Los Angeles Pierce College Nursing 402 Class Schedule and Topics Spring 2016 Unit Week Date 1 1 2 2/10/16 2/17/16 Content and Key Concepts MATH REVIEW AND THE NURSING PROCESS IN MEDICATION ADMINISTRATION A. Introduction; Measurements and Conversions Key Points: 1. Determining relative value. 2. Multiplication of decimal fractions and placement of the decimal point. 3. Use of zeros for correct placement of a decimal point. 4. Simplifying fractions for division. 5. Principles of “rounding.” 6. Solving equations with multiple fractions. 7. Finding common denominators. 8. Eliminating zeros from numerators and denominators without changing equation value. 9. Basic units of metric measure and their abbreviations. 10. Application of prefixes to basic metric units for larger and smaller units. 11. Conversion of units within the metric system by decimal point movement. 12. Proper transcription of fractional dosages. 13. Premise of international unit measurement. 14. Meaning of percentage strength of solutions and ointments. 15. Equivalencies of metric and household measures. 16. Comparison of prescription and over-the-counter drugs. 17. The “black box warning.” 18. Therapeutic and pharmacologic classifications of drugs. 19. Classification of therapeutic agents: drugs, biologics, CAM. 20. Use of generic vs brand-name drugs. 21. Concepts of abuse, dependency, and therapeutic us of schedule I-V in the United States. B. Ratio and Proportion; Formula Method of Calculation; Drug Administration; Pharmacokinetics and Pharmacodynamics Key Points: 1. Application of ratio and proportion in medication dosage and Reading Activities Due Curren Chapters 1-5 Due today: Adams, Holland, & Urban Chapters 1-2 Syllabus Acknowledgment form Refer to Syllabus Course Objectives 2, 3, 7 Homework 1 Reading Quiz Curren Chapters 12 and 14 Due today: Homework 2 2, 3, 7 Adams, Holland, & Urban Chapters 3-5 23 administration. Identifying known and unknown ratios for medication calculation. 3. Principles of placing (“setting up”) ratios in proportion for solving. 4. Selecting the appropriate method for solving medication administration problems. 5. Scope of the Nurse’s responsibilities in medication knowledge and administration. 6. The “Rights” and “checks” of drug administration. 7. Routes of drug administration and associated techniques and precautions. 8. Adverse events and effects associated with drug administration 9. Adverse drug effects and the older adult. 10. Pharmacokinetics vs pharmacodynamics. 11. Onset, peak plasma level, and plasma half-life. 12. Potency and efficacy 13. Loading dose vs maintenance dose. 14. Agonists vs antagonists. Oral and Parenteral Medication Labels; Principles of Safe Medication Administration; Syringe Use; Parenteral Dosage Calculation; Drug Reconstitution; The Nursing Process; Medication Errors Key Points: 1. Reading oral medication labels for single and combination drugs. 2. Oral syringes vs hypodermic syringes. 3. Tablet and capsule dosage calculation. 4. Reading parenteral medication labels. 5. Parenteral medication dosage calculation. 6. Calibration of 3ml, 5ml, 10ml, and TB syringes and syringes larger than 10ml. 7. Principles of reading calibrations on all syringes. 8. Common routes of parenteral medication administration. 9. Average volumes of IM and subcutaneous dosages. 10. Units of measure of parenteral medication dosages. 11. Principles of medication reconstitution. 12. Common forms of diluent. 13. Storage of a reconstituted solution. 14. Principles of reading reconstitution directions. 2. 3 2/24/16 C. Pertinent formulae: Reading Quiz X=DxQ H Or…. Str = Str Vol Vol Curren Chapters 6; 8-10 Adams, Holland, & Urban Chapters 6 and 7 Due today: Homework 3 2, 3, 7 Reading Quiz 24 4 3/2/16 5 3/9/16 6 3/16/16 2 15. How to label a reconstituted medication. 16. The Nursing Process in medication administration. 17. Reporting and documenting medication errors. 18. Strategies for reducing medication errors (QSEN). D. IV Therapy; IV Flow Rate Calculation; IV Infusion and Completion Times Key Points: 1. Parts of the IV infusion systems and their purposes. 2. Primary, secondary, peripheral, and central infusion lines. 3. Function of volume-controlled burettes. 4. Purpose of indwelling ports or locks. 5. Principles of patient-controlled analgesia. 6. Common IV fluids and their accepted abbreviations. 7. Common components of parenteral nutrition. 8. Calibration of IV administration sets. 9. Dimensional analysis method of flow rate calculation. 10. Method of regulating manual flow rate. 11. Principles of correcting off-schedule rates. 12. Calculation of infusion time. 13. Identification of completion time. 14. Concepts of labeling solution bags with infusion and completion times. 15. Psychosocial, cultural, ethnic, genetic, and gender influences on pharmacotherapy. 16. Challenges associated with the use of herbal and alternative therapies. 