NRDNP 838 Advanced Pathophysiology Fall 2013

Medical University of South CarolinaCollege of Nursing Syllabus

Course Number: NRDNP 838 W 01

Course Title: Advanced Pathophysiology

Semester and year: Fall 2013

Credit: Three (3) Semester Hours — 3 sh (45:0:0)

Placement in curriculum: (ONLINE) Fall 2013 from Friday 8/20/2013 to Friday 12/6/2013. All coursework & exams (which are in the online course) must be completed online by the end of the day on Monday, 12/9/2013. According to MUSC policy, if coursework is not completed by the end date of the course, the student will receive either a grade of “Incomplete” or an “F” grade due to zero credit on required assignments. If an “Incomplete” is granted, the student must then complete all coursework according to the MUSC policy (by posted date prior to the following term) to receive a numeric grade, or automatically receive an “F” grade. The “incomplete” option may be used only once per course and is NOT automatically granted (must be arranged in advance with instructor permission). Academic progress will be reviewed periodically throughout the term and warnings given as needed. This is a core MSN course, a grade of 85% (3.0) in clinical tracks is required.

Pre-and co-requisites: Graduate Standing

Faculty: Name: Claire DeCristofaro, MDMUSC Email: decristc@musc.eduRoom: No on-campus office or phonePhone: (828) 545-9406 (cell for calls & texts)Fax: n/aSkype name: n/a

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NRDNP 838 Advanced Pathophysiology Fall 2013

Instructor availability:

Office hours: You may contact instructor 24/7 using MUSC email or her cell phone (see above). Dr. D is happy to communicate with students outside of regular business hours. Her MUSC email and online course messages will be checked at least once daily (usually more often), including holidays and weekends. If she is not available for a specific segment of time, students will be notified within the online course. For regular communications, use MUSC email. For urgent communications, do not hesitate to use the provided instructor’s cell phone number (if no answer, leave your name, course, return numbers/times, reason for call; you can also text).

Course description: In-depth study of normal physiologic and pathologic mechanisms of disease across the lifespan providing a foundation for advanced clinical assessment, diagnostic reasoning, and management of common, episodic and chronic conditions.  Emphasis on the interpretation of diagnostic laboratory data as it reflects both normal function and pathological changes that result in signs and symptoms of disease. Prerequisite: Graduate standing.  Fall

Course objectives:

At the end of the course, the student will be able to:1.    Comprehend physiologic changes over the life span.

2.    Apply knowledge of developmental physiology, etiology, and pathogenesis of common diseases to the presentation, interpretation, and analysis of diverse symptom complexes.

3.     Analyze select diagnostic and laboratory studies from a physiological or pathophysiological perspective.

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NRDNP 838 Advanced Pathophysiology Fall 2013

Teaching strategies:Online course lecture notes, independent readings, clinical pathophysiological correlates (case studies), enhanced online content (audio, images, links) & instructor communications. This class is totally online (Web-Based). All exams, course notes, course

calendar, and communications are within the online course shell in the educational software used for online courses at MUSC.

This course is “asynchronous” – meaning you will not be obligated to attend class online at a specific date/time for learning activities. Assignments and assessments will have specific due dates in the course calendar.

There are instructor-created notes to supplement text readings as well as optional audio files in MP3 format to accompany the notes. Within the notes there may be internet links that you should follow as directed.

NOTES FILES:o The notes are in “PDF” format and are read using Adobe Acrobat

Reader, a free software that you can download from the internet (see below). Your computer probably already has this installed, but you want to be sure that you have the latest version. This is also a program (application) that you will need to view other files such as Clinical Practice Guidelines (e.g. from the CDC, National Institutes of Health) and many online files from the clinical literature. The filename extension for these files is “.pdf” In order to obtain this free program (application), go to http://get.adobe.com/reader/

o UNCHECK the box that says “McAfee” (unless you want this antivirus software). Download it to your desktop or another location in your computer that you will remember. Then, find the file after it has downloaded, double-click on it, and it will “self-install.” Be sure you do this at the start of this term to get the latest version or many PDF files won’t work for you.

