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DIXIE STATE COLLEGE OF UTAH
NURSING PROGRAM
NURS 2100
MEDICAL-SURGICAL NURSING II
Fall 2008
Phyllis Swift, MS, APRN, CEN, FNP-C
Office phone: 435-879-4804
Cell phone: 435-862-6332
Home phone: 435-773-4433
swift@dixie.edu
Office Hours:
Mornings – Mondays & Wednesdays 0800-1000
Afternoons – Thursday & Fridays 1400-1600
This syllabus is for information purposes only and may be subject to
change. Any changes will be given verbally or in writing.
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CODE FOR NURSES
1. The nurse provides services with respect for human dignity and the
uniqueness of the client unrestricted by considerations of social or
economic status, personal attributes, or the nature of health problems.
2. The nurse safeguards the client’s right to privacy by judiciously protecting
information of a confidential nature.
3. The nurse acts to safeguard the client and the public when health care
and safety are affected by the incompetent, unethical, or illegal practice of
any person.
4. The nurse assumes responsibility and accountability for individual nursing
judgments and actions.
5. The nurse maintains competence in nursing.
6. The nurse exercises informed judgment and uses individual competence
and qualifications as criteria in seeking consultation, accepting
responsibilities, and delegating nursing activities to others.
7. The nurse participates in activities that contribute to the ongoing
development of the profession’s body of knowledge.
8. The nurse participates in the profession’s efforts to implement and
improve standards of nursing.
9. The nurse participates in the profession’s efforts to establish and maintain
conditions of employment conducive to high quality nursing.
10. The nurse participates in the profession’s effort to protect the public from
misinformation and misrepresentation and to maintain the integrity of
nursing.
11. The nurse collaborates with members of the health professions and other
citizens in promoting community and national efforts to meet the health
needs of the public.
American Nurses Association
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Dixie State College of Utah
ADN Program
COURSE INFORMATION
A.
COURSE NAME AND NUMBER
Medical-Surgical Nursing II
B.
NURS 2100
CREDIT AND CONTACT HOURS
5 credit hours, 75 classroom theory hours, over the course of the
semester
Prerequisite: Acceptance into the associate degree-nursing program
Co-requisites: NURS 2101, 2105
C.
COURSE DESCRIPTION
Prepares the student to function within the scope of practice of the
registered nurse. Emphasis on more complex physiological and
psychosocial needs of adult patients using the nursing process. It
encourages the development of critical thinking, therapeutic
communication, technical skills, leadership/management skills, effective
time management, professional behavior and caring. Complex integrated
care is provided for medical/surgical patients in the RN level of nursing.
Human relations training is embedded within this course as human
need/therapeutic communication are constants in the nurse/client
relationship. Course fee required. 5 lecture hours per week.
D.
METHODS OF EVALUATION
Student work is evaluated according to the following breakdown:
Exams/quizzes; Content/pharmacology worksheets; Class presentation;
and an APA paper. Each student will be responsible for participating in a
community service project.
E.
STUDENT PERFORMANCE EXPECTATIONS
Students are expected to attend each class for the full duration of the
class. Students are expected to come to each class prepared with the
assigned readings and other written work completed and ready to make a
valuable contribution to each class. Students may be called upon to
answer questions concerning reading objectives.
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F.
REQUIRED TEXTS
Ignatavicius, D.D. & Workman, M.L. (2005). Medical-Surgical nursing:
Critical thinking for collaborative care (5th ed.). St. Louis: Elsevier
Saunders.
G.
RECOMMENDED TEXTS
Dubin, D. (2006). Rapid interpretation of EKG’s (6th ed.). Fort Myers,
Florida: Cover, Inc.
Ignatavicius, D.D. & Workman. M. L. (2005). Medical-Surgical nursing
critical thinking guide (5th ed.). St. Louis: Elsevier Saunders.
Hausman, K.A. (2006). Clinical Companion for Ignatavicius Workman
medical-surgical nursing critical thinking for collaborative care (5th
ed). St. Louis: Elsevier Inc.
http://www.rapitube.com/ I recommend that you go to this web site and
look at these two products. Then talk to me about whether you
want to purchase them.
H.
ACADEMIC INTEGRITY/STUDENT CONDUCT:
A fundamental quality of all successful nurses is integrity and a genuine
concern for the well being of the patient. Quality professional patient care
requires a relationship built on trust, trust requires honesty, and honesty is
the foundation of integrity.
Academic Integrity is expected of students and faculty at Dixie State
College. Students are expected to abide by the Dixie State College of
Utah (DSC) student code available at
http://www.dixie.edu/humanres/polstu.html. Dixie State College takes a
very serious view of violations of academic integrity. As members of the
academic community, the College’s administration, faculty, staff, and
students are dedicated to promoting an atmosphere of honesty and are
committed to maintaining the academic integrity essential to the
educational process. Inherent in this commitment is the belief that
academic dishonesty in all forms violates the principles of integrity and
impedes learning.
Students in DSC Nursing Programs have a responsibility to the public and
to the nursing profession; thus, it reserves the privilege of retaining only
those students who, in the judgment of the faculty, demonstrate high
academic standards. These academic standards include honesty,
accountability, and responsibility for one’s own work. Academic dishonesty
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is an unacceptable mode of conduct and will not be tolerated in any form.
Academic dishonesty includes, but is not limited to, plagiarism, cheating,
collusion, falsification, copying another student’s work, and soliciting
unauthorized information about an exam. Students who know about any
form of cheating or academic dishonesty and do not report it to
appropriate individuals are equally guilty of academic dishonesty and may
face the same consequences. Students who violate the student code of
conduct or rules of academic integrity may be subject to dismissal from
DSC Nursing Programs and the college according to college policy.
I.
ATTENDANCE AND TARDINESS POLICY
Attendance at all times is essential due to the nature of the nursing
program. The instructor will strictly adhere to the guidelines regarding
attendance and tardiness that are described in the Nursing Student
Handbook. Excessive and/or consecutive absences and/or tardiness could
result in a grade cut or dismissal from the program.
J.
EXAM REMEDIATION POLICY
As stated in the Nursing Student Handbook, students are required to
maintain at least a 74% exam average to pass the course. If a student
receives less than 74% on an interval exam, the student will schedule a
meeting with the instructor prior to taking the next exam to review exam
questions, identify areas of weakness, and plan strategies for improved
learning and test-taking. The student will be referred to the Tutoring
Center and/or Advisement and Counseling Office for further assistance as
needed. Exam remediation in the form of re-testing is not offered in this
course. Repeat interval or comprehensive exams are not offered.
K.
LATE ASSIGNMENT POLICY
All assignments must be submitted to the instructor on or before the date
that they are due unless the student has negotiated a different due date
with the instructor, at least 24 hours before an assignment is due. The
student must take the initiative to negotiate with the instructor with regard
to the revised date for submission as well as the consequences of failure
to submit the assignment by that revised date. If no negotiation is made
with the instructor, late assignments will receive a 10% reduction in
grade for each day it is late. If it is more than 4 days late, it will not
be accepted and receive a zero grade for that assignment.
L.
TESTING
Exams must be taken on the specific day(s) and/or class period. Any
exception to this will be at the discretion of the instructor. It will be the
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responsibility of the student to talk with the instructor about necessary
exceptions. An exception may result in an automatic reduction of points
on the exam taken at a different day and/or time than the originally
specified day and/or time.
M.
SERVICES FOR STUDENTS WITH DISABILITIES
“Proper documentation of a disability is required in order to receive
services or accommodations. Any student eligible for and requesting
reasonable academic accommodations due to a disability must provide a
letter of accommodation to their professor from the Disability Resource
Center within the first two weeks of the beginning of classes. Please
contact the Center on the main campus to follow through with the
documentation process. We are located in the Student Services Center
Room #201 or you may call for an appointment and further information
regarding the Americans with Disabilities Act (ADA) at 652-7516.”
N.
TESTING CENTER HOURS
The Testing Center’s hours of operation are posted online at
http://new.dixie.edu/testing/testing_hours.php
O.
REBELMAIL EMAIL ACCOUNT
Important class and college information will be sent to your Rebel mail
email account. This information includes your DSC bill, financial
aid/scholarship notices, notification of dropped classes, reminders of
important dates and events, and other information critical to your success
in this class and at DSC. All DSC students are automatically assigned a
Rebel mail email account. If you don’t know your user name and
password, go to www.dixie.edu and select “Rebel mail,” for complete
instructions. You will be held responsible for information sent to your
Rebel mail email, so please check it often.
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GRADING CRITERIA
Quizzes/Exams – 790 points possible
Quizzes 150 points possible – 10 points for each quiz
15 quizzes will be given throughout the semester. Content for the quizzes will
come from the assigned readings for the day. The quiz questions may contain
pharmacology content. Use the class objectives in the syllabus to help you
prepare for the quizzes. You may follow your grade on Blackboard Vista.
Unit Exams 350 points possible – 50 points for each exam
Unit exams will be administered as indicated below. Use the class objectives in
the syllabus to help you prepare for the exams. Your exam average including
unit and comprehensive exams must be no less than 74% to pass this course as
stated in the Nursing Student Handbook. Each interval exam has 50 questions
and is 5% of your course grade. You may follow your grade on Blackboard
Vista.
