Santa Monica College
Course Outline For
Course Title: Nursing 30 – Intermediate Medical-Surgical Nursing Units
2.5
IGETC Area:
Date Submitted: Fall 2003
CSU GE Area:
Updated: Fall 2006
Transfer:
CSU
I.
Catalog Description:
Prerequisite: Nursing 25, Nursing 25L, Nursing 16, Nursing 17
Corequisite: Nursing 30 Laboratory
This course presents increasingly complex concepts involving adults with both
medical and surgical health deviation and the required nursing assistance.It
utilizes Orem’s Self-Care Model in meeting health deviation needs of the patient
experiencinggastrointestinal,renal,oncological,hematological,female reproductive,
and immune system disorders. The universal self-care requisites are assessed and
evaluated. Emphasis is placed on the development of a broad, scientific
knowledge baseincludingreasoning, judgment, communication, criticalthinking,
and professional role development. The nursing process and professional role
development are used as an organization and practice framework. Gerontology
concepts are presented along with health promotion and health maintenance
strategies.
II.
Required Text and References:
1. Doenges, Marilyn, Nurse’s Pocket Guide: Nursing Diagnoses with Interventions,
7th ed., F.A. Davis, 2000.
2. Luekenotte, Annette G., Gerontological Nursing, 3rd ed., Mosby, 2006.
3. Estes, Health Assessment & Physical Examination, 2nd ed., Delmar, 2002.
4. Fishbach, Frances, Manual of Laboratory Diagnostic Tests, 6th ed., Lippincott, 2003.
5. SMC Nursing Student Handbook, current edition – available online
6. Smeltzer & Bare, Brunner’s Textbook of Medical-Surgical Nursing, 10th ed.,
Lippincott, 2004.
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III.
Course Objectives:
Upon completion of Nursing 30, students should be able to:
1. Utilize the Orem Self-Care Model as a framework to develop nursing system
designs for adults with health deviation involving the following:
a) gastrointestinal tract – absorption and elimination
b) liver, biliary tract and pancreas
c) immune and auto-immune system
d) hematological system
e) renal system
f) oncological
g) female reproductive system
2. Integrate principles of effective communication in all facets of nursing
practice, including the multi-disciplinary health care team.
3. Apply critical thinking to predict nursing assistance required for the
patient/client with a health deviation
4. Discuss behaviors that illustrate knowledge of the professional responsibilities
of the beginning manager of nursing care.
5. Evaluate the role of the nurse in disease prevention, health promotion and
health maintenance for adults and older adults.
7. Specify behaviors that reflect integration of the role of the professional nurse
including practice and leadership.
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IV.
Theoretical Objectives:
Upon completion of Nursing 30, the students will be able to:
1. Evaluate the universal requisites and self care agency of patients/clients with
pathology involving:
a) Upper and lower gastrointestinal tract
b) Liver, biliary tract and pancreas.
c) Immune system
d) Hematological system
e) Renal system
f) Cancer
g) Female reproductive system
2. Identify diagnostic procedures and nursing assistance associated with the following:
a) Upper and lower gastrointestinal tract
b) Liver, biliary tract and pancreas
c) Immune system
d) Hematological system
e) Renal system
f) Cancer
g) Female reproductive system
3. Describe differences and similarities in nursing assistance required for adults
and older adults with health deviations involving the following:
a) Upper and lower gastrointestinal tract
b) Liver, biliary tract and pancreas
c) Immune system
d) Hematological system
e) Renal system
f) Cancer
g) Female reproductive system
4. Health Deviations Involving Cancer
a) Describe the role of the nurse in health education and early
detection of cancer.
b) Describe the use of surgery, radiation therapy, chemotherapy,
biological response modifiers, bone marrow transplant, stem
cell therapy and gene therapy in treating cancer.
c) Describe the concept of hospice care for patients with cancer.
d) Differentiate between the characteristics of benign and
malignant neoplasm’s and treatment modalities.
e) Identity common coping strategies of individuals and families
affected by cancer to promote self-care and independent
functioning.
f) Utilize critical thinking skills to predict psychological and
emotional reactions of individuals and families experiencing
chronic and terminal illness.
g) Discuss the nutritional care of the patient with cancer.