AUDIO FILES: o There are available AUDIO (MP3) files for this course. They are

optional and designed to enrich the online learning environment. Most students find them very helpful. They can be played over the internet, downloaded to your computer and played using your computer, or any MP3 (music) player.

o They are available via weblink in the course for download. o Audio files will be uploaded as the course progresses. o Instructions for downloading these files are within the course.

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NRDNP 838 Advanced Pathophysiology Fall 2013

Course materials:

Required:1. Course notes will be available online: You will need the latest version of

Adobe Acrobat Reader (free) available ONLINE. In order to obtain this free program (application), go to http://get.adobe.com/reader/ UNCHECK the box that says “McAfee” (unless you want this antivirus software). Download it to your desktop or another location in your computer that you will remember. Then, find the file after it has downloaded, double-click on it, and it will “self-install.” Be sure you do this at the start of this term to get the latest version or many PDF files won’t work for you.

2. Optional audio files: MP3 audio files will be available to accompany most course notes. Instructions on the location of these files and how to download them will be provided in the online course. They can be played over the internet, or downloaded to be played on your computer or MP3 (music) player.

3. Assigned text readings from : McCance, K.L. & Huether, S.E. (2010) Pathophysiology: The Biologic Basis for Disease In Adults and Children. St. Louis: Mosby. ISBN: 978-0-323-06584-9 (Sixth Edition) Internet site for book: http://www.us.elsevierhealth.com/product.jsp?isbn=9780323065849 Beware of similar titles by the same author.

Recommended:1. Despopoulos, A. (2009) Color Atlas of Physiology. New York: Thieme Medical

Publishers. ISBN 9783135450063 (Sixth Edition) Softcover: http://www.thieme.com/index.php?page=shop.product_details&flypage=flypage.tpl&product_id=855&category_id=15&keyword=silbernagl&option=com_virtuemart&Itemid=53http://www.thieme.com/SID2478098062330/productsubpages/pubid2055675596.html

2. Silbernagl & Lang. (2010) Color Atlas of Pathophysiology (2nd edition). Thieme Medical Publishers. ISBN: 9783131165527 Softcover: http://www.thieme.com/index.php?page=shop.product_details&flypage=flypage.tpl&product_id=889&category_id=15&option=com_virtuemart&Itemid=53

3. Ganong, WF. Review of Medical Physiology. Appleton & Lange. Paperback, companion to text below. Physiology only (no pathophysiology).

4. McPhee, SJ, et. al. Pathophysiology of Disease: An Introduction to Clinical Medicine. Latest paperback edition. Does not contain info on Maternal/Fetal.

5. Guyton, A. Textbook of Medical Physiology. This is the "standard" hardcover text for physiology, but very little pathophysiology and no maternal/fetal medicine. Saunders.

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NRDNP 838 Advanced Pathophysiology Fall 2013

Topical outline:Basic concepts presented earlier in the course provide the basis for learning complex processes, with an eventual appreciation of the integration of physiologic functions across organ systems. This is the basis for the clinician's ability to analyze presenting signs and symptoms within a framework of health and disease. Clinical laboratory correlates are integrated into course content by organ system. Topics are covered in thematically related Learning Modules: 1. Cell Structure & Function (genetics, receptors, metabolism, immunity,

neoplasm)2. Nervous System3. Muscle, Bone & Integumentary4. Hematologic System5. Cardiovascular & Lymphatic Systems6. Pulmonary (Respiratory) Systems 7. Renal & Urologic Systems8. Acid-Base & Fluid-Electrolyte Balance9. Digestive System, Accessory Organs of Digestion, Liver, Lipoprotein

Physiology10. Endocrine System11. Reproductive System, Fetal & Neonatal Physiology12. Special Sense Organs & Clinical Laboratory Correlates

