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ST. PAUL UNIVERSITY, QUEZON CITY St. Paul University System Aurora Blvd.

, corner Gilmore Avenue, Quezon City


COLLEGE OF __NURSING_______ COURSE SYLLABUS & INSTRUCTIONAL GUIDE Paulinian Education for Social Transformation COURSE CODE and TITLE: NCM 106 CARE OF CLIENTS ACROSS THE LIFESPAN WITH PROBLEMS IN INFLAMMATORY AND IMMUNOLOGIC REACTION, CELLULAR ABERRATIONS, ACUTE BIOLOGIC CRISIS, INCLUDING EMERGENCY AND DISASTER NURSING CREDIT UNITS: COURSE DESCRIPTION: This course deals with the principles and techniques of nursing care management of sick clients across lifespan in varied settings with alterations / problems in inflammatory and immunologic reactions, cellular aberrations, acute biologic crisis, including emergency and disaster nursing and IV Therapy. PREREQUISITE(S): NCM 105 COURSE OBJECTIVES: Given actual clients with problems in inflammatory and immunologic reactions, cellular aberrations, acute biologic crisis and emergency, the students should be able to: 1. Utilize the nursing process in the care of individuals, families in selected settings. 1.1 Assess with client/s his/her/ their condition / health status through interview , physical examination, interpretation of laboratory findings 1.2 Identifies actual and potential nursing diagnosis 1.3 Plans appropriate nursing interventions with client/s and family for identified nursing diagnosis 1.4 Implements plan of care with client/s and family 1.5 Evaluates 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 5. Promotes personal and professional growth of self and others. COURSE OUTLINE Topi TOPIC (S) c No. 1 EXPECTED LEARNING OUTCOMES Correlat e the four classific ations of shock with their pathoph ysiology Formula te TIME FRA ME 24hrs LEARNING CONTENT LEARNING ACTIVITIES CRITICAL THINKING QUESTIONS/ APPLICATION STRATEGIES All lectures will be in PowerPoint presentation, printed in acetates, use diagrams/ illustrations to aid in exploring critical care nursing. Mr. Jones is a patient in the critical care unit who has experienced some shock episodes in recent ASSESSMENT STRATEGIES

CLIENTS IN CRITICAL CARE

KNOWLEDGE: I. Hemodynamic monitoring II. Measurement of hemodynamic parameters A. Intra-Arterial monitoring B. Pulmonary artery pressure monitoring C. Left atrial pressure monitoring D. Mixed venous oxygen saturation III. Cardiac Assist Devices

Utilize brainstorming activities and role playing on how to use the different hemodynamic monitoring system

Graded Recitation every meeting Pre test and Post test every meeting Submit a critique paper on any issue on withdrawal of life support, mechanical ventilator or

nursing diagnos es related to care critically ill patients Identify medical and nursing manage ment strategie s in the treatme nt of shock Correlat e effects of pharma cologic agents used to treat shock with nursing measur es for patients receivin g drug therapy

IV.

V.

VI.

VII.

A. Intra- aortic balloon pump B. Ventricular assist devices Intracranial Pressure Monitoring A. Types B. Management of patients with increased intracranial pressure Airway Assistance A. Oral airways B. Nasal C. Endotracheal intubation D. Tracheostomy Mechanical Ventilation A. Positive pressure ventilation B. Continuous Mandatory Ventilation C. Synchronized Intermittent Mandatory Ventilation D. Nursing Management E. Complications F. Weaning Ventilator Settings A. Positive End Expiratory Pressure B. Continuous Positive Airway Pressure C. Pressure Support Ventilation D. Inverse Ratio Ventilation E. Airway Pressure Release Ventilation F. Mandatory Minute Ventilation G. Proportional Assist Ventilation

days. While assessing the 48- hour intravenous flow rates, you note that each shift has been infusing the drug at a different rate. What are some possible explanations for the variation in the flow rates?

cardiac assist devices.

VALUES: Concern for others Critical thinking Discipline Competencies Coordination

Teamwork resourcefulness Respect for others Service Gentleness SKILLS: Given a client with acute responses to acute biologic crisis, the student will be able to: Identify significant subjective data from the client history. Apply knowledge of normal anatomy and physiology and assessment techniques in caring for clients with acute biologic crisis Formulate appropriate Nursing diagnosis as per priority. Discuss common health problems of client needing critical care 2 CLIENTS IN ACUTE BIOLOGIC CRISIS Compar e the etiology, pathoph ysiology , clinical manifest ations, and manage ment of infection s common ly found in critical settings Formula te 24hrs KNOWLEDGE I. Shock A. Classification B. Stages C. Collaborative Care Management II. Systemic Inflammatory Response Syndrome III. Respiratory System A. Review of anatomy and physiology B. Respiratory Distress Syndrome C. Pulmonary Embolism D. Tuberculosis E. Chest trauma F. Pulmonary Contusion G. Penetrating trauma H. Cor Pulmonale I. Bronchogenic Cancer Utilize brainstorming activities and six- thinking hats to elicit answers in topics that are not yet familiar to the students All lectures will be in PowerPoint presentation, printed in acetates, use diagrams/ illustrations to aid in exploring critical care nursing. You are caring for a 67year- old patient with lung cancer. His wife is always at his bedside. No other family members are available to assist with his care. He is not a candidate for surgical intervention, but he will have chemotherapy. What nursing interventions are important to institute with this patient? What are your Graded Recitation every meeting Pre test and Post test every meeting Submit a reaction paper on any article on any topics that were discussed in the module

