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  • 1. St. Catharine College – Kentucky’s Dominican College Associate Degree Nursing Program NUR232 Medical-Surgical Nursing II Fall 2009
  • 2. NUR232 Medical Surgical Nursing II The St. Catharine Nursing Student will continue their second year of the nursing program with medical-surgical nursing. This is the second semester of a two semester year ending their nursing program. NUR232 is an 8 week course consisting of medical-surgical nursing instruction in adult care. This 6 credit hour course is the second in a two-part series of courses designed to utilize the nursing process as part of reflective practice in providing care to clients across the lifespan. Teaching/learning principles will be introduced and applied in the care of clients at various developmental levels during acute/chronic episodes of altered basic human needs as well as during states of wellness. Emphasis on advanced nursing skills, critical thinking, and application and analysis of knowledge will begin to be incorporated into the nurse’s role as provider and manager of care using the nursing process. Topics include: problems of ventilation and oxygen transport, reproductive, and critical care among others. Many methods are used to deliver instruction and to introduce new material to the nursing student. These methods will include lecture, discussion, audiovisual, computer activities, simulation, class interaction, group work, care plans, case study, written assignments, laboratory assignments, and clinical care of the client. This course was developed toward fulfillment of the program’s philosophy and outcomes. All materials utilized in this course including text books, study aids, and on-line applications were chosen by experienced instructors in the medical- surgical field. Continued application of the nursing process is reinforced with critical thinking. At this level in the nursing program critical thinking is utilized as a process to allow the student to apply their knowledge to treatment of the client. By using critical thinking to apply the nursing process in the care of the client each student is able to draw upon their previous experience and knowledge in making decisions concerning nursing care utilizing the nursing process..
  • 3. The text for this course introduces the concepts of the nursing process including assessment, planning, implementation, and evaluation. The text also continues the study of principles of health promotion, patient teaching, and community health nursing. Throughout the course there is also the reinforcement of the standards of the American Nurses’ Association as well as evidence based practice, with cultural considerations. Cognitive learning is evaluated throughout the semester with exams and case studies. Culmination of learning is evaluated by a comprehensive final examination. In this course the students have access to nursing faculty for 1:1 tutoring in any area that the student or instructor identifies as an area for improvement ensuring their student’s success. This course utilizes a clinical component in the medical-surgical setting. In the clinical setting experienced instructors are provided to guide the student in the application of the nursing process in nursing care to the client in a hospital setting. Emphasis is placed on the use of critical thinking in all aspects of care from admittance to discharge of each client with individual plans of care. This setting allows the medical-surgical nursing student to gain the confidence and competence in the care of the client with the resource of an experienced clinical faculty member at hand for questions and feedback. A clinical practicum consisting of 120 hours of clinical practice shared with a clinical preceptor allows for the application of the nursing process in the clinical setting where each student is able to put the education acquired in the classroom to use. The didactic and clinical components of this course allow for the success of the nursing student in obtaining licensure and providing competent and compassionate nursing care.
  • 4. St. Catharine College Associate Degree Nursing Program NUR232 Medical-Surgical Nursing II Course Syllabus Fall 2009 Course Description: This second course in a two-part series of courses is designed to utilize the nursing process as a part of reflective practice in providing holistic care to clients across the lifespan. Teaching/learning principles will be introduced and applied in caring for clients at various developmental levels during acute/chronic episodes of altered basic human needs as well as during states of wellness. Emphasis on advanced nursing skills, critical thinking, and application and analysis of knowledge will begin to be incorporated into the nurse’s role as provider and manager of care. Topics covered include problems of oxygenation, ventilation, transport, male/female reproduction, and critical care. Prerequisite and Co requisite Courses: BIO 204, BIO 205, BIO 250, CHE 103, ENG 101, ENG 102, PHI 231, PSY 100, PSY 150, MAT 106, NUR 115, NUR 120, NUR 201, NUR 202, NUR 221, NUR 222 and REL. Course Placement: Fourth semester of the nursing program. Credit Hours: 8 week Session: 6 credit hours Lecture (9 contact hours) Instructor: Jenny Burch, MSN, RN – 859-336-5082, ext. 1277; email: jburch@sccky.edu Office Hours: Tuesday by appointment, Thursday 9am – 12pm. Methods of Instruction: May include discussion, scenarios, audiovisuals, computer activities, simulation, class interaction, care plans, written assignments, laboratory assignments, debates, or presentations.
  • 5. Course Requirements: A letter grade will be given for examinations and selected assignments. A theory grade of C (77%) or better must be earned to successfully complete the course. *Exam average must be > 77% in order to successfully pass the course. If the exam average is not 77% or higher, the course grade reported to the Registrar will reflect the exam average only. Grading Scale: A 93 – 100 B 86 – 92 C 77 – 85 Note: Assignment grades and course grades are NOT rounded. D 65 – 76 F 0 – 64 Methods of Evaluation: Nasogastric Tube Practice, Check off/Quiz Pass/Fail Average of Unit Exams (I, II, III, IV) 40% Comprehensive Final Exam 50% Volunteer/Charitable Organization Presentation 5% Case Studies 5%
  • 6. Required Resources: Lewis, S.M., Heitkemper, M.M.,Dirksen, S.R., O’Brien, P.G., & Bucher, L. (2007). Medical- surgical nursing: Assessment and management of clinical problems (7th ed.). St. Louis: Mosby. ISBN: 0323036600. Lewis, S.M. & O’Brien, P.G. (2004) Study guide for medical-surgical nursing (7th ed.). St. Louis: Mosby. ISBN: 0323018556. Silverstri, L. A. (2005). Saunders comprehensive review for the NCLEX-RN examination (3rd ed). St. Louis: Mosby. ISBN: 1416031995. In addition, the textbooks from the first year of nursing classes will be required. This includes: Taylor’s Skills Performance Checklist The Art and Science of Nursing Care APA’s Publication Manual (5th ed.) Deglin & Vallerand’s Davis’s Drug Guide (or comparable text) Pagana & Pagana’s Mosby’s Diagnostic and Laboratory Reference (or comparable text) Stedman’s Medical Dictionary (or comparable text) Dillon’s Health Assessment Text Recommended Resources: Handbook of nursing diagnosis (10th ed.) Carpenito-Moyet ISBN: 0781743559 NCLEX-RN 250 new format questions: Preparing for the revised NCLEX-RN Springhouse ISBN: 1582553076
  • 7. Course Objectives: A. Apply the nursing process and critical thinking to the basic human needs of selected adult medical-surgical clients within the acute care and community settings. B. Communicate effectively with clients, families, and the health care team. C. Practice nursing skills safely, considering both the internal and external environments of the client. D. Perform nursing actions according to legal and ethical standards. E. Demonstrate accountability in the professional nursing role. F. State the impact of health care economics on the practice of nursing and practice nursing accordingly. G. Evaluate one’s personal effectiveness, caring behaviors, and nursing care of clients. H. Provide evidence-based nursing care. I. Utilize teaching-learning principles to promote and maintain an optimal level of health for clients across the lifespan. J. For each of the following units: Cardiovascular, Neurologic, Visual, Auditory, Critical Care, Emergency and Disaster: 1. Review normal body structure and function as related to meeting the nursing needs of clients with health problems presented in each unit. 2. Identify the pathophysiology present in relation to the common health problems presented in each unit. 3. Identify common diagnostic measures related to the health problems presented in each unit with emphasis on nursing assessment and responsibilities. 4. Explain the various intrinsic and extrinsic factors which may influence the health problems as presented in each unit. 5. Indicate common symptoms and/or nursing problems associated with the health problems presented in each unit. 6. Identify the general medical/surgical management of clients with health problems presented in each unit. 7. Identify the general nursing management of the clients with health problems presented in each unit including: a) physical management b) psychosocial concepts c) diet modifications d) drug therapy e) teaching aspects Assessment: The student’s ability to master the above stated outcomes and therefore provide appropriate nursing care to the client with the previously identified conditions will be assessed through objective exams.
  • 8. Theory Expectations and Attendance: See Nursing Student Handbook, Fall 2009. Client Confidentiality: It is a program expectation that HIPAA regulations will be followed. Late Assignments: Assignments turned in late will result in a zero on that assignment unless prior authorization by the instructor is given. Grades and Course Updates: Course updates and grades will be available via the computer. Each student must have a valid email address to which course information may be sent. It is recommended that students check their email at least weekly. Changes in Course Syllabus: The purpose of this syllabus is to serve as a guide and is no way a binding contract between student and faculty. The syllabus may be subject to change, decided by circumstances, which occur throughout the course. Students will be notified in writing of any changes as they occur. NCLEX-RN CD-ROM EXAMS: The Saunders CD-Rom should be utilized in preparation for classroom discussion and exams. Unit Exams I-IV, Comprehensive Final: Each Unit/Final exam is timed. Calculators will be provided if needed. Nothing is allowed on the tables except what is provided by the instructor. #2 pencils must be used to mark the scanner forms, so please make sure you bring them on exam days. Cell phones are not to be out or on during testing. If you finish before the exam is over, you may remain in the classroom and must remain quiet. You may not get into your book bag or anything else that will cause noise. You may not write notes back and forth with your neighbor. You may not whisper to anyone. You may bring a non-nursing text to read, as reading your nursing book/notes will not be allowed. You may also leave the classroom once finished with your exam. Exam grades will be posted on mygradebook.com within 48 hours of the completion of the exam. Make – up Exams: In the event of an absence on the day a unit test is scheduled, a make-up exam may be taken. All make-up exams are administered at the end of the semester. Refer to the schedule for the exact date. The make-up exam may not be in the same format as the regularly scheduled exam. Only one make-up exam may be taken. If a student is absent for a second exam, a zero will be assigned for the second test. Make-up for the final will be offered at the discretion of the instructor after consultation with the department chair.
  • 9. Clinical Practice/Laboratory Assignments: Quizzes on lab skills will be graded as “Pass/Fail”. Quiz on Lab Skills NGT Insertion August 19 Check off for NGT Insertion August 26
  • 10. Volunteer/Charitable Organization Presentation A. The student is to research and choose a volunteer/charitable organization available to, or has the possibility of being available to, clients in the surrounding demographic area. B. The student will report to the class: 1. The reason for an interest in the organization. 2. Background information on how the organization came into existence. 3. The client population serviced by the organization. 4. How the organization is staffed and funded. 5. How the organization benefits the medical community. C. The organization must have relevance to the units covered in NUR232. D. The information about the organization must be visually and orally presented during class time in any format the student selects (e.g. poster, PowerPoint). Goals and Learning Objectives Upon completion of the presentations, the learner will: • Have an increased awareness of volunteer/charitable organizations available in the surrounding counties • Understand the role of the organization for the client/family • Understand the funding/staffing needs of the organization • Identify how the organization benefits the medical community • Use the information provided to enhance nursing care
  • 11. EVALUATION CRITERIA FOR VOLUNTEER/CHARITABLE ORGANIZATION* Student Name: Date: CRITERIA % EARNED/COMMENTS CONTENT (50%) The student provides: • a reason for an interest in the organization. • Background information on how the organization came into existence. • Who the organization serves. • How the organization is funded/staffed. • How the organization benefits the medical community. ORGANIZATION (20%) • Presentation is well-organized and attention getting; scenario is well thought out. • Highlights of the organization are verbally presented in a sequenced manner • Emphasis on key concepts is clear. PRESENTATION (30%) • Demonstrates creativity • Demonstrates preparation • Presentation is suitable to audience and content, including graphic and/or multimedia choices • Verbal/Volume and pace are suitable to audience and content; pitch, tone and volume vary • Non-verbal eye contact; facial, hand gestures are appropriate • Responds appropriately to audience feedback • Encourages and handles audience participation constructively TOTAL COMMENTS: * The student must obtain a 77% in order to pass this presentation assignment.
  • 12. Problems of Oxygenation: Perfusion – Nursing Assessment of the Cardiovascular System Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the anatomic location and function of the following cardiac structures: pericardial layers, atria, ventricles, semilunar valves, and atrioventricular valves. 2. Describe coronary circulation and the areas of heart muscle supplied by the major coronary arteries. 3. Explain the normal sequence of events involved in the conduction pathway of the heart. 4. Describe the structure and function of arteries, veins, capillaries, and endothelium. 5. Define blood pressure and the mechanisms involved in its regulation. 6. Identify the waveforms and the associated cardiac events represented on a normal electrocardiogram. 7. Identify the significant subjective and objective assessment data related to the cardiovascular system that should be obtained from a patient. 8. Describe the appropriate techniques used in the physical assessment of the cardiovascular system. 9. Differentiate normal from common abnormal findings of a physical assessment of the cardiovascular system. 10. Describe the age-related changes of the cardiovascular system and differences in assessment findings. 11. Describe the purpose, significance of results, and nursing responsibilities of diagnostic studies of the cardiovascular system. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of perfusion. 3. Discuss the clinical implications for the nurse and client when dealing with problems of perfusion Learning Activities: Read: Lewis, et al, Ch. 32 Review Key Terms: afterload, p. 742 ejection fraction, p. 757 arterial blood pressure, p. 743 mean arterial pressure, p. 744 cardiac index, p. 742 point of maximal impulse, p. 750 cardiac output, p. 742 preload, p. 742 cardiac reserve, p. 742 pulse pressure, p. 743 diastole, p. 742 systole, p. 742 diastolic blood pressure, p. 743 systolic blood pressure, p. 743
  • 13. Recommended Websites: Cardiovascular Classes from Nurse CEU.com An extensive directory to courses related to cardiovascular diseases, most offered free online. Clinical Practice Guidelines From the National Heart, Lung, and Blood Institute. Coronary Angiogram and Angioplasty An audiovisual online tutorial from the National Library of Medicine. The Determinants of Cardiac Output Transcript and online video by Robert M. Anderson, MD, et al. From the larger site on The Gross Physiology of the Cardiovascular System, University of Arizona. Electrophysiology Study: A Comprehensive Review Online continuing education article by Mina Attin, RN, MN. From the American Journal of Critical Care, July 2001, vol. 10, no. 4wew. The Heart Lessons Basic learning activities from Science Museum of Minnesota. Includes consumer targeted information on pulse rate, heart rates, heart sounds, and much more. Heart Sounds and Murmurs Includes audio and video files; from Introduction: Examination for Heart Sounds and Murmurs, Advanced Physical Diagnosis Skills for the Bedside By Linda E. Pinsky, MD, and Linda E. Pinsky, MD, Department of Medicine, University of Washington, Seattle. Introduction to Cardiovascular Pharmacology Lecture Notes from NetPharmacology, University of Utah; topics covered include: The Autonomic Nervous System; The Heart: Cardiac Anatomy, The Cardiac Cycle, Factors Influencing Cardiac Performance, Factors Affecting Pumping Efficiency, and Factors Affecting Myocardial Oxygen Consumption; The Vasculature: The Circulatory System, Vessels Controlling Blood Pressure; Regulation of Blood Pressure: Short-Term Regulation, Long-Term Regulation; Cardiovascular Diseases; Useful Equations; and a Glossary; Donald K. Blumenthal, Ph.D., site coordinator. Scientific Statement and Practice Guideline Topic List From the American Heart Association. State-of-the-Art Diagnostic Testing in Women: A Research Update A 29 page online report from the NHLBI Workshop on Women and Ischemia Syndrome Evaluation (WISE): Diagnosis and Pathophysiology of Ischemic Heart Disease, October 2-4, 2002, Marriott Inn, Baltimore Washington International Airport. Journals Heart Rhythm Published by Elsevier for the Heart Rhythm Society. The journal "provides rapid online and print publication of the most important basic and clinical scientific developments devoted to arrhythmias, devices, and cardiovascular electrophysiology. In addition, the Journal publishes scholarly reviews, editorials, unique case reports, letters to the editor, HRS annual plenary lecture, and several feature sections. These include: Creative Concepts, Featured Arrhythmias, Pacemaker/ICD Problems, Images: Cell to Bedside and videos viewable on the Internet, Viewpoints, and EP News." Registered users may purchase individual and society member subscriptions and individual articles online for immediate online access.