See topical outline below with course calendar by WEEK

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NRDNP 838 Advanced Pathophysiology Fall 2013

Fall 2013 Course Calendar – weeks are “Monday to Sunday” (except Finals Week):

Week/Date Learning Module Module Topic Contents Exams & Tasks ScheduleWeek 18/20-8/25

Start Module 1 Pathophysiology Basics (Start)

Email have read SyllabusComputer Readiness

Week 28/26-9/1

Continue Module 1 Pathophysiology Basics(Finish)

Week 39/2-9/8

Start Module 2(Labor Day 9/2 – CON closed)

Nervous System(Start)

Take Exam 1 (content from Module 1) Completion Deadline: Sun 9/9

Week 49/9-9/15

Complete Module 2 Nervous System(Finish)

Week 59/16-9/22

Complete Module 3 Muscle/Bone/Skin (Complete)

Take Exam 2 (content from Modules 2 & 3) Completion Deadline: Sunday 9/29

Week 69/23-9/29

CompleteModule 4

Hematology

Week 79/30-10/6

CompleteModule 5

Cardiovascular

Week 810/7-10/13

Complete Module 6 Pulmonary/Thorax

Week 910/14-10/20

Review Modules 4, 5 & 6 Review these modules Take Exam 3 (content from Modules 4, 5 & 6) Completion Deadline: Sunday 10/27

Week 1010/21-10/27

Complete Module 7 Renal/Urologic

Week 1110/28-11/3

Complete Module 8 Acid/Base/Electrolytes

Week 1211/4-11/10

Review Modules 7 & 8 GI & Accessory OrgansLipoproteins

Take Exam 4 (content from Modules 7 & 8) Completion Deadline: Sunday 11/17

Week 1311/11-11/17

Complete Module 9 GI & Accessory OrgansLipoproteins

Week 1411/18-11/24

Complete Module 10 Endocrine

Week 1511/25-12/1

Review Modules 9 & 10(Thanksgiving 11/28 & 11/29 – CON closed)

Study for and take Exam 5 (covers content from Modules 9 & 10) Completion Deadline: Sunday 12/8

Week 1612/2-12/8

Self-study Module 11 & Module 12 (not tested)

ReproductiveSpecial Senses

Take Optional Final Exam (content from Modules 1 – 11) Completion Deadline: Monday 12/9

Finals Week12/9-12/11

Optional Final Exam covers Modules 1-11; must take & submit for grading Exams 1-5 first

Optional Final Exam has completion deadline of Monday 12/9

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NRDNP 838 Advanced Pathophysiology Fall 2013

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NRDNP 838 Advanced Pathophysiology Fall 2013

Assessments:Below is a list of activities that are graded in this course, their due dates and percent of total grade for each. Below the grid is a brief description of each assessment including how it will be evaluated. There are five (5) required course examinations, with objective-type

questions, spaced throughout the course covering specific segments of course material; final grade is the average of all 5 exams.

All five required course exams (Exams 1 – 5 inclusive) must be taken and submitted for grading before the end of the semester to obtain course credit.

There is an optional final exam that is comprehensive; if taken, the five best exam grades are averaged to obtain your final grade (one worst grade of 6 is dropped). All of the required five course exams must be taken BEFORE attempting/submitting the final exam.

Exams cover specific segments of course material, but it is expected that the student remain responsible for prior knowledge learned earlier in the course.

THESE EXAMS ARE NOT "OPEN BOOK," THEY ARE ON THE HONOR SYSTEM, completed through INDIVIDUAL effort, without access to learning resources; they must be completed at one sitting. Any time limits for completion of an exam will be posted in the course.

