THE UNIVERSITY OF TEXAS AT BROWNSVILLE
AND
TEXAS SOUTHMOST COLLEGE
ASSOCIATE DEGREE NURSING PROGRAM
RNSG 2441 ADVANCED CONCEPTS OF CLINICAL
DECISION MAKING
LECTURE AND LABORATORY
COURSE SYLLABUS
PROFESSORS:
JOE LACHER, M.S.N., R.N., C.N.A.,B.C.
NORMA SILVA, M.S.N.,R.N.
BETSY FREETH, M.S.N., R.N.
SPRING 2006
THE UNIVERSITY OF TEXAS AT BROWNSVILLE
AND
TEXAS SOUTHMOST COLLEGE
ASSOCIATE DEGREE NURSING PROGRAM
RNSG 2441 ADVANCED CONCEPTS OF CLINICAL DECISION MAKING
COURSE DESCRIPTION: (WECM)
Application of advanced concepts and skills for development of the professional nurse’s role in complex client/nursing situations.
Emphasis on clinical decision-making for clients in medical-surgical settings experiencing health problems involving cardiovascular
disorders; neurologic disorders; liver, biliary and pancreatic disorders; renal and urinary disorders; hematologic disorders; and cancer.
Focus given to knowledge, judgment, skills, and professional values within a legal/ethical framework. Lec.4, Lab 1
KEY CONCEPTS AND COURSE PLAN
This classroom and simulated laboratory course provides an opportunity for the Level III student to acquire knowledge, including
scientific principles from the biological, psychological and social sciences and the concepts of caring, that relate to providing care to
groups of adult clients and their families with complex health care problems. Classroom learning experiences require the nursing
student to use current literature, critical thinking, the nursing process, assessment of cultural factors, and legal standards and ethical
principles to plan care for hypothetical clients and their families. This course examines the nurse’s role as teacher and communicator
and how these roles interface with his/her role as provider of care for the adult client and his/her family with common health care
needs. It also examines the nurse’s role as coordinator of care as it relates to promoting an optimal level of wellness and continuity of
care. How the nurse, in the role of coordinator, involves other members of the health care team to provide care for the adult client and
his/her family is also discussed. The role of the nurse as a member of a profession and as an advocate is also discussed.
PRE-REQUISITES
RNSG 2201, RNSG 2162, RNSG 2213, RNSG 2163, SPCH 1318, ENGL 1301
CO-REQUISITES
RNSG 2360, RNSG 2121, RNSG 2166, HUMANITIES ELECTIVE
3
Course Learning Outcomes (WECM)
The student will utilize critical thinking and a systematic problem-solving process as a framework for providing care for clients in
complex client/nursing situations; and analyze the roles of the professional nurse in the provision of care for clients and families.
COURSE LEARNING OUTCOMES (UTB/TSC)
Upon completion of this course the student should be able to meet the following course learning outcomes:
Provider of Care
1. Using case studies and/or other simulations of client encounters, analyze how basic human needs of a group of clients and their
families are affected by complex health care problems.
2. Using case studies and/or other simulations of client encounters, analyze and use scientific principles from the biological,
psychological and social sciences to develop an individualized plan of care for groups of clients and their families with various
complex health care needs.
3. Using case studies and/or other simulations of client encounters, apply the use of current literature, critical thinking and the
nursing process to organize the care of a group of clients and their families experiencing various complex health care problems.
4. Examine how to evaluate the response of a group of clients and their families to various therapeutic and culturally sensitive
nursing interventions used to assist those with complex health care needs.
5. Examine how to evaluate the effectiveness of communication techniques used with a group of clients and their families with
complex health care needs.
6. Using case studies and/or other simulations of client encounters, examine how to evaluate the effectiveness of health teaching
presented to groups of clients and their families experiencing various complex health care needs.
7. Examine legal and ethical issues that relate to the performance of nursing interventions for groups of clients and their families with
various complex health care needs.
4
Coordinator of Care
8. Examine various ways the nurse evaluates and revises the management of human and material resources to provide quality health
care to a group of clients and their families with complex health care needs.
9. Examine how the nurse evaluates the effectiveness of communication in collaborating with other members of the health care team
to coordinate care of a group of clients and their families with various complex health care needs.
10. Examine how the nurse evaluates, in collaboration with other members of the health care team, the effectiveness of teaching plans
for groups of clients and their families with various complex health care needs.
11. Using case studies and/or other simulations of client encounters, develop a plan of care that includes appropriate institutional
and/or community referral resources to assist groups of clients and their families in meeting complex health care needs and to
ensure continuity of care.
Member of a Profession
12. Examine how the nurse evaluates and revises activities related to client advocacy for groups of clients and their families with
complex health care needs.
13. Examine responsibilities that the nurse is liable and accountable for in relation to caring for groups of clients and their families
with complex health care needs.
TEACHING METHODS
Lecture, discussion, audiovisual aides, simulation, computer assisted instruction (C.A.I.), case studies, group projects.
TEACHING PERSONNEL
JOE LACHER, M.S.N., R.N., C.N.A.,B.C.
NORMA SILVA, M.S.N.,R.N.
BETSY FREETH, M.S.N., R.N.
Guest Speakers
Faculty members are available during office hours and by appointment.
5
METHODS AND CRITERIA FOR EVALUATION
EVALUATION
PERCENTAGE OF GRADE
1. Unit Examinations =
2. Comprehensive Final Exam
60% (#1=15%, #2=15%,#3=15%, #4=15%)
40%
GRADING SYSTEM OF A.D.N.
PROGRAM
A = 90–100%
B = 80-89%
C = 74.50-79%
D = 70-74.50%
F = 0-69%
Meds Publishing-Learning System RN
The student must complete the following LSRN exams as part of the course requirement. It is the student’s responsibility to take the
exam and provide a printout to the faculty. The student must make a 90% on the exam in order to receive credit. Five (5) attempts
are allowed EXCEPT the one (1) attempt allowed for each Integrated exam (there are 2: Med/Surg and Disaster Planning).
Med/Surg Test # 1 Cardiovascular
Med/Surg Test # 2 Integumentary
Med/Surg Test # 3 Endocrine
Med/Surg Test # 4 Gastrointestinal
Med/Surg Test # 5 Genitourinary
Med/Surg Test # 6 Hematologic
Med/Surg Test # 7 Immunologic
Med/Surg Test # 8 Infectious
Med/Surg Test # 9 Musculoskeletal
Med/Surg Test # 10 Neurological
Med/Surg Test # 11 Oncology
Med/Surg Test # 12 Respiratory
Med/Surg Test # 13 Sensory
Med/Surg Test # 14 Integrated
Disaster Planning Test 1 Integrated
Bio Terrorism
Triage
No make up examinations will be given. If a unit examination is missed because of illness or emergency, the percentage from the
unit exam will be added to the percentage for the final exam. The student must earn an overall grade of 74.50% or greater
in order to pass the course. It is the student’s responsibility to ensure that all the exam questions have been answered prior
to leaving the classroom.
THE STUDENT WHO NEEDS NOTE-TAKING AND/OR TEST-TAKING ACCOMMODATIONS MUST NOTIFY THE
FACULTY MEMBER PRIOR TO THE FIRST EXAM.
6
REQUIRED TEXTBOOKS
Boyer, M. (2004) Study Guide for Brunner and Suddarth’s Textbook of Medical-Surgical Nursing, 10th Ed., Lippincott: Philadelphia,
Pennsylvania. ISBN: 0-7817-3215-8
Corbett, J. (2004) Laboratory Test & Diagnostic Procedures, 6th Ed., Appleton & Lange: Pearson Prentice Hall: New Jersey. ISBN:
0-1304-9369-4.
