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COURSE OUTLINE

Assessment and Pathophysiology

ADN578

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ADN578

ASSESSMENT AND PATHOPHYSIOLOGY Credit: 3 Lecture Hours: 66 Lab Hours: 0 Clinical Hours: 0 Work Exp. Hours: 0 Text/Reference 1: Lewis, S., Heitkemper, M., and Dirksen, S. (2007). Medical-surgical nursing: assessment and management of clinical problems (7th ed). St. Louis: Mosby. Text/Reference 2: Jarvis, C. (2008). Pocket companion for physical examination and health assessment (5th ed.). St. Louis: Saunders. Description: This course provides the student with advanced assessment knowledge and techniques essential for the management of nursing care for patients with complex medical-surgical conditions. Consideration is given to the assessment of special populations. In-depth pathophysiology of body system disorders is discussed. The concepts of fluid and electrolyte and acid-base balance are addressed. This course provides the foundation for nursing care management of complex patients. Prerequisites: Concurrent with ADN142 Advanced Nursing Concepts. Focus: This course is designed to prepare the Associate Degree Nursing student to perform advanced level assessment techniques, collect pertinent patient data, analyze in-depth assessment findings, and formulate appropriate nursing diagnoses and interventions. The pathophysiology of medical-surgical conditions is addressed.

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Student Contribution: Class attendance and participation is expected in order to maximize the learning experience. Each student is required to prepare for class by reading assigned material. Evaluation: An examination schedule and grading criteria will be provided. Final grades will be based on the following percentages: A=93-100%; B=85-92%; C=78-84%; D=75-77%; F=0-74%. IMPORTANT: All examinations taken early/late will be given in an alternate format unless criteria for approved leave are met. Make-up examinations must be completed before the final week of the term unless prior approval of an excused leave is granted. In such cases, examinations must be completed within six weeks of the return from an excused leave. Course Goals: 1. discuss advanced assessment techniques 2. analyze supportive data 3. interpret in-depth assessment data 4. acquire advanced nursing assessment skills 5. select nursing diagnosis based on assessment findings 6. prioritize nursing diagnoses 7. discuss specific variations in assessment of special populations (perioperative, gerontologic, and oncologic patients) 8. describe a fluid and electrolyte related assessment 9. explain fluid and electrolyte regulation 10. correlate fluid volume and electrolyte alterations 11. relate acid-base balance mechanisms

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12. summarize fluid and electrolyte imbalance implications 13. describe a sensory system-focused assessment 14. examine pathophysiology of complex sensory system alterations 15. describe a respiratory system-focused assessment 16. examine pathophysiology of complex respiratory system alterations 17. examine complex cancer pathophysiology 18. describe a cardiovascular system-focused assessment 19. examine pathophysiology of complex cardiovascular system alterations 20. describe a musculoskeletal system-focused assessment 21. examine pathophysiology of complex musculoskeletal system alterations 22. describe a renal system-focused assessment 23. examine pathophysiology of complex renal system alterations 24. describe a reproductive system-focused assessment 25. examine pathophysiology of complex reproductive system alterations 26. describe a gastrointestinal and biliary system-focused assessment 27. examine pathophysiology of complex gastrointestinal and biliary system alterations 28. describe an endocrine system-focused assessment

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29. examine pathophysiology of complex endocrine system alterations 30. describe an integumentary system-focused assessment 31. examine pathophysiology of complex integumentary system alterations 32. describe a neurologic system-focused assessment 33. examine pathophysiology of complex neurologic system alterations Assessment: Student learning will be assessed throughout the course using a variety of classroom assessment techniques.

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Bibliography Assessment and Pathophysiology

Text References

Ackley, B. J., Ladwig, G. B., & Swan, B. A. (2008). Evidence-based nursing care guidelines - medical-surgical interventions. St. Louis, MO: Mosby.

Ignatavicius, D. D., & Workman, L. (2006). Medical-surgical nursing: critical thinking for collaborative care (5th ed.). St. Louis, MO: Saunders.

Zerwekh, J., Claborn, J. C., & Gaglione, T. (2006). Mosby's fluids & electrolytes memory notecards. St. Louis, MO: Mosby.