# Assessments Date due % final grade

1 Online Exam 1 Sunday, 9 September 2013 20%2 Online Exam 2 Sunday, 29 September 2013 20%3 Online Exam 3 Sunday, 27 October 2013 20%4 Online Exam 4 Sunday, 17 November 2013 20%5 Online Exam 5 Sunday, 8 December 2013 20%6 Optional Final Exam (may

replace one worst grade from required exams above)

Monday, 9 December 2013 n/a (see above)

Assessment details: all exams cover BOTH pathophysiology AND diagnostics content1. Exam 1 : Module 1 content (course notes & directed resources, text readings)2. Exam 2 : Modules 2 & 3 content (course notes & directed resources, text

readings)3. Exam 3 : Modules 4, 5 & 6 content (course notes & directed resources, text

readings)4. Exam 4 : Modules 7 & 8 content (course notes & directed resources, text

readings)5. Exam 5 : Modules 9 & 10 content (course notes & directed resources, text

readings)6. Optional Final Exam : Modules 1-11 content inclusive (course notes, directed

resources, text readings (optional and grade may replace one worse previous exam grade from exams 1-5; all exams 1-5 must have been taken and submitted for grading before attempting/submitting the optional final exam

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NRDNP 838 Advanced Pathophysiology Fall 2013

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NRDNP 838 Advanced Pathophysiology Fall 2013

Assignments:

First Week Readiness Tasks: Read all links at the top of the page in Moodle Read the Syllabus (this document) in entirety and email Dr. D that you

have read it and have no questions Computer Readiness – Update Adobe Reader Computer Readiness – Download/install LockDown Browser Computer Readiness – Take Fake Exam (in Moodle)

Reading Assignments: Reading assignments are from the required text for each module/unit

(note that the chapter assignments may not be in order!) For every module, there are extensive COURSE NOTES from the

instructor, which are ALSO part of the REQUIRED READING Assessment assignments follow on next page Module 1: course notes & text chapters 1, 2, 4, 5, 6, 7, 8, 9, 10, 11,12, 13 (NOT Ch. 3)

Module 2: course notes & text chapters 14, 15 (not Special Senses section), 16, 17, 18, 19.

Module 3: course notes & text chapters 41, 42, 43, 44, 45.

Module 4: course notes & text chapters 25, 26, 27, 28.

Module 5: course notes & text chapters 29, 30, 31.

Module 6: course notes & text chapters 32, 33, 34.

Module 7: course notes & text chapters 35, 36, 37.

Module 8: course notes & text chapters 3, 46, 47.

Module 9: course notes & text chapters 38, 39, 40.

Module 10: course notes & text chapters 20, 21.

Module 11: course notes & text chapters 22, 23, 24.

Module 12: course notes & text chapter 15 (section on Special Senses).

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NRDNP 838 Advanced Pathophysiology Fall 2013

Grading Scale: The grading scale from the current MUSC College of Nursing Student Handbook can be found by clicking on the link below and finding “grades” in the table of contents.Grading scale (at: http://academicdepartments.musc.edu/bulletin/acad_policies/grading.html )

Late assignment policy:

Students may request the instructor, in ADVANCE of posted deadlines, if a deadline extension may be granted. This may be granted at the discretion of the instructor. At instructor discretion, a “zero” grade may be assigned (or points taken off the numeric exam grade) if an exam is not taken by the posted completion deadline. No deadline extensions are possible beyond the posted end date of the course.

Accessing ALL course materials, demonstrating academic progress in the course throughout the term, and responding to instructor emails or other notices as directed are all part of the requirements for successful completion of this course. The student “tracking” function in the online course will be utilized as needed to demonstrate continued participation as per course calendar dates.

If all coursework and assignents/exams are not completed by the posted end date of the course, the student’s course grade is based on the available grades from completed assignments. The “Incomplete” grade option is NOT automatic and may be used only once per course. This option must be arranged well in advance of the end of the semester, and is only given with instructor and advisor permission. The student should be in good academic standing, with every expectation that coursework can be successfully completed before the beginning of the subsequent term, with all remaining work to be completed by specified dates to be determined by the instructor, or an “F” grade is assigned.

Student academic progress will be reviewed periodically throughout the term and academic warnings given as needed and copied to the student services department of the College of Nursing. This is a core course and a final grade of 85% (3.0) for those in clinical tracks is required.

