Trinity Valley Community College
Vocational Nursing Program
VNSG 1400 – Nursing In Health and Illness I
Course Objective and Rudimentary Outline Content
I.
II.
III.
IV.
V.
VI.
Introduction
A. Identify aspects of professionalism, character and nursing behaviors which contribute to
the well-being of the adult medical surgical patient.
B. Discuss care of the medical surgical patient with regards to the nursing scope of practice,
legalities, confidentiality and ethical decision making.
C. Discuss components of patient teaching as they apply to the adult medical surgical
patient.
D. Discuss the impact of cultural diversity on care of the adult medical surgical patient.
Identify four word parts that build a medical term
A. Prefix
B. Root
C. Suffix
D. Combining vowel
Identify the strategy to define a medical term.
Identify common prefixes, suffixes, and word roots as they pertain to:
A. Anatomical terms
B. Musculoskeletal system
C. Neurological system
D. Cardiovascular system
E. Respiratory system
F. Reproductive system
G. Integumentary system
H. Endocrine system
I.
Digestive system
J. Urinary system
K. Sensory system
L. Immune system
M. Obstetrics and Neonatal
N. Psychological and psychiatric conditions
Medical / Surgical / Nursing
A. Role of Nurse and other Health Care Professionals
B. Nursing Process
C. Evidence Based Practice
D. Resources
Discuss the use of the nursing process and Evidence Based Practice in the care of patients with
basic health care needs.
A. Comfort
1. Pain Theories
a. Specificity
b. Gait
c. Neurochemical-endorphins
2. Assessment
a. Factors influencing
b. Types of pain
c. Components of pain assessment
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B.
d. Rating scales
e. Characteristics of acute vs. chronic pain
f. Physiological/behavioral/affective responses
g. Nursing diagnoses
3. Planning/Implementing/Evaluation
a. Pharmacological management
1) Anti-inflammatory
2) Anesthetics
3) Narcotics/non-narcotics
4) Patient controlled analgesia (PCA)
5) Use of placebos
b. Guidelines for managing pain
c. Eliminate cause of pain
d. General nursing comfort measures
e. Cutaneous stimuli
f. Transcutaneous electrical nerve stimulation (TENS)
g. Imagery
h. Distraction
i.
Relaxation techniques
j.
Patient teaching
k. Refer to pain clinics
l.
Neurosurgical procedures
m. Development considerations
Fluid and Electrolyte Balance
1. Assessment
a. Monitor for signs/symptoms of fluid imbalance
1)
Extracellular fluid deficit
a) Hypovolemia
b) Dehydration
2)
Extracellular fluid excess
a) Hypervolemia
b) Primary water excess
b. Monitor of signs/symptoms of electrolyte imbalance
1)
Sodium
a) Hypernatremia
b) Hyponatremia
2)
Potassium
a) Hyperkalemia
b) Hypokalemia
3)
Chloride
4)
Magnesium
c. Monitor for signs/symptoms of shock
1)
Hypovolemic
2)
Normovolemic
a) Cardiogenic
b) Neurogenic
c) Anaphylactic
d) Septic
d. Intake and output
e. Daily weights
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f.
g.
VII.
Vital signs
Laboratory studies
1)
Electrolytes
2)
Urine specific gravity
2. Planning/Implementing/Evaluation
a. Maintain accurate I & O
b. Increase or restrict fluid intake as appropriate
c. Monitor vital signs
d. Monitor and report lab values
e. Interpret ABGs
f. Providing IV fluid therapy
1)
Hypotonic solutions
2)
Isotonic solutions
3)
Hypertonic solutions
g. Administering blood products
1)
Role of LVN in Blood Administration
2)
Scope of Practice
h. Providing parenteral nutrition
i.
Observe for signs/symptoms of imbalances
j.
Patient teaching
k. Developmental considerations
l.
Manage shock
1)
Positioning
2)
IV therapy
3)
Pharmacological support
4)
Psychological support
5)
Emergency equipment available
Identify the purposes for surgery, types of surgery, the effects of surgery on the body, and
surgical risk factors.