Journal Articles

Bonner, S. M. (2008). My aching back: Relieving the pain of herniated disk. Nursing Made Incredibly Easy!, 6(1), 19-31.

Coughlin, A. M. (2007). Coping with COPD. Nursing Made Incredibly Easy!, 5(6), 40-49.

Mazanec, P., & Tyler, M. K. (2003). Cultural considerations in end-of-life care. American Journal of Nursing, 103(3), 50-58.

Muller, A. C., & Bell, A. E. (2008). Electrolyte update: potassium, chloride, and magnesium. Nursing2008 Critical Care, 3(1), 5-7.

Quinn, B. (2007). Pharmacological treatment of heart failure. Critical Care Nursing Quarterly, 30(4), 299-306.

Dell, D. D. (2008). Conquering colorectal cancer. Nursing Made Incredibly Easy!, 6(2), 42-53.

Delville, C. L. (2008). Nutritional risk assessment: Are your patients at nutritional risk? The Nurse Practitioner: The American Journal of Primary Health Care, 33(2), 36-

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Weaver, C. (2008). Compassionate care for the mastectomy patient. Nursing Made Incredibly Easy!, 5(6), 26-37. Internet Resources

American Nursing Student eNews: http://www.nursingcenter.com/home/nansenewsletter.asp Nursing Resources: http://www.nursingcenter.com/home/index.asp Product Information: http://www.nursingcenter.com/nmie/upfront

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Advanced Physical Assessment OVERVIEW: This unit prepares the student to develop a complex nursing care plan using the nursing process. Advance physical assessment skills will also be discussed. OBJECTIVES: At the completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

1. Discuss the components of a health history. 1. Health history a. Nursing history b. Physical examination

Jarvis:

2. Explain the four techniques of a physical assessment. 2. Assessment techniques a. Inspection b. Palpation c. Percussion d. Auscultation

Assessment Video: Expert Nurse Series Head-to-Toe Assessment

3. Determine systematic and efficient method of performing a physical assessment.

3. Systematic approach: a. General Survey b. Vital signs c. Integumentary system: skin, hair and nails. d. Head and neck

1) Head 2) Eyes/Ears 3) Nose 4) Mouth 5) Neck 6) Neurological status

e. Extremities f. Thorax g. Abdomen h. Genitalia

4. Distinguish between normal and abnormal assessment findings. 4. Assessment findings (for each body system) a. Normal b. Abnormal

Nursing the Patient with Cancer

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OVERVIEW: This unit discusses diagnostic tests, various therapies and nursing care utilizing the nursing process for patients with cancer. OBJECTIVES: CONTENT: LEARNING EXPERIENCES Upon completion of this unit, the student will be able to: Discuss characteristics of cancer and the stages of the metastatic process.

1. Overview of Cancer

a. Description b. Stages of metastatic process

Lewis: Chapter 16

Identify the factors related to carcinogenesis. 2. Carcinogenesis a. Exposure to etiologic agents

1. Viruses 2. chemical 3. physical stressors 4. hormonal factors 5. genetic factors

Review concepts of altered cell growth. 3. Concept of altered cell growth a. Benign growth b. Malignant growth

Identify epidemiology of cancer occurrence. 4. Epidemiology of cancer occurrence

Discuss interventions utilized in primary and secondary prevention of cancer.

5. Prevention and detection of cancer a. Early warning signs b. Primary prevention c. Secondary prevention

Identify measures used to enhance early detection of cancer and recognize terminology used in tumor staging, grading and classification.

6. Cancer diagnosis a. Early detection b. Tumor staging/grading c. Classifying and naming neoplasms

Recognize goals of cancer treatment. 7. Goals of cancer treatment a. Curative b. Prevent metastasis c. Relieve symptoms d. Maintain high quality of life

Nursing the Patient with Cancer (cont.)

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OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize treatment methods.

