VNSG 1400 – NURSING IN HEALTH AND ILLNESS I

 

 

This course is part of the first semester curriculum of the vocational nursing program.  Successful completion of this foundational course (as well as the other required first semester courses) is mandatory for the student’s ability to progress to the second semester curriculum.

 

 

 

INSTRUCTORS:      Bowie campus:         D. Swafford, RN       (dswafford@nctc.edu)

                             Corinth campus:       J. Lopes, RN            (jlopes@nctc.edu)

Gainesville campus:  A. Hupp, RN             (ahupp@nctc.edu )       

Graham campus:      M. Enns, RN            (menns@nctc.edu)

 

 

 

COURSE DESCRIPTION

Introduction to general principles of growth and development, primary health care needs of the client across the lifespan, and therapeutic nursing interventions.  Introduction and development of the nursing process and concept mapping.  Concentration on cultural nursing aspects, therapeutic communication, nutrition, geriatrics, diabetes, mental health and illness, and muscular-skeletal pathophysiologies.

 

 

TEXTBOOKS and RESOURCE REQUIREMENTS

Linton, A.D.  Introduction to Medical Surgical Nursing.  6^th ed.  (2016) St. Louis: Elsevier  

 

EAQ to Accompany Introduction to Medical Surgical Nursing. 5^th ed. (2016) St. Louis: Elsevier  

 

Mosby 2016 Drug Reference (2016) St. Louis: Elsevier

 

Nettina, S.  Lippincott Manual of Nursing Practice  9^th ed. (2010)  Philadelphia: LWW.  ISBN # 13: 978-0-7817-9833-4

 

Silvestri, Saunder’s Comprehensive Review for NCLEX-PN  6th ed. (2014)  Philadelphia: Saunders  

 

Ladwig, GB. and Ackley, BJ.  Guide to Nursing Diagnosis 4^th ed. (2015) St. Louis: Mosby

 

 

 

 

 

 

 

 

 

 

 

 

OVERALL COURSE OBJECTIVES / LEARNING OUTCOMES

Upon successful completion of Nursing in Health and Illness I course, the student will be able to: 

 

1.       Describe the psychosocial, growth and development, and physiological needs of clients across the life span.   (DELC 1, 2, 3, 4) (SCANS 5)

 

2.       Discuss the principles involved in the causes of disease and the body's response to disease.   (DELC 1, 2, 3, 4) (SCANS 5)

 

3.       Discuss the nurse's role in preventing and controlling the transmission of community acquired and nosocomial infections. (DELC 8, 9, 10) (SCANS 5)

 

4.       Identify physical, mental, and emotional factors affecting the aging adult.      

          (DELC 1, 2, 3, 4) (SCANS 5)

 

5.       Identify nursing approaches to the needs of the adult client in acute, rehabilitative, long-     term and home settings.   (DELC 8, 9, 10) (SCANS 5)

 

6.       Discuss (common / overt / actual / potential) primary health care needs of a client with cancer, diabetes, muscular-skeletal dysfunction, a client with pain, a grieving client and family, and a client with mental health dysfunction, including pharmacologic interventions.   (DELC 1, 2, 3, 4, 8, 9, 10) (SCANS 1, 5)

 

7.       Discuss cultural differences in clients and the nurse's role in providing culturally        congruent nursing care.  

          (DELC 13, 14) (SCANS 5)

 

8.       Discuss the basic structure and function of the healthcare delivery system.

          (DELC 8, 9, 10, 13, 14) (SCANS 5)

 

9.       Describe the steps in the nursing process and define nursing diagnosis using universally accepted taxonomy.   

          (DELC 1, 2, 3, 4, 13, 14) (SCANS 5)

 

10.     List techniques for effective interviewing and communicating.  

          (DELC 1, 2, 3, 4, 9, 10) (SCANS 5)

 

11.     Define ethics and discuss principles that serve as a foundation for ethical decision-making.

          (DELC 13, 14) (SCANS 5)

 

12.     Describe and discuss basic concepts related to care of the patient experiencing mental           health problems.

