NU 16045: PHYSIOLOGIC ADAPTATION I
Traditional
Associate Degree Nursing
Arkansas Northeastern College
First Day Handout
Term:
Class Meeting Days:
Class Meeting Hours:
Clinical Days:
Clinical Hours: TBA
Spring 2012
Monday and Wednesday
1:30 p.m. – 4:45 p.m.
Tuesday, Thursday, or Friday
Instructor: April Nutt, BSN, RN
Office:
Paragould Campus
Phone:
870- 239-3200
Email:
anutt@smail.anc.edu
Office Hours: As posted and by appointment
Instructor:
Office:
Phone:
Email:
Office Hours:
Tonya Pankey, MSN, RN
Burdette Campus
870-780-1223
tpankey@smail.anc.edu
As posted and by appointment
Instructor: Shauna Winchester, BSN, RN
Office:
Burdette Campus
Phone:
870-780-1229
Email:
swinchester@smail.anc.edu
Office Hours: As posted and by appointment
Instructor:
Mandy Koekemoer, BSN, RN
Office:
Paragould Campus
Phone:
870-239-3200
Email:
mkoekemoer@smail.anc.edu
Office Hours: As posted and by appointment
I.
Welcome!
The faculty welcomes you into this continuation course of the Associate Degree Nursing program.
II.
Course Catalog Description
Focuses on identifying influencing factors specific to focal stimuli that promote or inhibit
adaptation. The student is introduced to the basic concepts of health care and nursing
interventions to manipulate the focal stimuli. The clinical component directs the student to
intervene in those illness problems which are acute-temporary interruptions in adaptive modes.
III.
Course Overview
This course focuses on identifying influencing factors specific to focal stimuli that promote or
inhibit adaptation. The student is introduced to basic concepts of health care and nursing
interventions to manipulate the focal stimuli. The clinical component directs the student to
intervene in those illness problems, which are acute-temporary interruptions in adaptive modes.
IV.
Course Rationale: A study of the biological, psychological, and sociological concepts applicable to
basic adaptation needs of the individual. Topics include physiologic adaptive responses related to
IV therapy administration, fluid and electrolyte, hematologic, hepatic and biliary, gastrointestinal,
and endocrine disturbances.
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V.
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Course Objectives
Classroom Objectives
Upon completion of this course the student will be provided the opportunity to
Describe and apply the principles from the natural and behavioral sciences, humanities, and
nursing sciences to the adaptive responses associated basic nursing needs.
Describe and begin critical analysis of the human responses of the body systems and the nursing
needs to the adaptive modes that occur with IV therapy administration.
Describe and begin critical analysis of the human response of the body systems and the nursing
needs to the adaptive modes that occur in shock.
Describe and begin the critical analysis of the human response of the body systems and the nursing
needs to the adaptive modes that occur in response to fluid and electrolyte imbalances.
Describe and begin critical analysis of the human response of the body systems and the nursing
needs to the adaptive modes that occur with disorders of the gastrointestinal system.
Describe and begin critical analysis of the human response of the body systems and the nursing
needs to the adaptive modes in response to disorders of the biliary system.
Describe and begin critical analysis of the human response of the body systems and the nursing
needs to the adaptive modes that occur in response to disorders of the hepatic system.
Describe and begin critical analysis of the human response of the body systems and the nursing
needs to the adaptive modes in response to disorders of the hematological system.
Describe and begin critical analysis of the human responses of the body systems and the nursing
needs to the adaptive modes in response to disorders of the endocrine system.
Clinical Objectives
Upon completion of this course the student will be provided the opportunity to:
Integrate and apply the principles from the natural and behavioral sciences, humanities, and
nursing sciences to the adaptive responses associated within the individual client in the acute care
setting.
Develop and utilize skills in systematic assessment and data interpretation.
Plan for selective therapeutic nursing interactions according to established priorities of nursing
process and critical thinking to meet the specific needs of the client.
Implement nursing interventions according to appropriate guidelines for the client.
Evaluate the effectiveness of nursing interventions by reviewing nursing care objectives and the
plan of care concurrently with intervention.
Modify interaction with the client to promote optimum adaptation of the client.
Apply teaching - learning principles to meet individual needs of the client in the acute care setting.
Demonstrate professional and collaborative behaviors of the Associate Nurse as a member of the
health team.
Set goals for own learning with evidence of self-direction.
Clinical Simulation Objectives:
 The clinical simulation scenarios are designed to address core nursing concepts so as to mimic reallife patient care in a controlled environment.
 The scenarios allow students to demonstrate competency in:
o Assess and manage the patients.
o Prioritize patient problems.
o Perform interventions for safe effective care.
VI.
Course Prerequisites
Prerequisites include:
Survey of Chemistry or General Chemistry I/Lab
Math for Health Sciences or College Algebra
2
Anatomy and Physiology I/Lab
Anatomy and Physiology II/Lab
Sociology or Marriage & Family Relations
Computer Fundamentals
Introduction to Nursing Interventions
Course Co-requisite
Adaptation in the Childbearing Years
VII.
