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MEDICAL-SURGICAL NURSING I & II

COURSE DESCRIPTION

TEXT: Linton, A. D. (2012). Introduction to Medical-Surgical Nursing


(5th ed.). St. Louis: Saunders Elsevier.

Silvestri, L. A. (2013). Saunders Comprehensive Review for the


NCLEX-PN Examination (5th ed.). St. Louis: Elsevier.

DESCRIPTION: This course is a study of disease and disorders of man, including


symptoms of illness and methods of diagnosis, prevention, and
treatment. The student is taught the care of adult persons with
common medical-surgical disorders. The content is presented in
sections according to body systems and taught through lecture,
films, demonstration, and supervised clinical experience.
Emphasis is placed on meeting needs of individual patients, as
determined by the nursing process.

TERMINAL OBJECTIVES: The student will demonstrate understanding of the theory on


written examinations. Upon completion of the course, the student
will have a minimum test average of 80%. The student will
perform basic nursing procedures with 100% accuracy and will
develop plans of nursing care based upon individual needs. The
student will demonstrate comprehension of classroom theory by
performing accurate nursing assessments; identifying common
signs and symptoms and patient problems associated with patient’s
diagnosis; and delivering and documenting prudent care.

GRADE ASSIGNMENT: Theory grade will be determined as follows:


Tests & Assignments 85%
Final Exam 15%
Clinical grade will be satisfactory or unsatisfactory and will be
determined by evaluation of nursing actions and criteria outlined in
the clinical syllabus.

HOURS: Theory Hours 186 hours that include:


AV Aids 4 hours
Testing 18 hours
Integrated Course Hours
Pharmacology 19.75 hours
Nutrition 6.75 hours
Anatomy 5.5 hours
Fundamentals 4.25 hours
Geriatrics 9 hours
Clinical Hours 294.5
TOTAL 480.5 hours
Written: 09/90
Reviewed: 11/05; 12/08; 12/09; 04/13; 05/14
Revised: 09/91; 09/92; 09/94; 12/00; 01/01; 08/03; 09/04; 12/06; 09/07; 01/11; 01/15
Unit: Introduction to Medical Surgical Nursing Implementation: Linton Ch. 8, Lecture, Discussion, Handouts
Lesson: 1 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: Health and Illness Application in Patient Care
Time: Theory 2 Hours Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Health-Illness Continuum VI. Concept of Illness
A. Traditional Views A. Acute vs. Chronic
1. Describe the health-illness continuum. B. Current Views B. Illness Behavior
2. Discuss traditional and current views of health and illness. and Behaviors C. Sick Role
3. List Maslow’s five basic human needs, and explain why they II. Maslow’s Hierarchy of Needs VII. Impact of Illness on Family
constitute a hierarchy. A. Human Needs VIII. Implications for Nursing Care
4. Explain four levels of adaptability to stress. B. Broad Categories A. Prevention
5. Discuss concepts related to health promotion, disease prevention, C. Hierarchy 1. Primary
and health maintenance. III. Stress and Adaptation 2. Secondary
6. Define acute and chronic illness. A. External 3. Tertiary
7. Discuss illness behavior and the impact of illness on the family. B. Internal B. Consumer Education and
8. Describe nursing measures for health promotion, health C. Physical Awareness
maintenance, and illness. D. Emotional C. Practices to Prevent
9. Describe complementary and alternate therapies and the nurse’s IV. General Adaptation Syndrome Illness
role in relation to both. A. Coping D. Meeting Unmet Patient
B. Adaptation Needs
C. Homeostasis E. Assisting Family
V. Health Promotion, Disease F. Assisting the Terminally
Prevention, & Health Maintenance Ill Patient
A. Goals for Healthy People IX. Complementary & Alternative
2020 Therapies: Nurse’s Role

Written: 09/90
Reviewed: 09/92; 07//98; 07/00; 06/02; 12/06; 05/12; 05/14
Revised: 07/94; 06/96; 12/04; 12/ 08; 07/09; 04/13
Unit: Introduction to Medical-Surgical Nursing Implementation: Linton Ch. 13 & p. 635, Lecture, Discussion, Handouts
Lesson: 2 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: Inflammation and Infection Application in Patient Care
Time: Theory 3 Hours Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Introduction X. Community: Collaborative Care
II. Physical and Chemical Barriers Management
1. Describe physical and chemical barriers. A. First Line Defense A. Communicable
2. Describe how inflammatory changes act as bodily defense B. Second Line Defense Diseases
mechanisms. III. The Inflammatory Process B. Prevention &
3. Identify the signs and symptoms of inflammation. A. Actions Involved Control
4. Discuss the processs of repairing and healing. B. Signs and Symptoms C. Immunizations
5. Differentiate infection from inflammation. IV. Wound Healing XI. Diagnostic Tests
6. Discuss the actions of commonly found infectious agents. V. Infectious & Communicable XII. Nosocomial: Collaborative Care
7. Describe the ways that infections are transmitted. Disease Management
8. Identify the signs and symptoms of infection. VI. Common Infectious Agents Recognition
9. Compare community-acquired and nosocomial infections. A. Bacteria A. Early Treatment
10. Describe the Centers for Disease Control and Prevention (CDC) B. Viruses B. Isolation
standard precautions guidelines for infection control. C. Retroviruses XIII. Immunocompromised Patients
11. Describe the CDC isolation guidelines for airborne, droplet, and D. Fungi XIV. Nursing Care of Patients with
contact precautions. E. Prions Infections
12. Discuss diagnostic tests used in the assessment and monitoring of a F. Parasites
patient with infection. VII. Transmission of Infection
13. Discuss the nursing and collaborative care of patients with VIII. Local & Generalized Infections
infections. A. Localized Signs &
14. Discuss nursing care adaptations for patients who are Symptoms
immunocompromised. B. Generalized Signs &
Symptoms
Written: 09/90 IX. Community & Healthcare
Reviewed: 09/93; 08/98; 08/02; 07/04; 05/08; 05/12; 05/14
Acquired (Nosocomial) Infections
Revised: 07/95; 08/96; 08/00; 06/06; 07/09; 04/13
Unit: Introduction to Medical-Surgical Nursing Implementation: Linton Ch. 13 & p. 635, Lecture, Discussion, Handouts
Lesson: 3 Evaluation: Written Test, Class Participation, Medication
Title: Immunity Summaries, Application in Patient Care
Time: Theory 2 Hours Integrated: N/A

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit the student will:
I. Immunity
1. Describe the immune response. A. Natural
2. Identify the cells and organs involved in immunity. B. Acquired
3. Compare natural and acquired immunity. C. Cells and Organs Involved
4. Differentiate between humoral and cell-mediated immunity. II. Nonspecific Defenses
5. Describe the nursing care of patients with immunodeficiency. III. Specific Defenses
6. Describe the nursing care of patients with allergies and anaphylaxis. A. Antibody-Mediated (Humoral) Immunity
7. Describe the process of autoimmunity. B. Cell-Mediated Immunity
IV. Immunodeficiency
A. Etiology
B. Risk Factors
C. Medical Treatment
D. Nursing Care
V. Hypersensitivity and Allergy
A. Etiology
B. Medical Treatment
C. Nursing Care
VI. Anaphylaxis
A. Etiology
B. Medical Treatment
C. Nursing Care
VII. Autoimmune Diseases
A. Etiology
Written: 09/90 B. Medical Treatment
Reviewed: 09/93; 08/98; 08/02; 07/04; 05/08; 05/12; 05/14
C. Nursing Care
Revised: 07/95; 08/96; 08/00; 06/06; 07/09; 04/13
Unit: Introduction to Medical Surgical Nursing Implementation: Linton Ch. 14, Lecture, Discussion, Handouts
Lesson: 4 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: Fluid and Electrolyte Balance Application in Patient Care
Time: Theory 3 Hours Integrated: N/A

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit, the student will be able to:
I. Homeostasis and Fluid Spaces
1. Describe the location and functions of body fluids, II. Physical Mechanisms for Fluid Movement
including factors that affect variations in fluid compartments. A. Osmosis
2. Explain the principles of osmosis, diffusion, active transport, B. Diffusion
and filtration. C. Active Transport
3. Describe how thirst, the organs of homeostasis (kidneys, heart D. Filtration
and blood vessels, lungs, adrenal glands, pituitary gland, and parathyroid E. Lymph
glands), and hormones function to maintain fluid III. Hormonal Regulations
homeostasis. A. Aldosterone
4. Describe the functions, regulation, sources, and losses of the B. ADH
main electrolytes of the body. C. Atrial Natriuretic Factor
5. Differentiate between fluid volume deficit and fluid volume IV. Body Fluids
excess. A. Sources of Intake
6. Discuss age-related fluid balance changes. B. Sources of Loss
7. Assess a client fluid and electrolyte balance. V. Electrolytes
A. Ions
1. Cations (+)
2. Anions (-)
B. Major Lytes
1. Functions
2. Sources & Losses
3. Regulation
4. Measurement
VI. Fluid Volume Deficit & Excess
VII. Age-Related Changes
VIII. Assessment of Client’s Status
A. History
B. Physical Assessment
C. Psychosocial Assessment
Written: 09/90 D. Diagnostic Assessment
Reviewed: 09/92; 07/98; 07/00; 06/02; 12/06; 05/12; 05/14
Revised: 07/94; 09/96; 12/04; 12/08; 07/09; 04/13
Unit: Introduction to Medical Surgical Nursing Implementation: Linton Ch. 14, Lecture, Discussion, Handouts
Lesson: 5 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: Interventions for Clients with Fluid and Electrolyte Application in Patient Care
Imbalance Integrated: N/A
Time: Theory 3 Hours

OBJECTIVES PLAN OF LESSON 5. Plan of Care


I. Dehydration III. Hypokalemia
Upon completion of this unit, the student will be able to: A. Types A. Pathophysiology
B. Health Promotion & B. Etiology
1. Identify clients at risk for fluid imbalances. Illness Prevention C. Collaborative
2. Use laboratory data and clinical manifestations to assess fluid C. Collaborative Management
balance and imbalance. Management 1. History
3. Apply appropriate nursing techniques to promote comfort and 1. History 2. Assessments
safety in the client with dehydration. 2. Assessments a. Physical
4. Prioritize nursing care for the client with dehydration. a. Physical b. Psychosocial
5. Explain why different types of intravenous fluids are used to b. Psychosocial c. Laboratory
treat different types of dehydration. c. Laboratory 3. Analysis
6. Develop a community-based teaching plan to prevent 3. Analysis 4. Nursing
dehydration in the older client at continuing risk for fluid loss. 4. Nursing Diagnoses and
7. Analyze changes in clinical manifestations to determine the Diagnoses and Collaborative
effectiveness of therapy for the client with dehydration. Collaborative Problems
8. Prioritize nursing care for the client with overhydration. Problems 5. Plan of Care
9. Analyze changes in clinical manifestations to determine the 5. Plan of Care IV. Hyperkalemia
effectiveness of therapy for the client with overhydration. II. Overhydration A. Pathophysiology
10. Identify clients at risk for imbalance of potassium. A. Types B. Etiology
11. Use laboratory data and clinical manifestations to assess B. Health Promotion & C. Collaborative
potassium balance and imbalance. Illness Prevention Management
12. Prioritize nursing care for the client with potassium imbalance. C. Collaborative 1. History
13. Explain the effects of potassium imbalance on the activity of Management 2. Assessments
digoxin. 1. History a. Physical
14. Differentiate diuretics that increase potassium loss from those 2. Assessments b. Psychosocial
that reduce potassium loss. a. Physical c. Laboratory
15. Analyze changes in clinical manifestations to determine the b. Psychosocial 3. Analysis
effectiveness of therapy for the client with potassium c. Laboratory 4. Nursing
imbalance. 3. Analysis Diagnoses and
Written: 09/90 4. Nursing Collaborative
Reviewed: 09/92; 07/98; 07/00; 06/02; 12/06; 05/12; 05/14
Diagnoses and Problems
Revised: 07/94; 09/96; 12/04; 12/08; 07/09; 04/13
Collaborative Problems 5. Plan of Care
Unit: Introduction to Medical Surgical Nursing Implementation: Linton Ch. 14, Lecture, Discussion, Handouts
Lesson: 5 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: Interventions for Clients with Fluid and Electrolyte Application in Patient Care
Imbalance Integrated: N/A
Time: Continued

OBJECTIVES PLAN OF LESSON


V. Hyponatremia
Upon completion of this unit, the student will be able to: A. Pathophysiology
B. Etiology
16. Identify clients at risk for imbalance of sodium. C. Collaborative Management
17. Use laboratory data and clinical manifestations to assess sodium balance 1. History
and imbalance. 2. Assessments
18. Prioritize nursing care for the client with sodium imbalance. a. Physical
19. Identify drugs that contain large amounts of sodium. b. Psychosocial
20. Differentiate diuretics that increase potassium loss from those that reduce c. Laboratory
potassium loss. 3. Analysis
21. Analyze changes in clinical manifestations to determine the effectiveness of 4. Nursing
therapy for the client with sodium imbalance. Diagnoses and Collaborative Problems
22. Identify clients at risk for imbalance of calcium. 5. Plan of Care
23. Use laboratory data and clinical manifestations to assess calcium balance VI. Hypernatremia
and imbalance. A. Pathophysiology
24. Prioritize nursing care for the client with calcium imbalance. B. Etiology
25. Analyze changes in clinical manifestations to determine the effectiveness of C. Collaborative Management
therapy for the client with sodium imbalance. 1. History
2. Assessments
a. Physical
b. Psychosocial
c. Laboratory
3. Analysis
4. Nursing
Diagnoses and Collaborative Problems
5. Plan of Care
VII. Hypocalcemia
A. Pathophysiology
B. Etiology
C. Collaborative Management
1. History
2. Assessments
a. Physical
b. Psychosocial
Written: 09/90 c. Laboratory
Reviewed: 09/92; 07/98; 07/00; 06/02; 12/06; 05/14
3. Analysis
Revised: 07/94; 09/96; 12/04; 12/08; 07/09; 04/13
4. Nursing a. Physical
Diagnoses and Collaborative Problems b. Psychosocial
5. Plan of Care c. Laboratory
VIII. Hypercalcemia 3. Analysis
A. Pathophysiology 4. Nursing
B. Etiology Diagnoses and Collaborative Problems
C. Collaborative Management 5. Plan of Care
1. History IX. Phosphorus Imbalances
2. Assessments X. Magnesium Imbalances
Unit: Introduction to Medical Surgical Nursing Implementation: Linton Ch. 14, Lecture, Discussion, Handouts
Lesson : 6 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: Acid-Base Imbalance Application in Patient Care
Time: Theory 2 Hours Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Introduction


II. Acids and Bases: pH
1. Describe the role of buffer systems and respiratory and renal III. Physiology
mechanisms in achieving nd maintaining acid-base balance. A. Chemical Buffering
2. Apply the principles of acid-base balance to the interpretation of 1. Bicarbonate Buffers
arterial blood gas (ABG) measurements. 2. Intracellular Buffers
3. Analyze components of ABGs to identify type of acid-base 3. Phosphate Buffers
disturbance. 4. Bone Buffers
4. Describe the causes and effects of each type of acid-base B. Respiratory Regulation
imbalance. C. Renal Regulation
5. Describe the management of patients with acid-base imbalances. D. ABG
fluid or electrolyte imbalances. E. Lab Values
6. Formulate a plan of care for the patient with an acid-base 1. Electrolytes
imbalance based on ABG findings. 2. Albumin
IV. Arterial Blood Gases
A. Values of Components
B. Guidelines for Analysis
( and ROME)
V. Acid-Base Disturbances
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
1. Causes
2. Assessment
3. Clinical Manifestations
4. Treatment
5. Collaborative Care
Written: 09/90 6. Plan of Care
Reviewed: 09/93; 08/98; 08/02; 07/04; 05/08; 05/12; 05/14
Revised: 07/95; 08/96; 08/00; 06/06; 10/08; 07/09; 04/13

9
Unit: Introduction to Medical Surgical Nursing Implementation: Linton Ch. 16, Lecture, Discussion, Handouts
Lesson : 7 Evaluation: Written Test, Class Participation, Medication Summaries,
Title: First Aid, Emergency Care, & Disaster Management Application in Patient Care
Time: Theory 3 Hours Integrated: Pharmacology 0.25 Hours

OBJECTIVES Obstruction)
C. Shock
Upon completion of this unit the student will: D. Hemorrhage

1. List the principles of emergency and first aid care.


2. List the steps of the initial assessment and interventions for the E. Traumatic Injuries
person requiring emergency care.
3. Describe the components of the nursing assessment of the person PLAN OF LESSON F. Thermal Exposure
requiring emergency care. G. Poisoning
4. Outline the steps of the nursing process for emergency or first aid I. General Principles of Emergency H. Bites
treatment of victims of cardiac/respiratory arrest, choking, shock, Care I. Stings
hemorrhage, traumatic injury, burns, heat or cold exposure, A. ABC IV. Bioterrorism/Natural Disasters
poisoning, bites, and stings. B. CPR as Needed A. Biologic Agents
5. Describe biologic agents and discuss the role of the nurse in C. Uncontrolled Bleeding B. Nurse’s Role
relationship to bioterrorism and natural diasters. D. Assess for Injuries Head V. Emergency Care: Legal
6. Explain the legal implications of administering first aid in to Toe Implications
emergency situations. 1. Immobilize Spine &
Limbs as Indicated
2. Medical Tag
Written: 07/09 II. Guidelines for First Aid
Reviewed: 05/12; 05/14 A. Nursing Assessment
Revised: 04/13 B. Physical Examination
III. Nursing Process for Emergency
Aid
A. CPR
B. Choking (Airway

