REPUBLIC OF THE PHILIPPINES VISAYAS STATE UNIVERSITY College of Nursing VISCA, BAYBAY, LEYTE Telephone: (053) 563-7226 NCM

106 COURSE OUTLINE CARE OF CLIENTS ACROSS THE LIFESPAN WITH PROBLEMS IN CELLULAR ABERRATIONS, ACUTE BIOLOGIC CRISIS, INCLUDING EMERGANCY AND DISASTER NURSING DATE June 11 & June 18 TOPIC I. MUSCULOSKELETAL FUNCTION A. Anatomic & Physiologic Overview 1. Skeletal System 2. Articular System 3. Skeletal Muscle System B. Assessment 1. Health History 2. Physical Assessment C. Diagnostic Evaluation 1. Radiographic Studies 2. CT 3. MRI 4. Arthrography 5. Bone Densitometry 6. Bone Scan 7. Arthroscopy 8. Arthrocentesis 9. EMG 10. Biopsy D. Clients With A Cast - Casting materials - Arm casts - Leg casts - Body or spica casts - Caring for a client with a cast E. Caring for a Client with Splints and Braces F. Caring for a Client with an External Fixator G. Clients in Traction - Principles of effective traction - Skin traction - Skeletal traction - Caring for a client in traction I. Common Problems with the Musculoskeletal System 1. Acute Low Back Pain 2. Bursitis & Tendinitis 3. Loose Bodies LECTURER ALMERIA

June 19

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June 25

June 26

4. Impingement Syndrome 5. Carpal Tunnel Syndrome 6. Ganglion 7. Dupuytrens Syndrome 8. Corns 9. Callus 10. Ingrown Toenail 11. Hammer Toe 12. Hallux Valgus 13. Pes Cavus 14. Mortons Neuroma 15. Flatfoot 16. Osteoporosis 17. Osteomyelitis 18. Osteomalacia 19. Pagets Disease 20. Bone Tumors 21. Contusions, Sprains and Strains 22. Joint dislocations 23. Sports Injuries - Rotator cuff tears - Epicondylitis - Lateral & medial collateral ligament injury - Anterior & posterior cruciate ligament injury - Rupture of the Achilles tendon 22. Fractures - Types - Kinds - Fracture healing 23. Amputation II. CELLULAR ABERRATIONS A. Review of the Cellular Physiology 1. The Cell Cycle 2. Differentiation 3. Proliferation B. Characteristics of Benign & Malignant Neoplasms 1. Terminology 2. Neoplasm 3. Benign 4. Malignant - Cancer cell characteristics - Invasion & metastasis - Tumor growth - General effects C. General Pathophysiology of Cellular Aberration D. Epidemiology (Local & International) a. Lung cancer b. Breast cancer c. Uterine cancer d. Prostate cancer

MENESES

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July 2 & July 3

e. Colorectal cancer E. Carcinogenesis & Causes of Cancer Oncogenesis Risk Factors: 1. Gender & Site 2. Age 3. Race & Ethnicity 4. Genetics 5. Hormonal Factors 6. Immunologic Factors 7. Oncogenic Viruses 8. Drugs & Chemicals 9. Radiation - Ionizing - UV - Electromagnetic - Radon 10. Lifestyle F. Significant Subjective Data from the Client - Family history - Chief complaints - Functional patterns - Psychosocial & behavioural assessment G. Principles & Techniques of Physical Examination in All Age Group, Deviations from Normal 1. Breast Self-Examination 2. Testicular Self-Examination 3. Digital Rectal Examination H. Diagnostic Tests & Nursing Responsibilities 1. Lung Cancer - Chest X-ray - Sputum cytology 2. Breast Cancer - Mammogram - Clinical breast exam - MRI - Tissue Sampling 3. Uterine Cancer - Transvaginal sonography - Hysteroscopy - Sonohysterography - Biopsy punch 4. Cervical Cancer - Pap smear with staging 5. Prostate Cancer - Digital rectal examination - Prostate-specific antigen 6. Colorectal Cancer - Fecal occult blood test - Sigmoidoscopy - Colonoscopy

PEREZ

- Double-contrasted barium enema 7. Other tests - Tumor markers - Radioisotope scan - MRI July 9, July 10 & I. Pathophysiologic Mechanisms Leading to Manifestations July 16 1. Lung Cancer 2. Breast Cancer 3. Uterine Cancer 4. Colorectal Cancer 5. Prostate Cancer 6. Non-Hodgkins Lymphoma 7. Kidney Cancer 8. Melanoma 9. Basal Cell Carcinoma 10. Thyroid Cancer 11. Leukemia 12. Childhood Cancers - Glioma - Neuroma - Wilms Tumor - Retinoblastoma - Ewings Sarcoma - Osteosarcoma July 17 J. Nursing Diagnoses Taxonomy/Development of Outcome Criteria 1. Potential for Infection 2. Disturbance in Body Image 3. Activity Intolerance 4. Potential for Alteration in Nutrition; Less than Body Requirements 5. Alteration in Oral Mucous Membrane Integrity 6. Alteration in Comfort 7. Fluid Volume Deficit K. Principles of Various Modalities of Management Against Cancer 1. Health promotion 2. Disease prevention 3. Curative 4. Restorative L. Principles of Management 1. Cancer Staging - TNM Classification - Clinical Staging - Metastatic Spread 2. Prevention of Infection 3. Hydration 4. Blood Component Replacement 5. Oxygen Therapy 6. Prevention of Complications 7. Rehabilitation M. Pharmacologic Actions (Therapeutic use, Side effects, Indications, Contraindications,

