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WALLA WALLA COMMUNITY COLLEGE NURSING EDUCATION BEGINNING NURSING CONCEPTS II NURS 102 Spring Quarter 2008 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 102 Syllabus Spring 2008 COURSE OUTLINE Course Identifier: NURS 102 Title: Beginning Nursing Concepts II Credits: 6 Class Hrs Per Wk: 6 Catalog Description: A continuation of NURS 101. The focus is on providing care to clients of all ages experiencing normal life processes or common/chronic disease processes in selected body systems. Prerequisites: NURS 101 and 111 Corequisites: NURS 112 and 197 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: Normal Maternal-Newborn Cardiac I Peripheral Vascular Gastrointestinal Special Senses Women's Health Evaluation Devices: Activities Unit Tests Comprehensive Final ATI Tests Nurs 102 Syllabus Spring 2008 2 Course Competencies: Critical Thinking 1. Demonstrate critical thinking in the use of the nursing process. 2. Demonstrate use of management/leadership principles in the delivery of client/patient care. Caring 3. Perform interventions in a safe and effective manner. 4. Use therapeutic communication. Professional Behaviors 5. Demonstrate professional behaviors. Nurs 102 Syllabus Spring 2008 3 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. Faculty hours are posted on each instructor's office door in Clarkston or on the Level I bulletin board in Walla Walla. Walla Walla Campus: Nursing Office: 509-527-4240 Clarkston Campus: Nursing Office: 509-758-1702 Director of Nursing Education: Marilyn D. Galusha, RN, MS Walla Walla-based Instructors Office Email addresses Number Carolyn Dinkmeier, RN, MN 527-4248 firstname.lastname@example.org ( 1st Year Lead Instructor) Patti McBride, RN, MN 527-4242 email@example.com Grace Hiner, RNC, MSN, NNP-BC 527-4421 firstname.lastname@example.org Brenda Anderson, RN, BSN 527-4246 email@example.com (Walla Walla Skills Practice Lab) Clarkston-based Instructors Carol McFadyen, RN, Ph.D. 758-1728 firstname.lastname@example.org (Clarkston Lead Instructor) Todd Carpenter, RN, BSN 758-1787 email@example.com Barb Hays, RN, MSN 758-1717 firstname.lastname@example.org (Evening Track Instructor) Stephanie Carpenter, RN 758-1722 email@example.com (Clarkston Skills Practice Lab) Nurs 102 Syllabus Spring 2008 4 BEGINNING NURSING CONCEPTS II NURS 102 Grading Criteria & Distribution of Points CONTENT POINT DISTRIBUTION INSTRUCTOR Normal Maternal-Newborn 12 Carol McFadyen Women's Health 3 Todd Carpenter Special Senses 6 Sarah Jean Cooper & Todd Carpenter Cardiac I 12 Grace Hiner Peripheral Vascular 3 Todd Carpenter Gastrointestinal 12 Patti McBride Total Activities 48 ATI Pharmacology 20 ATI OB/NB 25 ATI Nutrition 15 3 Unit Tests 165 Final Examination 70 Total Test Points 295 Total Points Available 343 (Most classes will be taught via ITV see calendar for more detail.) Note: You must achieve a cumulative minimum of 75% on tests before activity points count toward your final grade. Course Expectations: 1. Attend all scheduled classes and activities 2. If absent from class, no points shall be awarded for missed in class activities 3. All assignments must be accounted for before progression regardless of score achieved. 4. Follow all policies as outlined in Nursing Handbook 5. Date stamp all papers as they are turned in. Late papers will receive a one-point deduction per school day, when turned in after class starts on the date due. Nurs 102 Syllabus Spring 2008 5 Assessment Technologies Institute (ATI) Testing Three (3) computerized mastery examination will be administered this quarter (proctored): Maternal-Newborn; Pharmacology; & Nutrition Prior to taking each content mastery examination, each student must complete a non-proctored mastery test and achieve a score of 90%. This non-proctored exam can be taken more than once however, a 90% must be achieved. In order to be admitted to the proctored exam, you will need to submit a copy of your non- proctored individual score to Carolyn/Carol, front page only. On each Content Mastery exam, a Proficiency Level II must be