURS 101 Syllabus Winter 2010 Final 12.15.09 Silvestri, (4rd ed.) pp. 357-360 Review fall lecture (NURS 100) PowerPoint slides covering Sympathetic Nervous System and Parasympathetic Nervous System from Intro to Pharmacology & Medication Administration Class #1. Review the terms: sympathomimetic, adrenergic, anticholinergic, parasympathomimetic, muscurinic, and cholinergic. Doenges (11th ed.) Review the following nursing diagnoses 1. Ineffective Airway Clearance 2. Ineffective Breathing Pattern Bring Doenges (11th ed) Nursing Pocket Guide : Diagnoses, Interventions & Rationales to class. 15 RESPIRATORY I (CLASS #3) Topics Care of the Client with a Tracheostomy: Nursing Interventions Disorders of the Lower Respiratory System Nursing Interventions Objectives Assignment/Comments 1. Describe nursing interventions to maintain or restore health for the client with a tracheostomy Assessment Suctioning: Complications (Hypoxia, Trauma, Infection, Vagal Stimulation) Swallowing; Nutrition Communication; Psychosocial considerations Lewis, et al (7th ed.) pp. 543-550 (Tracheostomy) 2. Describe the etiology, pathogenesis, clinical manifestations, and nursing management of the client with: Acute Bronchitis; Bronchiolitis (Respiratory Syncytial Virus- RSV) Pneumonia Atelectasis Lung cancer Lewis, et al (7th ed.) pp. 561-569 (Acute Bronchitis & Pneumonia) pp. 578-585 (Lung cancer) 3. Describe nursing precautions and interventions in caring for the client with a respiratory infection Transmission based guidelines and best practices for drug resistant infections (Isolation Precautions) Laboratory assessment: CBC—focus on WBC & differential; Culture, Gram stain, & Sensitivity Silvestri (4rd ed.) pp. 360-362 (Bronchitis, RSV, Pneumonia) Potter & Perry (7th ed.) pp. 661-667 (Isolation Precautions) 4. Describe the action, therapeutic effects, side effects and nursing implications of medications used for the treatment of infections. Antipyretics Antimicrobial therapy 5. Develop a plan for providing information about continuing with antibiotic therapy after discharge Lewis, et al (7th ed.) pp. 640-643 (O2 therapy) 6. Describe the nursing responsibilities in relation to the use of oxygen therapy, including the assessment for complications. Goals of oxygen therapy Hazards and complications of oxygen therapy Types of oxygen delivery systems Bring Davis Drug Guide(11th ed.) to class NURS 101 Syllabus Winter 2010 Final 12.15.09 16 RESPIRATORY I (CLASS #4) Topic Objectives Obstructive Pulmonary Diseases: Asthma 1. Discuss the etiology, pathophysiology, clinical manifestations, and nursing management of the client with asthma. Triggers Peak flow monitoring Pharmacology 2. Describe the actions, therapeutic effects, and nursing implications of pharmacological therapies used to treat and prevent asthma attacks. Bronchodilators (short and long acting) Corticosteroids Methylxanthines Mast Cell Stabilizers (Cromolyn Sodium) Leukotrienne Modifiers COPD th Maintenance estoration 3. Discuss risk factors, etiology, pathophysiology, clinical manifestations and nursing management for the client with Chronic Obstructive Pulmonary Diseases (COPD). Chronic Bronchitis Emphysema 4. Cystic Fibrosis Describe the actions, therapeutic effects, and nursing implications of pharmacological therapies used to manage COPD 5. Discuss risk factors , etiology, pathogenesis, clinical manifestations and nursing management for the client with Cystic Fibrosis NURS 101 Syllabus Winter 2010 Final 12.15.09 Assignment/Comments Supplemental Reading Assignment on Peak Flow Meter—in NURS 101 syllabus Lewis, et al (7th ed.) Ch. 29: pp. 607-634; 646-659 Silvestri (4rd ed.) pp. 362-367 (Asthma and Cystic Fibrosis) Review the following lung volume terms (See Respiratory Class #1 lecture notes and Lewis, 7th ed, p. 531) 1. Peak Expiratory Flow Rate (PEFR) 2. Forced Vital Capacity (FVC) 3. Forced Expiratory Volume (FEV) 4. Residual Volume (RV) Doenges (11th ed.) Review the nursing diagnosis “Impaired Gas Exchange” 17 RESPIRATORY SUPPLEMENTAL