Emilio Aguinaldo CollegeCongressional Road, Burol Main, Dasmarias CaviteTel # (046) 416-4341 to42http//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 clients condition and outcomes of care. 2. Ensure a well-organized and accurate documentation system; 3. Relate with client/s and their family and the health team appropriately; 4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and, 5. Promote personal and professional growth of self and others.

EMILIO AGUINALDO COLLEGESCHOOL OF NURSINGCOURSE SYLLABUS IN CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINETIMEFRAME/WEEKCONTENT/TOPICINTERMEDIATE COMPETENCIESTEACHING-LEARNING ACTIVITIESINSTRUCTIONAL MATERIALSEVALUATIONASSIGNMENTREFERENCE

Week19hoursThe different risk factors among clients that contribute to the development of problems in oxygenation: a. Current respiratory problems b. History of respiratory diseasec. Lifestyle (smoking, alcoholism, exercise d. patterns) e. Presence of cough f. Presence of Chest Pain g. Lung Cancer h. Cardiovascular disease i. Stroke j. Tuberculosisk. Dietary assessment l. Medication historyAt 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).

Lecture Discussion

PowerpointPresentationWhiteboard MarkerOral ParticipationPost TestDo an advance reading regarding subjective data from client history related to problems in oxygenation1. Lippincott Williams &Wilkins. Introductory Medical Surgical nursing. 9th edition. 2007. Pp 337-405.

A. Chief complaintsB. Relevant information, to include eleven functional patterns: 1. Health perception management pattern 2. Nutritional/metabolic pattern3. Elimination pattern 4. Activity/exercise patterns5. Cognitive/perceptual pattern 6. Sleep-rest pattern 7. Self-perception-self-concept pattern 8. Role relationship pattern 9. Sexuality-reproductive pattern 10. Coping-stress tolerance pattern11. Value-belief pattern2.Learn significant subjective data from client history related to problems in oxygenationLecture/Discussion

Powerpoint PresentationWhiteboard and markerPre-Test

Recitation

Post-TestDo an advance reading about principles and techniques of physicalexamination in assessing the oxygenation status in newborn, children, 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.

a. Inspection- gas exchange, perfusion b. Palpation- gas exchange, perfusion c. Percussion- gas exchange d. Auscultation- gas exchange- heart sound, breath sounds, deviations, fluid transport3. Enumerate the principles and techniques of physical examination in assessing the oxygenation status in newborn, children, and adults.Lecture/DiscussionDemonstrationPowerpoint PresentationWhiteboard MarkerPretestRecitationReturn DemonstrationDo an advance reading on Screening procedure-peak flow meter1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.499-506.

Screening procedure-peak flow meterDiagnostic ProceduresNon-invasivePulmonary e.g. sputum microscopy, chest x-ray, pulmonary function tests, smoke analyzerFagerstrom 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, cardiac catheterization, CVP, hemodynamics monitoring, enzyme levels, Serum, Cholesterol Vascular: angiography Blood: CBC and bone marrow biopsy4. Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in Oxygenation.Lecture/Discussion

PowerpointPresentationWhiteboard MarkerPretestOral Recitation

Answer Chapter 22 critical thinking questions of the textbook page 5481. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.507-514.

3_9 hoursa. 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 (polycythemia5. Illustrate the pathophysiologicmechanisms of the alterations in oxygenCase AnalysisLecture/Discussion

PowerpointPresentationWhiteboard MarkerRecitationPost- TestDo a reporting in nursing diagnoses taxonomy1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.518-632.

a. Ineffective breathing pattern b. Ineffective airway clearance c. Impaired gas exchange d. Inability to sustain 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 hypoxia6. Formulate nursing diagnoses taxonomy pertinent to problems/alteration in Oxygenation.Case Analysis Lecture/Discussion Group discussion

PowerpointPresentationWhiteboard and marker

Pre-testPost-testDo a reporting regarding principles of various modalities of management clients with problems in oxygenation1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.518-632.

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 Hemodynamics monitoring O2 therapy Drug therapy Hydration Prevention of infection 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 infection Prevention of complications 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 restorativeReportingLecture/Discussion

PowerpointPresentationWhiteboard and markerHandoutsPretestOral Recitation RoleplayingDo a reporting about pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.518-632.

4_9 hours. Pulmonary Bronchodilators Expectorants Antitussives Antihistamines b. Cardiac Sympathomymetic agents Sympatholytic agents Anti-anginal agents Anti- arrhythmic agents Angiotensin converting enzyme inhibitors Antilipemic agents Anticoagulant agents Thrombolytics Peripheral vascular agents c. Blood Hematinics Vitamin supplements8. DescribePharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with oxygenation problems.ReportingLecture/DiscussionCase AnalysisGroup DiscussionPowerpointPresentationWhiteboard and markerPost TestRecitationSeatworkAnswer Chapter 25 critical thinking questions of the text book page 6801. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.518-632.

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, 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 isolation9. State the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in oxygenation.Lecture/DiscussionDemonstrationCase Analysis

Powerpoint PresentationWhiteboard MarkerRecitationReturn DemonstrationDo a reporting about risk factors among clients that contribute to the development of problems in Fluid and Electrolytes1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.636-679.