8. Treatment methods Goals

Nursing Diagnoses and interventions a. Surgery b. Chemotherapy c. Radiation d. Biologic Therapy e. Selected Medications

Recognize special nursing diagnoses in caring for patients with cancer. 9. Special nursing diagnoses a. Fear b. Pain c. Nutrition

Recognize various labs used in caring for patients with cancer. 10. Laboratory Studies a. WBC b. Platelets c. RBC d. Serum Calcium e. Uric Acid f. Acid Phosphatase (PAP) g. Alkaline phosphatase h. Carcinoembryonic antigen i. Chorionic-gonadotropin-beta j. Prostatic specific antigen (PSA)

Recognize associated emergencies in patients with cancer. 11. Emergencies a. Sepsis b. Hypercalcemia c. Syndrome of inappropriate

antidiuretic hormone (SIADH) d. Spinal cord compression e. Deseminating Intravascular

Coagulation (DIC) f. Hyperuricemia g. Superior Vena Cava Syndrome

Management of Patients with Integumentary Problems

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OVERVIEW: This section discusses the definition, causes, pathophysiology, signs/symptoms, treatment for common dermatological disorders and the burn patient. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review the anatomy and physiology of the skin. 1. Anatomy and physiology of the skin

Lewis: Chapter 23, 24

Describe assessment and diagnostic parameters in patients with skin disorders.

2. Assessment and diagnostic parameters for skin disorders.

Recognize specific disorders of the integumentary system. 3. Specific disorders of the integumentary system a. Sunburn b. Pediculosis c. Scabies d. Bacterial infections e. Viral diseases f. Contact dermatitis g. Atopic dermatitis psoriasis h. Tumors of the skin

Describe interventions specific to integumentary disorders. 4. Specific interventions and medications a. Therapeutic baths b. Topical medications c. Dressings d. Cryosurgery e. Plastic surgery (skin grafts) f. Selected Medications

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Alterations of Fluid and Gas Transport OVERVIEW: This unit discusses the internal and external environment of the body; how the balance of electrolytes, fluid and acid-base are maintained. OBJECTIVES: At the completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES:

Identify the main component of body fluid and fluid compartments. 1. Composition of body fluids and fluid compartments. a. Intracellular b. Extracellular c. Transcellular

Lewis: Chapter 17

Identify routes of fluid gains. 2. Routes of fluid gain a. Oral b. Parenteral c. Enteral

Identify routes of fluid loss and how these losses occur. 3. Body fluid losses a. Sensible b. Insensible

Recognize organs of the body utilized for homeostasis maintenance. 4. Homeostatic mechanisms a. Kidneys b. Heart lungs c. Pituitary gland d. Parathyroid glands e. Adrenal glands f. gastrointestinal

Define fluid volume deficit. 5. Fluid volume deficit a. Definition b. Etiology c. Pathophysiology d. Signs/symptoms e. Diagnostic tests f. Treatment and nursing care

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Alterations of Fluid and Gas Transport (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Define the basic acid-base imbalances involving metabolic and respiratory systems.

6. Metabolic alkalosis 7. Metabolic acidosis 8. Respiratory alkalosis 9. Respiratory acidosis

a. Definition b. Etiology c. Pathophysiology d. Signs/symptoms e. Diagnostic tests f. Treatment and nursing care

Recognize normal values of arterial blood gas readings. 10. Identify normal ABG values a. pH b. pCO2 c. pO2 d. Bicarbonate e. O2 Saturation

Identify types of intravenous solutions and define terms used to describe them.

11. Types of solutions a. Isotonic b. Hypotonic c. Hypertonic

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Sensorineural: Managing the Patient with Visual and Hearing Impairment OVERVIEW:This unit discusses causes, symptoms, treatment, patient teaching and nursing care of the eye and ear. OBJECTIVES: After completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review anatomy and physiology of the eye.

1. Anatomy and Physiology of the eye

Lewis: Chapter 21, 22

Identify assessment areas and nursing diagnosis of the eye.

2. Assessment and nursing diagnosis a. Elderly b. History c. Physical assessment d. Anxiety e. Knowledge Deficit f. Alteration in sensory perception g. Potential for injury h. Alterations in comfort i. Impaired physical mobility

Identify specific nursing interventions used in treating the eye. 3. Interventions a. Eye drops b. Irrigation c. General eye care d. Bandage / eye shield e. Selected Medications

Recognize specific nursing diagnosis related to pre- and post-operative surgery on the eye.

