Cebu Normal University

Graduate School
Cebu City

Nsg 4005: Facilitating Learning

COMPETENCY – BASED INSTRUCTIONAL MATRIX

Subject:
Medical-Surgical Nursing

Unit:
Nursing Care of Clients with Colorectal Cancer

Submitted by:

Bandala, Christine Joy J.

Cayao, Suzanne Mae V.
Cuizon, Apple Y.
Maranga, Clarissa A.
de Castro, Melvin R.

Submitted to:

DR. MARCELO T. LOPEZ

Professor

May 2009
 Learning Outcome Instructional Outcome
Competencies Elements Instructional Objectives Motor Declarative Procedural Strategic Attitude Activities Measures
(S) (K) (K) (K)

A. Safe and 1. Health Status of clients with At the end of the unit, the students will
quality colorectal cancer: be able to:
nursing
care to 1.1 What is colorectal 1.1a. Define colorectal cancer. Lecture Method Paper-Pencil
patients with  1. Read the Test:
cancer?
colorectal subject and Multiple Choice Test
cancer ask the
1.2 Etiologies and risk 1.2a. Identify the etiologies and risk  students to
factors of colorectal cancer read the
factors of colorectal cancer same topic in
advance
1.3a. Describe the nature of colorectal 
1.3 Pathophysiology and
cancer, its concept and pathophysiology. 2. Introduce the
clinical manifestations of topic to the
1.3b. Utilize effective and  students
colorectal cancer
comprehensive techniques in the
assessment of clients with colorectal 3. Conduct the
cancer discussion

Health history 4. Establish

Physical examination comparison
or cross
1.3c. Enumerate the clinical reference to
manifestations in clients with colorectal  what students
cancer have read

5. Review the
discussion
1.4 Stages of cancer 
1.4a. Describe the different stages of and
cancer summarize
the student’s
observations

6. Evaluate the
discussion
 1.5 Nursing Diagnoses: 1.5a. Identify the health needs of the Case Analysis Product
a. pain client through the formulation of  1. Case history is Assessment:
b. impaired skin prioritized nursing problems presented. Presentation of Case
integrity 2. Students Study
c. risk for infection discuss the using Rubrics
d. risk for fluid volume facts.
deficit
e. altered nutrition: 3. Students Product
less than body discuss and Assessment:
requirements identify the Nursing Care Plan
f. disturbed body broad problem (NCP)
image using Rubrics
g. social isolation 4. Students
h. ineffective individual formulate
coping decisions and
i. knowledge deficit actions on the
j. risk for ineffective case
management
5. Students
reflect on the
case as a
whole

2. Goals of management for 2a. Identify client-centered and Case Analysis Product
clients with colorectal cancer: SMART(specific, measurable,  6. Case history is Assessment:
attainable, realistic, time-bound) presented. Presentation of Case
a. Pain relief outcome criteria for the identified 7. Students Study
b. Improve wound nursing problems discuss the using Rubrics
healing and facts.
integrity
c. Infection control 8. Students Product
d. Fluid volume discuss and Assessment:
balance identify the Nursing Care Plan
e. Improved nutrition broad problem (NCP)
f. Decreased anxiety using Rubrics
and improved 9. Students
coping formulate
g. Increased decisions and
knowledge of actions on the
disease process and case
therapeutic
management 10. Students
 reflect on the
case as a
whole

3. Implementation of 3a. Outline appropriate care measures  Product

appropriate nursing interventions to address the nursing problems Assessment:
and measures identified, in line with the outcome Presentation of Case
criteria set Study
3.1. Independent Care using Rubrics
Measures
a. manage pain and
promote comfort Product
b. promote Assessment:
nutritional and Nursing Care Plan
fluid balance (NCP)
c. provide adequate using Rubrics
rest and sleep
d. prevent/control
infection
e. promote coping
and minimize
anxiety
f. provide client and
family teaching

3.2. Dependent/Collaborative
Care Measures
a. medications
b. intravenous fluids
c. laboratory and
diagnostic studies
d. other treatment
procedures

Product
4. Parameters in monitoring 4a. Establish evaluation parameters to  Assessment:
effectiveness of care based on monitor effectiveness of nursing care Presentation of Case
outcome criteria set measures Study
using Rubrics
5.Nurse as client advocate in the 5a. Identify themselves as the  Film Showing Assessment
therapeutic care of client with nurses caring for the patient with technique:
colorectal cancer. colorectal cancer, after viewing a Reflection
video on: Journal: Holistic
A case of a cancer patient. Rubric

i. identify personal strengths

supportive in the therapeutic
care of client with colorectal
cancer
.
ii. express willingness to take the
needed steps in improving one’s
weaknesses in order to render
therapeutic care for a client with
colorectal cancer.
 Learning Outcome Instructional Outcome
Competencies Elements Instructional Objectives Motor Declarative Procedural Strategic Attitude Activities Measures
(S) (K) (K) (K)