          (DELC 1, 2, 3, 4, 8, 9, 10) (SCANS 1, 5)

 

 

 

 

 

 

 

08/28/2018         Week 1                 Orientation to class. Begin Unit 1 Lecture (Chapters 1-4)

09/04/2018         Week 2                 DUE: Unit 1 quiz                                                                                                                                                                               Complete Unit 1 Lecture (Chapters 5-7)                                                                 

09/11/2018         Week 3                 UNIT 1 EXAM.                                                                                                                                                                                   DUE: Unit 1 ATI & essay on a malpractice suit                                                                                                                     Begin Unit 2 Lecture (Chapters 8-9)

09/18/2018         Week 4                 DUE: Unit 2 quiz                                                                                                                                                                             Complete Unit 2 Lecture (Chapters 10, 13)                                                           

09/25/2018         Week 5                 UNIT 2 EXAM.                                                                                                                                                                              DUE: Unit 2 ATI                                                                                                                                                                                                 Begin Unit 3 Lecture (Chapters 11 and 20)

10/02/2018         Week 6                 Continue Unit 3 Lecture (Chapters 21-23)

10/09/2018         Week 7                 DUE: Unit 3 quiz                                                                                                                                                                        Complete Unit 3 Lecture (Chapters 15, 24)

10/16/2018         Week 8                 UNIT 3 EXAM.                                                                                                                                                                                   DUE: Unit 4 quiz                                                                                                                                                                             DUE: Unit 3 ATI                                                                                                                                                                                 Begin Unit 4 Lecture (Chapter 12 and concept mapping)

10/23/2018         Week 9                 UNIT 4 EXAM.                                                                                                                                                                                   DUE: Unit 4 ATI                                                                                                                                                                                 Begin Unit 5 Lecture (Chapters 43-44)

10/30/2018         Week 10               DUE: Unit 5 quiz                                                                                                                                                                             Complete Unit 5 Lecture (Chapter 45)

11/06/2018         Week 11               UNIT 5 EXAM.                                                                                                                                                                                   DUE: Unit 5 ATI                                                                                                                                                                                 Unit 6 Lecture (Chapter 48)

11/13/2018         Week 12               DUE: Unit 6 quiz                                                                                                                                                                             Complete Unit 6 Lecture (Chapter 25)

11/20/2018         Week 13               UNIT 6 EXAM.                                                                                                                                                                                   DUE: Unit 6 ATI                                                                                                                                                                                 Begin Unit 7 Lecture (Chapters 55-56)

11/27/2018         Week 14               DUE: Unit 7 quiz                                                                                                                                             Complete Unit 7 Lecture (Chapters 57 and 22 Delirium vs Dementia)                 

12/04/2018         Week 15               UNIT 7 EXAM                                                                                                                                                                                     DUE: Unit 7 ATI & essay on a mental illness                                                                                                                        Review for Final

12/11/2018         Week 16               FINAL—TBA

 

Please note: This schedule is subject to change as the need arises.

ATI, quizzes, and essays will be averaged together for that units daily grade. If ATI or essays are not completed, you will receive a zero. Quizzes will be graded

Remediation is required for any exam scoring less than 80. All assignments are to be turned into instructor in the beginning of each class, late work will not be accepted.

If you have any questions, my office hours are Thursdays 08:00-09:00 and 16:00-17:00. Outside of office hours, you can email me at menns@nctc.edu

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

See NCTC Vocational Nursing Student Handbook for academic honesty, testing, and grading specifics.    ALL grades will be posted on CANVAS; except for the final exam grade.   Final exam grade and final course grade will be given individually to students during clinical evaluation.

 

Grading Calculation:         Unit Exams              70%  of final grade

                                      Daily Grades             5%  of final grade

                                      Final Exam              25%  of final grade

 

 

THERE IS ABSOLUTELY NO SCALING OF GRADES UNDER ANY CIRCUMSTANCES.