  • 14. Journal of the American College of Cardiology Tables of contents and abstracts are available online; full access is available by subscription. Online Journal of Cardiology Editor in Chief Dr. M. D. Rosengarten; "broadcast from Canada, with the support of McGill University."
  • 15. Problems of Oxygenation: Perfusion – Coronary Artery Disease, Acute Coronary Syndrome Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the etiology and pathophysiology of coronary artery disease, angina, and acute coronary syndrome. 2. Identify risk factors for coronary artery disease and the nursing role in the promotion of therapeutic lifestyle changes in patients at risk. 3. Compare and contrast the precipitating factors, clinical manifestations, and collaborative care and nursing management of the patient with coronary artery disease and chronic stable angina. 4. Describe the clinical manifestations, complications, diagnostic study results, and collaborative care of the patient with acute coronary syndrome. 5. Describe the pathophysiology of myocardial infarction from the onset of injury through the healing process. 6. Identify commonly used drug therapy in treating patients with coronary artery disease and acute coronary syndrome. 7. Identify key issues to include in the rehabilitation of patients recovering from acute coronary syndrome and coronary revascularization procedures. 8. Describe the precipitating factors, clinical presentation, and collaborative care of patients who are at risk for or have experienced sudden cardiac death. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with oxygenation related to perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with perfusion disorders. 3. Discuss the clinical implications for the nurse and client when dealing with perfusion disorders. Learning Activities: Read: Lewis, et al, Ch. 34 Review Key Terms: acute coronary syndrome, p. 802 myocardial infarction, p. 803 angina, p. 796 percutaneous coronary intervention, p. 801 atherosclerosis, p. 785 Prinzmetal’s angina, p. 797 chronic stable angina, p. 796 silent ischemia, p. 797 collateral circulation, p. 786 stent, p. 801 coronary artery disease, p. 785 sudden cardiac death, p. 817 coronary revascularization, p. 801 unstable angina, p. 802 metabolic equivalent (MET), p. 817
  • 16. Recommended Websites: ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Full-text From the American Heart Association. ACLS.Net Includes online practice algorithms, mnemonics, and online self-test quizzes. Aspirin as a Therapeutic Agent in Cardiovascular Disease A Statement for Healthcare Professionals From the American Heart Association. Coronary Angiogram and Angioplasty An audiovisual online tutorial from the National Library of Medicine. DASH Diet & Cookbook web site from the Oregon Dairy Council. Therapeutic Lifestyle Changes From the The National Heart, Lung, and Blood Institute (NHLBI); includes The Virtual Grocery Store, Cyber Kitchen, Cyber Cafe, TLC Diet, and more. Be prepared to discuss the following case study in class: Patient Profile Mr. Monroe is a 74-year-old obese white man who comes to the emergency department (ED) with a 2-day history of severe chest pain. Over the weekend the pain increased, but his wife could not convince him to go to the hospital. He comes to the ED today because the pain is severe and no longer relieved by rest. Subjective Data · Describes recurring chest pain for the past 6 months that was relieved by rest; describes that pain as a feeling of heaviness · Recently the pain has become severe and is no longer relieved by rest Objective Data Physical Examination · Alert and oriented to person, place, and time · Obese · Vital signs: blood pressure 180/90, pulse 92, temperature 99.8º F, respirations 20 · Skin diaphoretic and clammy · Heart rhythm regular, no murmurs or extra heart sounds · Denies nausea and vomiting Diagnostic Studies and Procedures · Hemoglobin 14 g/dl · Na, K, Cl, and HCO3 normal · Cardiac enzymes pending · Electrocardiogram showing changes that correlate with non–ST-segment–elevation myocardial infarction (NSTEMI) · D5W infusing into the intravenous catheter · Nitroglycerin and morphine given with relief of pain Psychosocial Data
  • 17. · States he has a positive family history of heart disease · Denies alcohol or drug use · States he smokes one and a half packs of cigarettes per day · Describes his lifestyle as sedentary Critical Thinking Questions 1. Which risk factors (modifiable and nonmodifiable) does Mr. Monroe have for coronary artery disease (CAD)? 2. What is the difference between chronic stable angina pain and pain associated with myocardial infarction? 3. What diagnostic studies are indicated for Mr. Monroe? Case Study Progression Mr. Monroe is diagnosed as having a myocardial infarction. 4. What is the priority nursing care for Mr. Monroe? 5. What are common complications after an MI?
  • 18. Problems with Oxygenation: Perfusion – Dysrythmias Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the nursing management of patients requiring continuous electrocardiographic (ECG) monitoring. 2. Identify the clinical characteristics and ECG patterns of normal sinus rhythm, common dysrhythmias, and acute coronary syndrome (ACS). 3. Describe the nursing and collaborative management of patients with common dysrhythmias and ECG changes associated with ACS. 4. Differentiate between defibrillation and cardioversion, identifying indications for their use and physiologic effects of each. 5. Describe the management of patients with temporary and permanent pacemakers. 6. Describe the management of patients with implantable cardioverter-defibrillators. 7. Explain the management of patients undergoing electrophysiologic testing and radiofrequency catheter ablation therapy. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with oxygenation and perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with perfusion disorders. 3. Discuss the clinical implications for the nurse and client when dealing with perfusion disorders. Learning Activities: Read: Lewis, et al, Ch. 36 Review Key Terms: asystole, p. 855 dysrhythmias, p. 842 atrial fibrillation, p. 852 electrocardiogram, p. 843 atrial flutter, p. 851 premature atrial contraction, p. 850 automaticity, p. 846 premature ventricular contraction, p. 854 cardiac pacemaker, p. 858 ventricular fibrillation, p. 855 complete heart block, p. 854 ventricular tachycardia, p. 854 Recommended Websites: ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Full-text From the American Heart Association. ACC/AHA Clinical Performance Measures for Adults with ST-Elevation and Non ST- Elevation Myocardial Infarction 2006. One of many Clinical Statements/Guidelines from the American College of Cardiology.
  • 19. Antiarrhythmic Agents From Einthoven Advances in Cardiac Arrhythmias site. Diagnosing syncope Part 1: Value of History, Physical Examination, and Electrocardiography; Clinical Guideline. In Annals of Internal Medicine June 15, 1997; contains a link to Part 2. ECG Library "©Copyright Dean Jenkins and Stephen Gerred. The ECGs and associated images on these web pages may be used for any non-commercial purpose as long as their source is acknowledged." ECG Learning Center in Cyberspace An extensive site on ECG's from the University of Utah School of Medicine. EKG Quiz Extensive ECG site from McGill University. Electrocardiogram A page from the Nobel Prize web site. Includes an interactive online program "Play the Electrocardiogram Game". Also includes a section on The Electrocardiogram – looking at the heart of electricity. Electrophysiology Study: A Comprehensive Review Online continuing education article by Mina Attin, RN, MN. From the American Journal of Critical Care, July 2001, vol. 10, no. 4wew. Pacemakers and Implantable Defibrillators A collection of web resources form the National Library of Medicine's Medline Plus.
  • 20. Problems with Oxygenation: Perfusion – Inflammatory and Structural Heart Disorders Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the etiology, pathophysiology, and clinical manifestations of infective endocarditis and pericarditis. 2. Discuss the collaborative care and nursing management of the patient with infective endocarditis and pericarditis. 3. Explain the importance of prophylactic antibiotic therapy in infective endocarditis. 4. Explain the etiology, clinical manifestations, collaborative care, and nursing management of myocarditis. 5. Describe the etiology, pathophysiology, and clinical manifestations of rheumatic fever and rheumatic heart disease. 6. Discuss the collaborative care and nursing management of the patient with rheumatic fever and rheumatic heart disease. 7. Identify the etiologies of acquired valvular heart diseases. 8. Discuss the pathophysiology, clinical manifestations, and diagnostic studies for the various types of valvular heart disease. 9. Describe the collaborative care and nursing management of the patient with valvular heart disease. 10. Describe interventions used in management of the patient with valvular heart disease. 11. Describe the pathophysiology and clinical manifestations of the different types of cardiomyopathies. 12. Discuss the nursing and collaborative management of patients with different types of cardiomyopathies. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with oxygenation and perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with perfusion disorders. 3. Discuss the clinical implications for the nurse and client when dealing with perfusion disorders. Learning Activities: Read: Lewis, et al, Ch. 37 Review Key Terms: aortic stenosis, p. 880 myocarditis, p. 874
  • 21. aortic valve regurgitation, p. 880 Osler’s nodes, p. 867 Aschoff’s bodies, p. 876 pericardial effusion, p. 872 cardiac tamponade, p. 872 pericardial friction rub, p. 872 cardiomyopathy, p. 885 pericardiocentesis, p. 873 dilated cardiomyopathy, p. 886 pericarditis,, p. 871 hypertrophic cardiomyopathy, p. 888 regurgitation, p. 878 infective endocarditis, p. 865 rheumatic fever, p. 875 Janeway’s lesions, p. 867 rheumatic heart disease, p. 875 mitral valve prolapse, p. 879 Recommended Websites: ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease Available online from the American College of Cardiology web site. Cardiothoracic Surgery Notes An "online interactive review developed by residents in cardiothoracic surgery." One of many resources available from the CTSNet: The Cardiothoracic Surgery Network. Cardiovascular Pathology Index Includes illustrations of a normal heart, as well as pathologic images from the Internet Pathology Laboratory. Cut to the Heart A NOVA presentation produced for PBS by the WGBH Science Unit; on heart surgery. Includes an animated explanation on blood flow in the heart. From Theory to Practice: Preventing Pain After Cardiac Surgery By Jocelyn Reimer-Kent ; open access continuing education article from American Journal of Critical Care, March 2003. ORLive and ORLive - Cardiology A site featuring online videos of surgical procedures. Use the search or subject categories to locate specific procedures. An extensive site owned and operated by slp3D.
  • 22. Problems with Oxygenation: Perfusion – Hypertension Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the mechanisms involved in the regulation of blood pressure. 2. Identify the pathophysiologic mechanisms associated with primary hypertension. 3. Describe the clinical manifestations and complications of hypertension. 4. Describe strategies for the prevention of primary hypertension. 5. Describe the collaborative care for hypertension, including drug therapy and lifestyle modifications. 6. Discuss the collaborative care of the older adult patient with hypertension. 7. Describe the nursing management of the patient with hypertension, emphasizing patient education. 8. Describe the clinical manifestations and collaborative care of hypertensive crisis. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with oxygenation and perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with perfusion disorders. 3. Discuss the clinical implications for the nurse and client when dealing with perfusion disorders. Learning Activities: Read: Lewis, et al, Ch. 33 Review Key Terms: blood pressure, p. 762 prehypertension, p. 761 hypertension, p. 761 primary hypertension, p. 765 hypertensive crisis, p. 781 secondary hypertension, p. 765 orthostatic hypotension, p. 778 systemic vascular resistance, p. 762 Recommended Websites: Antihypertensive Agents and Antihypertensive Agents lecture notes From NetPharmacology University of Utah. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Online materials from the National Heart, Lung, and Blood Institute. Blood Pressure Description with photo images, from Loyola University. Comprehensive High Blood Pressure Care for Young Urban Black Men "A Cross-disciplinary Program of Research, Patient Care and Teaching". A program from the Johns Hopkins
  • 23. University School of Nursing. Site includes extensive information on the study and abstracts of publications resulting from the project. DASH Diet & Cookbook web site from the Oregon Dairy Council. Dietary Electrolytes and Blood Pressure: A Statement for Healthcare Professionals From the American Heart Association Nutrition Committee Theodore A. Kotchen, MD; David A. McCarron, MD; from the Nutrition Committee, 1998. Heart Sounds and Blood Pressure Includes an online audio file. From John R. Waters, Penn State Biology Department. High Blood Pressure Information Slide Shows Available for viewing or downloading. Includes the The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) ; from the National Heart Lung and Blood Institute. National High Blood Pressure Education Program (NHBPEP) Contains online slide sets and other resources; from the National Heart, Lung, and Blood Institute - NHLBI. New Developments in the Management of Hypertension Online article from American Family Physician, September 1, 2003. NHBPEP Report on High Blood Pressure in Pregnancy: A Summary for Family Physicians Online article by Mark A. Zamorski, MD, MHSA, and Lee A. Green, MD, MPH. from American Family Physician, July 15, 2001. A link is provided to a patient information sheet on the topic. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) Includes links to supporting resources and Quick Reference Card. Journals American Journal of Hypertension Official Journal of the American Society of Hypertension. Full-text articles are available from 1995 to the present. Access to abstracts is complimentary. Access to full text is limited to print subscribers.
  • 24. Problems with Oxygenation: Perfusion – Heart Failure Learning Objectives: Upon completion of this topic the student will be able to: 1. Compare the pathophysiology of systolic and diastolic ventricular failure. 2. Discuss the compensatory mechanisms involved in heart failure. 3. Describe the nursing and collaborative management of the patient with acute decompensated heart failure and pulmonary edema. 4. Describe the collaborative care and nursing management, including drug and nutritional therapy, of the patient with chronic heart failure. 5. Describe the indications for cardiac transplantation and the nursing management of cardiac transplant recipients. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with oxygenation and perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with perfusion disorders. 3. Discuss the clinical implications for the nurse and client when dealing with perfusion disorders. Learning Activities: Read: Lewis, et al, Ch. 35 Review Key Terms: cardiac transplantation, p. 837 paroxysmal nocturnal dyspnea, p. 825 diastolic failure, p. 822 pulmonary edema, p. 824 heart failure, p. 821 systolic failure, p. 822 Recommended Websites: ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult—Summary Article From the Journal of the American College of Cardiology, 2005; 46:1116-1143. ACC/AHA Clinical Performance Measures for Adults with ST-Elevation and Non ST- Elevation Myocardial Infarction 2006. One of many Clinical Statements/Guidelines from the American College of Cardiology. ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina Full text online from the American Heart Association. Diagnosis and Management of Diastolic Dysfunction and Heart Failure An article by Chhabi Satpathy, MD, Trinath K. Mishra, MD, Ruby Satpathy, MD, Hemant K. Satpathy, MD, and Eugene Barone, MD, from American Family Physician, March 1, 2006, Vol. 73 No. 5.