Exam 1
Exam 2
Exam 3
Exam 4
Exam 5
Exam 6
Exam 7
September 5 – September 8
September 19 – September 22
October 3 – October 6
October 21 – October 23
November 4 – November 6
November 21 – November 24
December 12 – December 15
ATI Focused Non Proctored Exams, 10 points for each exam
There are 9 online focused non proctored exams, 10 points possible for each
exam, that can be taken as many times as you wish, worth (90 points) of your
grade. Explanation of how these exams will be administered and graded will be
explained the first day of class. You may follow your grade on Blackboard
Vista.
ATI Specialty Exams, 100 points for each exam
The Dixie State College Nursing Program is implementing ATI testing resources
in each course. The purpose of ATI is to help supplement the student’s education
throughout the nursing program. The main objective of ATI testing is to identify
the strengths and weaknesses of each student. Consequently, the key to
success is to remediate the weak areas identified by the testing as follows:
1. Take the proctored exam.
2. Identify items in the Topics to Review section.
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3. Create a focused review for topics identified. (See handout for specific
instructions.)
4. While reviewing your personalized Focused Review, create an outline or
concept map for each item in the Topics to Review section.
5. Submit a copy of Topics to Review list and outlines or concept maps of
items to the instructor.
After a student has taken a proctored assessment, and has completed the above
remediation plan, points will be given as described below:
Pharmacology Exam (10% of grade) 100 points possible
An ATI pharmacology exam will be administered during the semester. This exam
will be given 1 time. Students will be expected to remediate if a proficiency level
3 is not achieved.
Proctored Pharmacy Exam Assessed Once
Proctored Exam
Level 3=100 points
Level 2=60 points
Level 1=50 points
Below level 1= 30 points
Remediation
None
30 points for remediation
30 points for remediation
Make appointment with the instructor
30 points for remediation
ATI Final (10% of grade) 100 points possible
The final exam for NURS 2100 will be the comprehensive ATI Medical-Surgical
specialty exam. The ATI Med-Surg Specialty Exam may be given 2 times based
on how well the student does on the first proctored exam.
Proctored Medical-Surgical Exam Assessed Twice
Proctored Exam
Level 3=100 points
Level 2=60 points
Level 1=50 points
Below Level 1=30 points
Remediation
None
15 points for remediation and 15 points
for the retake of the proctored
assessment
15 points for remediation and 15 points
for the retake of the proctored
assessment
Make appointment with the instructor
15 points for remediation and 15 points
for the retake of the proctored
assessment
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The ATI exam dates will be announced. The ATI Specialty Exams are each
worth 10% (100 points) of your grade. You may monitor your grade on
Blackboard Vista. Each student is expected to study for these exams.
Papers/Presentations/Worksheets – 350 points possible
APA Paper – 100 points possible
This paper will cover one of 8 topics chosen by your instructor. You will be given
your assigned topic during the first day of class. Sources must come from official
nursing or medical journals published within the last five years. The paper is to
be 4 to 6 pages in length. The paper is to be in APA format with a minimum of
four sources. You must turn in photocopies of all sources cited with highlighting
or underlining of information used. A grading rubric can be found on
Blackboard Vista to assist you as you write this paper. This paper will help
assist each student with his/her group presentation (see below). You may follow
your grade on Blackboard Vista.
Group Presentation –100 points possible
Groups of 5 students will take the information covered in their APA paper and
present the information to the class. Critical thinking/creativity should be used to
design your presentation. The presentation will correspond with content being
covered at the time. A grading rubric can be found on Blackboard Vista to
assist you as your group prepares this presentation. You may follow your
grade on Blackboard Vista.
Content/Pharmacology Worksheets – 150 points possible
There is no distinct pharmacology course in the ADN program; pharmacology
content is an important component of the medical-surgical nursing course. Class
quizzes include pharmacology questions. Students also will be expected to pass
an ATI pharmacology exam. In addition to the quiz questions and pharmacology
exam, students are expected to complete 15 content/pharmacology worksheets
throughout the semester. The worksheets include content and medication
calculation questions.
Students are to use the medical-surgical nursing textbook, pharmacology
textbook, a drug handbook, and other resources to complete the worksheets.
The worksheets will be due during the time the content is taught. See unit
objectives for the due dates. You can find the worksheets on Blackboard
Vista. You may follow your grade on Blackboard Vista.
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NON-GRADED EVAULATIONS
Community Service
Each student is expected to complete four hours of community service to meet
the requirement of professional experiences. This means that the student must
participate in a community experience that is sponsored by an agency, group or
organization that has an interest in the health of individual lives. Examples of
such community experience might include: The Huntsman Senior Games,
Hospice, DRMC Health Fair, DSC Health Fair, Flu Shots, Learning Center Fairs,
Southwest Mental Health, Worthen Center, Doctor’s Free Clinic, or Alzheimer’s
Association. The students will make their own arrangements to participate in an
experience. They will complete a Community Time Sheet and return this to
Phyllis Swift. You must participate in the community service project to pass this
course.
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COMMUNITY LEARNING TIME SHEET
Student Name______________________________
________________
DATE:
Community experience facility:
Instructions: The student will complete the time schedule for each community
experience. Contact person at the facility must sign this sheet. Return sheet to
faculty liaison after you have completed the assignment along with a short
description of the experience.
Name of
Facility
Date attended
Arrival Time
Departure
Time
Total Time
Contact person signature______________________________________
Student Signature____________________________________________
Description of experience:
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Week
1
Tuesday (1000-1230)
Fridays (1000-1230)
August 26
Orientation
Critical Thinking and the Nursing Process
Cultural Care/Gerontology
September 2
Community, Managed Care, CAM
August 29
Emergency Concepts/Bioterrorism
3
September 9
Inflammation/Infection
September 5
Pain, EOL, Substance Abuse, Rehabilitation
Exam 1 – Sept. 5-8
September 12
Respiratory/Upper
4
September 16
Respiratory/Lower
Presentation – Types of Pneumonias’
September 23
Musculoskeletal
September 19
Acid-Base/Electrolytes/Fluids
Exam 2 – Sept. 19-22
September 26
c
Neurology
6
September 30
Neurology
7
October 7
Cardiovascular Assessment/Dysrhythmias
October 14
Peripheiral Vascular Disease
Presentation – Arterial vs. Venous Insufficiency
October 3
Neurology
Presentation – Paraplegia vs. Quadriplegia
Exam 3 Oct. 3-6
October 10
Cardiovascular Problems
October 17
Spring Break
2
5
8
9
10
11
12
13
October 21
Coronary Syndrome
Exam 4 – Oct. 21-23
October 28
Altered Immunity
November 4
Integumentary/Burns
Presentation – Skin Lesions – Are they Cancer?
Exam 5 – Nov. 4-6
November 11
Lower GI
Presentation – Crohns vs. Ulcerative Colitis
November 18
Career Day
No Class
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November 25
Female Reproductive & Breast Problems
15
December 2
Urinary, Renal, & Male Reproductive Disorders
Exam 6 – Apr. 22-24
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December 9
Diabetes
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December 15
Finals Begin
October 24
Cancer
October 31
Hematology
Presentation – Common Anemia’s
November 7
Upper GI
November 14
Billiary/Pancreas/ Liver
November 21
Renal failure
Presentation – Pre & Post Renal Disease
Exam 6 – Nov. 21-24
November 28
Thanksgiving Holiday
December 5
Endocrine
Presentation – Which Gland is causing the
Problem?
December 12
Shock/MODS
Critical Care
Exam 7 – Dec. 12-15
December 19
Finals End
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NURS 2100
MEDICAL-SURGICAL NURSING II
Fall 2007
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
Spring 2008
Phyllis Swift, MS, APRN
COURSE OBJECTIVES
1. Given case studies, in-class discussions, worksheet assignments, and
quizzes/exams the student will develop critical thinking skills related to
the medical-surgical patient.
2. Given a patient situation with a complex medical-surgical problem, the
student will prioritize the technical skills and nursing interventions
needed to provide care to the patient and propose outcomes of
effectiveness.
3. Given case studies, in class discussion, student-instructor
relationships, and quizzes/exams, the student will demonstrate
effective use of therapeutic communication as human needs are taken
into consideration.
4. Given an in class group presentation, the student works as an effective
member of the group and evaluates self and each member of the
group.
5. Given case studies, in class discussions, and quizzes/exams, the
student will prioritize and manage complex medical-surgical patient
situations.
6. Given student-instructor relationships, case studies, in class ethical
discussions, and adherence to academic integrity policy, the student
will demonstrate professional behaviors.
7. Given case studies, in class discussions, medical-surgical patient
situations and quizzes/exams, the student will take into consideration
the clients needs and demonstrate caring behaviors.
8. Given a complex medical-surgical patient situation, the student will
utilize the nursing process.
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At the completion of this course the student will also be able to:
1. Utilize the nursing process when providing care to clients, individuals or
groups in a variety of settings, with an understanding of the multiple
resources available, cultural differences, and end of life issues, in an everchanging world.
