RIZAL TECHNOLOGICAL UNIVERISTY College of Nursing Boni Avenue, City of Mandaluyong

RESOURCE UNITS IN NCM 103

Care of clients with problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocrine.

RTU Philosophy

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The Rizal Technological University believes in nurturing the creative potentials of Filipinos to excel in a dynamic world order and advocates commitment to global peace and sustainable development along peace and sustainable development along with a sense of moral responsibility and cultural patronage.

RTU Vision

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A prominent University recognized for its commitment to innovative programs in addressing society’s challenges.

RTU Mission

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Prepare student to create their future in a knowledge-driven and culturally diverse society.

Mission of the RTU-CON :

RTU College of Nursing commits in providing excellent nursing education by offering innovative education approaches within a caring philosophy, encourages research endeavor appropriate for a practice description and provide professional services which helps to meet the health care needs of Manilenos including the underprivileged population.

Vision of the RTU-CON

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RTU College of Nursing envision itself as: A leading institute in the development of highly skilled and globally competitive nurses by sustaining an innovative, creative, and nurture an environment that exert to prepare students at the baccalaureate level to practice the art and science of nursing and to promote lifelong learning, to meet the evolving health care needs of the diverse rural community, the global community and God.

interpretation of laboratory findings  Identify actual and at-risk nursing diagnosis  Plan appropriate nursing interventions with client and family for identified nursing diagnosis  Implement plan of care with client and family  Evaluate the progress of the client’s condition and outcomes of care 2. core values and nursing standards in the care of clients. Prerequisite NCM 102 Terminal Competencies At the end of the course and given actual clients with problems in oxygenation. 1st Sem. Utilize the nursing process in the care of individuals. Nutrition & Metabolism and Endocrine Function. Subject 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. Observe bioethical concepts/principles. Fluids & Electrolytes Balance. Nutrition and Metabolism and Endocrine Functions Subject Code NCM 103 Subject Credit 8 Units (8Hr/18wks.) 144 hours Placement 3rd Yr. Promote personal and professional growth of self and others . and 5.Subject Title Care of Clients with Problems in Oxygenation. metabolic and endocrine functions . Ensure a well organized and accurate documentation system 3. fluids and electrolytes balance. families in community and hospital settings. Fluid & Electrolyte Balance. population group in any setting with alterations/problems in Oxygenation. the student should be able to: 1.  Assess with client his condition/health status through interview. physical examination. Relate with client and their family and the health team appropriately 4.

risk factors related to malnutrition. Nutrition and metabolism .risk factors related to endocrine hypo or hyper-functioning 1. Chief complaints Formulates SMART Nursing Care Plans Lecture – Discussion Week 1 8 hours Pre-test/Post-test Reading Comprehension on the assigned concept Teacher-student discussion Virtual excursions on: case studies of clients with altered status Short/ Long Quiz  Lecture-discussion AV Presentation Week 2 8 hours Pre-test/Post-test . middle. obesity 4.2 Assess the health status of a client  Conduct a health history and functional health status Perform systematic and comprehensive physical assessment to validate B. fluid & electrolyte balance. old adult) with responses to altered endocrine functions. Risk factors among clients that contribute to the development of problems in the following: 1. dietary habits to include salt intake. Identifies significant subjective data from the client history related to problems in oxygenation. diabetes 3. Fluid and electrolyte – potential factors for exceeding renal reserve capacity. the student will be able to: 1.1 Apply knowledge of normal anatomy and physiology and assessment techniques in caring for clients The individual client with problems in oxygenation. fluid electrolyte . hypertension.INTERMEDIATE COMPETENCIES CONTENT TEACHING-LEARNING ACTIVITIES Lecture TIME ALLOTED EVALUATION Given a client (young. nutrition and metabolism & endocrine function: A. nutrition and metabolism and endocrine function 1. Endocrine function . infection. Oxygenation – cardiovascular risk factors (modifiable and non modifiable) 2.

Relevant information. Inspection – color. Palpation – focus on GIT for Case Review Lecture-discussion AV Presentation Case Review Week 3 Teacher-student discussion 8 Hours Virtual excursions on: case studies of clients with altered status Short/ Long Quiz Case Presentation . adults. texture of skin. mucous membrane. ascites. masses b. Auscultation – gas exchange – heart sound. Palpation – gas exchange . Inspection – gas exchange. Fluid and electrolyte balance a. neck vein filling. fluid transport 2. fluid d. diagnostic and laboratory examinations 2. b. characteristic of pulse c. Gastrointestinal Function – IPPA a. Ausculation – bowel sounds. hand vein filling. Inspection – signs of dehydration. Palpation – edema. Percussion – abdomen for presence of air.assessed data  Interpret deviations from normal findings in the physical assessment. scars. Auscultation – rates 3. 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 C. Percussion – gas exchange d. deviations from normal: 1.growth patterns. perfusion c. Oxygenation a. bruits c. Principles and techniques of physical examination in newborn. overhydration. deviations . perfusion b. neuromuscular irritability. children. breath sound.