  • 25. Digoxin Oral Information from Medline Plus Drug Information. Furosemide Information from Medline Plus Drug Information. Heart Failure Online consumer level information from the National Heart Lung and Blood Institute. Managing Heart Failure: A Case Study Approach Online continuing education article by Mary MacKlin, from the American Association of Critical-Care Nurses. Point-of-Care Guides: Predicting Mortality Risk in Patients with Acute Exacerbations of Heart Failure By Mark H. Ebell, MD, MS, available online from American Family Physician, April 15, 2007, Vol. 75 No. 8. Transplant Statistics From the US Transplant -- Scientific Registry of Transplant Recipients.
  • 26. Nursing Care in Specialized Settings – Critical Care, Emergency & Disaster Nursing Learning Objectives: Upon completion of this topic the student will be able to: 1. Differentiate among the certification roles of critical care nurses: CCRN, PCCN, CCNS, and ACNP. 2. Select appropriate nursing interventions to manage common problems and needs of critically ill patients. 3. Develop effective strategies to manage issues related to the families of critically ill patients. 4. Discuss the principles of hemodynamic monitoring and collaborative care and nursing management of the patient receiving hemodynamic monitoring. 5. Describe the purpose, indications, and function of circulatory assist devices and related collaborative care and nursing management. 6. Describe types of artificial airways and appropriate nursing interventions to manage the care of an intubated patient. 7. Differentiate the indications for and modes of mechanical ventilation. 8. Describe the principles of mechanical ventilation and collaborative care and nursing management of a patient receiving mechanical ventilation. Apply the sequential steps in triage, the primary, and the secondary survey to a patient in an emergency situation. 9. Describe the pathophysiology, assessment, and collaborative care of select environmental emergencies, including hyperthermia, hypothermia, submersion injury, and animal bites. 10. Describe the pathophysiology, assessment, and collaborative care of select toxicologic emergencies. 11. Differentiate between the various types and victims of violence. 12. Identify the agents most likely to be used in a terrorist attack. 13. Differentiate the responsibilities of health care providers, the community, and select federal agencies in emergency and mass casualty incident preparedness. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of nursing care in specialized settings. 2. Analyze the role and responsibility of the nurse when caring for a client in a specialized setting. 3. Discuss the clinical implications for the nurse and client when administering care in specialized settings. Learning Activities: Read: Lewis, et al, Ch. 66, Ch. 69 Review Key Terms: bioterrorism, p. 1838 continuous positive airway pressure, p. circulatory assist devices, p. 1747 1762
  • 27. emergency, p. 1842 mass casualty incident, p. 1842 endotracheal intubation, p. 1751 mechanical ventilation, p. 1759 heat cramps, p. 1828 negative pressure ventilation, p. 1759 heat exhaustion, p. 1829 phlebostatic axis, p. 1739 heatstroke, p. 1829 positive end-expiratory pressure, p. 1762 hemodynamic monitoring, p. 1738 positive pressure ventilation, p. 1760 high-frequency ventilation, p. 1763 pressure ventilation, p. 1760 hypothermia, p. 1831 triage, p. 1822 intraaortic balloon pump, p. 1748 ventricular assist device, p. 1750 jaw-thrust maneuver, p. 1823 volume ventilation, p. 1760 Recommended Websites: AACN Standards: Standards for Acute and Critical Care Nursing Practice Online overview and ordering information for the expanded version; from the American Association of Critical-Care Nurses. Advanced Trauma Life Support web site From the American College of Surgeons. Information on where and when materials and courses are available. Best BETs - Best Evidence Topics site. Reviews of literature for best practices for emergency care developed by the Emergency Department of Manchester Royal Infirmary, UK. Emergency Cardiovascular Care From the American Heart Association. Evaluation and Management of the Sexually Assaulted or Sexually Abused Patient Online handbook [134 pages] from the American College of Emergency Physicians, 1999. Injuries and Wounds Topics From Medline Plus. A collection of links to appropriate web resources is available for each topic. Mass Casualty Event Preparedness and Response "Information and tools to aid preparation for and response to mass trauma events." From the Centers for Disease Control and Prevention. National Trauma Data Bank From the American College of Surgeons. Includes online reports. Trauma Web site from the American College of Surgeons; includes a link to a collection of online resources on standards for trauma care and management of specific types of injury. Violence in the Emergency Care Setting 7/2001 Position statement from the Emergency Nurses Association.
  • 28. Problems with Oxygenation: Perfusion – Vascular Disorders Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the etiology and pathophysiology of peripheral arterial disease. 2. Identify the major risk factors associated with peripheral arterial disease. 3. Describe the pathophysiology, clinical manifestations, and collaborative care of aortic aneurysms. 4. Discuss the perioperative nursing care of a patient having an aortic aneurysm repair. 5. Describe the pathophysiology, clinical manifestations, and collaborative care of aortic dissection. 6. Discuss the clinical manifestations, collaborative care, and surgical management of peripheral arterial disease of the lower extremities. 7. Discuss the nursing management of the patient with acute arterial insufficiency affecting the lower extremities. 8. Differentiate the pathophysiology, clinical manifestations, and collaborative care of thromboangiitis obliterans (Buerger’s disease) and Raynaud’s phenomenon. 9. Identify the risk factors predisposing to the development of superficial thrombophlebitis and deep vein thrombosis. 10. Differentiate between the clinical characteristics of superficial thrombophlebitis and deep vein thrombosis. 11. Describe the collaborative care and nursing management of the patient with venous thrombosis, including superficial thrombophlebitis and deep vein thrombosis. 12. Describe the nursing management of the patient receiving anticoagulation therapy. 13. Discuss the pathophysiology, clinical manifestations, and collaborative and nursing management of patients with varicose veins, venous insufficiency, or venous leg ulcers. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with oxygenation and perfusion. 2. Analyze the role and responsibility of the nurse when caring for a client with perfusion disorders. 3. Discuss the clinical implications for the nurse and client when dealing with perfusion disorders. Learning Activities: Read: Lewis, et al, Ch. 38 Review Key Terms: acute arterial ischemia, p. 907 peripheral arterial disease, p. 893
  • 29. aneurysms, p. 894 Raynaud’s phenomenon, p. 908 aortic dissection, p. 898 superficial thrombophlebitis, p. 909 chronic venous insufficiency p. 919 thromboangiitis obliterans (Buerger’s disease), p. 908 critical limb ischemia, p. 903 varicose veins, p. 917 deep vein thrombosis, p. 909 venous thrombosis, p. 909 intermittent claudication, p. 900 Virchow’s triad, p. 909 Recommended Websites: Abdominal Aortic Aneurysms from the National Library of Medicine. Arteries An interactive learning program with schematic diagrams of location of major arteries; from Lumen, Loyola University. Atherosclerosis and Thrombosis Index Histologic and pathologic illustrations and text from the Internet Pathology Laboratory. Blood Clots Basic level illustrations and information from the Medical Encyclopedia, Medline Plus. A collection of links is provided to related topics such as Arterial embolism, Pulmonary embolus, Deep Venous Thrombosis, and others. Blood Lipid Lowering Agents From NetPharmacology, site coordinated by Donald K. Blumenthal, PhD, Department of Pharmacology and Toxicology, University of Utah. Buerger's Disease Information from the Vascular Disease Foundation. Carotid Endarterectomy An interactive tutorial from Medline Plus. Cholesterol Information and a collection of links to web resources from Medline Plus. Includes sections on Treatment and Tutorials. Coumadin® and Vitamin K From the National Institutes of Health Warren Grant Magnuson Clinical Center; includes a list of foods high in vitamin K. Diabetic Foot Ulcers: Pathogenesis and Management An article by Robert G. Frykberg, DPM, MPH, from American Family Physician, November 1, 2002. Diabetic Foot Ulcers: Prevention, Diagnosis and Classification An article by David G. Armstrong, DPM, and Lawrence A, Lavery, DPM, MPH, from American Family Physician,March 15, 1998. DIC (disseminated intravascular coagulation) Illustrations and information from the Medical Encyclopedia, Medline Plus. DVT and Pulmonary Embolism: Part I. Diagnosis and DVT and Pulmonary Embolism: Part II. Emergency Interventional Stroke Therapy: A Statement from the American Society of Interventional and Therapeutic Neuroradiology and the Society of Interventional Radiology. Homan's sign in the diagnosis of deep venous thrombosis. Online article by Frank L. Urbano, Hospital Physician, March 2001.
  • 30. Lipids Online Features a Slide Library, a Virtual Meeting Forum, and Commentaries on Research. Peripheral Arterial Disease: ACC/AHA 2005 Guidelines for the Management of Patients With (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report From the AAVS/SVS, SCAI, SVMB, SIR, and the ACC/AHA Task Force on Practice Guidelines Available online from the American College of Cardiology. Peripheral Arterial Disease and Claudication From the American Academy of Family Physicians. Postoperative Management of the Vascular Surgery Patient By John E. Ellis, MD, Michael O'Connor, MD, Copyright 1996, Department of Anesthesia and Critical Care, at the University of Chicago. Pulmonary Embolism and Deep Vein Thrombosis An illustrated patient education document from Circulation, 2002, made available by the American Heart Association. Raynaud's Disease A collection of links to web resources from Medline Plus. Reducing Tobacco Use: A Report of the Surgeon General Full-text online. Varicose Veins An online audio slide show from the National Library of Medicine. Venous Stasis Ulcers Information about venous stasis ulcers, complete with images and descriptions. From the Wound Healing / Burns / Stasis Ulcers site by John L. Bezzant, MD.
  • 31. Problems Related to Movement and Coordination – Nervous System Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the functions of neurons and neuroglia. 2. Explain the electrochemical aspects of nerve impulse transmission. 3. Explain the anatomic location and functions of the cerebrum, brainstem, cerebellum, spinal cord, peripheral nerves, and cerebrospinal fluid. 4. Identify the major arteries supplying the brain. 5. Describe the functions of the 12 cranial nerves. 6. Compare the functions of the two divisions of the autonomic nervous system. 7. Describe age-related changes in the neurologic system and differences in assessment findings. 8. Identify the significant subjective and objective data related to the nervous system that should be obtained from a patient. 9. Describe the techniques used in the physical assessment of the nervous system. 10. Differentiate normal from common abnormal findings of a physical assessment of the nervous system. 11. Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the nervous system. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the nervous system. 2. Analyze the role and responsibility of the nurse when caring for a client with neurological disorders. 3. Discuss the clinical implications for the nurse and client when dealing with neurological disorders. Learning Activities: Read: Lewis, et al, Ch. 56 Review Key Terms: autonomic nervous system, p. 1449 neuroglia, p. 1442 blood-brain barrier, p. 1452 neuron, p. 1442 central nervous system, p. 1442 neurotransmitter, p. 1444 cerebrospinal fluid, p. 1448 peripheral nervous system, p. 1442 cranial nerves, p. 1448 reflex, p. 1445 dermatome, p. 1448 synapse, p. 1443 lower motor neurons, p. 1445 upper motor neurons, p. 1445 meninges, p. 1452 Recommended Websites:
  • 32. Anatomy of the Brain On the public information resource of the American Association of Neurological Surgery. Atlas of Brain Perfusion SPECT By B.Leonard Holman, Puneet K. Chandak, and Basem M. Garada; includes illustrations of cognitive and neurologic disorders. Basic Neural Processes A "collection of tutorials on basic neural functions" by John H. Krantz, PhD, Hanover College, Indiana. Site includes an interactive quiz on the human brain, animated information on basic neurological function, and a glossary of terms. Brain Functions and Map By Robert P. Lehr Jr., PhD, Professor Emeritus, Department of Anatomy, School of Medicine, Southern Illinois University. Scroll down to the brain image and click on different sections of the brain to review brain functions; from the Centre for Neuro Skills, a multi-site brain injury rehabilitation company. Central Nervous System Exam By Arcot J. Chandrasekhar, MD, FRCP, FACP, FCCP, Loyola University. Detailed illustrated review of multiple systems related to the neurological exam. Cerebrospinal Fluid Analysis An article by Dean A. Seehusen, MD, Mark M. Reeves, MD, and Demitri A. Fomin, MD, from American Family Physician, September 15, 2003, vol. 68, no. 6. Clinical Utility of Evoked Potentials Online review from E-Medicine. Cranial Nerves Detailed illustrated site from Yale University School of Medicine. Some parts are still under construction. EMG & Nerve Conductions Homepage By Joe F. Jabre, MD; includes Electronic EMG Manual ©; Quick-Anatomy: Nerves; Quick-Anatomy: Muscles; Quick Set-Ups: Nerve Conductions; Nerve Conduction TeleEMG Calculator ©. History & Physical Examination: Clinical Patterns Part of the web site Neuromuscular Evaluation Protocols on the Neuromuscular Disease Center site, Washington University School of Medicine, St. Louis. Also includes information on Lab Testing: Especially for treatable diagnoses after history & examination and Nerve Biopsy. HyperBrain Extensive illustrated site from the University of Utah. Intracranial Pressure (ICP) Monitoring: Troubleshooting Elevated Pressures and Cerebral Perfusion Pressure (CPP) From the Edubriefs educational site, Critical Care Trauma Centre of the London Health Sciences Centre. Journal of Neuroscience Nursing Continuing Education Articles available from the American Association of Neuroscience Nurses - AANN. Medical Neuroscience From LUMEN Loyola University Medical Education Network; includes extensive pathological and histological illustrations of the brain stem and other parts of the nervous system. The Nervous System in Old Age From Neuroscience for Kids, Copyright, 1996-2007, Eric H. Chudler, PhD, a professor at the University of Washington.
  • 33. Neurophysiology An extensive collection of detailed tutorials on neurophysiologic functions with flash animations and online interactive experiments. Neurosurgery - What Is It? An online tutorial from the National Library of Medicine's Medline Plus site. The Normal Brain Illustrated overview from Roberta J. Seidman, MD, Associate Professor, SUNY Stony Brook Pathology Department. Screening Physical Exam Select the section on the Nervous System, by Arcot J. Chandrasekhar, MD, FRCP, FACP, FCCP, Loyola University. Secret Life of the Brain Companion web site to the PBS program of the same name. Includes sections on scanning and anatomy.
  • 34. Problems Related to Movement and Coordination – Acute Intracranial Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Identify the physiologic mechanisms that maintain normal intracranial pressure. 2. Identify the common etiologies, clinical manifestations, and collaborative care of the patient with increased intracranial pressure. 3. Describe the collaborative and nursing management of the patient with increased intracranial pressure. 4. Differentiate types of head injury by mechanism of injury and clinical manifestations. 5. Describe the collaborative care and nursing management of the patient with a head injury. 6. Compare the types, clinical manifestations, and collaborative care of patients with brain tumors. 7. Discuss the nursing management of the patient with a brain tumor. 8. Describe the nursing management of the patient undergoing cranial surgery. 9. Compare the primary causes, collaborative care, and nursing management of meningitis, encephalitis, and brain abscess. 10. Describe the etiology, clinical manifestations, and nursing and collaborative management of the patient with rabies. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the nervous system. 2. Analyze the role and responsibility of the nurse when caring for a client with neurological disorders. 3. Discuss the clinical implications for the nurse and client when dealing with neurological disorders. Learning Activities: Read: Lewis, et al, Ch. 57 Review Key Terms: cerebral edema, p. 1469 intracerebral hematoma, p. 1484 coma, p. 1469 intracranial pressure, p. 1468 concussion, p. 1482 meningitis, p. 1493 contusion, p. 1482 nuchal rigidity, p. 1494 encephalitis, p. 1497 subdural hematoma, p. 1483 epidural hematoma, p. 1483 unconsciousness, p. 1471 Glasgow Coma Scale, p. 1476 Recommended Websites: American Academy of Neurology Practice Guidelines These cover a wide range of topics.
