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DONA REMEDIOS T. ROMUALDEZ MEDICAL FOUNDATIONCOLLEGE OF NURSING
CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTEBALANCE, NUTRITION AND METABOLISM AND ENDOCRINE
Course Descr!"o#: This course deals with the principles and techniques of nursingcare management of sick clients across lifespan with emphasis onthe adult and the older person, population group in any setting withalterations/problems in oxygenation, fluid and electrolyte balance,nutrition and metabolism and endocrine function.
Course Co$e % NC !"#Course Cre$"% $ units lecture, % units &'(Co#"&c" Hours'se(% !#% hours lecture and #"% hours &'(Prere)us"e: NC !")P*&ce(e#": #rd year, !st semester Course O+ec"-es:
*t the end of the course, and gi+en actual clients with problems inoxygenation, fluid and electrolyte balance, nutrition and metabolism, andendocrine function, the student should ha+e:
!. used the nursing process in the care of indi+iduals, families in community andhospital settings.
assessed with client/s his/her/their condition/health status through inter+iew,physical examination, interpretation of laboratory findings
identified actual and atrisk nursing diagnosis planned appropriate nursing inter+entions with client/s and family for identified
nursing diagnosis
-mplementsed plan of care with client/s and family e+aluated the progress of his/her/their clients condition and outcomes of care). created a well organied and accurate documentation system0#. communicated with client/s and their family and the health team appropriately01. adopted bioethical concepts/ principles, core +alues and nursing standards in the care of clients0 and ,2. stimulated personal and professional growth of self and others.
LEARNING OBJECTIVE TOPIC DATE
AND
TIME
LECTU
RER
Given an adult
( young, middle, old,
old-old adult) with
responses to altered
Respiratory function,
the student will be
able to:
A Apply !nowledge
and normal anatomy
and physiology and
assessmenttechni"ues in caring
for clients
#. Responses to Altered Oxygent!on"
Resp!rtory Gs Ex#$nge" Trnsport"
Per%&s!on
#A Review: Anatomy and $hysiology of the
Respiratory %ystem
A &$$'R R'%$#RAR* RA+
- ose, $aranasal sinuses, $haryn,
tonsils, adenoids, .aryn, rachea
/ .0'R R'%$#RAR* RA+- .ungs, ediastinum, .obes- /ronchi and /ronchioles, Alveoli
2une
345
6-17
rs
Alfons
o
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3
LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
/ Assess the health
status of a client
1 +onduct a
health historyand functional
health status of
clients having
or at ris! for
alterations in
oygenation,
ventilation and
gas echange
3 $erform
systematic andcomprehensive
physical
assessment to
validate
assessed data
# / 8unctions of the Respiratory %ystem
- ygen ransport
- Respiration
- 9entilation
- Air $ressure 9ariances
- Airway Resistance
- +ompliance
- .ung 9olumes and +apacities
- $ulmonary i;usion and $erfusion
- 9entilation and $erfusion /alance and
#mbalance
- Gas 'change
#+ ursing $rocess:
A Assessment:
1 %ubing
- =emoptysis
- rthopnea- +yanosis
- Restlessness
- achypnea
- +onfusion
- %tridor
- asal and sinus complains
/ $ast =ealth, 8amily, and %ocial =istory
+ 8unctional =ealth $atterns
3 b
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@
LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
@ #nterprets
deviations from
normal ?ndings
in the physical
assessment,
diagnostic and
laboratory
eamination
&tili>e the
assessed data
in order to:
- $rioriti>e
nursing
diagnosis- iscuss the
pathophysiological responses
to altered
oygenation:
ventilation and
gas echange
- $lan the care of
clients utili>ing
evidence-based
nursing
research
/ iagnostic 'ams
b1 on-invasive
- $ulmonary 8unction est- $ulse imetry- 9entilation $erfusion %can- Radiologic %tudies: +hest B-rays- + %can, R#, $', $ulmonary- Angiography
b3 #nvasive
- 'ndoscopic 'ams: .aryngoscopy, /ronchoscopy, ediatinoscopy
- .ung /iopsy- horacentesis and $leural Cuid
Analysis- 8luoroscopic studies- .ung scans
b@ .aboratory ests
- %putum +ulture- ose and throat culture- A/GDs
- 8agerstrom est (%tandardi>eddegree of nicotine dependence)
- %mo!e analyser
/ AnalysisE ursing
iagnosis
1 #ne;ective airway clearance as
evidenced by shortness of breath,
dyspnea, orthopnea, retractions, nasal
Caring, altered chest ecursion
3 #ne;ective breathing patterns asevidenced by ine;ective cough,
diminished or abnormal breath sounds,
cyanosis, restlessness@ #mpaired gas echange as evidence by
cyanosis, abnormal respiratory rate,