 

 

Grading Scale:         90 – 100 =   A

                                    80 – 89   =   B

                                    77 – 79   =   C                  Minimum grade to remain in VN Program

                             65 – 76   =    D

                             ≤ 64       =    F

 

Chapter 1 – The Health Care System

 

CHAPTER 1 STUDENT LEARNING OUTCOMES:  The student will be able to:

1. Describe holistic nursing
2. Describe the organization of the health care system in the US.
3. Describe the focus of public health services.
4. Define the three levels of prevention.
5. Describe financing of health care in the US, including Medicare and Medicaid programs.
6. Describe the components of the health care system that provide both outpatient and inpatient care and the types of service each provides.
7. Describe the impact of cost containment measures on the delivery of health care

 

KEY TERMS:

Capitation                     Diagnosis-related group (DRG)                                    Long-term care facility

Managed health care     Health Maintenance Organization (HMO)                     Primary care

Older Americans Act     Preferred Provider Organization (PPO)

Medicaid                       Extended care                                       Public health service      Fee for service 

Medicare                       Primary prevention  (wellness)                Secondary prevention    Tertiary prevention

                                               

CHAPTER 1 LECTURE OUTLINE:

Organization of the health care system:  Administration and Financing

Components of the health care system:  Outpatient care and Inpatient care

 

STUDENT LEARNING ACTIVITIES:

1. Read the chapter.
2. View PowerPoints and Lecture Notes
3. Answer the review questions at the end of the chapter.
4. Complete any outside learning assignments provided by the instructor.
5. Complete and utilize study guide for resources as well as:
   1. ATI resources as available
   2. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

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Chapter 2 – Patient Care Settings

 

CHAPTER 2 STUDENT LEARNING OUTCOMES:  The student will be able to:

1. Describe the role of the nurse in community and home health, rehabilitation, and long-term care settings.
2. Discuss community health/public health and community-based nursing.
3. Describe the types of specialty care that nurses may provide in home health care.
4. Describe the nursing principles and goals of rehabilitation.
5. List the four levels of patient disability and the nurse’s role in meeting maximal independence potential.
6. Discuss legislation passed to protect the rights of the disabled.
7. Name the members of the rehabilitation team.
8. List and discuss the types of extended care facilities and the nurse’s role in each.
9. Discuss the effects of institutionalization on the elderly client and realistic nursing interventions in response.
10. Describe the principles of home care and the nurse’s role in meeting maximal independence potential.

 

KEY TERMS:    Disability          Handicap          Impairment        Rehabilitation        Skilled nursing facility                        Home health      Assisted Living     Acuity            Team Nursing               Primary Nursing

CHAPTER 2 LECTURE OUTLINE:

Nursing Theorist Overview:  Nightingale        Henderson        Weidenbach                  Orem                King

 

Acute Care Hospital:           Acuity         Primary care            Team Nursing           Long Term Acute Care

 

Community health nursing and home health nursing              Case Management

 

Rehabilitation:         Concepts                                  Levels of disability                    Goals of rehab              Legislation effecting rehab         Rehab team members               Approaches to rehab

 

Long-term care:       Risks for institutionalization                    Levels of care               Impact of relocation                               Effects of institutionalization                   Principles of long-term residential care

STUDENT LEARNING ACTIVITIES:

6. Read the chapter.
7. View PowerPoints and Lecture Notes
8. Answer the review questions at the end of the chapter.
9. Complete any outside learning assignments provided by the instructor.
10. Complete and utilize study guide for resources as well as:
    1. ATI resources as available
    2. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

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Chapter 3 – ETHICAL AND LEGAL CONSIDERATIONS

 

CHAPTER 3 STUDENT LEARNING OUTCOMES:  The student will be able to:

            1.   Explain the differences between laws and ethics

            2.   Differentiate sources of U.S. law

            3.   Differentiate intentional and unintentional torts

            4.   Summarize negligence, malpractice, and liability

            5.   Explain the elements of risk management and other methods to avoid malpractice suits.

            6.   Discuss informed consent, advance directives, and DNR orders.

            7.   Describe procedures and regulations to protect patient information

            8.   Interpret utilitarianism, deontology, non-malificence, justice, veracity, fidelity, duties and rights

            9.   Summarize the characteristic of ethical values

            10. Describe four basic principles of ethics

            11. Explain the ethical decision making model

      12. Discuss the legal and ethical aspects of the “Patient’s Bill of Rights”.

      13. Discuss HIPPA regulations and interpret HIPPA precedence utilizing scenarios.

 

 

CHAPTER 3 LECTURE OUTLINE:

            Laws                Code of Ethics              HIPPA              Living Will                     Good Samaritan Law