5_9 hoursPotential factors for exceeding renal reserve capacity, dietary habits to include salt intake, hypertension, infection, diabetes.10. Identify risk factors among clients that contribute to the development of problems in Fluid and Electrolytes.ReportingLecture/Discussion Group DiscussionPowerpointPresentationWhiteboard and markerPre-TestPost-TestRoleplayingDo an advance reading on principles and techniques of physical examination in newborn, children, adults, deviations from normal

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

Inspection- signs of dehydration, overhydrationPalpation- edema, ascites, neck vein filling, hand vein filling, neuromuscular irritability, characteristic of pulse Percussion- abdomen for presence of air, fluid Auscultation-rates11. Demonstrate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.Lecture/DiscussionDemonstration

PowerpointPresentationWhiteboard and markerOral ParticipationReturnDemonstration

Do an advance reading in Chapter 14 and answer Chapter 14 critical thinking questions of the textbook page 3101. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

6_9 hoursA. Diagnostic tests Non-invasive: electrolyte determination, intake and output, KUB-IVP and ultrasound Invasive biopsyB. WeightC. Vital Signs12.Identify results and implications of diagnostic/laboratory examinations of clients with reference to Fluid and Electrolyte imbalancesLecture/Discussion

PowerpointPresentationWhiteboard and markerPost testRecitationDo an advance reading on pathophysiologic mechanisms of fluid and electrolyte imbalances.

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

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 alkalosis13. Determine the Patho- physiologic Mechanisms of Fluid and electrolyte imbalances.Lecture Discussion

PowerpointPresentationWhiteboard and markerPost testDo an advance reading on nursing diagnoses taxonomy pertinent to problems/alteration in Fluid and electrolyte imbalance.1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

7_9hoursa. 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 integrity14. Explain Nursing diagnoses taxonomy pertinent to problems/alteration in Fluid and electrolyte imbalance.Case AnalysisLecture Discussion

PowerpointPresentationWhiteboard and markerOral Participation

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

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

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, 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 managementSupportive 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 Rehabilitation15. 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

Lecture Discussion

PowerpointPresentationWhiteboard and markerRecitationPost testDo a reporting about Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients in fluid and electrolyte imbalances.1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

8_9 hoursa.Fluid Parenteral fluids Hypotonic Hypertonic Isotonic b.Electrolyte Sodium Potassium Calcium Magnesium Phosphate c.diuretics Potassium-sparing Potasium-losing Osmotic diuretics d.Vitamin D supplements16. GivePharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients in fluid and electrolyte imbalances.Lecture/Discussion Case AnalysisPowerpointPresentationWhiteboard and markerOral ParticipationPost testDo an advance reading on purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances.

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

Renal dysfunction a.Major surgical procedures nephrectomy, nephrostomy, cystectomy, uterostomy, renal transplants, urinary diversion b.Special procedures- peritoneal dialysis, hemodialysis, bladder training, cystoclysis/bladder irrigation17. Name the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances.

Lecture Discussion QuestioningPowerpointPresentationWhiteboard and markerPretestOral ParticipationDo a reporting on risk factors among clients that contribute to the development of problems in Nutrition and Metabolism

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.264-309.

9_9 hoursRisk factors related to malnutrition, obesity.

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

PowerpointPresentationWhiteboard and markerPost test

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

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

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 pattern19. Identify significant subjective data from client history related to problems in nutrition and metabolism.

Lecture Discussion QuestioningPowerpointPresentationWhiteboard and markerPretestRecitationAnswer Chapter 41 critical thinking questions of the textbook pages 1242-12431. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

10_9 hours3.3 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, masses20. Demonstrate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.

Lecture/Discussion Demonstration

PowerpointPresentationWhiteboard MarketOral ParticpationReturn DemonstrationDo a reporting on results and implications of diagnostic/laboratory echanismn of clients with reference to problems in Nutrition and Metabolism.

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

21. Analyze results and implications of diagnostic/laboratory examinations of clients with reference to problems in Nutrition and Metabolism.

Lecture DiscussionQuestioningCase AnalysisPowerpointPresentationWhiteboard and markerOral ParticipationPost testDo an advance reading pathophysiologic echanism of the Alterations in Nutrition and Metabolism 1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

11_9 hoursa 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 conditionsd Disturbances in elimination bowel obstruction, hemorrhoids, diarrhea and constipation.22. Determine the Pathophysiologic mechanisms of the Alterations in Nutrition and Metabolism.

Lecture DiscussionCase Analysis

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

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

a.Alteration in nutrition less than body requirement b.Alteration in nutrition more than body requirement c.Alteration in oral mucous membrane integrity d.Alteration in comfort: epigastric pain/abdominal pain e.Fluid volume deficit23. Specify Nursing diagnoses taxonomy pertinent to problems/alteration in Nutrition and Metabolism.

