Republic of the Philippines SAMAR STATE UNIVERSITY COLLEGE OF NURSING Catbalogan City, Philippines

UNIFIED AND UPDATED SYLLABUS (Bachelor of Science in Nursing) I. Course Number: NCM 103

II. Course Descriptive Title:

CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE PERI-OPERATIVE NURSING

III. Credit Units: IV. Course Pre-requisite/s: V. Professor/s: VI. Academic Term and School Year: VII. Time Allotment: VIII. Vision and Mission of SSU: SSU VISION

XXX NCM 102 Leodoro J. Labrague, RN First Semester 2012-2013 XXX

The university commits itself to the development of human potentials and the fortification of human conditions as subsumed in the fundamental matrix of the life of the indigenous society and in the realities of global community. SSU MISSION The university shall primarily provide advanced instruction and professional training in the arts, philosophy, social sciences, agriculture, forestry, science and technology, engineering, education, law and other related fields. It shall undertake research and extension services, and provide progressive leadership in its areas of specialization. IX. CON Goals and Objectives GOALS To this end, the college shall: A. Foster academic excellence through Competency-based and community oriented curriculum responsive to the changing health care needs and services of the country and the global community. Trained, competent, dynamic and committed nursing and non-nursing faculty and staff. An academic and clinical environment contributing to efficient teaching and learning and the development of the full potentialities of the students. B. Produce graduates form all sectors of society especially from the grass-roots level. C. Render meaningful community based and extension services. Undertake research activities geared towards improvement of professional practices. OBJECTIVES Thus, graduates of the Bachelor of Science in Nursing (BSN) should be able to:

Utilize the nursing process in demonstrating knowledge and skills in health promotion, illness prevention of management of the sick clients and rehabilitation of patients throughout the life span. Render individualized, comprehensive, and holistic care to individuals, families, and communities in any of the health care setting and within the realities of the situation. Demonstrate critical thinking abilities when performing care and confronted with situations requiring astute decision-making. Utilize a broad base of theoretical knowledge drawn form nursing and behavioral sciences when rendering care and collaboration. Conduct actual research utilizing finding for improvements in nursing care. Practice leadership and management abilities in all areas of practice. Imbibe ethico-moral values, which shall serve as guidelines for professional conduct and practice. Be cognizant of the legal responsibilities and accountabilities. Assume responsibilities of continuing education.

XI-Course Description: 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. XII. Course Objectives:

Course Content A. Concept of Pain I. Definition of pain II. Pain Process a. Physiology of Pain b. Theories of Pain c. Types of Pain stimuli d. Types of Pain I. Factors Affecting Pain Experience II. Pain Assessment a. Pain History b. Observation of Behavior/Physiological Responses III. Assessments Tools a. Unidimentional Tool b. Multidimentional Tool IV. Pain Management a. Complementary Alternative Measures b. Pharmacologic Relief Measures V. Reassessment of Pain B. Concept of Surgery I. Definition of Surgery II. Classification of Surgery III. Factors Affecting Surgery IV. Phases of Surgical Experience a. Pre-Operative Phase i. Definition ii. Pre-Operative assessment iii. Pre-operative medication iv. Informed consent v. Pre-operative physical preparation vi. Pre-operative teachings vii. Pre-operative checklist b. Intra-Operative Phase i. Definition ii. Operating Room team 1. Coordinated Role of scrub nurse and circulator

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2. Behaviors of Operating room personnel iii. Universal precautions in OR 1. Principles of Sterile Technique 2. Surgical Scrubbing 3. Gowning and Gloving iv. Concept of Anesthesia 1. Level of Anesthesia 2. Types of Anesthesia v. Surgical Instrumentation 1. Classifications of instruments 2. Handling of instruments 3. Cleaning of instruments vi. Wound Closure materials 1. Wound Drain 2. Surgical Needle 3. Suturing Technique vii. Surgical hand and skin cleansing viii. Surgical positions c. Post-Operative Phase i. Phases of Postoperative Period ii. Initial Assessment of Post Operative Client iii. Aldrete scoring system iv. Post anesthesia scoring system v. Specific post operative goals Selected Surgical Specialties a. Cesarean Delivery b. Ophthalmic Surgery