                Torts                 Liability                         Malpractice       Power of Attorney         Incident Reports

            Consents          Patient Rights               Autonomy         Documentation              Nurse Practice Act

            Beneficence      Nonmaleficence            Justice              Fidelity / Veracity           Utilitarianism

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

11. Complete and utilize study guide for resources as well as:
12. ATI resources as available
13. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

 

 Chapter 5 – THE NURSE-PATIENT RELATIONSHIP

 

CHAPTER 5 STUDENT LEARNING OUTCOMES:  The student will be able to:

1. Define the holistic view of nursing: physical, mental, emotional, spiritual, cultural.
2. Define the concept of “self” and discuss the use of “self” in the practice of nursing.
3. Compare the meanings of the terms “patient” and “client”.
4. Discuss commonly held expectations of patients and families
5. Describe guidelines for nurse-patient relationships.
6. Describe basic components of therapeutic nursing communication.

 

 

KEY TERMS:    Action               Caring               Client                Empathy           Empowerment               Ethics

Holism              Morals              Self                  Values              Understanding   Therapeutic relationship

 

 

CHAPTER 5 LECTURE OUTLINE:

Holistic view of nursing care

Use of self in nursing:          Values, beliefs, and attitudes

                                          Knowledge and Skills

Perspective of the patient:    Patient versus client

                                          Patients’ rights

                                          Common Pts’ expectations

Guidelines for the nurse-patient relationship:             The helper role              Communication

Empathetic response     Ethical considerations

 

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

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Chapter 6 – CULTURAL ASPECTS OF NURSING CARE

 

CHAPTERS 6 STUDENT LEARNING OUTCOMES:  The student will be able to:

1. Describe cultural concepts related to nursing and health care.
2. Identify traditional health habits and beliefs of major ethnic groups in the US.
3. Explain cultural influences on the interactions of patients and families with the health care system.
4. Discuss cultural considerations in providing culturally sensitive nursing care.
5. Discuss how nursing interventions can be adapted to a patient’s ethnicity.
6. Describe roles and communication patterns within families.
7. Describe adaptive and mal-adaptive mechanisms used by families to cope with various stressors.
8. Describe the role of the nurse in dealing with families experiencing various stresses.
9. Identify community resources that may help to meet the family’s needs

 

KEY TERMS:    Assimilation                  Cultural diversity           Culture                          Ethnocentrism  

                        Ethnic group                 Sub-culture                   Generalization               Spacing                                    Transcultural nursing     Eye contact                  Family                          Role                                         Functional vs. Dysfunctional communication

 

CHAPTER 6 LECTURE OUTLINE:

            Characteristics of culture

Cultural beliefs related to health and illness

Communication with non-English speaking patients

           

            Types of families

            Family and culture

            Family developmental theory:     Family life cycle and developmental tasks

            Family roles and communications:          Family role structure

                                                                        Family interaction

                                                                        Family communication patterns

            Family coping:  Stress and adaptation /// Coping strategies

            Role of the nurse in family nursing care  /// Community resources

 

Traditional health habits and beliefs of major ethnic groups in the US:      Caucasians                                                                                                                                           Asians

                                                                                                            African Americans                                                                                                                                 Hispanics

                                                                                                            Native Americans

                                                                                                           

 

Traditional Health habits & beliefs of major religious groups in the USA:   Catholic            Jewish

                                                                                                            Muslim              Hindu

                                                                                                            Buddhist           Voodoo

                                                                                                            Mormon            Wiccan

                                                                                                            Baptist              Lutheran

                                                                                                            Pentecostal

                                                                                                            Salvation Army

                                                                                                            Seventh Day Adventist

                                                                                                            Christian Scientist

                                                                                                            Jehovah’s Witness

                                                                                                            Scientology

                                                                                                            New Age

 

Cultural influences on patient & family interactions with health care system:         Hospital health care

                                                                                                            Community and home care

                                                                                                            Long-term facility health care

     

      Cultural expressions and implications for nursing care:    Therapeutic relationship

                                                                                          Basic physiologic needs

                                                                                          Drug therapy

 

      Complementary and alternative therapies:                      Associated patient teaching

 

