Arkansas Northeastern College
Associate Degree Nursing
Course Syllabus
Course Title:
Physiologic Adaptation II
Course Number:
NU 26035
Course Prerequisites:
Survey of Chemistry or General Chemistry I/Lab
Math for Health Sciences or College Algebra
Anatomy & Physiology I/Lab
Anatomy & Physiology II/Lab
Sociology or Marriage & Family
General Psychology
Computer Fundamentals
English Composition I
English Composition II
Microbiology/Lab
Introduction to Nursing Intervention/LPN to RN Transition
Psychosocial Adaptation
Adaptation in the Child-Bearing Years
Physiologic Adaptation I
Adaptation in Early Developmental Years
Course Description:
This course focuses on the signs and symptoms of altered functions of an organ or
system for the purpose of recognizing coping responses designated to maintain integrity
of the internal environment. The course includes nursing theory basic to diagnosis,
planning, intervention, and evaluation of client care. The clinical component is designed
to provide integration of nursing theory with clients experiencing moderate to complex
interruption in adaptative modes.
Required Textbooks
And Equipment:
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner &
Suddarth’sTextbook of Medical-Surgical Nursing (12th ed.) Philadelphia, PA: Lippincott
Williams & Wilkins
Boyer, M. (2010). Study Guide to Accompany Brunner & Suddarth’s Textbook of MedicalSurgical Nursing(12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins
Jones, S. (2008). ECG Success: Exercises in ECG Interpretation. Philadelphia, PA: F.A.
Davis Company
Hayes, E.R., Kee, J.L., & McCuistion, L.E. (2009). Pharmacology: A Nursing Process
Approach, (6th ed.). Philadelphia, PA: WB Saunders Co.
Hayes, E.R., Kee, J.L., & McCuistion, L.E. (2009). Pharmacology: A Nursing Process
Approach Study Guide, (6th ed.). Philadelphia, PA: WB Saunders Co.
1
Taylor, C.M., & Sparks, S.M. (2005). Nursing Diagnosis and Reference Manual, (5th ed.).
Hagertown, Maryland: Lippincott, Williams, & Wilkins.
Current Edition of The Davis Drug Guide
Davis’s Q & A for the NCLEX-RN Examination – F. A. Davis
PrepU access code that accompanies Brunner & Suddarth’s Textbook of Medical-Surgical
Nursing (12th ed.) Philadelphia, PA: Lippincott Williams & Wilkins
Any current Laboratory & Diagnostic Guide
Nutrition for Nursing ATI Review Module Edition 4.0
RN Adult Medical-Surgical Nursing ATI Review Module Edition 8.0
Pharmacology for Nursing RN ATI Review Module Edition 5.0
Stethoscope, penlight, scissors
Rationale:
The goal of this course is to expand knowledge related to nursing concepts previously
learned and initiate the development and utilization of new ideas. To be a successful
nurse, one must be able to understand and apply scientific principles, to practice nursing
care safely, and to clearly communicate with a variety of patients in an empathetic,
warm, and honest manner. Objectives will be accomplished through learning activities.
Course Objectives:
Classroom Objectives
Upon completion of this course the student will be provided the opportunity to:
 Critically analyze the human response to pathophysiological disorders recognizing
the signs and symptoms of disease processes in order to differentiate normal from
abnormal responses as related to the cardiovascular system.
 Critically analyze the human response to pathophysiological disorders recognizing
the signs and symptoms of disease processes in order to differentiate normal from
abnormal responses as related to the respiratory system.
 Critically analyze the human response to pathophysiological disorders recognizing
the signs and symptoms of disease processes in order to differentiate normal from
abnormal responses as related to the neurologic system.
 Critically analyze the human response to pathophysiological disorders recognizing
the signs and symptoms of disease processes in order to differentiate normal from
abnormal responses as related to the musculoskeletal system.
 Identify specific nutritional alterations associated with the disease processes as
discussed in this course.
 Identify specific ethnic, cultural, and socially diverse considerations for clients with
the above diseases from a regional, national, and global perspective.
Clinical Objectives
The student will be expected to and evaluated on the following:
 Support optimal adaptation of ill clients in acute, critical care, emergency, and
community care settings with consideration of physical, psychosocial, spiritual,
cultural and family needs.
 Evaluate the effectiveness of selected therapeutic interventions that promote or
restore health as related to a specific disease process.
 Demonstrate self-direction in personal and professional growth by making accurate
decisions based on current trends in health care and collaboration among health
care disciplines.
 Demonstrate leadership in professional and collaborate behaviors of the associate
nurse as a member of the health team.
 Utilize therapeutic communication skills during interactions with others to establish,
2




maintain or restore interpersonal relationships and to gather and transmit pertinent
information in a collaborative environment.
Utilize the professional nurse’s role in assessment, problem identification, planning,
implementation, evaluation and revision of the nursing care for clients with
problems of the above disease processes.