4. Nursing Diagnoses a. Pre-operative

a. Anxiety b. Knowledge Deficit

b. Post-operative a. Potential for injury b. Alteration in comfort: pain c. Impaired physical mobility d. Impaired sensory perception e. Alteration in nutrition f. Potential fluid volume deficit

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Sensorineural: Managing the Patient with Visual and Hearing Impairment (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize various disorders of the eye.

5. Disorders of the eye a. Conjunctivitis b. Corneal Ulcer c. Corneal transplant d. Retinal detachment e. Diabetic retinopathy f. Glaucoma g. Cataracts h. Traumas i. Blindness

Review Anatomy and physiology of the ear.

6. Anatomy and physiology of the ear.

Identify assessment areas of the ear.

7. Assessment of the ear a. Physical Assessment b. Instrumentation

i. Tuning fork ii. Weber test

iii. Rinne test iv. Audiometry

Identify types of hearing loss. 8. Types of hearing loss a. Conductive b. Sensorineural c. Mixed d. Central e. Functional f. Congential g. Acquired

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Sensorineural: Managing the Patient with Visual and Hearing Impairment (cont.)

OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize general care of the ear. 9. General care of the ear.

Review anatomy and physiology of the ear 10. Common nursing interventions a. Ear drops b. Removal of cerumen c. Irrigation

Recognize common nursing diagnoses and interventions related to disorders of the ear.

11. Nursing Diagnoses / Interventions a. Knowledge Deficit: pre and post-op b. Potential for injury c. Impaired physical mobility d. Alteration in comfort: vertigo, N/V,

pain e. Knowledge Deficit: rehabilitation

requirements

Recognize common disorders of the ear.

12. Common Disorders of the ear a. External otitis b. Impacted ear wax c. Furunculosis d. Foreign body e. Middle ear disorders: Otitis media f. Mastoiditis g. Trauma h. Inner Ear : Meniere’s Disease

Identify care in common ear surgery 13. Ear Surgery a. Myringotomy b. Mastoidectomy c. Stapedectomy

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Management of Patients with Neurological Dysfunction

OVERVIEW: This unit discusses neurological disorders caused by disease or trauma and the nursing management of the disorders. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review of anatomy and physiology of the nervous system.

1. Review anatomy and physiology of

nervous system

Lewis: Chapters 56, 59, 60, 61

Review assessment of the nervous system. 2. Assessment of the nervous system

Describe diagnostic tests and medications related to the nervous system. 3. Diagnostic tests and medications a. Cerebrospinal fluid b. CT scan c. MRI d. Brain scan e. Myelography f. Cerebral angiogram g. Lumbar puncture h. Electroencephalography i. Electromyogram j. Skull X-Ray k. Selected Medications

Identify common neurological disorders. 4. Common neurological disorders a. Convulsive disorders b. Multiple sclerosis c. Parkinson’s disease d. Myasthenia gravis e. Amyotrophic lateral sclerosis f. Alzheimer’s disease g. Meningitis h. Guillian-Barre i. Head Injury j. Spinal cord trauma k. Huntington’s

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Upper and Lower Respiratory Tract Disorders OVERVIEW: This section discusses the management of the patient with upper and lower respiratory tract disorders, nursing interventions and management. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review the respiratory system

1. Respiratory system

a. Upper b. Lower

Lewis: Chapters 26, 27, 28, 29

Identify various respiratory disorders. For each of the following disorders, content will address:

Definition Etiology Pathophysiology Signs/Symptoms Diagnositc tests Collaborative Treatment Nursing Care Patient Teaching

2. Respiratory Infections

Identify disorders of the upper airway

3. Laryngeal Cancer

Identify malignancies of the chest.

4. Lung Cancer

Identify occupational pulmonary diseases.

5. Asthma

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Upper and Lower Respiratory Tract Disorders (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize various conditions related to chest trauma. 6. Tension pneumothorax

7. Pneumothorax 8. Hemothorax

Identify acute respiratory disorders. 9. Adult respiratory distress syndrome 10. Pulmonary embolism 11. Carbon monoxide poisoning

Identify common disorders of the lower respiratory tract. 12. Pneumonia 13. Chronic Obstructive Pulmonary

Disease (COPD) 14. Emphysema 15. Pulmonary Tuberculosis

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Cardiovascular OVERVIEW: This unit discusses the physiologic overview, nursing assessment, and diagnostic tests and procedures. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review anatomy and physiology of the cardiovascular system.