Course Credits
This is a 5 Credit hour Course
VIII.
Required Texts and Materials

Smeltzer, S.C., Bare, B.G., Hinkle, J.L., & Cheever (2010). Textbook of medical-surgical nursing,
(12thEd). Philadelphia, PA: Lippincott Williams & Wilkins.
 Medical Surgical Nursing: ATI Review Module Edition 8.0
 Nutrition: ATI Review Module Edition 4.0
 RN Pharmacology for Nursing: ATI Review Module Edition
 Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2012). Pharmacology: A nursing process approach, (7th
Ed.). St. Louis, MO: Elsevier Saunders.
 Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2012). Pharmacology: A nursing process approach:
Study Guide. (7th Ed.). St. Louis, MO: Elsevier Saunders
 Wilkinson, J. M., & Treas, L. S. (2011). Fundamentals of nursing: Theory,
concepts, and applications. (2nd ed., Vol. 1). Philadelphia, PA: F.A. Davis Company.
 Wilkinson, J. M., Treas, L. S., & , (2011). Fundamentals of nursing: Thinking,
doing, and caring. (2nd ed., Vol. 2). Philadelphia, PA: F.A. Davis Company.
 Doegenes, M. E., Moorhouse, M. F., & Murr, A. C. (2010). Nursing diagnosis
manual: Planning, individualizing, and documenting client care. (3rd ed.). Philadelphia, PA:
F.A. Davis Company.
 Ohman, K. A. (2010). Davis's q & a for the NCLEX-RN examination.
Philadelphia, PA: F.A. Davis Company.
 Nugent, P. M., & Vitale, B. A. (2008). Test success: test-taking techniques for
beginning nursing students. (5th ed.). Philadelphia, PA: F.A. Davis Company.
 Jarvis, C. (2012). Physical examination & health assessment. (6th ed.). St. Louis,
MO: Elsevier Saunders.
 Jarvis, C. (2011). Student laboratory manual for physical examination & health assessment, 6th ed.
Saunders.
 Van Leeuwen. Davis’s comprehensive handbook of laboratory & diagnostic tests
with nursing 1. F.A. Davis Company.
 Lippincott. (2010). Manual of nursing practice, 9th ed. Lippincott Williams & Wilkins.
 Houghton (2009). APA the easy way! 2nd ed. Baker.
 Taber’s Cylcopedic Medical Dictionary (21st ed.)
 Prep U
 Current Edition of The Davis Drug Guide
 Stethoscope, penlight, & scissors
 Supply Bag
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IX.
Basis for Final Grade
Unit Exams
50%
Comprehensive Final Exam
25%
Students must achieve an 80% on Unit Exams and Final prior to having other assignments and
ATI scores averaged into the grade.
Health Assessment with Nursing Diagnoses (1 physiological/1 psychosocial)
& other written work
20%
ATI Assessment
5%
Total
100%
Students achieving an 80% or greater in units exams and course final must maintain the 80%
average once other assignments and ATI scores are calculated into the grade to pass the course.
Grading Scale
100-91
90- 85
84 - 80
79- 70
Below 69
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XI.
A
B
C
D
F
Grade Dissemination
Instructors will review unit exams and provide rationales for test questions at student’s requests.
Faculty will utilize the myANC Gradebook, a component of the Learning Management System, to
record and disseminate unit exams, course finals and all other assigned work grades. This system
provides students the opportunity to track and be accountable for their own grade portfolio.
Students are responsible for verifying any questionable grades with the course instructors.
Following unit exams, instructor initiated counseling sessions will be provided for students scoring
less than 80%. Students may schedule appointments with instructors to discuss grades as deemed
necessary.
Unofficial mid-term and official final grades can be accessed by students utilizing Campus Connect
on myANC.
Course Policies:
Grades:
 Students must achieve an overall 80% average on all unit exams and course final as outlined in the
Syllabus and FDH prior to other written work and assignments begin averaged into the grade.
Students achieving an 80% average in unit exams and course final must maintain the 80% overall
average once other written work assignments are calculated into the grade to progress to the next
nursing course.
 Faculty will utilize the myANC Gradebook to record and post grades. Students not achieving an
average of 80% or greater on the course unit exams and final exam will receive that score as their
final course grade. Other assigned and written work will not be included in the final grade. The
myANC Gradebook will reflect a “faculty adjustment” that will reflect this score as the student’s
final course grade. Students failing to achieve 80% will not pass and will not progress to the next
nursing course.
 Following unit exams, instructor initiated counseling sessions will be provided for students scoring
less than 80%. Students may schedule appointments with instructors to discuss grades as deemed
necessary.
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 Students must achieve a satisfactory clinical performance. Students failing to achieve satisfactory
in clinical performance will not pass the course and will not be allowed to progress to the next
course.
 Students terminated from the program due to failing academic or clinical performance may apply
for re-entry into the program when the course is offered again, pending available space. Students
attempting to reenter the program greater than 1 year following termination must petition the
faculty for re-admittance.