rhythm, nasal Caring, tachycardia,
diaphoresis, confusion #mpaired spontaneous ventilation as
evidenced by dyspnea, use of
accessory muscles, tachycardia,
apprehensionF isturbed sleep pattern (sleep-rest)4 Aniety (%elf- $erception- %elf- +oncept)
+ $lanning:
1 $lanning for health promotion3 $lanning for health restoration and
maintenancea aintain airway patency: coughing
techni"ues, suctioningb Relieving apprehension and fear
c Reducing metabolic demandsd aintaining rest and activitye ecreasing the e;orts of breathingf aintaining nutrition and hydration
2une
345
17-
13
2une
3
6-13
rs
+adion
rs
+adion
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LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURER
- Achieve the
best clinical
outcomes
utili>ing ethico-
moral and legal
principles- $lan e;ective
care
g $reventing and controlling infectionh $lanning for oygen therapyi #ncentive spirometry
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F
- +ardiac amponade
- %ubcutaneous 'mphysema
- $ulmonary 'mbolism
- $ulmonary =ypertension
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
1 $erform
systematic
and
comprehensiv
e physical
assessment
to validate
assessed
data
A 8unctional =ealth $atterns/ $ast health, family and social history
3 b
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3 #nterprets
deviations
from normal
?ndings in
the physical
assessment,
diagnosticand
laboratory
eamination
/ iagnostic ests and $rocedures1 on-invasive:
- '+G- <rasound- chest Bray- +ardiac %tress esting- 'ercise stress esting- $harmacological %tress esting- 'chocardiography- + scan- R#- Radio-nuclides studies
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
&tili>e
the
assessed
data in
order to:
- $rioriti>e
nursing
diagnosis- iscuss the
pathophysiologi
cal responses
to altered
oygenation:
cardiac and
peripheraltissue
perfusionE
transport
F #nvasive %tudies:- +ardiac +atheteri>ation- Angiography- Aortography- +oronary Arteriography- Right =eart +atheteri>ation- 'lectrophysiologic esting- Arteriogram- 9enogram
- .ymphography- /one marrow aspiration- =emodynamic monitoring
5 +9$ 5 $ulmonary artery pressure 5 #ntraarterial /$ monitoring
4 .aboratory estsa +ardiomar!er analysis
- 'n>ymes and #soen>ymes %tudies: +$H-
/,- +-Reactive $rotein, roponin-#
b /lood +hemistry, =ematologyand coagulation studies
c /rain (/-type) atriuretic
$eptided +-reactive $roteine =omocysteinef '%R, A%-iterg orni"uet esth hroat +ulture
b AA.*%#%E &R%#G
#AG%#%:
1 ecreased +ardiac utput as
evidenced by increased=eart
rate, fatigue, %/, decreased
urine output,3 #mpaired mental processing,
decreasing .+@ Activity #ntolerance as evidenced
by wea!ness, fatigue, vital signs
changes 8atigue as evidenced by diIculty
completing usual daily activities,fre"uent desire to rest
F Ris! for peripheral neurovascular
dysfunction as evidenced by
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changes in color, temperature,
sensation of etremities4 #mpaired tissue integrity
(utrional etabolic) #ne;ective /reathing $atterns6 8luid 9olume 'cessJ utrition, Altered, less than body
re"uirement17Growth and development, altered118amily $rocess, Altered13$ain1@Activity #ntolerance
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
- $lan the care of
clients utili>ing
evidence-based
nursing research
- Achieve the
best clinical outcomes
utili>ing ethico-moral
and legal principles
- $lan e;ective
care
c $.A#G
1 $lanning for health promotion
a Ris! 8actor and ris! management
b $romotion of circulationc $revention of infection:
immuni>ationsd genetic counsellinge role of nutrition
3 $lanning for health aintenance and
restoration
a $lanning for basic life support, +$Rb $lanning for advanced life supportc $lanning for the client having cardiac
surgery
##+ + ='A.= $R/.'%
A ursing +are of +lients with
ysrhythmias and +onduction $roblems
1 ysrhythmias
a %#&% ' *%R=*=#A%- %inus /radycardia- %inus achycardia- %inus Arrhythmias
b AR#A. *%R=*=#A%- $remature atrial comple- Atrial 8lutter- Atrial 8ibrillation
c 2&+#A. *%R=*=#A%- $remature 2unctional +omple- onparoysmal 2unctional achycardia- Atrioventriculr odal Reentry
achycardia
d 9'R#+&.AR *%R=*=#A%- $remature 9entricular +omple- 9entricular achycardia- 9enticular 8ibrillation
2uly 16
6-13
rs e
Asis
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- #dioventricularrhythym- 9entricular asystole
3 +&+# A/RA.##'%a 8irst-degree Atriventricular bloc!b %econd-degree Atriventricular
/loc!, ype # (0enc!e /ach)c %econd-degree Atriventricular
/loc!, ype ##d hird-degree Atriventricular /loc!