smoke analyzer Fagerstrom test – standardized degree of nicotine dependence . rebound tenderness. delayed healing of wounds D.Cardiac: ultrasound.thyroid enlargement. masses. Ausculation – bruit. breath sounds c. ascites 4. masses. systemic effects of endocrine malfunction ) – IPPA a. 2-D echo. stress test.ray. mucous membrane.g. Screening procedure – peak flow meter b. ascites. edema d.presence of masses.Blood: pulse oximeter . obesity b. heart sounds. thoracentesis. edema e.Pulmonary: e. pulmonary Lecture-discussion Week 4 8 Hours Pre-test/Post-test AV Presentation Lecture-discussion AV Presentation Week 5 8 hours Short/ Long Quiz Case Review Teacher-student discussion . Diagnostic procedures –  Non-invasive: .Pulmonary: bronchoscopy. Inspection – color. . Percussion – liver span. Palpation – organ .Vascular: doppler ultrasonography . Metabolism and endocrine function ( focus on GIT. Results and implications of diagnostic/laboratory examinations of clients with reference to problems in: 1. chest x.  Invasive: . ECG. Percussion – fluid. Oxygenation: a. ABG. pulmonary function tests.growth patterns. texture of skin. sputum microscopy. Others – weight. distention d.

duodenoscopy). bone marrow biopsy 2. Serum. Basal metabolic rate (BMR).radio-iodine assay (RAI). . .Cardiac: CO determination. Thyroxin stimulating hormone (TSH) test. CVP.g.g. random blood sugar (RBS).3 Utilized the assessed data in order to:  Prioritize nursing diagnosis Discuss the pathophysiological processes Plan the care utilizing evidencebased nursing research   . blood sugar tests ( fasting blood sugar (FBS). VS 3.Blood: CBC.  Non-invasive: e. b. Screening: glucose tolerance test. liver function test . hemodynamics monitoring. Iodine 131 uptake. ketonuria)  Invasive: e.Vascular: angiography. endoscopy (gastroscopy. proctosigmoidoscopy. rectal examination a. enzyme levels. esophagoscopy. biopsy. derum thyroxine and triiodothyronine test. Diagnostic tests –  Non-invasive: electrolyte determination. cytology examination. Case Presentation Week 6 8 hours Pre-test/Post-test Lecture-discussion AV Presentation Short/ Long Quiz Preliminary Examination Lecture-discussion AV Presentation Case Review Week 7 8 hours 1. thyroid scan. intake and output. KUB-IVP. protein bound iodine (PBI). Cholesterol.Free thyroxin level. cardiac catheterization. percutaneous transhepatic cholangiogram. Ultrasound abdomen. OGTT (Glucose tolerance test) Urinalysis (glycosuria. stool culture  Invasive: to include: barium swallow. gastric secretion analysis. Fluid and Electrolyte Balance: a. Gastrointestinal function –  Non-invasive: Ultrasound o the abdomen. Ultrasound  Invasive – biopsy. GI x-ray.angiography . Weight.

Alteration in oxygen carrying capacity of the blood –decreased circulating erythrocytes (anemia) . hyp oand hypermagnesemia. endocrine assay E. Acid and base imbalances – metabolic acidosis and alkalosis. myocardial contractility c. hypo. increased circulating erythrocytes(polycythemia) 2. impaired diffusion. Disturbances in ingestion – problems in buccal cavity and Lecture-discussion AV Presentation Case Review Short/ Long Quiz   Teacher-student discussion Virtual excursions on: case studies of clients with altered status Week 8 8 Hours Case Presentation Pre-test/Post-test Short/ Long Quiz Lecture-discussion .Glycosylated hemoglogin (Hgb). Alteration in cardiac performance – heart rate problems. third space fluid shift b. impaired perfusion b. Two Achieve the best clinical outcomes utilizing ethico-moral and legal principles Plan effective care hour post prandial blood glucose).Osmotic imbalances – hyponatremia. hypo and hyperchloremia. hypernatremia c. Alterations in oxygenation a. Alteration in vascular integrity – transport network impairment d. respiratory acidosis and alkalosis 3. Alteration in gas exchange – ventilatory dysfunction. Pathophysiologic Mechanisms: 1. hypo.and hyperkalemia.and hyperphosphatemia d. fluid volume excess.and hypercalcemia. afterload. Volume impairment – fluid volume deficit. Impaired stroke volume secondary to altered preload. Ionic concentration problems – hypo. Fluid electrolyte imbalances a. Alterations in GIT function a.