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h) Interpret dietary guidelines for the prevention of cancer.
5. Health Deviations of the upper and lower gastrointestinal tract
a) Describe nursing assistance for patients/clients with ingestive
and digestive disorders.
b) Compare and contrast nursing assistance for patients/clients
receiving internal feedings and total parenteral nutrition.
c) Describe nursing assistance for the patients undergoing cancer
of the esophagus and a radical neck dissection.
d) Compare and contrast the nursing assistance for a patient/client
requiring gastrointestinal intubations for tube feeding or
intestinal decompression.
e) Describe types of solutions utilized for total parenteral
nutrition, methods of administration and related nursing
assistance.
f) Describe nursing assistance required for the patient/client with
chronic inflammatory bowel disease.
g) Compare and contrast nursing assistance for the patient will
small bowel obstruction and large bowel obstruction.
h) Predict nursing assistance required for the patients
experiencing need for fecal diversion such as ileostomy or
colostomy.
i) Describe nursing management of the client experiencing
conscious sedation.
j) Discuss the nutritional deficiencies associated with
malabsorption and dehydration.
k) Identify indications for internal or parenteral feedings.
l) Compare the types and purposes of commercially available
tube feeding formulas.
m) Compare and contrast peripheral parenteral nutrition (PPN) and
total parenteral nutrition (TPN)
n) Explain measures to avoid complications associated with PPN,
TPN and intralipids.
6. Health deviations of the liver, biliary tract and pancreas
a) Describe nursing assistance required for patients/clients with
alterations in liver, biliary, and exocrine function.
b) Identify clinical manifestations of altered liver function.
c) Correlate the onset of jaundice, portal hypertension, ascites and
hepatic encephalogy to pathophysiology of the liver.
d) Compare and contrast the various types of hepatitis based on
cause, prevention, clinical manifestations and treatment
modalities.
e) Describe the cause, prevention, and treatment modalities for
the patient with cirrhosis and esophageal varices.
f) Describe the treatment modalities for the patient with
cholelithiasis.
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g) Predict the nursing assistance required for the patient
undergoing different types of cholecystectomy.
h) Describe the nursing required for the patient with an alteration
in exocrine pancreatic function.
i) Relate several nutritional consequences of end-stage liver
disease.
7. Health deviations of the immune system
a) Describe treatment modalities for the patient experiencing
alterations in immune systems such as HIV infection,
rheumatoid arthritis and systemic lupus erythmatosis.
b) Explain the pathophysiology involved in the development of
health deviations of the immune system.
c) Describe the common opportunistic infections associated with
HIV infection and treatment modalities.
d) Discuss the pharmacological management of the patient with
HIV infection including antiretroviral drugs;
immunomodulator drugs and medications for HIV related
infections.
e) Compare and contract etiology, pharmacological management
and treatment modalities for the patient with rheumatoid
arthritis and systemic lupus erythmatosis.
f) Discuss the unique nutritional needs of the patient with HIV
and opportunistic infections.
8. Health deviations of the hematological system
a) Discuss nursing management concepts for patient/clients
experiencing alterations in hematopoiesis such as anemia,
leukemia and disseminated intravascular coagulopathy.
b) Differentiate between the hypoproliferative and hemolytic
anemia’s, including clinical manifestations and medical
management.
c) Compare the various leukemia’s in regard to incidence,
pathophysiology, clinical manifestations and medical
management.
d) Anticipate nursing assistance required for the patient with
disseminated intravascular coagulation.
e) Compare and contrast the common types of blood components,
implications for use, and methods of administration.
f) Describe symptoms of a transfusion reaction and related
nursing interventions.
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9. Health Deviations of the Renal System
a) Identify nursing management concepts for patients/clients
experiencing alteration in renal functions such as renal failure,
hemodialysis and peritoneal dialysis, kidney transplantation
and urinary diversions.
b) Compare and contrast nursing assistance required for the
patients with hemodialysis and peritoneal disease.
c) Compare and contrast nursing assistance required for the
patients with acute or chronic failure, including kidney
transplantation.
d) Discuss the goals of nutritional care for the patients with
kidney disease.
e) Discuss the relationship among kilocalorie intake, dietary
protein utilization and uremia.