/ ursing +are of +lients with +oronary
9ascular iseasea +oronary Atherosclerosisb Angina $ectorisc Acute +oronary %yndrome and
yocardial #nfarction
2uly 3
6-13
rs
Alfonso
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
+ ursing +are of +lients with %tructural,#nfectious and #nCammatory +ardiac
isordersa itral 9alve $rolapseb itral Regurgitationc itral %tenosisd Aortic Regurgitatione Aortic %tenosisf %eptal efectsg +ardiomyopathyh Rheumatic 'ndocarditisi #nfective 'ndocarditis
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- +=8- Rheumatic 8ever- $ersistent $ulmonary =ypertension- Hawasa!i isease- 'ndocarditis- Arrythmias- =ypertension- yslipidemia- +ardiomyopathy
8 $ediatric =ematologic isorders
- =yperbilirubinemia- Anemias- $olycythemia- .eu!emia- $urpuras- #$, =enoch%chonlein
syndrome- =emophilias: 8actors 6,J,11
de?ciencies,- 9on 0illebrandDs disease- halassemias- #+
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER- #mplement
individuali>ed nursing
care:
1 %afely and
!nowledgeably
administers prescribed
medications and
treatmentsE alternative
complementary
medicine
3 Actively
participates in
planning and
coordinating culturally
sensitive
interdisciplinary care@ $rovide
appropriate client
education and health
maintenance and
community- based
care of clients
#$.''A#:
1 $harmacologic herapy
- +holesterol lowering drugs, statins, bile
acids- %e"uestrants, nicotinic acid, ?bric acid
derivatives- Antianginal: itroglycerine, beta
bloc!ers, calcium +hannel bloc!ers- Antiplatelet: ral and #9 drugs- Antidysrhythmic rugs- =eart 8ailure: A+' inhibitors,
Angiotensin ##Receptor bloc!ers, diuretics, positive
inotropic Agents, sympathomimetics,
digoin, phophodi'sterase inhibitors
- Anemia: #ron sources, /13 sources,
folic acid%ources
- Antihypertensive: alpha adrenergic
bloc!ers,- A+' inhibitors, beta adrenergic
bloc!ers, calcium +hannel bloc!ers,
centrally acting- Anticoagulants: =eparin, 0arfarin
3 +omplementary and Alternative
herapies
- 8ish il- mega @ 8atty acids
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Given an adult
( young, middle, old,
old-old adult) with
responses to altered
nutrition-metabolism ,
the student will be
able to:
- =awthorn- =erbs that may a;ect clotting- atural .ipid .owering agents- $hototherapy- 9'
@ utrition and iet herapy- A%= iet- $rit!in iet- rnish iet- .ow %alt, .ow 8at- Gavage 8eeding
/lood ransfusionF /one arrow ransplant4 %plenectomy
' +lient 'ducation
III. RE'PON'E' TO ALTERED NUTRITION(
METABOLI'M
###a Review of Anatomy and $hysiology of
the G# and Accessory rgans
1 Alimentary ract
a ral +avity or outh
- ongue, eeth, $alate and onsils- %alivary Glands, $haryn, 'sophagus- %tomach, %mall #ntestines, .arge
#ntestines- Rectum and Anal +anal
Aug
6-13
rs e
Asis
LEARNINGOBJECTIVE
TOPIC DATETIME
LECTURER
3 'ndoscopic procedures- +olonoscopy- 'R+$- 'G- %igmoidoscopy- %mall bowel enteroscopy- $roctoscopy- Anoscopy
ther procedures- Anorectalanometry- 'sophagealanometry- 'sophageal$hmanometry- Gastric anometry
F .aboratory %tudies1 /lood +hemistries: serum amylase,
lipase, proteins3 otal lymphocyte count@ -ylose absorption test 8ecal Analysis: ccult, ova and
parasites,F Kuantitative fecal fat studies, fecal
leu!ocytes,4 %tool electrolyte tests
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&tili>e the
assessed data in
order to:
- $rioriti>e nursingdiagnosis
- iscuss the
pathophysiologi
cal responses to
altered
nutrition-
metabolism
- $lan the care of
clients utili>ing
evidence-based
nursing research- Achieve the best
clinical
outcomes
utili>ing ethico-
moral and legal
principles- $lan e;ective
care
'foliativecytologic analysis6 Gastric analysis