nursing diagnos es related to care critically ill patients Identify medical and nursing manage ment strategie s in the treatme nt highrisk pregnan cy Describ e the home care intervent ions and patient teaching necessa ry for the patient with a perman ent disability

J. Pneumonia K. Atelectasis IV. High- risk Pregnancy A. Complications of Pregnancy 1. Bleeding during pregnancy 2. Preterm labor 3. Preterm rupture of membranes 4. Pregnancy- induced hypertension 5. Multiple pregnancy 6. Hydramnios 7. Post- term pregnancy 8. Pseudocyesis 9. Isoimmunization (Rh incompatibility) 10. Fetal Death B. With Pre-existing or Newly Acquired Illness 1. STD 2. Hematologic Disorder 3. Renal and Urinary Disorder 4. Respiratory Disorder 5. Rheumatic Disorder 6. GI Disorder 7. Neurologic Disorder 8. Musculoskeletal Disorder 9. Cardiovascular Disorder 10. Endocrine Disorder 11. Cancer 12. Mental Illness 13. Trauma VALUES Concern for others Critical thinking Discipline Competencies Coordination Teamwork resourcefulness

responsibilities to his family? What referrals might be appropriate?

Respect for others Service Gentleness SKILLS Discuss the concepts of shock and systemic inflammatory response syndrome Apply knowledge of normal anatomy and physiology and assessment techniques in caring for clients with acute biologic crisis Identify significant subjective data from the client history. Identify deviation from normal using IPPA and results of diagnostic test. Formulate appropriate nursing diagnosis as to priority. Interpret deviations from normal findings in physical assessment, and diagnostic and laboratory Monitor results of diagnostic tests and report abnormal findings Discuss common health problems of client with acute biologic crisis Utilize appropriate nursing interventions to restore and maintain the health of clients with acute biologic crisis Explain and discuss the evaluation of the nursing care plan utilizing the ethico-moral and legal principles. discuss the effectiveness of nursing care, revising nursing care plan as needed to promote, maintain, or restore functional health status of clients Maintain confidentiality and protect clients privacy in reporting and documenting

findings in the clinical area Care of Clients with Problems in Inflammatory and Immunologic Reactions At the end of the course, the student will be able to: 1. Discuss and review anatomy and physiology related to the immune system. 2. Describe the function and characteristics of the immune system. 3. Describe the bodys general immune responses. 4. Discuss the stages of the immune response. 5. Describe the bodys defense mechanism against infection. 6. Differentiate between cellular and humoral immune responses At the end of the Course the student will be able to: 1. Discuss the definition of infectious disease. 2. Recognize and discuss modern 16 hrs KNOWLEDGE A. Care of Clients with Infection Overview of the Immune System B. Normal Immune Responses Tissue inflammation Infection C. Care of Clients with altered Immunity 1. Altered Immune Responses. 2. Auto-Immune Disorder. 3. Tissue Transplant. 4. Impaired Immune Response. A.HIV Infection. VALUES Professionalism Respect for others Patience Resourcefulness Tactfulness Politeness Caring attitude Neatness Conscientiousness Independence SKILLS Assessment skills, Critical thinking, Communication skills, decision making, research, and nursing interventions KNOWLEDGE 1. Nursing process of Clients with infection/ altered immune response 2. Understanding and managing infectious and Communicable diseases. 3. Common Communicable diseases and their management. -Use of power point presentation, concept mapping and visual aids will be utilized for presentation. -Film showing regarding immune system. -Learner Centered approach such as : -Microlab learner centered approach, the class is divided into 6 groups. The leader poses one question regarding the topic and each person gets one minute to answer the question in turn, No one else will talk or ask question when its someone else turn, and afterwards debriefing of the discussion will be done. -Brainstorming of the assigned topic to the student will be done to enable the students to present their ideas and learning on the topic assigned to them. - A situation such as: Mr. Santos is a 73year old male who presents to his doctors office with hot reddened skin and itching and swelling on his right leg. He states that he scratched his leg on a piece of wire while bicycling. He is experiencing intermittent chills and has a temperature of 102.4F. Pertinent medical history includes diabetes mellitus, type I; pus is oozing from the injured area? 1.What was the bodys first line of defense against this infection 2. What sign and symptoms consistent with infection are exhibited in this patient? 3. Explain why pus is present? - Pre-test and post- test will be given every meeting. - Graded recitation every meeting - Reaction paper will be submitted in a particular topic that has significant impact on the life of the student and their environment. - Role playing on topics that needs to be discussed and studied thoroughly. - Focus group discussion - Formal assessment

Care of Clients with Infection/ Altered Immune Response.