CON participation policy: A student who does not participate in a class for three consecutive weeks will be automatically dropped from the course. Participation is defined as your presence in class and active participation as evidenced by class preparation and discussion regarding the class topic

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NRDNP 838 Advanced Pathophysiology Fall 2013

Additional course-specific participation policies: The online course calendar and course information packet will have a timeline

for completion of course materials, learning activities, exams and/or other assignments. Any updates or changes will be made via course messaging (email), the course calendar, and/or course announcements.

You are expected to log in and check for course messages/emails and/or calendar updates and/or announcements at least three times per week during the active semester, and provide a response to instructor emails as requested within two business days.

You can expect the instructor to return student email within 24-48 hours. For urgent communications, use the instructor’s cell phone (provided); you may call or text any time. If you have not heard back from the instructor within the time frame expected, please RESEND your message.

Throughout the term, accessing all course materials and demonstrating appropriate academic progress, as well as completing assignments/exams on time, are additional requirements for successful completion of this course.

All five required course exams (Exams 1-5 inclusive) must be taken and submitted for grading before the end of the semester to obtain course credit. At instructor discretion, a “zero” grade may be assigned (or points taken off the numeric exam grade) if an exam is not taken by the posted deadline. See above policy on late assignment (deadline extensions) and late submissions.

Before the end of the term, the College of Nursing will make available an online anonymous evaluation that will allow you to evaluate the course and the instructor. Please complete this, student feedback is appreciated. You are also welcome to provide feedback on the course to the instructor at any time.

Resources:Technology support: A support hierarchy is in place to assist students enrolled in online courses. If you need assistance, please see below.

1. Nursing Technology Center, Monday - Friday, 8am-5pma. Email ntc@musc.edu first. This is the best way to set up an

appointment or request non-urgent help. b. If you cannot proceed with your work until you get assistance, call

Bernie Jansen (843) 792-02132. 24/7 support: OCIO-IS Support Desk is available Monday - Sunday, 24

hours, (843) 792-9700, or helpdesk@musc.edu to send an email. If you have forgotten your username and password, only OCIO-IS can help you.

3. For content-specific issues, remember to look in the syllabus. The answers to many of your questions can be found in the syllabus. Contact course faculty with course-specific questions.

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NRDNP 838 Advanced Pathophysiology Fall 2013

Required technology:Computer use at MUSC: Please read and understand the university’s computer use policy. It can be located by clicking below.Computer Use Policy: Prerequisite computer competencies: This information can be found in Section III of the current MUSC College of Nursing Student Handbook, which is posted on the website and can be accessed by clicking below. Computer Competencies

Honor Code:The faculty of the MUSC College of Nursing endorse the campus Honor Code and expect students to be familiar with and abide by its provisions. The Honor Code policy applies to all tests, written assignments, clinical behavior, clinical logs, medical record entries, and verbal and electronic communication. The Honor Code document can be viewed by clicking below. Honor Code

Plagiarism statement:Plagiarism is a form of academic misconduct and is the use of another person’s words or ideas without providing credit to that person. It is the theft of another person’s words or ideas to give the impression that you created them. These words and ideas may be from a variety of sources including printed works, speeches, presentations, and/or Internet sites and documents. Appropriate and complete referencing of words and ideas obtained from others is a requirement in ALL courses. If a work is anonymous, as may be the case with some Internet documents, it still must be fully referenced.

Course Evaluation:The practice of professional nursing involves internalizing values of altruism, autonomy, human dignity, and integrity (The essentials of baccalaureate education for professional nursing practice, 2008). While few would argue this occurs in caring for patients, it often does not translate into professional relationships. At the end of this course, you will be asked to evaluate the course and faculty. We ask that you do so with these values in mind. We value your honest opinions, but please be respectful.