b AnalysisE ursing iagnosis
1 8luid 9olume de?cit related to blood
loss from #n
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1@
- +ancer of the 'sophagus
/ ursing +are of +lients with Gastric
and uodenal &lcer- Gastritis- $&
- orbid besity- Gastric +a- Gastric %urgery- uodenal &lcers
+ ursing +are of +lients with #ntestinal
and Rectal isorders- +onstipation- iarrhea- 8ecal #ncontinence- 8ood $oisoning- #rritable /owel %yndrome
- +onditions of alabsorption- Appendicits- iverticular isease- $eritonitis- ypes of #nCammatory /owel isease- %mall /owel bstruction- .arge /owel bstruction- +olorectal +a- $olyps of the +olon and Rectum
isorders caused by food, vitamin and
mineral de?ciencies:
- Hwashior!or- arasmus- #odine e?ciency
' alabsorption %yndrome
- +eliac %prue- .actase e?ciency- %hort /owel %yndrome
8 ursing +are of +lients with =epaticisorders
- 2aundice- $ortal =ypertension- Ascites- 'sophageal 9arices- =epatic 'ncephalopathy- And coma
Aug
15
6-11
Aug
15
11-1pm
Aug
1F5
6-1pm
r
Astilla
rs
+adion
r
Astilla
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
- =ep A, /,+,,' 9irus- =ep G 9irus and G/ 9irus-+- oic =epatitis- rug- #nduced =epatitis
- $rimary .iver umors- .iver etastases- .iver ransplantation- .iver Abscess
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- #mplement
individuali>ed
nursing care:
1 %afely and
!nowledgeably
administersprescribed
medications and
treatmentsE
alternative
complementary
medicine3 Actively
participates in
planning and
coordinating
culturallysensitive
interdisciplinary
care
G ursing +are of +lients with /iliary
isorders- +holecystitis- +holelithiasis- Gallbladder +a- /iliary Atresia- Acute $ancreatitis- +hronic $ancreatitis- $ancreatic +yst- +ancer of the $ancreas- umors of the =ead of the $ancreas- $ancreatic #slet umors- =yperinsulinism- &lcerogenicumors
= $ediatric isorders:
- ral oniliasis- +left .ipE $alate- racheoesophageal atresia- racheoesophageal ?stula- $ediatric isorders:- 'n>yme e?ciencies- $yloric %tenosis- G'R: Achalasia- =iatal =ernia- ecroti>ing enterocolitis- ec!elDs diverticulum- egacolon
- #mperforate anus- #nCammatory bowel diseases- #ntestinal bstruction- #ntestinal $arasitic #nfections
#$.''A#
1 $harmacologic herapeutics- Antiemetics- Anticoagulants- =ematinics- .aatives
- Antipruritic- 9itamin supplement- Antacids- Antihyperlipidemics- Antispasmodics- Antidiarrheal- Antisecretory agents- 9asopressin- ctreotide- 'pinephrine- $romotility- +holinergic
- Antibiotics for = $ylori- A-interferon and ribavirin- $ancreatic 'n>yme Replacement
Aug 36
6-1pm
rs
+adion
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER3 +omplementary and Alternative
herapies- Ginger- il! hisle (%ilymarin)
@ %urgical and %pecial $rocedures:a %urgical $rocedures:
- Gastrostomy- Gastrectomy
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1F
@ $rovide
appropriate
client education
and health
maintenance
and community-
based care ofclients
Given an adult
( young, middle, old,
old-old adult) with
responses to altered
'ndocrine function, the
student will be able to:
A Apply !nowledge
and normal anatomy
and physiology and
assessment
techni"ues in caring
for clients
- +olostomy- =emorrhoidectomy- Gastrointestinal bypass- #leostomy- =emicolectomy
b %pecial $rocedures- $arenteral =yperalimentation- 8eeding per G,
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/ Assess the health
status of a client
1 +onduct a
health history and
functional health
status of clients having
or at ris! for
alterations in
endocrine function
3 $erform
systematic and
comprehensivephysical assessment to
validate assessed
data
- orepinephrineb Adrenal +orte- Glucocorticoids- ineralocorticoids- Androgens