achieved. This is considered minimum competency. Failure to achieve a Level II Proficiency on the first secured test shall require remediation prior to retesting. Failure to achieve a Level II Proficiency prior to the end of spring quarter will result in an “I” contract. Failure to clear the “I” 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 each 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. The Level II Proficiency cut score will be considered a “ C” grade. ATI scores shall be averaged with the quarter tests scores Nurs 102 Syllabus Spring 2008 6 LEARNING GUIDES Nurs 102 Syllabus Spring 2008 7 Unit: Maternal-Newborn Nursing Class #1 Date: 4/1 ITV from Clarkston Topic Objective Assignments/Comments Introduction 1. Identify the goals of maternal newborn care and the roles of the Leifer, G. (2007) Introduction to th providers of care maternity & pediatric nursing, 5 ed. Philadelphia: Saunders, chap. 1, p 6-7 Antepartum 2. Calculate estimated date of delivery (EDD) using: Chapter 4, p. 44 – 77 EDD Nagele’s Rule McDonald’s Rule 3. Differentiate between presumptive, probable, and positive signs of Signs of pregnancy Box 4-3, p. 48 Pregnancy 4. Relate the physiologic and psychosocial changes during pregnancy to variations in assessment of the pregnant client Table 4-6, p. 73 - 76 Assessment Reproductive system Breasts Systemic changes Management of common discomforts of pregnancy 5. Describe the development of the fetus during each month of Pregnancy and factors that effect fetal development Organogenesis Chapter 3, p. 31 – 40 Fetal Development Critical Period Teratogens 6. Identify the assessment measures completed during prenatal care Health Assessment Laboratory and diagnostic testing Table 4-2, p. 53 Physical Examination Risk Assessment Nurs 102 Syllabus Spring 2008 8 Nutritional 7. Describe the nutritional needs of the pregnant mother and assessment Needs measures indicating adequate nutrition Weight gain pattern Assessment of nutrient intake Nurs 102 Syllabus Spring 2008 9 Unit: Maternal-Newborn Nursing Class #2 Date: 4/2 ITV from Clarkston Topic Objective Assignments/Comments 1. Describe the physiologic changes that occur during the postpartum period Liefer, Chapter 9, p. 199-214 Postpartum Involution Physiologic Lochia needs Perineum/episiotomy Systemic changes Changes in vital signs Breasts/lactation Assessment/ 2. Complete an assessment of a postpartum client and document Documentation assessment findings using correct terminology Health History Box 9 – 1, p. 201 Laboratory data Box 9 – 2, p. 211 Physical assessment Psychosocial assessment Nursing care plan 3. Develop a nursing care plan to meet the needs of the postpartum client Pain Nursing Care Plan 9 -1, p. 209 - 212 Risk for Infection Sleep Pattern Disturbance Alteration in Nutrition Alteration in Elimination Altered Tissue Perfusion (peripheral), Risk for Altered Sexuality Patterns, Risk for Altered Parenting, Risk for Nurs 102 Syllabus Spring 2008 10 Medications 4. Identify the actions, therapeutic effect, and nursing implications for medications given in the postpartal period Oxytoxics Pain medications Stool softeners/Laxatives Rubella vaccine RhoGam Nurs 102 Syllabus Spring 2008 11 Unit: Maternal-Newborn Nursing Class #3 Date: 4/7 ITV from Walla Walla Topic Objective Assignments/Comments Newborn 1 Relate the changes in physiologic function that occur at birth to Leifer, Chapter 9, p 215 – 234, Chap 12, Physiologic function assessment and care of the newborn 279 – 303. Respiratory system Circulatory system Thermoregulation GI system Renal function Hepatic function Immunologic function Neurologic function 2 Complete an assessment of the newborn and document findings Assessment/ Documentation using correct terminology Physical Assessment Gestational Age assessment Behavioral Assessment Medications Liefer, p. 151 3. Identify the actions, therapeutic effects, and nursing implications of medications given to the newborn Vitamin K Erythromycin ointment Nurs 102 Syllabus Spring 2008 12 Teaching Plan 4. Develop a teaching plan to meet the needs of parents of a newborn Daily