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

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CHAPTER 9 - BASIC NUTRITION

 

NUTRITION UNIT STUDENT LEARNING OUTCOMES:  The student will be able to:

1. Explain the GI physiology in order to digest and absorb food nutrients.
2. List the functions of each of the six classes of essential nutrients.
3. Define macro-nutrient and micro-nutrient and identify foods sources of each of the vitamins & minerals.
4. Identify the food sources of proteins, carbohydrates, and fats.
5. List the possible health benefits of dietary fiber and identify food sources of dietary fiber.
6. Describe the changes in nutrient needs as an individual ages.
7. Distinguish between anorexia nervosa, bulimia nervosa, and binge eating disorders.
8. Discuss the different types of nutritional support.
9. Identify guidelines for the nutritional assessment.

 

KEY TERMS:    Amino acids      Basal metabolic rate      Complementary proteins            Complete protein

Calorie              Lipoproteins      Insoluble fiber               Unsaturated fatty acids              Incomplete protein

Lipids               Minerals            Micronutrients               Resting energy expenditure        Saturated fatty acids

Proteins            Vitamins           Macronutrients              Unsaturated fatty acids              Triglycerides                                        

LECTURE OUTLINE:

A + P of GI system:             Digestion and absorption, Regulators of GI activity, Digestive process, Nutrients

                                          Factors affecting digestion

Energy expenditure

 

Carbohydrates:       Definition, composition, classification, food sources, recommended dietary allowance

 

Lipids:        Functions, transport & storage, metabolism, recommended dietary allowance, food sources

 

Proteins:     Definition, composition, metabolism & synthesis, deficiency, evaluation of protein quality

 

Vitamins:    Fat-soluble, water soluble

 

Minerals

 

Water

 

Age related changes:   Energy, nutritional care of the older adult

 

Guidelines for dietary planning:        Food guide pyramid, Recommended daily allowance, Nat’l diet                                                          guidelines, Vegetarian diets

 

Nursing assessment of nutritional status and diet history

 

Weight management and eating disorders:   Anorexia nervosa, Bulimia, Binge eating disorder

 

Supplemental feedings:       Enteral tube feedings, Parenteral nutrition, Transitional feeding

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

 

CHAPTER 8 – THE Health Care Continuum

 

UNIT STUDENT LEARNING OUTCOMES:  The student will be able to:

1. Describe the health-illness continuum.
2. Define acute and chronic illness.
3. Discuss traditional and current views of health and illness.
4. Review Maslow’s Hierarchy and list Maslow’s five basic human needs.
5. Explain the four levels of adaptability to stress in humans.
6. Discuss concepts and nursing measures related to health promotion, disease prevention, and illness.
7. Discuss illness behavior and the impact of illness on the family.
8. Describe complementary and alternative therapies and the nurse’s role in relation to both.

 

KEY TERMS:    Acute illness                 Chronic illness               Coping          Homeostasis        Stress  

                        Primary prevention     Secondary prevention        Tertiary prevention            Alternative therapy                 Complementary therapy

 

LECTURE OUTLINE:

            The health-illness continuum

            Traditional vs. current views of health and illness

            Maslow’s basic human needs

            Adaptation to stress:     Stress response, coping, adaptation, homeostasis

Health, promotion, disease prevention, and health maintenance

Complementary and alternative therapies

The concept of illness:  Illness behavior

                                    Impact of illness on the family

Implications for nursing care:      Preventing health problems

                                                Helping to satisfy the patient’s unmet basic human needs

                                                Increasing adaptability

                                                Fostering independence

                                                Assisting family members in dealing with the patient’s illness

                                                Assisting terminally ill patients to a peaceful death

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CHAPTER 10 - HUMAN DEVELOPMENTAL PROCESSES

 

CHAPTER LEARNING OUTCOMES:  The student will be able to:

      1.          Discuss Erickson’s developmental tasks for successful adulthood.

2. Identify the health problems specific to the adult age groups
3. Discuss the health care needs of young, middle-aged, and older adults.
4. Discuss Maslow’s Hierarchy in determining prioritorization of human needs

 

KEY TERMS:                Biologic age                  Psychologic age           Social age

 

LECTURE OUTLINE:

            Maslow’s Hierachy of Human Needs

            Erickson’s Developmental Tasks throught he Lifespan

                        Young adulthood:          Developmental tasks, health problems, health care needs

                        Middle adult years:        Developmental tasks, health problems, health care needs

                        Older adults:                 Developmental tasks, health problems, health care needs

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Chapter 13 – INFLAMMATION, INFECTION, AND IMMUNITY

 

CHAPTER 13 STUDENT LEARNING OUTCOMES:   The student will be able to:

      1.          Describe the body’s natural physical and chemical barriers to infection.

2. Describe how inflammatory changes act as bodily defense mechanisms.
3. Identify the signs and symptoms of inflammation.
4. Discuss the process of repair and healing.
5. Differentiate infection from inflammation.
6. Discuss the transmission and actions of commonly found infectious agents.
7. Identify the signs and symptoms of infection and standard nursing care for patients with infections..
8. Compare community-acquired infections and nosocomial infections.
9. Describe the CDC standard precautions guidelines for infection control.
10. Describe the CDC isolation guidelines for airborne, droplet, and contact (transmission-based) precautions.
11. Describe the immune response, organs involved in immunity.
12. Compare natural immunity and acquired immunity.
13. Differentiate between humoral (antibody-mediated) and cell-mediated immunity.
14. Describe the nursing care of patients with allergies.
15. Describe the process of auto-immunity.

 

KEY TERMS:       Allergens        Antibody           Antigen             Bacteria                       Communicable disease

Fungi Immunity    Inflammation   Viruses             Infection           Contamination                Immunodeficiency

Medical asepsis                        Nosocomial infections               Surgical asepsis            Autoimmunity

 

CHAPTER 13 LECTURE OUTLINE:

 

Infectious Process (Chain of Infection)

Physical and chemical barriers

 

The inflammatory process:  Actions, signs and symptoms, wound healing

Infection:    Infectious agents, transmission of infection, signs and symptoms, types

 

Care of patients with infection:         Medical asepsis

                                                      Surgical asepsis

                                                      Standard precautions  (universal precautions)

                                                      Transmission-based (Isolation) precautions

                                                      Immuno-compromised patients

Immunity:    Innate (natural) versus acquired immunity

                  Cells and organs involved in immunity

Defenses against infection – the immune response:  Antibody-mediated (Immediate) immunity

                                                                              Cell-mediated (Delayed) immunity

Immunodeficiency:              Etiology and risk factors, medical treatment

Hypersensitivity and allergy:             Etiology and risk factors, medical treatment

Anaphylaxis:           Etiology and risk factors, medical treatment

Autoimmune diseases:        Etiology and risk factors, medical treatment

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

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CHAPTER 11 = THE OLDER PATIENT

 

UNIT STUDENT LEARNING OUTCOMES:  The student will be able to:

 

      1.          Describe the roles of the gerontological nurse.

      2.          Compare the myths and stereotypes of the aging population with current statistical trends.

 

      3.          Describe the physiologic and psychosocial factors associated with aging.

 

5. Describe the nurse’s role in modifications needed for activities of daily living of the elderly.
6. Identify various groups of drugs that need modification because of changes brought about by aging.
7. Describe incidences and factors that increase the risk of falls
8. Discuss the relationship between restraint use and falls.
9. Discuss types of restraints and regulations for restraint use.
10. Describe fall prevention techniques.
11. Describe nursing interventions to be used when a fall occurs.
12. Describe common problems associated with immobility.
13. Discuss the impact of exercise and positioning on preventing complications related to immobility.
14. Identify the risk factors, prevention, staging and treatment for pressure ulcers.
15. Discuss the impact of immobility on respiratory status, nutrition, and elimination.
16. Define delirium and dementia.
17. Identify the causes of acute confusion.
18. Explain the differences between delirium and dementia.
19. Discuss nursing assessment and interventions related to delirium and dementia.
20. Identify types of urinary and fecal incontinence.
21. Explain the pathophysiology and treatment of each specific type of incontinence.
22. Identify common therapeutic measures used for the incontinent patient.
23. List nursing assessment data needed to assist in the evaluation and treatment of incontinence.