Utilize the nursing process to incorporate scientific principles with critical thinking
skills necessary for development of therapeutic interventions that are safe and
appropriate within the scope of nursing practice.
Demonstrate proficiency in calculating drug dosages for medication administration
and relate pharmacological therapy to illnesses.
Apply teaching learning principles in providing nutritional guidance and
interventions related to selected disease processes.
Unit and Instructional Objectives:
Unit 1: Cardiovascular System Dysfunction
Unit Objectives:
On completion of this learning activity, and participation in lecture/discussion, the
student will be provided the opportunity to:
 Discuss cardiac physiology in relation to cardiac anatomy, blood flow and the
conduction system.
 Incorporate assessment of health behaviors and cardiac risk factors into the history
and physical assessment, and the cultural, ethnic, and social diversity of clients with
cardiovascular disorders.
 Identify various diagnostic tests and nursing implications related to procedures used
for assessment and management of clients with cardiovascular disorders.
 Compare central venous pressure, pulmonary artery monitoring and intra-arterial
pressure monitoring with regard to clinical usefulness, complications and nursing
responsibilities.
 Correlate the components of the normal ECG with physiologic events of the heart.
 Define ECG waveform related to electrode placement and cardiac monitoring.
 Analyze elements of a rhythm strip including calculating atrial and ventricular rate,
P wave, PR interval, QRS duration, ST segment and T wave.
 Identify criteria, causes, diagnosis and management of various dysrhythmias,
especially those that result in or predispose the client to sudden death or
hemodynamic instability.
 Compare types of pacemakers and their utilization for controlling heart blocks.
 Describe key points for use of a cardiac defibrillator, automated external
defibrillator (AED) and implantable cardioverter defibrillator (ICD).
 Use the nursing process as a framework for care of the client with a dysrhythmia.
 Describe the pathophysiology, clinical manifestations, and treatment of coronary
atherosclerosis, including pharmacologic treatment.
 Describe the pathophysiology, clinical manifestations, and treatment, including
pharmacologic treatment, of angina pectoris.
 Describe the pathophysiology, clinical manifestations, and treatment of myocardial
infarction, including pharmacologic treatments calculated on client’s weight.
 Use the nursing process as a framework of care for clients with coronary artery
disease, angina or myocardial infarction (acute coronary syndromes).
 Describe nursing implications related to invasive interventional procedures for
3



























treatment or diagnosis of heart or coronary disorders.
Describe treatment modalities for coronary revascularization and nursing
implications for caring for clients who have undergone these procedures.
Define cardiac valvular disorders and discuss pathophysiology, clinical
manifestations and management of clients, including pharmacology, with mitral and
aortic valvular disorders.
Describe procedures and treatments used to treat valvular problems.
Use the nursing process as a framework for care of clients with valvular disorders or
repair.
Describe the pathophysiology, clinical manifestations and management of clients
with cardiomyopathies, including pharmacologic and nutritional management.
Describe the pathophysiology, clinical manifestations, and management of clients
with cardiac infections, including calculation of medications according to client
weight.
Describe the rationale for prophylactic antibiotic therapy for clients with valvular
disease, infective or rheumatic endocarditis, and myocarditis and nursing
implications for prevention of complications.
Describe the clinical manifestations and management, including pharmacologic and
nutritional management, of chronic heart failure.
Differentiate between chronic and acute heart failure.
Describe nursing and medical management, including pharmacologic management,
of cardiogenic shock.
Know the correct procedures for basic cardiopulmonary support and resuscitation
(CPR).
Describe management and nursing implications related to clients who experience
thromboembolic episodes, pericardial effusion, cardiac tamponade, and myocardial
rupture.
Use the nursing process as a framework for care of clients, including but not limited
to nutritional changes, pharmacologic changes, and education topics associated
with heart failure or shock.
Develop culturally sensitive teaching plans for clients with heart failure.
Identify anatomic and physiologic factors that affect peripheral blood flow and
tissue oxygenation.
Use appropriate parameters for assessment of peripheral circulation.
Compare various diseases of the arteries, causes, clinical manifestations,
management and prevention.
Describe prevention and management of venous thrombosis.
Compare preventive management of venous insufficiency, leg ulcers and varicose
veins.
Describe the relationship between lymphangitis and lymphedema.
Use the nursing process as a framework for care of the client with peripheral
vascular disease.
Define blood pressure and identify risk factors for hypertension.
Discuss the significance of control of hypertension including culturally sensitive
client education.
Describe pharmacologic treatment and medical management of hypertensive crisis.
Describe treatment approach for hypertension including behavioral changes and
medication therapy.
Use the nursing process as a framework for care of the client with hypertension.
