NURS 1355 - Introduction to Adult Medical‑Surgical Nursing B

Credit Hours: 1.50

1. Upon completion of this Associate Degree of Applied Science in Nursing program, students will be able to evaluate the critical components of evidence-based nursing practice.

Course Outcome 1: Upon completion of this course, students will be able to apply critical components of evidence-based nursing practice for clients experiencing acid-base disturbances, respiratory disorders, and diabetes.

Objectives:

1. Recognize cues in subjective and objective data of clients experiencing acid‐base disturbances, respiratory disorders, and diabetes.
2. Select appropriate nursing diagnosis and collaborative problems based on current evidence and safety goals for clients experiencing acid-base disturbances, respiratory disorders, and diabetes.
3. Select evidence‐based nursing interventions for clients experiencing acid‐base disturbances, respiratory disorders, and diabetes.

Program Outcome/Student Learning Outcome:

2. Upon completion of this Associate Degree of Applied Science in Nursing program, students will be able to evaluate safety strategies that minimize risk of harm to clients and the healthcare team.

Course Outcome 2: Upon completion of this course, students will be able to implement safety strategies that minimize the risk of harm to clients and the healthcare team.

Objectives:

1. Recognize best-practice nursing standards when planning care for clients’ acid‐base disturbances, respiratory disorders, and diabetes.
2. Apply best-practice nursing standards when planning care for clients’ acid‐base disturbances, respiratory disorders, and diabetes.

• Communication: The graduate can communicate effectively for the intended purpose and audience.
• Critical Thinking: The graduate can make informed decisions after analyzing information or evidence related to the issue.
• Global Literacy: The graduate can analyze human behavior or experiences through cultural, social, political, or economic perspectives.
• Information Literacy: The graduate can responsibly use information gathered from a variety of formats in order to complete a task.
• Quantitative Reasoning: The graduate can apply quantitative methods or evidence to solve problems or make judgments.
• Scientific Literacy: The graduate can produce or interpret scientific information presented in a variety of formats.

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