10
Unit: The Surgical Patient Implementation: Linton Ch. 17, Lecture/Discussion, Transparencies,
Title: Pre-Operative Nursing Care Case Studies, Quizzing
Lesson: 1 Evaluation: Application in Patient Care, Written Exam, Class
Time: Theory 2 Hours Participation
Integrated: N/A
O. Nutritional Status
OBJECTIVES P. Surgical Anesthetic History
PLAN OF LESSON
Upon completion of this unit, the student will:
I. Surgical Procedures
1. Identify different classifications of surgeries. A. Degree Risk Q. Perception
2. Identify the biopsychosocial responses of patients to surgery. B. Extent 1. Surgical Procedure
3. Discuss the components and significance of the preoperative C. Anatomic Site 2. Pain
patient assessment. D. Timing or Physical Setting 3. Surgical Risk
4. Explain the potential for postoperative complications. II. Special Considerations R. Age
5. Identify preoperative nursing diagnoses. A. Neuroendocrine Response S. Physical Examination
6. Discuss expected patient outcomes for the preoperative phase. B. Psychologic Response 1. Purposes
7. Discuss nursing interventions in the preoperative phase. C. Sociologic Response T. Diagnostic
8. Discuss final preparations for the preoperative patient. III. Legal & Ethical Issues 1. Common Tests
A. Informed Consent V. Nursing Diagnoses, Outcomes &
B. Advance Directives Interventions
C. DNR Orders A. Nursing Diagnoses
IV. Nursing Management/Assessment 1. Anxiety
A. Health History 2. Ineffective Airway
B. Allergic Clearance
C. Medication & Substance 3. Risk for Ineffective
Abuse Peripheral Tissue
D. Herbs & Nutritional Perfusion
Supplements B. Outcomes
E. Cultural & Religious C. Interventions
Preferences 1. Patient Teaching
F. Social Support VI. Final Preparations for Surgery
G. Functional Assessment VII. Premedication
H. Pulmonary Status VIII. Preoperative Checklist
I. Renal Status IX. Documentation
J. Hepatic Function
K. Neurologic Status
L. Hematologic Status
M. Endocrine Function
N. Immunologic Status

Written: 09/90
Reviewed: 09/93; 05/98; 05/02; 06/08; 06/12; 05/14
Revised: 07/95; 05/96; 05/00; 05/04; 06/06; 06/10
Unit: Medical Surgical Nursing – The Surgical Patient Implementation: Linton Ch. 17, Lecture/Discussion, Transparencies,
Title: Intra-Operative Nursing Care Handouts, Quizzing
Lesson: 2 Evaluation: Application in Patient Care, Written Exam, Class
Time: Theory 2 Hours Participation
Integrated: Pharmacology 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will: I. Intraoperative Care Team
II. The Surgical Environment VII. Monitoring Patient
1. List the members of the intraoperative patient care team and A. Traffic Control VIII. Nurse’s Role
discuss their role in patient care. B. Environmental Conditions A. Induction
2. Discuss the significance of aseptic technique. C. Infection Control B. Emergence
3. Explain the purpose of the appropriate attire in the surgical suite. III. Septic Practices in OR C. Anesthesia Complications
4. Compare and contrast the different types of anesthesia. IV. Anesthesia IX. Physiologic Stress Response
5. Describe the physiologic stress response to anesthesia and surgery. A. Anesthesia A. Neuroendocrine Responses
6. Describe the components of the intraoperative patient assessment. B. Anesthesiologist B. Metabolic Responses
C. Anesthetist C. Thermoregulatory Responses
D. Sedative 1. Unplanned
E. Hypnotic Hypothermia
F. Tranquilizer 2. Malignant
V. Local Anesthesia Hypothermia
VI. Regional Anesthesia D. Other Conditions
A. Spinal 1. Latex Allergy
B. Nerve Block X. Intraoperative Patient Management
C. Bier Block A. Nursing Diagnoses
D. Minimal Sedation 1. Risk for Injury
E. Moderate Sedation 2. Risk for Imbalanced
F. Monitored Anesthesia Care Body Temperature
V. General Anesthesia 3. Risk for Imbalanced
A. Depth Fluid Volume
B. Phases 4. Risk for Infection
C. Balanced B. Expected Outcomes &
D. Inhalation Interventions
E. Intravenous
F. Opioid
G. Neuromuscular Blocking
Agents
H. Others

Written: 09/90
Reviewed: 09/93; 05/98; 05/02; 06/08; 06/12; 05/14
Revised: 07/95; 05/96; 05/00; 05/04; 06/06; 06/10
Unit: The Surgical Patient Implementation: Linton Ch. 17, Lecture/Discussion, Transparencies,
Title: Immediate Post-Operative Care Handout, Quizzing, Case Studies, Written Care Plan
Lesson: 3 Evaluation: Application in Patient Care, Written Exam, Class
Time: Theory 4 Hours Participation
Integrated: Nutrition 0.5 Hours

OBJECTIVES

Upon completion of this unit, the student will: PLAN OF LESSON

1. Describe the postoperative phase as a I. Introduction IV. Assessment in Complications


component of the surgical experiences. II. Phases of Postanesthesia Care A. Respiratory
2. Compare and contrast nursing care of the patient A. Phase I 1. Common Types
in postanesthesia Phase I and Phase II. B. Phase II 2. Risk Factors
3. Identify postoperative complications that may C. Phase III 3. Signs & Symptoms
compromise a patient’s safety and stability after III. Nursing Management B. Cardiovascular
anesthesia and surgical intervention. A. Immediate Assessment 1. Common Types
4. Discuss patient risk factors for postoperative 1. General Anesthesia 2. Risk Factors
complications. a. Respiratory 3. Signs & Symptoms
5. Formulate relevant postoperative nursing care b. Cardiovascular C. Gastrointestinal
plan. c. Thermoregulation 1. Common Reactions
d. Fluid Volume 2. Risk Factors
e. Gastrointestinal 3. Signs and Symptoms
2. Spinal Anesthesia V. Nursing Care Plan
a. Side Rails Up A. Nursing Diagnoses
b. Check Sensation 1. Acute Pain
in Lower 2. Fluid Volume Deficient
Extremities 3. Activity Intolerance
c. Flat in Bed for 6- 4. Ineffective Tissue
12 Hours Perfusion
d. May Turn on 5. Infection
Side B. Expected Outcomes & Interventions
e. Call Light in VI. Gerontological Considerations
Reach A. Mental Status
f. Complications B. Pain

Written: 09/90
Reviewed: 09/93; 05/98; 05/02; 06/08; 06/12; 05/14
Revised: 07/95; 05/96; 05/00; 05/04; 06/06; 06/10
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 25; ACS Cancer Facts & Figures; Lecture/Class Discussion;
Care of the Oncology Patient Transparencies; Handouts
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Facts About Cancer Integrated: N/A
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Cancer (CA) V. Diagnosis
A. Definition and Etiology A. Laboratory Studies
1. Define and discuss the term “cancer” and its etiology. B. Carcinogenesis B. X-Ray/Imaging Studies
2. Summarize the process of carcinogenesis. C. General Description and C. Thermography
3. Discuss how tumors are named, classified, graded, and staged. Characteristics D. Radioisotopes
4. Define metastasis and explain its pathophysiology. D. Tumor Classification E. Cytology
5. Define and discuss the characteristics of benign and malignant 1. Embryonal Tissues F. Biopsy
tumors. 2. Classification by Origin G. Endoscopy
6. List the ACS seven general warning signs of cancer, the ABCDEs 3. Grading H. Ultrasound
of skin cancer, and other s/s of cancer as identified by the 4. Staging: TNM System I. Others
American Cancer Society. a. Tumor
7. Discuss and list the causes of cancer, risk factors, and behaviors/ b. Node
lifestyle factors to minimize its incidence. c. Metastasis
8. Discuss cancer prevention and detection, and the importance of E. Metastasis
patient teaching and screening. 1. Primary Site(s)
9. List and discuss ways in which cancer is diagnosed. 2. Secondary Site(s)
F. Malignant and Benign Tumors
II. Warning Signs
A. CAUTION
B. ABCDEs
C. Others – s/s Breast, Prostate, Lung,
and Skin Cancers
III. Risk Factors and Screening
IV. Prevention
A. Primary
B. Secondary
C. Tertiary
D. Healthy People 2020

Written: 09/90
Reviewed: 09/93; 07/97; 07/99; 03/09; 07/13
Revised: 07/95; 02/01; 02/03; 03/05; 03/07; 03/11

14
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 25; ACS Cancer Facts & Figures; Clayton, Stock, & Cooper
Care of the Oncology Patient Ch. 44; Lecture/Class Discussion; Transparencies; Handouts
Lesson: 2 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Treatment and Nursing Care of the Patient with Cancer Integrated: Pharmacology 1 Hour
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Treatment
A. Surgery C. Chemotherapy
1. List the three basic methods of treatment of cancer. 1. Pre-Op Care 1. Antineoplastic Classifications/
2. Discuss surgery in the treatment of cancer. 2. Post-Op Care Protocols
3. Discuss radiotherapy in the treatment of cancer. B. Radiotherapy a. Alkylating Agents
4. List the two types of radiotherapy (XRT & IRT). 1. Definition b. Antimetabolites
5. Discuss side effects of XRT, including radiation reactions. 2. Effects c. Antitumor Antibiotics
6. Describe the nursing management of the patient receiving XRT, 3. Clinical Application d. Plant Alkaloids
including the importance of hydration, nutrition, and skin care. a. Sensitivity e. Monoclonal Antibodies
7. Describe safety principles related to internal radiation therapy. b. Individual Reactions f. Hormones
8. Discuss side effects and nursing management of the patient 4. Types g. Steroids
receiving IRT. a. External (XRT) h. Miscellaneous Agents
9. Discuss chemotherapy protocols in the treatment of cancer. i. Radiation Reaction 2. Clinical Trials
10. Describe the classifications of antineoplastic drugs. ii. Hydration and Nutrition 3. Administration
11. Define and discuss administration of antineoplastic agents, iii. Myelosuppression 4. Side & Adverse Effects
including the importance of clinical trials. iv. Other Effects a. Myelosuppression
12. List and discuss potential side/adverse effects of antineoplastic v. Nursing Management b. GI Effects/Stomatitis
drugs. vi. Follow-up Care c. Alopecia
13. Discuss the nursing management of the patient receiving b. Internal (IRT; Brachytherapy) d. Sexual Dysfunction
chemotherapy, including safety measures. i. Safety (Time, Distance, e. Vesicant Reactions
14. Summarize biotherapy and its role in cancer treatment. and Shielding) f. Organ Toxicities
15. Discuss benefits of bone marrow transplantation and other ii. Radioisotopes g. Body Image
supportive therapies in cancer treatment. iii. Side & Adverse Effects 5. Nursing Management and Safety
16. Discuss potential complications and emergencies that may occur as iv. Nursing Management D. Biotherapy
a result of CA or CA treatment. v. Follow-up Care E. Supportive Therapies
17. Discuss the various causes and methods of cancer pain F. Complications and Emergencies
management. G. Cancer Pain Management
18. List supportive, oncology-related organizations. H. Organizations

Written: 09/90
Reviewed: 09/93; 07/97; 07/99; 03/09; 07/13
Revised: 07/95; 03/01; 03/03; 03/05; 03/07; 03/11

15
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 24; Burton & Ludwig, Ch. 10; PowerPoint Presentation;
Care of the Dying Patient Lecture/Class Discussion; Handouts; Funeral Home Visit
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Physiological Aspects of Caring for the Dying Patient Integrated: Fundamentals 1 Hour; Pharmacology 0.5 Hour
Time: Theory 1.5 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Definitions X. Ethical Issues
II. Advance Directives A. Advanced Life Support
1. Define dying, death, clinical death, and brain death. A. Living Will B. Euthanasia
2. Describe advance directives, including the living will B. Medical Power of Attorney/ C. Other end-of-life choices
and medical power of attorney/health care agent. Health Care Agent
3. Discuss organ donation and the nurse’s role. III. Organ Donation
4. List clinical signs of impending death. IV. Clinical Signs of Impending Death
5. Identify the physiologic changes that occur within the V. Physiologic Changes/Patient Needs
body systems of the terminally ill and/or dying A. Comfort
patient. B. Skin
6. Describe the nursing management of physiologic C. GI/Nutrition
changes that occur during the dying process. D. Respiratory
7. Explain changes in the body after death, including E. CNS
rigor mortis and livor mortis. F. Psychosocial
8. Discuss nursing care of the body after death (post- G. Spiritual
mortem care). VI. Nursing Management
9. Discuss the responsibility for legal forms after a A. Assessment
patient dies. B. Nursing Diagnosis
10. Discuss ethical issues related to death and dying. C. Planning
D. Implementation
E. Evaluation
F. Documentation
VII. Post-Mortem Changes
VIII. Post-Mortem Care
IX. Legal Issues/Forms
A. Death Certificate
B. Autopsy Forms
C. Morgue Release
Written: 09/90
Reviewed: 09/93; 07/97; 07/99; 03/09
Revised: 07/95; 03/01; 03/03; 03/05; 03/07; 03/11; 07/13

16
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 24; Burton & Ludwig, Ch. 10; PowerPoint Presentation;
Care of the Dying Patient Lecture/Class Discussion; Handouts; Funeral Home Visit; Videos:
At Death’s Door. (1999). Paraclete Press. Run time 35 minutes.
Lesson: 2 Beyond Death’s Door. (1999). Paraclete Press. Run time 35 minutes.
Title: Psychological Aspects of Caring for the Dying Patient Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Time: Theory 3 Hours Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Death
A. Society’s View
1. Discuss death as viewed by society. B. Personal View
2. Discuss death as he/she personally perceives it, including his/her feelings about C. Insights and Attitudes
death and dying. 1. Personal Attitudes
3. Discuss the emotional aspects of caring for the dying patient. a. Hospice
4. Explain insights and attitudes to be considered when caring for the terminally-ill b. Home Care
patient. 2. Age and Developmental Level
5. Relate age and developmental level to perception of death. 3. Kubler-Ross’ Stages (DABDA)
6. Identify and describe the emotional-reaction stages of dying according to Dr. a. Denial
Elisabeth Kubler-Ross (DABDA). b. Anger
7. Discuss the nursing implications of each stage of the dying process (DABDA), c. Bargaining
including common fears expressed by the dying patient. d. Depression
8. Discuss emotional aspects of nursing care for the dying patient. e. Acceptance
9. Describe and comment on the Dying Patient’s Bill of Rights. 4. Fears
10. Discuss the history and objectives of hospice care. II. Nursing Implications
11. Define “caregiver burden” and related nursing implications. A. Emotional Support
12. Describe survivor’s guilt and related nursing implications. B. Communication
13. Discuss loss, bereavement, grieving, and the importance of emotional support C. Supporting the Family
for the family. III. Emotional Aspects and Other Topics
A. Patient
B. Family
C. Staff
IV. Hospice Care
Written: 09/90 V. Caregiver Burden
Reviewed: 09/93; 07/97; 07/99; 03/09
VI. Survivor’s Guilt
Revised: 07/95; 03/01; 03/03; 03/05; 03/07; 03/11; 07/13
VII. Family Support

17
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 50 and pp. 337-340, 641-642, and 953-956; Thompson, Ch. 5;
Disorders of the Skin Burton & Ludwig, Ch. 26; Lecture/Class Discussion; PowerPoint Slides
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Dermatologic Disorders Integrated: Pharmacology 1 Hour; Geriatrics 1 Hour
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Anatomy Review
A. Structures B. Psoriasis
B. Functions 1. Definition
1. Review the structures and functions of the skin. II. Care of the Skin 2. Symptoms
2. Discuss methods of caring for the skin. A. Cleanliness/Protection 3. Treatment
3. Identify specific changes in the skin associated with physiologic B. Preventing Dryness C. Sebaceous Cyst
aging. C. Preventing Dandruff 1. Definition
4. Describe and discuss the assessment of a patient with a D. Avoiding Sunburn 2. Symptoms
dermatologic disorder, defining common terms used in the III. Age Related Changes in Skin 3. Treatment
assessment of the skin. IV. Assessment Allergic Conditions (Eczema, Urticaria)
5. Discuss problems of disfigurement and the emotional impact on A. History D. Eczematous Dermatitis
B. Visual Inspection 1. Definition
the patient. 2. Symptoms
C. Terminology
6. List common treatments of skin disease. D. Diagnostic Tests 3. Treatment
7. Discuss the general nursing management of the patient with a V. Disfigurement E. Uticaria and Angioedema
dermatologic disorder, including pharmacologic considerations. A. Physical Aspects 1. Definition
8. Define and discuss the symptoms and treatments of common B. Psychological Aspects 2. Symptoms
dermatologic disorders. VI. Treatments 3. Treatment
9. Define and discuss the symptoms and treatment of infestations and A. Local Bacterial Infections (Impetigo, Furuncle,
bites. B. Systemic Furunculosis, Carbuncle, Cellulitis)
10. Define and describe the symptoms and treatment of systemic VII. Nursing Management F. Impetigo Contagiosa
A. Topical Medications 1. Definition
diseases that have dermatologic manifestations. 2. Symptoms
B. Dressings
11. Discuss benign, pre-malignant, and malignant skin lesions, C. Baths/Soaks 3. Treatment
including appearance, symptoms, and treatment. D. Sterile Compresses G. Furuncle/Furunculosis/Carbuncle
12. Describe pressure ulcer risk factors, prevention, stages, treatment VIII. Common Dermatologic Disorders 1. Definition
options, and nursing management. Benign Conditions (Acne, Psoriasis, 2. Symptoms
Sebaceous Cyst) 3. Treatment
A. Acne Vulgaris H. Cellulitis
1. Definition 1. Definition
Written: 09/90 2. Symptoms 2. Symptoms
Reviewed: 09/93; 07/99; 04/03; 03/09 3. Treatment 3. Treatment
Revised: 07/95; 07/97; 04/01; 05/05; 03/07; 03/11; 04/13