A. Reasons
1. Diagnosis
2. Curative
3. Palliative
4. Restorative
B. Types
1. Elective
2. Required
3. Urgent
4. Emergency
C. Effects
1. Stress
2. Risk of infection
3. Body image changes
4. Lifestyle changes
D. Risk Factors
1. Age extremes
2. Dehydration
3. Malnutrition
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VIII.
IX.
X.
4. Obesity
5. Smoking
6. Medical conditions
7. Pregnancy
8. Fear
Discuss the nurse’s responsibility in meeting the needs of the preoperative patient and family
A. Assessment
1. Admission
2. Informed consent
3. Cultural needs
4. Psychological needs
B. Intervention
1. Preop teaching
2. Preop orders
a. Diet/hospital diets
b. Elimination
c. Medication
3. Preop checklist
Describe intra-operative care including principles of peri-operative asepsis.
A. Surgical team
B. Anesthesia
1. Stages of anesthesia
2. General vs. regional/local anesthesia
C. Positioning
D. Complications
1. Hypotension
2. Hypothermia
3. Malignant hyperthermia
4. Respiratory
Describe post-operative nursing care responsibilities.
A. Post anesthesia recovery unit
1. Report from PACU nurse
2. Airway, breathing
3. Circulation
4. Dressings/drainage/tubes
5. Pain relief
6. Regimen for assessing vital signs
7. Discharge criteria
8. Loss of Conscious
B. Transfer to room
1. Comfort and safety
2. Pulmonary toilet
3. Voiding
4. Tubes, dressings and drainage
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XI.
XII.
XIII.
XIV.
XV.
5. Wound healing
6. Diet
7. Exercise
8. Ambulation
9. DVT prophylaxis
10. Day surgery considerations
11. Discharge planning
Identify nursing measures that can be used to decrease post-operative discomfort and
complications.
A. Post op discomforts
1. Pain
2. Nausea and vomiting
3. Urinary retention
4. Abdominal distention
B. Complications
1. Hemorrhage and shock
2. Respiratory problems
3. Thrombophlebitis and pulmonary embolus
4. Wound infection
5. Dehiscence and evisceration
6. Ileus
7. Urinary retention
8. Decrease loss of conscious
Discuss the assessment of patients with commonly occurring cardiac illnesses.
A. History
B. Physical
C. Risk factors
D. Developmental variations
Identify clinical significance and nursing implications of various tests and procedures used for
diagnosis of commonly occurring cardiac illnesses.
A. Other
1. Blood pressure
2. Diagnostics
Differentiate between the etiology, pathophysiology and clinical manifestations of selected
commonly occurring cardiac problems.
A. Hypertension
B. Heart Failure
Discuss the planning, implementation, and evaluation in nursing management of patients with
commonly occurring cardiac health problems.
A. Independent interventions
1. Assist with stress relief
2. Encourage maintenance of exercise regimen
3. Encourage smoking cessation
4. Encourage weight control
5. Patient teaching
6. Refer to American Heart Association
B. Dependent interventions
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XVI.
XVII.
XVIII.
XIX.
1. Medications
a. Diuretics
b. Beta-blockers
c. Calcium antagonists
d. Angiotensin converting enzyme
C. Interdependent
1. Encourage compliance with sodium restricted diet
Discuss the assessment of patients with commonly occurring respiratory illnesses.
A. History
B. Physical exam
C. Risk factors
D. Developmental variations
Identify clinical significance and nursing implications of various tests and procedures used for
diagnosis of commonly occurring respiratory illnesses.
A. Radiology
1. Chest x-ray
B. Laboratory studies
1. Arterial blood gases
C. Other
1. Pulmonary function tests
2. Pulse oximetry
Differentiate between the etiology, pathophysiology and clinical manifestations of selected
commonly occurring respiratory problems.
A. Asthma
B. Bronchitis
C. Emphysema
D. Pneumonia
E. Tuberculosis
Discuss the planning, implementation, and evaluation in nursing management of patients with
commonly occurring respiratory health problems.
