83578661 syllabus ncm 103 final

8/12/2019 83578661 Syllabus Ncm 103 Final

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F.L. VARGAS COLLEGE

Bagay Road, Caritan Centro

Tuguegarao City, Cagayan Valley

COLLEGE OF HEALTH SCIENCES

Course Name : CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRIN

Course Code : NCM 103

Course Description : This course deals with the principles and techniques of nursing care management of sick clients across lifespan with emphasis on the adult

the older person,population group in any setting with alterations/problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocr

function.

Course Credit : 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical)

Contact Hours/ Semester : 144 lecture hours; 306 RLE hours

Pre-requisite : NCM 102

Placement : 3rd

year, 1st

semester

Course Objectives : At the end of the course and given relevant actual clients with problems in oxygenation, fluid and electrolyte balance, nutrition and metabo

and endocrine

function, the student should be able to:

1. Utilize the nursing process in the care of individuals, families in community and hospital settings. Assess with client/s his/her/their condition/health status through interview, physical examination, interpretation of laboratory

findings.

Identify actual and at-risk nursing diagnosis Plan appropriate nursing interventions with client/s and family for identified nursing diagnosis Implement plan of care with client/s and family. Evaluate the progress of his/her/their clients condition and outcomes of care.

2. Ensure a well organized and accurate documentation system;3. Relate with client/s and their family and the health team appropriately;4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and,5. Promote personal and professional growth of self and others.

OBJECTIVES INTERMEDIATE

COMPETENCIES

COURSE CONTENT TEACHING-LEARNING

ACTIVITIES

VALUES

INTEGRATION

TIME

FRAME

EVALUATI

At the end of the lecture

discussion, the students

will be able to:

1. Utilize the nursingprocess in the care of

1.Identify risk factors amongclients that contribute to the

development of problems in

Oxygenation- cardiovascular

risk factors (modifiable and

The different risk factors among clients that

contribute to the development of problems in

oxygenation:

Current respiratory problems History of respiratory disease

Pre-tests Case Analysis Small Group

Assertiveness Cooperation Participation

2.5 hours

After the discus

students will be

identify the modi

non-modifiable ri


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individuals, families

with problems in

oxygenation in

community and

hospital settings;

2. Ensure a wellorganized and

accurate

documentation

system;

3. Relate with client/sand their family and

the health team

appropriately;

4. Observe bioethicalconcepts/principles,

core values and

nursing standards in

the care of clients;

and,

5. Promote personaland professional

growth of self and

others.

non-modifiable). Lifestyle (smoking, alcoholism, exercisepatterns)

Presence of cough Presence of Chest Pain Lung Cancer Cardiovascular disease Stroke Tuberculosis Obesity Dietary assessment Medication history

Learning

Lecture Discussion Post test

Sensitivity that contribute development of

in oxygenation.

2. Identify significantsubjective data from client

history related to problems

in oxygenation.

a. Chief complaintsb. Relevant information, to include eleven

functional patterns

Health perception management pattern Nutritional/metabolic pattern Elimination pattern Activity/exercise patterns Cognitive/perceptual pattern Sleep-rest pattern Self-perception-self-concept pattern Role relationship pattern Sexuality-reproductive pattern Coping-stress tolerance pattern Value-belief pattern


Learning

Lecture Discussion Postl test

Assertiveness Cooperation Participation Sensitivity

2 hours The students sable to identify

subjective dat

clients histo

enumerating the

chief complain

recording

information guide

eleven functional

3. Enumerate the principlesand techniques of physical

examination in assessing

the oxygenation status in

newborn, children, adults.

a. Inspection- gas exchange, perfusionb. Palpation- gas exchange, perfusionc. Percussion- gas exchanged. Auscultation- gas exchange- heart sound, breath

sounds, deviations, fluid transport

Demonstration Return

Demonstration



3 hours The students will perform the

techniques in

examination and

principles in

assessing the

children, and

oxygen statu

comparing any d

from normal findi

4. Identify results andimplications of

diagnostic/laboratory

examinations of clients

with reference to

problems in Oxygenation.