18
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 50 and pp. 337-340, 641-642, and 953-956; Thompson, Ch. 5;
Disorders of the Skin Burton & Ludwig, Ch. 26; Lecture/Class Discussion; PowerPoint Slides
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Dermatologic Disorders Integrated: Pharmacology 1 Hour; Geriatrics 1 Hour
Time: Theory 2 Hours (Cont’d)

Revised: 07/95; 07/97; 04/01; 05/05; 03/07; A. Lupus Erythematosus


03/11; 04/13 1. Definition
PLAN OF LESSON (Cont’d) 2. Dermatologic Symptoms

Viral Infections (Herpes Simplex, Herpes Zoster)


I. Herpes Simplex 3. Treatment
1. Definition B. Scleroderma
2. Symptoms C. Periarteritis Nodosa
3. Treatment X. Skin Lesions
J. Herpes Zoster A. Birthmark
1. Definition 1. Symptoms
2. Symptoms 2. Treatment
3. Treatment B. Nevus (Mole)
Fungal Infections (Candidiasis, Tinea) 1. Symptoms
K. Candidiasis 2. ABCDE Assessment
1. Definition C. Senile Keratosis
2. Symptoms 1. Definition
3. Treatment 2. Symptoms
L. Dermatophtosis Tinea 3. Treatments
1. Types (Pedis, Capitis, Corporis) D. Erythroplakia/Leukoplakia (Mucous
2. Symptoms Membranes)
3. Treatment 1. Symptoms
Infestations and Bites (Cimicidae, 2. Treatment
Pediculosis, Scabies) E. Malignant Melanoma
M. Cimicidae (Bedbugs) 1. Symptoms
1. Definition 2. Treatment
2. Symptoms F. Squamous Cell Carcinoma
3. Treatment 1. Symptoms
N. Pediculosis Capitis/Coporis/Pubis 2. Treatment
1. Definition G. Basal Cell Carcinoma
2. Symptoms 1. Symptoms
3. Treatment 2. Treatment
O. Scabies XI. Pressure Ulcers
1. Definition A. Definition
2. Symptoms B. Risk Factors
3. Treatment C. Stages
Written: 09/90
IX. Systemic Diseases D. Treatments
Reviewed: 09/93; 07/99; 04/03; 03/09

19
1. Topicals 3. Wound VAC
2. Pulse Lavage E. Prevention
Unit: Medical Surgical Nursing Implementation: Linton,, Ch. 50; Lecture/Class Discussion; PowerPoint Presentation
Disorders of the Skin Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 2 Integrated: Pharmacology 1 Hour; Nutrition 0.5 Hours
Title: The Burn Patient
Time: Theory 2.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Types of Burn Injuries B. Silver Nitrate solution
A. Thermal C. Mafenide Acetate (Sulfamylon)
B. Chemical D. Bacitracin
1. Define the types of burn injuries and the classifications of burns. E. Others
2. Differentiate and describe depth and extent as they relate to burn C. Electrical
D. Friction VIII. Skin Grafting Techniques
assessment. E. Inhalation Injury A. Sources
3. Discuss the prognosis for each type of burn. II. Classification of Burns B. Graft and Donor Sites
4. List the physiological changes after a burn injury. A. Depth B. Potential Complications
5. Discuss the initial assessment of the burn patient and the 1. Superficial Partial Thickness (1st IX. Nursing Care
subsequent stages of burn management. Degree) A. Emergency Care
6. Describe burn shock in relation to 2nd and 3rd spacing of fluids and 2. Deep Partial Thickness (2nd Degree) B. Wound Care
electrolyte shifting that occurs throughout the recovery process. 3. Full thickness (3rd Degree) C. Comfort and Pain Control
4. Deep Full Thickness (4th Degree) 1. Nursing Measures
7. Compare and contrast the two types of burn treatment methods, 2. Analgesics
including the advantages and disadvantages of each. B. Extent
1. Rule of Nines D. Nutrition
8. Identify the topical drugs commonly used in the treatment of 2. Lund & Browder Chart 1. Fluids and Electrolytes
burns. III. Prognosis 2. Protein
9. List and discuss common skin grafting techniques. IV. Physiological Changes 3. Calories
10. Discuss the treatment and general nursing care of the burn patient V.Treatment 4. Vitamins A, C, & E
for each stage of recovery. A. Initial First Aid 5. Minerals Zinc, Folate, and Iron
11. Define and discuss the potential complications for a burn patient. B. Initial Medical Treatment E. Prevention of Infection/Protective
12. Summarize the nutritional needs for the patient recovering from a 1. Fluid Shifting (2nd & 3rd Spacing) Isolation
2. Electrolyte Disturbances F. Other Physical Needs
burn. G. Psychosocial Needs
13. Discuss home health considerations for the burn patient following C. Stages
1. Emergent X. Complications
discharge from the hospital. 2. Acute A. Infection
14. Summarize burn prevention concepts. 3. Rehabilitation B. Renal Failure
VI. Burn Treatment Methods C. CV/Respiratory Problems
A. Open Method D. Curling’s Ulcer/GI Disturbances
B. Closed Method E. Anemia
1. Occlusive Dressings F. Contractures
2. Sterile Technique G. Pressure Ulcers
VII. Topical Drugs XI. Discharge Planning/Home Considerations
Written: 09/90 A. Silver Sulfadiazine (Silvadene) XII. Burn Prevention
Reviewed: 09/93; 07/99; 04/03; 03/09; 04/13
Revised: 07/95; 07/97; 04/01; 05/05; 03/07; 03/11

20
Unit: Medical Surgical Nursing Implementation: Linton,, Ch. 50; Lecture/Class Discussion
Disorders of the Skin Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 3 Integrated: None
Title: The Patient Undergoing Plastic Surgery
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Conditions
A. Congenital
1. List and describe the conditions that may be treated by plastic surgery. B. Deformities
2. Describe areas in which cosmetic surgery is indicated. C. Disfigurement
3. Define skin grafts related to source of donor. II. Cosmetic Surgery
4. Describe each type of skin graft and conditions for which it may be indicated. III. Skin Graft Donors
5. Summarize the three conditions for a graft to be successful or “take.” A. Autograft
6. Describe graft rejection. B. Homograft
7. Describe the pre- and post-operative assessment of the patient with a skin graft. C. Heterograft
8. Discuss the pre-and post-op nursing management of the patient with a skin graft. IV. Skin Graft Types
A. Split Thickness
B. Full Thickness
C. Postage Stamp
D. Pinch
E. Cover
F. Lace
G. Free Full Thickness
H. Pedicle Flap
V. Assessment
VI. Success/“Take”
A. Adequate Blood Supply
B. Remains Fixed/Intact
C. Free From Infection
VII. Rejection
Written: 09/90 VIII. Nursing Management: Graft & Donor
Reviewed: 09/93; 07/99; 04/03; 03/09; 04/13
Sites
Revised: 07/95; 07/97; 04/01; 05/05; 03/07; 03/11
A. Dressing
B. Infection Control
C. Limited Mobility
D. Physical Needs
E. Emotional Support

21
Unit: Medical Surgical Nursing Implementation: Linton Ch. 30 and Study Guide Unit 7; Thompson Ch. 17;
Disorders of the Respiratory System Lecture/Class Discussion; Quizzing; CD Human Body Dynamic;
Lesson: 1 Video: Respiratory System. (1992) Springhouse Corp. Run time 30 min
Title: Anatomy of the Respiratory System Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Time: Theory 1 Hour Integrated: Geriatrics 1 Hour

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit, the student will be able to:
I. Respiratory System
1. List the major components of the respiratory system. A. Nostril
2. Define respiration and differentiate between the two types. B. Pharynx
3. Name the two phases of respiration and state the functions of each. C. Larynx
4. State how respirations are controlled. D. Trachea/Windpipe
5. Define the various abnormalities of respirations. E. Bronchi
6. Identify the relationship between the respiratory system and 1. Alveoli
circulatory system. 2. Cilia
7. Describe age-related changes in the respiratory system. F. Lungs
G. Bronchioles
H. Bronchial/Subdivisions
I. Thoracic Cavity
1. Diaphragm
2. Pleura
3. Mediasttinum
II. Respiration
A. Internal Respiration
B. External respiration
III. Physiology of Respiration
A. Inhalation
B. Exhalation
IV. The Control of Breathing
V. Abnormal Respirations
VI. Relationship
A. Respiration
B. Circulation
VII. Age-Related Changes

Written: 09/90
Reviewed: 09/93; 07/99; 01/05; 01/11; 01/15
Revised: 09/95; 07/97; 01/01; 01/03; 07/04; 01/07; 01/09; 01/13

22
Unit: Medical Surgical Nursing Implementation: Linton Ch. 30 & 31; Study Guide Unit 7; Lecture/Class Discussion
Disorders of the Respiratory System Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 2 Integrated: N/A
Title: Physical Examination and Diagnostic Measures
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Assessment
II. Techniques of Physical Assessment
1. Identify the significant subjective and objective assessment data A. Significant Findings
that should be obtained from a patient. III. X-rays
2. Describe the techniques used in a physical assessment of the A. Fluoroscopy
respiratory system. IV. Pulmonary Function Tests
3. Identify adventitious lung sounds and possible causes of each. A. Mechanical Function (Spirometry)
4. Differentiate normal from common abnormal findings of a B. Blood Gas Analysis
physical assessment of the respiratory system. V. Sputum Specimens
5. State the purpose and function of the chest X-ray, CAT scan, lung A. Purpose
scan, and fluoroscopy. B. Procedure
6. Identify purpose and general procedure for pulmonary function C. Charting
tests. VI. Bronchography
7. State the purpose and procedure of blood gas analysis. VII. Bronchoscopy
8. Identify the purpose of obtaining a sputum specimen and indicate A. Purpose
the best time to obtain it. B. Nursing Care
9. Identify the procedure for obtaining a sputum specimen and state C. Complications
information that should be charted after specimen is obtained. VIII. Thoracentesis
10. State the purpose of bronchoscopy. IX. Diagnostic Test Results
11. Identify nursing care of the patient both before and after a A. Nurse’s Responsibility
bronchoscopy.
12. List complications that can occur from a bronchoscopy.
13. Define bronchography and identify the procedure.
14. Identify the use of thoracentesis as a diagnostic procedure and its
nursing care.
15. Describe the purpose, nursing responsibilities, and significant
results related to diagnostic studies.

Written: 09/90
Reviewed: 09/93; 07/99; 01/11; 01/15
Revised: 07/95; 07/97; 01/01; 01/03; 07/04; 01/05; 01/07; 01/09; 01/13

23
Unit: Medical Surgical Nursing Implementation: Linton Ch. 30 & 31; Lecture/Class Discussion; Quizzing; Handouts;
Disorders of the Respiratory System Anatomical Charts; Video: Breathing Sounds. (1988).
Lesson: 3 Springhouse Corp. Run time 30 min
Title: Common Respiratory Problems and their Implications Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
For Nursing Integrated: N/A
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Prevention of Respiratory Disease
II. General Nursing Care of Patient with
1. Identify general methods of preventing respiratory diseases and Respiratory Disorder
persons at high risk for these diseases. A. Cough
2. Define the two main categories of cough. 1. Categories
3. List nursing observations of a patient with a cough. 2. Nursing Observations
4. Identify nursing care for the patient with a cough. 3. Nursing Care
5. Identify clinical signs of respiratory distress and methods to relieve III. Respiratory Distress
these. IV. Fatigue
6. Identify the cause of fatigue in respiratory disorders and methods V. Abnormal Breathing Patterns
to relieve this. A. Hypercapnia
7. Define hypocapnia and indicate its results on the body. B. Hypocapnia
8. List symptoms of respiratory acidosis.
9. Define hypocapnia and its results on the body.
10. List conditions associated with hypocapnia.
11. Identify nursing responsibilities associated with caring for the
patient with abnormal breathing patterns.

Written: 09/90; 01/11


Reviewed: 09/93; 07/99; 01/03; 01/05; 01/07; 01/09; 01/15
Revised: 07/95; 07/97; 01/01; 07/04; 01/09; 01/13

24
Unit: Medical Surgical Nursing Implementation: Linton Ch. 30 & 31; Lecture/Class Discussion; Handouts; Guest
Disorders of the Respiratory System Speaker – Respiratory Therapist
Lesson: 4 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: General Nursing Care of the Patient with Integrated: Nutrition 1 Hour and Fundamentals 0.75 Hour
Respiratory Disease
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Nutrition
A. Nursing Management
1. List reasons for loss of appetite in the respiratory patient and 1. Six Meals
nursing measures to encourage nutrition. 2. Snacks
2. Identify reasons for forcing fluids in the respiratory patient. II. Hydration
3. Define humidification and aerosol and identify the four general III. Humidification
purposes of these therapies. A. Definition
4. Define nebulizers and humidifiers and indicate their uses. B. Purposes
5. Identify aims of pulmonary hygiene and methods by which they’re C. Methods
achieved. IV. Pulmonary Hygiene
6. Identify the procedure for postural drainage an percussion stating A. Aims
precautions which should be taken during the procedure. B. Postural Drainage
7. Identify the purpose of breathing exercises and describe the 1. Procedure
common ones used. 2. Precaution
8. Identify when the different concentrations of oxygen are used. C. Breathing Exercises
9. Identify indications for oxygen therapy. V. Oxygen Therapy
10. List signs and symptoms of inadequate oxygen supply. A. Oxygen Concentration
11. Indicate how oxygen can be a respiratory depressant. B. Indications for Oxygen Therapy
12. Identify the effects of oxygen toxicity. C. Assessment of Signs and Symptoms of
13. Identify different methods of oxygen administration, reasons for Inadequate Oxygen Supply
their use and special consideration of each. D. Oxygen Toxicity
14. Identify safety precautions to be observed when patients are E. Modes of Administration of O2
receiving oxygen therapy F. Safety Precautions
15. Identify two types of respirators and their purposes. VI. Mechanical Ventilation
16. Identify basic nursing care of the patient on a respirator. A. Types
B. Purposes
C. Nursing Care

Written: 09/90
Reviewed: 09/93; 07/99; 07/04; 01/05; 01/07; 01/11; 01/15
Revised: 07/95; 07/97; 01/01; 01/03; 01/09; 01/13

25
Unit: Medical Surgical Nursing Implementation: Linton Ch. 30 & 31, pp. 480-519; Lecture/Class Discussion;
Disorders of the Respiratory System Quizzing
Lesson: 5 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Pharmacology Integrated: Pharmacology 2.5 Hours
Time: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Methods of Administrations III. Adrenocorticosteroids
A. Oral 1. Action
1. List the four main methods of which drugs used in treatment of B. IV 2. Examples
respiratory diseases may be administered. C. IM 3. Side effects
2. State the purpose of giving drugs in inhalation therapy and list D. Subcutaneous
three methods by which it may be carried out. E. Inhalation Therapy
3. Explain the purpose of antipyretic drugs and give two examples. II. Drugs Acting on Respiratory System
4. List the two types of cough medications and explain their actions A. Antipyretics
and give examples of each. 1. Purpose
5. State the purpose of antihistamines and decongestants and give 2. Examples
examples of each. B. Cough Medications
6. Explain the action of bronchodilators and give examples of most 1. Expectorant
common ones used. a. Action
7. Indicate action of antispasmodics and bronchodilators. b. Examples
8. list side effects of antispasmodics and bronchodilators 2. Suppressant (Sedative)
9. List common antibiotics used in treating respiratory diseases. a. Action
10. State the action of adrenocorticosteroids and give examples of b. Examples
common ones used in treating respiratory disease. C. Mucolytic
11. Identify side effects of the patient on adrenocorticosteroids. 1. Action
2. Examples
D. Antihistamines
E. Decongestants
F. Bronchodilators
1. Action
2. Examples
G. Antispasmodics and Bronchodilators
1. Action
2. Examples
Written: 09/90
H. Antibiotics
Reviewed: 09/93; 07/99; 01/03; 07/04; 01/11; 01/15
Revised: 07/95; 07/97; 01/01; 01/05; 01/07; 01/09; 01/13

26
Unit: Medical Surgical Nursing Implementation: Linton Ch. 30; Study Guide Unit 7; Lecture/Class Discussion;
Disorders of the Respiratory System Handouts
Lesson: 6 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Acute Respiratory Disorders Integrated: N/A
Time: Theory 3 Hours