A. Independent interventions
1. Deep breathing exercises
2. Teach pursed lip breathing
3. Encourage annual influenza vaccine
4. Encourage smoking cessation
5. Patient teaching to avoid exposure to infections, irritants, change of temperature
6. Incentive spirometry
7. Positioning of optimal breathing
8. Provide humidification
9. Encourage fluids
10. Provide emotional support
11. Refer to American Lung Association
B. Dependent interventions
1. Medications
a. Bronchodilators
b. Corticosteroids
c. Expectorants
C. Interdependent interventions
1. Monitor ABGs
2. Chest physiotherapy
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XX.
XXI.
XXII.
XXIII.
XXIV.
XXV.
XXVI.
Discuss the assessment of patients with commonly occurring neurological illnesses.
A. History
B. Physical exam
C. Risk factors
D. Development variations
Identify clinical significance and nursing implications of various tests and procedures used for
diagnosis of commonly occurring neurological illnesses.
A. Radiology
B. Other
1. Basic neurological exam
2. Carotid Doppler studies
Differentiate between the etiology, pathophysiology and clinical manifestations of selected
commonly occurring neurological problems.
A. Cerebrovascular accident
1. Thrombolytic/embolic stroke
2. Hemorrhagic stroke
B. Transient ischemic attack (TIA)
C. Seizures
Discuss the planning, implementation and evaluation in nursing management of patients with
commonly occurring neurological problems.
A. Independent interventions
1. Perform frequent neuro checks
2. Monitor for signs of increasing intracranial pressure (ICP)
3. Prevent contractures, pressure ulcers, thrombosis
4. Proper positioning/turning
5. Range of motion exercises
6. Implement guidelines for communicating with patients with aphasia
7. Implement guidelines for working with patients with Dysphagia, hemianopsia,
unilateral neglect, and perceptual problems
8. Prevent aspiration
9. Assist with bowel & bladder retraining
10. Patient teaching to prevent CVA
B. Dependent interventions
1. Medications
a. Anticoagulant therapy if indicated
b. Antihypertensive therapy
C. Interdependent interventions
1. Assist interdisciplinary team with rehabilitation plan
Discuss nursing care for patients having surgeries involving commonly occurring neurological
health problems.
A. Carotid Endarterectomy
B. Other
Discuss the assessment of patients with commonly occurring endocrine illnesses.
A. History
B. Physical
C. Risk factors
D. Developmental variations
Identify clinical significance and nursing implications of various tests and procedures used for
diagnosis of commonly occurring endocrine illnesses.
A. Laboratory studies
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1. Blood glucose monitoring – glucometer
2. Fasting blood sugar
3. Glycosylated hemoglobin
4. Oral glucose tolerance test
5. Urine ketone testing
XXVII. Differentiate between the etiology, pathophysiology and clinical manifestations of selected
commonly occurring endocrine problems.
A. Independent interventions
1. Patient teaching
2. Foot care
3. Promoting proper hygiene
4. Promoting exercise regimen
5. Promote compliance
6. Assist with individual/family coping
7. Weight control
8. Refer to community resources
a. American Diabetes Association
b. Living Well with Diabetes
c. Juvenile Diabetes Foundation
9. Diabetes self-management
10. Monitor for signs/symptoms of complications
a. Diabetic ketoacidosis
b. Hyperglycemic, hyperosmolar, nonketotic coma
B. Dependent interventions
1. Medications
a. Insulin therapy
b. Oral hypoglycemic agents
2. Replacement fluids/electrolytes
C. Interdependent interventions
1. Dietary management
XXVIII. Discuss the assessment of patients with commonly occurring musculoskeletal disorders.
A. History
B. Physical exam
1. Pain
2. Altered sensation
3. Structural changes
4. Muscular weakness
5. Mobility (gait)
6. Neurovascular impairment
a. Pain
b. Pallor
c. Paresthesia
d. Pulselessness
e. Paralysis
f. Capillary refill
C. Risk factors
D. Developmental variations
XXIX. Identify clinical significance and nursing implications of various tests and procedures used for
diagnosis of musculoskeletal disorders.