Interpretation of normal and abnormal ECG rhythms and common ECG lead
4
placement used for continuous cardiac monitoring.
Unit 2: Nervous System Dysfunction and Musculoskeletal System
Upon completion of this learning activity, and participation in lecture/discussion, the
student will be provided the opportunity to:
 Describe the major structural and functional components of the central and
peripheral nervous system.
 Differentiate between pathologic changes that affect motor and sensory activity.
 Compare the functioning of the sympathetic and parasympathetic nervous systems.
 Describe the significance of physical assessment as it relates to the ethnic, cultural,
and social diversity of a diagnosis of neurological dysfunction.
 Describe age-related changes in the neurological system and how these relate to
neurological assessment.
 Describe neurologic diagnostic tests used for assessment and diagnosis of
neurological disorders and related nursing implications.
 Describe special nursing needs of clients with various neurological disorders.
 Describe the multiple needs of clients with altered levels of consciousness.
 Identify early and late manifestations of increased intracranial pressure.
 Describe the needs of clients undergoing intracranial of transsphenoidal surgery.
 Identify various types and causes of seizures.
 Use the nursing process to develop a culturally sensitive plan of care for the client
experiencing seizures.
 Identify the needs of clients experiencing headaches and develop a plan of care
using appropriate medication and dosages based on client weight.
 Use the nursing process as a framework for care of clients with various neurological
disorders.
 Describe the incidence and social impact of cerebrovascular disorders. Identify risk
factors and preventive measures for cerebrovascular disorders.
 Compare various types of cerebrovascular disorders, their causes, clinical
manifestations and medical management.
 Using the nursing process, relate concepts of nursing management to the care of
clients in the acute and recovery stages of ischemic stroke.
 Use the nursing process as a framework for care of a client with a cerebral
aneurysm.
 Identify essential elements of client and family teaching and preparation for home
care of the stroke patient.
 Differentiate among clients with head injuries according to mechanism of injury,
clinical signs and symptoms, diagnostic testing, and treatment options.
 Identify the population at greatest risk for spinal cord injury.
 Describe three clinical features of clients with neurogenic shock.
 Discuss pathophysiology of autonomic dysreflexia and describe appropriate nursing
interventions.
 Use the nursing process as a framework for care of clients with brain, head, or
spinal cord injuries.
 Differentiate among diseases of the nervous system according to causes,
manifestations, medical care and nursing management.
 Describe the pathophysiology, clinical manifestations, and medical management of
multiple sclerosis, Myasthenia Gravis and Guillian-Barre syndrome.
 Describe disorders of the cranial nerves and their clinical manifestations.
5





























Use the nursing process as a framework for nursing care of clients with multiple
sclerosis, Myasthenia Gravis and Guillian-Barre syndrome, and cranial nerve
disorders.
Identify the pathophysiologic process responsible for oncologic and degenerative
neurological disorders.
Describe brain and spinal cord tumors, their classification, clinical manifestations,
diagnosis and medical and nursing management.
Use the nursing process as a framework for care of clients with cerebral metastasis,
inoperable brain tumors and neurological degenerative disorders.
Identify resources for clients and their families with oncologic and degenerative
neurological disorders.
Describe the anatomy and physiology of the musculoskeletal system.
Discuss the significance of health history and physical assessment, incorporating
cultural, ethnic, and social diversity in relation to the assessment of musculoskeletal
health.
Specify diagnostic tests used for assessment of musculoskeletal function.
Describe physical assessment of the musculoskeletal system.
Describe teaching needs for a client with a cast and develop a culturally sensitive
plan of care.
Describe various types of traction and principles of effective traction.
Compare the nursing needs of the client undergoing total hip or total knee
replacement.
Use the nursing process as a framework for care of the clients with casts, traction or
orthopedic surgery.
Use the nursing process as a framework for care of clients with low back pain.
Describe various types of traction and principles of effective traction.
Compare the nursing needs of the client undergoing total hip or total knee
replacement, including pharmacologic needs according to weight dosage
calculation.
Use the nursing process as a framework for care of the clients with casts, traction or
orthopedic surgery.
Use the nursing process as a framework for care of clients with low back pain.
Describe the rehabilitation and health education needs of the client with low back
pain.
Describe conditions affecting the upper extremities and nursing care of the client
undergoing surgery on the hand or wrist.
Use the nursing process as a framework for nursing care of the client undergoing
foot surgery.
Explain the pathophysiology, prevention and management, including pharmacologic
management, of osteoporosis.
Identify the etiology and medial management of osteomalacia.
Describe the medication therapy program for clients with Paget’s disease.
Use the nursing process as a framework for care of clients with osteomyelitis or
bone tumors.
Differentiate between contusions, strains, sprains and dislocations.
Describe selected sports injuries and their nursing management.
Specify clinical manifestations and emergency management of the client with a
fracture.