OBJECTIVES PLAN OF LESSON VI. Pleurisy


A. Pathophysiology/ S & S
Upon completion of this unit, the student will be able to: I. Nursing Assessment of Respiratory B. Complications
System & Age-Related Changes in C. Diagnostic Measures
1. Identify data to be collected in the nursing assessment of the System D. Medical Treatment
patient with a respiratory disorder. II. Acute Viral Rhinitis E. Nursing Management
2. Identify the nursing implications of age-related changes in the A. Pathophysiology/ S & S VII. Pneumothorax
respiratory system. B. Complications A. Pathophysiology/ S & S
3. Describe the pathophysiology, signs and symptoms, complications, C. Diagnostic Measures B. Complications
diagnostic measures, and medical treatment for acute viral rhinitis. D. Medical Treatment C. Diagnostic Measures
4. Describe the pathophysiology, signs and symptoms, complications, E. Nursing Management D. Medical Treatment
diagnostic measures, and medical treatment for acute bronchitis. III. Acute Bronchitis E. Nursing Management
5. Describe the pathophysiology, signs and symptoms, complications, A. Pathophysiology/ S & S VIII. Hemothorax and Fractured Ribs
diagnostic measures, and medical treatment for influenza. B. Complications A. Pathophysiology/ S & S
6. Describe the pathophysiology, signs and symptoms, complications, C. Diagnostic Measures B. Complications
diagnostic measures, and medical treatment for pneumonia. D. Medical Treatment C. Diagnostic Measures
7. Describe the pathophysiology, signs and symptoms, complications, E. Nursing Management D. Medical Treatment
diagnostic measures, and medical treatment for pleurisy. IV. Influenza E. Nursing Management
8. Describe the pathophysiology, signs and symptoms, complications, A. Pathophysiology/ S & S IX. Pulmonary Embolus
diagnostic measures, and medical treatment for pneumothorax, B. Complications A. Pathophysiology/ S & S
hemothorax, and rib fractures/ C. Diagnostic Measures B. Complications
9. Describe the pathophysiology, signs and symptoms, complications, D. Medical Treatment C. Diagnostic Measures
diagnostic measures, and medical treatment for pulmonary E. Nursing Management D. Medical Treatment
embolus. V. Pneumonia E. Nursing Management
10. Assist in developing a nursing care plan for the patient who has an A. Pathophysiology/ S & S XI. Acute Respiratory Distress Syndrome
acute respiratory disorder. B. Complications A. Pathophysiology/ S & S
11. Describe the pathophysiology, signs and symptoms, complications, C. Diagnostic Measures B. Complications
diagnostic measures, and medical treatment for acute respiratory D. Medical Treatment C. Diagnostic Measures
distress syndrome (ARDS). E. Nursing Management D. Medical Treatment
E. Nursing Management
Written: 01/03
Reviewed: 01/11; 01/15
Revised: 07/04; 01/05; 01/07; 01/09; 01/13

27
Unit: Medical Surgical Nursing Implementation: Linton Ch. 31; Study Guide Unit 7; Clayton & Stock Ch. 31;
Disorders of the Respiratory System Lecture/Class Discussion; Transparencies; Quizzing; Video: TB or Not
Lesson: 7 TB. (1998). American Journal of Nursing. Run time 30 min
Title: Chronic Respiratory Disorders Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Time: Theory 3 Hours Integrated: Pharmacology 0.5 hours

OBJECTIVES PLAN OF LESSON E. Medical Treatment


F. Nursing Management
Upon completion of this unit, the student will be able to: I. COPD Types VII. Tuberculosis
II. Relationship of Cigarette Smoking to A. Pathophysiology
1. Identify examples of chronic inflammatory, obstructive, and Disease B. Signs & Symptoms
restrictive pulmonary diseases. III. Asthma C. Complications
2. Explain the relationship between cigarette smoking and chronic A. Pathophysiology D. Diagnotic Measures
respiratory disorders B. Signs & Symptoms E. Medical Treatment
3. Describe the pathophysiology, signs and symptoms, complications, C. Complications F. Nursing Management
diagnostic measures, and medical treatment for asthma. D. Diagnotic Measures VIII. Interstitial Lung Disease
4. Describe the pathophysiology, signs and symptoms, complications, E. Medical Treatment A. Pathophysiology
diagnostic measures, and medical treatment for chronic bronchitis. F. Nursing Management B. Signs & Symptoms
5. Describe the pathophysiology, signs and symptoms, complications, IV. Chronic Bronchitis C. Complications
diagnostic measures, and medical treatment for emphysema. A. Pathophysiology D. Diagnotic Measures
6. Describe the pathophysiology, signs and symptoms, complications, B. Signs & Symptom E. Medical Treatment
diagnostic measures, and medical treatment for bronchiectasis. C. Complications F. Nursing Management
7. Describe the pathophysiology, signs and symptoms, complications, D. Diagnotic Measures IX. Occupational Lung Disease
diagnostic measures, and medical treatment for tuberculosis. E. Medical Treatment A. Pathophysiology
8. Describe the pathophysiology, signs and symptoms, complications, F. Nursing Management B. Signs & Symptoms
diagnostic measures, and medical treatment for interstitial lung V. Emphysema C. Complications
disease. A. Pathophysiology D. Diagnotic Measures
9. Describe the pathophysiology, signs and symptoms, complications, B. Signs & Symptoms E. Medical Treatment
diagnostic measures, and medical treatment for occupational lung C. Complications F. Nursing Management
disease. D. Diagnotic Measures X. Lung Cancer
10. Describe the pathophysiology, signs and symptoms, complications, E. Medical Treatment A. Pathophysiology
diagnostic measures, and medical treatment for lung cancer. F. Nursing Management B. Signs & Symptoms
VI. Bronchiectasis C. Complications
A. Pathophysiology D. Diagnotic Measures
B. Signs & Symptoms E. Medical Treatment
C. Complications F. Nursing Management
Written: 09/90 D. Diagnotic Measures
Reviewed: 09/93; 07/99; 01/05; 01/11; 01/15
Revised: 07/95; 07/97; 01/01; 01/03; 07/04; 01/07; 01/09; 01/13

28
Unit: Medical Surgical Nursing Implementation: Linton Ch. 31; Lecture/Class Discussion; Quizzing; Video: Chest
Disorders of the Respiratory System Drainage. (1991). Springhouse Corp. Run time 30 min
Lesson: 8 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Intrathoracic Surgery Integrated: N/A
Time: Theory 1.5 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Pre-Operative Care for Intrathoracic Surgery
II. Post-Operative Care for Intrathoracic Surgery
1. Identify pre-operative care for the patient having chest surgery. III. Care of the Patient with Chest Tubes and Closed chest Drainage
2. Identify post-operative care for the patient who has had chest surgery. A. Types and Purposes
3. State symptoms which could indicate post-operative complications. B. Special Aspects of Caring for a Closed Drainage System
4. Identify types of closed drainage and its purpose. C. Caring for a Patient with Closed Chest Drainage
5. Identify special aspects of caring for a closed drainage system.
6. Identify special aspects of caring for a patient with a closed drainage system and
signs of respiratory distress.

Written: 09/90
Reviewed: 09/93; 07/99; 01/05; 01/09; 01/11; 01/15
Revised: 07/95; 07/97; 01/01; 01/03; 07/04; 01/07; 01/13

29
Unit: Medical Surgical Nursing Implementation: Linton (2012) Chapter 32
Lesson: 1 Lecture/Class Discussion; Transparencies; Quizzing; Charts; Games;
Title: Assessment of the Hematologic System Anatomical Model
Tome: Theory 1.5 Evaluation: Application in Patient Care, Written Test, Class Participation
Integrated: Anatomy 0.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I . Review of Anatomy
II. Physiologic Functions
1. Define blood dyscrasia. A. Oxygenation
2. Identify different types of pathologies in blood disorders and B. Hemostasis
similar problems in nursing management. III. Age Related Changes
IV. Nursing Assessment
3. List normal values for blood constituents. A. Health History
4. Define terms describing size, shape and color of blood cells. B. Physical Examination
5. Define hemoglobin and hematocrit and list normal values and V. Diagnostic Tests
interpretations of abnormal values. A. CBC
6. Define sternal puncture, explain the procedure and diagnosis made a. RBC
form this procedure. b. WBC
7. List, discuss the nurse’s function and psychological aspects related c. Platelet
to sternal puncture. d. Hemoglobin
8. Define capillary fragility test, explain the procedure and diagnosis e. Hematocrit
made from this procedure. B. Terminology
a. Normocytic
9. List, discuss that lab studies may indicate blood disorders or other
b. Microcytic
illnesses.
c. Macrocytic
10. Discuss the nurse’s role in diagnostic procedure. d. Hypochromic
e. Hyperchromic
C. Bone Marrow Biopsy
a. Nurse’s Function
VI. Therapeutic Measures
A. Transfusions
a. Packed Red Blood
Cells
b. Platlets
Written: 09/90 c. Fresh Frozen Plasma
Reviewed: 09/93, 08/00, 08/02, 08/06; 08/08; 08/14
Revised: 07/95, 08/96, 08/00, 07/04; 3/10;8/12 d. Reactions

30
Unit: Medical Surgical Nursing Implementation: Linton (2012) Chapter 32; Pharmacology
Insults to Cardiovascular Integrity Text; Lecture/Class Discussion
Lesson: 2 Evaluation: Written Test, Class Participation
Title: Hematologic Problems Integrated: Pharmacology 0.5 Hours and Nutrition 0.5 Hours
Time: Theory 3 Hours

OBJECTIVES PLAN OF LESSON E. Pernicious Anemia


a. Cause
Upon completion of this unit, the student will be able to: I.Anemia b. Signs/Symptoms
A. Definition c. Treatment
1. Define anemia and list normal counts, variation. B. Normal Counts and Variations F. Sickle Cell Anemia
2. List categories of anemia according to cause. C. Causes of Anemia a. Cause
3. List the symptoms of anemia. a. Sudden Blood Loss b. Treatment
4. List and discuss importance of diet in preventing and treating b. Chronic Blood Loss c. Signs/Symptoms
anemia. c. Nutritional III. Coagulation Disorders
5. Discuss iron supplements and related patient education. d. Hemolytic A. Thrombocytopenia
6. List dietary considerations to avoid anemia. e. Inadequate Productions B. Disseminated Intravascular
7. Define pernicious anemia and intrinsic factor. D. Symptoms of Anemia Coagulation
8. Define cyanocobalamin, list sources, patient education and method a. Fatigue C. Hemophilia
of administering. b. Anorexia
9. Discuss diagnosis of pernicious anemia. c. Faintness
10. Discuss treatment of pernicious anemia. d. Pallor
11. List other considerations and complications of pernicious anemia. II. Types of Anemia
12. Identify reasons for immunosuppression and need for protection. A. Polycythemia Vera
13. Discuss the need for patient education. a. Cause
14. List and discuss, identify anemia due to acute or chronic blood b. Signs/Symptoms
loss. c. Treatment
15. List causes, treatment, and management of anemia due to blood B. Aplastic Anemia
loss. a. Cause
16. List causes, symptoms, occurrence and treatment of hemolytic b. Signs/Symptoms
anemia, sickle-cell anemia, acquired hemolytic anemia, and c. Treatment
thalassemia. C. Autoimmune Hemolytic Anemia
a. Cause
b. Signs/Symptoms
c. Treatment
D. Iron Deficiency Anemia
Written: 09/90 a. Cause
Reviewed: 09/93, 08/98, 08/02, 08/06; 08/08; 08/14
b. Signs/Symptoms
Revised: 07/95, 08/96, 08/00, 07/04; 3/10; 8/12
c. Treatment

31
Unit: Medical Surgical Nursing Implementation: Linton (2012) Chapter 32; Pharmacology
Insults to Cardiovascular Integrity Text; Lecture/Class Discussion
Lesson: 2 Evaluation: Written Test, Class Participation
Title: Hematologic Problems Integrated: Pharmacology 0.5 Hours and Nutrition 0.5 Hours
Time: Theory 3 Hours (Continued)

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit, the student will be able to:
I. Anemia Due to Blood Loss
17. Define aplastic anemia. A. Blood Contains Plasma and Cells II. Thalassemia
18. Discuss and list causes, symptoms, treatment, and nursing 1. Normal Volume 4-6 qts. (L) A. Hereditary
management of aplastic anemia. 2. Kept Relatively Content B. Cooley’s anemia
19. List, discuss assessment and nursing management or leukemia B. Hypovolemia C. Occur in Person’s of
patient. 1. Acute Mediterranean Descent
20. List facts and techniques of physical care for the leukemia patient. 2. Due to Sudden Severe Bleeding D. Symptomatic Treatment
21. Discuss nursing management of the final illness. a. Trauma
22. Define and discuss, list symptoms of thrombocytopenia. b. Surgery
23. Discuss assessment and management of leukemia. c. Childbirth
24. Define and discuss hereditary factors, symptoms, life expectancy C. Chronic
and treatment of hemophilia. 1. Gastric or Peptic Ulcer
25. Define and discuss symptoms, treatment, and nursing management 2. Tumors in Bowel, Uterus
of polycythemia vera. 3. Hemorrhoids
26. Define, list symptoms, treatment, and nursing management of D. Treatment
agranulocytosis, multiple meloma, lymphosarcoma, Hodgkin’s 1. Iron Administration
Disease and infectious mononucleosis. 2. Transfusions
27. Discuss blood transfusions and transplants listing blood types, 3. Observations
blood elements, bone marrow transplants, and nursing E. Need for Continued Treatment
responsibilities. F. Symptoms of Fatigue and Weakness
May Persist After Crisis Passes

Written: 09/90
Reviewed: 09/93, 08/00, 08/02, 08/06; 08/08; 08/14
Revised: 07/95, 08/96, 08/00, 07/04; 3/10; 8/12

32
Unit: Medical Surgical Nursing Implementation: Linton (2012) Chapter 33; Pharmacology
Insults to Cardiovascular Integrity Text; Lecture/Class Discussion
Lesson: 2 Evaluation: Written Test, Class Participation
Title: Hematologic Problems Integrated: Pharmacology 0.5 Hours and Nutrition 0.5 Hours
Time: Theory 3 Hours (Continued)

PLAN OF LESSON
V. Hodgkin’s Disease
II. Leukemia A. Definition
A. Cause B. Symptoms
B. Signs/Symptoms C. Treatment and Nursing Management
C. Diagnosis VI. Non-Hodgkin’s Disease
D. Treatment A. Types
E. Management B. Symptoms
1. Remissions C. Treatment and Nursing Management
2. Exacerbations XV. Transfusions and Transplants
3. Continuance of Life A. Blood Types
F. Nursing Care as it Relates to: B. Nursing Responsibilities
1. Bleeding C. Blood Elements
2. Fever D. Bone Marrow Transplant
3. Skin Care
4. Mouth Care
5. Infection
6. Drug Toxicity
7. Blood Transfusions
G. Final Illness
1. Emotional Support
2. Spiritual Care
III. Agranulocytosis
A. Toxic Effects of Drugs
B. Symptoms
C. Prognosis
D. Treatment
IV. Multiple Myeloma
A. Onset and Symptoms
B. Treatment and Management
Written: 09/90
Reviewed: 09/93, 08/00, 08/02, 08/06 08/08; 08/14
Revised: 07/95, 08/96, 08/00, 07/04; 3/10; 8/12

33
Unit: Medical Surgical Nursing Implementation: Linton (2012) Chapter 35;
Insults to Cardiovascular Integrity Memmler Ch. 14; Lecture/Class Discussion
Lesson: 3 Anatomical Model; Transparencies; Charts; Quizzing; Games
Title: The Patient with Heart Disease: Evaluation: Written Test, Class Participation
Anatomy and Diagnostic Tests Integrated: Anatomy 0.5 Hours and Geriatrics 1 Hour
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Introduction V. Therapeutic Measures
A. Emotional Reaction A. Drug Therapy
1. Discuss the emotional reactions and fears of the cardiac patient. B. Fears B. Diet Therapy
2. Discuss incidence of cardiac disease. II. Incidence C. Oxygen Therapy
3. List and describe cardiac anatomy, cardiac cycle, and electrical III. Anatomy D. Pacemakers
system. A. Four Chambered Organ E. Cardioversion
4. Discuss, describe diagnostic procedure, complications and nursing 1. Atria (Auricles) F. CPR
management related to cardiac diagnostic procedures. 2. Ventricles G. Cardiac Surgery
5. Describe gerontologic changes of the cardiovascular system. B. Vessels
1. Entering vessels
a. Veins – Vena Cava
b. Pulmonary Vein
C. Valves
D. Layers of Tissue
E. Electrical System
IV. Age Related Changes
V. Nursing Assessment
A. Health History
B. Physical Examination
VI. Diagnostic Studies
A. Laboratory Tests
B. Radiologic Tests
C. Electrocardiogram
D. Echocardiogram
1. Transesophageal
E. X-Rays, Tests, Fluoroscopy
F. Cardiac Catheterization
Written: 09/90 G. Angiograms
Reviewed: 09/93, 08/98, 08/02, 08/04; 08/14
H. Possibility of Allergic Reactions
Revised: 07/95, 08/96, 08/00, 08/06; 08/08; 3/10; 8/12