care Sleeping Crying Circumcision care Continued Health Maintenance Car safety Meeting the nutritional needs of the newborn Breast feeding Bottle feeding Nurs 102 Syllabus Spring 2008 13 Unit: Maternal-Newborn Nursing Class #4 Date: 4/9 Live - Walla Walla 4/14 Live - Clarkston Topic Objective Assignments/Comments Preparation for 1. Identify the components of childbirth education classes Liefer, Chapter 7, p. 154-156 Childbirth Expectations during labor & delivery Managing discomfort during labor Conscious relaxation Managing discomfort during labor Controlled breathing Cutaneous stimulation Focusing Medications Liefer, Chap 6, p. 115-150 Intrapartum Care 2. Identify the signs of labor Signs of Preliminary Labor True vs: False Labor 3. Discuss the effect on labor progress for the following components of labor: Labor Passage Progress Passenger Powers Psyche Maternal / 4. Describe the maternal and fetal response during each stage of labor Table 6 – 3, p. 140-141 Fetal Response First Stage Latent Phase Active Phase Transition Second Stage Third Stage Fourth Stage Nurs 102 Syllabus Spring 2008 14 5. Describe nursing interventions related to pain control measures during labor Epidural Complete VCE on pain management Danger Signs 6. Identify the fetal and maternal danger signs during labor and delivery during labor and delivery Nurs 102 Syllabus Spring 2008 15 Unit: Women’s Health Date: 4/3 ITV from Clarkston Topic Objective Assignments/Comments Review of A&P 1. Review the anatomy and physiology of the female reproductive tract, including Lewis, et al. (Med Surg) Chap. 51, p the physiology of menstruation 1325-1342 Esp figs 51-3, 51-4, 51-5 Contraception 2. Describe the teaching needed for correct use of contraceptive Methods Leifer, (Maternity nursing: An Mechanical Barrier methods introductory text), Chap. 11, pp. 260- Hormonal Contraceptives 266 Vaginal Spermicides Infertility 3. Define infertility and describe the nurse’s role in working with infertile couples Leifer, Chap. 11, p. 268-272 Lewis, et al. Chap 54, p 1382-1383 4. Discuss the nursing care of the women undergoing diagnostic testing for Diagnostic Testing reproductive disorders Pelvic exam/ Pap smear Lewis,et al. Chap 51,p 1338-1341, Schiller’s Test table 51-12 Colposcopy Cervical/Endometrial Biopsy Cervical Conization Ultrasound Lewis, et al. Chap 51, p 1330-1331 5. Describe health promotion activities for the women experiencing Health Promotion menopause Lewis, et al. Chap. 51, p 1340, table Gerontological Considerations 51-12 GYN Surgery 6. Use the nursing process to provide care to a client undergoing GYN surgery Laporoscopy Lewis, et al. Chap 54, p 1404-1409 Dilatation & Curettage (D&C) Hysterectomy, Vaginal, Abdominal Anterior & Posterior Repair (A&P Repair) Nurs 102 Syllabus Spring 2008 16 Endometriosis 7. Compare and contrast the signs and symptoms, medical management and Lewis, et al. Chap 54, p 1395-1398 nursing care of the client with Endometriosis VS: Pelvic Inflammatory Disease (PID) Sexually 8. Identify the cause, treatment and prevention of the following sexually Leifer, Chap. 11, p. 254-258 Transmitted transmitted diseases (STD) Disease Syphilis Gonorrhea Herpes Chladmydia Human Papilloma Virus Trichimonas Candidias HIV/AIDS Warning signs of 9. Identify warning signs of cervical, ovarian, endometrial cancer Lewis, et al. Chap 54, p 1400-1404 cancer Breast Self 10. Describe the method for teaching breast self examination (BSE) to a client Examination Leifer Chap 11 p 250-251and skill 11- 1 Diagnostic 11. Describe the nursing care of clients undergoing diagnostic procedures of Procedures the breast Lewis, et al. Chap. 52, p 1344-1348 Mammography Ultrasonography Breast Biopsy Benign Breast 12. Describe the nursing care of clients with benign breast disorders Disorders Lewis, et al. Chap 52, p 1356-1360 13, Use the nursing process to develop a nursing care plan for a client NCP for breast with a malignant lesion in the breast malignancy Nurs 102 Syllabus Spring 2008 17 Unit: Disorders of the Eye Date: 4/16 ITV from Clarkston Topic Objective Assignments/Comments 1. Apply