10. Health Deviations of the Female Reproductive System
a) Discuss the nursing assistance required by the patients with a
malignant tumor of the female reproductive system
b) Identify nursing assistance required by the patient undergoing a
total abdominal hysterectomy and bilateral salpingooophorectomy.
c) Describe malignant conditions of the breast, chemoprevention,
and treatment modalities.
11. Professional Role Development
a) Recognize political and financial issues in contemporary health
care that impact the hospital, home and the community.
b) Examine differences and similarities among hospital, home and
community based practice.
c) Interpret cultural and communication differences which impact
care of clients with health care deviations.
d) Explain role of nursing care management such as decisionmaking, knowledge of caregiver’s scope practice,
responsibility to support personnel and achievement of
objectives through other’s actions.
e) Describe the role of the nurse in a variety of health care
delivery systems
V.
Methods of Presentation:
Small group presentation, small group discussion, assigned readings,
classroom demonstrations correlated with return student demonstrations in
learning center, group project, audio-visual aids, lecture, computer assisted
learning programs and an elective professional role activity. This course
is coupled with a mandatory clinical practice course, which requires
hands-on care of patients.
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VI.
Course Content:
Coverage
6.25
3.25
12.5
6.25
6.25
7.25
3.0
6.25
12.5
18.75
6.25
12.5
VII.
Topic
Oncology
Immune Function
Rheumatic Disorders
Hematology
Anemia
Bleeding Disorders
Leukemia
Hodgkins Disease
Renal Disease
Gastrointestinal Disorders
Liver, Pancreas, Gallbladder
Reproductive Disorders
Methods of Evaluation:
To achieve success in Nursing 30, the student will:
1. Successfully pass both theory and clinical components of Nursing 30
and Nursing 30L.
2. Achieve an average grade of C (75%) at the end of the course. Exams
are multiple choice and may contain a short answer question. Grading
is based on percentage scale of total points:
Theory Grading Scale:
100-92%
A
91-83%
B
82-75%
C
74-70%
D
69-0%
F
3. Students will be considered deficient if at any time they fall below the
75% grading scale. Consider test results as a notice of performance in
the didactic portion. Test results will be posted on e-Companion.
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Theory Grading = 100%
METHOD
Exams
1) Exam #1
2) Exam #2
3) Exam #3
4) Exam #4
5) Unannounced Quizzes
6) Final Exam
Activities
1) Software for Nurses
2) Professional development
course)
TOTAL POINTS
POINTS
60 points
70 points
60 points
70 points
30 points
100 points
10 points (mandatory)
2% (optional and cannot be used to pass the
400
For grading purposes, please purchase:
(1) Scantron #20787
(8) Parascore Enrollment Scantron #20788-ERI
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VIII.
Exit Skills N 30:
1. Utilize the nursing process to plan care for the patient/ client with a
selected disorder of the upper gastrointestinal tract.
2. Evaluate outcomes of the plan of care for the patient/client with a selected
disorder of the lower gastrointestinal tract.
3. Describe collaborative management of care for the patient/client with a
selected disorder of the liver, biliary tract and pancreas.
4. Prioritize interventions for the patient/client with a selected disorder of the
immune system.
5. Describe required nursing assistance for the patient/client with a selected
disorder of the hematological system.
6. Evaluate outcomes of the plan of care for the patient/client with a selected
disorder of the renal system.
7. Critique a plan of care for the patient/client with a selected disorder of the
female reproductive system.
8. Specify behaviors that reflect knowledge of the principles of effective
communication skills to promote collaborative care of the client.
9. Describe behaviors that reflect a knowledge of the special needs and
requirement of older adults experiencing health deviations of:
a) upper or lower gastrointestinal tract
b) female reproductive tract
c) liver, biliary tract and /or pancreas
d) immune system
e) hematological system
f) renal system
10. Describe the critical thinking process when used to analyze complex
health care problems
11. Explain roles of nursing care management such as decision-making,
knowledge of caregiver’s scope of practice, responsibility to support
personnel and achievement of objectives through the actions of others.
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