Screening procedure- peak flow meter Diagnostic Procedures Non-invasive: Pulmonary: e.g. sputum microscopy, chest x-

ray, pulmonary function tests, smoke analyzer

Fagerstrom teststandardized degree of


Learning



2.5 hours Given actual lresults of a pat

student should b

identify deviatio

normal findings.


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nicotine dependence

Cardiac: ultrasound, ECG, 2-D echo, stress test Vascular: Doppler ultrasonography Blood: pulse oximeter Invasive: Pulmonary: bronchoscopy, ABG, 3horacentesis,

pulmonary angiography

Cardiac: CO determination, cardiaccatheterization, CVP, hemodynamics

monitoring, enzyme levels, Serum, Cholesterol

Vascular: angiography Blood: CBC and bone marrow biopsy

5. Determine the Patho-physiologic mechanisms of

the Alterations in

oxygenation

a. Alteration in gas exchangeventilatordysfunction, impaired perfusion

b. Alteration in cardiac performanceheart rateproblems, impaired stroke volume secondary

to altered preload, afterload, myocardial

contractility

c. Alteration in vascular integritytransportnetwork impairment

d. Alteration in oxygen carrying capacity of theblood- decreased circulating erythrocytes

(anemia), increased circulating erythrocytes

(polycythemia)


Learning



16 hours The students sable to determ

patho-physiologic

mechanisms

different ox

problems.

6. Enumerate Nursingdiagnoses taxonomy

pertinent to

problems/alteration in

Oxygenation.

a. Ineffective breathing patternb. Ineffective airway clearancec. Impaired gas exchanged. Inability to sustain spontaneous

ventilation

e. Dysfunctional 3entilatory weaningresponse

f. Decreased cardiac output (CO)g. Altered tissue perfusion systemich. Impaired gas exchange related to

altered O2 carrying capacity of blood

due to decreased

erythrocytes/hemoglobin

i. Activity intolerance related tomalnutrition tissue hypoxia


Learning



2 hours The students sable to identify

nursing

taxonomy pertine

derived assessme

pertinent prob

oxygenation.

7. Identify principles of variousmodalities of management

of clients with problems in

oxygenation taking into

a. For altered pulmonary function: Airway patency Oxygen therapy Adequate ventilation


Learning


4 hours The students sable to apply th

principles

management


4/15

consideration the following

levels of care:

1. Health promotive2. Disease

preventive

3. Curative andrestorative

Drug therapy Hydration Removal of secretion Prevention of infection Prevention of complications Prevention of psychosocial problems Rehabilitation

b. For cardiac function Hemodynamics monitoring O2 therapy Drug therapy Hydration Prevention of infection Prevention of complications Prevention of psychosocial problems Rehabilitation

c. Oxygen carrying capacity of the blood Blood component replacement O2 therapy Drug therapy Hydration Prevention of infection Prevention of complications


with proble

oxygenation

actual clinica

practice.

The students sable to pro

patients/client

proper teach

health p

disease preve

curative andrestoration.

8. EnumeratePharmacologic actions,

therapeutic uses, side

effects, indications,

contraindications, and

nursing responsibilities in

administering medications

clients with oxygenation

problems.

a. Pulmonary Bronchodilators Expectorants Antitussives Antihistaminesb. Cardiac Sympathomymetic agents Sympatholytic agents Anti-anginal agents Anti- arrhythmic agents Angiotensin converting enzyme inhibitors Antilipemic agents Anticoagulant agents Thrombolytics Peripheral vascular agentsc. Blood Hematinics Vitamin supplements


Learning



2 hours The students sable to enume

different p

cardiac, blood me

with their corre

pharmacologic

therapeutic use

effects, indicati

contraindications

nursing responsi

the different m

of clients with ox

problems.


5/15

9. List th e purposes,indications, nursing

responsibilities for the

surgical and special

procedures in alterations in

oxygenation.

