Syllabus Ncm 103 Final 4e6o5r

F.L. VARGAS COLLEGE Bagay Road, Caritan Centro Tuguegarao City, Cagayan Valley COLLEGE OF HEALTH SCIENCES Course Name Course Code Course Description

Course Credit Hours/ Semester Pre-requisite Placement Course Objectives

: CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE : NCM 103 : This course deals with the principles and techniques of nursing care management of sick clients across lifespan with emphasis on the adult and the older person, population group in any setting with alterations/problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocrine function. : 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical) : 144 lecture hours; 306 RLE hours : NCM 102 : 3rd year, 1st semester : At the end of the course and given relevant actual clients with problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism, 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 client’s 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

At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of

1. Identify risk factors among clients that contribute to the development of problems in Oxygenation- cardiovascular risk factors (modifiable and

COURSE CONTENT The different risk factors among clients that contribute to the development of problems in oxygenation:  Current respiratory problems  History of respiratory disease

TEACHING-LEARNING ACTIVITIES   

Pre-tests Case Analysis Small Group

VALUES INTEGRATION   

Assertiveness Cooperation Participation

TIME FRAME

2.5 hours

EVALUATION

After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors

2.

3.

4.

5.

individuals, families with problems in oxygenation in community and hospital settings; Ensure a well organized and accurate documentation system; Relate with client/s and their family and the health team appropriately; Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and, Promote personal and professional growth of self and others.

non-modifiable).

2. Identify significant subjective data from client history related to problems in oxygenation.



Lifestyle (smoking, alcoholism, exercise patterns)  Presence of cough  Presence of Chest Pain  Lung Cancer  Cardiovascular disease  Stroke  Tuberculosis  Obesity  Dietary assessment  Medication history a. Chief complaints b. 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

 

    

3. Enumerate the principles and techniques of physical examination in assessing the oxygenation status in newborn, children, adults.

a. b. c. d.

Inspection- gas exchange, perfusion Palpation- gas exchange, perfusion Percussion- gas exchange Auscultation- gas exchange- heart sound, breath sounds, deviations, fluid transport

 

4.

   

Screening procedure- peak flow meter Diagnostic Procedures Non-invasive: Pulmonary: e.g. sputum microscopy, chest xray, pulmonary function tests, smoke analyzer Fagerstrom test – standardized degree of

  

Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in Oxygenation.



 

 

Learning Lecture Discussion Post test



Sensitivity

Pre-tests Case Analysis Small Group Learning Lecture Discussion Postl test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify significant subjective data from client’s history by enumerating the possible chief complaints and recording relevant information guided by the eleven functional patterns.

Demonstration Return Demonstration Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

3 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2.5 hours

The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adult’s oxygen status by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

that contribute to the development of problems in oxygenation.

     

5. Determine the Pathophysiologic mechanisms of the Alterations in oxygenation

  a. b.

c. d.

6.

Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Oxygenation.

7. Identify principles of various modalities of management of clients with problems in oxygenation taking into

a.

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, cardiac catheterization, CVP, hemodynamics monitoring, enzyme levels, Serum, Cholesterol Vascular: angiography Blood: CBC and bone marrow biopsy Alteration in gas exchange – ventilator dysfunction, impaired perfusion Alteration in cardiac performance – heart rate problems, impaired stroke volume secondary to altered preload, afterload, myocardial contractility Alteration in vascular integrity – transport network impairment Alteration in oxygen carrying capacity of the blood- decreased circulating erythrocytes (anemia), increased circulating erythrocytes (polycythemia) a. Ineffective breathing pattern b. Ineffective airway clearance c. Impaired gas exchange d. Inability to sustain spontaneous ventilation e. Dysfunctional 3entilatory weaning response f. Decreased cardiac output (CO) g. Altered tissue perfusion systemic h. Impaired gas exchange related to altered O2 carrying capacity of blood due to decreased erythrocytes/hemoglobin i. Activity intolerance related to malnutrition tissue hypoxia For altered pulmonary function:  Airway patency  Oxygen therapy  Adequate ventilation

    

    

  

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

16 hours

The students should be able to determine the patho-physiologic mechanisms in the different oxygenation problems.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in oxygenation.