2. Evaluate the management of clients with fluid, electrolyte, and acid-base
imbalances.
3. Manage the care of the client with alterations in mobility, sensation, and
cognition.
4. Manage the care of clients with problems of oxygenation, cardiac output,
and tissue perfusion
5. Evaluate the perioperative process and provide plans of care for those
clients at risk for altered protection.
6. Evaluate the care of clients with alterations in the digestion, metabolism,
and elimination/excretion.
7. Manage the care of clients with alterations in the reproductive systems.
8. Identify clients at risk for Multiple Organ Dysfunction Syndrome (MODS).
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Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
August 26, 2008
Phyllis Swift, MS, APRN
Applying Critical Thinking to the Nursing Process
Health Care of Older Adults and Cultural Aspects of Health
Class Objectives: Upon completion of the readings, assignments,
and class activities, the student will be able to:
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Explain how critical thinking is used in nursing practice.
Compare and contrast common definitions of health.
Compare and contrast 3 of the functions of nursing practice; independent,
dependent, and collaborative functions.
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Teach the nursing process to a group of 1st your students, identifying each
of the 5 phases and the importance of each.
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Compare and contrast the three levels of illness prevention and provide at
least one example for each level.
Assess for all factors that may affect the teaching-learning process.
Identify each phase of the nursing process where evaluation is appropriate
and defend your answer.
Compare and contrast a nursing diagnosis and a medical problem.
Identify best practice standards for documentation.
Identify four subgroups of older adults.
Describe nursing interventions for relocation stress syndrome.
Discuss common health issues that may concern older adults
Explain why older adults are at risk for falls and common interventions.
Explain the effects of drugs on the older adult.
Compare and contrast delirium and dementia.
Interpret the signs and symptoms of elder neglect or abuse.
Discuss government and community resources available for older adults.
Define culture, cultural competence, cultural awareness, and
ethnocentrism.
Describe three methods for cultural assessment.
Discuss specific cultural practices the nurse should consider when
assessing a client’s culture.
Describe ways that nurses can communicate sensitively with clients from
various cultural groups.
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Reading: Ignatavicius & Workman – Chapter 1, pp.2-16 & Chapters 5 & 6
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Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
August 29, 2008
Phyllis Swift, MS, APRN
Emergency Concepts and Environmental Emergencies
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:

Identify best practices guidelines to maintain staff and client safety in the
ED.
 Triage clients into emergent, urgent, and non-urgent categories.
 Prioritize interventions based on the primary survey of the ED client.
 Compare and contrast the triage process during usual conditions and
during a mass casualty.
 Identify the components of an Emergency Preparedness and Response
Plan.
 Compare and contrast two types of debriefing that occur after a mass
casualty incident.
 Describe what occurs in the ED when a client is suspected of a bioterrorism agent.
 Assess clients for common types of heat-related and cold related injuries,
and teach how to prevent such injuries.
 Prioritize first aid interventions for clients who have heat-related or cold
injuries.
 Prioritize first aid interventions for clients experiencing snakebites.
 Differentiate care for clients who have arthropod bites and stings and
teach preventive measures.
 Develop a plan of care for a client who is allergic to bees and experiences
a bee sting.
 Prioritize care for clients who have been struck by lightning.
 Develop a plan of care for a client with near drowning.
Readings: Ignatavicius & Workman, Chapters 12 & 13
17
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 2, 2008
Phyllis Swift, MS, APRN
Community-based care; Managed care; Complementary Alternative
Medicine (CAM)
Class Objectives: Upon completion of the readings, assignments and class
activities, the student will be able to:
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Describe the role of the nurse in home care.
Identify interventions for which Medicare typically pays in home care.
Compare and contrast the common types of long-term care settings.
Explain the primary purpose of managed health care, including factors
that drive concerns about cost and quality.
Compare the health maintenance organization (HMO) with the preferred
provider organization (PPO).
Explain the overall goals of case management.
Clarify the differences and similarities between case management and
disease management.
Describe the purposes of the National Center for Complementary and
Alternative Medicine (NCCAM).
Discuss implications for care of clients using complementary and
alternative therapies.
Readings: Ignatavicius & Workman – Chapters 2, 3, and 4.
Content/Pharmacology Worksheet #1 is due
18
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 5, 2008
Phyllis Swift, MS, APRN
Pain, End of Life (EOL), Substance Abuse, Rehabilitation
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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State what pain means to you.
Identify three populations at risk for the under-treatment of pain.
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Explain the attitudes and knowledge of nurses, physicians, and clients
regarding pain
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Compare and contrast addiction, tolerance, and physical dependence.
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Describe how you would complete a comprehensive pain assessment.
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Compare and contrast opioid analgesics, using an equianalgesic chart.
Explain the purpose of adjuvant medication in pain management.
Compare & contrast age related concerns in assessment & management
of pain.
Describe your role as an advocate in pain management.
Compare and contrast four routes of analgesic administration.
Debate substance abuse as a major health issue in the United States.
Compare and contrast assessment findings associated with use of
nicotine, alcohol, stimulants, hallucinogens, depressants, opioids,
inhalants, and steroids.
Compare and contrast the signs & symptoms that are indicative of
emergency situations associated with the different types of substance
abuse.
State what your responsibility would be if a peer or other health care
worker were suspected of abusing substances.
Plan the nursing care for clients who are in alcohol withdrawal.
Identify the purpose for advance directives.
Compare and contrast the philosophies of palliative and hospice care.
Describe the roles of all member of the interdisciplinary team in end-of-life
care.
Teach a 1st year nursing student the care of a client after death.
Debate the ethical & legal obligations of the nurse with regard to end-oflife care.
Compare and contrast impairment, disability, and handicap.
Teach members of a group the major components of a functional
assessment.
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Plan the nursing care for the client in a rehabilitation program.
Readings: Ignatavicius & Workman, Chapters 7, 8, 9, and 10
Exam 1 – begins September 5 and is available through September 8, 2008
in the testing center
20
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 9, 2008
Phyllis Swift, MS, APRN
Inflammation/Infection
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare and contrast inflammation and infection.
Describe the basis for the five cardinal manifestations of inflammation.
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Interpret a white blood cell count with differential.
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Compare and contrast the different types of antibody-mediated immunity
for their protection effectiveness and duration of immunity.
Describe how the immune system responds to the presence of
transplanted tissue or organs.
Explain the actions and short and long term side effects of
immunosuppressive drugs.
Compare and contrast osteoarthritis (OA) and rheumatoid disease (RA).
Determine common nursing diagnoses for postoperative clients having
total joint replacement surgery.
Identify the nursing implications associated with drug therapy for clients
with RA.
Identify educational needs for clients with arthritis.
Differentiate between discoid lupus erythematosus and systemic lupus
erythematosus.
Describe the treatment of gout.
Describe current treatment strategies for clients with fibromyalgia.
Explain the chain of infection.
Describe the principles of infection control in inpatient and community
based settings.
Differentiate the four types of transmission based precautions.
Identify the major causes and results of inadequate antimicrobial therapy.
Assess the common manifestations of infection.
Interpret laboratory test findings related to infection and implement nursing
interventions.
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Readings: Ignatavicius & Workman, Chapters 23, 24, & 29
Content/Pharmacology Worksheet #2 is due
21
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 12, 2008
Phyllis Swift, MS, APRN
Respiratory/Upper
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare the structures and functions of the upper airways to those of the
lower airways.
Describe the respiratory changes associated with aging.
Calculate the pack-year smoking history of the client who smokes or who
has ever smoked cigarettes.
Prioritize educational needs for the client undergoing pulmonary function
tests.
Interpret arterial blood gas values to assess the client’s respiratory status.
Plan care for the client undergoing a bronchoscopy or an open lung
biopsy.
Explain the problems of oxygen therapy for those clients whose
respiratory efforts are controlled by the hypoxic drive.
Evaluate the effectiveness of therapy for the client receiving oxygen.
Use laboratory data and clinical manifestations to determine the presence
of hypoxemia or hypercarbia.
Plan care for the client with a new tracheostomy.
Compare and contrast nursing care of a client with an anterior nosebleed
with those of a client with a posterior nosebleed.
Plan care for a client with facial trauma.
Describe the potential complications of sleep apnea.
Develop a plan of communication for a client who has a disruption of
speech and cannot read.
Identify the psychosocial consequences of a client undergoing head and
neck cancer surgery.
Develop a teaching plan for the client who is getting ready to go home
after undergoing a complete laryngectomy.
Readings: Ignatavicius & Workman, Chapters 30, 31, & 32
22
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 16, 2008
Phyllis Swift, MS, APRN
Respiratory/ Lower
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare and contrast bronchospasm and inflammation as it relates to
asthma.
Prioritize educational needs for the client with asthma at step III.
Interpret peak expiratory rate flow readings and the need for intervention.
Discuss the complications of chronic oral steroid therapy.
Identify risk factors for chronic obstructive pulmonary disease (COPD).
Describe the mechanisms of action, side effects, and nursing implications for
pharmacologic management of COPD.
Plan the nursing care for the client with COPD.
Evaluate the effectiveness of therapy in a client with obstructive or restrictive
breathing problems.
