LNUR 2255 - Intermediate Adult Medical-Surgical Nursing B

B. The student can apply the critical components of evidence-based nursing practice.  

LPN Course Outcomes:  

1. Upon completion of this course, the student will be able to apply evidence‐based practice for clients with urinary, renal, and endocrine problems. 

Objectives: The student will: 

1. The student will report subjective and objective data for clients with urinary, renal, and endocrine problems to the interdisciplinary team.  

2. The student will, in collaboration with interdisciplinary team data, implement appropriate nursing diagnoses and collaborative problems. 

3. The student will describe evidence‐based collaborative management for the client with urinary, renal, and endocrine problems. 

4. The student will implement evidence‐based nursing interventions in collaboration with the interdisciplinary team for clients with urinary, renal, and endocrine problems. 

LPN End of Program Student Learning Outcomes 

C. The student can identify quality improvement strategies as an integral component of nursing practice.  

Course Outcome 

1. Upon completion of this course, the student will be able to explain the role of the LPN in adhering to national patient safety goals and quality indicators for patients with urinary, renal, and endocrine problems  

Objectives: The student will: 

1. The student will describe the role of the LPN in maintaining quality indicators addressing minimization of indwelling catheter‐related infections. 

1. Overview  

a. Age-related changes of urinary system 

b. Review of definitions related to urinary system 

c. Diagnostic studies of urinary and renal system 

d. Patient safety/best practices prior to diagnostic studies 

e. CDC guidelines for indwelling urinary catheters 

f. Devices used in management of urinary disorders 

2. Infectious Disorders: Cystitis, Interstitial Cystitis  

a. Pathophysiology/risk factors 

b Assessment/clinical manifestations 

c. Diagnostics 

d. Collaborative management and interventions  

i. Pharmacological management 

ii. Urinary elimination management 

iii. Other interventions 

e. Evidenced base practice 

f. Culture/Ethnic or Gender considerations

3. Non‐infectious Disorders: Strictures, Incontinence, Urolithiasis, Urothelial Cancer  

a. Pathophysiology/risk factors 

b. Assessment/clinical manifestations 

c. Diagnostics 

d. Collaborative management and interventions  

i. Non‐surgical management 

ii. Pharmacological management 

iii. Surgical management 

iv. Other interventions 

e. Cultural, ethnic, and/or gender considerations 

4. Male reproductive disorders: BPH, Prostate Cancer, Testicular Cancer  

a. Pathophysiology/risk factors 

b. Assessment/clinical manifestations 

c. Diagnostics 

d. Collaborative management: non-surgical, pharmacologic, surgical management 

e. Cultural considerations 

5. Erectile Dysfunction: definition and pharmacological management 

      Unit 2 Renal Disorders 

1. Overview  

a. Age-related changes of renal system 

b. Functions of the kidney 

c. Hormonal functions of kidney 

2. Congenital Disorders: Polycystic Kidney Disease  

a.Pathophysiology 

b. Assessment/clinical manifestations 

c. Diagnostics 

d. Collaborative management and interventions 

3. Obstructive Disorders: Hydronephrosis, Hydroureter, Strictures  

a. Pathophysiology 

b. Assessment 

c. Collaborative management and interventions including nephrostomy tubes 

4. Infectious Disorders: Pyelonephritis  

a. Pathophysiology 

b. Assessment/clinical manifestations 

c. Diagnostics 

d.Collaborative management and interventions 

5. Acute and Chronic Glomerulonephritis, Nephrotic Syndrome  

a. Pathophysiology 

b. Assessment/clinical manifestations 

c. Diagnostics 

d. Collaborative management and interventions 

6. Nephrosclerosis, Renovascular Disease, Diabetic Nephropathy  

a.Pathophysiology 

b. Assessment 

c. Collaborative management and interventions 

7. Renal Cell Carcinoma  

a. Pathophysiology 

b. Assessment/clinical manifestations 

c.Diagnostics 

e. Collaborative management and interventions 

8. Renal Trauma  

a. Assessment 

b. Collaborative management  

i. Non‐surgical 

ii. Surgical 

Unit 3 Renal Failure 

1. Overview  

a. Review of terms 

b. Progression 

2. Acute Kidney Injury  

a. Etiology and pathophysiology 

b. Types  

i. Prerenal 

ii. Intrarenal 

iii. Postrenal 

c. Clinical course  

i. Onset phase 

ii. Oliguric phase 

iii. Diuretic phase 

iv. Recovery phase 

d. Assessment  

i. Physical assessment/history 

ii. Clinical manifestations 

iii. Diagnostics 

e. Collaborative management  

i. Drug therapy 

ii. Nutrition management 