Exams:
 Unit exams are scheduled on the Course Calendar and may cover handouts, textbook readings
including ATI texts, lecture material, assigned journal articles, and audiovisual material assigned.
 Each Nursing Course builds on content from previous courses; therefore, frequent and periodic
testing may
occur in all previous course contents areas.
 The Testing Policies noted in the Student Handbook will be enforced with all unit, final, and ATI
exams, along with all Competency Testing.
 All tests must be taken at the scheduled time. Students arriving late may take the unit exams for
only the remaining time that the exam is to be administered.
 Students absent on a day of a scheduled exam will be allowed to make-up only one exam per
course, if the absence is excused. To be considered for excuse, absences must be accompanied by
recognized written documentation. Illness, death in the immediate family, appearance in court,
and automobile accidents are examples of excused absences. Unexcused absences will result in a
score of zero for the exam grade.
 In event of absence or tardiness from an exam, the student must notify the classroom instructor
and the ADN secretary at the Burdette Campus.
 Students with an excused absence from an exam must make-up the exam by the next scheduled
class or a date approved by the course instructors.
 Instructors will review unit exams one time a semester within one week of taking the exam and
only after all students have completed the exam. Test reviews will take place at the end of the
scheduled class time.
 ATI Progressive Testing is completed within each course of the ADN program and is utilized to first
provide students a valuable teaching tool and then to measure student learning outcomes,
validating progression into the next nursing course. Students are encouraged to approach both
the ATI learning and testing activities with a positive attitude optimizing their effectiveness in
preparing for successful program completion and NCLEX success.
 The first ATI attempt is recorded as 5% of the course grade. A score of level 3 must be achieved to
opt-out of testing a second attempt. Students achieving level 3 are encouraged to take all ATI
Exams offered no matter the score on the first attempt. If the student scores a level 3 on the first
attempt or completes the second ATI with a score of level 2 or 3, the adjusted percentage scores
will be used to calculate extra credit points which will be added to the Final Exam score.
 Students achieving a level 1 or less at any time during the first or second attempt must complete a
remediation plan as outlined by the course instructors.
 If the student does not score a level 2 or 3 after the second attempt the student will receive an
Incomplete in the course and a third attempt scheduled prior to the beginning of the next nursing
course not to exceed a three week time frame.
 If a level 2 or level 3 has not been achieved on the ATI third attempt, the student must petition
faculty for the opportunity to test again. The petition must include a detailed action plan for
remediation for passing as outlined by the course instructors. Achievement of the level 2 or 3 must
be completed prior to progressing to the next nursing course. Students may be requested to
purchase additional ATI proctored exams after the second attempt.
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Late Work and Make-up Policy:
 All work must be turned in to receive a grade for the course.
 All written work must be appropriately referenced. Late assignments will be awarded points as
outlined in the Student Nurse Handbook.
 There will be no make-up quizzes.
 Exams may be made up as outlined in the Student Nurse Handbook.
Extra Credit Policy:
 Typically no extra credit assignments are given.
Grades of “Incomplete”:
The current College policy concerning incomplete grades will be followed in this course.
Incomplete grades are given only in situations where unexpected emergencies prevent a student
from completing the course and the remaining work will be completed the next semester.
Incompletes must be made up by mid-term of the following semester. In such cases, arrangements
will be made based on the needs of the individual. Faculty will decide based on the circumstances
presented whether an incomplete will be granted.
XII.
Course Policies: Technology and Media
Email: Arkansas Northeastern College has partnered with Google to host email addresses for ANC
students. myANC mail accounts are created for each student enrolled in the current semester and
is the email address instructors will use to communicate with students. Email accounts are
accessed by going to http://mail.google.com/a/smail.anc.edu and using the first and last names
(separated by a period) as the user name. The default password is your student ID, no hyphens.
For assistance accessing email, the MITS department may be contacted at 762-1020 ext 1150 or ext
1207 or emailed at ANChelp@smail.anc.edu.
Students are encouraged to check email daily for announcements.
Internet: Students are encouraged to login to myANC everyday as course assignments may be
posted. The internet is used to view videos as related to specific units within the course. Students
may access online videos by logging on to http://www.medcomrn.com/anc/ . User ID is the
student’s first initial, last name. The password is “anc123”.
Laptop/Cellphone Usage: Student requesting use of a laptop/tablet in class for note taking will be
evaluated on an individual basis. Students may be allowed to utilize computer devises for note
taking purposes only in the classroom. Cell phones must be silenced or turned off and not visible in
the classroom and are prohibited in the clinical setting and during all exams. In the classroom,
students whose cell phone rings during class or who is text messaging during class time will be
asked to leave the class and not allowed to return until the next scheduled break. Please refer to
the ADN Student Handbook for more information.
Classroom Devices: Tape recorders or other audio devices maybe used to audio record lectures.
Only calculators provided by instructors are permitted during exams.
Computer Labs: In addition to general-purpose classrooms, a number of computer laboratories are
provided for instructional and student use. These networked laboratories are state-of-the-art and
fully equipped with computers, printers, Internet connections, and the latest software. The labs
are open to students enrolled in one or more credit hours at the college.
