Chabot College
Fall, 2004
Course Outline for Nursing 60A
ADULT HEALTH 1
BIOPSYCHOSOCIAL PERSPECTIVES IN THE CARE OF THE ADULT CLIENT
IN THE HOSPITAL AND THE COMMUNITY
Catalog Description
60A - Adult Health I-Biopsychosocial Perspectives in the Care of the Adult Client
in the Hospital and the Community
8 Units
Emphasis is on the use of the nursing process in the care of adults experiencing selected conditions
requiring treatment in medical-surgical and psychiatric care settings. Theory and clinical practice
highlight the role of the nurse as a therapeutic agent (in both individual and group settings) in
facilitating the client’s mind/body adaptation and return to as healthy a state as is possible. Effects on
cultural diversity, growth and development, and the importance of support systems in assisting the
patient’s response to illness in acute and community care agencies are incorporated into health care
strategies used by the nurse. Theory and clinical practice includes integration of biopsychosocial
assessment skills, nutrition, pharmacological and crisis intervention concepts, legal-ethical issues,
and anger management (directed inward or towards the environment) into the care of these patients.
Prerequisites: Completion of Nursing 55, 56, 61, 69, and 74 with a “C” or better. Satisfactory
completion of or concurrent enrollment in Nursing 57, 58, 64, and 75. Theory may be offered in
Distance Education delivery format. Lecture: 4 hours; Clinical: 12 hours a week.
Prerequisite Skills:
Before entering the course, the student should be able to demonstrate competency in:
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handwashing;
assessing vital signs;
measuring height and weight;
positioning clients;
making occupied and unoccupied beds;
standard precautions;
transferring clients and ambulating clients;
principles of aseptic technique;
mechanical lifts;
feeding clients;
oral care;
placement on bedpan;
medication calculations;
enteral feedings;
medication administration;
fingerstick blood sugar;
preparation of insulin;
giving subcutaneous and intramuscular injections;
development of a nursing care plan;
principles of body mechanics;
I.V. drip rate calculations;
proper charting and reporting skills;
maintenance of client confidentiality;
application of basic organizational skills;
application of principles of professionalism;
basic pre/post operative care.
a. discuss the implication of nursing care as it incorporates physical characteristics
of human growth and development from infancy to middle adulthood;
b. discuss the importance of cognitive maturation during childhood (Piaget);
c. discuss the application of nursing care to the several stages of emotional and
psychosocial development according to Erikson and Freud;
Chabot College
Course Outline for Nursing 60A, Page 2
Fall, 2004
d. discuss application of nursing care to the physiological and psychological
implications of menopause and mid-life crisis;
e. evaluate the nutritional adequacy of normal and therapeutic diets;
f. use diabetic food exchanges;
g. describe nutritional assessment techniques; describe special nutritional needs for
pregnancy, infancy, childhood, adulthood, and the elderly person;
h. describe the rationale and modifications for low-sodium, low calorie, low-fat,
peptic ulcer, diabetic, renal, hepatic, gallbladder, and post-surgical diets;
i. describe techniques for identifying and writing care components—nursing
diagnosis, goals, nursing orders, and evaluation;
j. write a diagnostic statement, outcome criteria and nursing orders for a selected
client;
k. describe the key concepts of the theoretical framework selected by Chabot
College Nursing Program as the basis for nursing process;
l. Identify behaviors and responses according to physiological mode, role function
mode, self-concept mode, and interdependence mode;
m. discuss biopsychosocial theories of aging;
n. identify and discuss psychosocial concerns common to the elderly client;
o. demonstrate awareness of legislation applicable to the elderly client;
p. recognize the influence of ethnic origin on the client's adaptation to the aging
process;
q. adapt physical assessment skills to the elderly client;
r. discuss age related conditions of sensory losses:
1) cataracts;
2) glaucoma;
3) hearing loss;
s. describe nursing interventions that assist the elderly client with adaptation to
sensory losses;
t. apply principles and techniques for management of disruptive behavior by the
elderly client in acute and chronic health care settings:
1) reality orientation;
2) use of restrictive devices;
3) pharmacological management;
u. discuss ethical considerations in the implementation of gerontic nursing;
v. describe the impact of chronic illness on the elderly client and the family support
system;
w. list five community resources for assisting the elderly client in adaptations of
healthy living;
x. adapt health teaching to special needs of the aging client.
