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Emilio Aguinaldo College

Congressional Road, Burol Main, Dasmariñas Cavite

Tel # (046) 416-4341 to42

http//www.eac.edu.ph

Course Name: CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE

Course Code: NCM 103

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.

Course Credit: 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical)

Contact Hours/ Semester: 144 lecture hours; 306 RLE hours

Pre-requisite: NCM 102

Placement: 3rd year, 1st semester

Course Objectives: 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.

EMILIO AGUINALDO COLLEGE

SCHOOL OF NURSING

COURSE SYLLABUS IN CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE

TIMEFRAME/WEEK

INTERMEDIATE COMPETENCIES

COURSE CONTENT TEACHING-LEARNING ACTIVITIES

VALUES INTEGRATION

EVALUATION ASSIGNMENT REFERENCE

1_9hours

At the end of the unit, the students will be able to: 1. Identify risk factors among clients that contribute to the development of problems in Oxygenation- cardiovascular risk factors (modifiable and non-modifiable).

The different risk factors among clients that contribute to the development of problems in oxygenation:

Current respiratory problems

History of respiratory disease

Lifestyle (smoking, alcoholism, exercise

patterns) Presence of cough Presence of Chest

Pain Lung Cancer Cardiovascular

disease Stroke Tuberculosis Dietary assessment

Pre-tests Case Analysis Small Group

Learning Lecture Discussion Post test

Assertiveness

Cooperation

Participation

Sensitivity

After the discussion, the students were able to identify the factors that contribute to the development of problems in oxygenation thru written evaluation examination.

Do an advance reading regarding subjective data from client history related to

1. Lippincott Williams &Wilkins. Introductory Medical Surgical nursing. 9th edition. 2007. Pp 337-405.

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

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-testsCase AnalysisSmall Group

LearningLecture Discussion Post test

AssertivenessCooperation Participation Sensitivity

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.

Do an advance reading about the principles and techniques of physical examination in assessing the oxygenation status in newborn, children and adults.

1. Lippincott Williams &Wilkins. Introductory Medical Surgical nursing. 9th edition. 2007.

2. Barbara Kozier, Glenora erb, Audrey Berman and Shirlee Snyder. Fundamentals of Nurisng. 7th edition. 2004. P.272.

2_9hours

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

a. Inspection- gas exchange, perfusion b. Palpation- gas exchange, perfusion c. Percussion- gas exchange d. Auscultation- gas exchange- heart sound, breath sounds, deviations, fluid transport

Demonstration Return Demonstration Lecture Discussion Post test

Assertiveness Cooperation Participation Sensitivity

The students were able to perform the proper techniques in physical examination and apply the principles in correctly assessing the newborn, children, and adult’s

Do a Research

Do an advance Reading

Do a reporting

1. Lippincott Williams &Wilkins. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.499-506.

oxygen status by comparing any deviations from normal findings thru return demonstration.

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

Screening procedure-peak flow meter

Diagnostic Procedures

Non-invasive Pulmonary e.g.

sputum microscopy, chest x-ray, pulmonary function tests, smoke analyzer

Fagerstrom test-standardized degree of 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,

Case Analysis Lecture Discussion

AssertivenessCooperationParticipation Sensitivity

Given actual laboratory results of a patient, the students were able to identify deviations from normal findings.

Answer Chapter 22 critical thinking questions of the textbook page 548


cardiac catheterization, CVP, hemodynamics monitoring, enzyme levels, Serum, Cholesterol

Vascular: angiography

Blood: CBC and bone marrow biopsy

3_9 hours

5. Illustrate the pathophysiologicmechanisms of the alterations in oxygen

a. Alteration in gas exchange – ventilator dysfunction, impaired perfusion b. Alteration in cardiac performance – heart rate problems, impaired stroke volume secondary to altered preload, afterload, myocardial contractility c. Alteration in vascular integrity – transport network impairment d. Alteration in oxygen carrying capacity of the blood- decreased circulating erythrocytes (anemia), increased circulating erythrocytes (polycythemia)

Case AnalysisLecture Discussion

AssertivenessCooperation Participation Sensitivity

The students were able to determine the pathophysiologic mechanisms in the different oxygenation problems.