Identify the risk factors for lung cancer.
Compare and contrast the side effects of radiation treatment for lung cancer
to those of chemotherapy.
Identify adults at risk for contracting influenza.
Develop a teaching plan to prevent influenza in the older adult.
Identify clients at risk for developing community-acquired and/or hospitalacquired pneumonia.
Describe the mechanisms of action, side effects, and nursing implications of
drug therapy for pneumonia.
Identify adults at risk for tuberculosis (TB).
Describe mechanisms of action, side effects, and nursing implications of drug
therapy for TB.
Develop a teaching plan for continuing care of the client with active TB.
Identify the early and late manifestations of inhalation anthrax.
Describe the clinical manifestations of pulmonary embolism.
Describe the indications for intubation.
Identify clients at risk for development of pneumothorax.
Identify clients at risk for developing ARDS.
Develop a plan of care for a client diagnosed with ARDS.
Readings: Ignatavicius & Workman, Chapters 33, 34, & 35
Content/Pharmacology Worksheet #3 is due
Presentation #1 – Types of Pneumonias’
23
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 19, 2008
Phyllis Swift, MS, APRN
Electrolytes / Fluids / Acid-Base Balance
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Evaluate a client’s serum electrolyte values.
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Compare and contrast the effects of infusion of isotonic, hypertonic, or
hypotonic intravenous fluids on the blood volume.
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Explain the relationships between antidiuretic hormone, urine output
volume, and osmolarity.
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Analyze a client’s hydration status on the basis of physical assessment
findings.
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Identify clients at risk for fluid imbalances.
Apply appropriate nursing care to promote comfort and safety in the client
with dehydration.
Evaluate the effectiveness of therapy for the client with dehydration.
Plan nursing care for the client with over-hydration.
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Evaluate the effectiveness of therapy for the client with over-hydration.
Describe the relationship between free hydrogen ion level and pH.
 Compare and contrast the roles of the respiratory and the renal systems in
maintaining acid-balance.
 Describe the role of oxygen in maintaining acid-base balance.
 Analyze arterial blood gasses (ABGs) to determine whether acidosis is
respiratory or metabolic in origin.
 Analyze ABGs to determine whether respiratory acidosis is acute or
chronic.
 Plan nursing care for the client in acid base imbalance.
Readings: Ignatavicius & Workman, Chapters 14, 15, 16, 17, 18, & 19
Exam 2 – begins September 19 and is available through September 22,
2008 in the testing center
24
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 23, 2008
Phyllis Swift, MS, APRN
Musculoskeletal System
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Explain how physiologic aging changes of the musculoskeletal (MS)
system affect care of older adults.
Evaluate important assessment findings in a client with a (MS) health
problem.
Identify the use of radiography in diagnosing (MS) health problems.
Develop a teaching plan for clients undergoing arthroscopic procedures.
Explain the risk factors for primary and secondary osteoporosis.
Develop a teaching plan for all age groups concerning osteoporosis.
Describe the role of drug therapy in the prevention & management of
osteoporosis.
Identify common assessment findings in clients with Paget’s disease of
the bone.
Compare & contrast acute and chronic osteomyelitis.
Discuss the psychosocial aspects associated with a diagnosis of bone
cancer.
Explain the pathophysiology, risk factors, & treatment options for carpal
tunnel syndrome.
Compare and contrast common types of fractures.
Discuss the healing process for bone.
Develop a plan of care for a client with a fracture.
Analyze common nursing diagnoses for the client with a fracture.
Plan nursing care for the postoperative client with internal fixation of the
hip.
Explain the psychosocial aspects related to amputations.
Describe the collaborative management for the client with complex pain
syndrome.
Identify the common types of sports related injuries and their
management.
Readings: Ignatavicius & Workman, Chapters 53, 54, & 55
Content/Pharmacology Worksheet #4 is due
25
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 26, 2008
Phyllis Swift, MS, APRN
Nervous System
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare the functions of the major divisions of the nervous system.
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Describe the mechanisms of nerve impulse transmission.
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Identify the structure and function of different areas of the central and
peripheral nervous system.
Identify common physiologic changes associated with aging that affect the
nervous system.
Perform a neurological history & physical assessment & interpret findings.
Interpret results of cerebrospinal fluid analysis.
Plan and implement pre and post care for clients undergoing neurologic
testing.
Compare and contrast migraine, cluster and tension headaches.
Differentiate the common types of seizures.
Identify collaborative management options for clients diagnosed with
epilepsy.
Explain the nursing interventions provided to a client having a seizure.
Plan care for clients with meningitis and encephalitis.
Describe the pathophysiology of Parkinson disease.
Identify nursing implications related to giving medications for Parkinson
disease.
Analyze legal/ethical concerns related to genetic counseling of clients with
Huntington disease.
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Readings: Ignatavicius & Workman, Chapters 44 & 45
Content/Pharmacology Worksheet #5 is due
26
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
September 30, 2008
Phyllis Swift, MS, APRN
Central Nervous System/ Peripheral Nervous System/ Neurological
Problems
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare and contrast the common types of strokes.
Describe typical clinical manifestations associated with stroke.
Plan care for a client with a brain attack.
Explain the role of drug therapy in managing clients with strokes.
Identify signs of increasing ICP.
Differentiate the common types of traumatic brain injury (TBI).
Describe the psychosocial and behavioral manifestations associated with
TBI.
Prioritize nursing care for the client with TBI.
Explain the role of sedation and analgesia in managing the client with
intracranial hypertension.
Reading: Ignatavicius & Workman, Chapters 46, 47, & 48
27
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 3, 2008
Phyllis Swift, MS, APRN
Central Nervous System/ Peripheral Nervous System/ Neurological
Problems
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Identify risk factors that contribute to back pain.
Plan care for the client having a diskectomy, laminectomy, or spinal
fusion.
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Identify emergency care for the client suspected of a SCI.
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Plan nursing care of the client with an SCI.
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Discuss the six basic types of multiple sclerosis (MS).
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Discuss the treatment options used to manage clients with MS.
Develop a teaching plan for clients with MS.
Compare and contrast the clinical manifestations of MS and ALS.
Compare and contrast the pathophysiology and etiology of Guillain-Barre
Syndrome (GBS) and myasthenia gravis (MG).
Plan nursing care for the client with GBS or MG.
Differentiate between a myasthenia crisis and a cholinergic crisis.
Develop a teaching plan for the client with peripheral neuropathy.
Compare and contrast trigeminal neuralgia and facial paralysis.
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Reading: Ignatavicius & Workman, Chapters 46, 47, & 48
Presentation #2 – Paraplegia vs. Quadriplegia
Exam 3 – begins Oct. 3 and is available through Oct. 6, 2007 in the testing
center
28
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 7, 2008
Phyllis Swift, MS, APRN
Cardiovascular Assessment/ Dysrhythmias
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Review the anatomy and physiology of the cardiovascular system.
Identify factors that place clients at risk for cardiovascular problems
Perform appropriate physical assessment for clients with cardiovascular
problems.
 Interpret laboratory test findings for clients with suspected or actual
cardiovascular disease.
 Explain pre- and post-test care associated with diagnostic cardiovascular
testing.
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Explain the purpose of hemodynamic monitoring.
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Correlate the components of the electrocardiogram (ECG) with the cardiac
conduction system.
Analyze a rhythm strip or ECG tracing to identify common cardiac
dysrhythmias.
Identify typical physical assessment findings associated with common
dysrhythmias.
Prioritize nursing diagnoses and plan care for clients experiencing
dysrhythmias.
Implement appropriate treatment modalities, including antidysrythmic
drugs, for common and lethal dysrhythmias.
Explain the purpose and types of pacing used as interventions for clients
with dysrhythmias.
Develop a teaching plan for clients experiencing common dysrhythmias.
Differentiate between defibrillation and cardioversion, identifying the
indications for the use of each.
Plan community based care for a client after pacemaker or implantable
cardiovertor/defibrillator insertion.
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Readings: Ignatavicius & Workman, Chapters 36 & 37
29
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 10, 2008
Phyllis Swift, MS, APRN
Cardiovascular Problems
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Explain the pathophysiology, assessment, and treatment modalities for
each of the following: heart failure, valvular disease, cardiac inflammations
and infections.
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Identify common nursing diagnoses and collaborative problems for clients
with these cardiovascular problems.
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Interpret essential laboratory data related to risk for atherosclerosis.
Compare and contrast left and right-sided heart failure.
Evaluate the effects of interventions for reducing preload and afterload.
Identify common drug therapies to improve cardiac output.
Discuss the prevention of complications and prioritize care for clients with
heart failure.
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Compare and contrast common valvular disorders; discuss surgical
management and develop a teaching plan for clients with valvular disease.
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Differentiate between common cardiac inflammations and infections
(endocarditis, pericarditis, rheumatic cardioids).
Readings: Ignatavicius & Workman, Chapter 38
Content/Pharmacology Worksheet #6 is due
30
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 14, 2008
Phyllis Swift, MS, APRN
Peripherial Vascular Disease
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Explain the pathophysiology, assessment, and treatment modalities for
each of the following: hypertension, arteriosclerosis and atherosclerosis,
and peripheral arterial disease and peripheral vascular disease.