F he $ancreasa /eta +ells - #nsulinb Alpha +ells L Glucagon
4 he estes and the variesa 8emale- 'strogen- $rogesteroneb ale- estosterone
he hymus Gland- hymosin
6 he $ineal Gland
a elatonin
+ ther =ormones
1 $rostaglandins
3 'rythropoietin
@ =uman +horionic Gonadotropin
(=+G)
#9b ursing $rocess
a Assessment
1 %ub
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1
in the physical
assessment,
diagnostic and
laboratory
eamination
&tili>e the
assessed data in
order to:
- $rioriti>e nursing
diagnosis
- iscuss the
pathophysiological
responses to
altered nutrition -
metabolism
si>e, %hape, position, function by
scanning, &M, R#, + scan,
radionuclide imaging, testing
forAchilles tendon reCees, radioiodide
upta!e- est for adrenal structure and function:
.esions, diseases, +,- R#, adrenal venogram- And angiography- est of $ituitary structure and function:
%!ull B-ray, +, R#- etabolic 8unction %tudies- Abdominal &M, radiography, +
b #nvasive- Angiography- $ortal pressure measurement- /iopsy
- $aracentesis- 8ine needle aspiration biopsy
c .aboratory- Growth =ormoneE human hormone- %omatomedinN insulin li!e growth
factor- 0ater deprivation test- hyroid %timulating =ormone- hyroine ( )- riiodothyronine- hyroid antibodies
- $arathyroid ormone- +alcium- +ortisol- Aldosterone- A+=- A+= stimulation- A+= suppression- 1 !etosteroids- 8asting blood sugar- ral Glucose- olerance test- Glycosylated =emoglobin
b AnalysisE ursing iagnosis:
1 #mbalanced utrition less thanE more
than body Re"uirements as evidenced
by increased food #nta!e with weight
loss3 e?cient Cuid volume as evidenced by
dry mucus embrane, thirst and
decreased urine output@ =yperthermia as evidenced by body
temperature Ranging from @J-1degrees +elsius
17-1pm
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
#mpaired %!in integrity as evidenced
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- $lan the care of
clients utili>ing
evidence-basednursing research
- Achieve the best
clinical
outcomes
utili>ing ethico-
moral and legal
principles- - $lan
e;ective care
by dry,Rough, reddened and edematous s!in
F #ne;ective therapeutic regimen
management( health perception, health
management)4 isturbed body image ( self-
perception,%elf-concept)
c $lanning
1 $lanning for health restoration and
maintenance
MIDTERM E*AMINATION
#9+ + ='A.= $R/.'%
1 isorders of the thyroid glanda =yperthyroidism (thyrotoicosis)
- GraveDs isease
- oic odular Goiterb =ypothyroidism
- #odine de?ciency- =ashimotoDs thryroiditis- yedema coma- +ongenital hypothyroidism
3 isorders of the $arathyroids- =yperparathyroidism- =ypothyroidism- =ypocalcemia
@ isorders of the adrenal glands- =ypercortolism- AddisonDs disease- $heochromocytoma- +ongenital adrenogenital hyperplasia- +ushingDs syndrome
isorders of the $ituitary Gland- Anterior $ituitary isorders- Gigantism- Acromegaly- $osterior $ituitary gland
- %#A=- iabetes #nsipidus
F $ancreas- iabetes ellitus- =ypoglycemia- iabetic Hetoacidosis- =yperglycemic =yperosmolar
Aug
16-3@
%ept
6-13
%ept F6-13
rs e
Asis
rs eAsis
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1J
LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
- #mplementindividuali>ed nursing
care:
1 %afely and
!nowledgeably
administers prescribed
medications and
treatmentsE alternative
complementary
medicine
3 Activelyparticipates in
planning and
coordinating culturally
sensitive
interdisciplinary care
@ $rovide
appropriate client
education and health
maintenance and
community- based
care of clients
Given an adult
( young, middle, old,
old-old adult) with
responses to altered
&rinary elimination,
the student will be
able to:
A Apply !nowledge
