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I. II. III. IV. COURSE NUMBER: NCM 104 COURSE TITLE: CELLULAR ABERRATION/ONCOLOGY NURSING AIM: Demonstrates understanding the basic nature of a human cell and its compartments; as well as the effect of gene mutation in the cellular functioning. COURSE DESCRIPTION: This is a study of how cancer had developed in the human system; emphasis of basic medical and nursing management for cancer patients across the lifespan. V. LEARNING OBJECTIVES: On completion of this concept, the learner will be able to: a. Compare the structure and function of the normal cell and the cancer cell. b. Discuss the mitotic cell division, cell cycle, and its relationship to carcinogenesis and the administration of radiation or chemotherapeutic agents. c. Explain the biology of cellular aberration: Epidemiology and etiology. d. Describe the significance of health education and preventive care in decreasing the incidence of cancer. e. f. g. h. i. Familiarize the common warning signs of cancer. Differentiate the characteristics of benign and malignant neoplasm. Emphasize the steps in cancer prevention. Classify malignant tumors and the purpose of TNM classification. Familiarize cancer screening guidelines for asymptomatic people; know the common laboratory and diagnostic tests; appreciate the different types of biopsy. j. Discuss the goal of cancer therapy: cure, control, palliative, and prophylaxis. k. Identify tumor markers of specific oncologic disorder and discuss the modalities of cancer treatment l. Describe the roles of surgery, radiation therapy, chemotherapy, bone marrow transplantation, and other therapies in treating cancer. m. n. o. p. q. Describe the special nursing needs of patients receiving chemotherapy. Describe common nursing diagnoses and collaborative problems of patients with cancer. Use the nursing process as a framework for care of patients with cancer. Describe the concept of hospice in providing care for patients with advanced cancer. Discuss the role of the nurse in assessment and management of common oncologic emergencies.

r. Explain the pathophysiology of the common oncologic disorders including the nursing process approach VI. PRE-REQUISITES: NCM 103 and NCM 103.1

VII. TIME ALLOTMENT: 40 hours (lecture) VIII. UNITS CREDIT: 16 units (8 hours lecture, 8 hours RLE) Prepared by: Elizalde D. Bana, RN

TIME FRAME: First semester; Total weekly hours: 40 hours/week; Laboratory: 3 days/week (24 hours); Lecture: 5 days/week (40 hours) STRATEGY: Class discussion, class participation, visual aids, videos pertaining to the specified topic(s), community and hospital exposures (in the RLE), reporting, assignments, and quizzes. IX. Course Outcomes: CO # Description PO1 PO2 PO3 PO4 PO5 PO6 PO7

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State, explain and discuss the nature of normal cells and cancer cells, the mitotic cell division, the characteristics of cellular aberration, epidemiology and etiology, Explain and discuss the nature of oncology nursing evidences, screening guidelines, procedures and techniques and goal cancer therapy: surgery, radiation, chemotherapy, bone marrow transplant and other cancer treatment. Describe the concept of palliative care, hospice care in providing care for patients with advanced cancer.

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SPECIFIC OBJECTIVES Set learning contract and emphasize the VMGO of the school in the class. Know the basic compartments of the cell and its functions; mitotic cell division; phases of cell cycle; its relationship with chemotherapeutic agents administration LEARNING CONTENT VMGO orientation TEACHING LEARNING ACTIVITIES CLASSROOM RLE LECTURE PROBLEMPRESENTATION SOLVING (20%) S (60%) BOARD TYPE Practice the core EXERCISES values of the (20%) college College of Nursing Handbook Make an illustration of the anatomy of the cell and explain the physiology of each compartment Get oriented with # OF HRS RLE LEC EVALUATION 1. The students presented the innermost vision, mission, goal, and objective of the school 2. Class participation in group discussions 3. Pre-test(s) or posttest(s) will be given; announced or unannounced 4. The students are expected to read and prepare their

OVERVIEW OF CELLULAR ABERRATION Definition of cancer Medical terminologies Alopecia Anaplasia Apoptosis Biologic response modifier (BRM) therapy Biopsy Brachytherapy