knowledge of the anatomy and physiology of the eye to care for the client Lewis et al, Chapters 21 & 22 (eyes with vision disorders only) pp 398-437 Structures Vision Age related considerations rd 2. Describe variations from normal assessment data indicating eye or visual Saunders, NCLEX-PN 3 edition. Assessment disorders using correct terminology. Chap. 54. pp 795-822. History (eyes only) Clinical manifestations Blurred vision Diplopia Photopsia Nursing Diagnosis Doenges et al Floaters “Sensory perception disturbed Scotomata (specify)” Photophobia Pain Loss of Vision Examination Outer structures Visual acuity Near vision Visual fields Eye movements Color vision PERRLA Nurs 102 Syllabus Spring 2008 18 Diagnostic Tests 3. Describe the significance of findings from selected diagnostic tests to care of the client with disorders of the eye Visual examination Intraocular pressure Fluorescein staining Slit lamp Nursing Diagnosis Medications 4. Identify the actions, therapeutic effects, and nursing implications in the “Risk for ineffective management of administration of ophthalmic medications therapeutic regimen, needs” Topical Anesthetics rd Topical Steroids Saunders, NCLEX-PN 3 edition Antiinfective Agents Review Eye medications chapter 55 pp 823-833. Antibiotic-Steroid Combinations Topical Antiviral Adrenergics Beta Blockers Miotics Mydriatics & cycloplegics NSAIDs Nursing Diagnosis Nursing Care and 5. Relate the clinical manifestations and care of the client to the following disorders “Anxiety” Interventions of the eye Infections/inflammation of the eye Health Promotion Strabismus & Health Cataracts Maintenance Glaucoma Retinal problems Macular degeneration Trauma & chemical burns Nursing Diagnosis Teaching Plan 6. Develop an age appropriate teaching plan to meet the learning needs of a client “Powerlessness” undergoing ocular surgery. Nurs 102 Syllabus Spring 2008 19 Nursing Care Plan 7. Develop a plan of care to meet the needs of a client with low or loss of vision Learning needs & barriers to learning Safety Adaptive Devices Community Resources Health Promotion 8. Discuss health promotion activities to prevent the loss of vision Nurs 102 Syllabus Spring 2008 20 Unit: Disorders of the Gastrointestinal System #1 Date: 4/22 ITV from Clarkston Topic Objective Assignments/Comments Assessing Clients 1. Review anatomy and physiology of the gastrointestinal system ( overview only) Lewis, chpt. 39 with Complaints of the GI System 2. Identify specific topics to consider during a health history assessment (omit Liver, Biliary Tract & Pancreas) interview Lewis, chpt. 39 3. Describe physical assessment techniques used to evaluate GI and nutritional status VCE assignment due 4. Identify abnormal findings that may indicate impairment in the GI system 5. Identify specific diagnostic studies used to evaluate and/or diagnose gastrointestinal dysfunction Lewis, chpt. 40 p 960-968 6. Describe nursing considerations related to a client receiving enteral or parenteral nutritional support Bring calculator 7. Calculate enteral feeding formulas Nurs 102 Syllabus Spring 2008 21 Unit: Disorders of the Gastrointestinal System #2 Date: 4/28 ITV from Clarkston Topic Objective Assignments/Comments Nursing Care for 1. Discuss the etiology, pathophysiology, and clinical manifestations of common Lewis chap. 42 Children and Adults oral inflammations and infections with Common Conditions of the 2. Describe pathophysiology and nursing management for a child with cleft Mouth and lip/cleft pallet Leifer – Pediatric- pg 326-327 Esophagus 3. Describe clinical manifestations and nursing implications related to oral/esophageal CA 4. Describe pathophysiology, clinical manifestations and nursing management of clients experiencing gastroesophageal reflux disease 5. Describe pathophysiology, clinical manifestations and nursing management of clients with a hiatal hernia Pharmacology 6. Discuss drugs affecting gastrointestinal secretions Related to GI system 7. Discuss emetic and antiemetic agents 8. Discuss laxatives and antidiarrheal agents Nurs 102 Syllabus Spring 2008 22 Unit: Disorders of ther Gastrointestinal System #3 Date: 4/29 ITV from Walla Walla Topic Objective Assignments/Comments Care of the Client 1. Differentiate between acute and chronic gastritis – include pathophysiology Lewis chap. 42; with Problems of and nursing management the Stomach and Upper Small 2. Compare and contrast gastric and duodenal ulcers (peptic ulcer disease) Leifer chap 27- pediatrics Intestine including pathophysiology, nursing management and collaborative therapy 3. Explain etiology, clinical manifestations, and nursing management of an upper gastrointestinal bleed, gastric perforation, and dumping syndrome 4. Describe clinical manifestations of gastric cancer 5. Compare and contrast various types of hernias 6. Describe pathophysiology, clinical manifestation and nursing management for an adult/child with a gastric outlet obstruction 7. Discuss placement and management of various gastric/intestinal tubes (NG, Salem Sump, Blakemore) Nurs 102 Syllabus Spring 2008 23 Unit: Disorders of the Gastrointestinal System #4 Date: 4/30 ITV from Walla Walla Topic Objective Assignments/Comments Care of the Client 1. Explain common etiologies, collaborative care and nursing management of Lewis, chap 43 (child/adult) Lower diarrhea and constipations Gastrointestinal Leifer- chap 27- pediatrics (limit to Problems 2. Discuss common causes of acute abdominal pain and nursing management topics identified) of a client following abdominal surgery 3. Compare and contrast ulcerative colitis and Crohn’s disease including pathophysiology, clinical manifestations, complications and nursing management 4. Discuss causes of bowel obstructions – include collaborative care and nursing management 5. Discuss the nursing implications and psychosocial response for a client experiencing colorectal cancer – ostomies 6. Differentiate between diverticulosis and diverticulitis 7. Describe various types of malabsorption syndromes 8. Describe various anorectal conditions with related nursing management Nurs 102 Syllabus Spring 2008 24 Unit: Disorders of the Cardiac System I #1 Date: 5/12 ITV from Clarkston Topic Objective Assignments/Comments Function of the 1. Apply knowledge of the anatomy & physiology of the cardiac system to Lewis Med-Surg Text, Chapter 32 (p. Heart care of the client with cardiac disorders 739-760) Blood flow Regulation of impulses Normal sinus rhythm Age related changes 2. Identify significance of variations from normal assessment findings for both the adult and child with cardiac disease Assessment S1 and S2 S3 and S4 Murmurs 3. Describe nursing interventions to prepare a client for and/or in response to findings from common laboratory and diagnostic studies: Laboratory/ EKG/ Holter Monitoring Diagnostic Studies Echocardiogram Cardiac catheterization 4. Identify the actions, side effects, and nursing implications for the following classes of medications: Utilize your NCLEX-PN review book to Medication Beta-Adrenergic Receptor Blockers (Beta Blockers) review all the cardiovascular atenolol (Tenormin) medications that we will be covering in propranolol (Inderal) the 4 cardiac lectures. Calcium Channel Blockers Chapter 51 begins on page 729, and diltiazem (Cardizem) the practice questions begin on page verapamil (Calan) 739. digoxin (Lanoxin) Davis Drug Guide is also a good Anticoagulants resource. heparin & lovenox warfarin (Coumadin) Nurs 102 Syllabus Spring 2008 25 Unit: Unit: Disorders of the Cardiac System I #2 Date: 5/13 ITV from ClarkstonWalla Walla Topic Objective Assignments/Comments Hypertensive 1. Compare & contrast the etiology & pathophysiology of the various types of Lewis Med-Surg Text, Chapter 33 (p. Vascular Disease hypertensive diseases: 761-783) Primary HTN Health Secondary HTN Promotion Teaching 2. Identify health promotion measures to reduce the risk of developing hypertension. 