Pre-tests Case Analysis Small Group Learning

   

Assertiveness Cooperation Participation Sensitivity

4 hours

 The students should be able to apply the various principles in the management of clients

consideration the following levels of care: 1. Health promotive 2. Disease preventive 3. Curative and restorative

8. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in istering medications clients with oxygenation problems.

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

 

Lecture Discussion Post test

  

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

 

with problems in oxygenation in the actual clinical nursing practice.  The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications of clients with oxygenation problems.

9. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in oxygenation.

1.

Safe and comprehensive perioperative nursing care 1.1 Assessment and care during the perioperative period 1.2 Techniques in assisting the surgical team during the operation 1.3 Principles of safety, comfort and privacy during the perioperative period 1.4 Nursing responsibilities during the perioperative period  Preoperative – physical, psychological, spiritual preparation  Intraoperative – circulating nurse functions, scrub nurse functions  Postoperative – airway, breathings, circulation priorities. Meeting the physical, psychological and spiritual needs of the cliet. 2. Pulmonary a. Surgical procedures – tracheostomy, thoracostomy, lung resection, lobectomy, pneumonectomy, thoracoplasty, decortications b. Special procedures – endotrcheal/tracheal suctioning and care, humidication, IPPB, ventilator assist 3. Cardiac a. Surgical procedures – coronary aretery by, pacemaker insertion, valve replacement, repair of congenital abnormality, insertion of ventricular assist device, heart plansplant b. Special procedures – laser therapy, basic life , advance life 3.1 Vascular a. Surgical procedures – endarterectomy, aneurysmectomy, insertion of intravascular stents b. Special procedures – application of antiembolic stockings 3.2 Blood forming organs a. Surgical procedures – bone marrow aspiration, bone marrow transplant b. Special procedures – blood component transfusion, reverse isolation

    

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students will be able to list the different surgical and special procedures for clients with oxygenation problems and identify the nursing responsibilities in each procedure.

At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of individuals, families with problems in Fluids and electrolyte imbalances in community and hospital settings. 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.

10. Identify risk factors among clients that contribute to the development of problems in Fluid and Electrolytes.



11. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.

 

12. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in 13. Determine the Pathophysiologic Mechanisms of Fluid and electrolyte imbalances.

    

 

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

a. Diagnostic tests  Non-invasive: electrolyte determination, intake and output, KUB-IVP and ultrasound  Invasive – biopsy b. Weight c. Vital Signs a. b. c.

d.

14. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Fluid and electrolyte imbalance.

Potential factors for exceeding renal reserve capacity, dietary habits to include salt intake, hypertension, infection, diabetes.

a. b. c. d.

Volume impairment – fluid volume deficit, fluid volume excess, third space fluid shift Osmotic imbalances – hyponatremia, hypernatremia Ionic concentration problems – hypo- and hyperkalemia; hypo and hyperchloremia; hypoand hypermagnesemia; hypo- and hyperphosphatemia Acid and base imbalances – metabolic acidosis and alkalosis; respiratory acidosis and alkalosis

Risk for fluid volume deficit Fluid volume excess Fluid volume deficit High risk for injury related to electrolyte deficit/excess e. High risk for injury related to acid/base

   

         

    

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

Demonstration Return Demonstration Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

12 hours

The students should be able to determine the patho-physiologic mechanisms in the different fluid and electrolyte imbalances.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in fluid

After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in fluid and electrolyte imbalances. The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adult’s fluids and electrolyte balance status by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

15. Identify principles of various modalities of management of clients with problems in fluid and electrolyte imbalances taking into consideration the following levels of care: a. Health promotive b. Disease preventive c. Curative and restorative

imbalance f. Altered urinary elimination g. Impaired integumentary integrity a. Fluid Volume Deficit  Determination and management of cause  Hydration  Blood transfusion as needed  Drug therapy – electrolyte  ive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation b. Fluid Volume Excess  Determination and management of cause  Drug therapy – diuretics, electrolytes  Dietary restriction – sodium  ive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation c. Electrolyte Deficit – hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia  Determination and management of cause  Drug therapy – electrolyte replacement  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation d. Electrolyte Excess – hyperkalemia, 7ypercalcaemia, hypermagnesemia, hyperphosphatemia  Determination and management of cause  Drug therapy – electrolyte replacement  Dietary management

and electrolyte imbalances.

    

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

12 hours

 The students should be able to apply the various principles in the management of clients with problems in fluid and electrolyte imbalance in the actual clinical nursing practice.  The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

e.

f.

g.

 ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation Metabolic Alkalosis – Base bicarbonate exces  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation a. Metabolic Acidosis- base bicarbonate deficit  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation Respiratory Alkalosis – carbonic and acid deficit  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation Respiratory Acidosis – carbonic acid excess  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation

16. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in istering medications clients in fluid and electrolyte imbalances.

17. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances. At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of individuals, families with problems in nutrition and metabolism in community and hospital settings. 2. Ensure a well organized and accurate documentation system; 3. Relate with client/s and their family and the health team

18. Identify risk factors among clients that contribute to the development of problems in Nutrition and Metabolism.

19. Identify significant subjective data from client history related to problems in nutrition and metabolism.

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 Renal dysfunction a. Major surgical procedures – nephrectomy, nephrostomy, cystectomy, uterostomy, renal transplants, urinary diversion b. Special procedures- peritoneal dialysis, hemodialysis, bladder training, cystoclysis/bladder irrigation  Risk factors related to malnutrition, obesity.

    

         

a. b.

Chief complaints 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

    

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2.5 hours

The students should be able to enumerate the different medications in managing clients with fluid and electrolyte imbalances, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1 hour

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students will be able to list the different surgical and special procedures for clients with fluid and electrolyte imbalance and identify the nursing responsibilities in each procedure. After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in nutrition and metabolism. The students should be able to identify significant subjective data from client’s history by enumerating the possible chief complaints and recording relevant information guided by the eleven functional patterns

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.

   20. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.

21. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in Nutrition and Metabolism.

a.

22. Determine the Pathophysiologic mechanisms of the Alterations in Nutrition and Metabolism.

a.

b.

b. c.

d. 23. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Nutrition and Metabolism.

a. b. c. d. e.

24. Identify principles of various modalities of management of clients with problems in Nutrition and Metabolism

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

3.3 Gastrointestinal function – IPPA  Inspection- color, texture of skin, mucous membrane, growth patterns, scars, masses  Auscultation- bowel sounds, bruits  Palpation – focus on GIT for presence of masses, ascites, rebound tenderness, distention  Percussion – liver span, masses

 

Non-invasive: ultrasound of the abdomen, stool culture Invasive: to include: barium swallow, esophagoscopy, biopsy, cytology examination, gastric secretion analysis, endoscopy (gastroscopy, duodenoscopy), proctosigmoidoscopy and rectal examination

  

Disturbances in ingestion – problems in buccal cavity and esophagus Disturbances in digestion – peptic acid disease, gastritis and gastric cancer Disturbances in absorption – malnutrition, malabsorption syndrome and inflammatory bowel conditions Disturbances in elimination – bowel obstruction, hemorrhoids, diarrhea and constipation. Alteration in nutrition less than body requirement Alteration in nutrition more than body requirement Alteration in oral mucous membrane integrity Alteration in comfort: epigastric pain/abdominal pain Fluid volume deficit

  

A. Disturbances in ingestion  Determination and management of cause  Drug therapy

 

 

 

       

Demonstration Return Demonstration Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

12 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in nutrition and metabolism.

Pre-tests Case Analysis Small Group Learning

   

Assertiveness Cooperation Participation Sensitivity

12 hours

 The students should be able to apply the various principles in the management of clients

The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adult’s nutritional and metabolic status by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

The students should able to determine patho-physiologic mechanisms in different nutritional metabolic problems.

be the the and

taking into consideration the following levels of care: 4. Health promotive 5. Disease preventive 6. Curative and restorative

 Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation B. Disturbances in digestion  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation C. Disturbances in absorption  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation D. Disturbances in elimination  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation E. Disturbances in hepatic, biliary and pancreatic functions  Determination and management of cause  Drug therapy  Dietary management  ive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation

 

Lecture Discussion Post test

with problems in nutrition and metabolism in the actual clinical nursing practice.  The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

         

25. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in istering medications clients with Nutrition and Metabolism problems.

At the end of the lecture discussion, the students will be able to: 1. Utilize the nursing process in the care of individuals, families with problems in endocrine functioning in community and hospital settings. 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,

26. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in Nutrition and Metabolism.

a.

27. Identify risk factors among clients that contribute to the development of problems in Endocrine Function.



28. Identify significant subjective data from client history related to problems in endocrine functioning.

b.

