II.

CELLULAR ABERRATIONS
A. Review of the Cellular
Physiology
1. The cell cycle
2. Differentiation
3. Proliferation
B. Characteristics of Benign and
Malignant neoplasms
1. Terminology
2. Neoplasm
3. Benign
4. Malignant
-cancer cell characteristics
-Invasion and metastasis
-Tumor Growth
-General effects
C. General Pathophysiology of Cellular Aberration
Epidemiology: Local & International
a. lung
b. breast
c. uterine
d. prostate
e. colorectal
D. Carcinogenesis and Causes of
Cancer
Oncogenesis
Risk factors:
1. Gender and site
2. Age
3. Race and
ethnicity
4. Genetics
5. Hormonal Factors
6. Immunologic
Factors
7. Oncogenic
Viruses
8. Drugs and
Chemicals
9. Radiation
-ionizing
-UV
-electromagnetic
-radon
9. Lifestyle
-smoking
-nutrition/diet
-obesity
viruses
-psychosocial
Factors
F. Significant subjective data from the client
- family history
- chief complaints
- functional patterns
- psychosocial and
behavioral assessment
G. Principles and techniques of physical
examination in all age groups, deviations
from normal
1. Breast-Self examination
2. Testicular Examination
3. Digital Rectal Examination
The 9 Danger Signs [ CAUTION US ]
H. Diagnostic tests and Nursing
responsibilities
Lung Cancer
A. Chest X-Ray
B. Sputum Cytology
Breast Cancer
A. Mammogram
B. Clinical Breast Exam
C. MRI
D. Tissue Sampling
Uterine Cancer
A. transvaginal sonography
B. hysteroscopy
C. sonohysterography
D. Biopsy Punch
Cervical Cancer
A. Pap smear with staging
Prostate Cancer
A. Digital rectal examinanition
B. Prostate-Specific Antigen
Colorectal cancer
A. Fecal Occult blood test
B. Sigmoidoscopy
C. Colonoscopy
D. Double- contrast barium enema
Other tests:
A. Tumor markers
B. Radioisotope scan
C. MRI
I. Pathophysiologic Mechanisms leading to
manifestations
A. Lung Cancer
B. Breast Cancer
C. Uterine Cancer
D. Colorectal Cancer
E. Prostate Cancer
F. Non-Hodgkin Lymphoma
G. Kidney Cancer (Renal Cell)
H. Melanoma
I. Basal Cell carcinoma
J. Thyroid Cancer
K. Leukemia
L. Brain Cancer

Childhood Cancers
Medullablastoma
Glioma
Neuroblastoma
Wilm’s Tumor
Retinoblastoma
Ewing’s Sarcoma
Osteosarcoma

J. Nursing Diagnoses
Taxonomy/Development of Outcome
Criteria
A. Potential for Infection
B. Disturbance in Body Image
C. Activity Intolerance
D. Potential for alteration in nutrition; less
than body requirements
E. Alteration in oral Mucous Membrane
Integrity
F. Alteration in Comfort
G. Fluid Volume Deficit
K. Principles of Various Modalities of
Management Against CANCER
1. Health promotion
2. disease
prevention
3. Curative
4. Restorative