Do a reporting in nursing diagnoses taxonomy


6. Formulate nursing diagnoses taxonomy pertinent to problems/alteration in Oxygenation.

a. Ineffective breathing pattern b. Ineffective airway clearance c. Impaired gas exchange d. Inability to sustain

Pre-tests Case Analysis Small Group Learning

Assertiveness CooperationParticipation Sensitivity

The students wereable to identify possible nursing diagnoses

Do a reporting regarding principles of various modalities of management


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

Lecture Discussion Post test

taxonomy pertinent to the derived assessment data to pertinent problems in oxygenation.

clients with problems in oxygenation

7. Learn principles of various modalities of management of clients with problems in oxygenation taking into consideration the following levels of care: 1. Health promotion2. Disease preventive 3. Curative and restorative

For altered pulmonary function:

Airway patency Oxygen therapy Adequate

ventilation Drug therapy

Hydration Removal of

secretion Prevention of

infection Prevention of

complications Prevention of

psychosocial problems

Rehabilitation b. For cardiac

function

ReportingLecture Discussion

The students were able to apply the various principles in the management of clients with problems in oxygenation in the actual clinical nursing practice and wereable to provide the patients/clients with the proper teachings on health

Do a reporting about pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications


Hemodynamics monitoring

O2 therapy Drug therapy Hydration 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


complications

promotion, disease prevention and curative and health restoration.

4_9 hours

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

a. Pulmonary Bronchodilators Expectorants Antitussives Antihistamines

b. Cardiac Sympathomymetic

agents Sympatholytic

agents Anti-anginal agents Anti- arrhythmic

agents Angiotensin

Pre-tests ReportingLecture DiscussionPost test

Assertiveness Cooperation Participation Sensitivity

The students were able to enumerate the different pulmonary, cardiac, blood medications, with their corresponding pharmacologic actions, therapeutic uses, side effects,

Answer Chapter 25 critical thinking questions of the text book page 680


converting enzyme inhibitors

Antilipemic agents Anticoagulant

agents Thrombolytics

Peripheral vascular agents c. Blood Hematinics Vitamin supplements

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 care1.1 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. Pulmonarya. Surgical procedures – tracheostomy,

Case AnalysisLecture Discussion Post test

AssertivenessCooperationParticipationSensitivity

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

Do a reporting about risk factors among clients that contribute to the development of problems in Fluid and Electrolytes


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 bypass, pacemaker insertion, valve replacement, repair of congenital abnormality, insertion of ventricular assist device, heart plansplant b. Special procedures – laser therapy, basic life support, advance life support3.1 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

5_9 hours

10. Identify risk factors among clients

Potential factors for exceeding renal

Pre-testsReporting

AssertivenessCooperation

After the discussion,

Do an advance reading on

1. Lippincott Williams &Wilkins. Brunner and Suddarth’s Textbook of

that contribute to the development of problems in Fluid and Electrolytes.

reserve capacity, dietary habits to include salt intake, hypertension, infection, diabetes.

Lecture Discussion Post test

ParticipationSensitivity

the students were able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in fluid and electrolyte imbalances.

principles and techniques of physical examination in newborn, children, adults, deviations from normal

Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

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

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

LectureDiscussionDemonstrationReturnDemonstration


The students were 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.

Do an advance reading in Chapter 14 and answer Chapter 14 critical thinking questions of the textbook page 310


6_9 hours

12.Identify results and implications of diagnostic/laboratory examinations of clients with reference

a. Diagnostic tests Non-invasive:

electrolyte determination, intake and output,

Pretest Lecture Discussion Post test


Given actual laboratory results of a patient, the student were

Do an advance reading on pathophysiologic mechanisms of fluid and


to Fluid and Electrolyte imbalances

KUB-IVP and ultrasound

Invasive – biopsy b. Weight c. Vital Signs

able to identify deviations from normal findings.

electrolyte imbalances.

13. Determine the Patho- physiologic Mechanisms of Fluid and electrolyte imbalances.

a. Volume impairment – fluid volume deficit, fluid volume excess, third space fluid shiftb. Osmotic imbalances – hyponatremia, hypernatremia c. Ionic concentration problems – hypo- and hyperkalemia; hypo and hyperchloremia; hypo- and hypermagnesemia; hypo- and hyperphosphatemiad. Acid and base imbalances – metabolic acidosis and alkalosis; respiratory acidosis and alkalosis

Lecture DiscussionPost test


The students were able to determine the pathophysiologic mechanisms in the different fluid and electrolyte imbalances

Do an advance reading on nursing diagnoses taxonomy pertinent to problems/alteration in Fluid and electrolyte imbalance.