1. Safe and comprehensive perioperative nursingcare

1.1 Assessment and care during theperioperative period

1.2 Techniques in assisting the surgical teamduring the operation

1.3 Principles of safety, comfort and privacyduring the perioperative period

1.4 Nursing responsibilities during theperioperative period

Preoperativephysical,psychological, spiritual preparation

Intraoperativecirculating nursefunctions, scrub nurse functions

Postoperativeairway, breathings,circulation priorities. Meeting the

physical, psychological and spiritual

needs of the cliet.

2. Pulmonarya. Surgical procedurestracheostomy,

thoracostomy, lung resection, lobectomy,

pneumonectomy, thoracoplasty,

decortications

b. Special proceduresendotrcheal/trachealsuctioning and care, humidication, IPPB,

ventilator assist

3. Cardiaca. Surgical procedurescoronary aretery bypass,

pacemaker insertion, valve replacement,

repair of congenital abnormality, insertion of

ventricular assist device, heart plansplant

b. Special procedureslaser therapy, basic lifesupport, advance life support

3.1 Vasculara. Surgical proceduresendarterectomy,

aneurysmectomy, insertion of intravascular

stents

b. Special proceduresapplication ofantiembolic stockings

3.2 Blood forming organsa. Surgical proceduresbone marrow

aspiration, bone marrow transplant

b. Special proceduresblood componenttransfusion, reverse isolation


Learning



2 hours The students will list the differen

and special proce

clients with ox

problems and ide

nursing responsi

each procedure.


6/15



will be able to:



with problems in

Fluids and electrolyte

imbalances in

community and

hospital settings.2. Ensure a well

organized and

accurate

documentation

system;


the health team

appropriately;


core values and



and,

5. Promote personal andprofessional growth of

self and others.

10. Identify risk factorsamong clients that

contribute to the

development of problems in

Fluid and Electrolytes.

Potential factors for exceeding renal reservecapacity, dietary habits to include salt intake,

hypertension, infection, diabetes.


Learning



1.5 hours After the discussio

students will be a

identify the modif

non-modifiable ris

that contribute to

development of p

in fluid and electr

imbalances.

11. Enumerate theprinciples and techniques of

physical examination innewborn, children, adults,

deviations from normal.

Inspection- signs of dehydration, overhydration Palpation- edema, ascites, neck vein filling, hand

vein filling, neuromuscular irritability,characteristic of pulse

Percussion- abdomen for presence of air, fluid Auscultation- rates


Demonstration Lecture Discussion Post test


2 hours The students will

perform the

techniques in examination and

principles in

assessing the

children, and adu

and electrolyte

status by compa

deviations from

findings.




with reference to

problems in

a. Diagnostic tests Non-invasive: electrolyte determination, intake

and output, KUB-IVP and ultrasound

Invasivebiopsyb.

Weightc. Vital Signs


Learning

Lecture Discussion

Post test


1.5 hours Given actual l

results of a pat

student should b

identify deviatio

normal findings.

13. Determine the Patho-physiologic Mechanisms of

Fluid and electrolyte

imbalances.

a. Volume impairmentfluid volume deficit, fluidvolume excess, third space fluid shift

b. Osmotic imbalanceshyponatremia,hypernatremia

c. Ionic concentration problemshypo- andhyperkalemia; hypo and hyperchloremia; hypo-

and hypermagnesemia; hypo- and

hyperphosphatemia

d. Acid and base imbalances metabolic acidosisand alkalosis; respiratory acidosis and alkalosis


Learning



12 hours The students s

able to determ

patho-physiologic

mechanisms

different fluid

electrolyte imbala


pertinent to


Fluid and electrolyte

imbalance.

a. Risk for fluid volume deficitb. Fluid volume excessc. Fluid volume deficitd. High risk for injury related to electrolyte

deficit/excess

e. High risk for injury related to acid/base


Learning




able to identify

nursing

taxonomy pertine

derived assessme

pertinent problem


7/15

imbalance

f. Altered urinary eliminationg. Impaired integumentary integrity

and electrolyte im

15.Identify principles of variousmodalities of management


fluid and electrolyte

imbalances taking into

consideration the following

levels of care:

a. Health promotiveb. Disease preventivec. Curative and

restorative

a. Fluid Volume Deficit Determination and management of

cause

Hydration Blood transfusion as needed Drug therapyelectrolyte Supportive management Prevention of infection Prevention of complication Prevention of psychosocial problems Rehabilitation