17. Pertinent patient teaching topics for the patient using CAM therapies. Unit 1 Exam Renal, Cardiovascular, Respiratory, Inflammation and Fever Pharmacology E. The Renal System; Fluid Balance; Acid-Base Balance Key Points: 1. Renal function, anatomy and physiology. 2. Classifications of renal failure. 3. Classifications of diuretics and indications for their use. 4. Common nephrotoxic drugs. 5. Common side effects of diuretics, patient assessment, and safety precautions (QSEN). 6. Normal role of electrolytes in maintaining homeostasis. 7. Major body fluid compartments. Curren Chapters 17-19 Adams, Holland, & Urban Chapters 9 and 10 Adams, Holland, & Urban Chapters 23 and 24 Due today: Homework 4 2, 3, 7 Reading Quiz Reading quiz 1, 4, 5, 6, 7 Determine focus medication groups 25 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 7 8 3/23/16 3/30/16 F. Signs, symptoms of electrolyte imbalance and appropriate corrective measures (QSEN). Osmolality, iso-, hypo- and hypertonicity, and osmosis. Indications for crystalloid and colloid IV therapy. Physiological role of electrolytes. Pharmacotherapy of hypernatremia and hyponatremia. Pharmacotherapy of hyperkalemia and hypokalemia. Normal pH maintenance in the healthy adult. Pharmacotherapy of acidosis and alkalosis. Focus medications: (1) furosemide; (2) HCTZ; (3) spironolactone; (4) dextran 40; (5) bumetanide; (6) potassium chloride; (7) sodium bicarbonate; (8) Kayexalate. Applications of Key Terms identified in topic chapters. The Cardiovascular System: Hypertension, Angina, and Myocardial Infarction 1. Basic components of heart function. 2. Classifications of hypertension. 3. Key points of JNC8 Guidelines. 4. Physiology of blood pressure regulation: preload and afterload. 5. Pathogenesis of hypertension. 6. Ethnic influences on hypertension. 7. Nonpharmacologic management of hypertension. 8. Major classifications of antihypertensive agents: diuretics, antiadrenergics, and vasodilators. 9. Pathogenesis of coronary artery disease, angina, and myocardial infarction. 10. Nonpharmacologic management of angina. 11. Categories of medications used to treat angina and administration precautions. 12. Definition and diagnosis of acute coronary syndrome. 13. Blood tests used in treatment of acute MI. 14. Pharmacologic goals for treating a patient with acute MI. 15. Indications for thrombolytic therapy in the treatment of MI. 16. Use of antiplatelet and anticoagulant drugs in the treatment of MI. 17. Focus medications: (1) enalapril; (2) losartan; (3) nifedipine; (4) atenolol; (5) hydralazine; (6) nitroglycerine; (7) heparin; (8) clopidogrel 18. Applications of Key Terms identified in topic chapters. No Class! Assign Focus Medication: Group Med 1 2 3 4 5 6 7 8 Adams, Holland, & Urban Chapters 25 and 27 Reading Quiz 1, 4, 5, 6, 7 Assign Focus Medication: Group Med 1 2 3 4 5 6 7 8 26 9 3/314/10/16 Spring Break! 10 4/13/16 G. The Respiratory System: Pulmonary Disorders Key Points: 1. Anatomy and physiology of the lower respiratory tract. 2. Ventilation vs respiration. 3. Regulation of bronchodilation and bronchoconstriction. 4. Methods of delivering inhaled medications, including benefits and precautions. 5. Pathophysiology of asthma. 6. Classifications of drugs for the treatment of asthma. Duration of medications within the β-adrenergic agonsist class. 8. Indications for the use of anticholinergic drugs for asthma. 9. Uses, precautions, and administration of methylxanthine drugs for asthma. 10. Use of corticosteroids for asthma. 11. Uses of leukotriene modifiers in the treatment of asthma. 12. Pathophysiology of COPD. 13. Goals of pharmacotherapy in the treatment of COPD. 14. Drugs used in the treatment of COPD. 15. Assessment and management points for the patient receiving pharmacotherapy for respiratory disorder. 16. Focus medications: (1) albuterol; (2) levalbuterol; (3) ipratroprium; (4) theophylline; (5) beclomethasone; (6) zafirlukast; (7) cromolyn; (8) acetylcystine (see chapter 38). 17. Applications of Key Terms identified in topic chapter. H. Inflammation, Fever, and Pain 1. Physiology of inflammation. 2. Nonpharmacologic treatments of inflammation. 3. Primary chemical mediators of inflammation. 4. Primary classifications of drugs used to treat inflammation. 5. Advantages and precautions in the use of oral, parenteral, and topical medications for the treatment of inflammation. 6. Mechanism of action of NSAIDs: COX-1 and COX-2. 7. Mechanism of action of corticosteroids compared to that of Adams, Holland, & Urban Chapter 39 4/20/16 1, 4, 5, 6, 7 Assign Focus Medication: Group Med 1 2 3 4 5 6 7 8 7. 