7_9hours

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

a. Risk for fluid volume deficitb. Fluid volume excess c. Fluid volume deficit d. High risk for injury related to electrolyte deficit/excess e. High risk for injury related to acid/baseimbalance f. Altered urinary elimination g. Impaired integumentary integrity

Case AnalysisLecture Discussion


The students were able to identify possible nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in fluid and electrolyte

Do a reporting about principles of various modalities of management of clients with problems in fluid and electrolyte imbalances


imbalances.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

a. Fluid Volume Deficit • Determination and management of cause • Hydration • Blood transfusion as needed • Drug therapy – electrolyte • Supportive 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 • Supportive management • Prevention of infection • Prevention of complication • Prevention of psychosocial problems • Rehabilitation c. Electrolyte Deficit – hyponatremia, hypokalemia, hypocalcemia,

Lecture Discussion Oral Recitation


The students were 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 wereable to provide the patients/clients with the proper teachings on health promotion, disease prevention and curative and health restoration.

Do a reporting about Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients in fluid and electrolyte imbalances.


hypomagnesemia, hypophosphatemia • Determination and management of cause • Drug therapy – electrolyte replacement • Dietary management • Supportive 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

• Supportive management • Prevention of complication • Prevention of psychosocial problems • Rehabilitation e. Metabolic Alkalosis – Base bicarbonate exces • Determination and management of cause • Drug therapy • Dietary

management • Supportive management • Prevention of complication • Prevention of psychosocial problems • Rehabilitation a. Metabolic Acidosis- base bicarbonate deficit • Determination and management of cause • Drug therapy • Dietary management • Supportive management • Prevention of complication • Prevention of psychosocial problems • Rehabilitation f. Respiratory Alkalosis – carbonic and acid deficit • Determination and management of cause • Drug therapy • Dietary management • Supportive management • Prevention of complication • Prevention of psychosocial problems • Rehabilitationg. Respiratory Acidosis – carbonic acid excess

• Determination and management of cause • Drug therapy • Dietary management • Supportive management • Prevention of complication • Prevention of psychosocial problems • Rehabilitation

8_9 hours

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

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

Lecture Discussion Questioning


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.

Do an advance reading on purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances.


17. List the purposes, indications, nursing

Renal dysfunction a. Major surgical

Pre-tests Lecture

AssertivenessCooperation

The students were able to

Do a reporting on risk factors

1. Lippincott Williams &Wilkins. Brunner and Suddarth’s Textbook of

responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances.

procedures – nephrectomy, nephrostomy, cystectomy, uterostomy, renal transplants, urinary diversion b. Special procedures- peritoneal dialysis, hemodialysis, bladder training, cystoclysis/bladder irrigation

Discussion Questioning

ParticipationSensitivity

list the different surgical and special procedures for clients with fluid and electrolyte imbalance and identify the nursing responsibilities in each procedure.

among clients that contribute to the development of problems in Nutrition and Metabolism

Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

9_9 hours

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

Risk factors related to malnutrition, obesity.

Lecture DiscussionQuestioning Post test


After the discussion, the students were able to identify the modifiable and non-modifiable risk factors that contribute to the development of problems in nutrition and metabolism.

Do an advance reading on significant subjective data from client history related to problems in nutrition and metabolism


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

a. Chief complaints b. Relevant information, to include eleven functional patterns • Health perception management pattern • Nutritional/metabolic pattern • Elimination pattern

Pre-tests Lecture Discussion

Questioning


The students were able to identify significant subjective data from client’s history by enumerating

Answer Chapter 41 critical thinking questions of the textbook pages 1242-1243


• 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

the possible chief complaints and recording relevant information guided by the eleven functional patterns

10_9 hours

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

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

Lecture Discussion Demonstration Return Demonstration


The students were 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.

Do a reporting on results and implications of diagnostic/laboratory examinations of clients with reference to problems in Nutrition and Metabolism.