b. Fluid Volume Excess Determination and management of

cause

Drug therapydiuretics, electrolytes Dietary restrictionsodium Supportive management Prevention of infection Prevention of complication Prevention of psychosocial problems Rehabilitation

c. Electrolyte Deficithyponatremia,hypokalemia, hypocalcemia,

hypomagnesemia, hypophosphatemia

Determination and management ofcause

Drug therapyelectrolyte replacement Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

d. Electrolyte Excesshyperkalemia,7ypercalcaemia, hypermagnesemia,hyperphosphatemia


Drug therapyelectrolyte replacement Dietary management


Learning




principles

management

with problems

and e

imbalance in t

clinical nursing The students s

able to pro

patients/client

proper teach

health p

disease preve

curative and

restoration.


8/15

Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

e. Metabolic AlkalosisBase bicarbonate exces Determination and management of

cause

Drug therapy Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

a. Metabolic Acidosis- basebicarbonate deficit



f. Respiratory Alkalosiscarbonic and aciddeficit



g. Respiratory Acidosiscarbonic acid excess Determination and management of

cause



9/15


therapeutic uses, side effects,

indications, contraindications,

and nursing responsibilities in


clients in fluid and electrolyte

imbalances.

a. Fluid Parenteral fluids Hypotonic Hypertonic Isotonic

b. Electrolyte Sodium Potassium Calcium Magnesium Phosphate

c. diuretics Potassium-sparing Potasium-losing Osmotic diuretics

d. Vitamin D supplements


Learning



2.5 hours The students s

able to enume

different medica

managing clients

and electrolyte im

with their corre

pharmacologic

therapeutic use

effects, indicati

contraindications

nursing responsithe different med





fluid and electrolyte

imbalances.

Renal dysfunction

a. Major surgical proceduresnephrectomy, nephrostomy,

cystectomy, uterostomy, renal

transplants, urinary diversion

b. Special procedures- peritoneal dialysis,hemodialysis, bladder training,

cystoclysis/bladder irrigation


Learning



2.5 hours The students will

list the differen

and special proce

clients with f

electrolyte imbal

identify the

responsibilities

procedure.At the end of the lecture


will be able to:



with problems in

nutrition and

metabolism in

community and

hospital settings.


accurate

documentation

system;


the health team


contribute to the

development of problems

in Nutrition and

Metabolism.

Risk factors related to malnutrition, obesity. Pre-tests Case Analysis Small Group

Learning



1 hour After the discussio

students will be a

identify the modif

non-modifiable ris

that contribute to

development of p

in nutrition and

metabolism.

19.Identify significantsubjective data from client


in nutrition and

metabolism.

a. Chief complaintsb. Relevant information, to include eleven

functional patterns

Health perception management pattern

Nutritional/metabolic pattern Elimination pattern Activity/exercise patterns Cognitive/perceptual pattern Sleep-rest pattern Self-perception-self-concept pattern Role relationship pattern


Learning

Lecture Discussion

Post test


2 hours The students shou

able to identify sig

subjective data fr

clients history by

enumerating the

chief complaints a

recording relevan

information guide

eleven functional


10/15

appropriately;


core values and



and,

5. Promote personal andprofessional growth of

self and others.

Sexuality-reproductive pattern Coping-stress tolerance pattern Value-belief pattern

20. Enumerate theprinciples and techniques of

physical examination in

newborn, children, adults,

deviations from normal.

3.3 Gastrointestinal functionIPPA Inspection- color, texture of skin,

mucous membrane, growth patterns,

scars, masses

Auscultation- bowel sounds, bruits Palpationfocus on GIT for presence of

masses, ascites, rebound tenderness,distention

Percussionliver span, masses


Demonstration




perform the

techniques in

examination and

principles in

assessing the

children, and nutritional and

status by compa

deviations from

findings.




with reference to

problems in Nutrition and

Metabolism.

a. Non-invasive: ultrasound of the abdomen, stoolculture

b. Invasive: to include: barium swallow,esophagoscopy, biopsy, cytology examination,

gastric secretion analysis, endoscopy

(gastroscopy, duodenoscopy),

proctosigmoidoscopy and rectal examination


Learning



1.5 hours Given actual labo

results of a patien

student should be

identify deviation

normal findings.