Describe principles and methods of fracture reduction, immobilization and
management of open fractures.
6






Describe prevention and management of immediate and delayed complications of
fractures.
Describe the pathophysiology, clinical manifestations and management of clients
with bone infections.
Use the nursing process as a framework for care of the client with a simple fracture.
Will be able to identify special needs of the elderly who have experienced fractures
of other musculoskeletal disorders.
Describe the rehabilitative and health education needs of the client who has had an
amputation.
Use the nursing process as a framework for care of clients with amputations.
Unit 3: Respiratory Function






















Upon completion of this learning activity, and participation in lecture/discussion,
the student will be given the opportunity to:
Describe the structures and functions of the upper and lower respiratory tracts.
Describe ventilation, perfusion, shunting, and the relationship of pulmonary
circulation to these processes.
Discriminate between normal and abnormal breath sounds.
Use assessment parameters appropriate for determining the characteristics and
severity of major symptoms of respiratory dysfunction.
Identify the nursing implications of various procedures used for diagnostic
evaluation of respiratory function.
Describe the nursing management, in relation to cultural, ethnic, and social diversity
of clients with upper respiratory disorders.
Compare and contrast various respiratory disorders in regard to cause, incidence,
clinical manifestations, nursing and medical management and prevention.
Describe the nursing management of the client with epistaxis.
Use the nursing process as a framework for care of the client with respiratory
infections, including pharmacologic and nutritional needs.
Use the nursing process as a framework for care of the client undergoing a
laryngectomy.
Identify clients at risk for atelectasis and nursing interventions related to prevention
and management.
Compare various pulmonary infections related to cause, clinical manifestations,
complications, nursing management and prevention.
Relate pleurisy, plural effusion and empyema to pulmonary infection.
Describe the relation between smoking and air pollution to pulmonary disease.
Discuss the pathophysiology of acute respiratory distress syndrome and related
therapeutic management.
Describe risk factors for and prevention of pulmonary embolus.
Describe preventive measures for controlling and eliminating occupational lung
disease.
Describe various modalities used in the treatment of lung cancer.
Describe the complications of chest trauma, clinical manifestations and nursing and
medical management.
Describe education and preventive nursing measures related to aspiration.
Use the nursing process as a framework for nursing care of the client with
pulmonary disorders.
Describe the pathophysiology and risk factors related to the development of chronic
7













obstructive lung disease (COPD).
Describe education and nursing interventions to minimize or eliminate these risk
factors.
Use the nursing process as a framework for care of the client with COPD.
Develop a teaching plan for a client with COPD.
Describe the pathophysiology, medical management, including pharmacologic, and
self-management strategies for a client with asthma.
Describe the pathophysiology of cystic fibrosis. Describe nursing management for
clients receiving oxygen therapy, intermittent positive-pressure breathing, mininebulizer therapy, incentive spirometry, chest physiotherapy and breathing
retraining.
Describe education and home care considerations for clients receiving oxygen
therapy and develop a culturally sensitive plan of care.
Describe nursing implications for care of the client with an endotracheal tube or a
tracheostomy.
Demonstrate correct tracheal suctioning.
Describe the process of weaning a client from mechanical ventilation.
Describe the significance of preoperative teaching for a client who is to have
thoracic surgery.
Explain the concepts related to chest drainage and nursing implications for care of a
client with a chest tube.
Describe education and home care considerations for clients who have undergone
thoracic surgery.
Use the nursing process as a framework for clients who are experiencing respiratory
disorders or procedures.
Course Requirements, Evaluation, and Assessment Methods:
1. Grading:
Grades are calculated based on a percentage of the following categories:
Unit Exams
50%
Comprehensive Final Exam
25%
Students must achieve an 80% on Unit Exams and Final prior to having other assignments and
ATI scores averaged into the grade.
Health Assessment with Nursing Diagnoses (1 physiological/1 psychosocial)
& other written work
20%
ATI Assessment
5%
Total
100%
Students achieving an 80% or greater in units exams and course final must maintain the 80%
average once other assignments and ATI scores are calculated into the grade to pass the course.
*Students must achieve 80% average on unit exams (50%) and the final exam (25%) as
stipulated to pass the course and before including the ATI and other assignments (25%) in the
overall final grade.
8
1. Grading Scale:
100-91
90- 85
84 - 80
79- 70
Below 69
A
B
C
D
F
2. Clinical/laboratory Grading:
The clinical portion of the course is based on a pass/fail basis and is composed
of satisfactory performance of nursing care in the hospital/clinical setting and
satisfactory active participation in clinical conferences. An overall score of 80%
(.80) must be achieved to pass the clinical component. Any student with 3
criteria behavior deficiencies will fail the course.
Reviewed/Revised 1/12
9