NURS 2245 - Intermediate Adult Medical‑Surgical Nursing A

Credit Hours: 1.50

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 apply evidence‐based practice for patients with cardiovascular and hematologic problems.

Objectives: The student will:

1. The student will interpret subjective and objective data for patients with cardiovascular and hematologic problems.
2. The student will interpret data to select appropriate nursing diagnoses and collaborative problems.
3. The student will describe evidence‐based collaborative management for the patient with cardiovascular and hematologic problems.
4. The student will choose evidence‐based nursing interventions for patients with cardiovascular and hematologic problems.

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 explain national patient safety goals and quality indicators for patients with cardiovascular and hematologic problems.

Objectives: The student will:

1. The student will describe quality indicators for patients with heart failure.
2. The student will discuss quality indicators for patients with acute coronary syndromes.
3. The student will identify national patient safety goals for patients receiving blood transfusions.

1. Cardiac Function
   1. Anatomy
      1. Structures
      2. Blood supply
   2. Mechanical properties
      1. Cardiac output
      2. Stroke volume
      3. Preload
      4. Afterload
      5. Contractility
      6. Heart rate
2. Vascular Function
   1. Arterial pressure
      1. Pulse pressure
      2. Mean arterial pressure
      3. Peripheral vascular resistance
   2. Venous pressure
   3. Capillary pressure
   4. Regulation of cardiac function and blood pressure
      1. Autonomic nervous system
      2. Sympathetic system
      3. Parasympathetic system
      4. Baroreceptors
      5. Stretch receptors
      6. Chemoreceptors
      7. Hormonal influences
3. Aging Effects
4. Cardiac Assessment
   1. Health history
   2. Physical assessment
   3. Diagnostic tests
5. Cardiac Function Disorders
   1. Coronary artery disease
      1. Atherosclerosis
         1. Etiology/pathology
         2. Medical/nursing management
      2. Angina pectoris
         1. Etiology/pathology
         2. Medical/nursing management
      3. Myocardial infarction
         1. Etiology/pathology
         2. Medical/nursing management
      4. Quality indicators
   2. Heart failure
      1. Etiology/pathology
      2. Medical/nursing management
      3. Quality indicators
6. Cardiac Structure Disorders
   1. Infectious disorders
      1. Rheumatic fever
         1. Etiology/pathology
         2. Medical/nursing management
      2. Infective endocarditis
         1. Etiology/pathology
         2. Medical/nursing management
      3. Pericarditis
         1. Etiology/pathology
         2. Medical/nursing management
      4. Cardiac tamponade
   2. Cardiomyopathy
      1. Etiology/pathology
      2. Medical/nursing management
   3. Valvular heart disease
      1. Mitral valve disease
      2. Aortic valve disease
      3. Tricuspid and pulmonic valve disease
      4. Etiology/pathology
      5. Medical/nursing management
   4. Cardiac surgery
      1. Types
      2. Surgical management
      3. Nursing management
7. Vascular Disorders
   1. Vascular assessment
      1. History
      2. Physical examination
      3. Diagnostic tests
   2. Hypertension
      1. Pathology
      2. Clinical manifestations
      3. Medical/nursing management
      4. Malignant hypertension
   3. Acute/chronic venous pathology
      1. Superficial thrombophlebitis
      2. Deep vein thrombosis
         1. Medical/nursing management
      3. Chronic venous insufficiency
         1. Venous stasis ulceration
         2. Varicose veins
         3. Medical/nursing management
   4. Acute/chronic arterial pathology
      1. Chronic arterial occlusion
         1. Clinical manifestations
         2. Medical/nursing management
      2. Acute arterial occlusion
         1. Clinical manifestations
         2. Medical/nursing management
      3. Aneurysms
         3. Abdominal aortic aneurysms
         4. Aortic dissection
         5. Thoracic aortic aneurysms
      4. Raynaud’s syndrome
8. Shock
   1. Hypovolemic
   2. Cardiogenic
   3. Distributive
      1. Neural‐induced
      2. Chemical‐induced
         1. Anaphlaxis
         2. Sepsis
   4. Medical/nursing management
9. Disorders of Cardiac Rhythm
   1. Electrophysiologic properties
      1. Action potential
      2. Depolarization
      3. Repolarization
      4. Excitability
      5. Automaticity
      6. Conductivity
      7. Refractoriness
      8. Cardiac conduction system
      9. Cardiac cycle
   2. Sinus rhythms
   3. Atrial dysrhythmias
   4. Ventricular dysrhythmias
   5. Pulseless electrical activity
   6. Medical management
      1. Defibrillation
      2. Cardioversion
      3. Medications
   7. Surgical management
      1. Pacemakers
   8. Nursing management

UNIT 2 Hematologic System

1. Hematology Assessment
   1. Blood elements
      1. Erythrocytes
      2. Leukocytes
      3. Thrombocytes (platelets)
   2. History
   3. Physical examination
   4. Diagnostic tests
      1. Bone marrow aspiration
2. Hematological Disorders
   1. Anemia
      1. Iron deficiency anemia
      2. Pernicious anemia
      3. Aplastic anemia
      4. Hemolytic anemia
      5. Acute hemorrhage anemia
      6. Chronic hemorrhage anemia
      7. Clinical manifestations
      8. Medical management
      9. Nursing management
   2. Polycythemia
   3. Platelet disorders
   4. Transfusion of blood components
      1. Types
      2. Procedure
      3. Transfusion reactions

UNIT 3 Pharmacology

1. Antihyperlipidemic Agents
   1. Bile sequestering agents
   2. Reductase inhibitors
   3. Fibric acid derivatives
   4. Nicotinic acid (Niacin)
   5. Cholesterol absorption inhibitor
2. Vasodilators
   1. Nitrates
   2. Arteriolar dilator drugs
   3. Arterial and venous dilator drugs
3. Alpha Blockers
4. Beta‐Adrenergic Blockers
5. Calcium‐Channel Blockers
   1. Antianginal
   2. Antiarrhythmic
   3. Antihypertensive
6. Positive Inotropes
   1. Cardiac glycosides
   2. Phosphodiesterase inhibitors
7. Adrenergic Agents
8. Diuretics Agents
   1. Thiazides
   2. Loop diuretics
   3. Potassium‐sparing diuretics
9. Angiotensin‐Converting Enzyme Inhibitors (ACE‐I)
10. Angiotensin II ‐ Receptor Blockers (ARB)
11. Centrally Acting Alpha Agonists
12. Antidysrhythmics
    1. Class I
    2. Class II: Beta‐Blockers
    3. Class III
    4. Class IV: Calcium‐Channel Blockers
    5. Unclassified
13. Coagulation Modifiers
    1. Antiplatelets
    2. Anticoagulants
    3. Thrombolytics
    4. Others
14. Blood‐Forming Agents