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Identify common nursing diagnoses and collaborative problems for clients
with each of these vascular problems.
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Describe the difference between essential and secondary hypertension.
Compare and contrast assessment findings typically present in clients with
peripherial arterial disease (PAD) & peripherial venous disease (PVD).
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Assess clients at risk for venous thromboembolisms (VTE) and identify
when VTE occurs.
Describe the nurse’s role in monitoring clients who are receiving
anticoagulants.
Compare and contrast Reynaud’s and Berger’s disease.
Identify evidence-based practice for care of clients with venous leg ulcers.
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Readings: Ignatavicius & Workman, Chapter 39
Presentation #3 – Arterial vs. Venous Insufficiency
31
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 21, 2008
Phyllis Swift, MS, APRN
Coronary Syndrome
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Describe the relationship between coronary artery disease (CAD) and
acute coronary syndromes (ACS).
Explain the pathophysiology of ACS.
Compare and contrast stable angina, unstable angina, and myocardial
infarction (MI).
Identify modifiable and nonmodifiable risk factors for ACS.
Interpret physical and diagnostic assessment findings in clients who have
ACS.
Prioritize nursing care for clients who have ACS.
Identify life-threatening complications of ACS.
Compare and contrast the drug classifications used to treat ACS.
Describe the appropriate nursing interventions for monitoring clients
receiving drug therapy for ACS.
Develop a discharge plan for the client with ACS.
Develop a plan of care for a client in shock.
Readings: Ignatavicius & Workman, Chapters 40 & 41
Exam 4 – begins October 21 and is available through October 23, 2008 in
the testing center
32
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 24, 2008
Phyllis Swift, MS, APRN
Cancer
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Explain why causes of cancer can be hard to establish.
Compare the features of benign and malignant tumors.
List three cancer types associated with tobacco use.
Describe the TNM system for cancer staging.
Identify which cancer types arise from connective tissues and which types
arise from glandular tissues.
Describe how genetic predisposition can increase a person’s risk for
cancer development.
Identify the goals of cancer therapy.
Distinguish between cancer surgery for cure and cancer surgery for
palliation.
Discuss how the nursing care needs for the client undergoing cancer
surgery compare to those for the client undergoing any other type of
surgery.
Compare the purposes and side effects of radiation therapy and
chemotherapy for cancer.
Identify nursing interventions to promote safety for the client experiencing
chemotherapy induced anemia or thrombocytopenia.
Develop a community based teaching plan for the client receiving
chemotherapy.
Discuss the uses of biological response modifiers as supportive therapy in
the treatment of cancer.
Identify clients at risk for oncologic emergencies and prioritize nursing
care for them.
Readings: Ignatavicius & Workman, Chapters 27 & 28
Content/Pharmacology Worksheet #7 is due
33
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
October 28, 2008
Phyllis Swift, MS, APRN
Altered Immunity
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare primary and secondary immunodeficiency’s for cause and onset
of problems.
Explain the differences in nursing care required for a client with a
pathogenic infection versus a client with an opportunistic infection.
Distinguish between the conditions of human immunodeficiency virus
(HIV) infection and acquired immunodeficiency syndrome (AIDS) for
clinical manifestations and risks for complications.
Identify techniques to reduce the risk for infection in an
immunocompromised client.
Develop a community based teaching plan for the client with immune
deficiency living at home.
Plan a week of meals for the client who has protein-calorie malnutrition.
Identify drug therapy categories that have the potential to reduce immune
function.
Compare the basis and manifestations of allergy and autoimmunity.
Discuss the nursing responsibilities for a client with anaphylaxis.
Identify the common drugs, dosages, and side effects used as therapy for
anaphylaxis.
List the defining characteristics of type I, type II, type III, type IV, and type
V hypersensitivity reactions.
Develop a community based teaching plan for the client who has severe
allergic reactions.
Readings:
Ignatavicius & Workman, Chapters 25 & 26
34
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing
October 31, 2008
Phyllis Swift, MS, APRN
Hematology
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Describe the hematologic changes associated with aging.
Explain the process of erythrocyte maturation.
Describe the role of platelets in hemostasis.
Compare the structure and function of platelet plugs and fibrin clots and
interpret blood cell counts and clotting tests to assess the client’s
hematologic status.
Compare the actions and uses of anticoagulants, fibrinolytics, and
inhibitors of platelet activity.
Develop a community-base teaching plan for the client on anticoagulant
therapy at home.
Prioritize nursing care for the client after bone marrow aspiration.
Identify three clinical manifestations common to clients who have any type
of anemia.
Prioritize nursing care for the client who has sickle cell disease.
Explain the mechanism of action and potential side effects of epoetin
alpha therapy.
Compare the pathologic mechanisms of hemolytic anemia versus aplastic
anemia.
Compare leukemia and lymphoma for etiology, pathophysiology, and
clinical manifestations.
List four risk factors for development of leukemia.
Analyze laboratory data and clinical manifestations to determine the
presence of infection in a client who has neutropenia.
Prioritize nursing interventions for the client with neutropenia and for the
client with thrombocytopenia.
Prioritize nursing responsibility during transfusion therapy and identify
clients at risk for complications of transfusion therapy.
Readings: Ignatavicius & Workman, Chapters 42 & 43
Presentation #4 – Common Anemia’s
Content/Pharmacology Worksheet #8 is due
35
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
November 4, 2008
Phyllis Swift, MS, APRN
Integumentary System / Burns
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Describe the Integumentary changes associated with aging.
Use proper terminology to describe different skin lesions and be able to
associate lesions with skin disease.
Assess skin changes in clients with dark skin.
Compare and contrast normal variations and abnormal skin manifestations
with regard to skin color, texture, warmth, and moisture.
Describe the ABCD method of assessing skin lesions for cancer.
Compare wound healing by first, second, and third intention.
Identify clients at risk for pressure ulcer development.
Plan a strategy to prevent pressure ulcer development in clients at
increased risk.
Compare and contrast bacterial, viral, and fungal skin infections.
Identify interventions for prevention of skin cancer.
Describe the clinical manifestations of melanoma.
Identify burn clients at risk for inhalation injury.
Compare and contrast partial-thickness, and full-thickness burn injuries.
Explain the expected clinical manifestations of neural and hormonal
compensation during the emergent phase of burn injury.
Calculate the total body surface area involved in a burn injury.
Plan care for a client during the emergent phase of burn injury.
Evaluate the effectiveness of fluid resuscitation during the emergent
phase of burn injury.
Use the Parkland formula to establish fluid replacement.
Plan care for the client during the acute phase of burn injury.
Explain the alteration of nutritional needs for the burn client during the
acute phase of burn injury.
Evaluate wound healing in the client during the acute phase of burn injury.
Compare and contrast pain management strategies for clients in the
emergent and acute phases of burn injury.
Describe the characteristics of infected burn wounds.
Plan care for the client during the rehabilitation phase of burn injury.
Discuss the potential psychosocial problems associated with burn injury.
36
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Identify populations at risk for burn injury and discuss preventive
measures.
Readings: Ignatavicius & Workman, Chapters 70 & 71
Presentation #5 – Skin Lesions – Are they Cancer?
Content/Pharmacology Worksheet #9 is due
Exam 5 – begins November 4 and is available through November 6, 2008 in
the Testing Center
37
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
November 7, 2008
Phyllis Swift, MS, APRN
Upper GI
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:

Identify gastrointestinal (GI) system changes associated with aging.
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Perform a GI history using Gordon’s Functional Health Patterns.

Evaluate important physical assessment findings in a client with digestion,
nutrition, and elimination health problems.
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Explain the use of laboratory testing for a client with a GI health problem.
Describe the use of radiography in diagnosing GI health problems.
Plan pre & post care for clients having endoscopic procedures.
Explain the pathophysiology of gastroesophageal reflux disease (GERD).
Plan nursing care for the client with GERD.
Compare and contrast medications that are used for GERD.
Identify the risk factors for esophageal cancer.
Plan the postoperative care of the client undergoing surgery for
esophageal cancer.
Develop a postop teaching plan for the client having a hiatal hernia repair.
Compare & contrast acute and chronic gastritis.
Describe the key components of collaborative care for clients with
gastritis.
Compare and contrast gastric and duodenal ulcers.
Identify the complications that can result from peptic ulcer disease (PUD).
Analyze assessment data to determine nursing diagnoses associated with
PUD.
Discuss drug therapy for gastritis or PUD.
Plan nursing care a client with upper GI bleeding.
Explain Zollinger-Ellison syndrome and its associated clinical
manifestations.
Analyze risk factors for gastric carcinoma, including cultural
considerations.
Discuss the psychological and emotional concerns of clients with gastric
cancer.
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Readings: Chapters 56, 58, 59 in Ignatavicius & Workman text
Content/Pharmacology Worksheet #10 is due
38
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
November 11, 2008
Phyllis Swift, MS, APRN
Lower GI
Objectives: Upon completion of the readings, assignments, and class activities,
the student will be able to:
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Develop a teaching-learning plan for clients with irritable bowel syndrome
(IBS).