The use of medical

Cancer Carcinogenesis Chemotherapy Control Cure Cytokines Dysplasia Extravasation Grading Graft Versus Host Defense (GVHD) Graft Versus Disease Effect (GVDE) Hyperplasia Malignant Metaplasia Metastasis Myelosuppression Nadir Neoplasia Neutropenia Oncology Palliation Radiation therapy Stomatitis Staging Targeted therapies Thrombocytopenia Tumor-specific antigen (TSA) Vesicant Xerostomia The organelles or compartments of the cell Cell membrane Nucleus Cytoplasm Endoplasmic reticulum Ribosomes Golgi complex Lysosomes Peroxisomes

dictionaries in understanding the common medical terminologies

the equipment and facilities of the hospital for cancer patients Meet cancer patients and have a therapeutic data gathering Application of therapeutic communications Emotional support Compare the clients health status before and after having cellular aberration based on clients previous history Maintain privacy and use the therapeutic offering of self Study every medical intervention given by the oncologist Familiarize the common medications and adverse effects of chemotherapeutic drugs Differentiate medical management from nursing management in caring cancer patients Care of the client with stomatitis, skin desquamation,

lessons 5. The major reference material(s) introduced by the clinical instructor(s) must be emphasized for consistency of the subject matter 6. Case studies/presentation

Differentiate malignant cells.



Mitochondria Mitotic cell diviison Prophase Metaphase Anaphase Telophase Cytokinesis Phases of cell cycle Go phase G1 phase S phase G2 phase M Phase Cellular proliferation Loss of contact inhibition Cell biology of cancer Top 10 Causes of Mortality Top 10 Cancers Major dysfunction in the cell: Tumors (neoplasms) Benign Malignant Vascular system Lymphatic system Implantation Seeding Classification of cancer Route of metastasis Vascular Endothelial Growth Factor Angiogenesis Common sites of metastasis Characteristics of benign and malignant neoplasms Epidemiology and etiology Bacteria Fungi Viruses

Teaching materials appropriate in illustrating the morphology and physiology of the cell

Classify different forms of cancers according to cellular origin; methods, routes, and common sites of metastasis; the contribution of VEGF and angiogenesis to neoplasm development; characteristics of benign and malignant neoplasms. Explain the epidemiology etiology of cancer. and

Filmstrip about the mitotic cell division, cytokinesis, and phases of cell cycle

and fatigue as a product of cancer therapy Care of the client with fluids, electrolytes, and acid-base imbalances Assisting the physician in performing biopsy procedures or getting specimens Familiarize the boundaries of dependent, independent, and collaborative functions Pre-operative education to patient who will undergo biopsy Post-operative interventions after biopsy Observe the introduction of sealed and unsealed source radiation therapy Practice the standard precautionary measures in preventing exposure to radiations Nursing interventions to adverse effects of radiation therapy Nursing care for patients with

Familiarize the warning signs of cancer Discuss cancer the development of

Physical agents Chemical agents Genetic and familial factor Dietary factors Hormonal agents Idiopathic cancers

News and updates of cancer trends Tables of benign and malignant neoplasms including the method of spread

Identify and give examples of the 3 levels of prevention Discuss the vital functions of the immune or lymphatic system

The Nine (9) Warning Signs of Cancer Steps of carcinogenesis Levels of Prevention

adverse effects to chemotherapeutic agents and extravasations Immediate nursing interventions to clients with oncological emergencies (obstructive, metabolic, and infiltrative)

Familiarize the top ten (10) steps in preventing cancer formation Demonstrate and familiarize the steps of breast self-examination Discuss the importance of diagnostic and laboratory tests in identifying neoplasms Identify different forms of neoplasms according to cellular origin;

The Role of the Immune System Normal Immune Responses Immune System Failure Agammaglobulinemia versus hypogammaglobulinemia Top ten (10) steps of cancer prevention The Seven (7) Ps of Breast SelfExamination Secondary Preventions of Cancer

Animation: cancer development and metastasis

Explain and cite some examples of different factors that contributes to cancer

Explain the TNM classifying tumors.