  • 35. Anatomy of the Brain On the public information resource of the American Association of Neurological Surgery. Basic Neural Processes A "collection of tutorials on basic neural functions" by John H. Krantz, PhD, Hanover College, Indiana. Site includes an interactive quiz on the human brain, animated information on basic neurological function, and a glossary of terms. The Blood Brain Barrier Illustration and overview article from the Society for Neuroscience. Brain and Nerves Topics A directory to topical collections of web resources on these topics; from Medline Plus. Includes online tutorials and links to relevant organizations. Brain Atlas: Striatal System A collection of animations on several topics from Knowledge Weavers, University of Utah. Brain Functions and Map By Robert P. Lehr Jr., PhD, Professor Emeritus, Department of Anatomy, School of Medicine, Southern Illinois University. Scroll down to the brain image and click on different sections of the brain to review brain functions; from the Centre for Neuro Skills, a multi-site brain injury rehabilitation company. The Cranial Nerves From Loyola University, Chicago. EMG & Nerve Conductions Homepage By Joe F. Jabre, MD; includes Electronic EMG Manual ©; Quick-Anatomy: Nerves; Quick-Anatomy: Muscles; Quick Set-Ups: Nerve Conductions; Nerve Conduction TeleEMG Calculator ©. History & Physical Examination: Clinical Patterns Part of the web site Neuromuscular Evaluation Protocols on the Neuromuscular Disease Center site, Washington University School of Medicine, St. Louis. Also includes information on Lab Testing: Especially for treatable diagnoses after history & examination and Nerve Biopsy. Intracranial Pressure (ICP) Monitoring: Troubleshooting Elevated Pressures and Cerebral Magnetic resonance imaging, MRI Information and an online game from the Nobel Foundation. . Medscape Neurology & Neurosurgery Exceptional online resource that includes access to news, journals, and much more. Requires registration, which is free. . The Nervous System in Old Age From Neuroscience for Kids, Copyright, 1996-2007, Eric H. Chudler, PhD, a professor at the University of Washington. Neurological Eye Simulator From the University of California Davis; "application simulates eye motion and demonstrates the effects of disabling one or more of the 12 eyes muscles and one or more of the 6 cranial nerves that control eye motion"; teaches what to look for during a standard neurological eye exam; requires Shockwave (free plug-in). Neurophysiology An extensive collection of detailed tutorials on neurophysiologic functions with flash animations and online interactive experiments.
  • 36. The Normal Brain Illustrated overview from Roberta J. Seidman, MD, Associate Professor, SUNY Stony Brook Pathology Department. Screening Physical Exam Select the section on the Nervous System, by Arcot J. Chandrasekhar, MD, FRCP, FACP, FCCP, Loyola University. When a headache isn't just a headache An online article from Neurology Reviews, November 2000. The Whole Brain Atlas By Keith A. Johnson, MD, and J. Alex Becker; an exceptional site with extensive illustrations and even movies. Images are also grouped by specific disorders such as Stroke, Brain Tumors, Degenerative Diseases, and Infectious or Inflammatory Diseases. Also includes excellent MRI views of the normal and diseased human brain and Harvard Medical School lecture notes on brain diseases.
  • 37. Problems Related to Movement and Coordination – Stroke Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the incidence of and risk factors for stroke. 2. Explain mechanisms that affect cerebral blood flow. 3. Compare and contrast the etiology and pathophysiology of ischemic and hemorrhagic strokes. 4. Correlate the clinical manifestations of stroke with the underlying pathophysiology. 5. Identify diagnostic studies performed for patients with strokes. 6. Describe the collaborative care, drug therapy, and nutritional therapy for a patient with a stroke. 7. Describe the acute nursing management of a patient with a stroke. 8. Describe the rehabilitative nursing management of the patient with a stroke. 9. Explain the psychosocial impact of a stroke on the patient and family. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the nervous system. 2. Analyze the role and responsibility of the nurse when caring for a client with neurological disorders. 3. Discuss the clinical implications for the nurse and client when dealing with neurological disorders. Learning Activities: Read: Lewis, et al, Ch. 58 Review Key Terms: aphasia, p. 1508 ischemic stroke, p. 1505 brain attack, p. 1502 stroke, p. 1502 embolic stroke, p. 1506 subarachnoid hemorrhage, p. 1506 hemorrhagic strokes, p. 1506 thrombotic stroke, p. 1505 intracerebral hemorrhage, p. 1506 transient ischemic attack, p. 1504 Recommended Websites: American Heart Association Heart and Stroke Statistical Update The Brain Attack Coalition This site is designed for health professionals, especially those working as part of stroke teams. Includes direct links to Scales and Guidelines from a variety of sites. Brain Basics: Preventing Stroke From the National Institute of Neurological Disorders and Stroke.
  • 38. Carotid Endarterectomy An interactive tutorial from Medline Plus. Cognitive and Functional Rehabilitation in Brain Injury A slide set by Hilary Siebens, MD, Harvard Medical School. Cooling for Acute Ischemic Brain Damage (COOL AID) An Open Pilot Study of Induced Hypothermia in Acute Ischemic Stroke An online article from Stroke, 2001;32:1847. Emergency Interventional Stroke Therapy A Statement from the American Society of Interventional and Therapeutic Neuroradiology and the Society of Interventional Radiology. Guidelines for the Early Management of Patients With Ischemic Stroke A Scientific Statement From the Stroke Council of the American Stroke Association; from Stroke, 2003; 34:1056. The Internet Stroke Center An "independent web resource for information about stroke care and research." Includes a section on Clinical Trials, and Stroke Scales and Clinical Assessment Tools. Stroke Statistical overview from the Centers for Disease Control and Prevention. Stroke and Cerebrovascular Diseases: A Guide for Patients and their Families From the Stanford Stroke Center. Stroke Information Page One of the many Information Pages from the National Institute of Neurological Disorders and Stroke. Thrombolysis for acute ischaemic stroke (Cochrane Review) Wardlaw JM, del Zoppo G, Yamaguchi T. Thrombolysis (different doses, routes of administration and agents) for acute ischaemic stroke From the Cochrane Collaboration, by Liu M, Wardlaw J. Transient Ischemic Attack A collection of web resources from the National Library of Medicine's Medline Plus site. Journals Journal of Stroke and Cerebrovascular Diseases published by Elsevier for the National Stroke Association (NSA) and the Japan Stroke Society (JStS). Full-text articles are available to NSA members and personal subscribers starting from 2001 to the present; Abstracts and References are available from 1998 through the current issue. Tables of contents extend back to 1996. Access to abstracts is complimentary.
  • 39. Problems Related to Movement and Coordination – Chronic Neurological Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Compare and contrast tension-type, migraine, and cluster headaches in terms of etiology, clinical manifestations, collaborative care, and nursing management. 2. Describe the etiology, clinical manifestations, diagnostic studies, collaborative care, and nursing management of seizure disorders, multiple sclerosis, Parkinson's disease, and myasthenia gravis. 3. Describe the clinical manifestations and nursing and collaborative management of restless legs syndrome, amyotrophic lateral sclerosis, and Huntington's disease. 4. Explain the potential impact of chronic neurologic disease on physical and psychologic well-being. 5. Outline the major goals of treatment for the patient with a chronic, progressive neurologic disease. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the nervous system. 2. Analyze the role and responsibility of the nurse when caring for a client with neurological disorders. 3. Discuss the clinical implications for the nurse and client when dealing with neurological disorders. Learning Activities: Read: Lewis, et al, Ch. 59 Review Key Terms: amyotrophic lateral sclerosis, p. 1558 myasthenia gravis, p. 1555 epilepsy, p. 1533 Parkinson’s disease, p. 1547 headache, p. 1527 restless legs syndrome, p. 1557 Huntington’s disease, p. 1558 seizure, p. 1532 multiple sclerosis, p. 1542 Recommended Websites: Brain Matters A consumer education site from the American Academy of Neurology Education and Research Foundation. Cerebral Palsy A collection of links to web resources from the National Library of Medicine's Medline Plus. Dana BrainWeb An extensive site from the Dana Foundation that includes information on Memory, Alzheimer's Disease, Head Injuries, Stroke, Parkinson's Disease and more. Epilepsy Information from Medline Plus.
  • 40. Huntington's Disease Information Page and Huntington's Disease — Hope Through Research, an online booklet, from the National Institute of Neurological Disorders and Stroke. Ketogenic Diet and Vagus Nerve Stimulator A directory to information resources available on the web from the Pediatric Epilepsy Center, Washington University Comprehensive Epilepsy Program. Management of Normal Pressure Hydrocephalus An online article by Meg Verrees, MD, and Warren R. Selman, MD, from American Family Physician, September 15, 2004. Multiple Sclerosis An online tutorial from Knowledge Weavers, Spencer S. Eccles Health Sciences Library, University of Utah; includes videos, images, and extensive lecture materials. Neurologic Diseases Extensive links to web resources from the National Library of Medicine's Medline Plus. Parkinson's Disease From Medline Plus. Parkinson's Disease: What a Nurse Should Know An online continuing education article by Mary Lloyd, RN, PhD & Heather Maccarone, RN, BSN, from Nurse.com. Polio and Post-Polio Syndrome A collection of links to web resources from Medline Plus. Journals Epilepsy & Behavior Full access to all journal contents is available by subscription. The Journal of Neuroscience Online Tables of contents, abstracts, and selected items are available online; full access requires subscription; from the Society for Neuroscience. Seizure: The European Journal of Epilepsy A journal about seizures and epilepsy. Tables of contents and abstracts are available open access online; full access is available by subscription.
  • 41. Problems Related to Movement and Coordination – Alzheimer’s Disease and Dementia Learning Objectives: Upon completion of this topic the student will be able to: 1. Define dementia and describe its impact on society. 2. Compare and contrast different etiologies of dementia. 3. Describe the clinical manifestations, diagnostic studies, and collaborative management of dementia. 4. Describe the clinical manifestations of mild cognitive impairment. 5. Describe the clinical manifestations, diagnostic studies, and collaborative management of Alzheimer’s disease. 6. Describe the nursing management of the patient with Alzheimer’s disease. 7. Describe other neurodegenerative disorders associated with dementia, including Lewy body disease, Pick’s disease, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus. 8. Describe the etiology, pathophysiology, clinical manifestations, diagnostic studies, and collaborative management of delirium. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the nervous system. 2. Analyze the role and responsibility of the nurse when caring for a client with neurological disorders. 3. Discuss the clinical implications for the nurse and client when dealing with neurological disorders. Learning Activities: Read: Lewis, et al, Ch. 60 Review Key Terms: Alzheimer's disease, p. 1564 mild cognitive impairment, p. 1564 Creutzfeldt-Jakob disease, p. 1575 neurofibrillary tangles, p. 1565 delirium, p. 1576 Pick's disease, p. 1576 dementia, p. 1561 sundowning, p. 1573 frontotemporal dementia, p. 1576 vascular dementia, p. 1562 Lewy body dementia, p. 1575 Recommended Websites: Alzheimer's Disease Fact Sheet From the Alzheimer's Association. Alzheimer's Disease Fact Sheet and Care Giving: Home and Family resources and links to additional web sites from ADEAR: Alzheimer's Disease Education & Referral Center of the National Institute on Aging.
  • 42. Calming the Cognitively Impaired By Arlene Orhon Jech, RN, BSN; from Nursing Spectrum. Open-access online; continuing education credit requires payment of a fee. Dementia in the Elderly An online continuing education article by Caroline Fox, RN, C, CALA & Cynthia Richardson, BS, MA, from Nurse.com. Does He Have Alzheimer's Disease? By Chris Neal and Michael Meyer, MD; a case study from the University of Missouri's Virtual Health Care Team™ site. Planning Ahead resources of the Alzheimer's Association, National Office A source of information on Alzheimer's disease for patients, family, professionals, the media and researchers. Practice Guidelines for the Treatment of Patients with Alzheimer's Disease and Other Dementias of Late Life Full-text online; from the American Psychiatric Association.
  • 43. Problems Related to Movement and Coordination – Peripheral Nerve and Spinal Cord Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Explain the etiology, clinical manifestations, collaborative care, and nursing management of trigeminal neuralgia and Bell’s palsy. 2. Explain the etiology, clinical manifestations, collaborative care, and nursing management of Guillain-Barré syndrome, botulism, tetanus, and neurosyphilis. 3. Describe the classification of spinal cord injuries and associated clinical manifestations. 4. Describe the clinical manifestations, collaborative care, and nursing management of spinal cord shock. 5. Correlate the clinical manifestations of spinal cord injury with the level of disruption and rehabilitation potential. 6. Describe the nursing management of the major physical and psychologic problems of the patient with a spinal cord injury. 7. Describe the effects of spinal cord injury on the older adult population. 8. Explain the types, clinical manifestations, collaborative care, and nursing management of spinal cord tumors. 9. Describe the pathophysiology, clinical manifestations, and nursing and collaborative management of postpolio syndrome. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the nervous system. 2. Analyze the role and responsibility of the nurse when caring for a client with neurological disorders. 3. Discuss the clinical implications for the nurse and client when dealing with neurological disorders. Learning Activities: Read: Lewis, et al, Ch. 61 Review Key Terms: autonomic dysreflexia, p. 1603 neurosyphilis, p. 1589 Bell's palsy, p. 1584 paraplegia, p. 1590 botulism, p. 1587 postpolio syndrome, p. 1610 Brown-Séquard syndrome, p. 1591 spinal shock, p. 1590 Guillain-Barré syndrome, p. 1585 tetanus, p. 1588 neurogenic bladder, p. 1604 tetraplegia, p. 1589 neurogenic shock, p. 1590 trigeminal neuralgia, p. 1581 Recommended Websites: Anatomy of the Spine Information from the American Association of Neurological Surgeons.
  • 44. Assistive Technology Solutions "Providing Plans for Do-It-Yourself Devices to Assist Persons with Disabilities"; includes free plans for building assistive devices that can be downloaded directly from the online site, including a standing frame. Autonomic Dysreflexia From EDUBRIEFS in CCTC, Brenda Morgan, Clinical Educator, London Health Sciences Center, Canada. Bell's Palsy A collection of links to web resources from Medline Plus. Carpal Tunnel Syndrome Extensive resource edited by Frederick A. Matsen III, MD, from the Hand & Wrist section of the University of Washington Orthopaedics and Sports Medicine web site. Degenerative Spine Disease Online article by John R. Hesselink, MD, FACR, with references; from the Degenerative Disease Syllabus, Teaching File Database, from the University of California San Diego. Guillain-Barrè Syndrome Fact Sheet From the National Institute of Neurological Disorders and Stroke. Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia An online article by Seth John Stankus, Maj, MC, USA, Michael Dligopolski, Maj, MC, USA, and Deborah Packer, Maj, MC, USA; from American Family Physician, April 15, 2000. Spinal Cord Injury Information Network Includes a section on Information & Statistics about SCI. Spinal Cord Injury Nutrition Facts: 1 2, 3, 4, 5, and 6 From the Virtual Library of the Institute for Rehabilitation and Research, affiliated with Baylor College of Medicine. Toxic Neuropathies: Clinical and Pathological Features From Washington University, St. Louis. Trigeminal Neuralgia Definition and illustration from the Trigeminal Neuralgia Association National Office, U.S.