Use of power point presentation, concept mapping and visual aids will be utilized for presentation. -Film showing regarding immune system. -Learner Centered approach such as : -Microlab learner centered approach, the

Students will be group into 6 to 7 for a focus group discussion and discussed relevant issues regarding the subject matter. A situation such as: Ms. Thomas , a 15 year old female, went to the emergency room with her mother , with the following

- Pre-test and post- test will be given every meeting. - Graded recitation every meeting - Reaction paper will be submitted in a particular topic that has significant impact on the life of the student and their environment.

infectious control threats. 3. Enumerate and discuss the different management of infectious a communicable diseases. 4. Differentiate between infectious and communicable disease. 5. Describe two ways disease is spread. 6. Enumerate 4 causes of infectious diseases. 7. Discuss the different stages of an infectious disease. 8. Discuss the different communicable diseases and its nursing management. 9. Enumerate the different infection control measures. Introduction to Cellular Aberration At the end of the topic, the students will be able to: 1. Explain the concept of cellular aberration. 2. Identify

VALUES Compassion Kindness Tactfulness Critical thinking Resourcefulness Creativeness Professionalism SKILLS Critical thinking, communication skills, assessment skills , Nursing intervention, decision making, Health teaching skills,

class is divided into 6 groups. The leader poses one question regarding the topic and each person gets one minute to answer the question in turn, No one else will talk or ask question when its someone else turn, and afterwards debriefing of the discussion will be done. -Brainstorming of the assigned topic to the student will be done to enable the students to present their ideas and learning on the topic assigned to them.

chief complaints: She reports becoming ill after returning from summer camp, she complained of nausea, vomiting, abdominal cramping and bloody diarrhea. The mother, who picked her up in the camp, tells you that the condition at the camp were less than sanitary. There was a barrel in her dormitory lobby filled with ice, reported Mrs. Thomas. there were leaves and grass floating in the barrel, She observed that the girls filled their water bottles from that barrel and that some of the campers dipped their arms and hands in the barrel. Once, she said that her daughter even dipped her head in the barrel after an especially long practice session. - What is likely the source of the patients illness? -How could this exposure have been prevented? Would you expect to see additional patients with similar symptoms? The students will be grouped into 3-4 groups with 8-10 members. They will be given a real life situation or a paper problem. They will identify cues and learning issues in the paper problem. They will assign topics among

- Role playing on topics that needs to be discussed and studied thoroughly. - Focus group discussion - Formal assessment

KNOWLEDGE : Definition, signs and symptoms, occurrence, and pathophysiology of cancer. VALUES: Caring, compassion, and teamwork

5.

Problem-based learning will be utilized. This includes self-directed learning and small group discussion. - Use of power point presentation, concept mapping and visual aids will

1. Short quizzes will be given before the start of PBL tutorial/s. 2. Class standing during small group discussion and PBL tutorial/s. 3. Formal assessment.

different stages and grade of cancer. 3. Identify nursing interventions for promotion of health and prevention of cancer. 3. Demonstrate caring attitude towards patient with cancer. 4. Demonstrate skills in health dissemination activities. Management of cancer At the end of the topic, the students will be able to: 1. Identify treatment modalities for cancer patients. 2. Demonstrate caring attitude and teamwork. 3. Discuss nursing interventions before, during and after treatment. On completion of this topic, the learner will be able to: 1. Describe emergency care as collaborative, holistic approach, that

SKILLS: Communication skills, decision making, research, and nursing interventions

be utilized for presentation.

themselves for the selfdirected learning (SDL). Small group discussion (SGD) will be done after SDL to help the group formulate their solutions to the problem. The groups will present their output in the plenary.

KNOWLEDGE Medical and surgical management to cancer. Nursing management of patient with cancer. Nursing actions during end of life crisis among cancer patients. VALUES Caring attitude, compassion, and teamwork. SKILLS Communication skills, problem solving, research, and nursing interventions KNOWLEDGE I. Assessment II. Nursing Diagnosis III.Plan/Implementation A. Head trauma B. Abdominal trauma C. Dental trauma D. Near drowning E. Poisoning

Problem-based learning will be utilized. This includes self-directed learning and small group discussion. - Use of power point presentation, concept mapping and visual aids will be utilized for presentation.

7 Emergency Nursing

Simulation of emergency situations Learner centered approaches.