iii. Renal replacement therapies  

     1. Hemodialysis 

2. Peritoneal dialysis 

3. Access sites 

3. Chronic Kidney Disease  

a. Pathophysiology  

i. Stages 

ii. Cardiovascular/pulmonary changes 

iii. Metabolic changes 

iv. Hematologic changes 

v. Gastrointestinal changes 

vi. Neurological changes 

vii. Integumentary changes 

b. Incidence/prevalence 

c. Collaborative management and interventions  

i. Assessment/physical and psychosocial 

ii. Clinical manifestations 

iii. Lab assessment and other diagnostics 

iv. Specific nursing care issues 

d. Cultural and ethnic disparities 

4. Hemodialysis  

a. Principles  

i. Patient selection 

ii. Procedure 

iii. Access 

iv. Nursing considerations before, during, after dialysis 

v. Complications 

5. Peritoneal dialysis 

   a. Principles

i. Patient selection 

ii. Procedure 

iii. Complications 

iv. Advantages over hemodialysis 

6. Renal Transplantation  

a. Candidate selection 

b. Donors 

c. Preoperative care 

d. Operative procedures 

e. Immunosuppressive drug therapy 

f. Types of rejection: hyperacute, acute, and chronic 

g. Manifestations of Organ Rejection 

h. Health teaching and resources 

7. Evidence‐Based Practice and Safety Related to Renal Failure  

a. Quality of life issues 

b. Adherence to medication regimen 

Unit 4 Endocrine Disorders 

1. Endocrine Assessment  

a. Anatomy and physiology overview 

b. Endocrine changes associated with aging 

c. Assessment  

i. Physical 

ii. Lab 

iii. Diagnostic 

2. Diabetes: A Focus on Complications  

a. Overview of diabetes mellitus  

i. Pathophysiology 

ii. Incidence 

iii. Clinical manifestations 

iv. Diagnostics 

v. Pharmacological management  

1. Insulin 

2. Oral agents 

vi. Collaborative management 

vii. Quality indicators related to diabetes 

b. Acute complications of diabetes  

i. Diabetic ketoacidosis  

    1.  Pathophysiology 

2. Clinical manifestations 

3. Collaborative management 

4. Prevention 

ii. Hyperglycemic‐hyperosmolar state  

1. Pathophysiology 

2. Clinical manifestations 

3. Collaborative management 

i. Hypoglycemia  

1. Symptoms ‐ adrenergic (SNS) and neuroglycopenic 

2. Management 

3. Prevention 

ii.  Other hypoglycemic disorders 

c. Chronic complications of diabetes  

i. Macrovascular  

1. Cardiovascular 

2. Cerebrovascular 

ii. Microvascular  

1. Eye and vision 

2. Diabetic nephropathy 

iii. Neuropathies ‐ sensorimotor and autonomic neuropathies 

d. Gerontologic considerations 

3. Disorders of the Thyroid Gland  

a. Hyperthyroidism  

i. Pathophysiology 

ii. Collaborative management  

1. Assessment 

2. Clinical manifestations 

3. Diagnostic assessment 

4. Interventions 

5. Best practices for patient safety and quality care 

4. Disorders of the Parathyroid Gland  

a. Hyperparathyroidism  

i. Pathophysiology 

ii. Collaborative management  

1. Assessment 

2. Clinical manifestations 

3. Interventions 

b. Hypoparathyroidism  

i. Pathophysiology 

ii. Collaborative management  

1. Assessment 

2. Clinical manifestations 

3. Interventions 

5. Disorders of the Adrenal Gland  

a. Adrenal gland hypofunction ‐ Addison’s  

i. Pathophysiology 

ii. Collaborative management  

1. Assessment 

2. Clinical manifestations 

3. Labs 

4. Interventions 

iii. Best practice for patient safety and quality care 

b. Adrenal gland hyperfunction ‐ Cushing’s  

i. Pathophysiology 

ii. Collaborative management  

1. Assessment 

2. Clinical manifestations 

3. Labs 

4. Interventions 

iii. Hyperaldosteronism 

iv. Pheochromocytoma  

1. Pathophysiology 

2. Assessment 

3. Interventions 

6. Pituitary Disorders  

a. Hypopituitarism  

i. Pathophysiology 

ii. Management 

b. Hyperpituitarism (acromegaly/gigantism)  

i. Pathophysiology 

ii. Interventions  

1. Surgical 

2. Non‐surgical 

7. Disorders of the Posterior Pituitary Gland  

a. Diabetes insipidus  

i. Pathophysiology 

ii. Assessment 

iii. Interventions 

b. Syndrome of inappropriate ADH (SIADH)  

i. Pathophysiology 

ii. Assessment 

iii. Interventions 

8. Pharmacological Management  

a. Urinary Disorders  

i. Sulfonamides 

ii. Fluoroquinolones 

iii. Urinary antiseptics 

iv. Drugs used for BPH  

v. Drugs used for erectile Dysfunction

b. Renal Impairment  

i. Calcium products/Phosphate binders 

ii. Vitamin D preparations 

iii. Erythropoietin 

c. Diabetes  

i. Review of insulins 

ii. Review of oral hypoglycemic agents 

iii. Insulin drip to treat DKA 

d. Thyroid Disorders  

i. Antithyroid drugs 

ii Thyroid hormone replacement 

e. Adrenal Disorders  

i. Corticosteroids 

ii. Mineralocorticoids 

f. Pituitary Disorders  

i. Posterior Pituitary Hormones (DDAVP) 

ii. Drugs for Acromegaly