Compare the distinct characteristics of benign and

Classification of malignant tumors Cellular origin Carcinoma Adenocarcinoma Sarcoma Embryonal Lymphomas Leukemias

Common signs and symptoms of cancer manifestations

malignant neoplasms. Familiarize the different grading and staging system of cancer. Explain the cancer screening guidelines of asymptomatic clients.

TNM classification Names of Selected Benign and Malignant Tumors According to Tissue Types Grading and Staging the Tumors

Cite some Scenarios

Overview of Anatomy and Physiology

Enumerate and explain the common diagnostic tests; and discuss the different types of biopsy in determining cellular aberration.

Cancer screening guidelines for asymptomatic clients Colorectal cancer Breast cancer Cervical and uterine cancer Prostate cancer Health counselling and cancer check-up Treatment of cancer: diagnostics Common diagnostic tests Biopsy Needle Incisional Excisional Endoscopic Goals of cancer therapy Cure Control Palliative Prophylaxis Tumor Markers Chemotherapeutic Agents Classification of chemotherapeutic agents Administration of chemotherapeutic agents

Preferable foods for a healthy body Overview of the procedure

Describe the therapy

goals of cancer

Enumerate the common diagnostic and laboratory tests

Discuss the markers.



Examples of malignant tumors as specified in the Medical-Surgical Nursing book

Explain the basis of administering chemotherapeutic agents.

Dosage Special Problems: Extravasation Toxicity Modalities of cancer treatment Surgery Diagnostic surgery Staging surgery Curative surgery Palliative surgery Reconstructive surgery Preventive surgery Factors to consider for prophylactic surgery Side effects of surgery Goal of Chemotherapy Types of chemotherapy Combination therapy Adjuvant therapy Immunotherapy Vascular access methods of administration Nursing interventions in chemotherapy Chemotherapy: Problems and Nursing Implications Bone marrow depression Pulmonary toxicity Hyperuricemia Alopecia Stomatitis (mucositis) GIT disturbances o Anorexia o Nausea o Vomiting o Diarrhea o Constipation Tissue irritation, necrosis, ulceration from infusion therapy

TNM identification and interpretation Characteristics of benign and malignant neoplasms

Describe the modalities of cancer treatment. Namely: surgery, chemotherapy, radiation therapy, and nursing management.

Enumerate the grades and stages of cancer Specifications of screening guidelines frequency and interval based on age of client diagnosed with cancer

Presentation of different forms of biopsy

Qualifications of treatment goals for cancer patients based on the status.

Hematologic system o Thrombocytopenia o Leukopenia o Anemia Reproductive system Neurologic system Nursing Alert for Extravasation Radiation therapy Goal of radiation therapy Types of energy Alpha Beta Gamma Types of radiation therapy External beam therapy Implant therapy Unsealed source (isotope or radiopharmaceutical) Adverse effects of radiation therapy Safety precautions of preventing excessive exposure for health care providers Time Distance Shielding Bone Marrow Transplant Types of Donor Stem Cells Allogeneic Autologous Syngeneic Post-Transplantation Period of BMT Complications of BMT Failure to engraft GVHD in Allogeneic Transplants Veno-occlusive Radiation Safety Precautions Nursing implications and chemotherapy

Laboratory results Bodys response to chemotherapeuti c agents in relation to cellular activity (cell division and cycle) Purposes of different forms of surgery, chemotherapy, and radiation therapy; including the nursing implementations of each treatment. Common cancer cases requiring surgery. Reinforcement of the emotional status of clients with body loss resulting from surgery Emphasis of the toxic effects of chemotherapeuti c agents Nursing interventions for specific expected outcomes of chemotherapy

Enumerate the basic nursing interventions of chemotherapy according to: Psychosocial level Nutrition Elimination pattern Prevent/Decrease infectious process Prevent/Decrease haematological complication Maintain activity level Recognize complications specific to radiation and chemotherapy Oncological emergencies