M. Principles of Management
1. Cancer Staging:
Cancer naming Mnemonics
TNM classification
Clinical staging
Metastatic Spread
2. Prevention of Infection
3. Hydration
4. Blood component replacement
5. 0xygen therapy
6. Prevention of Complications
7. Rehabilitation
N. Pharmacologic Actions
Therapeutic use, side effects,
indications, contraindication, nursing
responsibilities
1. Biotherapy
Classification
Cytokines
Monoclonal Antibodies
Cellular Therapies
Immunodilators
Retinoids
2. Chemotherapeutic Agents
Classification
Cell cycle-specific
Cell cycle-nonspecific
Categories
Alkalating agents
Antibiotic
antineoplastic
Antimetabolite
Nitroureas
Plant derivatives
Hormonal
Special considerations in chemotherapeutic
drugs preparation
1. Proper attire
2. Chemo drug handling
H. Bioethics: Principles and application of
bioethics in the care of the clients
-Patient’s rights
-Confidentiality
-The Informed Consent
-Ethics of decision
-Advance Directives
O. Nursing Responsibilities for specific
surgical and special procedures
[Preoperatively and
Postoperatively]
-positioning
-dos and donts
-bedside equipment
-activity structuring
Safe and comprehensive perioperative
nursing care
5. Assessment and care during the
perioperative period
6. Techniques in assisting the surgical
team during the operation
7. Principles of safety, comfort and privacy
during the perioperative period
8. Nursing responsibilities during the
perioperative period
Surgical Procedures:
1. Modified radical mastectomy
(drainage/positioning)
2. Lobectomy (positioning)
3. Hysterectomy
4. Craniectomy
5. Transurethral resection of the prostate
(cystoclysis)
6. Colostomy ( care )
7. Bone Marrow and Peripheral Blood Stem
Cell Transplantation
Special procedures:
1. Radiation therapy
2. Cervical Implants
3. Reverse Isolation
P. Appropriate discharge plan including
health education
Q. Accurate recording and
Documentation
III. Acute Biologic Crisis
A. Standard Assessment of the Critically Ill
-Focused History Taking
-Discriminating Physical Examination
AIRWAY
BREATHING
CIRCULATION
HEMODYNAMIC STATUS
B. Pathophysiologic Mechanisms leading to
manifestations
1. Cardiac Failure
2. Acute Myocardial Infarction
3. Acute Renal Failure
4. Stroke
5. Increased Intracranial Pressure
6. Metabolic Emergencies
-DKA/HHNK
7. Massive Bleeding/Hypovolemic Shock
8. Extensive surgeries (include dehiscence
and evisceration)
9. Extensive Burns
(include staging and area computation)
10. Poisoning
11. Multiple Injuries
12`. Emerging illness (SARS, Avian Flu)
C. Nursing Diagnoses
Taxonomy/Development of Outcome
Criteria
5. Impaired Gas Exchange
6. Inability to sustain spontaneous
ventilation
7. Dysfunctional Ventilatory Weaning
Response
8. Decreased cardiac output
9. Altered tissue perfusion, systemic
10. Alteration in nutrition, less than body requirements
11. Fluid Volume Deficit
12. Activity Intolerance
D. Results/Implications of Diagnostic
Laboratory Exams
1. Non-Invasive: ECG, cardiac
rhythms
2. Invasive: ABG, Hemodynamic
monitoring, CVP, pulmonary
capillary wedge pressure (PCWP
E. Principles of Management
1. Determination and management
of Cause
2. Life saving interventions:
Basic Life support
Advanced Cardiac Life support
First aid Measures
Fluid Resuscitation
3. Life Maintaining Interventions:
-Airway management and care of
patients with ventilator
-Parenteral fluid administration
(blood and blood component therapy
-Interventions for hemodynamic
instability
-Continuous hemodynamic
monitoring
-Interventions for Nueral
Regulation
-Fluid and Electrolyte Problems
-Nutrition
-Perioperative Problems
4. Psychosocial and behavioral
interventions:
-measures to relieve anxiety
-fear, depression
- critical care concerns:
-immobility,
-sleep deprivation
-sensory overload
-body image alterations
-grieving
-sexuality
-spirituality
5. Supportive management
6. Prevention of complication
7. Rehabilitation-pulmonary, cardiac,
Neurologic
F. Pharmacologic Actions
Therapeutic use, side effects,
indications, contraindication, nursing
responsibilities
1. Analgesics
2. Narcotics
3. Corticosteroids
4. Antihypertensive
5. Vasopressors
6. Antibiotics
7. Parenteral fluids
G. Nursing Responsibilities for specific
surgical and special procedures
1. Tracheostomy
2. Endotracheal Intubation
3. Cardiocentesis
4. Thoracotomy
5. Cut-down
6. Aneurysm clipping
7. Defibrillation &
Cardioversion
[Preoperatively and Postoperatively]
-positioning
-dos and donts
-bedside equipment
-activity structuring
Safe and comprehensive perioperative
nursing care
9. Assessment and care during the
perioperative period
10. Techniques in assisting the surgical
team during the operation
11. Principles of safety, comfort and privacy
during the perioperative period
12. Nursing responsibilities during the
of bioethics in the care of the clients
-Patient’s rights
-Confidentiality
-The Informed Consent
-Advance Directives
I. Appropriate discharge plan including
health education
J. Accurate recording and
Documentation

