NURS 1355 - Introduction to Adult Medical‑Surgical Nursing B

Credit Hours: 1.50

Program Outcome/Student Learning Outcome:

1. Analyze and apply the critical components of evidence-based nursing practice.

Course Outcome:

1. Upon completion of this course, students will be able to explain the role of evidence in determining best clinical practice and differentiate clinical opinion from research and evidence summaries for patients with acid‐base disturbances, respiratory disorders, and diabetes.

Course Objectives:

1. The student will interpret subjective and objective data for patients with acid‐base disturbances, respiratory disorders, and diabetes.
2. The student will interpret data to select appropriate nursing diagnosis and collaborative problems.
3. The student will describe evidence‐based collaborative management for the patient with acid‐base disturbances, respiratory disorders, and diabetes.
4. The student will select evidence‐based nursing interventions for patients with acid‐base disturbances, respiratory disorders, and diabetes.

Program Outcome/Student Learning Outcome:

2. Recognize quality improvement strategies as an integral component of nursing practice.

Course Outcome:

 2. Upon completion of this course, students will be able to identify national patient safety goals and quality indicators for patients with acid‐base disturbances, respiratory disorders, and diabetes.

Course Objectives:

1. The student will recognize quality indicators for patients with bacterial pneumonia.
2. The student will define quality indicators for patients with adult asthma.
3. The student will explain quality indicators for the patient with COPD.
4. The student will state national patient safety goals to prevent ventilator‐acquired pneumonia.
5. The student will explain national patient safety goals to prevent injury in patients receiving anticoagulation therapy.
6. The student will explain quality indicators in the collaborative management of the patient with diabetes.

1. Assessment of the Respiratory System
   1. Anatomy & physiology overview
   2. Assessment techniques
      1. History
      2. Physical and psychosocial assessment
      3. Diagnostic assessment
   3. Changes in the respiratory system related to aging
2. Interventions for Patients requiring Oxygen or Tracheostomy
   1. Oxygen therapy
      1. Complications
      2. Deficiency systems
      3. Home care management
      4. Evidence‐based practice for patient requiring oxygen
   2. Tracheostomy
      1. Pre‐ and post‐op care
      2. Complications
      3. Trache tubes
      4. Trache care
      5. Evidence‐based practice for patients requiring suctioning
      6. Best practices for patients with tracheostomy
      7. Best practices to prevent aspiration
3. Interventions for Patients with Noninfectious Upper Respiratory Problems
   1. Disorders of nose and sinuses
      1. Fractures
      2. Epistaxis
      3. Cancers
      4. Trauma
   2. Disorders of pharynx
      1. Obstructive sleep apnea
      2. Management
         1. Assessment
         2. Interventions
            1. Non‐surgical
            2. Surgical
   3. Disorders of the larynx
      1. Vocal cord paralysis, nodules, and polyps
      2. Laryngeal trauma
   4. Upper airway obstruction and neck trauma
   5. Head and neck cancer
      1. Pathophysiology
      2. Assessment
      3. Interventions
         1. Non‐surgical
         2. Laryngectomy
      4. Pre‐ and post‐op care
      5. Speech rehab
      6. Home care
      7. Best practices to prevent aspiration
4. Interventions for Patients with Noninfectious Lower Respiratory Problems
   1. Chronic airflow limitations (asthma, emphysema, bronchitis)
      1. Pathophysiology
      2. Etiology
      3. Collaborative management
         1. Physical and psychosocial assessment
         2. Diagnostic assessment
         3. Nursing diagnosis
         4. Pharmacologic interventions
            1. Bronchodilators
            2. Steroids
            3. Expectorants
            4. Mucolytics
         5. Nursing management
      4. Quality indicators for asthma, COPD
   2. Pulmonary hypertension
   3. Interstitial pulmonary diseases
      1. Sarcoidosis
      2. Pulmonary fibrosis
   4. Occupational pulmonary diseases
   5. Lung cancer
      1. Pathophysiology
      2. Etiology
      3. Collaborative management
         1. Physical and psychosocial assessment
         2. Diagnostic assessment
         3. Operative procedures
         4. Post‐op care including chest tube management
         5. Palliative care
5. Interventions for Patients with Infectious Respiratory Problems
   1. Disorders of the nose and sinuses
      1. Rhinitis and sinusitis
         1. Assessment
         2. Interventions
         3. Drug therapy
            1. Antihistamines
            2. Decongestants
         4. Surgical interventions
   2. Disorders of pharynx and tonsils
      1. Pharyngitis and tonsillitis
         1. Assessment
         2. Interventions
      2. Tonsillectomy
   3. Disorders of the larynx and lungs
      1. Laryngitis, influenza, pneumonia, and TB
         1. Overview
         2. Pathophysiology
         3. Etiology
         4. Management
            1. Assessment
            2. Diagnostics
            3. Interventions
         5. Drug therapy
            1. Antibiotics (penicillins, cephalosporins, tetracyclines, aminoglycosides, macrolides, vancomycin)
            2. Antitubercular
         6. Health teaching
         7. Patient safety goals related to pneumonia/vent‐acquired pneumonia
      2. Other influenzas (avian flu, swine flu)
   4. Emphysema, abscesses
      1. Assessment
      2. Interventions
   5. Inhalation anthrax
6. Interventions for Critically Ill Patients with Respiratory Problems
   1. Pulmonary embolism
      1. Pathophysiology
      2. Etiology
      3. Management
         1. Assessment
         2. Diagnostics
      4. Non‐surgical interventions
         1. Oxygen therapy
         2. Anticoagulation therapy
            1. Heparin
            2. Coumadin
      5. Surgical interventions
      6. Health teaching
      7. Patient safety goals for patients receiving anticoagulation therapy
   2. Acute respiratory failure
   3. Acute respiratory distress syndrome
      1. Pathophysiology
      2. Etiology
      3. Management
         1. Assessment
         2. Interventions
            1. Drugs
            2. Oxygenation
   4. Intubation and mechanical ventilation
      1. Types of ventilators
      2. Modes
      3. Weaning
      4. Best practice to secure endotracheal tubes
      5. Best practices for patients requiring mechanical ventilation
   5. Chest trauma: rib fracture, flail chest, pneumothorax
      1. Overview
      2. Collaborative management

UNIT 2 ‐ DIABETES MANAGEMENT

1. Review of Diabetes
   1. Pathophysiology
   2. Diagnostics
2. Nutritional Interventions
3. Blood Glucose Monitoring
4. Exercise Therapy
5. Foot Care
6. Drug Therapy
   1. Oral agents
   2. Insulin therapy
      1. Complications
      2. Alternative methods
   3. Newer drugs
7. Quality Indicators for the Diabetic Patient

UNIT 3 ‐ ACID‐BASE DISORDERS

1. Introduction to Acid‐Base Balance
   1. Acid‐base chemistry
      1. Acids
      2. Bases
      3. Buffers
   2. Body fluid chemistry
   3. Acid‐base regulatory mechanisms
      1. Chemical
      2. Respiratory
      3. Renal
      4. Compensation
   4. Age related changes in acid‐base balance
2. Assessment of Acid‐Base Balance
   1. History
   2. Physical assessment
   3. Diagnostics
3. Interventions for Patients with Acid‐Base Imbalances
   1. Acidosis
      1. Metabolic
      2. Respiratory
      3. Combined
   2. Alkalosis
      1. Metabolic
      2. Respiratory
   3. Causes of metabolic and respiratory imbalances
   4. Assessment findings in metabolic and respiratory imbalances
4. Analysis of Arterial Blood Gases