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Technology Support: A lab assistant is generally present in the computer lab in B202 for assistance
in using the college computers. These assistants cannot help with course assignments; specific
questions regarding the technology requirements for each course should be directed to the
instructor of the course. Problems with myANC or college email accounts should be addressed by
email to ANCHelp@smail.anc.edu.
Clinical Simulation Laboratory Experiences: Clinical experiences will be supplemented and
enhanced through the use of clinical simulation. The simulation laboratory experiences will be
supervised by a designated instructor.
Compressed Video for Distance Learning: In order to provide simultaneous and equivalent learning
experiences for all nursing campuses, lecture and other learning experiences are transmitted via
compressed video to all locations. A qualified nursing instructor is always available on each campus
in addition to the compressed video.
XIII.
Course Policies: Student Expectations
Disability Access: Arkansas Northeastern College is committed to providing reasonable
accommodations for all persons with disabilities. This First Day Handout is available in alternate
formats upon request. Students with disabilities who need accommodations in this course must
contact the instructor at the beginning of the semester to discuss needed accommodations. No
accommodations will be provided until the student has met with the instructor to request
accommodations. Students who need accommodations must be registered with Dr. Blanche
Sanders or Suzanne Robinson at the Learning Assistance Center, Room L104.
Attendance Policy:
 Students are expected to attend all classes, be prompt, and remain in each class for the scheduled
length of time. Refer to the ANC Student Handbook and Student Nursing Handbook for the
attendance policy.
 Classroom days = 3 hours (Monday and Wednesday); Clinical days = 6 or 12 hours depending on the
semester/clinical rotation (Tuesday, Thursday, or Friday).
 Students are allowed no more than two (2) 6 hour or one (1) 12 hour clinical absence per semester.
Students are required to make up any missed clinical time and will be scheduled at the discretion of
the instructor. Students missing more than 12 hours of clinical may be terminated from the
program and not allowed to progress to the next semester. Refer to the Student Nursing
Handbook.
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 Students are allowed no more than two (2) 6 hour or one (1) 12 hour clinical absence per semester.
Students missing more than the allotted hours may be terminated from the program and not
allowed to progress to the next semester.
 Students are required to make-up all missed clinical hours at the discretion of the faculty.
 Students are required to notify the instructor, nursing department secretary, and clinical site PRIOR
to being tardy or absent from clinical.
 Students are required to telephone faculty PRIOR to missing a scheduled exam.
Professionalism Policy: Registered Nursing students are expected to exhibit professional behavior.
The Code of Ethics for Nurses applies to any setting the student may find themselves in.
Additional Information:
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 All students must comply with the uniform code as designated by the ANC Department of Nursing.
No jeans, shorts or tennis shoes are allowed in the clinical area. While in the clinical area preparing
for clinical, lab coats and street clothes are required.
 Students are to go the assigned clinical area the day before each clinical experience. Each student
is expected to meet the assigned client(s), review the chart, medication record, and become
familiar with procedures planned for the following clinical day. The student will then prepare a
nursing care plan and medication cards for each medication. The care plans and medication cards
are to be turned into the clinical instructor the day of the clinical experience. Failure to adequately
prepare will result in an unsatisfactory clinical grade and/or dismissal of the student from the
assigned clinical experience. Under no circumstances should a student ask another student,
hospital employee, or any other person to obtain clinical information for them.
 Prior to the administration of any medication in the clinical area, the student must have thorough
knowledge of the medication. Failure to do so will result in an unsatisfactory an unsatisfactory
clinical grade and/or dismissal of the student from the assigned clinical experience.
 All students are responsible for maintaining an accurate record of their addresses and telephone
numbers with the nursing department.
 Students with problems or concerns in the clinical/classroom are to discuss the concern with the
instructor first. If the problem or concern is unresolved following the discussion with the
instructor, the student will schedule an appointment with the instructor and the program director.
If the problem/concern remains unresolved, the student will schedule an appointment with the
program director and the dean of nursing.
 In keeping with classroom etiquette, mobile phones, iPods, etc. must be silenced during all
classroom lectures and are prohibited during clinical rotations. Students failing to adhere to these
guidelines may be dismissed from lecture/clinical for the remainder of the day.
 Students should arrive on time and be seated at the scheduled class time. Students arriving late
may find the door to the classroom locked and may not be permitted to enter until the class takes a
break. Quizzes missed during that time will not be made up.
Academic Integrity Policy: Academic dishonesty in any form will not be tolerated. If you are
uncertain as to what constitutes academic dishonesty, please consult ANC’s Student Handbook
(http://www.anc.edu/docs/Academic_Integrity_Policy.pdf) for further details. Students are
expected to do their own work. Plagiarism, using the words of others, without express permission
or proper citation, will not be tolerated. Any cheating (giving or receiving) or other dishonest
activity will, at a minimum, result in a zero on that test or assignment and may be referred, at the
discretion of the instructor, to the Department Chair and/or Vice President of Instruction for
further action.