Differentiate the most common types of hernias.
Interpret assessment findings for a client with colorectal cancer (CRC).
Identify health promotion practices to prevent CRC.
Discuss the psychosocial aspects associated with CRC and related
surgeries.
Develop a perioperative plan of care for a client undergoing a colon
resection & colostomy.
Compare and contrast a small bowel and a large bowel obstruction.
Explain the role of the nurse when caring for clients with nasogastric
tubes.
Plan care for the client with an abdominal trauma.
Explain the pathophysiology of malabsorption syndrome.
Compare and contrast the common types of acute inflammatory bowel
disease.
Plan care for the client who has peritonitis.
Discuss the common causes of gastroenteritis.
Explain the purpose of and nursing implications related to drug therapy for
clients with IBD.
Develop a perioperative plan of care for a client undergoing a colon
resection/colectomy and colostomy or ileostomy.
Explain the role of diet therapy in managing a client with diverticular
disease.
Plan care for the client with an anal abscess, fissure, or fistula.
Discuss ways that helminthic infestation, parasitic infection, and food
poisoning can be prevented.
Readings: Ignatavicius & Workman, Chapters 60 & 61
Presentation #6 – Crohns vs. Ulcerative Colitis
39
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
November 14, 2008
Phyllis Swift, MS, APRN
Liver/ Biliary/ Pancreas
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:

Describe the pathophysiology and complications associated with cirrhosis
of the liver.
 Plan nursing care for a client with cirrhosis of the liver.
 Formulate a collaborative plan of care for the client with severe late stage
cirrhosis.
 Identify emergency interventions for the client with bleeding esophageal
varices.
 Compare and contrast A, B, and C viral infections.
 Discuss the primary concerns about increasing incidence of hepatitis C.
 Identify treatment options for clients with cancer of the liver.
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Describe the complications that result from liver transplantation.
Identify the common causes of cholecystitis and cholelithiasis.
Interpret diagnostic test results associated with gallbladder disease.
Compare and contrast a traditional cholecystectomy with a laparoscopic
cholecystectomy.
Develop a teaching plan for clients with gallbladder disease, including care
of a T-tube.
Compare and contrast acute pancreatitis and chronic pancreatitis.
Plan nursing care for a client with acute pancreatitis.
Explain the use and precautions associated with enzyme replacement for
chronic pancreatitis.
Develop a postoperative plan of care for clients undergoing a Whipple
procedure.
Construct a discharge plan of care for a client with pancreatic cancer.
Discuss the psychosocial needs of the client with pancreatic cancer.
Readings: Ignatavicius & Workman, Chapters 62 & 63
Content/Pharmacology Worksheet #11 is due
40
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
November 21, 2008
Phyllis Swift, MS, APRN
Renal Disorders/ Renal Failure
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Develop a plan of care for the client with polycystic kidney disease.
Identify clients at risk for pyelonephritis.
Describe the mechanism of action, side effects, and nursing implications
for drug therapy for pyelonephritis.
Use laboratory data and clinical manifestations to determine the
effectiveness of therapy for pyelonephritis.
Compare and contrast the pathophysiology and clinical manifestations of
acute glomerular nephritis and nephritic syndrome.
Explain the relationship between hypertension and renal disease.
Develop a plan of nursing care for the client during the first 24 hours after
a nephrectomy.
Develop a community-based plan for the client who has had a
nephrectomy for renal cell carcinoma.
Describe strategies to prevent renal trauma.
Compare the pathophysiology, causes, and treatments of acute renal
failure (ARF) with those of chronic renal failure.
Use laboratory data and clinical assessment to determine the
effectiveness of therapy for renal failure.
Describe the mechanisms of action, side effects, and nursing implications
for pharmacologic management of renal failure.
Prioritize nursing care for the client with end-stage renal disease.
Discuss the mechanisms of peritoneal dialysis (PD) and hemodialysis
(HD).
Discuss the criteria for kidney donation.
Develop a community-based teaching plan for the client who has received
a kidney transplant.
Readings: Ignatavicius & Workman, Chapters 74, & 75
Presentation #7 – Pre and Post Renal Disease
Exam 6 – begins November 21 and is available through November 24, 2008
in the Testing Center
41
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
November 25, 2008
Phyllis Swift, MS, APRN
Female Reproductive & Breast Problems
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Describe the structures, functions, and major hormones of the male and
female reproductive systems.
Describe the physiologic and psychologic changes of a man and a woman
during the stages of sexual response.
Examine how aging affects the reproductive system.
Describe the purpose, significance of results, and nursing responsibilities
related to diagnostic studies of the breast and reproductive system.
Describe the etiology, pathophysiology, clinical manifestations,
collaborative and nursing management of the following sexually
transmitted diseases: syphilis, gonorrhea, genital herpes, chlamydia,
trichomoniasis, and condylomata acuminata.
Identify the nursing role in the care of a client with sexual dysfunction,
altered sexuality patterns, and/or rape-trauma syndrome.
Describe the etiology, pathophysiology, clinical manifestations,
collaborative care and nursing management of the following female
reproductive disorders: menstrual cycle variations, dysmenorrhea,
perimenopause, menopause, endometriosis, infertility, vaginitis, lower
genital tract disorders, pelvic inflammatory disease, and pelvic relaxation
Formulate a plan of care for a client undergoing a hysterectomy.
Describe the etiology, pathophysiology, clinical manifestations,
collaborative care and nursing management of the following breast
disorders: cancer, mastitis, fibrocystic changes, fibroadenoma, intraductal
papilloma, ductalectasia, and gynecomastia
Explain the physical and psychologic preoperative and postoperative
aspects of nursing management for the client undergoing a mastectomy
and/or breast reconstruction surgery.
Readings: Ignatavicius & Workman, Chapters 76, 77, 78, & 89
Content/Pharmacology Worksheet #12 is due
42
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
December 2, 2008
Phyllis Swift, MS, APRN
Urinary, Renal, & Male Reproductive Disorders
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:

Review the anatomy and physiology of the male reproductive system.

Discuss the components of a health history for reproductive health
problems using Gordon’s Functional Health Patterns.

Explain the procedure for physical assessment of the male reproductive
system.

Interpret common reproductive diagnostic lab test findings pertaining to
men.
 Describe common physical assessment findings, identify nursing
implications for pharmacologic management, and discuss options for
surgical management of the client with benign prostatic hyperplasia
(BPH).
 Develop a postoperative plan of care for a client undergoing a
transurethral resection of the prostate (TURP).
 Explain the procedures for prostate cancer screening and the role of
hormonal therapy in treating prostate cancer.
 Describe the options for treating erectile dysfunction.
 Discuss cultural considerations related to male reproductive problems.
 Analyze assessment data to determine priority nursing diagnoses and
collaborative problems for a man with testicular cancer.
 Compare hydrocele, spermatocele, and varicocele.
 Compare the four types of prostatitis.
 Discuss issues related to sexuality and body image for a man
experiencing male reproductive health problems
 Compare and contrast kidney function with functions of the ureters,
bladder, and urethra.
 Explain the influence of antidiuretic hormone and aldosterone on urine
formation.
 Describe age related changes in the renal/urinary system.

Use laboratory data to distinguish between dehydration and renal
impairment.

Identify teaching priorities for a client who needs to obtain a 24-hour urine
specimen.
43
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Describe the correct techniques to use in physically assessing the renal
system.
Describe the clinical manifestations of cystitis.
Compare and contrast the pathophysiology of stress, urge, overflow,
mixed, and functional incontinence.
Describe actions, side effects, and nursing implications for the
management of a urinary tract infection with sulfonamide and
fluoroquinolone antibiotics.
Explain the drug therapy for different types of incontinence.
Develop a teaching plan for the client who must perform intermittent selfcatheterization for incontinence.
Describe the manifestation of urinary obstruction.
Describe the common manifestations of bladder cancer.
Develop a community-based teaching plan for continuing care of clients
who have a urinary diversion for bladder cancer.
Readings: Ignatavicius & Workman, Chapters 72, 73, 78, & 79
Content/Pharmacology Worksheet #13 is due
44
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
December 5, 2008
Phyllis Swift, MS, APRN
Endocrine System
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Describe the relationship between hormones and receptor sites.
Explain negative feedback as a control mechanism for hormone secretion.
Discuss the structure and function of the following endocrine glands:
hypothalamus, anterior and posterior pituitary glands, adrenal glands,
thyroid and parathyroid glands, and pancreas.
Identify laboratory tests that aid in determining endocrine function and
dysfunction.
Interpret and compare the common clinical manifestations associated with
specific endocrine functions or dysfunctions.
Interpret clinical changes and laboratory data to determine the
effectiveness of interventions.
Describe the mechanisms of action, side effects, and nursing implications
for pharmacologic management of each disease or dysfunction associated
with the endocrine system.
Develop a community based teaching plan for the client with a specific
endocrine dysfunction or associated disease.
Readings: Ignatavicius & Workman, Chapters 65, 66, & 67
Presentation #8 – Which Gland is causing the Problem?