Expected Outcomes for Students:
Upon completion of the course, the student will demonstrate the ability to identify principles involved in:
Theoretical Outcomes:
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care of the patient experiencing illnesses with unpredictable outcomes;
perioperative period (including operating room and post-anesthesia care);
alterations in body image:
a. eating disorders;
b. wounds;
c. “-ostomy”; etc.;
addictions:
a. effects on physiological status;
b. effects on psychosocial behaviors;
care of the suicidal client;
Chabot College
Course Outline for Nursing 60A, Page 3
Fall, 2004
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management of clients with personality disorders;
techniques for intervening with angry, aggressive, manipulative, or impulsive clients;
the appropriate use of aseptic technique in delivering safe patient care;
therapeutic communication in groups and with individuals experiencing illnesses with
unpredictable outcomes;
application of principles of group dynamics in health care;
care of the client with alteration in thought processes:
a. psychoses;
b. dementias;
c. delirium;
effects of severe or panic levels of anxiety on the patient response to:
b. interpersonal situations;
c. physical conditions;
crisis intervention;
care of clients with:
a. peripheral vascular disease;
b. respiratory conditions;
c. gastrointestinal conditions;
d. cancer:
1) lung;
2) breast;
3) colon;
e. acute vs. chronic pain;
pharmacological interventions in:
a. physiological conditions:
1) peripheral vascular disease;
2) respiratory disease;
3) gastrointestinal diseases;
4) cancer;
5) acute vs. chronic pain;
b. perioperative care;
c. psychiatric conditions manifested by:
1) psychoses;
2) anxiety;
3) depression;
4) addictions;
5) mania;
6) personality disorders.
Clinical Outcomes:
1. using self as a therapeutic agent in the delivery of health care;
2. implementing the nursing process in the care of patients with the following nursing diagnoses:
a. sensory/perceptual alteration;
b. altered thought processes;
c. anxiety;
d. altered body image;
e. sleep pattern disturbance;
f. alteration in nutrition;
g. impaired social interaction;
h. ineffective individual coping;
i
impaired gas exchange;
j. altered tissue perfusion;
k. ineffective airway clearance;
l. memory, impaired;
m. fluid volume deficit/overload;
Chabot College
Course Outline for Nursing 60A, Page 4
Fall, 2004
n. risk for infection;
o. risk for injury;
p. risk of violence: self/others;
q. social isolation;
r. pain, acute or chronic;
s. self-care deficit;
3. principles and methods of teaching involved in the care of the patient in acute and chronic
settings;
4. legal-ethical concepts as they relate to clients in psychiatric settings;
5. successfully demonstrate the following skills:
a. peripheral-vascular assessments;
b. ostomy care;
c. sterile dressing change;
d. surgical asepsis: scrubbing, gowning, gloving;
e. insertion and care of nasalgastric tube;
f. administration of intravenous fluids and medications;
g. assessment and care of portable suction devices.
Course Content
1.
Perioperative care:
a. pre-operative
b. operative
c. post-operative
2.
Care of the client with conditions affecting the following systems:
a. Peripheral vascular
b. Respiratory
c. Gastrointestinal
3.
Care of the client with:
a. Cancer:
1) Lung
2) Breast
3) Colon
4.
Care of the client with acute vs. chronic pain
5.
Care of the client with disturbance in body image:
a. Wounds
b. “Ostomy”
c. Eating disorders
6.
Care of the client with psychological conditions:
a. Psychoses
b. Dementia and delirium
c. Problems managing anger, impulsivity, manipulation, aggression
d. Depression
e. Mania
f. Addiction
g. Anxiety
7.
Crisis theory and intervention
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Concepts of group theory:
a. Types of groups
b. Purposes of groups
c. Management of groups in medical-surgical and psychiatric settings
9.
The nurse’s role in pharmacological interventions in selected physiological and psychiatric
conditions
10.
Legal-ethical considerations in psychiatric care
Chabot College
Course Outline for Nursing 60A, Page 5
Fall, 2004
Methods of Presentation:
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Lecture
Seminar/Discussion
Interactive Computer Simulation
Assignments to acute care and community-based agencies
a. Medical-Surgical acute care
b. Psychiatric acute care
c. Adult Day Care
Assignments and Methods of Evaluating Student Progress:
1.
Typical Assignments
a. In-class case study assignments
b. Nursing Care Plans
c. Small group discussions
d. Workbooks
e. In-Class presentations
f. Nursing process notes
2.
Methods of Evaluating Student Progress
a. Critical thinking exercises
b. Written papers
c. Written examinations
d. Nursing Care Plans
e. Process notes; process recordings
Textbooks (Typical)
Psychiatric Mental Health Nursing, Townsend, Davis, 4th ed., 2003.
I.V. Therapy, Gahart, Mosby , 2003.
Special Student Materials
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Stethoscope
Student ID card
Lab Coat
Student uniform
Watch with sweep second hand
Students will provide own transportation to and from health care facilities.
Nsgotl60a.worddoc
Slj rev. 9/03