34
Unit: Medical Surgical Nursing Implementation: Linton (2012)
Insults to Cardiovascular Integrity
Lesson: 4 Lecture/Class Discussion; Anatomical Model; Transparencies;
Title: The Patient with Congestive Heart Disease Charts; Quizzing
Time: Theory 2 Hour Evaluation: Written Test, Class Participation
Integrated: Pharmacology 0.5 Hour and Nutrition 0.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Heart Failure 6. Dietary Measures
A. Compensated 7. Activity
1. Define, list and discuss facts concerning heart failure and its B. Decompensated VI. Patient Education
causes. C. Causes A. Determine Patient Knowledge
2. List, discuss symptoms, diagnosis, and treatment of hearth failure. D. Arteriolosclerosis B. Supplement
3. List and discuss assessment and nursing management of the patient E. Atherosclerosis C. Verify Understanding
with congestive heart failure including history, physical F. Right-Sided and Left-Sided Heart VII. Diet and Drug Therapy
assessment, and nursing measures. Failures A. Sodium restricted
4. Discuss patient education related to congestive hearth failure. II. Symptoms of Heart Failure B. Dietary Potassium
5. Discuss and list facts regarding dietary measures for the patient A. Fatigue C. Drug Therapy
with congestive heart failure. B. Dyspnea D. Digitalis
6. Discuss and list facts regarding drug therapy for congestive heart C. Edema E. Diuretics
failure. III. Diagnosis VIII. Acute Pulmonary Edema
7. List and describe symptoms, treatment (including rotating IV. Treatment A. Symptoms
tourniquets) for acute pulmonary edema. A. Rest B. Treatment
B. Low-Sodium Diet
C. Digitalis
D. Diuretics
E. Oxygen
V. Assessment and Management of the
Patient with Congestive Heart Failure
A. History
B. Physical Assessment
C. Ongoing Assessment
D. Nursing Management
1. Positioning
2. Skin Care
3. Careful I&O
Written: 09/90 4. Note Edema
Reviewed: 09/93, 08/98, 08/02, 08/06; 08/14
5. Drug Therapy
Revised: 07/95, 08/96, 08/00, 07/04; 08/08; 03/10; 8/12

35
Unit: Medical Surgical Nursing Implementation: Linton (2012)
Insults to Cardiovascular Integrity
Lesson: 5 Lecture/Class Discussion; Anatomical Model; Transparencies;
Title: The Patient with Inflammatory or Valvular Charts; Quizzing; Games
Disease of the Heart Evaluation: Written Test, Class Participation
Time: Theory 1 Hour Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Rheumatic Fever V. Pericarditis
A. Definition A. Symptoms
1. Define and discuss rheumatic fever, its cause, treatment, nursing B. Cause B. Treatment
management and prevention. C. Treatment and Prevention C. Nursing Management
2. Define and discuss facts concerning Valvular hear disease, its D. Nursing Management V. Acute Pericarditis
symptoms, treatment and nursing management. D. Prevention A. Symptoms
3. Define and discuss facts concerning ednocarditis, myocarditis, II. Valvular Heart Disease B. Treatment
pericarditis, and chronic constrictive carditis and list symptoms, A. Endocarditis C. Nursing Management
treatment, and nursing management. B. Mitral Stenosis VI. Chronic Constrictive Pericarditis
1. Symptoms A. Treatment
2. Treatment B. Nursing Management
C. Aortic Stenosis C. Complication
D. Aortic Insufficiency
III. Bacterial Endocarditis
A. Incidence
B. Etiology and Pathology
C. Signs and Symptoms
D. Diagnosis
E. Treatment and Nursing Management
1. Large Doses of Antibiotics – IV
2. Supportive Care
3. Close Observation
4. Activity
F. Prevention
IV. Myocarditis
A. Symptoms
B. Treatment
C. Nursing Management
Written: 09/90
Reviewed: 09/93, 08/00, 08/02, 08/06; 08/14
Revised: 07/95, 08/96, 08/00, 07/04; 08/08; 3/10; 8/12

36
Unit: Medical Surgical Nursing Implementation: Linton (2012)
Insults to Cardiovascular Integrity Lecture/Class Discussion; Anatomical Model;
Lesson: 6 Transparencies; Charts; Quizzing; Handouts
Title: The Patient with Cardiovascular Disease, Coronary Evaluation: Written Test, Class Participation
Artery Disease, Functional Heart Disease, or Integrated: Nutrition 0.5 Hours
Hypertension
Time: Theory 2 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Coronary Artery Disease 4. Other Causes
A. Coronary Artery Structure IV. Primary (Essential) Hypertension
1. Describe pathology of coronary artery disease, define B. Coronary Occlusion A. Malignant Hypertension
arteriosclerosis and atherosclerosis. 1. Arteriosclerosis B. Symptoms
2. Define and discuss collateral circulation. 2. Atherosclerosis C. Etiology
3. Define and discuss epidemiology and risk factors related to C. Collateral Circulation D. Incidence
coronary artery disease. D. Epidemiology E. Prevention
4. Describe, discuss, and list terms related to pathophysiology of E. Risk Factors F. Treatment
coronary artery disease. F. Pathophysiology G. Drugs
5. Describe, list, and discuss facts related to myocardial ischemia 1. Myocardial ischemia V. Assessment and Management of the
including characteristics, treatment, and daily activities. 2. Coronary Occlusions Patient with Hypertension
6. Describe, list, and discuss facts related to hypertension, its 3. Myocardial Infraction A. Assessment
categories, symptoms, assessment, and management. 4. Coronary Insufficiency B. Management
7. Discuss drug therapy for hypertension including drug names, II. Hypertension 1. Drug Therapy
dosages, actions, and nursing actions. A. Definition 2. Patient Education
8. Describe facts and considerations concerning rehabilitation and B. Arterial Blood Pressure VI. Secondary Hypertension
nursing implications with the patient who has hypertension. C. Diastolic Blood Pressure VII. Rehabilitation of Patients
9. List the nutritional and pharmacologic considerations D. Pulse Pressure A. Exercise
E. Physiologic Control Arterial Pressure B. Avoiding Obesity
1. Normal Fluctuations C. Minimize Emotional Stress
III. Hypertensive Disease D. Employment
A. Hypertensive Heart Disease VIII. Nursing Implications
B. Hypertensive Vascular Disease IX. General Nutritional Considerations
C. Hypertensive Cardiovascular Disease X. General Pharmacologic Considerations
D. Primary Hypertension
E. Secondary Hypertension
1. Pheochromocytoma
Written: 09/90 2. Toxemia of Pregnancy
Reviewed: 09/93, 08/00, 08/02, 08/06; 08/14
3. Kidney Disease
Revised: 07/95, 08/96, 08/00, 07/04; 08/08; 03/10; 8/12

37
Unit: Medical Surgical Nursing Implementation: Linton (2012)
Insults to Cardiovascular Integrity Lecture/Class Discussion; Transparencies;
Lesson: 7 Quizzing; Game
Title: The Patient with Vascular Disorder Evaluation: Written Test, Class Participation
Time: Theory 2 Hours Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Introduction C. Initial Treatment
A. Definition of Peripheral Vascular D. Surgery
1. Define peripheral vascular disease. Disease E. Assessment Nursing and Management
2. Discuss, list and define anatomic structures of the vessels. B. Anatomy Review VII. Pulmonary Embolism
3. Define, list symptoms and treatments for ischemia. 1. Arteries A. Definition
4. Define arteriosclerosis, atherosclerosis and give symptoms, 2. Veins B. Symptoms
treatment and nursing management. 3. Arterioles C. Treatment, Assessment, and
5. Define, list symptoms, treatment and nursing management of 4. Venule Management
Raynaud’s disease and Buerger’s disease. 5. Capillaries VIII. Lymphedema
6. Define, list causative factors, symptoms, treatment and nursing II. Ischemia A. Definition of Lymphatic and
management of varicose veins and leg ulcers. A. Definition Lymphedema
7. Define, list symptoms, treatment, and nursing management of B. Symptoms B. Symptoms
thrombosis and embolism. C. Measures to Increase Blood Supply C. Treatment and Management
8. Define pulmonary embolism, list symptoms, treatment, and III. Arteriosclerosis and Atherosclerosis IX. Aneurysms
nursing management. A. Definition A. Definition
9. Define lymphedema, list symptoms, treatment, and nursing B. Symptoms B. Symptoms
management. C. Treatment and Management C. Treatment
10. Define, list symptoms, and treatment of aneurysms. IV. Raynaud’s Disease 1. Surgical Repair
A. Definition-Incidents 2. Heart-Lung Repair
B. Symptoms
C. Treatment and Management
V. Varicose Veins
A. Definition-Incidence
B. Causative Factors
C. Symptoms
D. Treatment and Management
E. Leg Ulcers
F. Treatment of Leg Ulcers
VI. Thrombosis and Embolism
Written: 09/90 A. Definitions
Reviewed: 09/93, 08/00, 08/02, 08/06; 08/14
B. Symptoms
Revised: 07/95, 08/96, 08/00, 07/04; 08/08; 03/10; 8/12

38
Unit: Medical Surgical Nursing Implementation: Linton (2012)
Insults to Cardiovascular Integrity
Lesson: 8 Lecture/Class Discussion; Transparencies; Quizzing; Game; Handouts;
Title: The Patient with Heart Disease, Cardiac Dysrhythmias Recertification
Time: Theory 2 Hours Evaluation: Written Test, Class Participation
Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Cardiac Rhythmicity and Its Regulation C. Circulation, Cardiac Compression
A. Depolarization IV. Pharmacologic Considerations
1. List, define, and discuss cardiac rhythmicity. B. Repolarization
2. List cardiac arrhythmias and explain normal sinus rhythm. C. Refractory
3. Recognize the designations of a normal EKG tracing II. Cardiac Arrhythmias
4. Define and discuss PVC’s. A. Monitoring
5. Discuss, list facts about treatment of cardiac arrhythmias. B. Arrhythmias electrocardiography
6. Define, discuss facts concerning temporary and permanent C. Normal Sinus Rhythm
pacemakers and related nursing management. D. Sinus Bradycardia
7. Discuss discharge planning and patient education. E. Sinus Tachycardia
8. Complete CPR training and testing. F. Atrial Fibrillation
9. Be familiar with and be able to list the pharmacologic G. Complete Heart Block
considerations. H. Premature Ventricular Contractions
(PVC’s)
I. Treatment of Cardiac Arrhythmias
J. Drug Therapy
K. Electrical Therapy
L. Cardioversion
M. Defibrillation
N. The Patient with a Pacemaker
O. Nursing Management of the Patient
P. The Temporary External Pacemaker
1. Nursing Management
2. Troubleshooting
Q. The Permanent (Internal)
R. Post implantation Care
S. Discharge Planning
III. Cardiac Arrest
Written: 09/90 A. Airway
Reviewed: 09/93, 08/98, 08/02, 08/06; 08/14
B. Breathing
Revised: 07/95, 08/96, 08/00; 08/08; 03/10; 8/12

39
Unit: Medical Surgical Nursing Implementation: Linton (2012)
Insults to Cardiovascular Integrity Lecture/Class Discussion;
Lesson: 9 Transparencies; Quizzing; Handouts
Title: The Patient with Acute Myocardial Infarction Evaluation: Written Test, Class Participation
Time: Theory 2 Hours Integrated: N/A

OBJECTIVES PLAN OF LESSON B. Anterior Wall


C. Anteroseptal Infarction
Upon completion of this unit, the student will be able I. Definition of Myocardial Infarction VI. Objectives of Care
to: II. Symptoms of Myocardial Infarction A. Rest and Activity
III. Coronary Care Unit B. Hazards of Bed Rest
1. Define and list symptoms and incidence of A. Admissions C. Sedation
myocardial infarction. B. Assessment D. Ongoing Assessments
2. Discuss, list nursing measures of admission, C. Nursing Management E. Environmental and Emotional Support
assessment, and general management in the 1. Activity VII. Treatment of Complications
coronary care unit. 2. Oxygen Therapy A. Arrhythmias
3. Discuss and list facts and nursing measures 3. Relieving Pain
related to diagnosis of myocardial infarction. 4. Assessment
4. Discuss objectives of nursing care for the patient 5. Placing Electrodes B. Venous Thrombosis
following a myocardial infarction. 6. Intravenous Therapy C. Pulmonary Embolism
5. Discuss, list complications of MI and their 7. Diet D. Arterial Embolism
treatment. 8. Spiritual Care E. Congestive Heart Failure
6. Discuss nursing management in transfer of IV. Diagnosis F. Cardiogenic Shock
patients from CCU and rehabilitation. A. Physical Examination G. Other Complications
7. Be familiar with and be able to list the general B. Electrocardiogram VIII. Preparation for Transfer
nutritional and pharmacologic considerations. C. Laboratory Studies IX. Later Management and Rehabilitation
D. Temperature X. General Nutritional Considerations
Written: 09/90 V. Pathology XI. General Pharmacology Considerations
Reviewed: 09/93, 08/98, 08/02, 08/06; 08/14
A. Posterior Wall Infarction
Revised: 07/95, 08/96, 08/00, 07/04; 08/08; 03/10; 8/12

40
Unit: Medical Surgical Nursing Implementation: Linton, Lecture, Discussion, Demonstration, Handout
Emergency Nursing Evaluation: Written Test, Class Participation
Lesson: 1 Integrated: Pharmacology 1 Hour
Title: Crash Cart
Time: Theory 1 hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Structure of Crash Cart
A. Emergency Meds
1. Describe the structure of the crash cart. B. Indications for Use
2. Know the location of each emergency medication. C. Side Effects
3. Describe the indications of each of the emergency drugs. II. Respiratory and Cardiac Equipment
4. Explain the side effects of each emergency drug. A. Locations
5. Understand the use of respiratory and cardiac equipment. B. Purpose and Use
6. Know the location of all I.V. equipment. III. I.V. Equipment
7. Identify and state the purpose of each item needed to start an I.V. A. Location
8. Locate all miscellaneous items and name all miscellaneous items B. Identification
necessary for use of the crash cart. C. Use of
9. State clinical site protocol for checking equipment and drugs. IV. Miscellaneous

Written: 09/90
Reviewed: 09/93; 08/98; 08/02; 07/04, 08/06; 08/14
Revised: 07/95; 08/96; 08/00; 03/10; 8/12

41
Unit: Medical Surgical Nursing Implementation: Linton, Lecture, Discussion, Transparencies, Charts, Handout:
Emergency Nursing Controlling Bleeding, Demonstration, Foundations
Lesson: 2
Title: Dealing with Hemorrhage Evaluation: Written Test, Class Participation, Return Demonstration
Time: Theory 1 hour Integrated: N/A

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit the student will:
I. External Bleeding
1. Describe and demonstrate the proper technique to control bleeding per direct A. Direct Pressure
pressure and state rationale for actions. 1. Hand
2. Demonstrate three methods of applying direct pressure. 2. Splint
3. Locate all pressure points. 3. Bandage
4. List the symptoms and signs of internal bleeding. B. Pressure Points
5. Describe the symptoms of internal bleeding in the thoracic cavity. II. Internal Bleeding
6. List symptoms of internal bleeding into the abdominal cavity. A. Definition
7. List the symptoms of internal bleeding into the pelvic cavity. B. Affects on Vital Signs
8. Review the signs and symptoms of hypovolemic shock. C. Signs and Symptoms
9. Review the physiological changes that occur with hypovolemic shock. 1. Thorax
a. Causes
2. Abdomen
a. Causes
3. Pelvis
a. Causes
III. Hypovolemic Shock
A. Definition
B. Signs and Symptoms
C. Causes
Written: 09/90 D. Physiological Changes
Reviewed: 09/93; 08/98; 08/02; 07/04; 08/14
Revised: 07/95; 08/96; 08/00, 08/06; 03/10; 8/12

42
Unit: Medical Surgical Nursing-Disorders of the Nervous System Implementation: Linton (2012)
Lesson: 1 Lecture/Discussion, Transparencies, Quizzing
Title: Introductory to Neurological Disorders, Anatomy of the Evaluation: Written Test, Application in Patient Care
Nervous System Integrated: Geriatrics 1 hour
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Central Nervous System
A. Location
1. Describe structural units and functions of CNS B. Functions
and PNS. C. Parts
2. Describe structural units and function of autonomic II. Peripheral Nervous System
nervous system. A. Location
3. Describe passage of impulses through neurons and B. Functions
neural pathways. C. Parts
4. Identify different levels of consciousness. III. Autonomic Nervous System
5. Describe the normal age-related changes in the A. Location
neurological system and differences in assessment B. Functions
findings. C. Parts
6. Discuss and list reasons for neurological IV. Physiology of Nervous System
examination by MD. A. Neural Conduction
7. Describe and discuss the significance of a B. Excitability and Conductivity
neurological checks/assessment. C. Oxygen Requirements
8. List signs and symptoms of increased V. Assessment of Levels of Consciousness
intracranial pressure. VI. Normal Age-Related Changes
A. Memory
B. Vision
C. Hearing
D. Taste
E. Smell
F. Position Sense
G. Muscle Strength
H. Reaction Time
VII. Neurological Exam
A. Physical Preparation
B. Nurse’s Role
C. Glasgow Coma Scale
Written: 09/90
Reviewed: 09/93, 07/97, 07/99; 07/06; 03/11; 07/14
Revised: 07/95, 07/01, 07/03, 07/04; 07/07; 07/08; 10/10; 8/12

1
Unit: Medical Surgical Nursing-Disorders of the Nervous System Implementation: Linton (2012); Lecture/Discussion,
Lesson: 2 Transparencies, Handout, Quizzing
Title: Neurological Examination and Diagnostic Evaluation Evaluation: Written Test, Application in Patient Care
Time: 1 Hour Integrated: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Diagnostic Evaluation


A. Lumbar Puncture
1. Discuss and list six purposes of lumbar puncture. 1. Six Purposes
2. Discuss sequelae and nursing care of patient 2. Management
undergoing lumbar puncture. B. Contrast Studies; Preparation and
3. Discuss the preparation for contrast studies. Management After
4. Discuss management of patient after contrast 1. Cerebral Angiography
studies. 2. Ventriculography
5. Describe, discuss, and list the purposes of 3. Pneumoencephalography
E.E.G. 4. Myelography
6. Describe, discuss, and list the purposes of brain C. Other Diagnostic Studies
scan. 1. E.E.G
2. Brain Scan
3. C.T. Scan
4. MRI
5. Electromygraphy