REFERENCE Original Article:http://www.mayoclinic.com/health/asthma/AS00022 Asthma: Use a peak flow meter to gain control A peak flow meter is a simple, hand-held device that measures how efficiently you can move air out of your lungs. Peak flow readings can warn you of an impending asthma attack hours — or even days — before you experience any signs or symptoms. With time on your side, you can adjust your asthma medication and take other steps to help prevent an attack. One day at a time A peak flow meter allows you to objectively measure day-to-day variations in your breathing. When your asthma is under control, your airways are open and you can force more air into the peak flow meter. But when your airways are inflamed and constricted, you can't blow as hard into the meter — making your peak flow rate lower. Your doctor may recommend using a peak flow meter at least once a day — typically before taking your asthma medication in the morning. Use the peak flow meter at the same time every day, and record your readings in an asthma diary. These readings will help you and your doctor: Determine the severity of your asthma Evaluate the effectiveness of your current treatment Determine when to add or stop certain medications Recognize an asthma attack before signs or symptoms appear Decide when to seek emergency care Using your peak flow meter Peak flow meters are available over-the-counter. Better yet, they're easy to use. Move the marker to the bottom of the numbered scale, and connect the mouthpiece to the peak flow meter. Stand up. Take a deep breath, filling your lungs completely. Place your lips tightly around the mouthpiece. Blow as hard and as fast as you can with a single breath. Note the final position of the marker. This is your peak flow rate. Blow into the peak flow meter two more times. Record the highest reading of the three in your asthma diary. For the most accurate readings, it's important to keep your peak flow meter clean. Follow the manufacturer's instructions. NURS 101 Syllabus Winter 2010 Final 12.15.09 18 Determining your personal best Your "personal best" peak flow rate is the highest peak flow rate you can reach over a two- to three-week period when you feel good and have no asthma symptoms. This flow rate serves as a benchmark in your daily self-management plan. Because everyone's asthma is different, your personal best will be unique to you. Your doctor will help you determine your personal best. Typically, you'll take readings twice a day for two weeks when you're not having symptoms. Ignoring any outliers, the highest consistent reading during the trial period is your personal best. Organizing your peak flow zones Your doctor will use your personal best peak flow rate to organize peak flow zones: green (stable), yellow (caution) and red (alert). If your peak flow readings fall too far below your personal best, you'll need to take action to prevent or minimize an asthma attack. Green zone. Your peak flow rates are 80 percent to 100 percent of your personal best, an indication that your asthma is under good control. You probably have no asthma signs or symptoms. Take your preventive medications as usual. If you consistently stay within the green zone, your doctor may recommend reducing your asthma medication. Yellow zone. Your peak flow rates are 50 percent to 80 percent of your personal best, an indication that your asthma is getting worse. You may have signs and symptoms such as coughing, wheezing or chest tightness. You may need to increase or change your asthma medications. Red zone. Your peak flow rates are less than 50 percent of your personal best, an indication of a medical emergency. You may have severe coughing, wheezing and shortness of breath. Stop whatever you're doing and use a bronchodilator or other medication to open your airways. Your asthma action plan will help you decide whether to call your doctor, take an oral corticosteroid or seek emergency care. Taking control Take charge of your treatment — and your