Smeltzer, S. & Bare, B. (2004) Brunner and Suddarth’s Textbook of Medical Surgical Nursing, 10th Ed., Lippincott: Philadelphia,
Pennsylvania. ISBN: 0-7817-3193-3
RECOMMENDED TEXTBOOKS
Silvestri, L. (2005) Saunders’ Comprehensive Review for NCLEX-RN Examination, 3rd Ed. Mosby (Elsevier Health). ISBN: 07216-0347-5
RESOURCES
Black Board Course Website: http://myutbtsc.blackboard.com
Lippincott Connection: Smeltzer and Bare textbook online resources: http://connection.lww.com/go/smeltzer
All previous course textbooks should be used as resources.
SCANS
The Secretary’s Commission on Achieving Necessary Skills (SCANS) has identified Reading, Writing, Arithmetic or Mathematics,
Speaking and Listening, Thinking Skills, Personal Qualities, Work Place Competencies and Basic Use of Computers as competencies
required to enter employment. This course is part of a program in which all eight of these competencies are integrated. Reading,
Writing, Arithmetic or Mathematics, Speaking and Listening, Thinking Skills, Personal Qualities, Work Place Competencies, and
Basic Use of Computers are practiced in this course.
STATEMENT ON DISABILITIES (UTB/TSC)
Students with disabilities, including learning disabilities, who wish to request accommodations in this class should notify the
Disability Services Office early in the semester so that the appropriate arrangements may be made. In accordance with federal law, a
student requesting accommodations must provide documentation of his/her disability to the Disability Services counselor. For more
information, call or visit the Counseling Center at Tandy 205 (956-882-8292).
7
COURSE INFORMATION
Examinations and Assignments
A multiple-choice exam will be administered at the completion of each Unit. Exam questions will be directed at the student’s ability to
assess, analyze, plan, implement and evaluate client care.
General examination policies are as follows:
A. It is the student’s responsibility to notify the faculty member in advance if he/she is unable to take a scheduled exam.
B. It is the student’s responsibility to assure that he/she has answered all test items before leaving the room.
To preserve the integrity of examinations, the following policies apply:
A.
B.
C.
D.
E.
F.
Students will not have access to purses, paper, hats, caps, or any other items during the exam.
Students may be assigned seats by faculty proctors.
Cell phones and pagers are not permitted at any time during exams or exam reviews.
#2 pencils ONLY are permitted during an exam: no pens or calculators.
Food and/or drinks are not permitted during exams.
No one is permitted to leave the room after the exam has started. Persons who leave must turn in their exam for grading before
exiting the room.
G. Note-taking materials and any kind of recording device are not permitted during exam reviews.
Exam reviews will be conducted at the discretion of the faculty. The focus of the exam review will be on the most frequently missed
test items as demonstrated by the item analysis. The purpose of the review is to correct misconceptions and promote understanding of
the content.
No challenges to exam questions will be accepted. Adjustments to exam answers will be based solely on the computerized item
analysis.
Readings will consist of textbook readings and additional selected readings as assigned by faculty.
Additional required and/or recommended instructional computer software can be found in the Nursing Resource Center.
All course assignments (papers, projects, exams, etc.) must represent the student’s own accomplishments.
The faculty reserves the right to make additional or alternate assignments in order to assess the student’s progress in the program.
8
Attendance Policy
Classroom attendance is required as per UTB/TSC Catalog and UTB/TSC A.D.N. Faculty Policy. Refer to A.D.N. Student Guide
Extra Assistance
It is the responsibility of the student to seek assistance as necessary. Faculty members are available to assist students during office
hours or by appointment. Counselors are available in the Learning Assistance Center to assist students with such skills as test taking,
study habits, time management and prioritizing.
Classroom Attire and Decorum
Clothing worn to classes at UTB/TSC may range from dressy to casual. Although many styles are acceptable, it is recommended that
fashion excesses and extremes be avoided.
Students are expected to observe the following guidelines for classroom behavior:
1. Neither children nor pets may be brought to classes. Children must not be left unattended in any area in the school or on the school
2.
3.
4.
5.
grounds.
Guests may be brought to class if permission is previously obtained from the faculty member in charge of the class.
Permission to tape record class sessions needs to be obtained from the faculty presenting the class.
Classes will begin and end at the designated time. A 10-minute break will be provided for each hour of class.
No pagers or cellular phones are allowed while class is in session.
UNITS
Unit One contains Advanced concepts of clinical decision making in the areas of Cardiac and Respiratory Function
Unit Two contains Advanced concepts of clinical decision making in the areas of Urinary and Cancer Function
Unit Three contains Advanced concepts of clinical decision making in the areas of Neurological and Endocrine Function
Unit Four contains Advanced concepts of clinical decision making in the areas of Multi-system and Emergency nursing function.
9
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
Performance Outcomes
1. Review assessment of the cardiovascular system with
particular attention to assessment findings such as edema,
jugular vein distention and bruits and relate these findings
to complex cardiovascular disorders. ()*
2. Examine the significance of increasing or decreasing pulse
pressure as related to complex cardiovascular disorders. ()*
3. Analyze the clinical significance and related nursing
implications of various tests and procedures used to
diagnose complex cardiovascular disorders. ()*
4. Examine pre and post care nursing responsibilities for the
client undergoing cardiac catheterization. ()*
5. Compare and contrast central venous pressure (CVP)
monitoring, pulmonary artery pressure monitoring and
systemic intra-arterial monitoring with regard to clinical
usefulness and significance, possible complications, and
nursing responsibilities. ()*
6. Analyze abnormal findings of the electrocardiogram that
result from myocardial ischemia, injury, infarction, and
excess or deficits in electrolytes. ()*
7. Compare and contrast the etiology, ECG criteria,
prevention, medical management, and nursing implications
for various cardiac dysrhythmias and conduction problems.
()*
Key Concepts
Cardiovascular
Assessment (Edema,
Jugular Vein
Distention, Bruits)
Pulse Pressure
Learning Activities
Assessment Text and Medical Surgical Text
(REVIEW A&P AND ASSESSMENT
OF CARDIOVASCULAR SYSTEM
PRIOR TO CLASS)
Read Brunner, chapter 26, pg 662-663
Tests and Diagnostic
Procedures
Cardiac Enzymes,
Cardiac
Catheterization
Cardiac Cath: Nursing
Responsibilities
Complex Cardiac
Monitoring: CVP,
Pulmonary Artery,
Intra-arterial
Read Brunner, Chapter 26, pg 668-681
Abnormal
Electrocardiogram
(ECG) Findings
Cardiac Dysrhythmias:
Read Brunner, chapter 27
Basic EKG Rhythms tutorial online at:
http://www.randylarson.com/acls/start.html
Read Brunner, Chapter 27
Read Brunner, Chapter 26, pg 675-676
Read Brunner, Chapter 26, pg 677-681
Read Brunner, Chaopter 30, pg 788-792
Sinus: Bradycardia, Tachycardia;
Ventricular: PVC’s, Life
Threatening V-Tach, V-Vib,
Asystole; Atrial: PAC’s, A-Fib,
A-Flutter; Delays & Blocks:
1st Degree, 2nd Degree I & II, 3rd
Degree, Bundle Branch
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
10
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
Performance Outcomes
8. Differentiate between cardioversion and defibrillation
procedures and the indications for use of each of these
procedures. ()*
9. Compare and contrast various medications used to treat