1. Anatomy and Physiology of the

cardiovascular system.

Lewis: Chapters 32, 33, 34, 36, 37

Identify assessments and terms related to the patient with cardiovascular disorders.

2. Assessment of the cardiovascular patient a. Dyspnea b. Chest pain c. Weight gain d. Syncope e. Palpitations f. Fatigue g. Skin color and temperature h. Neck vein distention i. Respirations j. Peripheral edema k. Pulses l. Heart sounds m. Lung sounds

Identify various laboratory studies and diagnostic tests used in relationship to the patient with a cardiovascular disorder, including nursing care.

3. Labs and Diagnostic Tests a. CBC, WBC, RBC, ESR b. Enzyme studies c. Troponin d. Serum cholesterol and triglycerides e. PT/PTT/INR f. Serum Electrolytes g. Echocardiography h. Holter monitor i. Stress Test (treadmill) j. Chest X-Ray (fluoroscopy)

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Cardiovascular (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES

k. Angiography/arteriography l. Electrocardiogram (ECG, EKG) m. Electrophysiologic Studies (EP) n. Chronotropic/Inotropic Medications

Identify various types of hemodynamic monitoring. 4. Types of hemodynamic monitoring a. Central venous pressure b. Pulmonary artery wedge (PAW) c. Intra-arterial blood pressure

Identify various wave forms of an ECG strip and identify dysrhythmias. 5. Wave Forms of an ECG strip a. P Wave b. PR interval c. QRS complex d. ST segment e. T wave f. QT interval g. Dysrhythmias

Recognize the indications for, types, nursing care, and possible complications for use of a pacemaker, cardioversion and defibrillation.

6. Indications for, nursing care, types and possible complications of

a. Pacemaker b. Cardioversion c. Defibrillation

Identify inflammatory diseases of the heart and blood vessels. 7. Inflammatory disease of heart and blood vessels.

a. Infective endocarditis b. Pericarditis c. Cardiomyopathy

Medical Interventions and Patient Teaching

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Cardiovascular (cont.)

OBJECTIVES: CONTENT: LEARNING EXPERIENCES Identify various valvular disorders of the heart. 8. Valvular disorders of the heart

a. Mitral stenosis b. Mitral insufficiency c. Aortic stenosis d. Aortic regurgitation e. Mitral valve prolapse

Identify various cardiovascular surgeries, pre-op, post-op, and nursing implications.

9. Cardiovascular surgery, pre-op, post-op, and nursing implications.

a. Annuloplasty b. Valvuloplasty c. Commissurotomy d. Coronary artery bypass graft e. Repair of ventricular aneurysms f. Removal of tumors of the heart g. Heart transplant h. Thrombectomy i. Endarterectomy

Identify occlusive disorders of the coronary blood vessels. 10. Occulsive Disorders a. Coronary artery disease b. Angina pectoris c. Myocardial infarction

Identify conditions associated with failure of the heart. 11. Conditions associated with heart failure a. Left ventricular failure b. Right ventricular failure c. Acute Pulmonary Edema

Identify cardiovascular specific medications. 12. Selected Cardiovascular Medications

Identify occlusive disorders of the peripheral blood vessels. 13. Occlusive Disorders of peripheral blood vessels.

a. Arteriosclerosis/atherosclerosis b. Thromboangitis obliterans (Buerger’s

disease)

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Cardiovascular (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize hypertension as a disease process and nursing implications 14. Hypertension

a. Primary b. Secondary c. Risk factors d. Patient Teaching

Review basic anatomy and physiology of hematopoietic system. 15. Anatomy and Physiology of hematopoietic system

Identify assessment related to patient with hematopoietic disorders. 16. Assessment

Identify diagnostic studies used to diagnose hematopoietic disorders. 17. Diagnostic Studies a. Hemoglobin/Hematocrit b. RBC/WBC/Platelets c. Bone marrow aspiration d. Reticulocyte count e. Erythrocyte injdices f. Coombs test g. Schilling test

Identify disorders of the hematopoietic system. 18. Disorders of the hematopoietic system a. Aplastic anemia b. Folic acid deficiency c. Pernicious anemia d. Polycythemia vera e. Thrombocytopenia (ITP) f. Disseminated Intravascular

Coagulation (DIC) g.