3. Develop a teaching plan for a client with newly diagnosed hypertension. Lifestyle Modifications Medications Diuretics chlorothiazide (Diuril) furosemide (Lasix) spironolactone (Aldactone) Angiotensin Converting Enzyme (ACE) Inhibitors Angiotensin Receptor Blockers (ARBs) Calcium Channel Blockers Beta-Adrenergic Blockers Vasodilators hydralazine (Apresoline) sodium nitroprusside (Nipride) 4. Describe the pathophysiology and clinical manifestations of congestive heart Congestive Heart failure. Lewis Med-Surg Text, Chapter 35 (p. Failure (CHF) Left sided failure 821-837) Right sided failure Nurs 102 Syllabus Spring 2008 26 5. Differentiate the nursing & collaborative management of the patient with acute congestive heart failure (CHF) & pulmonary edema versus chronic congestive heart failure. 6. Identify the actions, side effects, & nursing implications of medications used for a client with (CHF): ACE Inhibitors; ARBs Diuretics digoxin (Lanoxin) Vasodilators: sodium nitroprusside (Nipride) nitroglycerin Beta-Adrenergic Blockers Nurs 102 Syllabus Spring 2008 27 Unit: Disorders of the Cardiac System I #3 Date: 5/19 ITV from Walla Walla Topic Objective Assignments/Comments Coronary Artery 1. Describe the pathophysiology and clinical manifestations of coronary artery disease Lewis Med-Surg Text, Disease (CAD) and lipoprotein disorders Chapter 34 (p. 784-819) Health 2. Discuss health promotion measures for the client at risk for coronary artery disease: promotion Assignment: 3. Develop a teaching plan for a client with coronary artery disease or lipoprotein RISKO Paper: Due before Teaching disorder(s) cardiac class # 3. See handout given at 4. Differentiate between angina pectoris and myocardial infarction. beginning of quarter for RISKO Paper criteria and 5. Describe the nursing management of the patient following a myocardial infarction. RISKO form. Include psychosocial needs of the client. 6. Identify the actions, side effects, and nursing implications for the following Medications medications: Platelet Aggregation Inhibitors aspirin plavix Lipid Lowering Agents atorvastatin (Lipitor) lovastatin (Mevacor) simvastatin (Zocor) Nitrates--Nitroglycerin Angiotensin-Converting Enzyme Inhibitors captopril (Capoten) enalapril (Vasotec) Morphine Fibrinolytics Activase Retavase Nurs 102 Syllabus Spring 2008 28 Unit: Disorders of the Cardiac System I #4 Date: 5/29 ITV from Walla Walla Topic Objective Assignments/Comments Congenital Cardiac 1. Describe risk factors associated with congenital cardiac defects Leifer, Introduction to Maternity & th Defects Pediatric Nursing 5 ed. p. 2. Differentiate between the pathophysiology and clinical manifestations for the 596-609. Skip section on Kawasaki Pathophysiology following congenital cardiac defects Disease on page 606 & 607. Increased pulmonary blood flow ("Acyanotic") Atrial Septal Defect (ASD) Ventral Septal Defect (VSD) Saunders NCLEX-PN (3rd ed) p. 373 - Patent Ductus Arteriosis (PDA) 383 Obstructive defect Coarctation of the aorta Decreased pulmonary blood flow ("Cyanotic") Tetraology of Fallot Mixed Transposition of the great arteries CHF in child 3. Compare and contrast the pathophysiology and clinical manifestation and medical management of congestive heart failure in a child with an adult 4. Discuss the role of the nurse in assisting the family with a child with a Family Coping congenital cardiac defect to cope Saunders NCLEX-PN (3rd ed) p. 321- Strategies Meeting growth and developmental needs 323 Coping with a child with a life threatening condition Nurs 102 Syllabus Spring 2008 29 Unit: Disorders of the Vascular System (PVD) Date: 5/27 ITV from Walla Walla Topic Objective Assignments/Comments 1. Apply knowledge of the anatomy and physiology of the Peripheral Vascular Lewis, et al. Chap. 38 p 892-924 System in providing care to clients with disorders of this system. Arteries, capillaries, and veins Saunders Comprehensive Review for Factors affecting blood flow NCLEX-PN, 3rd Ed pp, 711-728. o Diameter of the vessel o Elastic recoil o Viscosity of blood o Age related considerations Assessment 2. Describe variations in assessment data for the client with disorders of the Peripheral Vascular System, and Arterial Disorders Clinical manifestations of vascular dysfunction o Pain o Intermittent claudication o Rest pain o Venous insufficiency o Ischemic neuropathy