Learning Assistance Center: The Learning Assistance Center (LAC) is a free resource for ANC
students. The LAC provides drop-in assistance, computer tutorials and audio/visual aids to
students who need help in academic areas. Learning labs offer individualized instruction in the
areas of mathematics, reading, writing, vocabulary development and college study methods.
Tutorial services are available on an individual basis for those having difficulty with instructional
materials. The LAC also maintains a shelf of free materials addressing specific problems, such as
procedures for writing essays and term papers, punctuation reviews, and other useful materials.
For more information, visit the LAC website at http://www.anc.edu/LAC or stop by room L104 in
the Adams/Vines Library Complex.
Other Student Support Services: Many departments are ready to assist you reach your
educational goals. Be sure to check with your advisor; the Learning Assistance Center, Room L104;
Student Services, Room S145; and Student Success, Room L101 to find the right type of support for
you.
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XIV.
Important Dates to Remember
Classes Begin:
IV Exam & Check Offs
Martin Luther King’s B’D
Clinical Orientation at St. Bernard’s
Clinical Orientation (location TBA)
Clinical Orientation (location TBA)
January 9, 2012
January 12, 2010
January 16, 2012
January 20, 2012
January 26, 2012
January 31, 2012
President’s Day
February 20, 2012
Mid-Term Week:
PA1 1st Bib Card Due
Assessment / Care Plan #1 Due
Week of March 2, 2012
March 12, 2012
March 26, 2012
Assessment/Care Plan #2 Due
Assessment/Care Plan #3 Due
Withdrawal Deadline:
April 2, 2012
April 9, 2012
April 13, 2012
Clinical Make-Up
Pinning Practice
Pinning Ceremony
May 1, 2012
May 8, 2012
May 9, 2012
Clinical Logs due the Monday Following Your Surgery or Outpatient Rotation
Refer to Course Calendar.
All Dates subject to change and will be posted on the LMS.
XV.
Unit and Instructional Objectives
Unit 1 ADAPTIVE RESPONSES FOR THE CLIENT RECEIVING IV THERAPY
Rationale: Nurses provide IV therapy to clients in a variety of settings. Nurses must have the knowledge
and skill to provide this therapy safely for the client
A. OBJECTIVES:
Upon completion of learning activities, participation in lecture/discussion, and clinical activities,
the student will be provided the opportunity to:
1.
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8.
Demonstrate a safe and effective procedure of venipuncture.
Plan nursing interventions to include cultural, ethnic, and social diverse population
within caring for a client receiving intravenous fluid therapy.
Successfully complete the classroom clinical and theory component of IV workshop.
Describe the procedures for blood and blood product administration, and assess
and evaluate a client’s response to blood or blood products.
Describe management of clients receiving parenteral nutrition.
Describe measures used for preventing complications of IV therapy.
Demonstrate safe and effective management of IV fluids, IV tubing, and electronic
IV flow controllers.
Demonstrate understanding of IV site care and infection control principles.
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9.
B.
Demonstrate skill in procedure of IV infusion to INT conversion and discontinuation
of IV therapy.
CONTENT:
1.
IV Therapy
A.
B.
C.
D.
E.
F.
G.
H.
I.
Venipuncture
Tubing and pump preparation
IV additives and piggybacks
Complications
Parenteral Nutrition
Blood & blood products
Calculations
Peripheral Intravenous Locks (INTs, saline locks)
Implanted Ports and Central Lines
C.
REQUIRED READINGS/VIDEOS
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Smeltzer & Bare: Chap 14 pgs. 298 - 309
Wilkinson & Treas : Volume 1: Chap 36: pgs. 933-949 & Chapter 26; pgs 642-644
Wilkinson & Treas : Volume 2: Chap 36; pgs. 902-943 & Chapter 26; pgs 575-578
Kee, Hayes, & McCuistion: Ch 4; Section 5E; pgs 87-99 & Chapter 17 pgs 249-252 &
corresponding chapter in Pharmacology Study Guide.
ATI Pharmacology: Chapters 4 & 33
ATI Nutrition: Chap 10
ATI Med-Surg: Chap 44
Med- Com Video #109: Intravenous Therapy: Basis & Venipuncture
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UNIT II ADAPTIVE RESPONSES FOR THE CLIENT WITH FLUID/ELECTROLYTE IMBALANCE
Rationale: Fluid and electrolyte imbalances affect all the client’s body systems, and a through knowledge
of the imbalances and the management of them is essential for the nurse to provide holistic
care.
A. OBJECTIVES:
Upon completion of learning activities, participation in lecture/discussion, and clinical activities,
the student will be provided the opportunity to:
1.
2.
3.
4.
Differentiate between osmosis, diffusion, filtration, and active transport.
Describe the role of the kidneys, lungs and endocrine glands in regulating the body’s fluid
composition and volume.
Identify the effects of aging on fluid and electrolyte regulation.
Plan effective care of patients with the following imbalances: fluid volume deficit and fluid
volume excess; sodium deficit (hyponatremia) and sodium excess (hypernatremia);
potassium deficit (hypokalemia) and potassium excess (hyperkalemia).
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5.