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Management Modalities for patients with Musculoskeletal Dysfunction OVERVIEW: This unit discusses the physiologic overview, nursing assessment, and diagnostic tests and procedures. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review the anatomy and physiology of the musculoskeletal system.

1. Anatomy and physiology of the

musculoskeletal system

Lewis: Chapters 62, 63, 64, 65

Identify assessments related to the patient with musculoskeletal disorders. 2. Assessment of musculoskeletal patient

Identify various labs, diagnostic tests used in relationship to the patient with musculoskeletal disorders to include nursing care.

3. Labs/Diagnostic tests a. Electromyography (EMG) b. Magnetic Resonnance Imaging

(MRI) c. Biopsy d. Arthroscopy e. Bone scan f. X-Ray g. Myelography h. CT Scan i. ESR j. Uric Acid k. Serum Calcium l. Alkaline phosphatase m. Antinuclear Antibodies (ANA) n. Serum phosphorus

Identify orthopedic disorders. 4. Orthopedic disorders a. Fractures b. Muscle sprain c. Muscle strain d. Dislocation/Subluxation e. Low Back Pain

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Management Modalities for patients with Musculoskeletal Dysfunction (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize treatment for orthopedic, connective tissue, and degenerative disorders.

5. Treatments a. Casts b. Traction c. Orthopedic surgery

1. Pre-operative care 2. Post-operative care

a. Amputations b. Laminectomy c. Fractures of hip/knees

Recognize connective tissue and degenerative disorders. 6. Connective tissue and degenerative disorders a. Rheumatoid arthritis b. Osteoarthritis c. Gouty arthritis d. Systemic lupus erythromatosus

(SLE) e. Bone Tumors f. Osteomylitis g. Carpel tunnel h. Osteoporosis

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Renal and Urinary System Disorders OVERVIEW: This section discusses the assessment and management of persons experiencing disorders of the kidney and urinary tract. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review the anatomy and physiology of the urinary system, role of the kidney in regulation of fluids, electrolytes and acid-base balance.

1. Review the anatomy and physiology and

regulatory mechanisms

Lewis: Chapters 45, 46

Describe assessment parameters in patient’s experiencing renal dysfunction.

2. Assessment parameters a. Clinical manifestations b. Health History c. Nursing assessment d. Physical Assessment

Describe diagnostic and lab tests used to determine renal and urinary function and nursing interventions.

3. Diagnostic and lab tests used and nursing interventions a. CBC b. WBC c. Urinalysis d. BUN e. Creatinine f. Hemoglobin/Hematocrit g. ESR h. Urine collection for specimens i. KUB j. IVP k. Retrograde pyelogram l. Voiding cystourethrography m. Renal angiography/arteriography n. CT scan o. Ultrasound p. Cyctoscopy q. Renal biopsy

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Renal and Urinary System Disorders (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Recognize disorders of the urinary system

4. Disorders of the urinary system

a. Polycystic kidney b. Urinary tract infection c. Cystitis d. Pyelonephritis e. Glomerulonephritis f. Nephrotic syndrome g. Hydronephrosis h. Renal calculi i. Tumors of the kidney j. Tumors of the bladder k. Urethral strictures

Identify various urological surgeries and nursing management.

5. Various urological surgeries and nursing

management. a. Surgery of the kidney b. Surgery of the ureters and bladder c. Urinary diversion procedures

Identify and discuss medications associated with renal failure.

6. Selected renal medications

Discuss selected medications relevant to care of patient experiencing urinary problems.

7. Relevant medications

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Reproductive System Disorders

OVERVIEW: This unit discusses assessment and disorders of the female and male reproductive systems. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review anatomy and physiology of female and male reproductive system.

1. Anatomy and physiology of reproductive

system.