Content/Pharmacology Worksheet #14 is due
45
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
December 9, 2008
Phyllis Swift, MS, APRN
Diabetes
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Compare the age of onset, clinical manifestations, and pathologic
mechanisms of type 1 and type 2 diabetes mellitus.
Explain the effects of insulin on carbohydrate, protein, and fat metabolism.
Evaluate laboratory data to determine whether the client is using the
prescribed dietary, medication, and exercise interventions for diabetes.
Discuss the dietary requirements of clients taking Humalog insulin before
meals.
Compare the mechanisms of action of the sulfonylureas, meglitinide
analogs, biguanides, alpha glycosidase inhibitors, and thiazolidinediones
as antidiabetic agents.
Explain the effect of hypertension on the development of diabetic
nephropathy and diabetic retinopathy.
Identify clients at risk for hypoglycemia.
Prioritize nursing interventions for the client with mild to moderate
hypoglycemia and moderate to severe hypoglycemia.
Identify clients at risk for diabetic ketoacidosis (DKA) and prioritize nursing
interventions for these clients.
Identify clients at risk for hyperglycemic-hyperosmolar nonketotic
syndrome (HHNS) and prioritize nursing interventions for them.
Describe correct techniques for mixing (or not mixing) and administering
each type of insulin.
Compare the clinical manifestations of hyperglycemia and hypoglycemia.
Perform foot assessment and foot care for the client with diabetes.
Readings: Ignatavicius & Workman, Chapters 64 & 68
46
Dixie State College
ADN Program
NURS 2100
Medical-Surgical Nursing II
December 12, 2008
Phyllis Swift, MS, APRN
Shock/Multiple Organ Failure/Critical Care
Class Objectives: Upon completion of the readings, assignments, and class
activities, the student will be able to:
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Identify clients at risk for septic shock.
Describe the clinical manifestations associated with the compensatory
mechanisms for shock.
Compare and contrast the three types of shock

Explain the use of intravenous therapy in the treatment of shock

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Evaluate the effectiveness of therapy for shock.
Describe the mechanisms of actions, side effects, and nursing
implications for pharmacologic management of shock.
Explain the rationale for the drug therapy for septic shock
Plan care for the client in the hyperdynamic stage of septic shock
Plan care for the client in the hypodynamic stage of septic shock
Identify those at risk for developing Multiple Organ Dysfunction
Syndrome (MODS)
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Readings: Ignatavicius & Workman, Chapter 40 & 41. The objectives should
help guide your reading
Content/Pharmacology Worksheet #15 is due
Exam 7 – begins December 12 and is available through December 15, 2008
in the testing center
Final Exam - TBA
47
SYLLABUS ATTACHMENTS
Core Pharmacology List
Web Sites
Pew Health Professions Commission Competencies
48
CORE PHARMACOLOGY LIST
CENTRAL NERVOUS SYSTEM (CNS) AGENTS
Opioid (Narcotic) Analgesics
morphine sulfate (Roxanol, MS Contin)
meperidine HCl (Demerol)
oxycodone (Percocet, Percodan)
hydrocodone (Vicodin, Lortab)
codeine sulfate (Tylenol #3)
fentanyl (Fentanyl, Duragesic)
methadone HCl (Dolophine)
Opioid (Narcotic) Antagonist
naloxone HCl (Narcan)
Non-opioid (Narcotic) Analgesics
acetaminophen (Tylenol)
tramadol hydrochloride (Ultram)
Anesthetic Agents
propofol (Diprivan)
etomidate (Amidate)
Local Anesthetic Agents
lidocaine (Xylocaine)
Neuromuscular Blocking Agents
succinylcholine (Anectine)
CNS Depressants
temazepam (Restoril)
midalozam (Versed)
zolpidem (Ambien)
Anti-Epileptic Agents
phenobarbitol (Solfoton)
carbamazepine (Tegretol)
clonazepam (Klonipin)
gabapentin (Neurotin)
phenytoin (Dilantin)
valproic acid (Depakote, Depakene)
49
Anti-Parkinsonian Agents
selegiline (Eldepryl)
levodopa-carbidopa (Sinemet)
entacapone (Comtan)
Anti-Anxiety agents
alprazolam (Xanax)
lorazepam (Ativan)
diazepam (Valium)
chlordiazepoxide (Librium)
buspirone (Buspar)
clonazepam (Klonipin)
Anti-Manic Agents
lithium (Eskalith)
Anti-Depressants
Selective Serotonin Reuptake Inhibitors (SSRI’s)
fluoxetine (Prozac)
sertaline (Zoloft)
citalopram (Celexa)
Second & Third Generation Anti-Depressants
buproprium (Wellbutrin)
venlafaxine (Effexor)
mirtazapine (Remeron)
Tricyclic Anti-Depressants
amitriptyline (Elavil)
Monoamine Oxidase Inhibitors
phenelzine (Nardil)
Anti-Psychotics
chlorpromazine (Thorazine)
haloperidol (Haldol)
Atypical Anti-Psychotics
risperidone (Risperdal)
olanzapine (Zyprexa)
ziprasidone (Geodon)
CNS Stimulants
caffeine (No-Doz, Vivarin)
methyphenidate HCl (Ritalin, Concerta)
50
Serotonin Agonist
sumatriptan (Imitrex)
AUTONOMIC NERVOUS SYSTEM AGENTS
Adrenergic Agents
epinephrine (Adrenalin)
dopamine (Intropin)
pseudoephedrine (Sudafed, Afrin)
Adrenergic-Blocking Agents
Alpha-Blockers
ergotamine tartrate (Ergostat)
Beta-Blockers
atenolol (Tenormin)
carvedilol (Coreg)
metoprolol (Lopressor, Toprol XL)
propranolol (Inderal)
Cholinergic Agents
donepezil (Aricept)
Cholinergic-Blocking Agents
atropine
dicyclomine (Bentyl)
tolterodine (Detrol)
CARDIOVASCULAR AGENTS
Positive Inotropic Agents
digoxin (Lanoxin)
nesiritide (Natrecor)
Anti-Dysrhythmic Agents
Class I Anti-Dysthythmic Agents
lidocaine (Xylocaine)
Class II Anti-Dysthythmic Agents (Beta-Blockers)
metoprolol (Lopressor, Toprol XL)
sotalol (Betapace)
Class III Anti-Dysthythmic Agents
Amiodarone (Cordarone, Pacerone)
51
Class IV Anti-Dysthythmic Agents (Calcium Channel Blockers)
diltiazem (Cardiazem)
verapamil (Calan, Verelan)
Unclassified Agents
adenosine (Adenocard)
Anti-Anginal Agents
Nitrates & Nitrites
nitroglycerin (Nitro-Bid, Nitrostat)
Beta-Blockers
metoprolol (Lopressor)
Calcium Channel Blockers
diltiazem (Cardiazem)
nifedipine (Procardia)
verapamil (Calan, Verelan)
Anti-Hypertensive Agents
Adrenergic Agents
clonidine (Catapres)
Angiotensin Converting Enzyme (ACE) Inhibitors
lisinopril (Prinivil, Zestril)
enalapril (Vasotec)
Angiotensin II Receptor Blockers (ARB’s)
losartan (Cozaar)
valsartan (Diovan)
Calcium Channel Blockers
(Same agents used for angina, dysrhythmias)
Vasodialors
hydralazine HCl (Apresoline)
minoxidil (Loniten)
DIURETICS
Loop Diuretics
furosemide (Lasix)
52
Osmotic Diuretics
mannitol (Osmitrol)
Potassium Sparing Diuretics
spironolactone (Aldactone)
Thiazide & Thiazide-Like Diuretics
hydrochlorothiazide (HCTZ, HydroDIURIL)
metolazone (Zaroxylyn)
FLUIDS & ELECTROLYTES
Crystalloids
0.9% sodium chloride (Normal Saline, NS)
Lactated ringers (LR)
5% Dextrose (D5W)
Colloids
albumin (Albuminar)
hetastarch (Hespan)
Blood Products
fresh frozen plasma (FFP)
packed red blood cells (PRBC’s)
Potassium Agents
potassium (KCl, K-Dur, Micro K)
sodium polystyrene sulfonate (Kayexalate)—Potassium binding agent
COAGULATION MODIFIER AGENTS
Anti-Coagulants
heparin
enoxaparin (Lovenox)
warfarin (Coumadin)
Anti-Coagulant antagonists
Vitamin K
Protamine
Anti-Platelet Agents
aspirin (ASA)
clopidogrel (Plavix)
53
Thrombolytic Agents
streptokinase (Streptase)
alteplase (Activase)
ANTI-LIPEMIC AGENTS
HMG-CoA Reductase Inhibitors (Statins)
atorvastatin (Lipitor)
simvastatin (Zocor)
Fibric Acid Derivatives
gemfibrozil (Lopid)
Cholesterol Absorption Inhibitor
ezetimibe (Zetia)
ENDOCRINE AGENTS
Pituitary Agents
vasopressin (Pitressin)
somatrem (Protropin)
corticotrophin (Acthar)
Thyroid Agents
levothyroxine (Levoxyl, Synthroid)
Anti-Thyroid Agents
propythiouracil (PTU)
Insulins
Rapid-Acting Insulins
insulin lispro (Humalog)
insulin aspart (NovoLog)