Describe the etiology, clinical manifestations, management and nursing interventions for the
following imbalances: calcium deficit (hypocalcemia) and calcium excess (hypercalcemia):
magnesium deficit (hypomagnesemia) and magnesium excess (hypermagnesemia);
phosphorus deficit (hypophosphate) and phosphorus excess (hyperphosphatemia); chloride
deficit (hypochloremia) and chloride excess (hyperchloremia).
Explain the role of the lungs, kidneys and chemical buffers in maintaining acid-base balance.
Compare metabolic acidosis and alkalosis with regard to causes, clinical manifestations,
diagnosis and management.
Compare respiratory acidosis and alkalosis with regard to causes, clinical manifestation,
diagnosis and management.
Interpret arterial blood gas measurements.
6.
7.
8.
9.
B.
CONTENT:
Body Fluids and Electrolytes
A.
Normal adaptive responses
B.
Adaptive responses in illness
D.
REQUIRED READINGS:
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Smeltzer & Bare: Chap 14 .
Kee, Hayes, & McCuistion: Chap 16 and corresponding study guide chapter.
ATI Med-Surg- Chap 48, 49, & 50.
UNIT III
PROMOTION OF ADAPTATION FOR THE CLIENT WITH ENDOCRINE PROBLEMS:
Rationale: Clients with Endocrine disorders require special care. It is essential that nurses have the
knowledge to provide that care.
A.
OBJECTIVES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Describe the functions of each of the endocrine glands and their hormones.
Identify the diagnostic tests used to determine alterations in function of each of the
endocrine glands.
Compare hypothyroidism and hyperthyroidism: their causes, clinical manifestations, and
management and nursing interventions.
Develop a plan of nursing care for the patient undergoing thyroidectomy.
Compare hyperparathyroidism and hypoparathyroidism: their causes, clinical
manifestations, and management and nursing interventions.
Compare Addison’s disease with Cushing’s syndrome: their causes, clinical
manifestations, management, and nursing interventions.
Use the nursing process as a framework for care of patients with adrenal insufficiency.
Use the nursing process as a framework for care of patients with Cushing’s syndrome.
Identify the teaching needs of patients requiring corticosteroid therapy.
Differentiate between type I and type 2 diabetes.
Describe etiologic factors associated with diabetes.
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12.
Relate the clinical manifestations of diabetes to the associated pathophysiologic
alterations.
Identify the diagnostic and clinical significance of blood glucose tests.
Explain the dietary modifications used for management of people with diabetes.
Describe the relationship between diet, exercise and medication (i.e., insulin or oral
hypoglycemic agents) for people with diabetes.
Identify the role of oral antidiabetic agents in diabetic therapy.
Differentiate between hypoglycemia and diabetic ketoacidosis, and hyperosmolar
nonketotic syndrome.
Describe management strategies for a person with diabetes to use during “sick days”.
Describe the major macrovascular, microvascular and neuropathic complications of
diabetes and the self-care behaviors important in their prevention.
Use the nursing process as a framework for care of the patient with diabetes.
Develop a plan of care for the client that is culturally, ethically, and socially diverse.
13.
14.
15.
16.
17.
18.
19.
20.
21.
B.
CONTENT: DIABETES:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Definition
Epidemiology
Types of diabetes
Etiology
Pathophysiology
Clinical manifestations
Diagnostic evaluations
Management
Acute complications of diabetes
Long-term complications of diabetes
Special problems in diabetes
OTHER ENDOCRINE DISORDERS:
1.
2.
3.
4.
5.
6.
C.
Physiologic overview
The thyroid gland
The parathyroid glands
The adrenal gland
The pituitary gland
The pancreas
REQUIRED READINGS:





UNIT IV
Smeltzer & Bare; Chap: 41 & 42
Kee, Hayes, & McCuistion; Chap: 51 & 52 & corresponding study guide chapters.
ATI Med-Surg: Chapters 89, 90, 91, 92, 93, 94, 95, 96, 97
ATI Nutrition: Chapter 15
ATI Pharm: Chapters 39 & 40
PROMOTION OF ADAPTATION FOR THE CLIENT WITH GASTROINTESTINAL PROBLEMS
Rationale: Clients with gastrointestinal problems require special care. It is essential that nurses have the
knowledge to provide that care.
A.
OBJECTIVES:
12
Upon completion of learning activities, participation in lecture/discussion, and clinical activities,
the student will be provided the opportunity to:
1.
2.
3.
Describe the structure and function of the gastrointestinal (GI) system.
Identify normal physiological GI changes associated with aging.
Describe the appropriate preparation, teaching and follow-up care for patients who are
undergoing diagnostic testing of the GI tract.
Describe the nursing management of patients with abnormalities of the lips, gums,
teeth, mouth and salivary glands
Use the nursing process as a framework for care of patients with cancer of the oral
cavity.
Identify the physical and psychosocial long-term needs of patients with oral cancer.
Use the nursing process as a framework for care of patients with neck dissection.
Use the nursing process as a framework for care of patients with conditions of the
esophagus.