o Ulceration or gangrene o Changes in skin color, temperature, and integrity o Bruits o Abdominal pulsations History Risk factors Physical examination Pathophysiology 3. Review the pathophysiology and factors related to arteriosclerosis and Lewis et al. Chap 38 atherosclerosis Review anatomy and physiology of peripheral vascular system. Nurs 102 Syllabus Spring 2008 30 Diagnostic 4. Describe the nursing care of clients undergoing diagnostic testing and relate Lewis et al. Chap 38 Testing findings to the care of clients with peripheral vascular disorders. Common arterial diagnostic studies Common venous diagnostic studies 5. Identify the actions, therapeutic effects and nursing implications of Saunders Comprehensive Review for Medications medications used to treat peripheral vascular diseases. NCLEX-PN, 3rd ed. Pp 729-747 Hypolipedemics Anticoagulants Vasodilators Antiplatelet aggregation agents 6. Differentiate pathophysiology, assessment and medical management of Arterial vs: arterial vascular disease from venous vascular disease. Include: Nursing Diagnosis venous disease Aneurysms “ Ineffective Tissue Perfusion, Peripheral” Buerger's Disease Raynaud's Penomenon Venous Thrombosis Varicose Veins Information located throughout Health 7. Describe the goals of medical management of peripheral arterial and venous vascular disease and health maintenance activities to meet the goals. chapter Maintenance Diet Lifestyle Nursing Diagnosis Medications “ Knowledge Deficit”, Safety Prevention of complications 8. Develop a teaching plan for a client with peripheral vascular disease Nursing Diagnosis Readiness model for Smoking Cessation “Ineffective Health Maintenance” Nursing Diagnosis of patients with Peripheral Arterial Disease of the Lower Extremities Nurs 102 Syllabus Spring 2008 31 Unit: Disorders of the Ear Date: 5/21 Live - Clarkston 5/28 Live – Walla Walla Topic Objective Assignments/Comments Anatomy and Physiology 1. Apply knowledge of the anatomy and physiology of the ear to care for the Lewis et al Chap 20 pp 430-438 Chap client with hearing or balance disorders 21 pp 462-473 Outer ear Middle ear Inner ear Age related considerations Assessment/Diagnostic 2. Describe variations in assessment data for the client with disorders of Testing hearing and/or balance. Clinical manifestations Hearing loss - types Otalagia Otorrhea Tinnitus Vertigo History and Diagnostic procedures Hearing Pneumatoscopy Tuning Fork tests Audiometry Vestibular Balance, gait & past pointing Electronystagmography Caloric test Health Promotion 3. Identify the common causes of hearing loss. Develop a plan to prevent or decrease the incidence of hearing loss in children and adults 4. Define ototoxicity and list common medications that are ototoxic Silvestri NCLEX 3rd edition, pp 828- 830 (ear only) Nurs 102 Syllabus Spring 2008 32 5. Discuss nursing interventions and the rationale for the interventions used in the care of client with problems of the: Nursing Diagnosis Outer Ear. “ Social Interaction, Impaired”, Infections/inflammations Cerumen impaction Foreign bodies Middle Ear rd Otitis media – acute, chronic, and serous Silvestri. NCLEX, 3 edition, pp 358 Tympanic membrane rupture (Otitis Media) Mastoiditis Otosclerosis Foreign bodies Inner Ear Tinnitus and hearing loss Labyrinthitis Meniere’s disease Acoustic Neuroma 6. Develop a nursing care plan for the client undergoing surgery of the ear: Nursing Care Plan Tympanoplasty & myringotomy Nursing Diagnosis Stapedectomy “ Sensory-Perceptual Alteration Mastoidectomy (Auditory)”, Cochlear implants Communication with the 7. Describe the variations in communication for the hearing impaired client who is hearing impaired hospitalized. Guest speaker and Handouts 8. Compare and contrast the different types of hearing aids and the common problems encountered with each type Psychosocial Needs 9. Describe the psychosocial needs of the individual and family experiencing hearing loss and the nurses role in providing assistance to these individuals Nurs 102 Syllabus Spring 2008 33
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