IV. Disaster and Emergency

A. Definition of Emergency and
other terminologies
-Disaster
-Trauma
B. Triage
Definition
Objectives
1. START Triage system
(Simple Triage and Rapid System)
Indication for use of START triage
System
The Mnemonic/Procedure:
Respiration
Pulse/Perfusion
Mental Status
ADULT START Triage System
PEDIATRIC START Triage System
START Flow Chart
Four Triage Categories/Color Coding
Evacuation Prioritization according to
category
The Incident Command System
2. MILITARY TRIAGE
Indication of use for Military Triage
5 Categories of Severity
1. Black/ Expectant
2. Red/ Immediate
3. Yellow/Observation
4. Green/Wait (Walking wounded)
5. White/Dismiss
C. Hospital Operations Plan
D. Types of Emergency with
appropriate nursing interventions
8. Airway obstruction
9. Myocardial Infarction
10. Near drowning
11. Hemorrhage
12. Head/Chest/abdominal
Trauma
13. Poisoning and Overdose
14. Hypo/Hyperthermia
15. Snake bite/Animal bites
16. Nitrogen Narcosis
17. Fractures
18. Spinal cord Injury
E. The Crash Cart/E-Cart
-Contents of the Crash cart
- A-Z Emergency Drugs
-Defibrillator
-Oxygen Saturation Monitor
F. Personal Protective
Equipment
G. Hazardous Materials
H. Decontamination
I. Biologic Warfare and Biologic
agents
J. Blast Injuries
K. Natural Disasters
L. Stress Reactions
-Post Traumatic
-Stress Disorder Critical Incident
Stress management
-Debriefing
M. Special Emergency
Procedures
1. Tracheostomy
2. Endotracheal Intubation
3. Cardiocentesis
4. Thoracotomy
5. Cut-down
6. Aneurysm clipping
7. Defibrillation &
Cardioversion
N. Nursing Responsibilities for specific
surgical and special procedures
[Preoperatively and
Postoperatively]
-positioning
-dos and donts
-bedside equipment
-activity structuring
Safe and comprehensive perioperative
nursing care
Assessment and care during the
perioperative period
Techniques in assisting the surgical team
during the operation
Principles of safety, comfort and privacy
during the perioperative period
Nursing responsibilities during the
perioperative period
O. Universal Precaution Application in an
emergency set-up
V. IV THERAPY
A. Philosophy
B. Definition
C. Basic Foundation of IV Therapy
1. Historical background of IV
therapy
2. Ethico-legal aspects of IV
therapy
2.1 Role of ANSAP
2.2 Difference between RA 9173
and RA 7160
3. Standards of IV therapy
D. Review of Anatomy and Physiology of
the vascular system
E. Peripheral and Integumentary System
F. Fluid and Elecrolyte therapy
1. Types of Fluids/ Solution and
uses
2. Drug Interaction with IV fluids
3. Handling of IV solutions, blood
products and components
G. Nursing process in IV therapy
H. Venipuncture Technique on Adult &
children
-Prescribed cannula and indications of each
-Color, gauge
-Ideal period of usage of an IV set,
indications
-Process in keeping a set sterile
I. Complications of IV therapy
J. Infection Control & Microbiology
Principles
K. Demonstration of Procedure