dysrhythmias. ()*
10. Compare and contrast different types of pacemakers, their
uses, nursing implications and interventions. ()*
11. Examine the application of the nursing process to plan and
coordinate effective care for clients experiencing various
cardiac dysrhythmias and conduction problems. ()*
12. Interpret assessment findings in a client with acute
myocardial infarction. ()*
13. Examine the application of the nursing process to plan and
coordinate effective care for clients experiencing a
myocardial infarction. (1)*
Key Concepts
Noninvasive
Procedures:
Cardioversion &
Defibrillation
Antiarrhythmic
Medications
Pacemakers: Nursing
Implications and
Interventions
Nursing Process:
Common Nursing
Diagnosis, Planning
Interventions
(including client
teaching, home care),
Evaluation
Acute Myocardial
Infarction: Assessment
Findings
Nursing Process:
Analysis (Altered tissue
perfusion, Decreased cardiac
output, activity intolerance;
Interventions: (Nutrition,
Activity, Client/Family
Education,); Evaluation
(Absence of chest pain, control of
dysrhythmias, pre-infarct activity
level)
Learning Activities
Read Brunner, Chapter 27, pag 705-707
Read Brunner, Chapter 27
Read Brunner, Chapter 27, pg 700-704
Read Brunnert Chapter 27,
Case Studies, Critical Thinking Exercises
Read Brunner, Chapter 28,
Case Studies
Read Brunner, Chapter 28, Case Studies
Critical Thinking Exercises
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
11
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
Performance Outcomes
14. Compare and contract medications used to treat myocardial
infarction. ()*
15. Examine the application of the nursing process to planning
and coordinating the care of clients experiencing cardiac
arrest. ()*
Key Concepts
Medications for
Myocardial Infarction:
Thrombolytics, Analgesics,
ACE Inhibitors
Assessment: Signs &
Symptoms, ECG Strips
Nursing Diagnoses:
Altered Tissue Perfusion,
Impaired Gas Exchange
Interventions: CPR
16. Compare and contrast the medications used to manage
cardiac arrest. ()*
17. Develop a pre-operative nursing care plan for clients and
their families undergoing coronary artery bypass graft
surgery (CABG). ()*
Learning Activities
Read Brunner, Chapter 28
Read Brunner, Chapter 30, pg 810-812,
Case Studies, Critical Thinking
Exercises
Evaluation
Epinephrine, Atropine, Read Brunner, Chapter 30, pg 812
Bicarbonate, Lidocaine
Read Brunner, Chapter 28
Pre-operative Care
Case Studies
Plan (CABG):
Assessment (Unique
client/family psychosocial
needs), Analysis,
Interventions Reduce fear
by explaining CCU
environment, incisions,
tubes; Educate of
respiratory and leg
exercises & pain
management
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
12
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
Performance Outcomes
18. Develop a post-operative nursing care plan for clients and
their families undergoing coronary artery bypass graft
surgery (CABG). ()*
Key Concepts
Pre-operative Care
Plan (CABG):
Learning Activities
Read Text Chapter 30,
Assessment: Physiological
status (Hemodynamics,
Ventilation, Rhythm,
Fluid/Lytes), Potential
Complications (Cardiac
failure, pulmonary edema,
dysrhythmias, pericardial
effusion; Analysis;
Interventions (Cardiac
Output, gas exchange,
fluid/lytes balance, rest,
tissue perfusion)
Case Studies
19. Develop a nursing care plan for clients and their families
with various types of pacemakers (temporary, external,
permanent implantable defibrillators ()*
Assessment, Analysis,
Interventions (Educating
Read Brunner, Chapter 27, pg 700-704
Online tutorial:
http://www.chfpatients.com/implants/pace
makers.htm
20. Examine the nursing and medical management of clients
and their families experiencing acute cardiac failure. ()*
Cardiac Failure:
Medical Management,
Nursing Management:
client & family of
prevention of infection &
self-care program)
Read Brunner, Chapter 30
Case Studies
Assessment, Analysis,
Interventions (Education –
Dietary Modifications)
21. Examine the etiology, pathophysiology of pulmonary
edema and the medical interventions used to care for
clients with pulmonary edema ()*
Medical Interventions:
Read Brunner, Chapter 30
Furosemide, Morphine, Oxygen,
Aminophylline, Nitroglycerin
infusion, Nitroprusside infusion,
foley catheter, intubation,
ventilation
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
13
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
Performance Outcomes
22. Examine the clinical manifestations and management of
clients with cardiogenic shock. ()*
Key Concepts
Cardiogenic Shock:
Learning Activities
Read Brunner, Chapter 30
Clinical manifestations,
Collaborative management,
Assessment (Signs &
symptoms, diagnostic evaluation,
pulmonary artery catheter);
Analysis, Planning,
Implementation, Evaluation
23. Differentiate between cardiogenic shock and hypovolemic
shock. ()*
24. Explore the pathophysiology and assessment findings of
clients with pericardial effusion/tamponade and the
medical interventions used to care for those with
pericardial effusion/tamponade. ()*
Cardiogenic Shock Vs
Hypovolemic Shock
Pericardial
Effusion/Tamponade:
Read Brunner, Chapter 30
Read Brunner, Chapter 30
Pathophysiology,
Assessment Findings,
Medical Management
(Pericardial aspiration, Diuretics,
Corticosteroids, Pericardial
window)
25. Compare and contrast the pathophysiology, clinical
manifestations and management of the various valvular
heart diseases. ()*
Pathophysiology of
Valvular Heart
Diseases: Mitral
Read Brunner, Chapter 29
Insufficiency, Mitral Valve
Prolapse, Aortic Stenosis,
Aortic Insufficiency
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
14
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
Performance Outcomes
26. Examine the application of the nursing process to planning
and coordinating the care of clients and their families
undergoing cardiac valve surgery. ()*
Key Concepts
Cardiac Valve Surgery
Assessment, Analysis
(Decrease cardiac output, Activity
intolerance, Fear),
Learning Activities
Read Brunner, Chapter 29
Case Studies, Critical Thinking Exercises
Planning/Implementation
(Maintain hemodynamics),
27. Compare and contrast the pathophysiology, prevention and
collaborative management of clients and their families with
inflammatory and infectious heart diseases ()*
Evaluation
Pathophysiology of: Infective
Endocarditis, Pericarditis,
Pericardial effusion, cardiac
tamponade, cardiomyopathy
Read Text Chapter 29
Collaborative Management,
Nursing Assessment,
Nursing Diagnoses
(Decreased cardiac output,
Potential for ineffective coping),
Planning/Implementation
(Drug therapy, nonpharmacologic,
surgical), Evaluation
Advocacy
Class discussion
28. Examine how the nurse can be an advocate for the client
experiencing complex cardiovascular disorders. ()*
Complex Cardiovascular
29. Examine legal and ethical issues and effective
Class discussion
Disorders:
Legal/Ethical
communication techniques related to the care of the clients
Issues, Communication
and their families experiencing complex cardiovascular
disorders. ()*
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
15
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit I
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX CARDIOVASCULAR DISORDERS
LABORATORY
Performance Outcomes
Key Concepts
1. Demonstrate auscultation of the aortic , pulmonic, tricuspid Advanced Assessment
of Heart
and mitral areas and the ability to recognize S3 and S4 on
auscultation. ()*
Learning Activities
Review Assessment Text
Read Text Chapter 26
Online tutorial: Auscultation Assistant:
http://www.med.ucla.edu/wilkes/lungintro.
htm
Advanced Assessment Read Text Chapter 26
2. Demonstrate the ability to measure jugular venous
of Cardiovascular
distention. ()*
Video: Cardiac Signs and Symptoms
Status
Demonstration, Simulation, Supervised
Practice & Return Demonstration
3. Differentiate between pericardial and pleural friction rubs. Advanced Assessment Online tutorial: Auscultation Assistant:
of Cardiovascular
()*
http://www.med.ucla.edu/wilkes/lungintro.