and normal anatomy
and physiology and
assessment
techni"ues in caring
for clients
- on!etotic %yndrome- acrovascular+omplicstions- icrovascular +omplications
- iabetic nephropathies- 8oot and leg problems
d #mplementation
1 $harmacologic therapeutics
- #odine sources- hyroid preparations- +ortisol replacement- #nsulin- ral =ypoglycemics
3 +omplementary and Alternative
herapies
- Aloe vera- /ilberry- /ittermelon- 8enugree!- 8ish oils- Garlic- Ginseng- Gymnema
- =orse chestnut seed etract- arshmallow- il! thistle- opa- $ric!ly pear cactus- /urdoc! (may increase blood sugar)
@ %urgical procedures:- hryroidectomy- $atrathyroidectomy- &nilateral or bilateral adrenalectomy- (transphenoidal) hypophysectomy
- Amputation of diabetic patient- $ancreas transplant- #slet cell transplant
%pecial $rocedures:
- Adminitration of insulin- Adminstration of hormone
utrition and diet therapy
F $atient education
V. CARE O) CLIENT' +IT, RE'PON'E'
TO ALTERED URINAR- ELIMINATION
9a Review of Anatomy and $hysiology of the
&rinary %ystem
A %tructure and 8unction
1 Hidney
a Gross structure of the Hidney
b icroscopic structure of the !idney L
nephron
%ept115
6-11
%ept
115
11-1pm
rAstilla
rs
+adion
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LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
/ Assess the health
status of a client
1 +onduct a
health history and
functional health
status of clients having
or at ris! for
alterations in
oygenationN cardiac
and peripheral tissue
perfusionE transport
3 $erform
systematic and
comprehensive
physical assessment to
validate assessed
data
c /lood %upply d 8unctions e &rine $roduction- 8iltration- Reabsorption- %ecretion
f +omposition of &rineg Regulation of urine concentration and
volumeh =ormonal echanismsi ';ect of %ympathetic innervation
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LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
@ #nterprets
deviations from
normal ?ndings
in the physical
assessment,
diagnostic and
laboratory
eamination
&tili>e the
assessed data in order
to:
- $rioriti>e nursing
diagnosis- iscuss the
pathophysiological responses to
altered urinary
elimination
- $lan the care of
clients utili>ing
evidence-based
nursing research- Achieve the best
clinical
outcomes
utili>ing ethico-
moral and legal
principles- $lan e;ective
care
3 iagnostics and .aboratory'aminations
a on-invasive- est for renal function- $rostate speci?c antigen- &rinalysis- +- R#, B-ray of H&/- &rine culuture- /&- +reatinine clearance test- /ladder ultrasonography
b #nvasive- #9$- Retrograde $yelography- +ystourethrogram- Renal %cans- +ystoscopy- Renal biopsy- Radioisotope scanning- uclear %cans- #ntraveous urography- Renal angiography
- 9oiding cystourethrography
b AnalysisE ursing iagnosis
1 #mpaired urinary elimination as
evidenced by , urgency, fre"uency,
hesitancy, dysuria, nocturia3 &rge urinary incontinence as
evidenced by fre"uency, urgency, loss
of urine before reaching toilet and
voiding in small and large amount@ &rinary retention as evidenced by
dribbling urine with increasedintraabdominal pressure, urinary
urgency, urinary fre"uency Acute $ainF #ne;ective health maintenance
c $lanning
1 $lanning for health promotion- $romoting urinary elimination- $reventing urinary infection- anaging ris! as renal calculi and
hypertension
3 $lanning for health maintenance andRestoration
- +atheters: &rethral, ephrostomy,
&reteral, %uprapubic- %ystem intermittent and intermittent
self- catheteri>ation, indwelling-
edwelling drainage system- &rulogic %urgery:
a ephrotomyb ephrectomy
c $yelotomyd &reterotomye +ystotomy, cystectomyf .ithotripsy
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33
