NRS-410V Pathophysiology and Nursing Management of Clients’ Health Course Syllabus

Course Description

This course is designed to enhance the working RN’s existing understanding of the pathophysiological processes of disease as they affect clients across the lifespan. The interrelationship of structural and functional reactions of cells and tissues to genetic alterations and injurious agents provide the foundation for comprehending clinical manifestations and treatment protocols. Critical thinking and nursing management are enhanced through the use of case studies that integrate nutritional and pharmacological concepts. The understanding of environmental and biological risk factors provides the nurse with the knowledge to provide health promotion and prevention education.

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Topic 1: Cardiorespiratory Complexities

Objectives:

Evaluate functions of the cardiac and respiratory systems based on findings.
Develop a health promotion with a restoration teaching plan for a patient with cardiorespiratory complexities.
Develop a method for patient education to prevent hospital readmission.

Tasks

Case Study: Mrs. J.

Description:

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula athome during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is “running away.”
Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

Topic 1 DQ 1

Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion.

Topic 1 DQ 2

Discuss what resources are often necessary for nonacute care for cardiorespiratory issues. Explain how they support patient independence and decrease readmission.

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NRS-410V Pathophysiology and Nursing Management of Clients’ Health Course Syllabus

Topic 2: Neurological, Perceptual, and Cognitive Complexities

Description

Objectives:

Evaluate functions of the neurological, perceptual, and cognitive systems based on findings.
Propose an intervention for a patient with a cognitive complexity.

Tasks

Case Study: Mr. M.

Description:

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

Temperature: 37.1 degrees C
BP 123/78 HR 93 RR 22 Pox 99%
Denies pain
Height: 69.5 inches; Weight 87 kg

Laboratory Results

WBC: 19.2 (1,000/uL)
Lymphocytes 6700 (cells/uL)
CT Head shows no changes since previous scan
Urinalysis positive for moderate amount of leukocytes and cloudy
Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

Describe the clinical manifestations present in Mr. M.
Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
Discuss what interventions can be put into place to support Mr. M. and his family.
Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each

Topic 2 DQ 1

Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Outline steps for prevention or health promotion for the patient and family.

Topic 2 DQ 2

Discuss characteristic findings for a stroke and how it affects the lives of patients and their families. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. Provide an example.

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NRS-410V Pathophysiology and Nursing Management of Clients’ Health Course Syllabus

Topic 3: Elimination Complexities

Objectives:

Evaluate functions of systems related to elimination.
Examine the nurse’s role of supporting the patient’s psychological and emotional needs.
Recommend resources to assist in patient recovery.

Tasks

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

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Objective Data:

Height: 68 inches; weight 134.5 kg 2. BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

Describe the clinical manifestations present in Mr. C.
Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception,

health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)

Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

Topic 3 DQ 1

Discuss how elimination complexities can affect the lives of patients and their families. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. Provide an example.

Topic 3 DQ 2

Discuss how functional patterns help a nurse understand the current and past state of health for a patient. Using a condition or disease associated with an elimination complexity, provide an example

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NRS-410V Pathophysiology and Nursing Management of Clients’ Health Course Syllabus

Topic 4: Cellular and Immunological Complexities

Objectives:

Discuss characteristic findings for a cellular complexity.
Discuss characteristic findings for an immunological complexity.
Explain how the nursing process is utilized to provide safe and effective care for patients across the life span.

Tasks

Benchmark – Nursing Process: Approach to Care

Description:

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.

Topic 4 DQ 1

Discuss characteristic findings of immune dysfunction for either hypersensitivity reactions or AIDS. Explain what symptomology the patient would exhibit and how these symptoms may complicate daily living and relationships.

Topic 4 DQ 2

Discuss what symptoms are associated with anaphylactic shock and how the nurse differentiates these from other conditions or issues. What steps should be taken if the nurse suspects anaphylactic shock?

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NRS-410V Pathophysiology and Nursing Management of Clients’ Health Course Syllabus

Topic 5: Musculoskeletal, Metabolism, and Multisystem Complexities

Objectives:

Describe pathophysiological changes and abnormal findings associated with musculoskeletal, metabolic, and multisystem health dysfunctions.
Evaluate a research-based nursing intervention or treatment tool for the management of diabetes.

Tasks

CLC – Evidence-Based Practice Project: Intervention Presentation on Diabetes

Description:

This is a Collaborative Learning Community (CLC) assignment.

As a group, identify a research or evidence-based article published within the last 5 years that focuses comprehensively on a specific intervention or new treatment tool for the management of diabetes in adults or children. The article must be relevant to nursing practice.

Create a 10-15 slide PowerPoint presentation on the study’s findings and how they can be used by nurses as an intervention. Include speaker notes for each slide and additional slides for the title page and references.

Include the following:

Describe the intervention or treatment tool and the specific patient population used in the study.

Summarize the main idea of the research findings for a specific patient population. The research presented must include clinical findings that are current, thorough, and relevant to diabetes and nursing practice.
Provide a descriptive and reflective discussion of how the new tool or intervention can be integrated into nursing practice. Provide evidence to support your discussion.
Explain why psychological, cultural, and spiritual aspects are important to consider for a patient who has been diagnosed with diabetes. Describe how support can be offered in these respective areas as part of a plan of care for the patient. Provide examples.

Topic 5 DQ 1

Describe some of the more common pathophysiological changes and abnormal findings associated with musculoskeletal, metabolic, and multisystem health dysfunctions. Explain what symptoms are associated with the findings and how these affect patient function.

Topic 5 DQ 2

Explain the risk factors for osteoporosis. What can a nurse do to help manage this health condition to restore the patient to optimal health?