Written: 09/90
Reviewed: 09/93, 07/97, 07/99; 07/06; 03/11; 07/14
Revised: 07/95, 07/01, 07/03, 07/04; 07/07; 07/08; 10/10; 8/12

2
Unit: Medical Surgical Nursing-Disorders of the Nervous System Implementation: Linton (2012) ; Lecture/Discussion
Lesson: 3 Transparencies, Case Studies, Quizzing
Title: Specific Neurological Problems and Their Implications Evaluation: Written Test, Application in Patient Care
for Nursing Integrated: Pharmacology 0.5 Hour
Time: Theory 2.5 Hours

OBJECTIVES PLAN OF LESSON


IX. Multiple Sclerosis
Upon completion of this unit the student will: I. Alzheimer’s A. Incidence
II. IICP B. Cause
1. Define and list causes, medical treatment of A. Signs and symptoms C. Symptoms
Alzheimer’s Disease and the nursing care B. Management D. Treatment
required by a patient with Alzheimer’s Disease. III. Epilepsy E. Prognosis
2. List the signs and symptoms and medical treatment for IICP. A. Cause F. Emotional Response
3. Define and list causes and types, medical treatment of B. Treatment G. Complications
seizures and the nursing care required by a C. Nursing Care X. Amyotrophic Lateral Sclerosis (ALS)
patient with seizures. D. Common Medications A. Cause
4. Describe management of a patient during and after IV. Headaches B. Treatment
a grand mal seizure. A. Cause C. Nursing Care
5. Define and list causes, medical treatment of headaches B. Treatment XI. Huntington’s Disease
and migraine headaches and the nursing care required by C. Nursing Care A. Cause
a patient with headaches and migraine headaches. V. Meningitis XII. Myasthenia Gravis
6. Define and list causes, medical treatment of A. Cause A. Cause
meningitis and the nursing care required by a patient B. Treatment B. Treatment
with meningitis. C. Nursing Care C. Nursing Care
7. Define and list causes, medical treatment of VI. Encephalitis XIII. Trigeminal Neuralgia
encephalitis and the nursing care required by a A. Cause A. Cause
patient with encephalitis. B. Treatment B. Treatment
8. Define and list causes, medical treatment of C. Nursing Care C. Nursing Care
Guillain-Barre Syndrome and the nursing care VII. Guillian-Barre Syndrome XIV. Bell’s Palsy
required by a patient with Guillain-Barre. A. Cause XV. Herpes Zoster/Shingles
9. Define and list causes, medical treatment of B. Treatment A. Cause
Parkinson’s disease and the nursing care C. Nursing Care B. Treatment
required by a patient with Parkinson’s disease. VIII. Parkinson’s Disease C. Nursing Care
A. Cause
B. Treatment
Written: 09/90 C. Nursing Care
Reviewed: 09/93, 07/97, 07/99; 07/06; 03/11; 07/14
Revised: 07/95, 07/01, 07/03, 07/04; 07/07; 07/08; 10/10; 03/11; 8/12

3
Unit: Medical Surgical Nursing-Disorders of the Nervous System Implementation: Linton (2012); Lecture/Discussion
Lesson: 3 Transparencies, Case Studies, Quizzing
Title: Specific Neurological Problems and Their Implications Evaluation: Written Test, Application in Patient Care
for Nursing Integrated: Pharmacology 0.5 Hour
Time: Theory 2.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: XVI. Polio


XVII. Brain Tumors
10. Define and list causes, medical treatment of A. Cause
multiple sclerosis and the nursing care required B. Complications
by patients with multiple sclerosis. C. Features
11. Define and list causes, medical treatment of D. Management
ALS and the nursing care required by a patient E. Nursing Care
with Amyotrophic Lateral Sclerosis. XVIII. Brain Injury
12. Define and list causes, medical treatment of
Huntington’s Disease and the nursing care
required by a patient with Huntington’s.
13. Define and list causes, medical treatment of
myasthenia gravis and the nursing care
required by a patient with myasthenia gravis.
14. Define and list causes, medical treatment of
trigeminal neuralgia and the nursing care required
by a patient with trigeminal neuralgia (tic douloureux).
15. List the signs and symptoms and medical treatment
of Bell’s Palsy.
16. Define and list causes, medical treatment of
herpes zoster/shingles and the nursing care required by
a patient with herpes zoster/shingles.
17. Define and list causes, medical treatment of poliomyelitis
and the nursing care required by a patient with poliomyelitis.
18. Define and list causes, medical treatment of brain tumors and
the nursing care required by a patient with brain tumors.
19. List the signs and symptoms of brain injury.
20. Define the different types of injuries to the brain.

Written: 09/90
Reviewed: 09/93, 07/97, 07/99; 07/06; 03/11; 07/14
Revised: 07/95, 07/01, 07/03, 07/04; 07/07; 07/08; 10/10; 03/11; 8/12

4
Unit: Medical Surgical Nursing-Disorders of the Nervous System Implementation: Linton (2012)
Lesson: 4 Lecture/Discussion, Transparencies, Case Studies, Quizzing
Title: Care of a Patient with Cerebrovascular Disease Evaluation: Written Test, Application in Patient Care
Time: Theory 1.5 Hours Integrated: Pharmacology 0.5 Hours

OBJECTIVES PLAN OF LESSON


VII. Rehabilitation
Upon completion of this unit the student will: I. Cerebrovascular Disease A. ADL
A. Pathophysiology
1. Define cerebrovascular disease. B. Symptoms
2. Define atherosclerosis and arteriosclerosis. C. Treatment
3. Understand special problems with cerebrovascular II. Atherosclerosis/Arteriosclerosis
disease. A. Differences
4. Define CVA/stroke. B. Symptoms
5. Define cerebral insufficiency. III. Problems of Cerebrovascular Disease
6. Define aneurysms of blood vessels of the brain. A. Behavior
7. List nursing management of a CVA patient in the B. Changes and Orientation
acute phase. C. Dependence
8. Discuss nutritional considerations of CVA patients. D. Independence
9. Discuss drug therapy in a patient with CVA. E. Families
10. Discuss phases of rehabilitation of the CVA patient. IV. Cerebral Insufficiency
A. Treatment
B. Nursing Management
V. Aneurysms
A. Medical Treatment
B. Surgical Treatment
C. Nursing Management of Each
VI. CVA’s
A. Signs and Symptoms
B. Diagnosis
C. Treatment
D. Nursing Management
E. Nutritional Considerations
1. Thick It
2. Role of Speech Therapist
Written: 09/90 F. Drug Therapy
Reviewed: 09/93, 07/97, 07/99; 07/06; 03/11; 07/14
1. Anticoagulants
Revised: 07/95, 07/01, 07/03, 07/04; 07/07; 07/08; 10/10; 8/12
2. Stoll Softeners
3. Sedatives of Tranquilizers

5
Unit: Medical Surgical Nursing-Disorders of the Nervous System Implementation: Linton (2012);Quizzing, Case Studies,
Lesson: 5 Lecture/Discussion, Transparencies
Title: The Patient with Spinal Cord Impairment Evaluation: Written Test, Application in Patient Care
Time: Theory 3 hour Integrated: N/A

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit the student will:
I. Functions of Spinal Cord
1. Know the areas of functions of the spinal cord. II. Causes of Spinal Nerve Root
2. List causes and treatments of cord and spinal nerve Compression
root compression. A. Trauma
3. List pre- and post-operative management of a B. Herniated Intervertebral Disc
patient with a laminectomy. C. Cervical Spondylosis
4. Define paraplegia and its cause. D. Tumor Management
III. Treatment and Management
A. Conservative Therapy
B. Nursing Management
C. Surgery
1. Pre-op Care
2. Post-op Care
IV. Paraplegia
A. Early Treatment
B. Assessment and Management
1. Complications
2. Nutrition
3. Elimination
4. Psychological Problems
5. Rehabilitation
V. Tumors of Spinal Cord
A. Cause
B. Signs & Symptoms
C. Treatment

Written: 09/90
Reviewed: 09/93, 07/97, 07/99; 07/06; 03/11; 07/14
Revised: 07/95, 07/01, 07/03, 07/04; 07/07; 07/08; 10/10; 8/12

6
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 38; Thompson, Ch.20; Lecture/Discussion; Transparencies;
Disturbances of the Gastrointestinal System PowerPoint Presentation; Handouts; Quizzing
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Introduction, Diagnostic Tests, and Functional Disorders Integrated: Anatomy 0.5 Hour; Fundamentals 0.5 Hour; Pharmacology 0.5 Hour;
Time: Theory 2 Hours and Geriatrics 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I.Introduction VI.Gastrointestinal Decompression
II.Etiology (Cause) A. Definition
1. Discuss the various factors related to disorders of the A. Disease B. Description
gastrointestinal system. B. Allergy C. Indications
2. Identify, in writing and by diagram, the anatomical parts of the III.General Concerns D. Types of GI Tubes
digestive tract and accessory organs. A. Psychological Aspects 1. Levin
3. Define and describe common gastrointestinal diagnostic tests. B. Physical Aspects 2. Miller-Abbott
4. Describe the preparations necessary for each of the common IV.Anatomy E. Nursing Management
gastrointestinal diagnostic tests. A. Major Organs 1. NGT
5. Explain the purpose of gastrointestinal decompression. B. Accessory Organs 2. Intestinal Tubes
6. List the indications for gastrointestinal decompression. V.Diagnostic Test and Preparations VII. Functional Disorders
7. List, describe and differentiate among the types of GI tubes. A. Gastric Analysis A. Nausea and Vomiting
8. List and describe the steps of insertion and removal of a B. Stool Analysis B. Anorexia
nasogastric (NG) tube. C. X-Ray and Fluoroscopy C. Heartburn
9. Describe the nursing management of the patient with an NG tube. D. Endoscopy D. Diarrhea and Constipation
10. Describe the nursing management of the patient with an intestinal 1. Esophagogastroduodenoscopy E. Irritable Colon
tube. (EGD) F. Anorexia Nervosa
11. List and describe functional disorders of the GI system. 2. Gastroscopy G. Bulimia
12. Explain the nursing management of the patient with each of the 3. Colonoscopy H. Treatment and Nursing
functional disorders. Management
13. Discuss gerontologic changes that occur in the GI system. VIII.Gerontologic Changes

Written: 09/90
Reviewed: 09/93; 09/14
Revised: 07/95; 09/96; 09/98; 09/00; 09/02; 10/04; 12/06; 09/08; 01/10; 09/12

3
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 38; Clayton, Stock, & Cooper, Ch. 33; Lecture/Discussion;
Disturbances of the Gastrointestinal System Handouts; Transparencies; Color Photos (EGD)
Lesson: 2 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient with an Upper Gastrointestinal Disorder Integrated: Pharmacology 0.5 Hour and Nutrition 0.5 Hour
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. UGI Disorders 9. Postoperative Management
A. Esophageal/Hiatal Hernia a. Dumping Syndrome
1. Describe the etiology and symptomatology of esophageal/hiatal 1. Symptoms b. Postprandial Hypoglycemia
hernia and gastritis. 2. Treatment c. Pernicious Anemia
2. Describe the medical-surgical management of the patient with an 3. Assessment and Management D. Gastroesophageal Reflux Disease
upper gastrointestinal disorder. B. Gastritis (GERD)
3. Describe the medical management of gastritis. 1. Symptoms 1. Etiology
4. Discuss the pathophysiology, etiology, and incidence of peptic 2. Treatment 2. Symptoms
ulcer disease (PUD), including the role of Helicobacter pylori. 3. Management 3. Diagnosis
5. List and explain the symptoms, diagnosis, treatment, and nursing C. Peptic Ulcer Disease (PUD) 4. Treatment/Medications
interventions for a patient with peptic ulcer disease. 1. Pathophysiology 5. Nursing Management
6. List and describe the complications that can occur as a result of a. Helicobacter pylori 6. Patient Teaching
peptic ulcer disease. (H. pylori) 7. Complications
7. Discuss the surgical treatment of the patient with peptic ulcer b. Acidity/Blood Flow E. Surgical Management
disease. 2. Etiology 1. Pre-op Concerns
8. Describe the etiology and incidence of gastroesophageal reflux 3. Incidence 2. Post-op Complications
disease (GERD). 4. S/s and Diagnosis
9. Summarize the symptoms, diagnosis, treatment, nursing 5. Treatment, Including
interventions, and patient teaching for a patient with GERD. Medications (e.g. PrevPak)
10. List and describe the complications that can occur as a result of 6. Assessment and Management
GERD. 7. Complications
11. Explain the pre-operative and post-operative management of the a. Hemorrhage
patient undergoing gastric surgery. b. Obstruction
c. Perforation
8. Surgery
a. Subtotal Gastrectomy
b. Gastroenterostomy
c. Vagotomy
Written: 09/90
Reviewed: 09/93; 09/14
Revised: 07/95; 09/96; 09/98; 09/00; 09/02; 10/04; 12/06; 09/08; 01/10; 09/12

4
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 38; Lecture/Discussion; Transparencies; Handouts; Color
Disturbances of the Gastrointestinal System Photos (Colonoscopy)
Lesson: 3 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient with an Intestinal or Rectal Disorder Integrated: Pharmacology 0.5 Hour and Nutrition 0.25 Hour
Time: Theory 2.25 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Intestinal Disorders
A. Appendicitis G. Crohn’s Disease (Regional
1. Define appendicitis and explain its symptoms, diagnosis, 1. Symptoms Enteritis)
treatment, and management. 2. Diagnosis 1. Symptoms
2. Define peritonitis and explain its symptoms, diagnosis, treatment, 3. Treatment and Management 2. Diagnosis
and management. B. Peritonitis 3. Treatment and Management
3. Define and differentiate between the different types of hernias and 1. Symptoms 4. Dietary Considerations
discuss their etiology, symptoms, diagnosis, treatment, and 2. Diagnosis 5. Comparison to Ulcerative
complications. 3. Treatment and Management Colitis
4. Explain mechanical intestinal obstruction and discuss its causes, C. Abdominal Hernias H. Malabsorption
symptoms, diagnosis, and treatment. 1. Types II. Rectal Disorders
5. Describe and differentiate between diverticulosis and diverticulitis. 2. Symptoms A. Hemorrhoids
6. Explain the symptoms, diagnosis, and treatment of diverticulosis 3. Diagnosis 1. Symptoms
and diverticulitis, including dietary management. 4. Treatment and Management 2. Diagnosis
7. Explain ulcerative colitis and discuss the symptoms, diagnosis, and 5. Complications 3. Treatment and Management
treatment. D. Mechanical Intestinal Obstruction B. Pilonidal Cyst
8. Discuss the dietary considerations of the patient with ulcerative 1. Causes 1. Symptoms
colitis. 2. Symptoms 2. Diagnosis
9. Define and explain Crohn’s disease (regional enteritis) and discuss 3. Diagnosis 3. Treatment and Management
its symptoms and treatment. 4. Treatment and Management C. Other Rectal Conditions
10. Compare and contrast ulcerative colitis and Crohn’s disease. E. Diverticulosis and Diverticulitis 1. Anal Fissure
11. Define and discuss malabsorption. 1. Symptoms 2. Anal/Perirectal Abscess
12. Define hemorrhoids and discuss the etiology, symptoms, diagnosis, 2. Diagnosis 3. Anal Fistula
and treatment. 3. Treatment, Including Diet III. Medications & Dietary Considerations
13. Explain pilonidal sinus and discuss its management. Management
14. Discuss the etiology and treatment for anal fissure, perirectal 4. Assessment and Management
abscess, and anal fistula. F. Ulcerative Colitis
1. Symptoms
2. Diagnosis
Written: 09/90
3. Treatment and Management
Reviewed: 09/93; 09/14
Revised: 07/95; 09/96; 09/98; 09/00; 09/02; 10/04; 12/06; 09/08; 01/10; 09/12 4. Dietary Considerations

5
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 25 & 38; Power Point Presentation; Lecture/Discussion;
Disturbances of the Gastrointestinal System Handouts; Color Photos (EGD & Colonoscopy)
Lesson: 4 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient with Cancer of the GI Tracts Integrated: N/A
Time: Theory 2.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. GI Cancers
A. Statistics
1. Summarize current cancer-related statistics as reported by the B. Symptoms/CAUTION
American Cancer Society (ACS). C. Associated Conditions
2. Explain the symptoms associated with cancer of the GI tract. 1. Leukoplakia
3. Memorize and write out the details of the ACS CAUTION 2. Erythroplakia
acronym. 3. Barrett’s Esophagus
4. Define leukoplakia and erythroplakia. 4. Inflammatry Bowel Disease
5. Discuss the individual symptoms, management, and possible D. Treatment
complications of cancer of the mouth. II. Types
6. Discuss the individual symptoms and general management of A. Oral CA
cancer of the esophagus. 1. Symptoms
7. Explain and discuss cancer of the stomach. 2. Tx & Management
8. Differentiate between the nursing care of the patient having a 3. Complications
subtotal and a total gastrectomy. B. Esophageal CA
9. Explain the symptoms and management of the patient with cancer 1. Symptoms
of the colon. 2. Tx & Management
10. Discuss cancer of the rectum and list the symptoms. 3. Complications
11. Explain the treatment and management of the patient with cancer C. Stomach CA
of the rectum. 1. Symptoms
12. Describe the post-operative management of the patient with an 2. Tx & Management
abdominal resection. a. Subtotal Gastrectomy
b. Total Gastrectomy
D. Colon CA
1. Symptoms
2. Tx & Management
E. Rectal CA
1. Symptoms
2. Tx & Management
Written: 09/90 3. Colorectal Surgeries
Reviewed: 09/93; 09/14; 01/15
Revised: 07/95; 09/96; 09/98; 09/00; 09/02; 10/04; 12/06; 09/08; 01/10; 09/12