Short-Acting Insulin
regular (Humulin R, Novolin R)
Intermediate-Acting Insulin
insulin NPH (Humulin N, Novolin N)
Long-Acting Insulins
insulin glargine (Lantus)
54
Fixed Combination Insulins
insulin regular/NPH (Humulin 70/30)
insulin lispro protamine suspension/insulin lispro (Humalog 75/25)
Oral Anti-Diabetic Agents
Sulfonylurea Agents
glipizide (Glucotrol)
glimepiride (Amaryl)
Biguanide
metformin (Glucophage)
Thiazolidinedione
rosiglitazone (Avandia)
Alpha-Glucosidase Inhibitor
acarbose (Precose)
Glucose Elevating Agent
glucagon
Adrenal Agents
Glucocorticoids
prednisone (Deltasone, Solu-Medrol)
dexamethasone (Decadron)
Mineralcortacoid
fludrocortisone (Florinef)
WOMEN’S HEALTH AGENTS
Estrogens
estrogen (Premarin)
Progestins
medroxyprogesterone (Provera, Depo-Provera)
Contraceptive Agents
norethindone/ethinyl estradiol (Ortho-Novum)
55
Anti-Osteoporosis Agents
alendronate (Fosamax)
raloxifene (Evista)
Labor & Delivery/ Postpartum Agents
magnesium sulfate
oxytocin (Pitocin)
methylergonovine (Methergine)
terbutaline (Brethine)
MEN’S HEALTH AGENTS
finasteride (Propecia, Proscar)
sildenafil (Viagra)
RESPIRATORY AGENTS
Anti-Histamines
diphenhydramine (Benadryl)
loratadine (Claritin)
Decongestants
pseusoephedrine (Sudafed)
oxymetazoline (Afrin)
Anti-Tussives
dextromethorphan (Combination products, such as Vicks, Robitussin DM)
Expectorants
guaifenesin (Guiatuss, Humibid, Robitussin)
Bronchodilators
Xanthines
theophylline (Aminophylline, Theo-Dur)
Beta-Adrenergic Agonists
albuterol (Proventil)
salmeterol (Serevent)
epinephrine (Adrenalin)
Anti-Cholinergic Agents
ipratropium bromide (Atrovent)
Anti-Leukotriene Inhibitors
montelukast (Singulair)
56
Inhaled Corticosteroids
Fluticasone (Flovent)
Mast Cell Stabilizers
cromolyn (Intal)
Combination Inhalers
fluticasone/salmeterol (Advair)
albuterol/ipratropium bromide (Combivent)
GASTRO-INTESTINAL AGENTS
Acid-Controlling Agents
Antacids
calcium carbonate (TUMS)
aluminum & magnesium hydroxide (Maalox & Mylanta)
H2 Antagonists
famotidine (Pepcid)
cimetidine (Tagamet)
Proton Pump Inhibitors (PPI’s)
omeprazole (Prilosec)
lanzoprazole (Prevacid)
Anti-Diarrheal Agents
loperamide (Imodium)
Laxatives
Emollient Laxatives
docusate sodium (Colace, Surfak)
Bulk-Forming Laxatives
Psyllium (Metamucil)
Hyperosmotic Laxatives
Polyethylene glycol (GoLYTELY, MiraLax)
ANTI-EMETIC AGENTS
Pro-Kinetic Agents
metoclopramide (Reglan)
57
Serotonin Blockers
ondansetron (Zofran)
Neuroleptic Agents
promethazine (Phenergan)
VITAMINS & MINERALS
vitamin K (AquaMEPHYTON)
vitamin B9 (folic acid)
vitamin B3 (niacin)
vitamin B12 (cyanocobalamin)
ferrous fumarate (Feostat)
iron dextran (InFeD)
ANTI-INFECTIVES
Antibiotics
Sulfonamides
sulfamethoxazole/trimethoprim (Bactrim, Septra DS)
Penicillins
penicillin G/V (Pen Vee K)
amoxicillin (Amoxil)
ampicillin/clavulanic acid (Augmentin)
Cephalosporins
cephalexin (Keflex)
cefazolin (Ancef, Kefzol)
ceftriaxone (Rocephin)
Macrolides
erythromycin (E-mycin, Eryc)
azithromycin (Zithromax)
Tetracyclines
doxycycline (Vibramycin)
Aminoglycosides
gentammicin (Garamycin)
Fluoroquinolones
ciprofloxacin (Cipro)
levofloxacin (Levaquin)
58
Miscellaneous Antibiotics
metronidazole (Flagyl)
nitrofurantoin (Macrodantin)
vancomycin (Vancocin)
clindamycin (Cleocin)
Anti-Viral Agents
acyclovir (Zovirax)
zidovudine (Retrovir, AZT)
Anti-Tubercular Agents
isoniazid (INH)
Anti-Fungal Agents
fluconazole (Diflucan)
lotrimazole (Lotrimin)
Anti-Malarial Agents
primaquine
Anti-Protozoal Agents
metronidazole (Flagyl)
Antihelmintic Agents
mebendazole (Vermox)
MUSCULOSKELETAL AGENTS
Non-Steroidal Anti-Inflammatory Agents (NSAID’s)
aspirin (ASA)
Ibuprofen (Advil, Motrin)
ketolorac (Toradol)
celecoxib (Celebrex)
Muscle Relaxants
cyclobenzaprine (Flexeril)
Anti-Gout Agents
allopurinol (Zyloprim)
IMMUNE & BIOLGOIC MODIFIERS, ANTI-NEOPLASTIC AGENTS
Immunosuppressant Agents
azathioprine (Imuran)
cyclosporine (Sandimmune)
59
Immunizing Agents
diphtheria, tetanus, acellular pertussis (DtaP)
diphtheria, tetanus (DT)
measles, mumps, rubella (MMR II)
hepatitis B (Recombivax HB)
Rho(D) immune globulin (RhoGAM)
Anti-Neoplastic Agents
methotrexate (Folex PFS, Rheumatrex)
tamoxifen (Nolvadex)
Immunomodulating Agents
epoetin alfa (Epogen, Procrit)
filgrastim (Neupogen)
Dermatologic Agents
isotretonoin (Accutane)
hydrocortisone 1% (Cortisporin)
OPTHALMIC & OTIC AGENTS
pilocarpine (Pilopine)
imolol (Timpoptic)
latanoprost (Xalatan)
hydrocortisone, neomycin, polymixin B (Corticosporin Otic)
This list is subject to revision
60
WEB SITES
Pharmacology:
www.drugguide.com
www.genrx.com (Top 200 prescribed drugs)
Evidenced-based practice reviews and protocols:
www.cochrane.org (Cochrane Library and database)
Health promotion:
www.health.gov/healthypeople (latest updates and documents on Healthy
People 2010)
Nursing journals:
www.nursingcenter.com/journals (Online access to Lippincott Nursing Center
and several nursing journals)
Dermatology:
www.dermis.net (great online photographs of dermatology disorders)
General:
www.cdc.gov (Centers for Disease Control web site, latest information on
statistics, treatment, etc of communicable diseases)
www.medscape.com (one of the best online sources for medical information)
www.medal.org (over 1600 computations, formulas, surveys, tables spanning
major medical domains)
Any of the consumer oriented Web sites sponsored and maintained by well
known consumer organizations, e.g. American Diabetes Association, American
Heart Association, are great sources of medical information helpful to consumers
and health care providers.
61
Pew Health Professions Commission
Twenty-one Competencies for the Twenty-First Century
The twenty-one competencies are widely recognized for their identification of the
competencies that are relevant to contemporary and future nursing practice in
response to current and evolving health care needs. The National League for
Nursing Accrediting Commission supports the Pew Health Professions
Commission competencies in providing direction for curriculum development in
nursing programs and in embracing the concept of lifelong learning for nurses.
The twenty-one competencies are congruent with and strengthen the Dixie State
College nursing program curriculum model and conceptual framework (“fruit
tree”) as well as support the learning objectives of this course.
The twenty-one competencies are:
1. Embrace a personal ethic of social responsibility and service.
2. Exhibit ethical behavior in all professional activities.
3. Provide evidence-based, clinically competent care.
4. Incorporate the multiple determinants of health in clinical care.
5. Apply knowledge of the new sciences.
6. Demonstrate critical thinking, reflection, and problem-solving skills.
7. Understand the role of primary care.
8. Rigorously practice preventive health care.
9. Integrate population-based care and services into practice.
10. Improve access to health care for those with unmet health needs.
11. Practice relationship-centered care with individuals and families.
12. Provide culturally sensitive care to a diverse society.
13. Partner with communities in health care decisions.
14. Use communication and information technology effectively and
appropriately.
15. Work in interdisciplinary teams.
16. Ensure care that balances individual, professional, system and societal
needs.
17. Practice leadership.
18. Take responsibility for quality of care and health outcomes at all levels.
19. Contribute to continuous improvement of the health care system.
20. Advocate for public policy that promotes and protects the health of the
public.
21. Continue to learn and help others learn.