Describe the various conditions of the esophagus and their clinical manifestations and
management.
Compare the etiology, clinical manifestations, and management of acute gastritis,
chronic gastritis, and peptic ulcer.
Use the nursing process as a framework for care of patients with gastritis and peptic
ulcer disease.
Describe the dietary, pharmacologic, and surgical treatment of peptic ulcer.
Describe the nursing management of patients who undergo surgical procedures to treat
obesity.
Use the nursing process as a framework for care of patients with gastric cancer
undergoing gastric surgery.
Identify the complications of gastric surgery and their prevention and management.
Describe the home health care needs of the patients who have had gastric surgery.
Compare the conditions of malabsorption with regard to their pathophysiology, clinical
manifestations, and management.
Use the nursing process as a framework for care of patients with diverticulitis.
Compare regional enteritis and ulcerative colitis with regard to their pathophysiology,
clinical manifestations, diagnostic evaluation, and medical, surgical and nursing
management.
Use the nursing process as a framework for care of the patient with an inflammatory
bowel disease.
Describe the various types of intestinal obstructions and their management.
Use the nursing process as a framework for care of the patient with cancer of the colon
or rectum.
Use the nursing process as a framework for care of the patient with an anorectal
condition.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
B.
CONTENT:
1.
Assessment of Digestive and Gastrointestinal Function
A. Anatomy and physiology review
B. History and physical assessment review
C. Diagnostic evaluation
D. Pathophysiologic and psychological considerations
2.
Management of Patients with oral and esophageal disorders
A. Disorders of the teeth
B. Disorders of the jaw
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C.
D.
E.
F.
C.
Disorders of the salivary glands
Cancer of the oral cavity
Neck dissection
Disorders of the esophagus
3.
Management of patients with gastric and duodenal disorders
A. Gastritis
B. Gastric and duodenal ulcer
C. Morbid obesity
D. Gastric cancer
E. Gastric surgery
4.
Management of patients with intestinal and rectal disorders
A. Abnormalities of fecal elimination (pp. 1033 – 1034)
B. Acute inflammatory intestinal disorders
C. Inflammatory bowel disease
D. Intestinal obstruction
E. Diseases of the anorectum
REQUIRED READINGS:





Smeltzer & Bare: Chap: 34 - 38
Kee, Hayes, & McCuistion: Chap: 47 & 48 and corresponding study guide chapters.
ATI Med-Surg: Chapters 51, 52, 53, 54, 55, 56, 57, 58, 59
ATI Nutrition: Chapter 13; pgs 120-126
ATI Pharmacology: Chapters 28 & 29
UNIT V SURGICAL PATIENT AND SHOCK:
Rationale: Clients requiring surgery or experiencing shock require special care from nurses. It is essential
that nurses have the knowledge to provide for the client’s needs.
A.
OBJECTIVES:
Upon completion of learning activities, participation in lecture/discussion, and clinical activities, the
student will be provided the opportunity to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Describe the three phases of the perioperative period.
Describe a comprehensive preoperative assessment of identify surgical risk factors.
Identify the causes of preoperative anxiety and describe nursing measures to alleviate it.
Identify legal and ethical considerations related to informed consent.
Describe preoperative nursing measures that decrease the risk for infection and other
postoperative complications.
Describe the immediate preoperative preparation of the patient.
Develop a preoperative teaching plan designed to promote the postoperative complications.
Describe the interdisciplinary approach to the care of the patient during surgery.
Describe the principles of surgical asepsis.
Describe various nursing roles as well as the role of the anesthesiologist or anesthetist in the
intraoperative phase of care.
Identify adverse effects of surgery and anesthesia.
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12.
Identify the surgical risk factors related to age-specific population and nursing interventions to
reduce those risks.
Compare various types of anesthesia with regard to uses, advantages, disadvantages and
nursing responsibilities.
Identify the use of nursing process for optimizing patient outcomes during the intraoperative
period.
Describe the responsibilities of the postanesthesia care unit nurse in the prevention of
immediate postoperative complications.
Compare postoperative care of the ambulatory surgery patient and the hospitalized surgery
patient.
Identify common postoperative problems and their management.
Describe the gerontologic considerations related to postoperative management of patients.
Describe variables that affect wound healing.
Demonstrate postoperative dressing techniques.
Identify assessment parameters appropriate for the early detection of postoperative
complications.
Describe shock and its underlying pathophysiology.
Compare clinical findings of the compensatory and progressive stages of shock.
Describe organ damage that may occur with shock.
Compare hypovolemic, cardiogenic and circulatory shock in terms of causes, pathophysiologic
effects and medical and nursing management.
Describe indications for varying types of fluid replacement.
Identify vasoactive medications used in treating shock, and describe nursing implications
associated with their use.
Discuss the importance of nutritional support in all forms of shock.
Discuss the role of the nurse in psychosocial support of both the patient experiencing shock
and the family.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
B.
CONTENT:
1.
2.
3.
4.
5.
6.
7.
8.
C.