Status
htm
Complex Cardiac Care Read Text Chapter 27
4. Demonstrate the ability to set up tubing and prepare a
Demonstration, Simulation, Supervised
Skill
client for pulmonary artery catheter insertion. ()*
Practice & Return Demonstration
5. Interpret heart rates from electrocardiogram strips. ()*
Complex Cardiac Care Software: Recognizing Common
Skill
Dysrhythmias
Rhythm analysis exercises
6. Systematically analyze cardiac rhythm strips. ()*
Complex Cardiac Care Read Text Chapter 27
Rhythm analysis exercises
Skill
7. Interpret EKG strips that depict a pacemaker’s rhythm and Complex Cardiac Care Read Text Chapter 27
Rhythm analysis exercises
Skill
analyze pacemaker function. ()*
8. Demonstrate mastery of content covered in UNIT I. ()*
Unit I Content
UNIT I EXAMINATION
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
16
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit II
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX RESPIRATORY DISORDERS
Performance Outcomes
1. Demonstrate mastery of content covered in UNIT I. ()*
2. Review assessment of the respiratory system with
particular attention to assessment findings such as upper
airway obstruction, sternal retraction and hypoxemia and
relate these findings to complex respiratory disorders. ()*
Key Concepts
Unit Content
Respiratory
Assessment (Upper
3. Examine the clinical manifestations of respiratory failure
and upper airway obstruction. ()*
Respiratory Failure &
Upper Airway
Obstruction
Read Brunner, Chapter 22, pg 503-514
4. Develop a nursing care plan for clients experiencing
respiratory failure. ()*
Assessment (Upper airway
Read Brunner, Chapters 23, 24, 25
Case Studies, Critical Thinking Exercises
Airway Obstruction,
Sternal Retraction,
Hypoxemia)
obstruction, endotracheal
intubation, tracheostomy, sternal
retraction, hypoxemia, ABG’s);
Learning Activities
UNIT I EXAMINATION
(REVIEW A&P AND ASSESSMENT
OF RESPIRATORY SYSTEM PRIOR
TO CLASS)
Read Brunner, Chapter 21
Nursing Diagnoses
(Ineffective airway clearance,
Decreased cardiac output,
impaired gas exchange);
Planning/Implementation
(Avoid O2 induced
hypoventilation, O2 toxicity,
Intubation, Suctioning,
Mechanical Ventilation
5. Examine the rationale for the nursing interventions used for Nursing Interventions &
Rationale for Intubated
airway management of intubated clients. ()*
Read Brunner, Chapter 25
6. Examine the indications for mechanical ventilation,
compare the types of mechanical ventilators. ()*
Read Brunner, Chapter 25
7. Examine the application of the nursing process to plan and
coordinate the care of mechanically ventilated clients.
Include planning for teaching, home care and therapeutic
and culturally sensitive interventions. ()*
Clients
Mechanical Ventilation:
Indications, Types of
Ventilators
Nursing Care: Ventilated
Clients – Settings, PEEP,
CPAP, Monitoring client,
Managing the machine,
Maintaining airway, Preventing
complications, Troubleshooting,
Weaning, Positioning, Client
Teaching
Brunner, Chapter 25, pg 620-622
Case Studies, Critical Thinking Exercises
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
17
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit II
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX RESPIRATORY DISORDERS
Performance Outcomes
Key Concepts
Learning Activities
8. Compare and contrast indications and medical management Thoracic surgical
Procedures: Indications &
of various thoracic surgical procedures. ()*
Read Brunner, Chapter 25, pg 626-641
9. Examine the application of the nursing process to plan and
coordinate the care of clients experiencing thoracic surgery
and/or the presence of chest tubes. Include planning for
teaching, home care and therapeutic and culturally
sensitive interventions. ()*
Read Brunner, Chapter 25, pg 626-641
Case Studies, Critical Thinking Exercises
10. Examine the application of the nursing process to plan and
coordinate the care of clients experiencing adult respiratory
distress syndrome (ARDS) or non-cardiogenic pulmonary
edema. Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
Management
Nursing Process:
Assessment; Nursing
Diagnoses (Pain, Ineffective
airway clearance, Impaired gas
exchange); Planning &
Implementation (Pain control,
Maintain airway, Decreased
hypoxia, Surgical management
(Pre-op, Post-op chest tubes &
water –seal drainage));
Evaluation
Nursing Process: ARDS &
Pulmonary Edema
Collaborative Management;
Assessment, Nursing
Diagnoses, Planning &
Implementation (Ventilation,
Read Brunner, Chapter 23, pg 544-547
Case Studies, Critical Thinking Exercises
Sedation, Maintain airway,
Corticosteroids, Antibiotics, Fluid
balance parameters, Nutrition,
High Lipids, High energy, low
effort foods
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
18
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit II
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX RESPIRATORY DISORDERS
Performance Outcomes
1. Skillfully interpret blood gas analyses. ()*
LABORATORY
Key Concepts
Advanced Nursing Skill
Blood Gas Interpretation
2. Skillfully demonstrate tracheostomy care and
tracheal/endotracheal suctioning. ()*
Tracheostomy care and
Tracheal/Endotracheal
Suctioning
3. Demonstrate the ability to manage a ventilator. ()*
Advanced Nursing Skill:
Ventilator Management
4. Demonstrate the procedure for assisting a physician with
chest tube insertion and chest drainage set-up. ()*
Advanced Nursing Skill:
Assisting with Chest Tube
Insertion and Chest
Drainage Set-Up
Advanced Nursing Skill:
Maintaining Chest Tubes
Learning Activities
Read Brunner, Chapter 14, pgs 278-282,
Online: Arterial Blood Gas Exercises:
http://maagnursing.com/ABG/
Read Text Chapter 25, Demonstration,
Simulation, Supervised Practice & Return
Demonstration
Read Text Chapter 25, Demonstration,
Simulation, Supervised Practice & Return
Demonstration
Read Text Chapter 25, Demonstration,
Simulation, Supervised Practice & Return
Demonstration
5. Demonstrate the ability to maintain chest tubes (water-seal
Read Text Chapter 25, Demonstration,
management, care of tubes, changing chest tube dressing).
Simulation, Supervised Practice & Return
()*
Demonstration
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
19
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit III
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX URINARY AND RENAL DISORDERS
Performance Outcomes
1. Demonstrate mastery of content covered in UNIT II. ()*
2. Review the anatomy and physiology and the assessment of
the urinary and renal system. Relate particular assessment
findings such as elevated B.U.N. and creatinine to complex
renal disorders. ()*
3. Compare and contrast chronic and acute renal failure. ()*
Key Concepts
Unit II Content
Urinary and Renal
A&P and Assessment
Learning Activities
UNIT II EXAMINATION
Assessment Text and Medical Surgical
Text (REVIEW PRIOR TO CLASS)
Renal Failure: Acute
(Classifications, Phases,
Management, Prevention
and Health Maintenance
Chronic (Stages, Metabolic
alterations, Management
with ESRD, Hemodialysis,
Peritoneal Dialysis, Renal
Transplant)
Read Text Chapter
Read Text Chapter, Case Studies, Critical
Nursing Process:
4. Examine the application of the nursing process to the care
Thinking Exercises
Renal Failure (Acute
of clients and their families experiencing renal failure.
and Chronic)
Include planning for teaching, home care and therapeutic
and culturally sensitive interventions. (2, 3, 5, 12)*
Read Text Chapter
5. Examine the application of the nursing process to plan and Nursing Process: PreCase Studies, Critical Thinking Exercises
coordinate the care of clients and their families undergoing op & Post-op
Considerations,
kidney surgery or transplantation. Include planning for
Collaborative
teaching and therapeutic and culturally sensitive
Management
interventions. ()*
Read Text Chapter
6. Examine the application of the nursing process to plan and Nursing Process:
Case Studies, Critical Thinking Exercises
coordinate the care of clients and their families undergoing Clients Undergoing
surgery for urinary diversion. Include planning for teaching Urinary Diversion
and therapeutic and culturally sensitive interventions. ()*
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
20
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit III
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX URINARY AND RENAL DISORDERS
1.
2.
LABORATORY
Performance Outcomes
Key Concepts
Legal and Ethical
Examine the legal and ethical issues related to kidney
Issues Related to
transplantation and how the nurse can be a client advocate
Kidney
in regard to kidney transplantation. ()*
Transplantation, Client
Advocacy
Legal and Ethical
Examine the legal and ethical issues related to
hemodialysis and how the nurse can be a client advocate in Issues Related
Hemodialysis, Client
regard to kidney transplantation. ()*
Advocacy
Demonstrate the ability to interpret abnormal renal function Interpreting Renal
Function Studies
results. ()*
Demonstrate the process of peritoneal dialysis. ()*
Peritoneal Dialysis
Learning Activities
Read Text Chapter
Read Text Chapter
Read Text Chapter, Exercises with Renal
Function Studies Results
4.
