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F.L.

VARGAS COLLEGE Bagay Road, Caritan Centro Tuguegarao City, Cagayan Valley COLLEGE OF HEALTH SCIENCES Course Name Course Code Course Description : CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE : NCM 103 : This course deals with the principles and techniques of nursing care management of sick clients across lifespan with emphasis on the adult and the older person, population group in any setting with alterations/problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocrine function. : 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical) : 144 lecture hours; 306 RLE hours : NCM 102 : 3rd year, 1st semester : At the end of the course and given relevant actual clients with problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism, and endocrine function, the student should be able to: 1. Utilize the nursing process in the care of individuals, families in community and hospital settings. Assess with client/s his/her/their condition/health status through interview, physical examination, interpretation of laboratory findings. Identify actual and at-risk nursing diagnosis Plan appropriate nursing interventions with client/s and family for identified nursing diagnosis Implement plan of care with client/s and family. Evaluate the progress of his/her/their clients condition and outcomes of care. 2. Ensure a well organized and accurate documentation system; 3. Relate with client/s and their family and the health team appropriately; 4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and, 5. Promote personal and professional growth of self and others.
INTERMEDIATE COMPETENCIES
1. Identify risk factors among clients that contribute to the development of problems in Oxygenation- cardiovascular risk factors (modifiable and

Course Credit Contact Hours/ Semester Pre-requisite Placement Course Objectives

OBJECTIVES
At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of

COURSE CONTENT
The different risk factors among clients that contribute to the development of problems in oxygenation: Current respiratory problems History of respiratory disease

TEACHING-LEARNING ACTIVITIES

VALUES INTEGRATION

TIME FRAME

EVALUATION

Pre-tests Case Analysis Small Group

Assertiveness Cooperation Participation

2.5 hours

After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors

2.

3.

4.

5.

individuals, families with problems in oxygenation in community and hospital settings; Ensure a well organized and accurate documentation system; Relate with client/s and their family and the health team appropriately; Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and, Promote personal and professional growth of self and others.

non-modifiable).

2. Identify significant
subjective data from client history related to problems in oxygenation.

Lifestyle (smoking, alcoholism, exercise patterns) Presence of cough Presence of Chest Pain Lung Cancer Cardiovascular disease Stroke Tuberculosis Obesity Dietary assessment Medication history a. Chief complaints b. Relevant information, to include eleven functional patterns Health perception management pattern Nutritional/metabolic pattern Elimination pattern Activity/exercise patterns Cognitive/perceptual pattern Sleep-rest pattern Self-perception-self-concept pattern Role relationship pattern Sexuality-reproductive pattern Coping-stress tolerance pattern Value-belief pattern a. b. c. d. Inspection- gas exchange, perfusion Palpation- gas exchange, perfusion Percussion- gas exchange Auscultation- gas exchange- heart sound, breath sounds, deviations, fluid transport

Learning Lecture Discussion Post test

Sensitivity

that contribute to the development of problems in oxygenation.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Postl test

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify significant subjective data from clients history by enumerating the possible chief complaints and recording relevant information guided by the eleven functional patterns.

3. Enumerate the principles and techniques of physical examination in assessing the oxygenation status in newborn, children, adults.

Demonstration Return Demonstration Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

3 hours

4.

Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in Oxygenation.

Screening procedure- peak flow meter Diagnostic Procedures Non-invasive: Pulmonary: e.g. sputum microscopy, chest xray, pulmonary function tests, smoke analyzer Fagerstrom test standardized degree of

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2.5 hours

The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adults oxygen status by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

5. Determine the Pathophysiologic mechanisms of the Alterations in oxygenation

a. b.

c. d.

6.

Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Oxygenation.