Lecture DiscussionQuestioning

PowerpointPresentationWhiteboard MarkerPretestOral Recitation

Do a reporting regarding principles of various modalities of management of clients with problems in Nutrition and Metabolism 1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

12_9 hrsMIDTERM EXAMINATION

13_hrsA. 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 management Prevention of complication Prevention of psychosocial problems Rehabilitation Disturbances in absorption Determination and management of cause Drug therapy Dietary management Supportive management Prevention of complication Prevention of 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 Supportive management Prevention of complication

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

Lecture/DiscussionQuestioningPowerpointPresentationWhiteboard and markerPretestRecitationDo a ResearchDo an advance ReadingDo a reporting1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

Antiemetics Anticoagulants Hematinics agents Laxatives and stool softeners Antipruritus Vitamin supplement Antacids Antihyperlipidemics Antispasmodics Antidiarrheal25. List Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with Nutrition and Metabolism problems.

Lecture/Discussion QuestioningCase AnalysisPowerpointPresentationWhiteboard and markerOral ParticipationSeatwork

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

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

14_9 hoursa. Surgical procedures gastrostomy, gastrectomy, colostomy, hemorrhoidectomy, gastrointestinal bypass, ileostomy b. Special procedures parenteral 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 bath26. Know the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in Nutrition and MetabolismLecture/DiscussionQuestioning

PowerpointPresentationWhiteboard MarkerHandoutsOral ParticipationPost testDo an advance reading on risk factors among clients that contribute to the development of problems in Endocrine Function. 1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1117-1243.

Risk factors related to endocrine hypo or hyperfunctioning.27. Recognize risk factors among clients that contribute to the development of problems in Endocrine Function.Lecture/Discussion QuestioningPowerpointPresentationWhiteboard and markerPretestRecitaion1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

15_9 hoursA. 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 pattern28. Differentiate significant subjective data from client history related to problems in endocrine functioningLecture Discussion Questioning

PowerpointPresentationWhiteboard MarkerPretestSeatworkDo an advance reading on principles and techniques of physical examination in newborn, children, adults, deviations from normal in the endocrine system1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

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 wounds29. Demonstrate the principles and techniques of physical examination in newborn, children, adults, deviations from normal in the endocrine system Lecture/Discussion DemonstrationGroup Discussion

PowerpointPresentationWhiteboard MarketHandoutsReturn DemonstrationOral ParticipationAnswer Chapter 42 critical thinking questions of the text book pages 1287-1288

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

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 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 assay30. Evaluate results and implications of diagnostic/laboratory examinations of clients with reference to problems in endocrine functioning.Lecture/Discussion QuestioningCase Analysis

PowerpointPresentationWhiteboard and markerPosttest.SeatworkDo an advance reading on pathophysiologic mechanisms of the Alterations in endocrine functioning.1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

16_9 hoursa.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, NIDDM)31. Determine the Pathophysiologic mechanisms of the Alterations in endocrine functioning.Lecture/DiscussionCase Analysis Group DiscussionPowerpointPresentationWhiteboard and markerPretestSeatworkOral ParticipationDo a reporting about nursing diagnoses taxonomy pertinent to problems/alteration in endocrine functioning1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

a.Alterations in nutrition less than body requirement b.Fluid volume deficit c.Activity intolerance32. Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in endocrine functioningLecture Discussion RecitationPowerpointPresentationWhiteboard MarkerHandoutsPretestRecitationDo reporting on Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with endocrine problems.

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

Corticosteroids Alpha-adrenergic blocking agents Beta-adrenergic blocking agents Tyrosine inhibitors Dopamine receptor antagonists Glucocorticoids Parathyroid hormone agents Thyroid hormone agents Insulin Oral hypoglycemic agents33. Name Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with endocrine problems.

Lecture Discussion Case AnalysisPowerpointPresentationWhiteboard and markerHandoutsOral RecitationPost test Do a reporting about principles of various modalities of management of clients with problems in endocrine

1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

17_9 hours Determination and management of cause Drug therapy - diuretics, electrolytes Dietary management Supportive management Prevention of complication Prevention of psychosocial problems Rehabilitation34. Know the 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 restorativeLecture Discussion QuestioningPowerpointPresentationWhiteboard and markerPretestSeatworkDo an advance reading on purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in endocrine functioning.1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

A. Surgical procedures thyroidectomy, parathyroidectomy B. Special procedures monitoring of blood glucose levels; maintenance of blood glucose diet, exercise, drugs35. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in endocrine functioning.Lecture Discussion QuestioningGroup DiscussionPowerpointPresentationHandoutsWhiteboard and markerPretestRecitationDo a documentation on return demonstration done for the whole unit.1. Lippincott Williams &Wilkins. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010. Pp.1246-1285.

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) MAJOR SURGICAL 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% Attendance10% Recitation20% Quizzes30% Assignment 20% Project 20%

100%

Class Standing25%Prelim15%Midterm15%Finals15%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 Suddarths Textbook of Medical-Surgical Nursing. 12th edition. 2010

EMILIO AGUINALDO COLLEGESCHOOL OF NURSINGCOURSE SYLLABUS IN

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

Submitted to:Ms. Obdulia AlmarezSubmitted by:Bato-bato, JobBustonera, Maria RocellCaliolio, AimeeCamarinta, CarylMay 20, 2014