The students will be grouped into 3-4 groups with 8-10 members. They will be given a real life situation or a paper problem. They will identify cues and learning issues in the paper problem. They will assign topics among themselves for the selfdirected learning (SDL). Small group discussion (SGD) will be done after SDL to help the group formulate their solutions to the problem. The groups will present their output in the plenary. A 23 year old man walks into the emergency department. He tells you that he was in a motor vehicle accident about 4 hours ago. The police were at the scene, but refused to be transported to the emergency

Short quizzes will be given before the start of PBL tutorial/s. 2. Class standing during small group discussion and PBL tutorial/s. 3. Formal assessment.

Disaster Nursing

includes the patient, family, and significant others. 2. Discuss priority emergency measures instituted for any patient with an emergency condition. 3. Compare and contrast the emergency management of patients with heat stroke, frostbite, and hypothermia. 4.Specify the similarities and differences of the emergency management of patients with swallowed or inhaled poisons, skin contamination, and food poisoning. On completion of this topic, the learner will be able to: 1. Categorize patient based on priority of care. 2. Classify the major types of disasters based on their unique characteristics and the consequences

F. Foreign body obstruction G. Trauma related to environment exposure H. Bites I. Burn trauma J. Simulation emergency situations VALUES Compassion Kindness Tactfulness Resourcefulness SKILLS Compare and contrast the emergency management of patients with heat stroke, frostbite, and hypothermia.

department because he felt fine, he went home. At home, however, the client started to experience worsening shoulder and posterior neck pain. His mother urged him to come to the emergency room. He tells you that he has numbness in his fingers and a tingling feeling in his right elbow. If you were the triage nurse: A. What potential problems would You consider that this client might have? B. Would you classify the client as emergent, urgent, or non-urgent? C. What measures should you take to ensure the clients safety?

Quizzes Graded Recitation Graded Simulation of emergency situations. Formal Assessment

18

KNOWLEDGE I. Essential of Disaster Planning II.Types of Disasters III. Health Effects of disasters IV. Hazard identification and vulnerability V. Disaster Management VI.Phases of disaster VALUES Compassion Kindness Tactfulness Resourcefulness

Learner centered approaches Show video clips of different disasters

Scenarios: Multiple patients have been arriving at the ED Complaining of burning eyes and difficulty of breathing. All of these persons work at the railroad yard, where there are frequently tankers trucks transporting chemical agents. What should you do first? Where do you find information about chemical agents and

Quizzes Graded Recitation Graded Simulation of emergency situations Formal Assessment

of these disasters if not managed properly. 3. Described two principles of disaster planning. 4. Identify hazards and analyzes, disaster vulnerability of the community. 5. Discuss nursing interventions during emergency and disaster situation.

their treatment? SKILLS Classify the major types of disasters based on their unique characteristics and the consequences of these disasters if not managed properly.

EVALUATION OF STUDENTS PERFORMANCE: Midterm Grade =60% (1/4)(UA1+UA2+UA3+UA4) + 40%ME Pre-Final Grade = 60% (1/4)(UA5+UA6+UA7+UA8) + 40%FE Final Grade= Midterm Grade + Pre-Final Grade 2 where ME= Midterm Examination Equivalent FE = Final Examination equivalent UA= Unit Average = ( Formal Assessment = Creative Assessments)

REQUIREMENTS: Class Participation/ Recitation Creative Assessment Projects, Linear Constructs, Conceptual Transforms Reflection papers, Reaction Papers , Book Reports, Critiques, etc. Four (4) Formal Assessments Summative Assessment = Midterm and Final Tests Others: ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

Minimum Learning Passing Percentage = 60% (i.e. 60/100=75%)


sources.

REFERENCES: Enumerate your references in APA format. Include recent books as well as journals accessed from the ONLINE JOURNAL collections in the SPUQC Library or from other websites. Be sure to acknowledge all web Smeltzer, Suzanne and Bare, Brenda. Brunner and Suddarths TEXTBOOK OF MEDICAL SURGICAL NURSING 11TH EDITION J.B. Lippincott Company, Philadelphia:USA 2010 Vol1&2 Kozier, Erb, et. Al. FUNDAMENTALS OF NURSING PRACTICE: CONCEPTS, PROCESS AND PRACTICE 7th Edition; Prentice Hall, New Jersey, 2010 Http:/evolve Elsevier.com/black/medsurg

Prepared by: ___________________________________________ SHERLY BILLIONES, CHERYLEEN TAN

Date _____

Reviewed by:

Date _____

Approved by:

Date _____________

_______________________________ WENDY DELOS SANTOS Area Team Leader/ Program Chair MARICAR TAN , WENDY DELOS SANTOS __________________________________ Name and Signature of the Faculty

SR. TRECELLA MAY MACALAM,SPC Dean, College of Health Sciences

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