NURS 2455 - Advanced Adult Medical-Surgical Nursing

Credit Hours: 1.50

Objectives:

1. The student will analyze and apply the critical components of evidence‐based nursing practice to patients with oncologic disorders.
2. The student will analyze and apply the critical components of evidence‐based nursing practice to patients with neurologic disorders.
3. The student will analyze and apply the critical components of evidence‐based nursing practice to patients with musculoskeletal disorders.

Outcome 2: Upon completion of this course, students will be able to explain why continuous quality improvement is an essential part of professional nursing practice and uses national safety resources for patients with neurologic, orthopedic, and oncologic problems.

Objectives:

1. The student will discuss quality indicators for acute stroke patients.
2. The student will recognize quality indicators for cervical spine treatment.
3. The student will identify quality indicators for patients with a hip fracture.

1. Nursing Care of Patients with Oncological Problems
   1. Cancer in the adult patient
      1. Prevention and control
      2. Maintaining wellness during treatment
      3. Rehabilitation
   2. Cancer treatment management
      1. Goals
      2. Modalities
         1. Chemotherapy
            *Alkylating agents
            *Antimetabolites
            *Mitotic inhibitors
            *Antineoplastic antibiotics
            *Topoisomerase inhibitors
            *Miscellaneous agents
         2. Radiation
         3. Biologic response modifiers
         4. Research
         5. Quackery
      3. Evaluation of treatment and modality response
         1. Myelosuppression
         2. Gastrointestinal effects
         3. Integumentary effects
         4. Effects on the reproductive system
         5. Oncologic emergencies
      4. Cancer pain
         1. Pharmacologic interventions
            *Opiates
            *Nonopiates
            *Adjuvants
         2. Home management
         3. Complimentary therapy
      5. Cultural and family influences on cancer
         1. Hospice care
   3. Management of the patient with lymphoma
      1. Hodgkin’s and Non‐Hodgkin’s Lymphoma
   4. Management of the patient with skin cancer
      1. Basal cell carcinoma
      2. Squamous cell carcinoma
      3. Malignant melanoma
      4. Mycosis fungoides
      5. Kaposi’s sarcoma
2. Nursing Care of Patients with Neurological Problems
   1. Brief review of anatomy and physiology of the neurologic system
   2. Review of assessment of the neurologic dysfunction
      1. Adult life span considerations
      2. Cultural considerations
      3. Diagnostic procedures
   3. Clinical manifestations of neurologic problems
      1. Altered levels of consciousness
      2. Glasgow coma scale
   4. Management of patients with cerebral disorders
      1. Hemorrhagic cerebrovascular disorders
      2. Stroke
      3. Transient ischemic attacks
   5. Management of patients with peripheral nervous system disorders
      1. Lower back pain
      2. Cervical disc disorders
      3. Spinal tumors
      4. Disorders of the cranial nerves
         1. Trigeminal neuralgia
         2. Bell’s palsy
      5. Upper and lower motor lesions
      6. Peripheral neuropathies
   6. Pharmacological interventions
      1. Opiates
      2. Nonopiates
      3. Adjuvants
      4. Antiepileptic drugs
      5. Nimodipine (Nimotop)
      6. Mannitol (Osmitrol)
      7. Dopamine agonists
      8. Dopaminergics
      9. Catechol O-methyltransferase Inhibitors
      10. Cholinesterase inhibitors
      11. N-methyl-D-asparatate (MNDA) receptor antagonist
   7. Management of patients with degenerative neurologic disorders
      1. Creutzfeldt‐Jakob disease
      2. Huntington’s disease
      3. Multiple sclerosis
      4. Guillain‐Barre syndrome
      5. Parkinson’s disease
      6. Myasthenia gravis
      7. Amyotrophic lateral sclerosis
   8. Management of patients with neurological trauma
      1. Spinal cord injury
      2. Head and neck injury
3. Nursing Care of Patients with Musculoskeletal Disorders
   1. Brief review of anatomy and physiology of the musculoskeletal system
   2. Review of assessment of the musculoskeletal system
   3. Adult life span considerations
   4. Diagnostic tests
   5. Management of patients with musculoskeletal disorders
      1. Osteoarthritis
      2. Metabolic bone disorders
      3. Pagets disease
      4. Gout and gouty arthritis
      5. Bone tumors
      6. Pharmacological interventions
         *NSAIDs
         *Opiates
         *Adjuvants
   6. Management of patients with back and neck disorders
   7. Management of patients with musculoskeletal trauma or overuse
      1. Hip fractures
      2. Sports injuries
      3. Overuse syndromes of upper and lower extremities
      4. Rotator cuff tears
      5. Anterior cruciate ligament injuries
      6. Meniscal injuries
   8. Management of patients with autoimmune disease r/t the musculoskeletal system
      1. Rheumatoid arthritis
      2. Systemic lupus erythematosus
      3. Progressive systemic sclerosis
      4. Ankylosing spondylitis
      5. Sjorgen’s syndrome
      6. Fibromyalgia syndrome
      7. Mixed connective tissue disease
      8. Lyme disease
      9. Secondary arthritis