and Hyperfunction of the parathyroid organ e. Impaired gas exchange related to AV Presentation Case Review Pre-test/Post-test Week 9 8 Hours Lecture-discussion AV Presentation Case Review Short/Long Quiz Teacher-student discussion Virtual excursions on: case studies of clients with altered status Case Presentation . hemorrhoids.and Hyperfunction of the hypothalamus c. Hypo. Altered tissue perfusion systemic h. Inability to sustain spontaneous ventilation e.and Hyperfunction of the thyroid organ d.and Hyperfunction of the adrenal organ f.and Hyperfunction of the gonads g. Ineffective breathing pattern b. Oxygenation a. gastritis. Hypo. Disturbances in digestion – peptic acid disease. Hypo. Disturbances in absorption – malnutrition. Impaired gas exchange d. malabsorption syndrome.and Hyperfunction of the pituitary organ b. Problems in glucose metabolism – hypoglycemia and Hyperglycemia (IDM. NIDDM) F.esophagus b. diarrhea. Alterations in endocrine function a. Hypo. Dysfunctional ventilatory weaning response f. Disturbances in elimination – bowel obstruction. Hypo. Nursing Diagnoses taxonomy pertinent to problems/ alteration in: 1. Decreased cardiac output (CO) g. inflammatory bowel conditions d. gastric cancer c. Hypo. constipation 4. Ineffective airway clearance c.

Alteration in oral mucous membrane integrity d. Risk for fluid volume deficit b. Fluid volume excess d. Principles of Various Modalities of Management 1. Disease Preventive 3. Alteration in comfort: epigastric pain/abdominal pain e. Alteration in nutrition more than body requirement c. 2. For Altered Pulmonary Function  Airway patency Case Presentation Lecture-discussion AV Presentation Case Review Week 10 8 Hours Pre-test/Post-test Short/ Long Quiz Teacher-student discussion Pre-test/Post-test . Activity intolerance related to malnutrition.altered O2 carrying capacity of blood due to decreased erythrocytes/hemoglobin i. Fluid and Electrolyte Imbalance a. Alteration in nutrition less than body requirement b. Gastrointestinal Function a. High risk for injury related to electrolyte deficit/excess e. tissue hypoxia. Fluid volume deficit c. Activity intolerance F. Endocrine Function a. Fluid volume deficit c. Impaired integumentary integrity 3. Altered urinary elimination g. Health Promotive 2. Principles of Management 1. High risk for injury related to acid/base imbalance f. Fluid volume deficit 4. Curative and Restorative G. Alterations in nutrition less than body requirement b.

electrolyte  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial Week 11 8 Hours Lecture-discussion AV Presentation Short/ Long Quiz Lecture-discussion AV Presentation Pre-test/Post-test Teacher-student discussion Week12 8 Hours Short/ Long Quiz Lecture-discussion AV Presentation . Fluid Volume Deficit  Determination and management of cause  Hydration  Blood transfusion as needed  Drug therapy . Oxygen therapy  Adequate ventilation  Drug therapy  Hydration  Removal of secretion  Prevention of infection  Prevention of complications  Prevention of psychosocial problems  Rehabilitation 2. For Cardiac Function  Hemodynamics monitoring  O2 therapy  Drug therapy  Hydration  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 3. Oxygen Carrying Capacity of the Blood  Blood component replacement  O2 therapy  Drug therapy  Hydration  Prevention of infection  Prevention of complications  Prevention of psychosocial problems  Rehabilitation 4.

hypokalemia. Fluid Volume Excess  Determination and management of cause  Drug therapy – diuretics. Electrolyte Excess.hypernatremia. hypomagnesemia. hyperphosphatemia  Determination and management of cause  Drug therapy – electrolyte replacement  Dietary management  Supportive management  Prevention of complication  Prevention of psychosocial problems Lecture-discussion AV Presentation Week 13 8 Hours Teacher-student discussion Short/ Long Quiz Case Presentation Pre-test/Post-test Week 14 8 Hours .sodium  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 6. hypophosphatemia  Determination and management of cause  Drug therapy – electrolyte replacement  Dietary management  Supportive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 7. hypocalcemia.problems  Rehabilitation Midterm Examination 5.hypercalcemia. electrolytes  Dietary restriction . Electrolyte Deficit – hyponatremia. hyperkalemia. hypermagnesemia.

 Rehabilitation 8. Respiratory Alkalosis – Carbonic acid deficit  Determination and management of cause  Drug therapy  Dietary management  Supportive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 11. Metabolic Acidosis – Base bicarbonate deficit  Determination and management of cause  Drug therapy  Dietary management  Supportive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 10. Metabolic Alkalosis – Base bicarbonate excess  Determination and management of cause  Drug therapy  Dietary management  Supportive management  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 9. Respiratory Acidosis – Carbonic acid excess  Determination of cause  Drug therapy  Dietary management  Supportive management Lecture-discussion AV Presentation Short/ Long Quiz Lecture-discussion AV Presentation Teacher-student discussion Pre-test/Post-test Week 15 8 Hours .

