LEVEL IV
RNSG 2414 - INTEGRATED CARE OF THE CLIENT WITH
COMPLEX HEALTH CARE NEEDS
Credit Hours: 4 Lecture Hours: 4
Prerequisite: RNSG 2535, RNSG 2660, and RNSG 2161
Corequisite: RNSG 2562 and RNSG 2307
WECM COURSE DESCRIPTION
Application of a systematic problem-solving process and critical thinking skills to provide
comprehensive nursing care to diverse clients/families across the life span with complex health
care needs including, but not limited to, complex childhood/adolescent diseases, complicated
perinatal care, acute mental illness, complex perioperative care, serious adult health problems
and health issues related to aging. Emphasis on tertiary disease prevention, health
maintenance/restoration and collaboration with members of the multidisciplinary health care
team. Topics include the role of the nurse as client advocate and coordinator of care and
applicable competencies in knowledge, judgment, skills, and professional values within a
legal/ethical framework. This course lends itself to an integrated approach.
WECM COURSE LEARNING OUTCOMES
Develop and implement a teaching plan for a client/family to promote health maintenance/health
restoration based on assessment data; demonstrate the ability to utilize critical thinking skills to
make safe and ethical clinical decisions; use a systematic problem-solving process; develop and
implement a plan of care for the diverse client/family across the life span with complex health
care needs in a variety of health care settings; demonstrate a working knowledge of the
implications of the Nurse Practice Act; apply therapeutic communication skills with diverse
clients and families; recognize opportunities for client advocacy and professional development
activities; and collaborate in multidisciplinary planning to provide care for clients/families with
complex health care needs.
KEY CONCEPTS AND GENERAL COURSE PLAN
This course builds on concepts and principles learned in RNSG 2535 – Integrated Client Care
Management. It addresses nursing care of clients experiencing major psychiatric disorders,
pregnancy and newborn complications, and disorders of the neuromuscular, endocrine, and
immune systems. Discussion of fluid and electrolyte disorders and rehabilitation needs are also
covered. Emphasis is placed on the roles of the nurse and development of critical thinking tools,
including the nursing process, in the care of the client whose health needs may be difficult to
predict.
COURSE OBJECTIVES
By the end of this course, the student will be able to:
1. Discuss the incorporation of principles of health promotion in the care of diverse clients in a
variety of settings.
2. Utilize the nursing process to develop, implement, and evaluate a plan of care for diverse
simulated clients/families whose health needs may be difficult to predict.
3. Analyze the effectiveness of client and family teaching in relation to health
maintenance/health restoration.
4. Evaluate the effectiveness of communication skills in applying the nursing process to diverse
clients/families in collaboration with members of the multidisciplinary health care team.
5. Utilize critical thinking skills to demonstrate ability to make safe and ethical collaborative
decisions for diverse simulated clients/groups of clients.
6. Discuss the application of leadership and management skills in caring for small groups of
diverse clients in a variety of health care settings.