22.Determine the Patho-physiologic mechanisms of

the Alterations in Nutrition

and Metabolism.

a. Disturbances in ingestionproblems in buccalcavity and esophagus

b. Disturbances in digestionpeptic acid disease,gastritis and gastric cancer

c. Disturbances in absorptionmalnutrition,malabsorption syndrome and inflammatory

bowel conditions

d. Disturbances in eliminationbowel obstruction,hemorrhoids, diarrhea and constipation.

Pre-tests

Case Analysis Small Group

Learning


Assertiveness

Cooperation Participation Sensitivity


able to determ

patho-physiologic

mechanisms

different nutritio

metabolic problem


pertinent to


Nutrition and Metabolism.

a. Alteration in nutrition less than body requirementb. Alteration in nutrition more than body

requirement

c. Alteration in oral mucous membrane integrityd. Alteration in comfort: epigastric pain/abdominal

paine. Fluid volume deficit


Learning




able to identify

nursing

taxonomy pertine

derived assessme

pertinent probnutrition and met



Nutrition and Metabolism

A. Disturbances in ingestion Determination and management of

cause

Drug therapy


Learning



principles

management


11/15

taking into consideration

the following levels of care:

4. Health promotive5. Disease

preventive

6. Curative andrestorative

Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation

B. Disturbances in digestion Determination and management of

cause


C. Disturbances in absorption Determination and management of

cause


D. Disturbances in elimination Determination and management of

cause


E. Disturbances in hepatic, biliary andpancreatic functions




with proble

nutrition

metabolism in

clinical nursing


patients/client

proper teach

health p

disease preve

curative andrestoration.


12/15







clients with Nutrition and

Metabolism problems.

Antiemetics Anticoagulants Hematinics agents Laxatives and stool softeners Antipruritus Vitamin supplement Antacids Antihyperlipidemics Antispasmodics Antidiarrheal


Learning




able to enume

different p

cardiac, blood me

with their corre

pharmacologic

therapeutic use

effects, indicati

contraindications

nursing responsi

the different mof clients with

and metabolism d





Nutrition and Metabolism.

a. Surgical proceduresgastrostomy, gastrectomy,colostomy, hemorrhoidectomy, gastrointestinal

bypass, ileostomy

b. Special proceduresparenteralhyperalimentation; feeding per nasogastric,

jejunostomy, gastrostomy tubes; colostomy care

and irrigation, dietary planning for common GT

and endocrine problems; administering

medications via NGT, J tube, G tube; hot sitz bath


Learning




list the differen

and special proce

clients with nutr

metabolism prob

identify the

responsibilities

procedure.



will be able to:



with problems in

endocrine functioning

in community and

hospital settings.


accurate

documentation

system;

3. Relate with client/sand their family andthe health team

appropriately;



contribute to the

development of problems

in Endocrine Function.

Risk factors related to endocrine hypo or hyper-functioning.


Learning



1.5 hours After the discussio

students will be a

identify the modif

non-modifiable ris

that contribute to

development of p

in endocrine func

28.Identify significantsubjective data from client


in endocrine functioning.

A. Chief complaintsB. Relevant information, to include eleven

functional patterns

Health perception management pattern Nutritional/metabolic pattern Elimination pattern Activity/exercise patterns Cognitive/perceptual pattern Sleep-rest pattern Self-perception-self-concept pattern Role relationship pattern Sexuality-reproductive pattern Coping-stress tolerance pattern Value-belief pattern


Learning



2 hours The students shou

able to identify sig

subjective data fr

clients history by

enumerating the

chief complaints a

recording relevan

information guide

eleven functional


13/15

core values and



and,

5. Promote personaland professional

growth of self and

others.

29. Enumerate theprinciples and

techniques of physical

examination in

newborn, children,

adults, deviations

from normal in the

endocrine system.