XII. Course Objectives B: General Objectives At the end of the course, and given 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. a. Assess with client/s his/her/their condition/health status through interview, physical examination, interpretation of laboratory findings. b. Identify actual and at-risk nursing diagnosis. c. Plan appropriate nursing interventions with client/s and family for identified nursing diagnosis. d. Implement plan of care with client/s and family. e. 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. XIII. Course Content A. Gastrointestinal, Hepatic, and Pancreatic Systems Function, Assessment, and Therapeutic Measures I. Review of Normal Gastrointestinal, Liver, Gallbladder, and Pancreas Anatomy and Physiology 1. Oral cavity 2. Esophagus 3. Stomach 4. Small intestine 5. Large intestine 6. Liver 7. Gallbladder

8. Pancreas II. Nursing Assessment/Data Collection 1. Subjective data 2. Objective data 3. Diagnostic studies 4. Laboratory tests 5. Radiographic tests 6. Nuclear scanning 7. Angiography 8. Liver scan 9. Endoscopy 10. Gastric analysis 11. Ultrasonography 12. Percutaneous liver biopsy Therapeutic Interventions 1. Gastrointestinal intubation 2. Tube feedings 3. Gastrointestinal decompression 4. Total parenteral nutrition 5. Peripheral parenteral nutrition Gastrointestinal Drugs

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IV.

B. Pathophysiology, Signs and Symptoms, Diagnosis , Medical and Surgical management and Nursing Care of Patients with Upper Gastrointestinal Disorders 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Nausea and Vomiting Eating Disorders Obesity Oral Health and Dental Care Oral Inflammatory Disorders Oral Cancer Esophageal Cancer Hiatal Hernia Gastrointestinal Reflux Disease Esophageal Varices Gastritis Peptic Ulcer Disease Stress Ulcer Gastric Bleeding Gastric Cancer Gastric Surgeries

C. Pathophysiology, Signs and Symptoms, Diagnosis and Nursing Care of Patients with Upper Gastrointestinal Disorders 1. Problems with Elimination a. Constipation b. Diarrhea 2. Inflammatory and Infectious Disorders a. Appendicitis b. Peritonitis c. Diverticulosis and Diverticulitis 3. Inflammatory Bowel Disease a. Crohns Disease b. Ulcerative Colitis 4. Irritable Bowel Syndrome 5. Abdominal Hernias 6. Absorption Disorders 7. Intestinal Obstruction a. Small bowel obstruction b. Large bowel obstruction 8. Anorectal Problems a. Hemorrhoids b. Anal fissures c. Anorectal abscess

9. Lower Gastrointestinal Bleeding 10. Colon Cancer 11. Ostomy and Continent Ostomy Management a. Ileostomy b. Colostomy D. Pathophysiology, Signs and Symptoms, Diagnosis, Medical and Surgical management and Nursing Care of Patients with liver, Gallbladder, and Pancreatic Disorders 1. Disorders of the Liver a. Hepatitis b. Acute Liver Failure c. Chronic Liver Failure d. Transplantation e. Cancer of the Liver 2. Disorders of the Pancreas a. Pancreatitis b. Acute Pancreatitis c. Cancer of the Pancreatitis 3. Disorders of the Gallbladder a. Cholecystitis b. Cholelithiasis c. Choledocholithiasis XV. Methodologies / Strategies

Lecture-discussion Group Activities Return Demonstration

XVI. Evaluation Parameters / Measures a. 40%-Quizzes b. 10%-Project c. 50%-Periodic Exams Final rating = 30% midterm grade 70% final grade XVII. References:

1. 2. 3. 4. 5. 6. 7. 8.

Understanding Medical Surgical Nursing, Third Edition, Williams and Hopper Medical-Surgical Nursing, Eight Edition, Black and Hawks Fundamentals of Nursing, Taylor et al Medical Surgical Nursing, Black and Hawks Nursing Health Assessment, Patricia Dillon Managing Pain, Roman Jovey Operating Room Technique, Lucy Jo Atkinson and Nancymarie Fortunato Differentiating Surgical Instruments, Coleen J. Rutherford

Prepared by:

Leodoro J. Labrague, RN Clinical Instructor

Approved by:

Dolores L. Arteche, RN, MPM, MAN Dean, College of Nursing