LEARNING
OBJECTIVE
TOPIC DATE
TIME
LECTUR
ER
- #mplement
individuali>ed
nursing care:
1 %afely and
!nowledgeably
administers
prescribed
medications and
treatmentsE
alternativecomplementary
medicine3 Actively
participates in
planning and
coordinating
culturally
sensitive
interdisciplinary
care@ $rovide
appropriateclient education
and health
maintenance
a 'tracorporeal renal surgeryb $ercutaneous nephrostomyc &rinary diversiond Renal transplante ialysis types
9+ + ='A.= $R/.'%
# ursing +are of +lients with &rinary
isorders
- .ower &rinary ract #nfections- &pper &rinary ract #nfections- &rinary #ncontinence- &rinary Retention- &rinary calculi- eurogenic /ladder- +ancer of the /ladder
## ursing +are of +lients with Renal
isorder
- ephrosclerosis- $rimary Glomerular disease- $olycystic disease
- Acute Renal 8ailure- +hronic Renal 8ailure- Hidney rauma
### isorders a;ecting $ediatric +lients
- 9esicoureteral reCu- 0ilmDstumor- Acute poststreptococcal- glomerulonephritis- $olycystic !idney- %ystemic .upus 'rythomatosus
d #mplementation
a $harmacologic therapeutics
- iuretics- edications for Gout- Antispasmodics- +holinergics- Analgesics- Alpha-/loc!ers
3 +omplementary and Alternative
herapies
- /iofeedbac! for urinary incontinence- =alamangGamot
@ utrition and diet therapy
a $rotein-mineral-and 8luid odi?ed
iets
$atient education
%ept 13
6-13
rs
Alfonso
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3@
and community-
based care of
clients
LEARNINGOBJECTIVE
TOPIC DATETIME
LECTURER
Given an adult
( young, middle, old,
old-old adult) with
responses to altered
Cuids, electrolytes and
acid-base balance, the
student will be able to:
A Apply !nowledgeand normal anatomy
and physiology and
assessment
techni"ues in caring
for clients
/ Assess the health
status of a client
1 +onduct a
health history and
functional health
status of clients having
or at ris! for
alterations in
oygenation,
ventilation and gas
echange
3 $erform
systematic and
comprehensive
physical assessment to
validate assessed
data
@ #nterprets
deviations from normal
?ndings in the physical
assessment, diagnostic
and laboratory
eamination
VI. CARE O) CLIENT' +IT, ALTERED
)LUID'" ELECTROL-TE' AND ACID(BA'E
BALANCE
9# a verview of ormal Cuid and
electrolytes /alance
9# b ursing $rocess
a Assessment
1 ursing =istorya %ub
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3
LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
&tili>e the
assessed data in
order to:
- $rioriti>e nursing
diagnosis
- iscuss thepathophysiologi
cal responses to
altered Cuid,
electrolytes and
acid-base
balance
- $lan the care of
clients utili>ing
evidence-based
nursing research- Achieve the best
clinical
outcomes
utili>ing ethico-
moral and legal
principles- $lan e;ective
care
1 #mpaired ral ucous embrane3 Ris! for in
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3F
b etabolic Acid-base #mbalance
- Acidosis
- Al!alosis
LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
#mplement
individuali>ed nursing
care:
1 %afely and
!nowledgeably
administers prescribed
medications and
treatmentsE alternative
complementary
medicine
3 Actively
participates in
planning and
coordinating culturally
sensitive
interdisciplinary care
@ $rovide
appropriate client
education and healthmaintenance and
community- based
care of clients
n completion of thischapter, the students
will be able to:
1 e?ne the @
phases of
perioperative
care3 escribe a
comprehensive
preoperative
assessment to
identify surgicalris! factors
@ #dentify health
factors that
a;ect patientDs
preoperatively #dentify legal
and ethical
considerations
related to
obtaining
informedconsent
F escribe the
preoperative