ALMERIA

MENESES

July 23 & July 24

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Nursing responsibilities) 1. Biotherapy - Cytokines - Monoclonal Antibodies - Cellular Therapies - Immunodilators - Retinoids 2. Chemotherapeutic Agents a. Classification - Cell cycle-specific - Cell cycle-nonspecific b. Categories - Alkalating agents - Antibiotic - Nitroureas - Plant derivatives - Hormonal N. Special Considerations in Chemotherapeutic Drugs Preparation 1. Proper attire 2. Chemo drug handling O. Special Procedures 1. Radiation therapy 2. Cervical implants 3. Reverse isolation P. Appropriate Discharge Plan Including Health Education MIDTERMS EXAM III. ACUTE BIOLOGIC CRISIS A. Standard Assessment of the Critically Ill - Focused history taking - Discriminating physical examination AIRWAY BREATHING CIRCULATION HEMODYNAMIC STATUS

July 30 August 7, 13

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B. Pathophysiologic Mechanisms Leading to Manifestations 1. Cardiac Failure 2. Acute Myocardial Infarction 3. Acute Renal Failure August 14 & August 4. Stroke 20 5. Increaased Intracranial Pressure 6. Metabolic Emergencies - DKA/HHNK 7. Massive Bleeding/Hypovolemic Shock 8. Extensive Injuries - Dehiscence - Evisceration 9. Extensive Burns - Staging - Area Computation

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August 28

- IVF Replacement C. Nursing Diagnoses Taxonomy/Development of Outcome Criteria 1. Impaired Gas Exchange 2. Inability to Sustain Spontaneous Ventilation 3. Dysfunctional Ventilatory Weaning Process 4. Decreased Cardiac Output 5. Altered Tissue Perfusion, Systemic 6. Alteration in Nutrition; Less than Body Requirements 7. Fluid Volume Deficit 8. Activity Intolerance D. Results/Implications of Diagnostic Laboratory Exams 1. Non-invasive: ECG, cardiac rhythms 2. Invasive: ABG, Hemodynamic Monitoring, CVP, Pulmonary Capillary Wedge Pressure (PCWP) & 3. Life Maintaining Interventions - Airway management & care of clients with a ventilator - Interventions for hemodynamic instability - Continuous hemodynamic monitoring - Interventions for neural regulation - Fluid & Electrolyte problems - Nutrition E. Pharmacologic Actions (Therapeutic use, Side effects, Indications, Contraindications, Nursing responsibilities) 1. Analgesics 2. Narcotics 3. Corticosteroids 4. Antihypertensives 5. Vasopressors 6. Antibiotic 7. Parenteral fluids IV. DISASTER NURSING A. Definition of Emergency & Other Terminologies - Disaster - Trauma B. Triage - Definition - Objectives 1. START Triage System - Indication for use - Mnemonic/Procedure - ADULT START Triage System - PEDIATRIC START Triage System - START Flow Chart - Color Coding - Evacuation Prioritization According to Category - Incident Command System 2. MILITARY TRIAGE - Indication for use - 5 Categories of Severity

PEREZ

August 29 September 3

MENESES

September 4

PEREZ

September 10

D. The Crash Cart/E-Cart - Contents - A-Z Emergency Drugs E. Personal Protective Equipment F. Hazardous Materials G. Decontamination H. Biologic Warfare & Biologic Agents K. Blast Injuries J. Natural Disasters

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K. Stress Reactions - Post Traumatic Stress Disorder - Critical Incident Stress Management - Debriefing September 11 & V. IV THERAPY September 17 A. Philosophy B. Definition C. Basic Foundation of IV Therapy 1. Historical Background 2. Ethico-legal Issues - Role of ANSAP - Difference between RA 9173 & RA 7160 3. Standards of IV Therapy D. Review of Anatomy & Physiology of the Vascular System E. Peripheral & Integumentary System F. Fluid & Electrolyte Therapy 1. Types of Fluids/Solutions and Uses 2. Drug Interaction with IV Fluids 3. Handling of IV Solutions, Blood Products & Components G. Nursing Process in IV Therapy H. Venipuncture Technique in Adult & Children - Prescribed cannula & indications of each color & gauge - Ideal period of usage of an IV set, Indications - Process in keeping a set sterile I. Complications of IV Therapy J. Infection Control & Microbiology Principles K. Demonstration of Procedure

ALMERIA

PREPARED BY: KRISHNA RAE Z. ALMERIA, RN, MAN