Sealed Source and/or Systemic radiation Unsealed source

Discuss the common oncologic disorders in a nursing process approach (ADPIE):

Nursing interventions of chemotherapy Psychosocial level Nutrition Elimination pattern Prevent/Decrease infectious process Prevent/Decrease haematological complication Maintain activity level Recognize complications specific to radiation and chemotherapy Recognizing oncological emergencies Obstructive emergencies o Superior vena caval syndrome (SVCS) o Spinal cord compression (SCC) o Third space syndrome (TSS) o Intestinal obstruction Metabolic emergencies o SIADH o Hypercalcemia o Tumor lysis syndrome (TLS) Infiltrative emergencies o Cardiac tamponade o Carotid artery rupture Dissiminated intravascular coagulation Nonpharmacologic pain therapies Managing pain and providing rest

Nursing interventions for clients with extravasation. Effects of the radiation.

Differences of radiation therapy.

Management of the after effect of radiation therapy Protection for the healthcare team rendering the radiation therapy interventions. The ability of the bone marrow to differentiate. The danger of failure to engraft.

Decrease/Limit exposure to infections Common oncological disorders: Leukemia Lymphoma: Hodgkins disease Multiple myeloma Testicular cancer Cervical cancer Ovarian cancer Endometrial cancer Breast cancer Gastric cancer Pancreatic Intestinal cancer Lung cancer Laryngeal cancer Prostate cancer Bladder cancer

Emphasis of patient excretas regarding the sealed and unsealed form of radiation. Care of the client who underwent chemotherapy

Pathophysiology of oncological disorders: A nursing process approach.

X. Teaching-Learning Activities (TLA) TLA Description 1 Lecture presentation 2 Problem-solving 3 Board exercises XI. Assessment Tools (AT) AT 1 2 3 Description Assignments and seatwork Examinations and Case Studies Recitations and quizzes (pre-test and post-test)

CO1 60% 30% 10%

CO2 60% 30% 10%

CO3 70% 20% 10%

CO1 10% 50% 40%

CO2 10% 50% 40%

CO3 10% 50% 40%

XII. Computation of Scores: Prelims: Prelim Grade = 10%SW/A + 40% QUIZ + 50% EXAM Midterms: Raw Midterm Grade = 10% SW/A + 40% QUIZ + 50% EXAM Midterm Grade = 50% Prelim Grade + 50% Midterm Raw Score Finals: Raw Final Grade = 10% SW/A + 40% QUIZ + 50% EXAM Final Grade = 50% Midterm grade + 50% Raw Final Grade References: Brunner and Suddarths Textbook of Medical-Surgical Nursing, 12th edition, 2010 Authors: Suzanne C. Smeltzer, Brenda G. Bare, Janice L. Hinkle, and Kerry H. Cheever Illustrated Study Guide for the NCLEX-RN Exam, 7th edition Authors: JoAnn Zerwekh and Jo Carol Claborn Kozier and Erbs Fundamentals of Nursing: Concepts, Process, and Practice (8th edition, 2007)

Authors: Audrey Berman, Shirlee Snyder, Barbara Kozier, and Glenora Erb Lippincott Manual of Nursing Practice, 9th edition, 2010 Author: Sandra M. Nettina Medical-Surgical Nursing: Clinical Management for Positive Outcomes, 8 th edition, 2008 Authors: Joyce Black and Jane Hokanson Hawks NCLEX-RN REVIEW, 5th edition Author: Alice M. Stein

Principles of Anatomy and Physiology, 12th edition, 2009 Author: Gerard J. Tortora

Stedmans Medical Dictionary for the Health Professions and Nursing, 7 th edition (2011) Publisher: Lippincott Williams and Wilkins Textbook of Medical Physiology, 11th edition, 2008 Authors: Arthur C. Guyton and John E. Hall Understanding Medical-Surgical Nursing, 3 rd edition, 2007 Authors: Linda S. Williams and Paula D. Hopper