  • 45. Problems Related to Movement and Coordination – Musculoskeletal System Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the gross anatomic and microscopic composition of bone. 2. Explain the classification system of joints and movements at synovial joints. 3. Describe the types and structure of muscle tissue. 4. Describe the functions of cartilage, muscles, ligaments, tendons, fascia, and bursae. 5. Describe age-related changes in the musculoskeletal system and differences in assessment findings. 6. Identify the significant subjective and objective data related to the musculoskeletal system that should be obtained from a patient. 7. Describe the appropriate techniques used in the physical assessment of the musculoskeletal system. 8. Differentiate normal from abnormal findings of a physical assessment of the musculoskeletal system. 9. Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the musculoskeletal system. To achieve these objectives, the student will need to: 1. Review the literature pertaining to the musculoskeletal system. 2. Analyze the role and responsibility of the nurse when caring for a client with musculoskeletal disorders. 3. Discuss the clinical implications for the nurse and client when dealing with musculoskeletal disorders. Learning Activities: Read: Lewis, et al, Ch. 62 Review Key Terms: ankylosis, p. 1623 crepitation, p. 1623 arthrocentesis, p. 1627 isometric contractions, p. 1618 arthroscopy, p. 1624 isotonic contractions, p. 1618 atrophy, p. 1623 kyphosis, p. 1623 contracture, p. 1623 lordosis, p. 1623 Recommended Websites: Anatomical Terms and Glossary From the eSkeletons Project. Includes illustrations and animations. Bone Cancer "oncologist-approved cancer information" from People Living With Cancer, "the patient information website of the American Society of Clinical Oncology (ASCO)".
  • 46. Bone Densitometry An online audiovisual tutorial from the National Library of Medicine. Bone Density Scan A patient education handout from the Warren Grant Magnuson Clinical Center, National Institutes of Health. Bones, Joints and Muscles Topics A directory to topical collections of web resources on these topics; from Medline Plus. Includes online tutorials and links to relevant organizations. Characteristic Gait Patterns in Neuromuscular Pathologies An online article by Deanna J. Fish, MS, CPO. Diagnostic and Therapeutic Injection of the Shoulder Region An online article from American Family Physician, March 15, 2003. Good Moves For Life - United States Bone and Joint Decade A "global, multi-disciplinary initiative targeting the care of people with musculoskeletal conditions--bone and joint disorders." Guidelines for Evaluation of Neuromusculoskeletal Disability From the California Industrial Medical Council. Hypermuscle: Muscles in Action A collection of online movies illustrating specific muscle movements. Medscape-Orthopaedics Excellent metasite featuring online journals, articles and news. Registration is required, but free. Romberg and Sharpened Romberg By Susan L. Whitney, PhD, PT, ATC, for the Pennsylvania Physical Therapy Association. Screening Physical Exam Select section on Joints, by Arcot J. Chandrasekhar, MD, FRCP, FACP, FCCP, Loyola University. Screening for Idiopathic Scoliosis in Adolescents: Recommendation Statement From the American Academy of Family Phtysicians, May 15, 2005. Includes a direct link to the Brief Evidence Update: Screening for Idiopathic Scoliosis in Adolescents From the U.S. Preventive Services Task Force. Skeletal Radiology Tutorial Created by Darren Davenport, MD, Department of Radiology Indiana University Medical Center. Images are not presented with detailed explanations, as they are designed to be used with an instructor. Spasticity Information and Spasticity: Etiology, Assessment, and Management - a slide set; from WE MOVE, a worldwide organization for movement disorders. Journals Journal of Bodywork and Movement Therapies Tables of contents, abstracts, and selected items available online.
  • 47. Journal of Bone and Mineral Research All "articles one year or older are freely accessible on this website. Full-text access to the most current articles is still available with a subscription or ASBMR membership." Manual Therapy Tables of contents, abstracts, and selected items available online. Orthopaedic Nursing Journal of the National Association of Orthopaedic Nurses - NAON; online articles are available by subscription or pay per item. Ortho Supersite Features content from Orthopedics Today, Orthopedics Today International, Knee Surgery, and Orthopedics. Access is free, but requires registration.
  • 48. Problems Related to Movement and Coordination – Musculoskeletal Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the pathophysiology, clinical manifestations, collaborative care, and nursing management of osteomyelitis. 2. Describe the types, pathophysiology, clinical manifestations, and collaborative care of bone cancer. 3. Differentiate between the causes and characteristics of acute and chronic low back pain. 4. Describe the conservative and surgical therapy of intervertebral disk damage. 5. Describe the postoperative nursing management of a patient who has undergone spinal surgery. 6. Explain the etiology and nursing management of common foot disorders. 7. Describe the etiology, pathophysiology, clinical manifestations, and collaborative and nursing management of osteomalacia, osteoporosis, and Paget’s disease. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with the musculoskeletal system. 2. Analyze the role and responsibility of the nurse when caring for a client with musculoskeletal disorders. 3. Discuss the clinical implications for the nurse and client when dealing with musculoskeletal disorders. Learning Activities: Read: Lewis, et al, Ch. 64 Review Key Terms: degenerative disk disease, p. 1680 osteomalacia, p. 1686 herniated intervertebral disk, p. 1680 osteomyelitis, p. 1668 muscular dystrophy, p. 1675 osteoporosis, p. 1686 osteochondroma, p. 1673 Paget's disease, p. 1690 osteogenic sarcoma, p. 1674 Recommended Websites: Adolescent Idiopathic Scoliosis: Review and Current Concepts Online article from American Family Physician, July 1, 2001. Allopurinol (Zyloprim) Information from Medline Plus Drug Information. See also Gout From Medline Plus. Provides links to many web based resources on diagnosis and treatment. There is also a complete online tutorial.
  • 49. Alternative Therapies for Traditional Disease States: Osteoarthritis An online article from American Family Physician, January 15, 2003. Includes information on Glucosamine and Chondroitin. Bone Cancer "oncologist-approved cancer information" from People Living With Cancer, "the patient information website of the American Society of Clinical Oncology (ASCO)." Bone Health and Osteoporosis: A Report of the Surgeon General Issued October 14, 2004. Available online [437 pages] from the related site from the Office of the Surgeon General, which contains related brochures, fact sheets, and other materials. Chronic Fatigue Syndrome Links to resources from the National Institute of Allergy and Infectious Diseases. Includes a Chronic Fatigue Syndrome State of the Science Conference Report, October 23-24, 2000. Fast Facts From the National Osteoporosis Foundation. Fibromyalgia An interactive tutorial from the National Library of Medicine. Fortnightly review: The muscular dystrophies Online article by Alan E H Emery, from BMJ 1998;317:991-995 ( 10 October ); includes definitions and classifications and illustrations. Ibuprofen (Motrin, Advil, and others) Information from Medline Plus Drug Information. See also Pain Relievers, a collection of web resources from Medline Plus. Osteomalacia Extensively illustrated site from the University of Washington. Part of a larger site Osteoporosis and Bone Physiology maintained by Susan Ott, MD. Osteoporosis An online audiovisual tutorial from the National Library of Medicine. Osteoporosis in Men Online article from American Family Physician, April 1, 2003. Polymyalgia Rheumatica and Temporal Arteritis An online article by Ted D. Epperly, COL, MC, USA, Kevin E. Moore, CPT, MC, USA, and James D. Harrover, CPT, MC, USA; from American Family Physician, August 15, 2000.
  • 50. Problems Related to Movement and Coordination – Musculoskeletal Trauma & Orthopedic Surgery Learning Objectives: Upon completion of this topic the student will be able to: 1. Explain the etiology, pathophysiology, clinical manifestations, and collaborative care of soft tissue injuries, including strains, sprains, dislocations, subluxations, bursitis, repetitive strain injury, carpal tunnel syndrome, rotator cuff injury, meniscus injury, and muscle spasms. 2. Describe the sequential events involved in fracture healing. 3. Differentiate among closed reduction, cast immobilization, open reduction, and traction regarding purpose, complications, and nursing management. 4. Describe the neurovascular assessment of an injured extremity. 5. Explain common complications associated with a fracture and fracture healing. 6. Describe the collaborative care and nursing management of patients with specific fractures. 7. Describe the indications for and collaborative care and nursing management of the patient with an amputation. 8. Describe the types of joint replacement surgery associated with arthritis and connective tissue diseases. 9. Identify the preoperative and postoperative management of the patient having joint replacement surgery. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with the musculoskeletal system. 2. Analyze the role and responsibility of the nurse when caring for a client with musculoskeletal disorders. 3. Discuss the clinical implications for the nurse and client when dealing with musculoskeletal disorders. Learning Activities: Read: Lewis, et al, Ch. 63 Review Key Terms: arthroplasty, p. 1662 phantom limb sensation, p. 1660 bursitis, p. 1635 repetitive strain injury, p. 1633 carpal tunnel syndrome, p. 1633 sprain, p. 1630 compartment syndrome, p. 1650 strain, p. 1630 dislocation, p. 1632 subluxation, p. 1632 fat embolism syndrome, p. 1651 synovectomy, p. 1662 fracture, p. 1635 traction, p. 1638
  • 51. Recommended Websites: About Joint Arthroscopy An animated online presentation from the Arthritis Foundation. Amputees A collection of links to web resources from the National Library of Medicine's Medline Plus. Athletic Injuries Select a body part to get more information; from the Yale Sports Medicine Center. Compartment syndromes and fat embolism Online overview from Surgical Tutor. Diagnosis and Management of Osteomyelitis An online article from American Family Physician, June 15, 2001. Dwarfism: Achondroplasia and Hypochondroplasia From the International Center for Limb Lengthening, Sinai Hospital of Baltimore. Fractures and Sprains An online tutorial from the National Library of Medicine. Hip Injuries and Disorders A collection of links to web resources from the National Library of Medicine's Medline Plus. Hip Replacement A collection of links to web resources from the National Library of Medicine's Medline Plus. Knee Arthroscopy An online audiovisual tutorial from the National Library of Medicine. Medscape-Orthopaedics Excellent meta-site featuring online journals, articles and news. Registration is required, but free. Meniscal tear and Meniscal Transplants Consumer level information sheets from Your Orthopaedic Connection, a consumer information web site from the American Academy of Orthopaedic Surgeons. Orthopedic Procedures From the Southern California Orthopedic Institute, with basic level information with good graphics and photographs. Pin Care Protocol From the University of Michigan Health System. Rotator Cuff Injuries An interactive online tutorial from the National Library of Medicine. Shoulder Arthroscopy An online audiovisual tutorial from the National Library of Medicine. Tennis Elbow An online audiovisual tutorial from the National Library of Medicine. Vertebral Compression Fractures in the Elderly An illustrated article by Jerry L. Old, MD, and Michelle Calvert, MD, from American Family Physician, January 1, 2004. Journals Journal of Arthroplasty Official Journal of the American Association of Hip and Knee
  • 52. Surgeons. Full-text articles are available to AAHKS members and personal subscribers starting from June 2000 to the present; abstracts, references, and PDFS are available from 1997 to the present. Access to tables of contents and abstracts is complimentary. Journal of Prosthetics and Orthotics (JPO) Online Library Contains all issues of the journal dating back to 1989 in a fully searchable format. It is presented by the American Academy of Orthotists and Prosthetists, as a service to clinicians worldwide. Journal of the American Academy of Orthopaedic Surgeons A publication of the American Academy of Orthopaedic Surgeons. Tables of contents and abstracts are available online; full access is available by subscription. Ortho Supersite Features content from Orthopedics Today, Orthopedics Today International, Knee Surgery, and Orthopedics. Access is free, but requires registration. The Physician and Sportsmedicine Contains many articles on disorders of joints and bones, with the full article available online.
  • 53. Problems Related to Movement and Coordination – Arthritis and Connective Tissue Diseases Learning Objectives: Upon completion of this topic the student will be able to: 1. Compare and contrast the sequence of events leading to joint destruction in osteoarthritis and rheumatoid arthritis. 2. Describe the clinical manifestations, collaborative care, and nursing management of osteoarthritis and rheumatoid arthritis. 3. Compare and contrast the pathophysiology, clinical manifestations, collaborative care, and nursing management of ankylosing spondylitis, psoriatic arthritis, and reactive arthritis. 4. Describe the pathophysiology, clinical manifestations, and collaborative care of septic arthritis, Lyme disease, and gout. 5. Describe the pathophysiology, clinical manifestations, collaborative care, and nursing management of systemic lupus erythematosus, polymyositis, dermatomyositis, and Sjögren's syndrome. 6. Describe the drug therapy and related nursing management associated with arthritis and connective tissue diseases. 7. Compare and contrast the possible etiologies, clinical manifestations, and collaborative and nursing management of myofascial pain syndrome, fibromyalgia syndrome, and chronic fatigue syndrome. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems with the musculoskeletal system. 2. Analyze the role and responsibility of the nurse when caring for a client with musculoskeletal disorders. 3. Discuss the clinical implications for the nurse and client when dealing with musculoskeletal disorders. Learning Activities: Read: Lewis, et al, Ch. 65 Review Key Terms: ankylosing spondylitis, p. 1711 osteoarthritis, p. 1693 arthritis, p. 1693 polymyositis, p. 1725 chronic fatigue syndrome, p. 1728 Raynaud's phenomenon, p. 1723 dermatomyositis, p. 1725 rheumatoid arthritis, p. 1702 fibromyalgia syndrome, p. 1727 Sjögren's syndrome, p. 1726 gout, p. 1715 systemic lupus erythematosus, p. 1716 Lyme disease, p. 1714 systemic sclerosis, p. 1723 myofascial pain syndrome, p. 1726
  • 54. Recommended Websites: Arthritis Source An extensive site from the University of Washington; includes specific disorders and problems related to specific locations (elbow, hand, etc.). Disease Management of Osteoarthritis An online continuing education article by Karen Gabel Speroni, RN, PhD, from Nurse.com. Johns Hopkins Arthritis Center Includes a separate section on Rheumatoid Arthritis and an online lecture series. Pathophysiology of Osteoarthritis From the Johns Hopkins Arthritis Center. Osteoarthritis An online audiovisual tutorial from the National Library of Medicine. Types of Drugs From the online Drug Guide of the Arthritis Foundation. Journals Arthritis Today Tables of contents and selected articles are available online; some issues require Adobe Acrobat Reader. Best Practice & Research: Clinical Rheumatology Full-text articles are available from 1999 to the present. Access to abstracts is complimentary. Access to full-text is limited to print subscribers. Bulletin on the Rheumatic Diseases Open-access online. This is an archival site with materials online through 2004, when the publication ceased. Journal of Arthroplasty Official Journal of the American Association of Hip and Knee Surgeons. Full-text articles are available to AAHKS members and personal subscribers starting from June 2000 to the present; abstracts, references, and PDFS are available from 1997 to the present. Access to tables of contents and abstracts is complimentary. Osteoarthritis and Cartilage Tables of contents and abstracts are available online; full access is available by subscription. Rheumatology News Full-text articles are available to subscribers starting from 2002 to the present. Access to tables of contents is complimentary. Seminars in Arthritis and Rheumatism Full-text articles are available to personal subscribers starting from February 2001 to the present; abstracts, references, and PDFs are available from 2000 to the present. Access to tables of contents and abstracts is complimentary.