21. Identify results and implications of

a Non-invasive: ultrasound of the abdomen, stool

Lecture DiscussionQuestioning

AssertivenessCooperationParticipation

Given actual laboratory results of a

Do an advance reading pathophysiologi

1. Lippincott Williams &Wilkins. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 12th edition.

diagnostic/laboratory examinations of clients with reference to problems in Nutrition and Metabolism.

culture b Invasive: to include:

barium swallow, esophagoscopy, biopsy, cytology examination, gastric secretion analysis, endoscopy (gastroscopy, duodenoscopy),

proctosigmoidoscopy and rectal examination

Post test Sensitivity patient, the student should be able to identify deviations from normal findings

c mechanisms of the Alterations in Nutrition and Metabolism

2010. Pp.1117-1243.

11_9 hours

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

a Disturbances in ingestion – problems in buccal cavity and esophagus

b Disturbances in digestion – peptic acid disease, gastritis and gastric cancer

c Disturbances in absorption – malnutrition, malabsorption syndrome and inflammatory bowel conditions

d Disturbances in elimination – bowel obstruction, hemorrhoids, diarrhea and constipation.

Pre-tests Lecture DiscussionQuestioning


The students were able to determine the pathophysiologic mechanisms in the different nutritional and metabolic problems.

Do an advance reading on nursing diagnoses taxonomy pertinent to problems/alteration in Nutrition and Metabolism.


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

a. Alteration in nutrition less than body requirement b. Alteration in nutrition more than body



The students should be able to identify possible

Do a reporting regarding principles of various


Nutrition and Metabolism.

requirement c. Alteration in oral mucous membrane integrity d. Alteration in comfort: epigastric pain/abdominal pain e. Fluid volume deficit

nursing diagnoses taxonomy pertinent to the derived assessment data to pertinent problems in nutrition and metabolism.

modalities of management of clients with problems in Nutrition and Metabolism

12_9hrs MIDTERM EXAMINATION13_hrs 24. Identify

principles of various modalities of management of clients with problems in Nutrition and Metabolism taking into consideration the following levels of care:

4. Health promotive

5. Disease preventive

6. Curative and restorative

A. Disturbances in ingestion • Determination and management of cause • Drug therapy • Dietary management • Supportive

management • Prevention of

complication • Prevention of

psychosocial problems • Rehabilitation Disturbances in digestion • Determination and

management of cause • Drug therapy • Dietary management • Supportive





The students were able to apply the various principles in the management of clients

Do a ResearchDo an advance ReadingDo a reporting


psychosocial problems • Rehabilitation Disturbances in absorption • Determination and

management of cause • Drug therapy • Dietary management • Supportive



psychosocial problems • Rehabilitation Disturbances in elimination • Determination and

management of cause • Drug therapy • Dietary management

Supportive management

Prevention of complication

Prevention of psychosocial problems

Rehabilitation Disturbances in

hepatic, biliary and pancreatic functions

Determination and management of cause

Drug therapy Dietary

management



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

Antiemetics Anticoagulants Hematinics

agents Laxatives and

stool softeners Antipruritus Vitamin

supplement Antacids Antihyperlipidemi

cs Antispasmodics Antidiarrheal

Lecture Discussion QuestioningPost test


The students were 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.

Do a reporting about purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in Nutrition and Metabolism


14_9 hours

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

a. Surgical procedures – gastrostomy, gastrectomy, colostomy, hemorrhoidectomy, gastrointestinal bypass, ileostomy b. Special procedures – parenteral



The students were able to list the different surgical and special procedures for clients with

Do an advance reading on risk factors among clients that contribute to the development of problems in


hyperalimentation; feeding per nasogastric, jejunostomy, gastrostomy tubes; colostomy care and irrigation, dietary planning for common GT and endocrine problems; administering medications via NGT, J tube, G tube; hot sitz bath

nutrition and metabolism problems and identify the nursing responsibilities in each procedure.

Endocrine Function.

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

Risk factors related to endocrine hypo or hyperfunctioning.

Pre-tests Lecture Discussion Questioning


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


15_9 hours

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

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

Pre-tests Lecture Discussion

Questioning


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

Do an advance reading on principles and techniques of physical examination in newborn, children, adults, deviations from normal in the endocrine system


• Self-perception-self-concept pattern • Role relationship pattern • Sexuality-reproductive pattern • Coping-stress tolerance pattern • Value-belief pattern

information guided by the eleven functional patterns

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

• 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



The students were 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 nor

Answer Chapter 42 critical thinking questions of the text book pages 1287-1288


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

a. 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

Lecture Discussion QuestioningPost test


Given actual laboratory results of a patient, the student should be able to identify deviations from normal findings.

