COURSE GUIDE
Course: NCM 411 – Nursing Care of Clients Semester: 1st School Year: 2023 - 2024
with Life Threatening Conditions, Acutely
Ill/Multi Organ Problems High Acuity and
Emergency Situation, Acute and Chronic
Class Schedule: Monday and Tuesday Instructor: Ma. Natividad B. Baldono, Vanessa C.
Edaniol
Course Description:
This course deals with concepts, principles, theories and techniques of nursing care of at risk and
sick adult clients in any setting with alteration/problems in nutrition, and gastro-intestinal, metabolism
and endocrine, perception and coordination, acute and chronic toward health promotion, disease
prevention, restoration and maintenance, and rehabilitation. The learners are expected to provide
safe, appropriate and holistic nursing care to at-risk and sick adult clients utilizing the nursing process.
Course Outline:
SCHEDULE TOPICS
Week 1 Orientation to the course, ESSU VMGO, Program Goal, Program Outcomes, and
requirements:
Introduction and Overview of the Concepts of NCM 411/ Nursing Care of
Clients with Life Threatening Conditions, Acutely Ill/Multi Organ Problems
High Acuity and Emergency Situation, Acute and Chronic
I. INTRODUCTION TO CRITICAL CARE
A. Scope of Critical Care Practice
1. Development of Critical Care Nursing Practice, Education and
Professional Activities in the Philippines
2. Critical Care Body of Knowledge, Critical Care Competencies,
Professional Organizations
Week 2 II. NURSING CARE OF CLIENTS WITH LIFE-THREATENING
CONDITIONS, ACUTELY ILL/MULTI-ORGAN PROBLEMS, HIGH
ACUITY AND EMERGENCY SITUATIONS
A. Assessment
1. Subjective Data
History
2. Objective Data
Physical Assessment
Diagnostic Studies/Procedures
B. Analysis/Nursing Diagnosis
C. Planning
D. Implementation of Care of Clients
E. Client Education
F. Evaluation of the Outcome of Care
G. Reporting and Documentation of Care
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Week 3 III. RESPONSES TO ALTERATIONS/PROBLEMS AND ITS
PATHOPHYSIOLOGIC BASIS IN LIFE-THREATENING CONDITIONS,
ACUTELY ILL/MULTI-ORGAN PROBLEMS, HIGH ACUITY AND
EMERGENCY SITUATION
A. Responses to Altered Ventilatory Function
1. Assessment
Subjective Data
Nursing History
Objective Data
Physical Assessment
Diagnostic Assessment
a. Non – Invasive Oximetry
b. Invasive
ABG
Pulmonary Capillary Wedge Pressure
Pleural Fluid Analysis
Pulmonary Angiography
Ventilation-Perfusion (V/Q) Scan
Capnography
2. Nursing Diagnosis
3. Planning for Health Restoration and Maintenance
Week 4
4. Alterations in Ventilation
Acute and Chronic Obstructive Pulmonary Disease
Pulmonary Embolism
Acute Respiratory Distress Syndrome/Acute Lung Injury
Respiratory Failure
Pneumonia
- Community Acquired
- Ventilator Acquired
Respiratory Pandemics
Pulmonary Hypertension
Pneumothorax
5. Implementation
Medical-Surgical Management
Mobilization of Secretions
Artificial Airway Management
Administering Oxygen Therapy
Mechanical Ventilation
Thoracic Surgeries
Lung Transplantation
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Pharmacologic Management
Complementary and Alternative Medicines
Echinacea
Goldenseal
Zinc
Nutritional and Diet Therapy
Tube Feedings
Fluid Therapy
High CHON, High Calorie Supplements
6. Client Education
7. Evaluation of the Outcome of Care
8. Reporting and Documentation of Care
Week 5 B. Responses to Altered Tissue Perfusion
1. Assessment
Subjective Data
Nursing History
Objective Data
Physical Assessment
Diagnostic Assessment
a. Non-invasive
- ECG
- Echocardiography
b. Invasive
- Cardiac Catheterization