  • 55. Problems Related to Altered Sensory Input – Visual & Auditory System/Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the structures and functions of the visual and auditory systems. 2. Describe the physiologic processes involved in normal vision and hearing. 3. Identify the significant subjective and objective assessment data related to the visual and auditory systems that should be obtained from the patient. 1. Describe the appropriate techniques used in the physical assessment of the visual and auditory systems. 2. Differentiate normal from common abnormal findings of a physical assessment of the visual and auditory systems. 3. Describe age-related changes in the visual and auditory systems and differences in assessment findings. 4. Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the visual and auditory systems. 5. Describe the types of refractive errors and appropriate corrections. 6. Describe the etiology and collaborative care of extraocular disorders. 7. Explain the pathophysiology, clinical manifestations, and nursing management and collaborative care of the patient with selected intraocular disorders. 8. Describe the nursing measures that promote the health of the eyes and ears. 9. Explain the general preoperative and postoperative care of the patient undergoing surgery of the eye or ear. 10. Describe the action and uses of drug therapy for treating problems of the eyes and ears. 11. Explain the pathophysiology, clinical manifestations, and nursing management and collaborative care of common ear problems. 12. Compare the causes, management, and rehabilitative potential of conductive and sensorineural hearing loss. 13. Explain the use, care, and patient teaching related to assistive devices for eye and ear problems. 14. Describe the common causes and assistive measures for uncorrectable visual impairment and deafness. 15. Describe the measures used to assist the patient in adapting psychologically to decreased vision and hearing. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of altered sensory perception. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of altered sensory perception. 3. Discuss the clinical implications for the nurse and client when dealing with problems of altered sensory perception.
  • 56. Learning Activities: Read: Lewis, et al, Ch. 21, Ch. 22 Review Key Terms: amblyopia, p. 417 labyrinthitis, p. 442 aqueous humor, p. 399 lens, p. 401 astigmatism, p. 400 myopia, p. 417 blepharitis, p. 422 nystagmus, p. 409 cataract, p. 425 otosclerosis, p. 440 conjunctiva, p. 400 presbycusis, p. 446 conjunctivitis, p. 422 presbyopia, p. 417 enucleation, p. 437 retina, p. 401 external otitis, p. 438 retinopathy, p. 429 glaucoma, p. 432 sclera, p. 400 hyperopia, p. 400 tinnitus, p. 409 keratitis, p. 423 vertigo, p. 409 keratoconus, p. 425 Recommended Websites: Acoustic Neuroma A collection of links to web resources from the National Library of Medicine's Medline Plus site. Acute Otitis Media: Part I. Improving Diagnostic Accuracy Online article from American Family Physician, April 1, 2000. Acute Otitis Media: Part II. Treatment in an Era of Increasing Antibiotic Resistance Online article from American Family Physician, April 15, 2000. Cataracts Interactive online audiovisual tutorial from the National Library of Medicine. Cholesteatoma Illustrated site by Mark J. Levenson, MD, FACS; from the Ear Surgery Information Center. Diabetes - Eye Complications Interactive online audiovisual tutorial from the National Library of Medicine. Differential Diagnosis and Treatment of Hearing Loss An article by Jon E. Isaacson MD, and Neil M. Vora MD, from American Family Physician, September 15, 2003, 68:1125-1132. The Eye An extensive online lecture with animations, simulations, and interactive experiments related to vision. Part of the extraordinary site on Neurophysiology, an extensive collection of detailed tutorials on neurophysiologic functions with flash animations and online interactive experiments. Eye and Ear On JayDoc HistoWeb; lavish illustrations; University of Kansas Medical Center.
  • 57. Vision Problems in the U.S.--Prevalence of Adult Vision Impairment and Age-Related Eye Diseases in America "A joint project of the National Eye Institute and Prevent Blindness America"; includes a map demonstrating rates of vision impairment and blindness, and related tables. Eye Care America The public service foundation site of the American Academy of Ophthalmology. Provides an extensive collection of materials on eye care and disease related eye problems. Eye Disease Simulations Pictures that demonstrate how the world appears to individuals with different eye diseases; from the National Eye Institute. Glaucoma Interactive online audiovisual tutorial from the National Library of Medicine. Hearing Aids Information from the National Institute on Deafness and Other Communication Disorders. Hearing Loss From the National Institute on Aging. Laser Eye Surgery A collection of links to web resources from the National Library of Medicine's Medline Plus site. LASIK Interactive online audiovisual tutorial from the National Library of Medicine. National Eye Health Education Program (NEHEP) Information in English and Spanish from the National Eye Institute. Covers Diabetic Eye Disease, Glaucoma, and Low Vision. NetSurgery.com Information and online videos of surgical procedures from Healthology Inc., a Health Education Company. Includes several items on laser eye surgery. Use search or browse functions to locate other specific topics. A Practical Guide to Drug-Induced Ocular Side Effects On the New York Glaucoma Research Institute server, reprinted with permission from Review of Ophthalmology, Kristine Morrell, Managing Editor. Tinnitus Interactive online audiovisual tutorial from the National Library of Medicine. Vision Problems in the U.S.--Prevalence of Adult Vision Impairment and Age-Related Eye Diseases in America "A joint project of the National Eye Institute and Prevent Blindness America"; includes a mapdemonstrating rates of vision impairment and blindness, and related tables. Vision Impairment and Blindness Links to web resources from the National Library of Medicine's Medline Plus.
  • 58. Problems Related to Altered Sensory Input – Integumentary System/Problems & Burns Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the structures and functions of the integumentary system. 2. Describe age-related changes in the integumentary system and differences in assessment findings. 3. Describe the significant subjective and objective data related to the integumentary system that should be obtained from a patient. 4. Describe specific assessments to be made during the physical examination of the skin and appendages. 5. Explain the critical components for describing a lesion. 6. Describe the appropriate techniques used in the physical assessment of the integumentary system. 7. Explain the structural and assessment differences in dark skin color. 8. Differentiate normal from common abnormal findings in a physical assessment of the integumentary system. 9. Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the integumentary system. 10. Describe health promotion practices related to the integumentary system. 11. Explain the etiology, clinical manifestations, and nursing and collaborative management of common acute dermatologic problems. 12. Describe the psychologic and physiologic effects of chronic dermatologic conditions. 13. Explain the etiology, clinical manifestations, and collaborative care of malignant dermatologic disorders. 14. Explain the etiology, clinical manifestations, and collaborative care of bacterial, viral, and fungal infections of the integument. 15. Explain the etiology, clinical manifestations, and collaborative care of infestations and insect bites. 16. Explain the etiology, clinical manifestations, and collaborative care of allergic dermatologic disorders. 17. Explain the etiology, clinical manifestations, and collaborative care related to benign dermatologic disorders. 18. Describe the dermatologic manifestations of common systemic diseases. 19. Explain the indications and nursing management related to common cosmetic procedures and skin grafts. 20. Describe the causes and prevention of burn injuries. 21. Describe the burn injury classification system. 22. Describe the relationship between the involved structures and the clinical appearance of partial- and full-thickness burns. 23. Identify the parameters used to determine the severity of burns. 24. Describe the pathophysiology, clinical manifestations, complications, and nursing and collaborative management of the three burn phases. 25. Explain fluid and electrolyte shifts during the emergent and acute burn phases. 26. Describe the nutritional therapy of the burn patient during the three burn phases.
  • 59. 27. Describe the interventions that the nurse may use in the management of pain in the burn patient. 28. Explain the physiologic and psychosocial aspects of burn rehabilitation. 29. Describe the nursing management of the emotional needs of the burn patient and family. 30. Discuss the issues involved and rationale for preparing the burn patient to return home. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of altered sensory perception. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of altered sensory perception. 3. Discuss the clinical implications for the nurse and client when dealing with problems of altered sensory perception. Learning Activities: Read: Lewis, et al, Ch. 23, Ch. 24, Ch. 25 Review Key Terms: actinic keratosis, p. 463 enzymatic debridement, p. 501 alopecia, p. 452 excision and grafting, p. 501 apocrine sweat glands, p. 451 full-thickness burns, p. 486 basal cell carcinoma, p. 463 hypermetabolic state, p. 499 burn, p. 483 intertriginous, p. 454 chemical burns, p. 484 lichenification, p. 477 contracture, p. 504 keloids, p. 457 cultured epithelial autograft, p. 501 keratinocytes, p. 450 cryosurgery, p. 476 malignant melanoma, p. 465 curettage, p. 476 melanocytes, p. 449 debridement, p. 496 partial-thickness burns, p. 486 dermis, p. 450 pruritus, p. 454 dysplastic nevi, p. 466 sebaceous glands, p. 451 eccrine sweat glands, p. 451 smoke and inhalation injuries, p. 484 epidermis, p. 449 squamous cell carcinoma, p. 464 escharotomy, p. 491 sun protection factor (SPF), p. 461 electrical burns, p. 485 thermal burns, p. 484 Recommended Websites: Ambulatory Management of Burns An illustrated online article from American Family Physician, November 1, 2000. Includes links to two patient handouts on this topic. Anatomy and Histology of Normal Skin By Jason R. Swanson and Jeffrey L. Melton, MD, Loyola University; this extensive site includes the skin and appendages. Assessment and Initial Care for Burn Patients Full-text online standard from the American College of Surgeons; requires Adobe Acrobat Reader to view or print.
  • 60. Burns A collection of links to web resources from Medline Plus. Includes links on treatment and prevention. Care of Burn Patients in the Hospital Overview from the educational resources site of the International Society for Burn Injuries. Cellulitis A collection of links to web resources from Medline Plus. Cuts, Scrapes and Stitches: Caring for Wounds from the American Academy of Family Physicians. Dermatologic Image Database An extensive collection of images from the Department of Dermatology, University of Iowa College of Medicine. Piercing and Tattoos A collection of web based resources from Medline Plus, National Library of Medicine. Primary Care Dermatology Module: Nomenclature of Skin Lesions An illustrated online tutorial developed by Gary Williams, MD, and Murray Katcher, MD, PhD, Department of Pediatrics, University of Wisconsin, Madison, with funding and support from the Wisconsin Area Health Education Center (AHEC) System. Screening Physical Exam Select the section on Skin; by Arcot J. Chandrasekhar, MD, FRCP, FACP, FCCP; from Loyola University. Skin Cancer (PDQ®): Screening An extensive site from the National Cancer Institute. Skin Care and Aging From the National Institute on Aging. Skin Conditions and Skin, Hair, and Nails Topical directories to collections of web resources from Medline Plus. Skin engineering, the future treatment for burns and wounds An article from the Faculty of Medicine, University of Hong Kong, Public Health Education Campaign, Issue 29. Split-thickness skin graft Online review by Don R. Revis Jr., MD, and Michael B. Seagel, MD; from eMedicine. Split-Thickness & Full Thickness Grafts Illustrated site from Burn Survivors Throughout The World, Inc. Sunburn An online review by Lyn Guenther, MD, Benjamin Barankin, MD, and Julie Powell, MD; from eMedicine.
  • 61. Problems of Ingestion, Digestion, Absorption, and Elimination – Assessment Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the structures and functions of the organs of the gastrointestinal tract. 2. Describe the structures and functions of the liver, gallbladder, biliary tract, and pancreas. 3. Explain the processes of ingestion, digestion, absorption, and elimination. 4. Explain the processes of biliary metabolism, bile production, and bile excretion. 5. Describe age-related changes in the gastrointestinal system and differences in assessment findings. 6. Identify the significant subjective and objective data related to the gastrointestinal system that should be obtained from a patient. 7. Describe the appropriate techniques used in the physical assessment of the gastrointestinal system. 8. Differentiate normal from common abnormal findings of a physical assessment of the gastrointestinal system. 9. Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the gastrointestinal system. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of ingestion, digestion, absorption and elimination. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of ingestion, digestion, absorption and elimination. 3. Discuss the clinical implications for the nurse and client when dealing with problems of ingestion, digestion, absorption and elimination. Learning Activities: Read: Lewis, et al, Ch. 39 Review Key Terms: borborygmi, p. 940 melena, p. 940 cheilosis, p. 939 pyorrhea, p. 939 endoscopy, p. 944 pyrosis, p. 939 hematemesis, p. 939 steatorrhea, p. 940 hepatocytes, p. 930 tenesmus, p. 940 Kupffer cells, p. 931 Valsalva maneuver, p. 930 Recommended Websites:
  • 62. The Abdomen By Richard Rathe, MD. Updated: July, 1997. Copyright © 1997 by Richard Rathe, MD. All Rights Reserved. Extensively illustrated with drawings and photographs. Atlas of Gastrointestinal Endoscopy Includes sections on Inflammatory Bowel Diseases, Colon and Ileum; © 1996-2007 Atlanta South Gastroenterology, P.C. Includes section on the esophagus. Diagnosis of Acute Abdominal Pain in Older Patients An online article from American Family Physician, November 1, 2006. Digestive Diseases Statistics From the National Digestive Diseases Information Clearinghouse. Gastrointestinal Disorders An extensive collection of materials covering many disorders, available full-text online from the Merck Manuals Online Medical Library. Medscape and Medscape - Gastroenterology A specialty site from the Medscape metasite. Extensive online service providing access to news items, conference materials, articles and more. Registration is required, but is free. Nuclear Medicine Imaging and Function Studies of the Gastrointestinal System Copyright © Lyle J Goodin, BSc, MRT(N), ACNM; an extensively illustrated site. Screening Physical Exam Select relevant sections from this main menu; from Loyola University. Journals American Journal of Gastroenterology Tables of contents and abstracts are available online. Full-text is accessible only by subscription. Gastroenterology Nursing Official Journal of the Society of Gastroenterology Nurses and Associates; articles are available online through subscription or pay-per-view. Gastrointestinal Endoscopy Official Journal of the American Society for Gastrointestinal Endoscopy. Full-text articles are available to ASGE members and personal subscribers starting from 1994 to the present. Access to tables of contents and abstracts is complimentary.
  • 63. Problems of Ingestion, Digestion, Absorption, and Elimination – Nutritional Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the essential components of a nutritionally good diet and their importance to health. 2. Describe possible adverse interactions between drugs and various foods. 3. Describe the common etiologic factors, clinical manifestations, and management of malnutrition. 4. Explain the indications for use, complications, and nursing management of tube feedings. 5. Describe the types of feeding tubes and related nursing management. 6. Define the indications, complications, and nursing management related to the use of parenteral nutrition. 7. Compare the etiologic factors, clinical manifestations, and nursing management of eating disorders. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of ingestion, digestion, absorption and elimination. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of ingestion, digestion, absorption and elimination. 3. Discuss the clinical implications for the nurse and client when dealing with problems of ingestion, digestion, absorption and elimination. Learning Activities: Read: Lewis, et al, Ch. 40 Review Key Terms: anorexia nervosa, p. 968 malnutrition, p. 951 bulimia nervosa, p. 969 marasmus, p. 952 enteral nutrition, p. 960 parenteral nutrition, p. 965 malabsorption syndrome, p. 953 protein-calorie malnutrition, p. 951 Recommended Websites: American Heart Association Dietary Guidelines and Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association. Site also includes eating plans and information on the older Step I , Step II and TLC Diets with links to the new An Eating Plan for Healthy Americans and Easy Food Tips for Heart-Healthy Eating (also available in Spanish). DASH Diet & Cookbook web site from the Oregon Dairy Council. Diabetic Recipes From Recipe Source: SOAR, The Searchable Online Archive of Recipes, by Rolozo Tolkien.