7. Identify principles of various modalities of management of clients with problems in oxygenation taking into

a.

nicotine dependence Cardiac: ultrasound, ECG, 2-D echo, stress test Vascular: Doppler ultrasonography Blood: pulse oximeter Invasive: Pulmonary: bronchoscopy, ABG, 3horacentesis, pulmonary angiography Cardiac: CO determination, cardiac catheterization, CVP, hemodynamics monitoring, enzyme levels, Serum, Cholesterol Vascular: angiography Blood: CBC and bone marrow biopsy Alteration in gas exchange ventilator dysfunction, impaired perfusion Alteration in cardiac performance heart rate problems, impaired stroke volume secondary to altered preload, afterload, myocardial contractility Alteration in vascular integrity transport network impairment Alteration in oxygen carrying capacity of the blood- decreased circulating erythrocytes (anemia), increased circulating erythrocytes (polycythemia) a. Ineffective breathing pattern b. Ineffective airway clearance c. Impaired gas exchange d. Inability to sustain spontaneous ventilation e. Dysfunctional 3entilatory weaning response f. Decreased cardiac output (CO) g. Altered tissue perfusion systemic h. Impaired gas exchange related to altered O2 carrying capacity of blood due to decreased erythrocytes/hemoglobin i. Activity intolerance related to malnutrition tissue hypoxia For altered pulmonary function: Airway patency Oxygen therapy Adequate ventilation

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

16 hours

The students should be able to determine the patho-physiologic mechanisms in the different oxygenation problems.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in oxygenation.

Pre-tests Case Analysis Small Group Learning

Assertiveness Cooperation Participation Sensitivity

4 hours

The students should be able to apply the various principles in the management of clients

consideration the following levels of care: 1. Health promotive 2. Disease preventive 3. Curative and restorative

8. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with oxygenation problems.

Drug therapy Hydration Removal of secretion Prevention of infection Prevention of complications Prevention of psychosocial problems Rehabilitation b. For cardiac function Hemodynamics monitoring O2 therapy Drug therapy Hydration Prevention of infection Prevention of complications Prevention of psychosocial problems Rehabilitation c. Oxygen carrying capacity of the blood Blood component replacement O2 therapy Drug therapy Hydration Prevention of infection Prevention of complications a. Pulmonary Bronchodilators Expectorants Antitussives Antihistamines b. Cardiac Sympathomymetic agents Sympatholytic agents Anti-anginal agents Anti- arrhythmic agents Angiotensin converting enzyme inhibitors Antilipemic agents Anticoagulant agents Thrombolytics Peripheral vascular agents c. Blood Hematinics Vitamin supplements

Lecture Discussion Post test

with problems in oxygenation in the actual clinical nursing practice. The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications of clients with oxygenation problems.

9. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in oxygenation.

1.

Safe and comprehensive perioperative nursing care 1.1 Assessment and care during the perioperative period 1.2 Techniques in assisting the surgical team during the operation 1.3 Principles of safety, comfort and privacy during the perioperative period 1.4 Nursing responsibilities during the perioperative period Preoperative physical, psychological, spiritual preparation Intraoperative circulating nurse functions, scrub nurse functions Postoperative airway, breathings, circulation priorities. Meeting the physical, psychological and spiritual needs of the cliet. 2. Pulmonary a. Surgical procedures tracheostomy, thoracostomy, lung resection, lobectomy, pneumonectomy, thoracoplasty, decortications b. Special procedures endotrcheal/tracheal suctioning and care, humidication, IPPB, ventilator assist 3. Cardiac a. Surgical procedures coronary aretery bypass, pacemaker insertion, valve replacement, repair of congenital abnormality, insertion of ventricular assist device, heart plansplant b. Special procedures laser therapy, basic life support, advance life support 3.1 Vascular a. Surgical procedures endarterectomy, aneurysmectomy, insertion of intravascular stents b. Special procedures application of antiembolic stockings 3.2 Blood forming organs a. Surgical procedures bone marrow aspiration, bone marrow transplant b. Special procedures blood component transfusion, reverse isolation

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

The students will be able to list the different surgical and special procedures for clients with oxygenation problems and identify the nursing responsibilities in each procedure.

At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of individuals, families with problems in Fluids and electrolyte imbalances in community and hospital settings. 2. Ensure a well organized and accurate documentation system; 3. Relate with client/s and their family and the health team appropriately; 4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and, 5. Promote personal and professional growth of self and others.

10. Identify risk factors among clients that contribute to the development of problems in Fluid and Electrolytes.

Potential factors for exceeding renal reserve capacity, dietary habits to include salt intake, hypertension, infection, diabetes.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

1.5 hours

11. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.