A. Lab tests
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1. Blood
2. Urine
B. Diagnostic imaging
1. Scans
2. Bone density
XXX. Using the nursing process describe the nursing management of the patients needing assistive
devices.
A. Casts
B. Tractions
C. Splints
D. Turning frames
E. Prosthesis
F. Braces
G. Crutches
H. Walker
XXXI. Describe etiology, pathophysiology, and clinical manifestations of the selected musculoskeletal
disorders.
A. Arthritis
B. Gout
C. Osteoporosis
XXXII. Using the nursing process to describe care for patients with selected musculoskeletal disorders
including treatments, medications, teaching plans and complications.
A. Dependent
1. Medications
B. Independent
C. Complications
1. Fat embolus
2. Gas gangrene
3. Tetanus
4. Compartment syndrome
5. Volkmann’s contracture
D. Patient teaching
E. Refer to community resources
1. American Chronic Pain Association
2. Arthritis Foundation
3. National Easter Seals Society
4. National Osteoporosis Foundation
5. National Institute of Arthritis and Musculoskeletal and Skin Disorders
6. National Osteoporosis Association
7. National Association of Orthopedic Nurses
8. National Rheumatoid Association
XXXIII. Discuss the interdisciplinary approach to rehabilitation for the care of patients with self-care
deficit, impaired physical mobility, impaired skin integrity, and altered patterns of elimination.
A. Interdisciplinary approach to rehab
1. Activities of Daily Living
2. Positioning
3. Range of Motion Exercises
4. Independent mobility
5. Ambulatory aides
6. Skin integrity
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XXXIV.
XXXV.
XXXVI.
XXXVII.
7. Urinary and bowel training
B. Role of rehab team members
C. Significance of continuity of care
Discuss nursing care of patients having surgeries involving the musculoskeletal system.
A. Open reduction internal fixation (ORIF)
B. Reconstructive joint surgery
1. Hip replacement
2. Knee replacement
3. ORIF
Identify clinical significance and nursing implications of various tests and procedures used for
diagnosis of commonly occurring oncologic illnesses.
A. Radiology
1. Computed tomography (CT)
2. Magnetic Resonance Imaging (MRI)
3. Mammogram
B. Laboratory studies
1. Papanicolaou test (PAP)
2. CA-125
3. Prostate Screening Antigen (PSA)
4. Complete blood count
C. Other
1. Breast self-exam (BSE)
2. Biopsy
3. Testicular self-exam (TSE)
4. Colonoscopy
5. Prostate exam
6. Bronchoscopy
Differentiate between etiology, pathophysiology and clinical manifestations of selected
commonly occurring oncologic problems.
A. Breast cancer
B. Vaginal cancer
C. Cervical cancer
D. Ovarian cancer
E. Prostate cancer
F. Testicular cancer
G. Hodgkin’s disease
Discuss the planning, implementation, and evaluation in nursing management of patients with
commonly occurring oncologic health problems.
A. Independent interventions
1. Patient teaching about prevention/warning signs
2. Assist with individual/family coping
3. Assist with maintaining nutritional status
4. Prevention of infection
5. Refer to community resources
a. Reach to Recovery
b. American Cancer Society
c. Living with Cancer
d. I Can Cope
e. Hospice
B. Interdependent interventions
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1.
Radiation therapy
a. External
b. Internal
c. Nursing implications
d. Safety precautions
e. Managing side effects of radiation
2. Chemotherapy
a. Managing side effects
1) Leukopenia
2) Thrombocytopenia
3) Nausea/vomiting
4) Stomatitis
5) Alopecia
b. Care of implanted venous ports
3. Pain Management
XXXVIII. Discuss nursing care for patients having surgeries involving commonly occurring oncologic
health problems.
A. Male Reproductive
B. Female Reproductive
C. Reconstructive
Revised 7/2013
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