At the end of the unit, the students will be

able to: Lecture Method
1. Read the subject Paper-
B. Health 1. Comprehensive and ask the students Pencil
education health education to read the same Test:
plan based on plan on the topic in advance Multiple
assessed and anticipated and Choice
anticipated assessed learning 2. Introduce the topic to Test
learning needs needs of the the students
of clients with clients with
colorectal colorectal cancer 3. Conduct the discussion
cancer
1.1. Learning needs: 4. Establish comparison or
a. Medications 1.1a. Identify the medications associated in cross reference to what
the care of patients with colorectal cancer  students have read

b. Activity, 1.1b. Recognize the importance of activity,  5. Review the discussion

exercise and exercise, rest and hygiene in the care of and summarize the
rest patients with colorectal cancer  student’s observations
c. Hygiene
1.1c. describe the prescribed therapeutic diet  6. Evaluate the discussion
d. Therapeutic
diet / nutrition 1.1d. be aware of support groups
e. Moral and
spiritual needs

1.2. Define health education needs 

1.2. Nursing Diagnosis comprehensively through the formulation of
a. Knowledge nursing diagnosis
deficit
b. ineffective

therapeutic management 1.3. Outline objectives, content, strategies
and resources needed for the health
1.3. Learning education
objectives
1.4. Content
1.5. Teaching
strategies
1.6. Teaching-learning 1.4 Establish evaluation parameters to 
resources assess effectiveness of health
1.7. Evaluation
parameters

2. Comprehensive
health education
plan on the Group Discussion Product
anticipated 2.1 Assess patients’ anxiety level and coping  assessm
learning needs of mechanisms. 1. State objectives ent:
the client with Teaching
colostomy 2.2 Distinguish health care resource that is 2. Assign groups Plan using
best suited for the situation  Rubrics
2.1 Psychosocial 3. Introduce the problems
preparation and issues

2.2 Health care 4. Facilitate open discussion Pencil-

resources 2.3 Perform proper colostomy care  Paper
5. Question ideas test:
a. Out Patient Multiple
Department 6. Develop a sample Choice
b. Rural Health 2.4 Recognize signs and symptoms of  teaching plan Test
unit consequent complications.
c. Home Care 7. Evaluate learning

2.3 Colostomy
care
a. Changing
pouch system
b. irrigation
2.4 Signs and 2.5 List dietary and activity modifications 
symptoms of necessary for patients with colostomy
complications
a. bowel
obstruction
b. hemorrhage
c. sepsis
d. prolapsed of
stoma
2.5 Lifestyle
changes
a. Diet
b. Activity
restrictions
 3.1 Enumerate interventions for potential 
complications

3.2 Perform the following procedures 

correctly, as necessary

a. Nasogastric intubation and feeding

b. Wound care

3. Comprehensive 3.3 recognize situations wherein the 

health education followings procedures would be necessary to
plan on nursing address the complications related to
interventions for colorectal cancer:
potenial
complications a. intake and output monitoring

3.1 Paralytic Ileus b. administration of antibiotics as prescribed.

3.2 Meachnical
Obstruction c. application of hot and cold therapy
3.3 Peritonitis
3.4 Abcess
Formation
3.5 Wound
infection
3.6 Wound
Disruption
3.7
Mucocutaneous
Separation
3.8 Dehiscence of
anastomosis
 3.
Management
of resources
and 1. Proper utilization of
environment equipments
for patients
with colorectal 1.1 Protective gears for
cancer chemotherapy and
radiation
1.2 Infusion pump
1.3 colostomy bag
2.Appropriate referral to:
2.1 Case managers/ social
workers
2.2 Enterostomal therapist
2.3 Support groups
2.4 Hospice services
3. Home Care
Management
3.1 resources available for
continuity of care in the
home
3.2. family members as
health care providers
Group Discussion Pencil-
Paper
1.1.Describe proper use of protective gears  1. State objectives test:
for chemotherapy and radiation Multiple
2. Assign groups Choice
1.2.Operate infusion pump  Test
3. Introduce the problems
1.3. demonstrate proper installation of and issues
Colostomy bag. 
4. Facilitate open discussion
5. Question ideas

6. Develop a sample
teaching plan
Recognize the available inter-sectoral
linkages 7. Evaluate learning

Identifies resources needed in delivering
patient care in the home. 
Determines tasks and procedures that can
safely be assigned to family members of the
patient.