Accommodation for disabilities:Section 504 of the Rehabilitation Act of and the Americans with Disabilities Act of 1990 requires MUSC to provide academic adjustments or accommodations for students with documented disabilities. Students seeking academic adjustments or accommodations must self-identify with the Associate Dean for Academics in the College of Nursing. The Disability Accommodation Request form may be found in the Office of Student services. After consulting with the Associate Dean for Academics, students are encouraged to meet with instructors to discuss their needs and, if applicable, any clinical safety concerns related to their disabilities.

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NRDNP 838 Advanced Pathophysiology Fall 2013

FREE STUFF!!!

US Public Service Task Force: Guide to Clinical Preventive Services at http://www.ahrq.gov/clinic/pocketgd.htm (scroll down to the Online Store)

Join the NIH, FDA, CDC and other listservs (free): A listserv subscribes you to receive email updates; can unsubscribe any time CDC: http://www.cdc.gov/subscribe.html FDA:

http://www.fda.gov/AboutFDA/ContactFDA/StayInformed/GetEmailUpdates/default.htm

NIH listserv signup: https://list.nih.gov/cgi-bin/wa.exe?A0=nihpress FDA Med-Watch: http://www.fda.gov/Safety/MedWatch/ucm228488.htm Be sure to check your email within 24 hours – they will want you to confirm

that you have joined the list in order to establish your membership in the list

The Merck Manual Professional Online: http://www.merckmanuals.com/professional/index.html and smartphone apps at http://www.merckmedicus.com/pp/jsp/home.jsp http://www.merck.com/

Monthly Prescribing Reference (MPR) online: Drug database resource: http://www.empr.com/ register for free email

newsletter on new drugs Downloadable app for smartphone/PDA: http://www.empr.com/download-

empr/section/753/

Diagnosaurus: free “app” for PDA/smartphone. Google “diagnosaurus” or find using your app store on your device. This app allows you to generate a differential diagnosis list!!

Morbidity & Mortality Weekly Report MMWR): weekly with periodic summaries, CDC guidelines and advice for screening & intervention strategies, travel recommendations. You may request to be put on their listserv email notification system so you will know when new issues are available and can link to them via email: http://www.cdc.gov/mmwr/mmwrsubscribe.html

Physician's Desk Reference (PDR): can register for free newsletters and also use their searchable drug information database at http://www.pdr.net/

Order free monofilaments for neuropathy testing: http://www.ask.hrsa.gov/detail_materials.cfm?ProdID=3465

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NRDNP 838 Advanced Pathophysiology Fall 2013

THINGS THAT COST MONEY

LexiComp Smartphone/PDA database: databases for drug interaction, drug database and more. Much of this is now available at the MUSC library. You will also purchase a discounted student subscription for your smart phone before we begin Advanced Pharmacology – if questions, ask Dr. D.

Pharmacology Continuing Education: (print, smartphone, online)The Medical Letter on Drugs & Therapeutics: http://secure.medicalletter.org/ The Prescriber’s Letter: http://prescribersletter.therapeuticresearch.com/home.aspx?cs=&s=PRL

Lippincott Manual Series: http://www.lww.com Washington University Manual on Medical Therapeutics – hospital diagnosis & therapeuticsProblem Oriented Medical Diagnosis – great for beginning clinical students (symptom-based diagnosis) Many other “manuals” in this series (orthopedics, ophthalmology, etc.) – usually available as print manual and/or PDA/smartphone app.

Harriet Lane Handbook (Johns Hopkins Hospital), Pub: Mosby, new edition updated every 2 years. Pediatric handbook & reference values; carry size handbook with PDA link (be sure to purchase the book that also gives you the PDA link for download).

Dermatology: Fitzpatrick. Color Atlas and Synopsis of Clinical Dermatology. McGraw –Hill

Red Book, Report of The Committee on Infectious Disease, American Academy of Pediatrics, published every 2 - 3 years. Latest recommendations for topics relating to infectious disease, including vaccinations & infectious and/or pediatric care issues. Can be purchased online as PDA download, or text, or computer download. URL: http://aapredbook.aappublications.org/

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