NURS 2455 - Advanced Adult Medical‑Surgical Nursing

Credit Hours: 1.50

Outcome 1: Upon completion of this course, students will be able to evaluate the critical components of evidence-based nursing practice.

Objectives:

1. Differentiate chronic versus emergent presentations of neurological, musculoskeletal, and oncologic conditions using current pathophysiological and clinical evidence.
2. Interpret diagnostic and assessment data to identify priority patient needs and detect early signs of deterioration or complications.
3. Integrate evidence-based nursing interventions and safety strategies to deliver patient-centered care for individuals with musculoskeletal, oncologic, and neurological conditions, minimizing risk and promoting optimal outcomes.
4. Evaluate the effectiveness of pharmacologic and non-pharmacologic therapies, including symptom-management strategies, using evidence-based clinical guidelines.

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

Objectives:

1. Implement timely, high-acuity interventions for patients experiencing rapidly changing neurological, musculoskeletal, or oncologic emergencies while maintaining patient safety.
2. Formulate evidence-based nursing plans of care related to neurological, musculoskeletal, and oncology that integrate patient preferences, safety standards, and inter-professional coordination.

• 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. 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
2. Nursing Care of Patients with Neurological Problems
   1. 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. N-methyl-D-asparatate (MNDA) receptor antagonist
   7. Management of patients with degenerative neurologic disorders
      1. Huntington’s disease
      2. Multiple sclerosis
      3. Guillain‐Barre syndrome
      4. Parkinson’s disease
      5. Myasthenia gravis
      6. 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. Sjorgen’s syndrome
      4. Fibromyalgia syndrome
      5. Lyme disease
      6. Secondary arthritis