Read Text Chapter, Demonstration,
Simulation, Supervised Practice & Return
Demonstration
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
3.
21
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit IV
NURSING MANAGEMENT OF CLIENTS WITH CANCER
Performance Outcomes
1. Demonstrate mastery of content covered in UNIT III. ()*
2. Compare and contrast the various diagnostic tests used to
detect cancer. ()*
3. Differentiate among the purposes of surgical procedures
used in cancer treatment, diagnosis, prophylaxis, palliation
and reconstruction. ()*
4. Compare and contrast the following therapies used in
treating cancer: Surgery, radiation therapy, chemotherapy,
hyperthermia, biologic response modifiers and gene
therapy.()*
5. Examine possible complications and special nursing needs
of clients receiving chemotherapy. ()*
Key Concepts
Unit III Content
Diagnostic Tests to
Detect Cancer (Include
Early Detection)
Purposes of Various
Cancer Treatments
Learning Activities
UNIT III EXAMINATION
Read Text Chapter
Read Text Chapter
Case Studies, Critical Thinking Exercises
(Surgical procedures,
diagnosis, prophylaxis,
palliation, reconstruction)
Comparison of Cancer
Therapies
Read Text Chapter
Clients & Chemotherapy:
Complications, Nursing
Needs
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Nursing Process:
6. Examine common nursing diagnoses and collaborative
Nursing Diagnoses
problems that relate to clients with cancer. ()*
Read Text Chapter
Legal and Ethical
7. Examine legal and ethical issues and effective
communication techniques related to the care of the clients Issues,
experiencing cancer and how the nurse can be an advocate Communication,
Advocacy
for the client experiencing cancer. ()*
Read Text Chapter
8. Examine the application of the nursing process to plan and Nursing Process,
Case Studies, Critical Thinking Exercises
Teaching: Cancer
coordinate the care of clients and their families with
cancer. Include planning for teaching and therapeutic and
culturally sensitive interventions.
Hospice Care
Read Text Chapter
9. Examine the concept of hospice in providing care for
clients with advanced cancer.
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
22
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit IV
NURSING MANAGEMENT OF CLIENTS WITH CANCER
Performance Outcomes
10. Compare the various leukemias, their incidence, risk
factors, physiologic alterations, clinical manifestations,
management and prognosis. ()*
Key Concepts
Leukemias: Incidence,
Learning Activities
Read Text Chapter
Physiologic alterations,
Clinical Manifestations,
Management, Prognosis
Read Text Chapter
Nursing Care of
Case Studies, Critical Thinking Exercises
Clients and Their
Families with
Leukemia
Read Text Chapter
Lymphoma: Causes,
risk factors, clinical
manifestations,
diagnostic tests
13. Examine the application of the nursing process to plan and Nursing Process: Care Read Text Chapter
Case Studies, Critical Thinking Exercises
of Clients and Their
coordinate the care of clients and their families with
Families with
lymphoma. Include planning for teaching and therapeutic
Lymphoma
and culturally sensitive interventions. ()*
Cancer of Respiratory Read Text Chapter
14. Analyze etiologies and risk factors that predispose a client
System: Etiology, Risk
to cancer of the respiratory system. ()*
Factors
Clinical Manifestations Read Text Chapter
15. Compare and contrast clinical manifestations of a client
with cancer in the upper respiratory system with those of a of Cancer: Upper &
Lower Respiratory
client with cancer of the lower respiratory system. ()*
16. Examine the application of the nursing process to plan and Nursing Process: Care Read Text Chapter
Case Studies, Critical Thinking Exercises
coordinate the care of clients and their families undergoing of Clients and Their
Families Undergoing
laryngectomy. Include planning for teaching and
Laryngectomy
therapeutic and culturally sensitive interventions. ()*
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
11. Examine the application of the nursing process to plan and
coordinate the care of clients and their families with
various leukemias. Include planning for teaching and
therapeutic and culturally sensitive interventions. ()*
12. Examine the causes, risk factors, clinical manifestations
and specific diagnostic tests that relate to the diagnosis of
lymphoma. ()*
23
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit IV
NURSING MANAGEMENT OF CLIENTS WITH CANCER
Performance Outcomes
17. Explore the medical and nursing management of clients
and their families with cancer of the lung. ()*
Key Concepts
Lung Cancer: Medical
Management, Nursing
Care
Learning Activities
Read Text Chapter
Case Studies, Critical Thinking Exercises
Etiology, Incidence, Risk
18. Compare and contrast the etiology, incidence, risk factors
Read Text Chapter
Factors,
Prevention
of
and prevention of the following cancers: renal, bladder,
Cancer (Renal, Bladder,
prostate, testicular, endometrial, ovarian, uterine, cervical
Prostate, Testicular, Endometrial,
Ovarian, Uterine, Cervical, Breast)
and breast cancers. ()*
Nursing Process: Types of
19. Compare and contrast the application of the nursing
Read Text Chapter
Cancer (Renal, Bladder,
process to plan and coordinate the care of a clients and
Case Studies, Critical Thinking Exercises
Prostate, Testicular,
their families with various types of renal and reproductive
Endometrial, Ovarian,
cancers. Include planning for teaching and therapeutic and Uterine, Cervical, Breast)
culturally sensitive interventions. ()*
Pre-op and Post-op
20. Develop a pre-op and post-op plan of care for clients and
Read Text Chapter
Care: Nephrectomy,
their families undergoing the following surgical
Case Studies
with urinary
interventions due to cancer: nephrectomy, cystectomy with Cystectomy
diversion, TUR, Prostectomy,
urinary diversion, transurethral resection (TUR),
Orchiectomy, Oopherectomy,
Hysterectomy, Mastectomy
prostetectomy, orchiectomy, oopherectomy, hysterectomy
and mastectomy. ()*
Read Text Chapter
Nursing Care Needs:
21. Examine nursing care needs that are specific to the care of
Eye Cancer
clients and their families with an eye tumor. ()*
Nursing Process: Types of
22. Compare and contrast the application of the nursing
Read Text Chapter
Cancer:
Lip,
Oral
Cavity
process to plan and coordinate the care of a clients and
Case Studies, Critical Thinking Exercises
(Neck Dissection
their families with various types of gastrointestinal cancers. Required), Tongue,
Include planning for teaching and therapeutic and
Salivary Glands, Stomach,
culturally sensitive interventions. ()*
Colorectal)
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
24
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit IV
NURSING MANAGEMENT OF CLIENTS WITH CANCER
Performance Outcomes
Key Concepts
Nursing Process:
23. Compare and contrast the application of the nursing
Cancers of the
process to plan and coordinate the care of clients and their
Endocrine System
families with various types of cancers involving the
(Liver, Pancreas,
endocrine system. Include planning for teaching and
Thyroid)
therapeutic and culturally sensitive interventions. ()*
24. Examine the application of the nursing process to plan and Nursing Process:
Cancers of the Central
coordinate the care of clients and their families with
neoplasms of the central nervous system. Include planning Nervous System
(Intracranial Tumors)
for teaching and therapeutic and culturally sensitive
interventions. ()*
LABORATORY
Collaboration:
1. Examine community resources that are available to meet
Community Resources
the needs of clients and their families dealing with cancer.
()*
Maintaining
2. Examine the unique nutritional needs of clients
Nutritional Status
experiencing the effects of cancer treatment. ()*
(Anorexia, Cachexia,
Malabsorption
3. Demonstrate the ability to perform ileostomy care.
Skill Post-Bladder
Surgery
Learning Activities
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Read Text Chapter
Read Text Chapter, Demonstration,
Simulation, Supervised Practice & Return
Demonstration
Read Text Chapter, Demonstration,
Skill Post-Bladder,
4. Demonstrate the ability to perform 3-way bladder
Simulation, Supervised Practice & Return
Prostate Surgery
irrigation.