 

 

KEY TERMS:    Ageism                                     Aging                                       Cataract                                                Conduction deafness                Gerontological nurse                 Gerontology                                          Glaucoma                                 Kyphosis                                  Presbycusis                                          Presbyopia                               Sensorineural deafness             Erythema

                        Physical restraint                       Contracture                               Delirium                                                Extrinsic factors                        Intrinsic factors                         Chemical restraint                                  Dementia                                  Confusion                                 Pressure ulcer                                       Shearing forces                        ROM exercise                           Immobility        

                        Void                                         Active exercise                          Isometric exercise                                 Passive exercise                       Anorectal incontinence               Crede’s technique        

                        Fecal incontinence                     Micturation                                Functional incontinence                         Neurogenic bladder                   Reflex incontinence                   Urinary incontinence                              Transient incontinence               Overflow incontinence (fecal)     Stress incontinence      

                        Urge incontinence                     Neurogenic incontinence            Symptomatic incontinence                     Overflow incontinence (urine)                                                     Overactive bladder

                                   

 

 

 

GERIATRIC LECTURE OUTLINE:

Definitions of old age

 

Roles of the gerontological nurse

 

Ageism – myths and stereotypes

Theories on aging

 

Physiologic changes in aging:    Nervous system            Respiratory system                   Renal system                                                    Cardiovasc. system       Integumentary system               Sensory system                                                Musculoskeletal system

 

Coping and adaptation (family, individual)

 

Functional assessment

 

Drug therapy and older adults:   absorption, distribution, metabolism, excretion, adverse drug reactions

 

Definition of falls, incidence and risk factors

Restraints:        Physical and chemical

Nursing assessment and intervention:     Fall prevention

                                                            When a fall occurs

 

Definition of pressure ulcers

Decubiti risk factors and prevention

Nursing assessment and intervention:           Exercise, Positioning, Skin integrity, Respiratory status,

                                                                  Food and fluid intake, Elimination

Decubiti staging

 

Delirium vs. dementia 

Guidelines for working with dementia patients

 

Urinary incontinence: prevalence and cost

Physiology of urination

Diagnostic tests and procedures:    Laboratory tests, Post-void residual, Provocative stress testing, Cystoscopy,

 

Common therapeutic measures:             Behavioral interventions             Reflex training

                                                            Drug therapy                             Urine collection devices

                                                      Penile clamp                             Pelvic organ support devices

                                                            Surgical treatment                     Garments and pads for incontinence

           

Types of urinary incontinence:    Urge incontinence         Reflex incontinence                   Overflow incontinence

                                                Stress incontinence       Functional incontinence             Total incontinence

 

Fecal incontinence

Physiology of defecation

Diagnostic tests and procedures

Common therapeutic measures:             Enemas, Pouches, Drug therapy, Biofeedback, Dietary changes

 

Types of fecal incontinence:       Overflow incontinence                            Neurogenic incontinence                                                            Symptomatic incontinence                     Anorectal incontinence

                                               

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Chapter 15 – CARING FOR CLIENTS IN PAIN

 

CHAPTER 15 STUDENT LEARNING OUTCOMES:   The student will be able to:

 

1.         Define pain and explain its physiologic basis

2.         Identify situations in which patients are likely to experience pain.

3.         Explain the relationships between past pain experiences, anticipation, culture, anxiety, or                         activity and a patient’s response to pain.

4.         Identify differences in the duration of pain and patient responses to acute and chronic pain.

5.         Explain the special needs of the elderly patient with pain.

6.         Describe the data to be collected in assessing pain and list nursing interventions to manage                     pain.

      7.         Describe the nursing care of patients receiving opioid and non-opioid analgesics for pain.

      8.         List the factors that should be considered when pain is not relieved with analgesic medications.

 

 

 

KEY TERMS:    Acute pain                    Addiction                      Analgesia                      Analgesic                                  Chronic pain                  Tolerance                     Anesthesia                    Pain threshold                           Pain tolerance                       Physical dependence                

 

 

 

CHAPTER 15 LECTURE OUTLINE:

Definition of pain

Physiology of pain:  Gate-control theory

 

Factors influencing response to pain:            Physical factors, Psychological factors

 

Responses to pain:  Autonomic nervous system

                              Acute pain vs. chronic pain

 