Do an advance reading on pathophysiologic mechanisms of the Alterations in endocrine functioning.


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.

16_9 hours

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

a. Hypo- and Hyperfunction of the pituitary organ b. Hypo- and Hyperfunction of the hypothalamus c. Hypo- and Hyperfunction of the thyroid organ d. Hypo- and Hyperfunction of the parathyroid organ e. Hypo- and Hyperfunction of the adrenal organ f. Hypo- and Hyperfunction of the gonads g. Problems in glucose metabolism – hypoglycemia and hyperglycemia (IDM,

Pre-tests Case Analysis Lecture DiscussionRecitation


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

Do a reporting about nursing diagnoses taxonomy pertinent to problems/alteration in endocrine functioning


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

a. Alterations in nutrition less than body requirement b. Fluid volume deficit c. Activity intolerance

Pre-tests Lecture Discussion Recitation


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

Do an advance reading on Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with endocrine problems.


33. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with endocrine problems.

Corticosteroids Alpha-adrenergic

blocking agents Beta-adrenergic

blocking agents Tyrosine inhibitors Dopamine receptor

antagonists Glucocorticoids Parathyroid

hormone agents Thyroid hormone

agents Insulin Oral hypoglycemic

agents



The students were able to apply the various principles in the management of clients with problems in endocrine functioning in the actual clinical nursing practice and were able to provide the patients/client

Do an advance reading on principles of various modalities of management of clients with problems in endocrine


s with the proper teachings on health promotion, disease prevention and curative and health restoration.

17_9 hours

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

preventivec. Curative and

restorative

Determination and management of cause

Drug therapy - diuretics, electrolytes

Dietary management



Prevention of psychosocial problems

Rehabilitation



The students were 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

Do a ResearchDo an advance ReadingDo a reporting


35. List the purposes, indications, nursing responsibilities for the surgical and special

a. Surgical procedures – thyroidectomy, parathyroidectomy

b. Special procedures –

Pre-tests

Case Analys

Assertiveness

Coopera

The students will be able to list the different

Do a Research

Do an


procedures in alterations in endocrine functioning.

monitoring of blood glucose levels; maintenance of blood glucose – diet, exercise, drugs

is Small

Group Learning

Lecture

Discussion

Post test

tion Participa

tion Sensitivi

ty

surgical and special procedures for clients with endocrine problems and identify the nursing responsibilities in each procedure.

advance Reading

Do a reporting

18_9 hours FINAL EXAMINATION

Guide for RLE: Provide opportunities to demonstrate the procedures for oxygenation, fluid electrolytes balance, nutrition and metabolism, endocrine functions, and intra-operative care.

Regarding the intra-operative care experience, provide opportunities for the following:1. Act as a circulating nurse in THREE (3) MAJORSURGICAL CASES IN THE HOSPITAL SETTING2. Act as a scrub nurse in AT LEAST THREE (3) MAJOR

SURGICAL CASES IN THE HOSPITAL SETTING ONLYIn the event that the required competencies are not developed within the allotted hours/weeks, the nursing student/s shall be made to “extend” his/her Related Learning Experience (RLE) exposure until the expected competencies are satisfactorily achieved.To standardize documentation, a prescribed form shall be completed right after the related clinical experience.Provide opportunities for actual hospital and community experiences to ensure that competencies are developed.

GRADING SYSTEM:

Class Standing 25%

Attendance 10% Recitation 20% Quizzes 30% Assignment 20% Project 20%

100%

Class Standing 25%

Prelim 15%

Midterm 15%

Finals 15%

RLE 30%

100%

REFERENCE:

1. Lippincott Williams &Wilkins. Introductory Medical Surgical nursing. 9th edition. 2007.2. Barbara Kozier, Glenora erb, Audrey Berman and Shirlee Snyder. Fundamentals of Nurisng. 7th edition. 2004.1. Lippincott Williams &Wilkins. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 12th edition. 2010

EMILIO AGUINALDO COLLEGE

SCHOOL OF NURSING

COURSE SYLLABUS IN

CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE

Submitted to:

Ms. Obdulia Almarez

Submitted by:

Bato-bato, Job

Bustonera, Maria Rocell

Caliolio, Aimee

Camarinta, Caryl

May 20, 2014

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