COURSE OUTLINE
I. Care of the Client Experiencing Major Psychiatric Disorders
A. Anatomy and physiology
B. Assessment
C. Disorders
1. Psychotic Disorders
a. Schizophrenia
b. Other Psychotic disorders
2. Mood Disorders
a. Major depression
b. Bipolar
3. Child and Adolescent Disorders
a. Disruptive Behavioral Disorders
(1) Attention Deficit Hyperactivity Disorder
(2) Oppositional Defiant Disorder
(3) Conduct Disorder
b. Pervasive Developmental disorders
4. Cognitive Disorders
a. Delirium
b. Dementias
5. Personality disorders
(1) Cluster A
(2) Cluster B
(3) Cluster C
D. Selected nursing diagnosis/nursing implementation/evaluation of outcomes
E. Legal responsibilities
II. Care of the Client Requiring Rehabilitation
A. Philosophy and issues
B. Responsibilities of team members
C. Assessment
D. Selected nursing diagnoses/nursing interventions/evaluation of outcomes
III. Care of the Client Experiencing Problems with Fluid and Electrolyte Balance
A. Anatomy and physiology
B. Assessment
C. Fluid and electrolyte imbalance problems
1. Burns
2. Nephrotic syndrome
3. Renal failure
a. Acute
b. Chronic
D. Selected nursing diagnoses/nursing interventions/evaluation of outcomes
IV. Care of the Client Experiencing Problems with the Endocrine System
A. Anatomy and physiology
B. Assessment
C. Endocrine problems
1. Thyroid
a. Hypothyroid
b. Hyperthyroid
2. Diabetes insipidus
3. Syndrome of Inappropriate Hormone Diuretic Hormone (SIADH)
4. Addison’s disease
5. Cushing’s disease
D. Selected nursing diagnoses/nursing interventions/evaluation of outcomes
V. Care of the Client Experiencing Problems with the Immune system
A. Anatomy and physiology
B. Assessment
C. Problems of the immune system
1. Rheumatoid arthritis
2. Systemic Lupus Erythematosis
3. Acquired Immune Deficiency Syndrome
4. Pneumocystic carinii pneumonia
D. Complimentary Alternate Medicine (CAM)
E. Selected nursing diagnoses/nursing interventions/evaluation of outcomes
VI. Care of the Client Experiencing Neuromuscular Problems
A. Anatomy and physiology
B. Assessment
C. Neuromusculoskeletal problems
1. Spinal cord injury
2.
3.
4.
5.
6.
7.
8.
9.
Head injury
Intracranial pressure (ICP)
Seizures
Herniated disc
Multiple sclerosis
Parkinson’s disease
Meningitis
Eye disorders
a. Cataract
b. Glaucoma
c. Retinal detachment
10. Amputation
11. Osteoarthritis
D. Selected nursing diagnoses/nursing interventions/evaluation of outcomes
VII.
VIII.
\
Care of the Client Experiencing Complications of Pregnancy
A. Anatomy and physiology
B. Assessment
C. Complications of pregnancy
1. Gestational onset
2. Fertility issues
3. Hypertension
4. Endocrine disorders
5. Infectious disorders
6. Preterm labor
7. Post term labor
8. Hemorrhage/clotting disorders
9. Perinatal loss
10. Post partum psychiatric disorders
D. Selected nursing diagnoses/nursing interventions/evaluation of outcomes
Care of the Newborn Experiencing Complications
A. Anatomy and physiology
B. Assessment
C. Newborn complications
1. High risk neonate
2. Congenital heart abnormalities
3. Gastrointestinal disorders
4. Neural tube defects
5. Bone/joint disorders
6. Cognitive disorders
\Selected nursing diagnoses/implementation/evaluation of outcomes
COURSE REQUIREMENTS
The student will be required to take:
1. 5 unit exams
2. 1 comprehensive final
3. 1 comprehensive pharmacology
See the Evaluation Policy in the student handbook for grading and progression information.
See the Attendance Policy in the student handbook for attendance requirements.
See the Policy for Test Taking/Grade Information in the student handbook for information on
testing.
Utilize Blackboard for course enhancement. The student must check the postings on Blackboard
for announcements, interactive assignments, and Blackboard mail communication.
The student must take the HESI Exit Exam and complete remediation if not attaining a grade of
950. If a student makes greater than 950 on the HESI Exit Exam the student may defer taking the
RNSG 2414 final examination.
BONUS POINTS
Bonus points may be offered during the semester. These opportunities will be discussed on the
sophomore announcement Blackboard site. Failure to follow directions will result in the student
not receiving credit for the activity. Bonus points must be complete with internet web site listed.
Wikipedia is not an appropriate web site.
Bonus points are added to the lecture grade only after the student has attained the required
number of points to pass the course satisfactorily. The student can only receive up to a total of 20
bonus points for this course.
N:Spring\RNSG 2414\Intro RNSG 2414
Reviewed 11/13