Demonstration
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
25
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit V
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX NEUROLOGICAL DISORDERS
Performance Outcomes
1. Demonstrate mastery of content covered in UNIT IV. ()*
2. Review assessment of the neurological system with
particular attention to assessment findings such as
decreased level of consciousness (LOC), increased cranial
pressure (ICP), abnormal motor function and abnormal
respiratory patterns and relate these findings to complex
neurological disorders. ()*
3. Analyze the clinical significance and related nursing
implications of various tests and procedures used to
diagnose complex neurological disorders. ()*
4. Compare and contrast the clinical manifestations and the
application of the nursing process to plan and coordinate
care for clients and their families with the following
neurological disorders: increased ICP, unconsciousness,
cerebral vascular accident (CVA) and intracranial surgery.
Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
5. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients and their
families in the critical stage of various types of
neurological disorders. Include planning for teaching and
therapeutic and culturally sensitive interventions. ()*
Key Concepts
Unit IV Content
Neurological
Assessment (Decreased
LOC, Increased ICP,
Abnormal motor function,
Abnormal respiratory
patterns)
Tests and Diagnostic
Procedures
Arteriography, CAT
Scan, EEG, Lumbar
Puncture, MRI
Nursing Process: IICP,
Unconsciousness,
CVA, Intracranial
Surgery
Learning Activities
UNIT IV EXAMINATION
Assessment Text and Medical Surgical
Text (REVIEW A&P AND
ASSESSMENT OF NEUROLOGICAL
SYSTEM PRIOR TO CLASS)
Read Text Chapter
Read Text Chapter
Case Studies, Critical Thinking Exercises
Comparison : Nursing Read Text Chapter
Case Studies, Critical Thinking Exercises
Process in Critical
Stage of Epilepsy
(Seizures), Multiple
Sclerosis, Myasthenia
Gravis
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
26
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit V
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX NEUROLOGICAL DISORDERS
6.
7.
8.
1.
Performance Outcomes
Key Concepts
Nursing Process:
Compare and contrast the application of the nursing
Infective/Inflammatory
process to plan and coordinate the care of clients and their
(Meningitis,
Encephalitis,
families in the critical stage of various types of
Brain
Abscess,
Guillaininfective/inflammatory neurological disorders. Include
Barre Syndrome,
planning for teaching and therapeutic and culturally
Neurosyphillis, TB)
sensitive interventions. ()*
Nursing Process: Brain
Compare and contrast the application of the nursing
Injury, Spinal Cord
process to plan and coordinate the care of clients and their
families in the critical stage of brain injury and spinal cord Injury
injury. Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
Neurological
Examine legal and ethical issues and effective
communication techniques related to the care of the clients Disorders: Legal &
Ethical Issues,
and their families in the critical stages of neurological
Advocacy
disorders and how the nurse can act as an advocate for
these clients. ()*
LABORATORY
Examine assessment tools used to assess ICP. ()*
ICP Assessment:
Learning Activities
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Read Text Chapter
Rancho Los Amigos Scale,
Glasgow Coma Scale, ICP
Monitoring (Ventricular
Catheter or Bolt)
Read Text Chapter, Simulated Case
Neurological Care
2. Demonstrate documenting neurological assessment
Studies Practice Documentation
Flow Sheet
findings on a critical nuerological care flow sheet. ()*
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
27
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VI
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX ENDOCRINE DISORDERS
Performance Outcomes
1. Demonstrate mastery of content covered in UNIT V. ()*
2. Review the anatomy and physiology and the assessment of
the endocrine system. Relate such assessment findings as
G.I. hemorrhage ascites, polyuria, polydipsia, blurred
vision, weakness, headache, abdominal pain, nausea,
vomiting, acetone breath, and Kussmaul respirations to
complex endocrine disorders. ()*
3. Analyze the clinical significance and related nursing
implications of various tests and procedures used to
diagnose complex endocrine disorders. ()*
Key Concepts
Unit V Content
Endocrine Assessment
(G.I. hemorrhage Ascites,
Polyuria, Polydipsia, Blurred
Vision, Weakness, Headache,
Abdominal Pain, Nausea,
Vomiting, Acetone Breath, and
Kussmaul Respirations)
Tests and Diagnostic
Procedures
Learning Activities
UNIT V EXAMINATION
Assessment Text and Medical Surgical
Text (REVIEW A&P AND
ASSESSMENT OF ENDORINE
SYSTEM PRIOR TO CLASS)
Read Text Chapter
(Serum liver function studies
(AST, ALT, Ammonia,
Prothrombin Time, Barium
Studies, Measurement of Portal
Pressure, EEG, Angiography, CT
Scan, MRI, Serum Glucose,
Ketones, Electrolytes, Arterial
Blood Gases, Creatinine, BUN,
Serum Antidiuretic Hormone)
Read Text Chapter
Nursing Process:
4. Examine the application of the nursing process to the care
Acute or Critical Stage Case Studies, Critical Thinking Exercises
of clients and their families experiencing critical
complications in cirrhosis of the liver such as coma and/or of Cirrhosis of the
seizures. Include planning for teaching and therapeutic and Liver
culturally sensitive interventions. ()*
Nursing Process: Liver Read Text Chapter
5. Examine the application of the nursing process to the care
Case Studies, Critical Thinking Exercises
Transplantation
of clients and their families undergoing liver
transplantation. Include planning for teaching and
therapeutic and culturally sensitive interventions. ()*
Long-Term Complications
6. Compare and contrast the clinical manifestations, medical
Read Text Chapter
of Diabetes: Macrovascular,
management and nursing management of long-term
Microvascular (Ocular),
complications of diabetes()*
Neuropathy
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
28
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VI
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX ENDOCRINE DISORDERS
Performance Outcomes
Key Concepts
Learning Activities
Nursing Process: DKA Read Text Chapter
7. Compare and contrast the application of the nursing
Case Studies, Critical Thinking Exercises
and HHNK
process to the care of clients and their families
experiencing diabetic ketoacidosis (DKA) and
hyperglycemic hyperosmolar nonketotic syndrome
(HHNK). Include planning for teaching and therapeutic
and culturally sensitive interventions. ()*
Read Text Chapter,
Nursing Process: DI
8. Compare and contrast the medical management and
Case Studies, Critical Thinking Exercises
application of the nursing process to the care of clients and and SAIAH
their families experiencing diabetes insipidus (DI) and
syndrome of. inappropriate antidiuretic hormone (SAIAH).
Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
Read Text Chapter,
Nursing Process:
9. Examine the application of the nursing process to the
Case Studies, Critical Thinking Exercises
critical care of clients and their families experiencing acute Acute Pancreatitis
(Critical Care)
pancreatitis. Include planning for teaching and therapeutic
and culturally sensitive interventions. ()*
Read Text Chapter
Nursing Process:
10. Examine the etiology, diagnosis, management and
Thyrotoxic Crisis
application of the nursing process to the critical care of
(Critical Care)
clients and their families experiencing a thyrotoxic crisis.
Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
Read Text Chapter
Nursing Process:
11. Examine the etiology, diagnosis, management and
Addisonian Crisis
application of the nursing process to the critical care of
(Critical Care)
clients and their families experiencing acute Addison’s
disease (addisonian crisis). Include planning for teaching
and therapeutic and culturally sensitive interventions. ()*
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
29
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VI
NURSING MANAGEMENT OF CLIENTS WITH COMPLEX ENDOCRINE DISORDERS
1.
2.
3.
4.