6
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 26 & 38; Lecture/Discussion; Transparencies; Handouts
Disturbances of the Gastrointestinal System Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 5 Integrated: N/A
Title: The Patient with an Ostomy
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Ostomy
A. Nursing Management
1. Define and discuss the terms ostomy, ileostomy, and colostomy. 1. Attitude
2. Discuss and explain in detail the nursing management of the 2. Patient Teaching
patient with an ostomy, including stoma care. 3. Stoma Assessment and Care
3. Explain the assessment and management of the ileostomy patient. 4. Enterostomal Therapy (ET)
4. Summarize the potential fluid and electrolyte shifts that may occur Nursing
in the patient with an ileostomy. B. Ileostomy
5. Explain the selection and application of the ostomy appliance. 1. Assessment and Management
6. Explain skin care and odor control in the use of an ostomy 2. F & E Shifting
appliance. 3. Appliances
7. Explain pouch ileostomy and the two main types. a. Selection
8. Differentiate among the types of ostomies. b. Application
9. Explain the general management of the ostomy patient with regard 4. Skin Care
to diet, clothing, and cleanliness. 5. Control of Odor and Gas
10. Discuss the colostomy irrigation procedure and list the steps 6. Obstruction
involved. 7. Pouch Ileostomy
a. Indiana Pouch
b. Kock Pouch
C. Colostomy
1. Types
2. Patient Cleanliness
3. Management
4. Irrigation
5. Stoma Covering
6. Diet
7. Clothing

Written: 09/90
Reviewed: 09/93; 09/14
Revised: 07/95; 09/96; 09/98; 09/00; 09/02; 10/04; 12/06; 09/08; 01/10; 09/12

7
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 39; Thompson, Ch. 20; Lecture/Discussion; Transparencies;
Disturbances of the Gastrointestinal System Handouts
Lesson: 6 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient with a Disorder of the Liver, Gallbladder, Integrated: Pharmacology 0.5 Hour
or Pancreas
Time: Theory 3 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Disorders of the GI Accessory Organs: Liver
A. Liver Disease
1. Identify the basic anatomy and physiology of the liver. 1. Anatomy & Physiology
2. Explain liver function tests in regards to diagnosis of liver disease. 2. Diagnosis
3. Explain the preparation and procedure for a liver biopsy. a. Liver Function Tests
4. Explain the assessment and nursing management of the patient post-liver biopsy. i. Total Bilirubin
5. Explain the use of x-rays/ultrasound in diagnosing liver disease. ii. Serum Enzyme Studies
6. Explain the three different types of jaundice. iii. Protime
7. Discuss jaundice, pruritis, and bleeding in regards to liver disease. iv. Protein Electrophoresis
8. Explain the pathology of cirrhosis. v. Protein Studies
9. Differentiate between various types of cirrhosis and explain each. vi. Cholesterol
10. Describe the management of the patient with cirrhosis. vii. Ammonia
11. List the complications that can occur as a result of cirrhosis. b. Liver Biopsy
12. Explain the pathophysiology of viral hepatitis. c. Radiographic Studies
13. Describe the five major types of viral hepatitis (A, B, C, D, E). d. Ultrasound
14. List and explain the symptoms of viral hepatitis. 3. Disorders
15. Discuss the treatment and nursing management of viral hepatitis. a. Main Symptom: Jaundice
16. Explain non-infectious hepatitis. i. Hemolytic
17. Discuss symptoms, treatment, and management of liver tumors. ii. Hepatocellular
18. Define and discuss cholecystitis and tests used to diagnose it. iii. Obstructive
19. Explain the treatment and management of cholecystitis. b. Cirrhosis
20. Explain the symptoms and treatment of choledocholithiasis. i. Pathology
21. Discuss acute and chronic pancreatitis. ii. Types
22. List the symptoms, treatment, and management of acute and chronic 1. Laennec’s
pancreatitis. 2. Post-Necrotic
23. Explain the symptoms of pancreatic cancer and its diagnosis. 3. Biliary
24. Describe the treatment and management of cancer of the pancreas, including 4. Congestive
surgery (Whipple procedure). iii. Management
iv. Complications
Written: 09/90
Reviewed: 09/93; 09/14
Revised: 07/95; 09/96; 09/98; 09/00; 09/02; 10/04; 12/06; 09/08; 01/10; 09/12

8
A. Anatomy & Physiology
B. Viral Hepatitis B. Disorders
1. Pathophysiology 1. Cholecystitis
2. Types 2. Cholelithiasis
3. Symptoms C. S/s
4. Diagnosis & Prognosis D. Diagnosis & Tx
5. Prevention, Including E. Nursing Management
Available Vaccines III. Disorders of the GI Accessory Organs: Pancreas
6. Tx & Nursing Management A. Anatomy & Physiology
C. Non-Infectious Hepatitis B. Disorders
D. Tumors of the Liver 1. Pancreatitis
1. Symptoms 2. Pancreatic CA
2. Treatment C. S/s
3. Nursing Management D. Diagnosis & Tx
II. Disorders of the GI Accessory Nursing Management
Organs: GB

9
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 41; Thompson, Ch.68 – 9; Lecture/Discussion; Handouts;
Disorders of the Musculoskeletal System Transparencies; Skeletal Model
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Review of the Anatomy of the Musculoskeletal System Integrated: Anatomy 1 Hour and Geriatrics 1 Hour
Time: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Bone Structure
A. Osteoblasts
1. Describe bone structure. B. Osteoclasts
2. List number of bones in adult and children. C. Marrow
3. Describe and list functions of bones. 1. Red
4. Describe and list the divisions of the skeleton and nomenclature. 2. Yellow
5. List and describe landmarks of bones. D. Bone Layers
6. Describe muscle structure and function; name and locate the most II. Bone Functions
common muscle groups. III. Divisions of the Skeleton
7. Discuss commonly injured/torn musculoskeletal areas, including A. Framework of the Head
the rotator cuff, medial meniscus, anterior cruciate ligament, and B. Framework of the Trunk
Achilles tendon. C. Bones of the Extremities
8. Discuss the physiologic changes that occur in the musculoskeletal D. Shoulder Girdle
system as a result of the aging process. E. Pelvic Girdle
IV. Common Muscle Groups
A. Trapezius (Traps)
B. Deltoid
C. Biceps
D. Triceps
E. Pectorals (Pecs)
F. Abdominalis (Abs)
G. Gluteals (Glutes)
H. Quadriceps (Quads)
I. Hamstrings
J. Gastrocnemius
V. Commonly Injured/Torn Areas
A. Rotator Cuff
B. Medial Meniscus
C. Anterior Cruciate
Written: 09/90 Ligament (ACL)
Reviewed: 09/93; 10/04; 07/12; 07/14
D. Achilles Tendon
Revised: 07/95, 07/96, 07/98, 07/00, 08/02; 12/06; 07/08; 01/10; 05/13

10
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 42; Lecture/Discussion; Handouts; Transparencies;
Disorders of the Musculoskeletal System Display of Casting Materials
Lesson: 2 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient with a Fracture and a Cast Integrated: N/A
Time: Theory 3 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Types of Fractures D. Moving the Patient
A. Open E. Itching
1. Discuss the types of fractures. B. Closed F. Exercise
2. Discuss pathology of fractures, list the steps of healing, and the C. Displaced G. Psychological/Emotional
advantages of early mobilization. D. Greenstick Aspects
3. List causes and incidence of fractures. E. Complete H. Encouragement
4. List the symptoms of fractures. F. Comminuted I. Explanation
5. Discuss and describe the first aid measures for fractures. G. Impacted J. Later Care
6. Describe diagnostic testing and treatment of fractures. H. Complicated K. Removal of Cast
7. Describe and discuss the types of reduction and casting commonly I. Pathologic L. Medications
used. II. Pathology of Fractures and Bone X. Major Complications of Fractures
8. Discuss nursing measures and management of the patient with a Repair A. Compartment Syndrome
cast. A. Steps in Healing B. Fat Embolism
9. Describe major complications of fractures, their s/s, and their B. Early Mobilization C. Nonunion/Malunion
management (medical and nursing). III. Incidence of Fractures
IV. Symptoms of Fractures
V. First Aid
VI. Hospital Treatment of Fractures
VII. Types of Reduction
A. Open
B. Closed
VIII. Cast Application
A. Drying/Finishing the Cast
B. Edges
C. Spica Casts
IX. Assessment and Management of the
Patient in a Cast
A. Elevation of the Limb
Written: 09/90 B. Nursing Observations
Reviewed: 09/93; 10/04; 07/12; 05/13; 07/14
C. Cast Windowing/Bivalving
Revised: 07/95, 07/96, 07/98, 07/00, 08/02; 12/06; 07/08; 01/10

11
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 41-42 & pp. 527 – 529; Lecture/Discussion; Handouts;
Disorders of the Musculoskeletal System Transparencies; Display of Devices for Bone Fixation
Lesson: 3 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient in Traction/Orthopedic Trauma Integrated: Nutrition 0.5 Hour and Pharmacology 0.5 Hour
Time: Theory 4 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Traction V. Dislocations
A. Types A. Definitions
1. List and describe types of traction and the procedure for placing a B. Explanations B. Treatment
patient in traction. C. Placing the Patient in Traction C. Nursing Management
2. Describe and discuss the assessment and nursing management of a II. Assessment and Management of the VI. Sprains
patient in traction. Patient in Traction A. Definition
3. List, discuss, and describe nursing measures and management of a A. Problems of Immobility B. Treatment (RICE)
patient who has had an open reduction internal fixation (ORIF) of B. Psychological Problems C. Nursing Management
a fracture, including the possible complications. C. Points in Assessment VII. Other Orthopedic Trauma
4. Describe and discuss surgical treatment, devices, and post-op D. Pin Care A. Contusion
management for the patient with a fractured hip and total hip E. Removal of Traction B. Strain
replacement. III. Open Reduction Internal Fixation C. Nursing Management
5. Be aware of and discuss safety related to ambulation and (ORIF) IX. Carpal Tunnel Syndrome
walker/cane/crutches use. A. Postoperative Assessment and A. Definition
6. Define and describe fractures of the spine, mandible, clavicle, and Management B. Medical Management
ribs, and discuss treatment and nursing management of these B. Complications C. Surgical Treatment
fractures. C. Problems due to Immobilization D. Nursing Management
7. Define and discuss dislocations and sprains and the related IV. The Patient with a Fractured Hip X. General Nutritional Considerations
treatment and nursing management. A. Occurrence A. Proteins
8. Define and discuss contusions and strains, and the related nursing B. Fixation Devices B. Minerals
management. C. Bone Grafts C. Vitamins
9. Describe carpal tunnel syndrome and its medical/surgical and D. Complications XI. General Pharmacologic
nursing management. E. Post-Operative Care/Precautions Considerations
10. List general nutritional and pharmacologic consideration. F. Total Hip Replacement
G. Safe Ambulation (Walker/Cane/
Crutches Use)
V. Other Fractures
A. Spine
B. Mandible
Written: 09/90 C. Clavicle
Reviewed: 09/93; 10/04; 07/12; 07/14; 01/15
D. Ribs
Revised: 07/95, 07/96, 07/98, 07/00, 08/02; 12/06; 07/08; 01/10; 05/13

3
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 41 – 42; Clayton & Stock, Ch. 20, 38, & 45; Lecture/
Disorders of the Musculoskeletal System Discussion; Handouts; Transparencies; Videos: Knee Replacement.
Lesson: 4 (1996). Medcom. 25 Minutes. Hip Fracture. (1996). Medcom. 21
Title: The Patient with a Disease of the Bones and Joints Minutes. Hip Replacement. (1996). Medcom. 25 Minutes
Time: Theory 3.5 Hours Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Integrated: Pharmacology 0.5 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Rheumatoid Arthritis (RA) E. Diet Therapy/Patient Education
A. Incidence F. Nursing Management
1. Define arthritis, listing the major types (rheumatoid, osteo, and B. Pathology/Signs & Symptoms IV. Bone Tumors
gouty). C. Diagnosis & Treatment A. Types
2. Define and discuss rheumatoid arthritis, its incidence, pathology, D. Drug Therapy B. Symptoms
symptoms, and treatment. 1. Salicylates C. Treatment and Nursing
3. List drugs used to treat arthritis, their actions, dosages, side effects, 2. Corticosteroids Management
and nursing implications. 3. Injections V. Osteomyelitis
4. Discuss the nursing management of arthritis. E. Nursing Management A. Definition
5. Define and discuss osteoarthritis (degenerative joint disease), 1. Exercise/Rest B. Symptoms
related facts, treatment including total joint replacement (hip and 2. Equipment/Therapy C. Treatment
knee), and nursing management. 3. Corrective Surgery D. Nursing Management
6. Define gout and discuss related facts and nursing management. 4. Patient Education E. Complications
7. Define bone tumors and discuss related facts and nursing II. Osteoarthritis (OA; Degenerative VI. Herniated Nucleus Pulposus
management. Joint Disease; DJD) (Herniated Disk)
8. Define osteomyelitis and discuss related facts and nursing A. Incidence and Etiology A. Definition
management. B. Pathology/Signs & Symptoms B. S/s
9. Define herniated nucleus pulposus and describe its s/s, tx/surgical C. Diagnosis & Treatment, C. Tx/Surgical Management
Management, and nursing care. Including Medications/Injections D. Nursing Care/Precautions
10. Describe osteoporosis, including its etiology, risk factors, D. Total Joint Replacement VII. Osteoporosis
treatment, nursing management, complications, and preventive 1. Total Hip Replacement A. Definition
measures. (THR) B. S/S
11. List general nutritional and pharmacologic considerations. 2. Total Knee Replacement C. Etiology/Risk Factors
(TKR) D. Diagnosis & Treatment
E. Nursing Management E. Nursing Management
III. Gouty Arthritis F. Complications
A. Incidence G. Prevention
B. Pathology/Signs & Symptoms VII. General Nutritional & Pharmacologic
Written: 09/90 C. Diagnosis & Treatment Considerations
Reviewed: 09/93; 10/04; 07/12; 05/13; 07/14
D. Drug Therapy
Revised: 07/95, 07/96, 07/98, 07/00, 08/02; 12/06; 07/08; 01/10

4
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 43; Lecture/Discussion; Handouts; Transparencies
Disorders of the Musculoskeletal System Evaluation: Class Participation, Quizzing, Written Test, Application in Patient
Lesson: 5 Integrated: N/A
Title: The Patient with an Amputation
Time: Theory 2.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Psychological Aspects
II. Etiology
1. Discuss psychological aspects and emotional support for the patient III. Nursing Management
experiencing amputation. A. Pre-Operative Phase
2. Discuss etiology for upper and lower extremity amputations. B. Surgical Phase
3. List points in nursing management related to amputation, including the pre- IV. Other Amputations
operative and surgical phases. A. Upper Extremities
4. Discuss nursing management of amputations, including pre- and post-operative 1. Pre-op
care, care of stump, and use of prosthesis. 2. Post-op
5. Discuss and state related ideas about rehabilitation. B. Lower Extremities
6. Describe phantom limb sensation/pain, its psychological effects on the patient, 1. Pre-op
etiology, and medical/nursing management. 2. Post-op
C. Nursing Management
D. Prosthesis
1. Temporary
2. Upper Extremity
3. Lower Extremity
4. Stump Preparation and Care
E. Rehabilitation/Training with Prosthesis
Written: 09/90 V. Phantom Limb Sensation/Pain
Reviewed: 09/93, 08/02; 07/08; 07/12; 05/13; 07/14; 01/15
Revised: 07/95, 07/96, 07/98, 07/00; 10/04; 12/06; 01/10

5
Unit: Medical Surgical Nursing Implementation: Linton & Study Guide Ch. 44-46; Thompson Ch. 12; Lecture/Class
The Endocrine System Discussion; Transparencies; Handouts; Quizzing
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Assessment of the Endocrine System Integrated: Anatomy 1 Hour and Geriatrics 1 Hour
Time: N/A

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Introduction V. Patient Assessment
II. General Endocrine Processes A. Health History
1. List the location of hormone producing glands in the body. A. Functions of Hormones 1. Intake
B. Mechanisms of Hormone Action 2. Elimination
2. Describe the mechanisms that control hormone synthesis and 1. Hormone Release 3. Energy Level
release from the endocrine glands.
2. Hormone Transport 4. Perceptions of Body
3. Define, describe in detail and give the functions of each hormone 3. Hormone Action Characteristics
secreted by the various endocrine glands. III. Endocrine Structures and Hormonal 5. Reproductive and Sexual
4. Compare the biological effects of deficit and excess of each major Functions Function
hormone. A. Pituitary B. Physical Examination
5. Describe the normal age-related changes in the endocrine system. 1. Anterior Lobe Hormone 1. Observations of Adult
6. Describe data essential to the assessment of patients wit actual or 2. Posterior Lobe Hormone 2. Gerontologic
potential health problems of the endocrine system. B. Thyroid Assessment
7. Discuss the common diagnostic tests used to identify endocrine C. Parathyroid VI. Diagnostic Tests & Interpretation
dysfunction and explain the meaning of the results. D. Thymus A. Principles of Lab Evaluation
E. Adrenals B. Dynamic Testing
1. Cortex C. Urine Assessment of
2. Medulla Hormonal Status
F. Pancreas D. Imaging Studies
G. Gonads E. Assessing Functions of
IV. Normal Age-Related Changes Individual Endocrine Glands
A. Parathyroid Gland Activity
B. Thyroid Gland Activity