Inspection- signs of dehydration, overhydration Palpation- edema, ascites, neck vein filling, hand vein filling, neuromuscular irritability, characteristic of pulse Percussion- abdomen for presence of air, fluid Auscultation- rates

Demonstration Return Demonstration Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

12. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in 13. Determine the Pathophysiologic Mechanisms of Fluid and electrolyte imbalances.

a. Diagnostic tests Non-invasive: electrolyte determination, intake and output, KUB-IVP and ultrasound Invasive biopsy b. Weight c. Vital Signs a. b. c. Volume impairment fluid volume deficit, fluid volume excess, third space fluid shift Osmotic imbalances hyponatremia, hypernatremia Ionic concentration problems hypo- and hyperkalemia; hypo and hyperchloremia; hypoand hypermagnesemia; hypo- and hyperphosphatemia Acid and base imbalances metabolic acidosis and alkalosis; respiratory acidosis and alkalosis

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

1.5 hours

After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in fluid and electrolyte imbalances. The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adults fluids and electrolyte balance status by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

Assertiveness Cooperation Participation Sensitivity

12 hours

The students should be able to determine the patho-physiologic mechanisms in the different fluid and electrolyte imbalances.

d.

14. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Fluid and electrolyte imbalance.

a. b. c. d.

Risk for fluid volume deficit Fluid volume excess Fluid volume deficit High risk for injury related to electrolyte deficit/excess e. High risk for injury related to acid/base

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in fluid

15. Identify principles of various modalities of management of clients with problems in fluid and electrolyte imbalances taking into consideration the following levels of care: a. Health promotive b. Disease preventive c. Curative and restorative

imbalance f. Altered urinary elimination g. Impaired integumentary integrity a. Fluid Volume Deficit Determination and management of cause Hydration Blood transfusion as needed Drug therapy electrolyte Supportive management Prevention of infection Prevention of complication Prevention of psychosocial problems Rehabilitation b. Fluid Volume Excess Determination and management of cause Drug therapy diuretics, electrolytes Dietary restriction sodium Supportive management Prevention of infection Prevention of complication Prevention of psychosocial problems Rehabilitation c. Electrolyte Deficit hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia Determination and management of cause Drug therapy electrolyte replacement Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation d. Electrolyte Excess hyperkalemia, 7ypercalcaemia, hypermagnesemia, hyperphosphatemia Determination and management of cause Drug therapy electrolyte replacement Dietary management

and electrolyte imbalances.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

12 hours

The students should be able to apply the various principles in the management of clients with problems in fluid and electrolyte imbalance in the actual clinical nursing practice. The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

e.

f.

g.

Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation Metabolic Alkalosis Base bicarbonate exces Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation a. Metabolic Acidosis- base bicarbonate deficit Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation Respiratory Alkalosis carbonic and acid deficit Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation Respiratory Acidosis carbonic acid excess Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

16. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients in fluid and electrolyte imbalances.

17. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances. At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of individuals, families with problems in nutrition and metabolism in community and hospital settings. 2. Ensure a well organized and accurate documentation system; 3. Relate with client/s and their family and the health team 18. Identify risk factors among clients that contribute to the development of problems in Nutrition and Metabolism.

Fluid Parenteral fluids Hypotonic Hypertonic Isotonic b. Electrolyte Sodium Potassium Calcium Magnesium Phosphate c. diuretics Potassium-sparing Potasium-losing Osmotic diuretics d. Vitamin D supplements Renal dysfunction a. Major surgical procedures nephrectomy, nephrostomy, cystectomy, uterostomy, renal transplants, urinary diversion b. Special procedures- peritoneal dialysis, hemodialysis, bladder training, cystoclysis/bladder irrigation Risk factors related to malnutrition, obesity.

a.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2.5 hours

The students should be able to enumerate the different medications in managing clients with fluid and electrolyte imbalances, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

1 hour

19. Identify significant subjective data from client history related to problems in nutrition and metabolism.

a. b.

Chief complaints Relevant information, to include eleven functional patterns Health perception management pattern Nutritional/metabolic pattern Elimination pattern Activity/exercise patterns Cognitive/perceptual pattern Sleep-rest pattern Self-perception-self-concept pattern Role relationship pattern

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

The students will be able to list the different surgical and special procedures for clients with fluid and electrolyte imbalance and identify the nursing responsibilities in each procedure. After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in nutrition and metabolism. The students should be able to identify significant subjective data from clients history by enumerating the possible chief complaints and recording relevant information guided by the eleven functional patterns

appropriately; 4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and, 5. Promote personal and professional growth of self and others.

20. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.

Sexuality-reproductive pattern Coping-stress tolerance pattern Value-belief pattern Demonstration Return Demonstration Lecture Discussion Post test Assertiveness Cooperation Participation Sensitivity 1.5 hours The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adults nutritional and metabolic status by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

3.3 Gastrointestinal function IPPA Inspection- color, texture of skin, mucous membrane, growth patterns, scars, masses Auscultation- bowel sounds, bruits Palpation focus on GIT for presence of masses, ascites, rebound tenderness, distention Percussion liver span, masses

21. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in Nutrition and Metabolism. 22. Determine the Pathophysiologic mechanisms of the Alterations in Nutrition and Metabolism.

a. b.

Non-invasive: ultrasound of the abdomen, stool culture Invasive: to include: barium swallow, esophagoscopy, biopsy, cytology examination, gastric secretion analysis, endoscopy (gastroscopy, duodenoscopy), proctosigmoidoscopy and rectal examination Disturbances in ingestion problems in buccal cavity and esophagus Disturbances in digestion peptic acid disease, gastritis and gastric cancer Disturbances in absorption malnutrition, malabsorption syndrome and inflammatory bowel conditions Disturbances in elimination bowel obstruction, hemorrhoids, diarrhea and constipation. Alteration in nutrition less than body requirement Alteration in nutrition more than body requirement Alteration in oral mucous membrane integrity Alteration in comfort: epigastric pain/abdominal pain Fluid volume deficit A. Disturbances in ingestion Determination and management of cause Drug therapy

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

1.5 hours

a. b. c.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

12 hours

The students should able to determine patho-physiologic mechanisms in different nutritional metabolic problems.

be the the and

d. 23. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Nutrition and Metabolism. a. b. c. d. e. 24. Identify principles of various modalities of management of clients with problems in Nutrition and Metabolism

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test Pre-tests Case Analysis Small Group Learning

Assertiveness Cooperation Participation Sensitivity

1.5 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in nutrition and metabolism. The students should be able to apply the various principles in the management of clients

Assertiveness Cooperation Participation Sensitivity

12 hours

taking into consideration the following levels of care: 4. Health promotive 5. Disease preventive 6. Curative and restorative

Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation B. Disturbances in digestion Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation C. Disturbances in absorption Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation D. Disturbances in elimination Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation E. Disturbances in hepatic, biliary and pancreatic functions Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

Lecture Discussion Post test

with problems in nutrition and metabolism in the actual clinical nursing practice. The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

25. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with Nutrition and Metabolism problems.

Antiemetics Anticoagulants Hematinics agents Laxatives and stool softeners Antipruritus Vitamin supplement Antacids Antihyperlipidemics Antispasmodics Antidiarrheal

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2 hours

26. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in Nutrition and Metabolism.

a.

b.

At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of individuals, families with problems in endocrine functioning in community and hospital settings. 2. Ensure a well organized and accurate documentation system; 3. Relate with client/s and their family and the health team appropriately; 4. Observe bioethical concepts/principles,

27. Identify risk factors among clients that contribute to the development of problems in Endocrine Function.

Surgical procedures gastrostomy, gastrectomy, colostomy, hemorrhoidectomy, gastrointestinal bypass, ileostomy Special procedures parenteral hyperalimentation; feeding per nasogastric, jejunostomy, gastrostomy tubes; colostomy care and irrigation, dietary planning for common GT and endocrine problems; administering medications via NGT, J tube, G tube; hot sitz bath Risk factors related to endocrine hypo or hyperfunctioning.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2.5 hours

The students should be able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications of clients with nutrition and metabolism disorders. The students will be able to list the different surgical and special procedures for clients with nutrition and metabolism problems and identify the nursing responsibilities in each procedure. After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in endocrine functioning. The students should be able to identify significant subjective data from clients history by enumerating the possible chief complaints and recording relevant information guided by the eleven functional patterns

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

1.5 hours

28. Identify significant subjective data from client history related to problems in endocrine functioning.

A. Chief complaints B. Relevant information, to include eleven functional patterns Health perception management pattern Nutritional/metabolic pattern Elimination pattern Activity/exercise patterns Cognitive/perceptual pattern Sleep-rest pattern Self-perception-self-concept pattern Role relationship pattern Sexuality-reproductive pattern Coping-stress tolerance pattern Value-belief pattern

Assertiveness Cooperation Participation Sensitivity

2 hours

core values and nursing standards in the care of clients; and, 5. Promote personal and professional growth of self and others.

29. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal in the endocrine system.

a.

Inspection- color, texture of skin, mucous membrane, growth patterns, obesity Auscultation bruit, heart sounds, breath sounds Palpation- organ-thyroid enlargement, masses, edema Percussion- fluid, edema Others weight, delayed healing of wounds Screening: glucose tolerance test Non-invasive: e.g. GI x-ray, ultrasound abdomen, Radio-iodine assay (RAI), protein bound iodine (PBI), thyroid scan, free thyroxin level, basal metabolic rate (BMR), thyroxine stimulating hormone (TSH) test, OGTT (Glucose tolerance test) urinalysis (glycosuria, ketonuria) Invasive: e.g. percutaneous transhepatic cholangiogram, liver function test, serum thyroxine and triiodothyronine test, iodine 131 uptake, blood sugar tests (fasting blood sugar FBS), random blood sugar (RBS), glycosylated hemoglobin (Hgb), two-hour post prandial blood glucose, endocrine assay. Hypo- and Hyperfunction of the pituitary organ Hypo- and Hyperfunction of the hypothalamus Hypo- and Hyperfunction of the thyroid organ Hypo- and Hyperfunction of the parathyroid organ Hypo- and Hyperfunction of the adrenal organ Hypo- and Hyperfunction of the gonads Problems in glucose metabolism hypoglycemia and hyperglycemia (IDM, NIDDM) Alterations in nutrition less than body requirement Fluid volume deficit Activity intolerance

Demonstration Return Demonstration Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

1.5 hours

30. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in endocrine functioning.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2.5 hours

The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adults endocrine functioning by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

31. Determine the Pathophysiologic mechanisms of the Alterations in endocrine functioning.

a. b. c. d. e. f. g.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

10 hours

The students should be able to determine the patho-physiologic mechanisms in the different endocrine problems.

32. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in endocrine functioning.

a. b. c.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test Pre-tests Case Analysis

Assertiveness Cooperation Participation Sensitivity

1.5 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in endocrine functioning. The students should be able to apply the various

33. Enumerate Pharmacologic actions,

Corticosteroids Alpha-adrenergic blocking agents

Assertiveness Cooperation

2.5 hours

therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with endocrine problems.

Beta-adrenergic blocking agents Tyrosine inhibitors Dopamine receptor antagonists Glucocorticoids Parathyroid hormone agents Thyroid hormone agents Insulin Oral hypoglycemic agents

Small Group Learning Lecture Discussion Post test

Participation Sensitivity

34. Identify principles of various modalities of management of clients with problems in endocrine functioning taking into consideration the following levels of care: a. Health promotive b. Disease preventive c. Curative and restorative

Determination and management of cause Drug therapy - diuretics, electrolytes Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

12 hours

35. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in endocrine functioning.

a. b.

Surgical procedures thyroidectomy, parathyroidectomy Special procedures monitoring of blood glucose levels; maintenance of blood glucose diet, exercise, drugs

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

2.5 hours

principles in the management of clients with problems in endocrine functioning in the actual clinical nursing practice. The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration. The students should be able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications of clients with endocrine problems. The students will be able to list the different surgical and special procedures for clients with endocrine problems and identify the nursing responsibilities in each procedure.

References: th 1. Lippincott Williams & Wilkins. The Lippincott Manual of Nursing Practice 7 edition. 2001. th 2. Marieb, Elaine N. Essentials of Human Anatomy and Physiology 8 edition. Pearson Education South Asia PTE. LTD. 2006 th 3. Brunner and Suddarth. Textbook of Medical-Surgical Nursing 12 edition. 2010

Prepared by: FREIDA MICHELLE BONNIT-TAJA, RN, MAN Instructor Approved by: MR. JOSEPH B. FURIGAY Director for Instruction

Recommending Approval: KATLYN C. MANGUPAG, RN, MSN OIC, COLLEGE OF HEALTH SCIENCES