LABORATORY
Performance Outcomes
Key Concepts
Compare and contrast legal and ethical issues and effective Legal and Ethical
communication techniques related to the care of clients and Issues Related to
Complex Endocrine
their families experiencing various complex endocrine
Disorders
disorders. ()*
Nurse Advocacy for
Examine how the nurse can be an advocate for the client
Clients with Complex
experiencing various complex endocrine disorders ()*
Endocrine Disorders
Liver Transplantation:
Examine legal and ethical issues related to liver
Legal & Ethical Issues
transplantation. ()*
Pharmacologic Agents
Compare and contrast pharmacologic agents used to treat
Used to Treat: Acute
various complex endocrine disorders.()*
Learning Activities
Read Text Chapter
Read Text Chapter
Read Text Chapter
Read Text Chapter
Liver Cirrhosis, Liver
Transplantation, DKA,
HHNK, DI, SAIAH, Acute
Pancreatitis, Thyrotoxic
Crisis, Addisonian Crisis
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
30
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VII
NURSING MANAGEMENT OF CLIENTS WITH MULTISYSTEM DISORDERS
Performance Outcomes
1. Demonstrate mastery of content covered in UNIT VI. ()*
2. Compare and contrast the etiology, pathophysiology and
clinical manifestations of the various types of shock and
multiple organ dysfunction syndrome (MODS). ()*
3. Compare and contrast the medical management of the
various types of shock and multiple organ dysfunction
syndrome. ()*
4. Compare and contrast the application of the nursing
process to the critical care of clients and their families
experiencing various types of shock and MODS. Include
planning for teaching and therapeutic and culturally
sensitive interventions. ()*
5. Examine the etiology, clinical manifestations, medical
management and nursing management of disseminated
intravascular coagulation (DIC). ()*
Key Concepts
Unit VI Content
Etiology, Pathophysiology,
Clinical Manifestations:
Hypovolemic, Cardiogenic,
Anaphylactic, Neurogenic,
Septic Shock & MODS
Medical Management:
Hypovolemic, Cardiogenic,
Anaphylactic, Neurogenic,
Septic Shock & MODS
Nursing Process: Critical
Care Hypovolemic,
Cardiogenic, Anaphylactic,
Neurogenic, Septic Shock
& MODS
Etiology, Clinical
Manifestations, Medical &
Nursing Management of
DIC (Planning – Treat underlying
Learning Activities
UNIT VI EXAMINATION
Read Text Chapter
Read Text Chapter
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
disease, Inhibit thrombin action,
Replace coagulation factors)
6. Examine the pathophysiology, modes of transmission, the
physiology underlying the clinical manifestations, and the
management of HIV infection. ()*
HIV Infection:
Pathophysiology, Modes of
Transmission, Physiology
underlying Clinical
Manifestations
Read Text Chapter
Case Studies, Critical Thinking Exercises
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
31
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VII
NURSING MANAGEMENT OF CLIENTS WITH MULTISYSTEM DISORDERS
Performance Outcomes
Key Concepts
Learning Activities
Nursing
Process:
AIDS:
7. Examine the application of the nursing process to the care
Read Text Chapter
(History of family,
of clients and their families experiencing acquired immune Assessment
Case Studies, Critical Thinking Exercises
sexual practices, other STD’s;
Signs
of
infection;
Psychosocial
deficiency syndrome (AIDS). Include planning for teaching
findings, Laboratory findings)
and therapeutic and culturally sensitive interventions. ()*
Nursing Diagnoses (Diarrhea, Risk
for Infection, Ineffective airway
clearance, Altered nutrition, less
than body requirements,
Knowledge deficit, Social
Isolation) Planning &
Implementation (Administer
medications, Resource
management, Care based on
nursing diagnoses, Support,
Coordinated care, Detailed care)
8. Relate possible clinical manifestations found in multiple
body systems to the diagnosis of AIDS. ()*
Clinical Manifestations in
Multiple Body Systems
Related to AIDS:
Respiratory (Opportunistic
Read Text Chapter
diseases such as pneumocystis
carinii pneumonia,
Mycobacterium avium complex,
Tuberculosis), Gastrointestinal
(Loss of appetite, nausea,
vomiting, oral and esophageal
candidiasis, chronic diarrhea,
wasting syndrome) Oncologic
(Kaposi’s Sarcoma, B-Cell
lymphomas), Neurologic (HIV
encephalopathy),
Integumentary (Seborrheic
dermatitis, Herpes zoster &
simplex), Reproductive (Other
STD’s), Psychologic
(Depression)
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
32
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VII
NURSING MANAGEMENT OF CLIENTS WITH MULTISYSTEM DISORDERS
Performance Outcomes
9. Examine the local and systemic effects of a major burn
injury. ()*
10. Differentiate between the three phases of burn care and the
priorities of care for the acute/intermediate and
rehabilitation phases (priorities of care for the
emergent/resuscitative phase with be examined in the
emergency care unit). ()*
11. Examine the application of the nursing process to plan and
coordinate the care of clients and their families
experiencing major burns. Include planning for teaching
and therapeutic and culturally sensitive interventions. ()*
Key Concepts
Major Burn Injury: Local &
Systemic Effects
Learning Activities
Read Text Chapter
(Cardiovascular, Fluid &
Electrolyte, Pulmonary, Renal
Function, Decreased Immunologic
Defense, Body Temp. Regulation,
G.I.)
Phases of Burn Care
Read Text Chapter
Nursing Process: Major
Burns Assessment (Size: Rule of
Read Text Chapter, Case Studies
Nine, Berkoro’s Method, Lund &
Browder, Depth, Type, Location,
Client age, Medical history)
Planning & Implementation
(Monitor F&E Balance, Detect
and Prevent Infection, Wound
Care, Provide Adequate Nutrition,
Promote Skin Integrity, Pain
Management) Collaborative Care
(Physical Therapy for joint
immobility, Respiratory Therapist,
Nutritionist, Other Team Members
to strengthen coping strategies &
support client/family processes)
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
33
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
SPRING 2006
Unit VII
NURSING MANAGEMENT OF CLIENTS WITH MULTISYSTEM DISORDERS
LABORATORY
Performance Outcomes
Key Concepts
Legal and Ethical
1. Examine legal and ethical issues and effective
communication techniques related to the care of clients and Issues in Caring for
Clients with
their families experiencing multisystem disorders. ()*
Multisystem Disorders
Client Advocacy in
2. Examine how the nurse can be an advocate for clients and
Multisystem Disorders
their families experiencing multisystem disorders. ()*
3. Examine the common problems experienced by clients and Common Client Problems
in Critical Care Settings
their families in critical care settings and nursing
and Nursing Prevention
interventions that can be implemented to prevent these
Interventions Psychosocial
problems. ()*
(Coping with Stressors –
Learning Activities
Read Text Chapter, Case Studies
Read Text Chapter
Read Text Chapter Case Studies
Regression, Suppression, Denial,
etc.; Self-concept Disturbances;
Familiy Needs & Coping
Strategies, Sleep Deprivation,
Nutritional Impairment. Stress
Ulcers
4. Relate various emotional, ethical, and legal issues to those
clients and their families experiencing AIDS. ()*
Read Text Chapter
Emotional, Ethical &
Legal Issues Related to
Caring for
Clients/Families with
AIDS
Advocacy: AIDS
Read Text Chapter
5. Examine how the nurse can be an advocate for the clients
and their families experiencing AIDS. ()*
Nursing Issues: Stressors in Read Text Chapter
6. Examine the following issues that concern the nurse when
Caring for Burn Clients,
caring for clients with major burns: stressors specific to
Continuity of Care, Caring
caring for burned clients, continuity of care and caring for
for Burns at Home
burns in the home setting. ()*
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
34
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
Spring 2006
Unit VIII
NURSING MANAGEMENT OF CLIENTS REQUIRING EMERGENCY CARE
Performance Outcomes
1. Examine the steps of accurate, rapid client assessment in a
pre-hospital setting and the impact pre-hospital care has on
morbidity and mortality. ()*
2. Relate the concepts of holism and collaboration to
emergency care. ()*
3. Examine priority emergency measures instituted for any
client with an emergency condition.()*
4. Differentiate between basic and advanced life support. ()*
5. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing various cardiac emergencies. Include
planning for teaching and therapeutic and culturally
sensitive interventions. ()*
Key Concepts
Pre-hospital Assessment:
(Environmental security, Primary
survey, Secondary survey, Triage
system, Physical Assessment in
ED) Impact on Morbidity
and Mortality
Holism and Collaboration
in Emergency Care
(Include client, family and
significant others in care)
Priorities Emergency
Measures: Preserve life,
Prevent deterioration,
Restore to optimal function
Basic Life Support (Airway
management, Circulation, One &
Two-man CPR) Advanced
Life Support (Oropharyngeal
airway, Endotracheal intubation,
Surgical procedures for airway
management, O2, Cardiac
medication administration,
External & Internal Defibrillation)
Nursing Process: Care of
Cardiac Emergencies
(Angina, M.I., Congestive Heart
Failure, Cardiac tamponade,
Aortic dissections) Therapeutic
Interventions: Priority setting,
Pharmacologic Intervention
(Nitroglycerin, Morphine, Nitrous
Oxide, TPA, Lidocaine) ECG
Monitoring
Learning Activities
Read Text Chapter
Read Text Chapter
Read Text Chapter
Read Text Chapter
Read Text Chapter
Case Studies, Critical Thinking Exercises
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
35
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
Spring 2006
Unit VIII
NURSING MANAGEMENT OF CLIENTS REQUIRING EMERGENCY CARE
Performance Outcomes
6. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing various medical and traumatic respiratory
emergencies. Include planning for teaching and therapeutic
and culturally sensitive interventions. ()*
7. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing various oncologic emergencies that may
occur as a result of malignancy, metastasis or the effects of
chemotherapy and/or radiation therapy. Include planning
for teaching and therapeutic and culturally sensitive
interventions. ()*
8. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing various medical and traumatic neurologic
emergencies. Include planning for teaching and therapeutic
and culturally sensitive interventions. ()*
Key Concepts
Nursing Process: Care of
Respiratory Emergencies
(Upper airway obstruction,
Pulmonary embolus, Spontaneous
pneumothorax, Pleurisy,
Pneumonia, Pulmonary edema,
Asthma, ARDS, Near Drowning
(Sea water, Fresh water) Blunt &
Penetrating Trauma, Hemothorax,
Contusions
Nursing Process: Care of
Respiratory Emergencies
(Superior Vena Cava Syndrome,
Spinal Cord compression ,
Hypercalemia, DIC, Septic Shock,
SIADH, Hyperuricemia,
Pericardial effusion/tamponade)
Nursing Process: Care of
Neurologic Emergencies
Hypertensive Crisis, Hypertensive
Cerebrum, Seizures, TIA, CVA,
Diving Accidents, Head Injury
(Concussion, Contussion,
Laceration, Epidural & Subdural
HemorrhageSpinal Cord Injury)
Nursing Process: Care of
Endocrine & Metabolic
Emergencies (DKA, Thyroid
Crisis, Hypothyroid Coma,
Electrolyte Disorders, Acute
Alcohol Intoxication, Drug
Overdose)
Learning Activities
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Case Studies, Critical Thinking Exercises
Read Text Chapter
Case Studies, Critical Thinking Exercises
9. Compare and contrast the application of the nursing
Read Text Chapter
process to plan and coordinate the care of clients
Case Studies, Critical Thinking Exercises
experiencing various endocrine and metabolic
emergencies. Include planning for teaching and therapeutic
and culturally sensitive interventions. ()*
Process: Care of Client in
10. Examine the application of the nursing process to plan and Nursing
Read Text Chapter
ED with Shock: Interventions:
coordinate the care of clients experiencing shock. Include
Case Studies, Critical Thinking Exercises
Pneumatic Anti-shock Garment,
Maintain Airway, Fluid/Blood
planning for teaching and therapeutic and culturally
Replacement, Maintain Body
sensitive interventions. ()*
Temperature
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
36
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
Spring 2006
Unit VIII
NURSING MANAGEMENT OF CLIENTS REQUIRING EMERGENCY CARE
Performance Outcomes
11. Examine the application of the nursing process to plan,
prioritize and coordinate the care of clients experiencing
multiple trauma injury. ()*
Key Concepts
Nursing Process: Care of
Client with Multiple
Trauma Injury Primary
Assessment ABC4 – Airway,
Learning Activities
Read Text Chapter
Case Studies, Critical Thinking Exercises
Breathing, CC1 (Circulation), CC2
(Cervical Spine), CC3 (Chest),
CC 4 (COC) Secondary
12. Examine the application of the nursing process to plan and
coordinate the care of clients experiencing intra-abdominal
injuries. Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
13. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing various vascular (hemotalogic) emergencies.
Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
14. Compare and contrast the emergency management of
clients who have been exposed to poisons by swallowing or
inhaling poisons, eating poisoned food or by skin contact
with poisons. ()*
15. Compare and contrast the emergency management of
clients with the following environmental emergencies: heat
stroke, frostbite, hypothermia, snake bites and spider bites.
()*
Assessment Survey
Nursing Process: Care of
Client with IntraAbdominal Injuries
Read Text Chapter
Case Studies, Critical Thinking Exercises
Nursing Process: Care of
Vascular (Hemotalogic)
Emergencies (Sickle Cell
Read Text Chapter
Case Studies, Critical Thinking Exercises
Disease, Hemophiliac Anemia,
Thrombocytopenia, DIC)
Assessment, Intervention
(Pain management,
Pharmacologic)
Emergency Management of
Clients Exposed to Poisons
Read Text Chapter
(Swallowing, Inhaling, Eating
Poisoned Food, Skin Contact)
Nursing Process: Care of
Client in ED with Shock:
Interventions: Pneumatic Anti-
Read Text Chapter
Case Studies, Critical Thinking Exercises
shock Garment, Maintain Airway,
Fluid/Blood Replacement,
Maintain Body Temperature
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.
37
The University of Texas at Brownsville and Texas Southmost College
Associate Degree Nursing Program
RNSG 2441 Advanced Concepts of Clinical Decision Making
Spring 2006
Unit VIII
NURSING MANAGEMENT OF CLIENTS REQUIRING EMERGENCY CARE
Performance Outcomes
16. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing genitourinary emergencies. Include planning
for teaching and therapeutic and culturally sensitive
interventions. ()*
Key Concepts
Nursing Process: Care of
Genitourinary Emergencies
Traumatic (Renal, Bladder,
Urethral) Non-traumatic
Learning Activities
Read Text Chapter
Case Studies, Critical Thinking Exercises
(Infections, Renal colic & calculi,
Dialysis clients with clotted grafts
or shunts, Hematuria, Oliguria,
Anuria)
17. Examine the application of the nursing process to plan and
coordinate the care of clients experiencing intra-abdominal
injuries. Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
18. Compare and contrast the application of the nursing
process to plan and coordinate the care of clients
experiencing various vascular (hemotalogic) emergencies.
Include planning for teaching and therapeutic and
culturally sensitive interventions. ()*
Nursing Process: Care of
Client with IntraAbdominal Injuries
Read Text Chapter
Case Studies, Critical Thinking Exercises
Nursing Process: Care of
Vascular (Hemotalogic)
Emergencies (Sickle Cell
Read Text Chapter
Case Studies, Critical Thinking Exercises
19. Compare and contrast the emergency management of
clients who have been exposed to poisons by swallowing or
inhaling poisons, eating poisoned food or by skin contact
with poisons. ()*
20. Compare and contrast the emergency management of
clients with the following environmental emergencies: heat
stroke, frostbite, hypothermia, snake bites and spider bites.
()*
Emergency Management of
Clients Exposed to Poisons
Disease, Hemophiliac Anemia,
Thrombocytopenia, DIC)
Assessment, Intervention
(Pain management,
Pharmacologic)
Read Text Chapter
(Swallowing, Inhaling, Eating
Poisoned Food, Skin Contact)
Nursing Process: Care of
Client in ED with Shock:
Interventions: Pneumatic Anti-
Read Text Chapter
Case Studies, Critical Thinking Exercises
shock Garment, Maintain Airway,
Fluid/Blood Replacement,
Maintain Body Temperature
*Numbers in parentheses after each performance outcome correspond with course learning outcomes met by this outcome.