Course: NURS 100, NURS 120 CONCEPT DEFINITIONS: FUNDAMENTALS / MEDICAL-SURGICAL Each concept will be presented in a consistent way in each course with understanding and application expanded through scaffold exemplars. For each chosen exemplar, the following items will be included as to the relationship to the alteration as applicable: 1. Pathophysiology review 2. Clinical findings/Manifestations 3. Laboratory tests/Results 4. Relevant fluid and electrolyte/Acid base imbalances 5. Diagnostic procedures 6. Medical management 7. Pharmacologic management 8. All aspects of the nursing process 9. Prioritization, delegation, and teaching needs 10. Care coordination across settings 11. Family issues 12. Grief and end of life care Concept Focus Oxygenation Perfusion Intracranial Regulation Nutrition Elimination Mobility Page 1 of 2 Definition Oxygenation is the ability to collect, transport, and store oxygen for use by the body’s tissues, as well as the ability to promote exchange of oxygen with waste products for respiratory elimination. • The nurse must be able to assess a person’s oxygenation, identify factors which may impede effective oxygenation; analyze assessment findings and define goals related to improvement of oxygenation; delineate independent and collaborative activities to improve oxygenation, sustain effective oxygenation, or prevent alterations in oxygenation; and evaluate the achievement of patient-centered goals. Perfusion is the ability to transport oxygen, nutrients and blood cells through the vascular system for use by the body’s organs and tissues. • The nurse must be able to assess a person’s perfusion status, identify factors which may impede effective perfusion; analyze assessment findings and define goals related to improvement of perfusion; delineate independent and collaborative activities to improve or sustain effective perfusion; and evaluate the achievement of patient-centered goals. Intracranial regulation is the process of intracranial compensation and adaptive neurological function. • The nurse must be able to maintain optimal intracranial regulation by assessing sensory and motor function, mental abilities, internal and external factors that promote or impair intracranial function. The nurse must be able to develop, implement, and evaluate a multidisciplinary plan of care to maintain optimal functioning. Nutrition is the process by which the body ingests, digests, absorbs, uses, transports, and eliminates nutrients. • The nurse must be able to assess nutritional status, identify individuals with nutrition imbalances, identify individuals at risk for nutrition imbalances, formulate appropriate goals and collaborative interventions for individuals experiencing problems with nutrition, demonstrate nursing measures to promote optimal nutritional balance based on patient needs and alterations in physiological and psychological function, and teach individuals about the importance of lifestyle modification to promote health. Elimination is the process of excretion of waste products. The concept of elimination is optimal when there is a routine and voluntary passage of waste products. • The nurse must be able to assess the normal bowel and urinary elimination patterns, identify risk factors for impaired elimination, develop and implement collaborative interventions to optimize elimination, and evaluate outcomes. Mobility is a function regulated by the musculoskeletal and nervous system that controls movement. Course: NURS 100, NURS 120 CONCEPT DEFINITIONS: FUNDAMENTALS / MEDICAL-SURGICAL Concept Focus Tissue Integrity Metabolism Fluid Regulation Infection / Inflammation Pain Health Promotion Safety Collaboration Page 2 of 2 Definition • The nurse must be able to assess factors that affect mobility and identify changes in levels of functioning associated with movement. Using a collaborative approach, the nurse must be able to develop, implement, and evaluate interventions to improve mobility and prevent complications of immobility. Tissue Integrity is the ability of body tissues to regenerate and/or repair to maintain normal physiological processes. • The nurse must be able to maintain tissue integrity by assessing internal factors of genetics, age and underlying health as well as external factors such as activity, injury, and wellness, to develop a collaborative plan of care. Metabolism is the process of energy generation and use. Metabolism includes the variety of physical and chemical processes in the body that foster the growth of cells and the regulation of body functions. • The nurse must utilize the nursing process to not only identify alterations in metabolism, but to identify probable causes and systemic implications. Assessment of all systems, formulation of goals to improve metabolic functioning and to prevent impaired metabolism, implementation of collaborative strategies for optimal metabolic functioning, and evaluation of these strategies is central to the well-being of the patient. Fluid Regulation is the maintenance of the appropriate volume of body fluids to maintain homeostasis. • The nurse must be able to identify and assess factors that influence and impair fluid regulation including physical activity, environmental factors, electrolyte and chemical imbalances. The nurse then must be able to formulate goals, define appropriate multidisciplinary interventions, and evaluate outcomes to maintain optimal fluid regulation. Infection and Inflammation are tissue responses to an invasion of the body by microorganisms or other harmful material seen by the body as foreign. • The nurse must be able to employ evidence-based practices to develop, implement, and evaluate a multidisciplinary plan of care to and prevent, diagnose, and treat infectious and inflammatory states. Pain is a subjective report of unpleasant sensory or emotional experience associated with an actual or perceived negative stimulus. • The nurse must be able to respond to the patient’s manifestations of pain by utilizing the nursing process and employing appropriate interventions in a timely manner. Health promotion is central to nursing practice. It is aimed at preventing illness, reducing disability, and assisting each person to achieve optimal health. • The nurse must be able to utilize the nursing process in a collaborative manner to prevent negative outcomes from factors such as: decreased physical activity, obesity, tobacco and substance abuse, mental health, violence, immunizations, and access to health care. The nurse also promotes wellness through role-modeling, education, and identification of resources to meet the specific needs of each patient as well as the general population. Safety is the ability to deliver evidence-based practice in a multidisciplinary patient care environment which promotes well-being and prevention of injury. • The nurse must be able to utilize the nursing process with consideration for the following including but not limited to: accuracy of patient identification, improved communication among caregivers, accurate administration of medications, reduced the risk of infections, reduced patient harm resulting from falls, and prevention of pressure ulcers. Collaboration: Collaboration entails a multidisciplinary approach to provide best practice in all aspects of patient care. • The nurse must be able to communicate and work effectively with members of the health care team to provide evidence-based practice in the delivery of holistic care.