d #mplementation
1 $harmacologic therapeuticsa #9 Additives
- H+.- +a+l- g%
- =+@-b $lasma 'panders
- +olloids- etran- =eastarch
3 utrition and diet therapya 8ood sources
- %odium- $otassium- +alcium- $hosphate
- agnesium
@ $atient education
VII. NUR'ING CARE O) CLIENT'
UNDERGOING 'URGER-
# #ntroductory #nformation:
$erioperative ursing
A 8undamentals of heory and $ractice
a $erioperative 'ducationb 8oundations of $erioperative
+are %tandardsc .egal and 'thical #ssues
/ he $erioperative $atient +are eama he $erioperative $atient +are
eamb he %urgical 8irst Assistantc Administration of $erioperative
$atient +are %ervice+ he $atient as a &ni"ue #ndividual
a he $atient: he Reason for your
eistenceb $erioperative $ediatricsc $erioperative Geriatrics
he $erioperative 'nvironmenta $hysical 8acilitiesb Ambulatory %urgery +entersc +are of he $erioperative
'nvironmentd $otential %ources of #n
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34
nursing
measures that
decrease the
ris! for infection
and other
postoperative
complications
d econtamination and
isinfectione %terili>ation
LEARNING OBJECTIVE TOPIC DATE
TIME
LECTURE
R
4 escribe
the immediate
preoperative
preparation of
the patient
evelop a
preoperative
teaching plan
designed to
promote the
patientDs
recovery from
anesthesia and
surgery, thus
preventingpostoperative
complications
8 %urgical #nstrumentation and
'"uipmenta %urgical #nstrumentationb %peciali>ed %urgical '"uipment
G $reoperative $atient +area $reoperative $reparation of the
$atientb iagnostic $rocedures
= $harmacology and Anesthesiaa %urgical Anesthesiab Anesthesia: echni"ues and
Agents# #ntraoperative $atient +are
a +oordinated Roles of the %crub
$erson and the +irculatorb $ositioning, $repping and draping
the $atientc $hysiologic aintenance and
onitoring of the $erioperative
$atient
2 %urgical %pecialtiesH %urgical %ite anagement
a =emostasis and 0ound +losureb 0ound =ealing
- 0ound dressing
- 8luids and nutrition- edications- $ost operative ischarge
instructions- Rest and activity- 'ating- %leeping- 0ound healing- /owel and urinary
elimination- /athing, showering- +lothing
- riving- /ending and lifting- edications- 8ollow up care-
. $erianesthesia and $ostprocedural
$atient +area $ostoperative $atient +areb $otential $erioperative
+omplications- %hoc!- =emorrhage
- $ulmonary embolism- eep vein thrombosis- &rinary retention- #ntestinal obstruction
ct @
6-13
ct J
6-13
ct 17
6-13
ct 14
6-13
ct 15
6-11
ct
15
11-1pm
ct 31-
3@
r
Astilla
rs
Alfonso
rs
Alfonso
r
Astilla
r
Astilla
rs
+adion
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3
- =iccups- 0ound infection- ehiscence- 'visceration- $sychological disturbances
)INAL E*AMINATION
': A. 8 1@4 hrs ( 6 hours per wee! ecept those where 5 (F hours : 6am-1pm instead of6am-13nn) is indicated to complete the total number of hours P 1@4 hoursQ in 16 wee!s ) %+='&.': =&R%A*%: 6:77 A L 13:77 8R#A*%: 6:77 A - 13: 77
Re%eren#es
/. Br&nner nd '&ddrt$. Text0oo1 o% Med!#l('&rg!#l N&rs!ng 2 /3t$
ed!t!on. 45/34. Joy#e M. Bl#1 nd Jne ,o1nson ,61s. Med!#l('&rg!#l N&rs!ng( 7t$
Ed. 45583. L!pp!n#ott +!ll!9s : +!l1!ns. T$e L!pp!n#ott Mn&l o% N&rs!ng
Pr#t!#e 2/5t$ ed!t!on.;. Nett!n" 'ndr L!pp!n#ott Mn&l o% N&rs!ng Pr#t!#e" 7T, Ed. +!ll!9s
nd +!l1!nss Opert!ng Roo9 Te#$n!?&e" /4t$
Ed!t!on. 45/3@. P!ll!tter!" A. Mternl : C$!ld ,elt$ N&rs!ng Cre o% t$e C$!ld0er!ng :
C$!ldrer!ng )9!ly" @T, Ed. 45/5
Leel III Cl!n!#l Instrtors
Al%onso" Lo&rdel U." MAN" RN Ast!ll" Jere9ey" MAN" RN Cd!on" Dor!s '." MAN" RN De As!s" Re0e##" MAN" RN
PREPARED B- APPROVED B-
LOURADEL U. AL)ON'O" MAN" RN DR. 'OCORRO '.GA'CO" RN" DM,RMACADEMIC COORDINATOR DEAN" COLLEGE O)NUR'ING