- Central Venous Pressure (CVP)
- Pulmonary Artery Pressure (PAP)
- Intra-Arterial Blood Pressure Monitoring
- Left Arterial Pressure Monitoring
2. Nursing Diagnosis
3. Planning
Recognize Myocardial Ischemia
Relieve Chest Pain
Maintain a Calm Environment
Balance of Myocardial Oxygen Supply and Demand
Optimize Cardiopulmonary Function
Promote Comfort and Emotional Support
Monitor Effects of Pharmacological Therapy
Patient Education
Week 6 4. Alteration in Perfusion
Acute Ischemic Heart Disease
Heart Failure
Cardiogenic Arterial Disease
Hypertensive Crisis
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Cardiomyopathy
Arrhythmias
5. Implementation
Medical/Surgical Management
Recanalization
Palliative Care for End-Stage Heart Failure
Percutaneous Transluminal Angioplasty
Pacemakers
Cardioversion
Ablation
CABG
IABP
Heart Transplantation
Pharmacological Management
Complementary/Alternative Therapies
Fish Oil/Omega 3 Fatty Acids
Hawthorn
Gingko Biloba
Ginseng
Garlic
6. Patient Education
MIDTERM EXAMINATION
Week 12 E. Responses to Altered Perception
1. Assessment
Subjective Data
Nursing History
Objective Data
Physical Assessment
Diagnostic Assessment
a. Brain Imaging Techniques – CT; MRI; PET; Cerebral
Angiography, Cerebral Perfusion, Intracranial Pressure
Monitoring
b. Pulse Wave Forms
c. Assessment of Cerebral Perfusion – CCP
d. Assessment of Cerebral Oxygenation – Jugular Venous
Oximetry, Partial Brain Tissue Oxygenation Monitoring
e. Non-invasive: Transcranial Doppler, Continous EEG, Near
Infrared Spectroscopy
- Neurological Assessment
a. Level of Consciousness
- Glasgow Coma Scale (GCS)
- Full Outline of Unresponsiveness (FOUR) Score
- Mental Status
b. Cranial Nerve Testing
c. Cerebellar Testing
d. Sensory Assessment
e. Motor Assessment
f. Reflexes
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2. Nursing Diagnosis
3. Planning
- Performing Frequent Assessment
- Maintaining Surveillance for Complications
4. Neurologic Alterations
- Traumatic Alteration
- Acute Ischemic Stroke
- Traumatic Spinal Cord Injury
5. Implementation
Medical/Surgical Management
- Bleeding Management
- Evacuation of Blood Clots
Pharmacological Management
Diet Nutritional Therapy
- Antioxidants
- Phytochemical
Complementary and Alternative Therapy
- Bilberry
6. Client Education
7. Evaluation of the Outcome Care
8. Reporting and Documentation of Care
Week 14 F. Multisystem Problems
1. Shock
2. Systemic Inflammatory Responses Syndrome (SIRS)
3. Multi Organ Dysfunction Syndrome (MODS)
Assessment
- Clinical Manifestation and Effects
- Sequential Organ Failure Assessment (SOFA)
- Diagnostic Studies
Nursing Diagnosis
Planning
Implementation
- Collaborative Care
- Drug Therapy
- Nursing Management Evaluation
Week 15 Environmental Emergency
a. Heat Related Emergencies
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b. Submersion Injuries
c. Advocacy: Access to Social Care Services
- Philhealth
- DOH
- DSWD
- PAGCOR
- PCSO
C. Professional Decorum in Critical Care
X. Filipino Culture, Values, and Practices in Care of group of Clients with Life-
Threatening Conditions, Acutely Ill/Multi-Organ Problems, High Acuity and
Emergency Situation
Week 18 FINAL EXAMINATION
Course Requirements:
Term Examination, assignments, Quizzes and other related activities
Course Learning Outcomes: Required Output:
1.
Course Policies: Grading System:
Course Policies:
References:
1.
Consultation Schedule:
Prepared by: Approved:
INSTRUCTOR PROGRAM HEAD
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