Disturbances in Absorption  Determination and management of cause  Hydration  Drug therapy  Dietary management  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation Lecture-discussion AV Presentation Case Review Short/ Long Quiz Pre-test/Post-test Lecture-discussion AV Presentation Week 16 8 Hours Teacher-student discussion Short/ Long Quiz Case Presentation  Actively participates in planning. Disturbances in Digestion  Determination and management of cause  Hydration  Drug therapy  Dietary management  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 1. coordinating culturally sensitive disciplinary care Pre test/ Post test .4 Implement individualized nursing care:  Safely and knowledgeably administers prescribed medications and treatments 14. Disturbances in Ingestion  Determination and management of cause  Hydration  Drug therapy  Dietary management  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 13. Prevention of complication  Prevention of psychosocial problems  Rehabilitation 12.

Disturbances in Hepatic. Provide appropriate client education and health maintenance and community based-care Efficiently and effectively utilize available resources in the care of clients to achieve outcomes  15.sodium  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation Lecture-discussion Week 17 8 Hours AV Presentation Lecture-discussion AV Presentation Short/ Long Quiz Teacher-student discussion . Disturbances in Elimination  Determination and management of cause  Hydration  Drug therapy  Dietary management  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 16. Biliary and Pancreatic Function  Determination and management of cause  Hydration  Drug therapy  Dietary management  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation 17. Disturbances in Endocrine hypofunction  Determination and management of cause  Drug therapy – diuretics. electrolytes  Dietary restriction .

Disturbances in Endocrine Hyperfunction  Determination and management of cause  Drug therapy – diuretics. Parenteral fluids – Lecture-discussion AV Presentation Week 18 8 Hours Lecture-discussion AV Presentation Teacher-student discussion Lecture-discussion . electrolytes  Dietary restriction . and nursing responsibilities: 1. Cardiac  Sympathomymetic agents  Sympatholytic agents  Anti-anginal agents  Anti-arrhythmic agents  Angiotensin converting enzyme inhibitors  Antilipemic agents  Anticoagulant agents  Thrombolytics  Peripheral vascular agents 3. Fluid a.sodium  Supportive management  Prevention of infection  Prevention of complication  Prevention of psychosocial problems  Rehabilitation H. indications. Pharmacologic actions.18. Pulmonary  Bronchodilators  Expectorants  Antitussives  Antihistamines 2. Blood  Hematinics  Vitamin supplements 4. side effects. therapeutic use. contraindication.

 hypotonic. Electrolyte  Sodium  Potassium  Calcium  Magnesium  Phosphate 6.5 Evaluate the effectiveness of nursing care. revising the NCP as needed to promote.  hypertonic  isotonic solutions 5. Endocrine function  Corticosteroids  Alpha-adrenergic blocking agents  Alpha-adrenergic blocking agents  Beta-adrenergic blocking agents  Tyrosine inhibitors  Dopamine receptor antagonists  Glucocorticoids  Parathyroid hormone agents  Thyroid hormone agents  Insulin  Oral hypoglycemic agent AV Presentation Final Examination Individual Case Studies Lecture-discussion AV Presentation 1. restore functional health status of the clients Teacher-student discussion . Diuretics  Potassium-sparing  Potassium-losing  Osmotic diuretics 7. Vitamin D supplements 8. Gastrointestinal. hepato-biliary and pancreatic function  Antiemetics  Anticoagulant  Hematinics agents  Laxatives and stool softeners  Antipruritus  Vitamin supplement  Antacids  Antihyperlipidemics  Antispasmodics  Antidiarrheal 9.

6th Edition Medical-Surgical Nursing. Recitation 4. Udan. MAN Clinical Instructor _________________________ Liza Marie B. Concepts and Clinical Application. 6.8th Edition Essentials of Human Anatomy and Physiology. 4. RN. Ignativicius and Workman. 9th Edition Prepared By: ___________________________ Ruperto E. Gnilo. Oropesa III. Medical-Surgical Nursing. Espares Dean . RN. Journal Readings/Review 5. Elvisa B. 3. 5. 2nd Edition Brunner and Suddarth’sTextbook of Medical-Surgical Nursing. Critical Thinking for Collaborative Care. 12th Edition Saunder’s Comprehensive Review for the NCLEX-RN Examination. MAN Level III Coordinator ____________________ Dr. Case References: 1.Academic Exercises may be composed of one or all of the following: 1. 4rd Edition Lippincott Manual of Nursing Practice. Assignment 6. Smeltzers and Bare. Silvestri. Seatwork 3. Quiz/Long Test Study/Presentation 2. 2. Marieb.

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