11 Reading quiz Adams, Holland, & Urban Chapters 33 and 18 (pp 222234) Reading Quiz 1, 4, 5, 6, 7 Assign Focus Medication: Group Med 1 2 3 4 27 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 12 4/27/16 13 5/4/16 3 NSAIDs. Comparison of risks and benefits among anti-inflammatory drugs. Benefits and risks of fever. Common medications used to treat fever. Common medications that can cause drug-induced fever. Ethnic considerations in the use of acetaminophen. Classifications of pain. Description of the pain “process.” Nonpharmacologic techniques for treating pain. Major classifications of pain medication. Precautions with the use of opioids and management of toxicity, overdose, or dependence. Pain management combination products. Patient controlled analgesia. Focus medications: (1) aspirin; (2) ibuprofen; (3) acetaminophen; (4) prednisone; (5) celecoxib; (6) gabapentin; (7) morphine; (8) naloxone Applications of Key Terms identified in topic chapters. 21. Unit 2 Exam Bacterial Disease, Endocrine, and Gastrointestinal Disease Pharmacology I. Bacterial Disease Key Points: 1. Pathogenicity vs virulence. 2. Methods of classifying bacteria. 3. Methods of classifying antibiotics/antiinfectives. 4. The role of selective toxicity. 5. Potential actions of anti-infective drugs. 6. The phenomenon of acquired resistance. 7. The development of health care acquired infections. 8. The process of developing drug resistance. 9. Selection of an effective antibiotic. 10. Host factors that can influence antibiotic therapy. 11. Classifications of antibacterial drugs. 12. Mechanism of action, adverse effects, administration precautions of each antibacterial classification. 13. Nursing considerations regarding the elderly patient prescribed an antibiotic. 14. Unique pharmacotherapy considerations in treating the patient with tuberculosis. 15. Teaching points for the patient electing to use goldenseal as 5 6 7 8 Adams, Holland, & Urban Chapter 34 Reading Quiz 1, 2, 4, 5, 6, 7 Assign Focus Medication: Group Med 1 2 3 4 5 6 7 8 28 14 15 5/11/16 5/18/16 complementary or alternative therapy. 16. Focus medications: (1) amoxicillin-clavulanate; (2) cefazolin; (3) tetracycline; (4) erythromycin; (5) gentamycin; (6) ciprofloxacin; (7) trimethoprim-sulfamethoxazole; (8) isoniazid. 17. Application of Key Terms identified in topic chapter. J. The Endocrine System: Diabetes Key Points: 1. Various capacities of insulin syringes and associated applications. 2. Denotation of “-lin” and “-log” of specific insulin preparations. 3. Principles of mixing types of insulin (combining insulin dosages). 4. Methods of and sites for appropriate insulin injection. 5. Physiology of blood glucose regulation. 6. Consequences of untreated diabetes. 7. Etiology and signs and symptoms of Type 1 diabetes (T1DM). 8. The “fundamental principle” of insulin therapy. 9. Insulin action times: onset, peak, and duration of various insulin drugs. 10. Symptoms of hyper- and hypoglycemia. 11. Treatment of mild to moderate and severe hypoglycemia. 12. Description of the Somogyi phenomenon. 13. Etiology of Type 2 diabetes (T2DM). 14. Lifestyle modification recommendations for the diabetic patient. 15. Treatment goals for the treatment of T2DM. 16. Specific drugs that can raise or lower blood glucose. 17. Action and adverse effects of each of the six primary groups of antidiabetic drugs for T2DM. 18. Focus medications: (1) insulin; (2) glipizide; (3) metformin; (4) pioglitazone; (5) nateglinide; (6) exenatide; (7) sitagliptin; (8) glucagon. 19. Application of Key Terms identified in topic chapters. K. The Gastrointestinal System 1. Normal anatomy and physiology of the gastrointestinal system. 2. Pathogenesis of peptic ulcer disease and duodenal ulcer. 3. Pathogenesis of GERD. 4. Actions, adverse effects, and administration precautions of Curren Chapter 11 Adams, Holland, & Urban Chapter 44 Adams, Holland, & Urban Chapters 40 and 41 Reading Quiz 1, 2, 4, 5, 6, 7 Assign Focus Medication: Group Med 1 2 3 4 5 6 7 8 Reading Quiz Assign Focus Medication: Group Med 1 2 29 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 16 16 17 5/25/16 5/25/16 5/31-6/5/16 proton pump inhibitors. Actions and adverse effects of H2-receptor blockers. Actions and adverse effects of antacids. Actions of antibiotics used for treatment of peptic ulcer disease. Standard regimen for eradicating H. pylori. Normal function of the lower digestive tract. Etiology of constipation. Primary classifications of laxatives. Pathophysiology of diarrhea. The role of probiotics. Classifications of antidiarrheals. Irritable bowel syndrome vs inflammatory bowel disease. Pathophysiology of nausea and vomiting. Classifications of antiemetics. Focus medications: (1) omeprazole; (2) ranitidine; (3) metoclopramide; (4) aluminum hydroxide; (5) diphenoxylate with atropine; (6) sulfasalazine; (7) prochlorperazine (8) psyllium mucilloid. Applications of Key Terms identified in topic chapters. 19. Unit 3 Exam Review—Optional; To Be Arranged Final Exam Schedule (TBA) Exam for N402 is comprehensive. 3 4 5 6 7 8 Critique due 30