Lewis: Chapters 51, 52, 54, 55

Identify specific female reproductive problems. 2. Female reproductive problems a. Fibroid tumors b. Endometriosis c. Cancer of cervix d. Cancer of the ovary e. Premenstral syndrome f. Menopause g. Pelvic Floor weaknesses

Recognize non-malignant and malignant disorders of the breast. 3. Non-malignant and malignant disorders of the breast. a. Fibrocystic changes b. Malignant disorders of the breast

Recognize diseases of the male reproductive system. 4. Diseases of the male reproductive system a. Prostatitis b. Epididymitis c. Benign prostatic hypertrophy d. Proastatic Cancer e. Cancer of the testes

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Management of Patient with Endocrine Disorders

OVERVIEW: This section discusses assessment and management of the patient with disorders of the endocrine system. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review anatomy and physiology of the endocrine system.

1. Anatomy and physiology of endocrine

system

Lewis: Chapters 48, 49, 50

Review assessment of the patient with endocrine disorders. 2. Assessment of patient with endocrine disorders

Identify disorders and problems of the pituitary, thyroid, parathyroid, and adrenal glands. Definition Etiology Pathophysiology Signs/Symptoms Diagnostic/Lab Tests Treatment/nursing care Patient Teaching

3. Specific disorders/problems of the pituitary, thyroid, parathyroid and adrenal glands. a. Hyperthyroidism b. Hypothyroidism c. Hyperparathyroidism d. Hypoparathyroidism e. Hyperfunction of adrenal gland

(Cushing’s Syndrome) f. Hypofunction of adrenal gland

(Addison’s) g. Disorders of the Anterior Pituitary h. Disorders of the Posterior Pituitary

Identify specific management of patient with other endocrine disorders. Definition Etiology Pathophysiology Signs/Symptoms Diagnostic/Lab Tests Treatment/nursing care Patient Teaching

4. Other endocrine disorders a. Diabetes Mellitus b. Selected Medications related to

Diabetes Mellitus

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Gastrointestinal and Liver-Biliary Disorders OVERVIEW: This section discusses the assessment and management of the patient with gastrointestinal and liver-biliary disorders. OBJECTIVES: Upon completion of this unit, the student will be able to:

CONTENT: LEARNING EXPERIENCES

Review assessment of the gastrointestinal system, nutritional status, and dietary counseling.

1. Review assessment of gastrointestinal

system, nutritional status, and dietary counseling

Lewis: Chapters 39, 40, 41, 42, 43, 44

Identify various diagnostic tests, medications and treatments used in assessing GI disorders.

2. Various diagnostic tests and medications a. Stool Specimens b. Barium Enema c. Upper GI d. Gastric analysis e. Endoscopy f. Colonoscopy g. CEA h. Selected Medications

Identify specific problems and disorders of ingestion. 3. Specific problems and disorders of ingestion a. Obesity b. Anorexia nervosa c. Bulimia nervosa

4. Gastrostomy/alternative feeding routes 5. Tumors of the mouth/oral cavity 6. Esophageal disorders

a. Gastroesophageal reflux disease b. Esophageal carcinoma

Identify specific problems and disorders of digestion. 7. Gastritis 8. Peptic Ulcer Disease 9. Cancer of the stomach 10. Malabsorption syndrome

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Gastrointestinal and Liver-Biliary Disorders (cont.) OBJECTIVES: CONTENT: LEARNING EXPERIENCES Identify specific problems and disorders of intestinal elimination. 11. Specific problems with intestinal

elimination a. Constipation – Diarrhea b. Appendicitis c. Peritonitis d. Crohn’s disese e. Ulcerative colitis f. Diverticular disease g. Irritable bowel syndrome h. Hernia i. Benign – cancer of the bowel

Review anatomy and physiology of gallbladder and pancreas. 12. Anatomy and physiology of the gallbladder and pancreas

Identify diagnostic and laboratory tests associated with gallbladder and pancreas

13. Diagnostics and Laboratory tests

Identify specific disorders and problems of the gallbladder and exocrine pancreas.

14. Specific problems and disorders of the gallbladder and exocrine pancreas a. Cholelithiasis – Cholecystitis b. Pancreatitis: acute and chronic c. Cancer of the pancreas

Review anatomy and physiology of the liver. 15. Anatomy and physiology of the liver

Identify specific lab, diagnostic tests, and assessments associated with the liver

16. Specific labs, diagnostic tests and assessments

Identify specific problems and disorders of the liver 17. Specific problems and disorders of the liver a. Hepatitis – A, B, C b. Benign – Cancerous tumors of the

liver