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

Surgical procedures – gastrostomy, gastrectomy, colostomy, hemorrhoidectomy, gastrointestinal by, ileostomy Special procedures – parenteral hyperalimentation; feeding per nasogastric, jejunostomy, gastrostomy tubes; colostomy care and irrigation, dietary planning for common GT and endocrine problems; istering medications via NGT, J tube, G tube; hot sitz bath Risk factors related to endocrine hypo or hyperfunctioning.

    

    

    

A. Chief complaints B. 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

    

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

After the discussion, the students will be able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in endocrine functioning.

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2 hours

The students should be able to identify significant subjective data from client’s history by enumerating the possible chief complaints and recording relevant information guided by the eleven functional patterns

The students should be able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications of clients with nutrition and metabolism disorders. The students will be able to list the different surgical and special procedures for clients with nutrition and metabolism problems and identify the nursing responsibilities in each procedure.

core values and nursing standards in the care of clients; and, 5. Promote personal and professional growth of self and others.

29. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal in the endocrine system.

30. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in endocrine functioning.

     a. 



31. Determine the Pathophysiologic mechanisms of the Alterations in endocrine functioning.

a. b. c. d. e. f. g.

32. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in endocrine functioning.

33. Enumerate Pharmacologic actions,

a. b. c.

 

Inspection- color, texture of skin, mucous membrane, growth patterns, obesity Auscultation – bruit, heart sounds, breath sounds Palpation- organ-thyroid enlargement, masses, edema Percussion- fluid, edema Others – weight, delayed healing of wounds

 

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 transhepatic cholangiogram, 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. Hypo- and Hyperfunction of the pituitary organ Hypo- and Hyperfunction of the hypothalamus Hypo- and Hyperfunction of the thyroid organ Hypo- and Hyperfunction of the parathyroid organ Hypo- and Hyperfunction of the adrenal organ Hypo- and Hyperfunction of the gonads Problems in glucose metabolism – hypoglycemia and hyperglycemia (IDM, NIDDM) Alterations in nutrition less than body requirement Fluid volume deficit Activity intolerance

  

Corticosteroids Alpha-adrenergic blocking agents

Demonstration Return Demonstration Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2.5 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

10 hours

The students should be able to determine the patho-physiologic mechanisms in the different endocrine problems.

   

Assertiveness Cooperation Participation Sensitivity

1.5 hours

 

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

The students should be able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in endocrine functioning.

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Pre-tests Case Analysis

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Assertiveness Cooperation

2.5 hours

 The students should be able to apply the various

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The students will be able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adult’s endocrine functioning by comparing any deviations from normal findings. Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in istering medications clients with endocrine problems.

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

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34. Identify principles of various modalities of management of clients with problems in endocrine functioning taking into consideration the following levels of care: a. Health promotive b. Disease preventive c. Curative and restorative

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

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35. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in endocrine functioning.

a. b.

Surgical procedures – thyroidectomy, parathyroidectomy Special procedures – monitoring of blood glucose levels; maintenance of blood glucose – diet, exercise, drugs

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Small Group Learning Lecture Discussion Post test

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Participation Sensitivity

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

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Assertiveness Cooperation Participation Sensitivity

12 hours

Pre-tests Case Analysis Small Group Learning Lecture Discussion Post test

   

Assertiveness Cooperation Participation Sensitivity

2.5 hours

References: th 1. Lippincott Williams & Wilkins. The Lippincott Manual of Nursing Practice – 7 edition. 2001. th 2. Marieb, Elaine N. Essentials of Human Anatomy and Physiology – 8 edition. Pearson Education South Asia PTE. LTD. 2006 th 3. Brunner and Suddarth. Textbook of Medical-Surgical Nursing – 12 edition. 2010

principles in the management of clients with problems in endocrine functioning in the actual clinical nursing practice.  The students should be able to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration. The students should be able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects, indications and contraindications and nursing responsibilities in the different medications of clients with endocrine problems. The students will be able to list the different surgical and special procedures for clients with endocrine problems and identify the nursing responsibilities in each procedure.

Prepared by:

Recommending Approval: FREIDA MICHELLE BONNIT-TAJA, RN, MAN Instructor

KATLYN C. MANGUPAG, RN, MSN OIC, COLLEGE OF HEALTH SCIENCES Approved by: MR. JOSEPH B. FURIGAY Director for Instruction