Inspection- color, texture of skin, mucousmembrane, growth patterns, obesity

Auscultationbruit, heart sounds, breathsounds

Palpation- organ-thyroid enlargement, masses,edema

Percussion- fluid, edema Othersweight, delayed healing of wounds


Demonstration




perform the

techniques in

examination and

principles in

assessing the

children, and

endocrine functi

comparing any d

from normal findi30. Identify results and

implications of



with reference to

problems in endocrine

functioning.

a. Screening: glucose tolerance test Non-invasive: e.g. GI x-ray, ultrasound

abdomen, Radio-iodine assay (RAI), protein

bound iodine (PBI), thyroid scan, free thyroxin

level, basal metabolic rate (BMR), thyroxine

stimulating hormone (TSH) test, OGTT (Glucose

tolerance test) urinalysis (glycosuria, ketonuria)

Invasive: e.g. percutaneous transhepaticcholangiogram, liver function test, serum

thyroxine and triiodothyronine test, iodine 131

uptake, blood sugar tests (fasting blood sugar

FBS), random blood sugar (RBS), glycosylated

hemoglobin (Hgb), two-hour post prandial

blood glucose, endocrine assay.


Learning



2.5 hours Given actual labo

results of a patien

student should be

identify deviation

normal findings.

31.Determine the Patho-physiologic mechanisms of

the Alterations in

endocrine functioning.

a. Hypo- and Hyperfunction of the pituitary organb. Hypo- and Hyperfunction of the hypothalamusc. Hypo- and Hyperfunction of the thyroid organd. Hypo- and Hyperfunction of the parathyroid

organ

e. Hypo- and Hyperfunction of the adrenal organf. Hypo- and Hyperfunction of the gonadsg. Problems in glucose metabolismhypoglycemia

and hyperglycemia (IDM, NIDDM)


Learning




able to determ

patho-physiologic

mechanisms

different

problems.


pertinent to

problems/alteration inendocrine functioning.

a. Alterations in nutrition less than bodyrequirement

b. Fluid volume deficitc. Activity intolerance


Learning Lecture Discussion Post test



able to identify

nursing

taxonomy pertinederived assessme

pertinent prob

endocrine functio


Corticosteroids Alpha-adrenergic blocking agents Pre-tests Case Analysis Assertiveness Cooperation

2.5 hours The students sable to apply th


14/15






clients with endocrine

problems.

Beta-adrenergic blocking agents Tyrosine inhibitors Dopamine receptor antagonists Glucocorticoids Parathyroid hormone agents Thyroid hormone agents Insulin Oral hypoglycemic agents

Small GroupLearning


Participation Sensitivity

principles

management

with proble

endocrine func

the actual

nursing practic


patients/client

proper teach

health pdisease preve

curative and

restoration.



endocrine functioning

taking into consideration

the following levels of care:

a. Health promotiveb. Disease preventivec. Curative and

restorative

Determination and management of cause Drug therapy - diuretics, electrolytes Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation


Learning




able to enume

different p

cardiac, blood me

with their corre

pharmacologic

therapeutic use

effects, indicati

contraindications

nursing responsi

the different m

of clients with

problems.





endocrine functioning.

a. Surgical proceduresthyroidectomy,parathyroidectomy

b. Special proceduresmonitoring ofblood glucose levels; maintenance of

blood glucosediet, exercise, drugs


Learning




list the differen

and special proce

clients with

problems and ide

nursing responsi

each procedure.

References:

1. Lippincott Williams & Wilkins. The Lippincott Manual of Nursing Practice7thedition. 2001.2. Marieb, Elaine N. Essentials of Human Anatomy and Physiology8thedition. Pearson Education South Asia PTE. LTD. 20063. Brunner and Suddarth. Textbook of Medical-Surgical Nursing12th edition. 2010


15/15

Prepared by: Recommending Approval:

FREIDA MICHELLE BONNIT-TAJA, RN, MAN KATLYN C. MANGUPAG, RN, MSN

Instructor OIC, COLLEGE OF HEALTH SCIENCES

Approved by:

MR. JOSEPH B. FURIGAY

Director for Instruction

83578661 syllabus ncm 103 final

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