  • 64. Diagnosis of eating disorders in primary care Online article from American Family Physician, January 15, 2003. Dying to Be Thin A PBS broadcast that you can actually view on the Web. Includes additional resource materials and a teacher's guide. Eating Disorders An excellent collection of links from Medline Plus designed for health consumers. Includes links to information in Spanish as well as English, and links to clinical trials. Total Parenteral Nutrition From Medline Plus Drug Information. Gastrostomy Tube Home Care Information for family caregivers from the Cincinnati Children's Hospital Medical Center. Guidelines for enteral feeding in adult hospital patients An online article by M Stroud, H Duncan, and J Nightingale, from Gut 2003; 52:vii1. Heart-Healthy Latino Recipes Available online from the National Heart, Lung, and Blood Institute. Nausea and Vomiting A collection of links to web resources from the National Library of Medicine's Medline Plus. Nutrition Recommendations and Interventions for Diabetes From Diabetes Care 30: Supplement 1, 2007. Parenteral Nutrition for the Acutely Ill By Patricia Worthington, RN, MSN, CNSN, Karen A. Gilbert, RN, MSN, CNSN, and Beth A. Wagner, RN, MSN, CNSN; an online continuing education article available full-text from AACN Clinical Issues Advanced Practice in Acute & Critical Care. Risk of Colonization of Central Venous Catheters: Catheters for Total Parenteral Nutrition vs. Other Catheters Online continuing education article by Justin B. Dimick, Sandra Swoboda, Mark A. Talamini, Robert K. Pelz, Craig W. Hendrix, and Pamela A. Lipsett; from American Journal of Critical Care®, July 2003 - Vol 12, No. 4. A Survey of Bedside Methods Used to Detect Pulmonary Aspiration of Enteral Formula in Intubated Tube-fed Patients By Norma A. Metheny, RN, PhD, Myra A. Aud, RN, MSN, GNP, and Rita J. Wunderlich, RN, MSN, CCRN. An abstract of an article from American Journal of Critical Care, June 1999, Vol 8, Issue 3. Total Parenteral Nutrition An overview from Medline Plus for the patient on TPN. Using the Diabetes Food Pyramid Information from the American Diabetes Association. Verification of Feeding Tube Placement A Practice Alert from the American Association of Critical-Care Nurses, May 2005. Journals
  • 65. Journal of Nutrition and Cancer Selected abstracts from the Soy and Human Health page at the University of Illinois. Journal of Renal Nutrition Published by W.B. Saunders Company, an imprint of Elsevier for The National Kidney Foundation, Inc. Full-text articles are available to NKF CRN members, ISRN&M members, and personal subscribers starting from 2002 to the present; abstracts, references, and PDFs are available from 1995 to the present; tables of contents are available from 1991 to the present. Access to tables of contents and abstracts is complimentary. JPEN: Journal of Parenteral and Enteral Nutrition A publication of the American Society of Parenteral and Enteral Nutrition - ASPEN. Tables of contents and abstracts are available online. Full online access to articles is available to members and subscribers. Nutrition in Clinical Practice A publication of the American Society of Parenteral and Enteral Nutrition - ASPEN. Tables of contents and abstracts are available online. Full online access to articles is available to members and subscribers.
  • 66. Problems of Ingestion, Digestion, Absorption, and Elimination – Obesity Learning Objectives: Upon completion of this topic the student will be able to: 1. Discuss the etiologies and collaborative care of obesity. 2. Describe the classification systems for determining a person’s body size. 3. Explain the health risks associated with obesity. 4. Discuss nutritional therapy and exercise plans for the obese patient. 5. Describe the different bariatric surgical procedures used to treat obesity. 6. Describe the nursing management related to conservative and surgical therapies for obesity. 7. Describe the etiology, clinical manifestations, and nursing and collaborative management of metabolic syndrome. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of ingestion, digestion, absorption and elimination. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of ingestion, digestion, absorption and elimination. 3. Discuss the clinical implications for the nurse and client when dealing with problems of ingestion, digestion, absorption and elimination. Learning Activities: Read: Lewis, et al, Ch. 41 Review Key Terms: bariatric surgery, p. 982 morbidly obese, p. 974 body mass index, p. 974 obese, p. 974 lipectomy, p. 984 overweight, p. 974 metabolic syndrome, p. 987 waist-to-hip ratio, p. 974 Recommended Websites: Aim for a Healthy Weight An extensive online educational program for professionals and the public from the National Heart, Lung, and Blood Institute. Bariatrics Online multimedia continuing education programs from Kinetic Concepts Inc. Body Mass Index site of the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Includes links to growth charts, tables, and calculators. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults 2003, full-text, with special topics such as Body Mass Calculator, Evidence Tables, and Tip Sheets; and OEI Treatment Guidelines Implementation Tool for Palm OS and
  • 67. PocketPC 2003 Devices. Available online from the National Heart Lung and Blood Institute, NHLBI. See also: The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, order information and access to online versions of this 1998 report from the National Heart, Lung, and Blood Institute. Dietary Protein and Weight Reduction: A Statement for Healthcare Professionals From the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association; Circulation. 2001; 104:1869. Health Risk Classification According to Body Mass Index (BMI) [Table] From Healthy Weights site, Health Canada. The Ins and Outs of Insulin Resistance From the International Food Information Council Foundation. Insulin Resistance Syndrome An online article by Goutham Rao, MD, American Family Physician, March 15, 2001. Mayo Clinic Updated every weekday, this site, prepared and reviewed by a team of Mayo Clinic physicians and scientists, gives access to a variety of medical topics including healthy weight topics. Extensive database provides information on treatment of illnesses and disease prevention. Nutrition and Overweight From Healthy People 2010. Obesity: Assessment and Management in Primary Care Article from American Family Physician, June 1, 2001. Obesity and Heart Disease: A Statement for Healthcare Professionals From the Nutrition Committee, American Heart Association; Circulation. 1997; 96:3248-3250. Physical Activity and Good Nutrition: Essential Elements to Prevent Chronic Diseases and Obesity At A Glance From the Centers for Disease Control and Prevention. Practice Guideline for the Treatment of Patients With Eating Disorders, Third Edition From the American Psychiatric Association. Prescription Medications for the Treatment of Obesity From the National Institute of Diabetes and Digestive and Kidney Diseases - NIDDK. Understanding Obesity in Youth: A Statement for Healthcare Professionals From the Committee on Atherosclerosis and Hypertension in the Young of the Council on Cardiovascular Disease in the Young and the Nutrition Committee, American Heart Association; Circulation. 1996; 94:3383-3387; full-text online. Weight Control Information Network From the National Institute of Diabetes and Digestive and Kidney Diseases; includes a series of Weight Loss and Control Publications and Statistics Related to Overweight and Obesity online. Weight Loss Surgery A collection of links to web resources from the National Library of Medicine's Medline Plus.
  • 68. Journals The International Journal of Obesity and Related Metabolic Disorders Official journal of the International Association for the Study of Obesity; tables of contents are available online. Obesity Tables of contents and abstracts are available online; access to full-text articles available by subscription. WIN Notes A newsletter "produced by the Weight-control Information Network (WIN)."
  • 69. Problems of Ingestion, Digestion, Absorption, and Elimination – Upper Gastrointestinal Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Describe the etiology, complications, collaborative care, and nursing management of nausea and vomiting. 2. Describe the common etiology, clinical manifestations, collaborative care, and nursing management of upper gastrointestinal bleeding. 3. Describe the etiology, clinical manifestations, and treatment of common oral inflammations and infections. 4. Describe the etiology, clinical manifestations, complications, collaborative care, and nursing management of oral cancer. 5. Explain the types, pathophysiology, clinical manifestations, complications, and collaborative care, including surgical therapy and nursing management, of gastroesophageal reflux disease (GERD) and hiatal hernia. 6. Describe the pathophysiology, clinical manifestations, complications, and collaborative care of esophageal cancer, diverticula, achalasia, and esophageal strictures. 7. Differentiate between acute and chronic gastritis, including the etiology, pathophysiology, collaborative care, and nursing management. 8. Compare and contrast gastric and duodenal ulcers, including etiology and pathophysiology, clinical manifestations, complications, collaborative care, and nursing management. 9. Describe the clinical manifestations, collaborative care, and nursing management of stomach cancer. 10. Identify the common types of food poisoning and nursing responsibilities related to food poisoning. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of ingestion, digestion, absorption and elimination. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of ingestion, digestion, absorption and elimination. 3. Discuss the clinical implications for the nurse and client when dealing with problems of ingestion, digestion, absorption and elimination. Learning Activities: Read: Lewis, et al, Ch. 41 Recommended Websites: Abdominal Trauma: A Major Cause of Morbidity and Mortality An online continuing education article by Connie Goldsmith, RN, MPA & Scott E. Stover, APRN, BC, MSN, MBA, CEN, NREMT-P, from Nurse.com.
  • 70. Achalasia and Esophageal Motility Disorders Description by Mark Ferguson, MD, and Medical Illustrations by Jill Rhead, MA; patient level materials from the Society of Thoracic Surgeons. Acute Stress Ulceration (GI) By Philip Cumpston ; from the Australian and New Zealand Intensive Care Society. Diseases of the Mouth From PathWeb at the University of Connecticut Health Center. Gastroesophageal Reflux: Medical and Surgical Treatment Options An editorial from American Family Physician, October 1, 2003. GERD Information Resource Center Sponsored by AstraZeneca LP. Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)) From the National Institute of Diabetes and Digestive and Kidney Diseases. Management of Gastroesophageal Reflux Disease An online article by Joel J. Heidelbaugh, MD, Timothy T. Nostrant, MD, Clara Kim, MD, and R. Van Harrison, PhD; from American Family Physician, October 1, 2003. A link is included for a Patient Education handout. Oral Health homepage from the Centers for Disease Control and Prevention. Gateway site to a large collection of full-text resources, including Oral Health in America: A Report of the Surgeon General and more. Proton Pump Inhibitors: An Update Online article by Bruce T. Vanderhoff, MD, and Rundsarah M. Tahboub, MD; from American Family Physician, July 15, 2002. Update on Helicobacter pylori Treatment An online article from American Family Physician, February 1, 2007. Journals American Family Physician Open access to full-text online articles, current issue and backfiles; from the American Academy of Family Physicians. CA - A Cancer Journal for Clinicians Issues are available online from 1999 to the present.
  • 71. Problems of Ingestion, Digestion, Absorption, and Elimination – Lower Gastrointestinal Problems Learning Objectives: Upon completion of this topic the student will be able to: 1. Explain the common etiologies, collaborative care, and nursing management of diarrhea, fecal incontinence, and constipation. 2. Describe common causes of acute abdominal pain and nursing management of the patient following an exploratory laparotomy. 3. Describe the collaborative care and nursing management of acute appendicitis, peritonitis, and gastroenteritis. 4. Compare and contrast the inflammatory bowel diseases of ulcerative colitis and Crohn’s disease, including pathophysiology, clinical manifestations, complications, collaborative care, and nursing management. 5. Differentiate among mechanical, neurogenic, and vascular bowel obstructions, including causes, collaborative care, and nursing management. 6. Describe the clinical manifestations and collaborative management of colorectal cancer. 7. Explain the anatomic and physiologic changes and nursing management of the patient with an ileostomy and a colostomy. 8. Differentiate between diverticulosis and diverticulitis, including clinical manifestations, collaborative care, and nursing management. 9. Compare and contrast the types of hernias, including etiology and surgical and nursing management. 10. Describe the types of malabsorption syndrome and collaborative care of celiac disease, lactase deficiency, and short bowel syndrome. 11. Describe the types, clinical manifestations, collaborative care, and nursing management of anorectal conditions. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of ingestion, digestion, absorption and elimination. 2. Analyze the role and responsibility of the nurse when caring for a client with problems of ingestion, digestion, absorption and elimination. 3. Discuss the clinical implications for the nurse and client when dealing with problems of ingestion, digestion, absorption and elimination. Learning Activities: Read: Lewis, et al, Ch. 43 Review Key Terms:
  • 72. appendicitis, p. 1048 inflammatory bowel disease, p. 1051 celiac disease, p. 1079 irritable bowel syndrome, p. 1046 colostomy, p. 1069 lactase deficiency, p. 1081 Crohn’s disease, p. 1051 ostomy, p. 1069 diverticulum, p. 1076 paralytic (adynamic) ileus, p. 1060 gastroenteritis, p. 1050 peritonitis, p. 1049 hemorrhoids, p. 1082 short bowel syndrome, p. 1081 hernia, p. 1077 steatorrhea, p. 1079 ileostomy, p. 1069 ulcerative colitis, p. 1051 Recommended Websites: About Ulcerative Colitis From the Disease Information site of the Crohn's and Colitis Foundation of America. ACS Colorectal Cancer Facts and Figures - Special Edition 2005 From the American Cancer Society. Can Colorectal Polyps and Cancer be Found Early? From the American Cancer Society. Clostridium difficile-Associated Diarrhea An article by Michael S. Schroeder, MD, available online from American Family Physician, March 1, 2005, vol. 71, no. 5. Colorectal cancer screening and surveillance: Clinical guidelines and rationale—Update based on new evidence By Sidney Winawer , Robert Fletcher , Douglas Rex , John Bond , Randall Burt , Joseph Ferrucci , Theodore Ganiats , Theodore Levin , Steven Woolf , David Johnson , Lynne Kirk , Scott Litin , Clifford Simmang and for the U.S. Multisociety Task Force on Colorectal Cancer. From Gastroenterology, Volume 124, Issue 2, Pages 544-560 (February 2003), official journal of the American Gastroenterological Association, available online. Constipation in the Elderly Online article by David C. Schaefer, MD, PhD, and Lawrence J. Cheskin, MD, from American Family Physician September 15, 1998. Diarrhea Information from the Division of Parasitic Diseases, National Center for Infectious Diseases. Includes specific information about different parasites and about waterborne diseases. Hernia A collection of links to web resources from the National Library of Medicine's Medline Plus. Includes materials available in Spanish. Inflammatory Bowel Disease An online article by William A Rowe, from eMedicine. Updated October 4, 2005.