life. Identify the things that trigger your asthma symptoms or make them worse. Meet with your doctor periodically to review your asthma action plan and revise it as needed. Show your doctor how you're using your peak flow meter, just to make sure you're doing it correctly. Your lifestyle matters, too. Eat a healthy diet. Exercise regularly, with your doctor's OK. Don't smoke. Get enough sleep. Taking good care of yourself can help you handle life with asthma. © 1998-2007 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. NURS 101 Syllabus Winter 2010 Final 12.15.09 19 INTEGUMENTARY Topic Anatomy & Physiology Assessment/ Documentation Objectives 1. Discuss the anatomy and physiology of the skin in relation to care of the client with integumentary disorders. Assignment/Comments Lewis et al (7th ed.) Ch. 23 and 24, pp 449-489 2. Describe assessments to identify integumentary dysfunction and documentation of assessment findings: History & physical examination Clinical manifestations & types of lesions Diagnostic procedures 3. Describe the risk factors, etiology, and clinical manifestations of the major skin disorders: Infections (Bacterial, fungal, viral) Inflammations (Dermatitis) Eruptions/Allergic reactions Structural Disorders Infestations, bites, stings Pharmacology 4. Describe the actions, therapeutic effect and nursing implications for medications used to treat integumentary problems Oral and parental medications Topical medications Baths 5. Discuss the nursing responsibility in care of the client undergoing: Ultraviolet radiation Dermatologic surgical procedures Learning Needs 6. Discuss nursing interventions and common learning needs for the client and family with skin disorders. Health Promotion 7. Discuss health promotion measures to prevent integumentary system disorders in children, adults, and older adults. NURS 101 Syllabus Winter 2010 Final 12.15.09 Doenges (11th ed.) Review the nursing diagnoses “Body Image Disturbance” “Impaired Skin Integrity” 20 MUSCULOSKELETAL (CLASS #1) Topic Anatomy & Physiology Assessment Sports Injuries Objectives Lewis, et al (7th ed.) Ch. 62, pp. 1614-1621, 1623-1628 2. Describe nursing assessment related to musculoskeletal function: Health interview/client history Physical assessment/examination Significant diagnostic procedures Changes in function across the life span Lewis, et al (7th ed.) Chap. 62, Table 62-5, p. 1623 3. Discuss cause of soft tissue injuries and usual management Strains/sprains Dislocations/subluxations Injuries to ligaments and tendons Lewis, et al (7th ed.) Ch. 62, p. 1628 (Arthroscopy) Ch. 63, pp. 1629-1651 4. Describe “R.I.C.E.” therapy for soft tissue injury Management of Clients with Fractures Assignment/Comments 1. Review the anatomy and physiology of the musculoskeletal system in relation to care of the client with disorders in the musculoskeletal system. 5. Describe clinical manifestations of fractures and identify the stages of healing 6. Discuss the nursing management of a client with a fracture Reduction Immobilization Casts/ Cast Care Traction External/Internal Fixation 7. Describe assessments and nursing interventions for common complications of fractures Compartment Syndrome Avascular necrosis Osteomyelitis Venous Thrombosis Fat Embolism NURS 101 Syllabus Winter 2010 Final 12.15.09 Leifer (5th ed.) pp. 549-551; 563-564 Leifer (5th ed.) Nursing Tip, p. 552 Lewis, et al (7th ed.) Chap. 63, pp. 1635-1651 Leifer (5th ed.) Nursing Tip, pp. 553, 555, NCP 24-1, p. 558-559 Lewis, et al (7th ed.) Ch. 64, pp. 1668-1672 21 MUSCULOSKELETAL (CLASS #2) Topic Pathophysiology: Arthritis Objectives 1. Compare and contrast the etiology, pathophysiology, clinical manifestations, diagnostic studies and medical management for clients with Arthritis Osteoarthritis Rheumatoid Arthritis Gout Medications 2. Describe the actions and nursing implications of common medications used in the treatment of connective tissue diseases Salicylates Non-steroidal anti-inflammatory drugs (NSAIDS) Non opioid/opioid analgesics