Non-pharmacologic interventions for pain:    Comfort measures, diversion, meditation, relaxation, biorythms

 

Common pharmacological treatments for pain  (opioid vs. non-opioid drugs)

      -  Assessments needed before medicating

      -  Common side effects and potential adverse reactions

 

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

 

 

 

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Chapter 24 – LOSS, DEATH, AND END-OF-LIFE ISSUES

 

CHAPTER 24 STUDENT LEARNING OUTCOMES:   The student will be able to:

 

1.         Describe beliefs and practices related to death and dying.

2.         Describe responses of patients and their families to terminal illness and death.

3.         Identify nursing diagnoses that are appropriate for the terminally ill.

4.         Identify nursing goals that are appropriate for the terminally ill.

5.         Identify nursing interventions to meet the needs of terminally ill and dying patients.

6.         Discuss the needs of the terminally ill patient’s significant others.

7.         Discuss the ways nurses can intervene to meet the needs of the terminally ill patient’s significant others.

8.         Explore the responses of the nurse who works with the terminally ill.

9.         Explore the needs of the nurse who works with terminally ill patients.

10.        Identify issues related to caring for the dying patient, including advance directives, do-not-resuscitate

            decisions, brain death, organ donations, and pronouncement of death.

 

 

KEY TERMS:    Advance directive                      Autopsy                        Cerebral death              Denial                           Grief                                         Palliative care                Loss                             Shroud                         Rigor mortis                           Hospice

 

 

CHAPTER 24 LECTURE OUTLINE:

 

Concept of loss

 

Types of loss                Real, anticipatory, imagined

 

The grieving process:    Kubler-Ross’ Stages of grieving

Common signs and symptoms of grief

Fears associated with terminal illness and death

 

Clinical signs of impending death:          Loss of muscle tone

                                                            Circulatory and respiratory changes

                                                            Sensory changes

 

Physical changes after death

 

Care of the body after death

 

Issues related to terminal illness and death:        CPR vs DNR

Organ donation

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

 

 

 

 

Chapter 12 – THE NURSING PROCESS AND CRITICAL THINKING

 

CHAPTER 12 STUDENT LEARNING OUTCOMES:  The student will be able to:

      1.          Describe the five components of the nursing process.

2.       Describe the formats for NANDA diagnoses, NIC interventions and NOC Outcomes.

      3.          Describe proper documentation of nursing process using a problem-oriented nursing record format 

4.         Explain the relationship between the nursing process and critical thinking.

2.       Describe the characteristics of a critical thinker.

      6.          Describe how critical thinking skills are used in clinical practice.

 

KEY TERMS:                Assessment                  Auscultation                  Inspection         Nursing diagnosis Nursing process Objective data               Subjective data             Palpation          Physical assessment Problem-oriented medical record                                                  Percussion

 

CHAPTER 12 LECTURE OUTLINE:

      Components of the nursing process:                  Assessment

                                                                              Nursing diagnosis (NANDA)

                                                                              Planning  (goal setting)

                                                                              Intervention / Implementation

                                                                              Evaluation

 

      Nursing Process Documentation

 

      Explanation and comparison of NANDA Nursing Dx’s

 

            Practice writing nursing care plans using the nursing process

           

            Critical thinking:             Relationship to nursing process

                                                Characteristics of a critical thinker

 

STUDENT LEARNING ACTIVITIES:

• Read the chapter.
• View PowerPoints and Lecture Notes
• Answer the review questions at the end of the chapter.
• Complete any outside learning assignments provided by the instructor.

1. Complete and utilize study guide for resources as well as:
2. ATI resources as available
3. 1. “Elsevier Learning System”  http://evolve.elsevier.com/Linton/ for tutorials and remediation

                                                Critical thinking tools

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CONCEPT MAPPING

 

CLASS LEARNING OUTCOMES:  The student will be able to:

 

            1.   Utilize the nursing process to create a theoretic overview (concept map) of any particular disease                    process on one page using appropriate textbook resources.

 

            2.   Utilize the nursing process and the theoretic disease process overview pages to construct a patient-                specific  concept map, integrating all of the patient’s physical, psychosocial, emotional, spiritual,               and cultural needs on one page.