  • 73. Problems of Ingestion, Digestion, Absorption, and Elimination – Liver & Pancreas Learning Objectives: Upon completion of this topic the student will be able to: 1. Define jaundice and describe signs and symptoms that may occur with the different types of jaundice. 2. Differentiate among the types of viral hepatitis, including etiology, pathophysiology, clinical manifestations, complications, and collaborative care. 3. Describe the nursing management of the patient with viral hepatitis. 4. Describe the pathophysiology, clinical manifestations, complications, and collaborative care of the patient with nonalcoholic fatty liver disease. 5. Explain the etiology, pathophysiology, clinical manifestations, complications, collaborative care, and nursing management of the patient with cirrhosis of the liver. 6. Describe the clinical manifestations and management of liver cancer. 7. Describe the pathophysiology, clinical manifestations, complications, and collaborative care of acute and chronic pancreatitis. 8. Describe the nursing management of the patient with pancreatitis. 9. Explain the clinical manifestations and collaborative care of the patient with pancreatic cancer. 10. Explain the pathophysiology, clinical manifestations, complications, and collaborative care, including surgical therapy, of gallbladder disorders. 11. Describe the nursing management of the patient undergoing conservative or surgical treatment of cholecystitis and cholelithiasis. To achieve these objectives, the student will need to: 16. Review the literature pertaining to problems of ingestion, digestion, absorption and elimination. 17. Analyze the role and responsibility of the nurse when caring for a client with problems of ingestion, digestion, absorption and elimination. 18. Discuss the clinical implications for the nurse and client when dealing with problems of ingestion, digestion, absorption and elimination. Learning Activities: Read: Lewis, et al, Ch. 44 Review Key Terms:
  • 74. acute pancreatitis, p. 1118 hepatic encephalopathy, p. 1104 ascites, p. 1104 hepatitis, p. 1088 asterixis, p. 1106 hepatorenal syndrome, p. 1106 cholecystitis, p. 1126 jaundice, p. 1088 cholelithiasis, p. 1126 nonalcoholic fatty liver disease, p. 1101 chronic pancreatitis, p. 1124 paracentesis, p. 1107 cirrhosis, p. 1101 portal hypertension, p. 1104 esophageal varices, p. 1104 spider angiomas, p gastric varices, p. 1104 Recommended Websites: ABC of diseases of liver, pancreas, and biliary system: Portal hypertension-1: varices Illustrated online article from the StudentBMJ. The ABCs of Hepatitis Online continuing education program by Carmen Hench, RN & Sandra Simpkins, MSN, RN; from Nurse.com. Acute Pancreatitis: Diagnosis, Prognosis, and Treatment An article by Ennifer K. Carroll, MD, MPH; Brian Herrick, MD, Teresa Gipson, MD, and Suzanne P. Lee, MD, from American Family Physician,, May 15, 2007, vol. 75, no. 10. Alcohol's Effect on Organ Function An issues of Alcohol Research & Health Volume 21, Number 1, 1997. Full-text online; includes sections on pancreas, liver, and gastrointestinal effects; from the National Institute on Alcohol Abuse and Alcoholism. Chronic Hepatitis C: Current Disease Management From the National Digestive Diseases Information Clearinghouse - NDDIC. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation An article by Joel J. Heidelbaugh, MD, and Michael Bruderly, MD, from American Family Physician,, September 1, 2006. Diagnosis and Management of Acute Pancreatitis Online article from American Family Physician, July 1, 2000. Endoscopic Retrograde Cholangiopancreatography (ERCP) for Diagnosis and Therapy NIH Consensus Statement, January 14-16, 2002 Vol. 18, No. 1, full-text online. Gallstones and Laparoscopic Cholecystectomy NIH Consensus Development Conference, Sept. 14-16, 1992; full-text online. Guidelines for the Management of Occupational Exposures to Hepatitis B, Hepatitis C, and HIV and Recommendations for Postexposure Prophylaxis Updated U.S. Public Health Service Guidelines, 2001, and Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis September 2005. Hepatitis A, Hepatitis B, and Hepatitis C Collections of links to web resources from Medline Plus.
  • 75. The Liver: Introduction and IndexWell illustrated and animated site from the Pathophysiology of the Digestive System site, Colorado State University. The Sol Goldman Pancreatic Cancer Research Center An extensive site from the Johns Hopkins University. Includes a section on Surgery for Pancreatic Cancer with an illustration of the Whipple Procedure. Viral Hepatitis: Epidemiology and Prevention of Viral Hepatitis A to E: An Overview. PowerPoint and Adobe Acrobat files available for downloading from the Centers for Disease Control and Prevention.
  • 76. Nursing Care in Specialized Settings – Shock & Respiratory Failure Learning Objectives: Upon completion of this topic the student will be able to: 1. Define shock. 2. Differentiate the two major classifications of shock: low blood flow and maldistribution of blood flow. 3. Describe the pathophysiology and clinical manifestations of the different types of shock. 4. Compare and contrast the effects of shock, systemic inflammatory response syndrome, and multiple organ dysfunction syndrome on the major body systems. 5. Compare the collaborative care, drug therapy, and nursing management of patients with different types of shock. 6. Describe the nursing management of a patient experiencing multiple organ dysfunction syndrome. Compare the pathophysiologic mechanisms that result in hypoxemic and hypercapnic respiratory failure. 7. Differentiate between early and late clinical manifestations of acute respiratory failure. 8. Describe the nursing and collaborative management of the patient with hypoxemic or hypercapnic respiratory failure. 9. Relate the pathophysiologic mechanisms that result in acute respiratory distress syndrome (ARDS) to the clinical manifestations. 10. Describe the nursing and collaborative management of the patient with ARDS. 11. Identify complications that may result from acute respiratory failure or ARDS and measures to prevent or reverse these complications. To achieve these objectives, the student will need to: 1. Review the literature pertaining to problems of nursing care in specialized settings. 2. Analyze the role and responsibility of the nurse when caring for a client in a specialized setting. 3. Discuss the clinical implications for the nurse and client when administering care in specialized settings. Learning Activities: Read: Lewis, et al, Ch. 67, Ch. 68 Review Key Terms:
  • 77. acute respiratory distress syndrome, p. hypovolemic shock, p. 1775 1812 multiple organ dysfunction syndrome, p. alveolar hypoventilation, p. 1802 1794 anaphylactic shock, p. 1777 neurogenic shock, p. 1777 cardiogenic shock, p. 1773 refractory hypoxemia, p. 1813 diffusion limitation, p. 1802 sepsis, p. 1778 hypercapnia, p. 1799 septic shock, p. 1778 hypercapnic respiratory failure, p. 1800 shock, p. 1772 hypoxemia, p. 1799 systemic inflammatory response syndrome, hypoxemic respiratory failure, p. 1799 p. 1794 hypoxia, p. 1804 Recommended Websites: ABC of intensive care: Respiratory support Illustrated article by Maire P Shelly and Peter Nightingale; from BMJ 1999;318:1674-1677 ( 19 June ). ABG Tutorial Online review by Margaret Hansen, EdD, MSN, RN, from the Nursing Education web site. The Acute Respiratory Distress Syndrome: Myths and Controversies By Joseph Varon, MD, FACA, FACP, and Olivier Wenker, MD, DEAA; online article from the Internet Journal of Emergency & Intensive Care Medicine. Anaplyaxis.com Information site for health professionals from the manufacturers of EpiPen®. Cardiogenic Shock Online article from eMedicine, updated July 18, 2005. Targeting the Underlying Cause in the Assessment and Evidence-Based Management of Dyspnea Online continuing education article by Nancy Spector, RN, DNSc & Diane Klein, RN, PhD; from Nurse.com. Chest drains An overview from Surgical Tutor, UK. Eliminate the air of mystery from chest tubes An article by Deborah Lazzara, from Nursing 2002, June 2002, Volume 32, Number 6, Pages 36 - 43. Available online from Nursing Center. Hemodynamics and Fluid Disturbances: Edema, Congestion, and Shock Lewis D. Johnson, University of South Carolina. An online learning module from the Basic Medical Pathology Series. Includes online videos and quizzes. Interpretation of ABGs: Acid - Base Balance A Four Step Method An online course by Mark Guinan, RN, CCRN. Learning from SARS: Preparing for the Next Disease Outbreak -- Workshop Summary Stacey Knobler, Adel Mahmoud, Stanley Lemon, Alison Mack, Laura Sivitz, and Katherine Oberholtzer, Editors; Forum on Microbial Threats; 376 pages, 2004. Available full-text online from the National Academies Press.
  • 78. A Multisite Survey of Suctioning Techniques and Airway Management Practices Online continuing education article by Mary Lou Sole, Jacqueline F. Byers, Jeffery E. Ludy, Ying Zhang, Christine M. Banta, and Kathy Brummel; from the American Journal of Critical Care, May 2003, vol. 12, no. 3. A Practical Guide to Anaphylaxis An online article by Angela W. Tang, MD, from American Family Physician, October 1, 2003. Respiratory Failure Online tutorial by Patrick Neligan, University of Pennsylvania, from the Severe Acute Respiratory Syndrome A collection of links to web resources from Medline Plus. Surviving Sepsis Campaign: Guidelines for management of severe sepsis and septic shock Full text from Critical Care Medicine, 2004, vol.32, no. 3, pp. 858-873; from the Society for Critical Care. There is also an erratum on the Society's Guidelines page.
  • 79. St. Catharine College Associate Degree Nursing Program - NUR232 Fall 2009 Class Schedule Tentative Class Schedule* Problems of Oxygenation: Perfusion OVERVIEW DATE READING OTHER ASSIGNMENTS ASSIGNMENTS CLASS MEETING Cardiovascular 8/17/09 Lewis, et al. Ch 32, pg Be prepared to System 739-760 discuss case study Coronary Artery Lewis, et al. Ch 34, pg found in syllabus Disease, Acute 784-820 Coronary Syndrome Dysrhythmias Lewis, et al. Ch 36, pg 842-864 LABORATORY MEETING Course Overview 8/19/09 Review of the 9am - 12 Syllabus Nasogastric Tube Taylor, Skill 11-2, pg NGT Quiz Insertion 602-610 Skill 11-4, pg 619-620 CLASS MEETING Inflammatory and 8/19/09 Lewis, et al. Ch 37, pg Structural Heart 865-891 Disorders CLASS MEETING Hypertension 8/20/09 Lewis, et al. Ch 33, pg 761-783 Heart Failure Lewis, et al. Ch 35, pg 821-841 Nursing Care in Specialized Settings Emergency & 8/24/09 Lewis, et al. Ch 66, pg Disaster Nursing, 1733-1771 Critical Care Lewis, et al. Ch 69, pg 1821-1844 LABORATORY MEETING Nasogastric Tube 8/26/09 Skill Check Off Insertion 9am - 12
  • 80. OVERVIEW DATE READING OTHER ASSIGNMENTS ASSIGNMENTS CLASS MEETING Vascular 8/26/09 Lewis, et al. Ch 38, pg Disorders 892-925 CLASS MEETING Case Studies 8/27/09 HTN, CAD, CHF CLASS MEETING Exam I 8/31/09 Problems of Review Study Guide Oxygenation: Perfusion Nursing Care in Specialized Settings Problems Related to Movement and Coordination – Nervous System OVERVIEW DATE READING OTHER ASSIGNMENTS ASSIGNMENTS CLASS MEETING Nursing 9/2/09 Lewis, et al. Ch 56, pg Be prepared to Assessment of 1441-1466 discuss case study the Nervous Lewis, et al. Ch 57, pg found in syllabus System, 1467-1501 Acute Intracranial Problems CLASS MEETING Stroke, 9/3/09 Lewis, et al. Ch 58, pg Be prepared to 1502-1526 discuss case study Chronic Lewis, et al. Ch 59, pg found in syllabus Neurologic 1527-1560 Problems LABOR DAY 9/7/09 HOLIDAY CLASS MEETING Alzheimer’s 9/9/09 Lewis, et al. Ch 60 pg Disease and 1561-1579 Dementia Lewis, et al. Ch 61, pg Peripheral Nerve 1580-1613 and Spinal Cord Problems CLASS MEETING Case Studies 9/10/09 CVA, Seizures, Spinal Cord Injury, Head Injury CLASS MEETING Exam II 9/14/09 Nervous System Review Study Guide
  • 81. Problems Related to Movement and Coordination-Musculoskeletal System OVERVIEW DATE READING OTHER ASSIGNMENTS ASSIGNMENTS CLASS MEETING Nursing 9/16/09 Lewis, et al. Ch 62, pg Assessment 1614-1628 Musculoskeletal System, Nursing Lewis, et al. Ch 64, pg Management of 1668-1692 Musculoskeletal Problems CLASS MEETING Musculoskeletal 9/17/09 Lewis, et al. Ch 63, pg Trauma and 1629-1667 Orthopedic Surgery CLASS MEETING Arthritis and 9/21/09 Lewis, et al. Ch 65, pg Connective Tissue 1693-1732 Diseases Problems Related to Altered Sensory Input OVERVIEW DATE READING OTHER ASSIGNMENTS ASSIGNMENTS CLASS MEETING Nursing 9/23/09 Lewis, et al. Ch 21, pg Assessment of 398-415 Visual and Lewis, et al. Ch 22, pg Auditory Systems, 416-448 Visual and Auditory Problems CLASS MEETING Nursing 9/24/09 Lewis, et al. Ch 23, pg Assessment of 449-459 the Integumentary Lewis, et al. Ch 24, pg System, 460-482 Integumentary Lewis, et al. Ch 25, pg Problems, Burns 483-508 CLASS MEETING Exam III 9/28/09 Musculoskeletal Review Study Guide System, Visual, Auditory, Integumentary System & Burns
  • 82. Problems of Ingestion, Digestion, Absorption, and Elimination OVERVIEW DATE READING OTHER ASSIGNMENTS ASSIGNMENTS CLASS MEETING Nursing 9/30/09 Lewis, et al. Ch 39, pg Assessment 926-947 Gastrointestinal Lewis, et al. Ch 40, pg System, 948-970 Nutritional Problems CLASS MEETING Obesity, Upper GI 10/1/09 Lewis, et al. Ch 41, pg Be prepared to Problems 971-989 discuss case study Lewis, et al. Ch 42, pg found in syllabus 990-1034 CLASS MEETING Lower GI 10/5/09 Lewis, et al. Ch 43, pg Problems, 1035-1086 Hepatitis Lewis, et al. Ch 44, pg 1087-1100 CLASS MEETING Liver, Pancreas, 10/7/09 Lewis, et al. Ch 44, pg and Biliary Tract 1100-1135 Problems Nursing Care in Specialized Settings CLASS MEETING Shock, Systemic 10/8/09 Lewis, et al. Ch 67, pg Inflammatory 1772-1798 Response Lewis, et al. Ch 68, pg Syndrome, 1799, 1820 Multiple Organ Dysfunction Syndrome, Respiratory Failure CLASS MEETING Case Studies 10/12/09 Hepatitis, PUD, Inflammatory Bowel Disease, Cirrhosis CLASS MEETING Exam IV 10/14/09 Problems of Ingestion, Review Study Guide Digestion, Absorption, and Elimination, Shock, MOD, Respiratory Failure
  • 83. CLASS MEETING Evaluations 10/15/09 Ms. McNary Volunteer/ Refer to Rubric found Charitable in syllabus Organization Presentation FALL BREAK 10/19-10/20 HOLIDAY CLASS MEETING TBA 10/21/09 CLASS MEETING Comprehensive 10/22/09 Review Study Guide Final Exam *Any Changes Will Be Announced In Class