Corticosteroids Disease modifying antirheumatic drugs o Methotrexate o Gold salts o Anti-malarial drugs (Plaquinel ®) Biologic Therapy Specific anti-gout medications o Colchicine o Benemid ® o Zyloprim ® Pathophysiology: Connective Tissue Disorders 3. Compare and contrast the etiology, pathophysiology, clinical manifestations, diagnostic studies and medical management for clients with connective tissue disorders Systemic Lupus Erythematosus Soft tissue rheumatic syndrome o Fibromyalgia NURS 101 Syllabus Winter 2010 Final 12.15.09 Assignment/Comments Lewis, et al (7th ed.) Ch. 65, pp. 1693-1711, 1715-1716 Table 65-6, p. 1704 Liefer, (5th ed.) Chap 24, pp. 561-562 Lewis, et al (7th ed.) Ch. 65, pp. 1716 22 MUSCULOSKELETAL (CLASS #3) Topic Amputation Objectives 1. Discuss the physiologic, psychosocial and health restoration needs of a client with an amputation Assignment/Comments Lewis, et al (7th ed.) Ch. 63, pp. 1658-1662 Doenges (11th ed.) “Disturbed Body Image” Orthopedic surgery 2. Discuss nursing interventions for the client experiencing orthopedic surgery on the joints Hip pinning (ORIF) Total hip arthroplasty (replacement) Total knee arthroplasty (replacement) 3. Discuss the manifestations of Ewing’s and osteogenic sarcoma Congenital Anomalies Metabolic bone disease Lewis, et al (7th ed.) Ch. 63, p. 1662-1666 Lewis, et al (7th ed.) Ch. 64, pp. 1668-1672 Leifer, Chap. 24, p.561 4. Discuss nursing care for clients with disorders of the foot: Bunion Hammertoe Morton’s neuroma Lewis, et al (7th ed.) Ch. 64, p. 1684-1686 5. Describe the clinical manifestations, nursing assessment for and treatment of common congenital anomalies Dysplasia of the hip Talipes equinovarus (clubfoot) Liefer, (5th ed.) Ch. 14, pp. 328-332 6. Compare and contrast the etiology, pathophysiology and medical management of metabolic bone diseases Osteomalacia Paget’s Disease Osteoporosis NURS 101 Syllabus Winter 2010 Final 12.15.09 Lewis, et al (7th ed.) Ch. 64, p. 1686-1691 23 Health promotion 7. Describe health promotion measures to reduce the incidence and progression of osteoporosis Nutrition Exercise Medications Medications 8. Describe the actions, therapeutic effects and nursing implications for the medications used in the treatment of osteoporosis Calcium Supplementation Estrogen Replacement Calcitonin Bisphosphonates (Fosamax ®) Estrogen receptor Modulators (Evista ®) Human parathyroid hormone (Forteo ®) NURS 101 Syllabus Winter 2010 Final 12.15.09 24 MEN’S HEALTH Topic Anatomy and Physiology: Male Reproductive System Male Reproductive Problems Objectives 1. Describe anatomy and physiology of the male reproductive system 2. Identify psychological and emotional implications related to disorders/dysfunction of the male reproductive system 3. Describe historical data, physical examination procedures used to diagnose dysfunction of the male reproductive system. 4. Describe health promotion/maintenance measures for males across the life span. 5. Discuss the laboratory and diagnostic test findings used in diagnosing dysfunction of the male reproductive system Assignment/Comments Lewis, et al (7th ed.) pp. 1154-1187 (review elimination, tests) Lewis, et al (7th ed.) pp. 1339-1340; pp. 347-1348 (male reproductive system) and other content related to male reproductive system Lewis, et al (7th ed.) pp. 1414-1438 (Male reproductive problems) 6. Discuss pathophysiology, clinical manifestations, and collaborative care of benign prostatatic hypertrophy (BPH) 7. Discuss nursing management of clients with infection/inflammation of the male reproductive system. 8. Briefly discuss cancers of the male reproductive system 9. Discuss nursing management of problems related to male sexual function/dysfunction 10. Discuss nursing care for clients with common problems affecting the penis, scrotum, and testes Hydrocele Scrotal trauma Priapism Cryptorchism Phimosis 11. Formulate a nursing plan for the post-surgical client following male reproductive surgery. NURS 101 Syllabus Winter 2010 Final 12.15.09 25