Perioperative nursing care
Classification of surgery
Preoperative surgical phase
Intraoperative surgical phase
Postoperative surgical phase
Pathophysiology of shock
Classification of shock
Manifestations of shock
REQUIRED READINGS:



UNIT VI
Smeltzer & Bare: Chapters: 15, 18, 19, 20.
Kee, Hayes, & McCuistion: Chapter 21 & corresponding chapter in Pharmacology Study Guide.
ATI Med Surg: Chapters 41, 107, 108, & 109
PROMOTION AND ADAPTATION FOR THE CLIENT WITH HEMATOLOGIC DISORDERS:
15
Rationale: Clients with hematologic disorders require special nursing care. It is essential that nurses have
the knowledge to provide that care.
A.
OBJECTIVES:
Upon completion of learning activities, participation in lecture/discussion, and clinical activities,
the student will be provided the opportunity to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
B.
Describe the hematologic changes with aging.
Describe the process of hematopoiesis.
Describe the processes involved in maintaining hemostatsis.
Differentiate between the hypoproliferative and the hemolytic anemias and compare
and contrast the physiologic mechanisms, clinical manifestation, medical management
and nursing interventions for each.
Use the nursing process as a framework for care of patients with anemia.
Compare the leukemias, their incidence, physiologic alterations, clinical manifestations,
management and prognosis.
Use the nursing process as a framework for care of patients with acute leukemia.
Use the nursing process as framework for care of patients with lymphoma or multiple
myeloma.
Use the nursing process as a framework for care of patients with bleeding disorders.
Identify therapies for blood disorders.
CONTENT:
1.
2.
C.
Anatomic and Physiologic Overview
Management of Hematologic Disorder
REQUIRED READINGS:





Smeltzer & Bare: Chap: 33 (pp. 1035 – 1112)
Kee, Hayes, & McCuistion: Chapters 45 & 46 pgs 689-692 and corresponding chapters and
content in Pharmacology study guide.
ATI Med Surg: Chapters 45, 46, & 47
ATI Pharmacology: Chap 25
ATI Nutrition: Chap 12; pgs 115-116
UNIT VII
PROMOTION OF ADAPTATION FOR THE CLIENT WITH HEPATIC AND BILIARY HEALTH
PROBLEMS
Rationale: Clients with hepatic and biliary disorders require special care. It is essential that nurses have
the knowledge to provide that care.
A.
OBJECTIVES:
Upon completion of learning activities, participation in lecture/discussion, and clinical activities,
the student will be provided the opportunity to:
1.
Identify the metabolic functions of the liver and the alterations in these functions that
occur with liver disease.
16
2.
Explain liver function tests and the clinical manifestations of liver dysfunction in relation
to pathophysiologic alterations of the liver.
Relate jaundice, portal hypertension, ascites, varices, nutritional deficiencies and
hepatic coma t pathophysiologic alterations of the liver.
Describe the medical, surgical and nursing management of patients with cirrhosis of the
liver.
Compare the various types of patients and their causes, prevention, clinical
manifestation, management, prognosis, and home health care needs.
Use the nursing process as a framework for care of the patient with cirrhosis of the liver.
Compare the non-surgical and surgical management of patients with cancer of the liver.
Describe the postoperative nursing care of the patient undergoing liver transplantation.
Compare approaches to management of cholecystectomy.
Use the nursing process as a framework for care of patients with choleithiasis and those
undergoing laparoscopic or open cholecystectomy.
Differentiate between acute and chronic pancreatitis.
Use the nursing process as a framework for the care of patients with acute pancreatitis.
Describe the nutritional and metabolic effects of surgical treatment of tumors of the
pancreas.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
B.
C.
CONTENT:
1.
The Hepatic-Biliary System in Health and Illness.
A.
Structural and functional interrelationships
B.
Pathophysiological influences and effects
C.
Related system influences and effects
D.
Psychosocial/lifestyle influences and effects
2.
The nursing process for clients with hepatic-biliary system dysfunction
A.
Nursing assessment: Establishing the data base
B.
Nursing diagnosis
C.
Planning and intervention
D.
Evaluation
3.
Specific Disorders of the hepatic-biliary system
A.
Congenital disorders
B.
Disorders of multi-factorial origin
C.
Infections and inflammatory disorders
D.
Neoplastic and obstructive disorders
E.
Traumatic disorders
4.
Surgical approaches to hepatic-biliary dysfunction
A.
Surgical approaches to disorders affecting the liver
B.
Surgical approaches to disorders affecting the gallbladder
REQUIRED READINGS:
Smeltzer & Bare: Ch ap: 39 & 40
ATI Med Surg: Chapters 60, 61, 62, 63, & 64
ATI Nutrition: Chapter 13; pg 126 & 127
17
Disclaimer: This First Day Handout was prepared under certain limited assumptions. Therefore, if the
students in the class seem to "fit" the design for the course and if events occur as planned, the schedule,
assignments, and assessments will be followed. The instructor has the option, however, to eliminate or
add assignments and/or assessments if he/she feels it is in the best interest of the students.
Reviewed & Revised 1/12
18