Written: 09/90
Reviewed: 09/93, 07/99, 07/03; 05/06
Revised: 07/95, 07/97, 05/01; 09/05; 05/07; 05/09; 05/11; 05/13

6
Unit: Medical Surgical Nursing Implementation: Linton and Study Guide Ch. 44-45, Lecture/Class Discussion
Lesson: 2 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Disorders of the Pituitary, Thyroid, Parathyroid, and Integrated: Pharmacology 0.5 Hours
Adrenal Glands
Time: Theory 3 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to:


III. Parathyroid Disorders
1. Differentiate between the pathophysiology of hypersecretion I. Pituitary Disorders A. Hyperparathyroidism
and hyposecretions of the anterior lobe of the pituitary gland. A. Anterior Lobe 1. Symptoms
2. Differentiate between the pathophysiology of hypersecretion B. Posterior Lobe 2. Diagnostic Tests
and hyposecretions of the posterior lobe of the pituitary gland II. Thyroid Disorders 3. Treatment and Nursing
3. Explain in detail the etiology, symptoms, treatment and nursing A. Hyperthyroidism Management
management of the patient with hyperthyroidism. 1. Etiology IV. Adrenal Disorders
4. List the types of goiters and their etiology, symptoms, treatment 2. Symptoms A. Addison’s Disease
and nursing management. 3. Diagnostic Tests B. Cushing’s Disease
5. Describe thyroid cancer and discuss symptoms, incidence, 4. Treatment and Nursing C. Pheochromocytoma
treatment and prognosis. Management V. Hormonal Replacement
6. Formulate a nursing plan of care for a patient after a B. Goiters Therapy
thyroidectomy 1. Types 1. Self-care Skills
7. Define hypothyroidism and explain the etiology, symptoms, 2. Etiology
diagnosis, treatment and nursing management. 3. Symptoms
8. Explain hypo- and hyperparathyroidism and discuss their 4. Treatment
symptoms, diagnosis and treatment. C. Cancer
9. Explain and discuss the adrenal disorders with regards to 1. Radiation
symptoms, treatment and nursing management. 2. Surgery
10. Describe the self-care skills needed by a patient receiving long- a. Post-Op Plan of Care
term hormonal replacement therapy for pituitary, thyroid, D. Hypothyroidism
parathyroid, or adrenocortical insufficiency. 1. Etiology
2. Symptoms
3. Diagnosis
4. Treatment and Nursing
Management

Written: 09/90
Reviewed: 09/93, 07/99, 07/03; 05/06; 05/13; 01/15
Revised: 07/95, 07/97, 05/01; 09/05; 05/07; 05/09; 05/11

7
Unit: Medical Surgical Nursing Implementation: Linton Ch. 46; Lecture/Class Discussion; Transparencies; Handouts
Lesson: 3 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Diabetes: General Information Integrated: Pharmacology 1 Hour and Nutrition 0.5 Hours
Time: Theory 1.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. General Information
A. Definition
1. Define diabetes mellitus. B. Incidences
2. Identify the incidence and statistics related to diabetes. C. Types
3. Differentiate the two types of diabetes. D. Etiology
4. Briefly summarize the etiology, epidemiology, and E. Epidemiology
pathophysiology of diabetes. F. Pathophysiology
5. Describe in detail the physical changes taking place in the diabetic G. Symptoms
patient. H. Diagnostic Tests
6. List general symptoms of diabetes. I. Treatment
7. Identify the diagnostic test for diabetes. 1. Medical
8. Discuss the guidelines of treatment for the diabetic treatment. 2. Surgical

Written: 09/90
Reviewed: 09/93, 07/97, 07/99, 07/03; 05/06; 05/13
Revised: 07/95, 05/01; 09/05; 05/07; 05/09:05/11

8
Unit: Medical Surgical Nursing Implementation: Linton Ch. 46; Lecture/Class Discussion; Handouts; Quizzing;
The Endocrine Systems Case Studies
Lesson: 4 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Diabetes: Complications (Acute and Chronic) Integrated: Pharmacology 0.25 Hours
Time: Theory 3.25 Hours

OBJECTIVES
PLAN OF LESSON
Upon completion of this unit, the student will be able to:
I. Acute complications
1. Define and list the symptoms of diabetic shock and diabetic coma. A. Hyperglycemia
2. Discuss the treatment and nursing management of the patient in 1. Diabetic Ketoacidosis
diabetic shock and diabetic coma. 2. Hyperglycemic Hyperosmolar
3. List and discuss the symptoms and treatment of retinopathy and Nonketotic Coma
nephropathy. B. Hypoglycemia
4. Define and discuss the risk factors of atherosclerosis. 1. Diabetic Shock
5. Discuss the symptoms and prevention of large and small vessel II. Chronic Complications
disease of the legs and feet. A. Small Vessel Disease
6. Describe the neuropathic changes taking place in the peripheral 1. Retinopathy
and autonomic systems. 2. Nephropathy
B. Large Vessel Disease
1. Atherosclerosis
C. Large and Small Vessel Disease of
Legs and Feet
1. Foot Care
D. Nervous System Complications
1. Neuropathy
a. Peripheral
b. Autonomic
III. Miscellaneous Information
A. Social Considerations

Written: 09/90
Reviewed: 09/93, 07/99, 07/03; 05/06; 05/09; 05/13
Revised: 07/95, 07/97, 05/01; 09/05; 05/07:05/11; 01/15

9
Unit: Medical Surgical Nursing Implementation: Linton Ch. 46; Clayton, Stock, & Cooper, Ch. 36; Lecture/Class
The Endocrine System Discussion; Transparencies; Quizzing; WMHS Diabetic Teaching Packet
Lesson: 5 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care,
Title: Diabetic Teaching Written Care Plan on Diabetic Teaching
Time: Theory 1.5 Hours Integrated: Pharmacology 0.5 Hours and Nutrition 0.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Understanding the Disease Process
II. Maintaining Health at Optimum Level
1. List and discuss the major concepts in diabetic education. III. Blood/Urine
2. Discuss ways of teaching the diabetic how to maintain optimum health. IV. Dietary Consideration
3. Describe the steps involved in educating the diabetic patient regarding blood and V. Exercise
urine testing. VI. Insulin/Oral Hypoglycemic
4. Identify and discuss the food exchange list in education of the diabetic patient. VII. Prevention of Complications
5. Discuss the need and identify ways of educating the diabetic about insulin use VIII. Students Develop a Teaching Booklet
and administration and oral hypoglycemic.
6. Describe preventive care for the diabetic patient.

Written: 09/90
Reviewed: 09/93, 07/99, 07/03; 05/06
Revised: 07/95, 07/97, 05/01; 09/05; 05/07; 05/09; 05/11; 05/13

10
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 51; Herlihy Ch. 13; Clayton, Stock & Cooper, Ch. 43;
Disorders of the Eyes, Ears, Nose and Throat Lecture/Class Discussion; Transparencies; Braille Displays
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Visual Impairment Integrated: Anatomy 0.25 Hours; Fundamentals 0.5 Hours; Pharmacology 0.25 Hours;
Time: Theory 1.25 Hour Geriatrics 0.5 Hours

OBJECTIVES PLAN OF LESSON


Upon completion of this unit, the student will be able to: 3. Adaptations
I. Introduction C. Rehabilitation
1. Define optician, optometrist, and ophthalmologist. A. Definitions VIII. Refractive Errors
2. Identify the structures of the eye and their functions. 1. Optician A. Myopia
3. Identify the normal ophthalmic changes that occur with aging. 2. Optometrist B. Hyperopia
4. Describe the meaning of PERRLA and its assessment. 3. Ophthalmologist C. Astigmatism
5. Identify the instruments used in an examination of the eye and the II. Review of Anatomy and D. Presbyopia
meaning of the results/measurements. Physiology of the Eye E. Accommodation
6. List aspects of daily eye care. III. Changes that Occur with Aging IX. Cataracts
7. Describe the procedure for removing a foreign object form the eye. IV. Eye Examination A. Causes
8. Describe the procedure for irrigating an eye. A. Instruments B. Treatment
9. Explain the values used to describe visual acuity, as determined by 1. Ophthalmoscopy C. Nursing Care
the Snellen and Jaegar tests. a. Purpose and Use 1. Pre-op Care
10. Differentiate “legally blind” and “partially sighted.” b. Normal Fundus 2. Post-op Care
11. Name the rehabilitation objectives for the visually impaired. 2. Tonometry X. Glaucoma
12. Name the aids available for the blind. a. Purpose and Use A. Definition and Classifications
13. Describe nursing care variations for the patient with visual b. Normal Intraocular 1. Acute (Closed-Angle)
impairment. Pressure (IOP) a. Symptoms
14. Describe life adaptations necessary for the patient with visual B. Other Diagnostic Tests b. Treatment
impairment. V. Factors of Daily Eye Care 2. Chronic (Open-Angle)
15. Define conjunctivitis and summarize its treatment and nursing VI. Trauma and First Aid a. Symptoms
care. A. Foreign Body b. Treatment
16. Define terms that indicate refractive errors. B. Irrigation B. Nursing Management
17. Describe the causes and development of cataracts. VII. Visual Handicap XI. Macular Degeneration
18. Describe the treatment and nursing management of a patient with a A. Visual Acuity A. Symptoms
cataract. 1. Snellen Test B. Treatment
19. Define glaucoma and differentiate between the classes of glaucoma 2. Jaegar Test C. Nursing Management
and their signs and symptoms. 3. Legally Blind XII. Detached Retina
20. Describe the treatment of and nursing management for acute and 4. Partially Sighted A. Definition
chronic glaucoma. B. Blindness B. Symptoms
Written: 09/90 1. Aids C. Treatment
Reviewed: 09/93; 07/99; 10/09; 03/13 2. General Nursing Measures
Revised: 07/95; 07/97; 07/01; 07/03; 07/05; 06/07; 03/11

11
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 51; Herlihy Ch. 13; Clayton, Stock & Cooper, Ch. 43;
Disorders of the Eyes, Ears, Nose and Throat Lecture/Class Discussion; Transparencies; Braille Displays
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Visual Impairment (Cont’d) Integrated: Anatomy 0.25 Hours; Fundamentals 0.5 Hours; Pharmacology 0.25
Time: Theory 1.25 Hours Hours; Geriatrics 0.5 Hours

OBJECTIVES (CONT’D) PLAN OF LESSON (CONT’D)

Upon completion of this unit, the student will be able to: X. XIII.Enucleation
A. Definition
21. Describe the symptoms, treatment, and nursing management for B. Causes
the patient with macular degeneration. C. Care of Prosthesis
22. Define detached retina and describe the symptoms associated with XI. XIV.Pre-Operative Care
the disorder. A. Admission Interview/Patient
23. Briefly describe the methods of treatment for detached retina. Orientation
24. Define enucleation. B. Pre-Operative Sedation
25. Describe the care of an artificial eye. C. Eye Drops/Ointments
26. Describe nursing considerations when admitting a patient for eye 1. Mydriatics
surgery. 2. Cycloplegics & Miotics
27. List and state the indications for pre-operative medications. 3. Others (Antibiotics, Antivirals,
28. Demonstrate proper technique of administration of eye drops. Corticosteroids)
29. Discuss post-operative nursing care of a patient following eye 4. Procedure for Instilling
surgery. XV.Post-Operative Care/Nursing
Management

Written: 09/90
Reviewed: 09/93; 07/99; 10/09; 03/13
Revised: 07/95; 07/97; 07/01; 07/03; 07/05; 06/07; 03/11

12
Unit: Medical Surgical Nursing Implementation: Linton, , Ch. 52; Herlihy Ch. 13; Lecture/Class Discussion;
Disorders of the Eyes, Ears, Nose and Throat Transparencies; Demonstration
Lesson: 2 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Hearing Impairment Integrated: Anatomy 0.25 Hours; Fundamentals 0.5 Hours; Pharmacology 0.25
Time: Theory 1 Hour Hours; Geriatrics 0.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Introduction A. Otosclerosis
A. Review of Anatomy 1. Definition
1. Label the parts of the ear and state the function of each. 1. External Ear 2. Symptoms
2. Discuss assessment of the ear and hearing, including otoscopic 2. Middle Ear 3. Treatment
exam. 3. Inner Ear 4. Surgical Management
3. Describe age-related changes in the ear and hearing. B. Assessment (Stapedectomy)
4. Explain the two types of hearing loss and state examples. 1. Otoscopic Exam 5. Nursing Care
5. Discuss the factors influencing communication for the hearing 2. Romberg Test B. Otitis Media
impaired. 3. Tuning Fork Tests 1. Definition
6. Identify the OSHA standards for ear protection in the workplace. 4. Audiometry 2. Symptoms
7. Discuss rehabilitation of the hearing impaired and the use of 5. CT/MRI 3. Treatment
hearing aids. II. Age Related Changes 4. Surgical Management
8. Describe common disorders of the external ear and their III. Hearing Loss (Myringotomy & Tympanostomy
treatments. A. Conductive Tubes)
9. Discuss and demonstrate the proper technique for irrigating the B. Sensorineural 5. Nursing Care
external auditory canal and for ear drop/ointment administration. C. OSHA Standards 6. Potential Complications
10. Define and list the signs and symptoms of otosclerosis. IV. Communication C. Chronic Otitis Media
11. Explain the treatment of otosclerosis. A. Attitudes D. Mastoiditis
12. Define otitis media, its types, treatment, and nursing management. B. Environmental Factors 1. Acute
13. Discuss the complications of otitis media. C. Rehabilitation 2. Chronic
14. Define chronic otitis media. 1. Hearing Aids a. Definition
15. Define mastoiditis, acute and chronic. 2. Surgery b. Symptoms
16. Explain the symptoms and treatment for acute and chronic V. Disorders of External Ear c. Treatment
mastoiditis. A. Impacted Cerumen d. Post-op Nursing Care
17. Discuss the post-op care of the patient having ear surgery. 1. Irrigation VII. Disorders of the Inner Ear
18. Define and list the symptoms of Meniere’s disease. 2. Nursing Care A. Meniere’s Disease
19. Summarize the treatment and nursing care of the patient with B. External Otitis 1. Definition
Meniere’s disease. C. Foreign Material/Insects 2. Symptoms
1. Treatment 3. Treatment
Written: 09/90
2. Prognosis 4. Nursing Management
Reviewed: 09/93; 07/99; 10/09; 03/13
Revised: 07/95; 07/97; 07/01; 07/03; 07/05; 06/07; 03/11 VI. Conditions of the Middle Ear

13
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 53; Herlihy Ch. 22; Lecture/Class Discussion
Disorders of the Eyes, Ears, Nose and Throat Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 3 Integrated: Anatomy 0.25 Hours; Pharmacology 0.25 Hours; Nutrition 0.25 Hours
Title: Disorders of the Nose
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Introduction: Review of Anatomy B. Common Causes
and Physiology C. Treatment
1. Identify the structures and functions of the nose and sinuses. II. Disorders of the Nose 1. First Aid
2. Describe assessment and diagnostic tests pertaining to the nose and A. Sinusitis 2. Topical Vasoconstrictors
sinuses, including the speculum exam. 1. Definition 3. Silver Nitrate
3. Define sinusitis. 2. Predisposing Factors 4. Electrocautery
4. List the predisposing factors, treatment, and complications of 3. Symptoms 5. Nasal Packing
sinusitis. 4. Treatment 6. Balloon Packing
5. Define polyps, and list its signs and symptoms, common methods 5. Surgical Management
of treatment, surgical management, and nursing care. 6. Complications
6. Define rhinitis, state the symptoms, and identify the drug therapy B. Polyps
used. 1. Definition
7. Define adenoids and adenoiditis, and describe the symptoms 2. Symptoms
associated with this condition. 3. Treatment
8. Define deviated septum and discuss treatment for the disorder. 4. Surgical Management
9. Discuss the nursing care of the patient with nasal surgery. C. Rhinitis
10. Define epistaxis, listing the common causes and treatment of the 1. Definition
condition. 2. Symptoms
3. Drug Therapy
D. Adenoiditis
1. Definition
2. Symptoms
E. Deviated Septum
1. Definition
2. Symptoms
III. Care of Patient with Nasal Surgery
A. Pre-operative Care
B. Post-operative Care
C. Nasal Drops/Spray
Administration
Written: 09/90 IV. Epistaxis
Reviewed: 09/93; 07/99; 10/09; 03/13 A. Definition
Revised: 07/95; 07/97; 07/01; 07/03; 07/05; 06/07; 03/11

14
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 53; Herlihy Ch. 22; Lecture/Class Discussion;
Disorders of the Eyes, Ears, Nose and Throat Transparencies
Lesson: 4 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Disorders of the Throat Integrated: Anatomy 0.25 Hours; Pharmacology 0.25 Hours; Nutrition 0.25 Hours;
Time: Theory 1 Hour Fundamentals 0.25 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Introduction
A. Anatomy and Physiology
1. Identify the structures and functions of the throat. 1. Taste Buds
2. Identify the locations and types of taste buds. 2. Speech
3. Identify physiology of speech. II. Disorders of the Throat
4. Describe the clinical manifestations and treatment of “strep throat.” A. Streptococcal Infection
5. Identify the potential complications of “strep throat.” 1. Definition
6. Identify the types of adenoviral infections, stating their symptoms and treatment. 2. Symptoms
7. Define pharyngitis, listing symptoms and describing common treatment. 3. Treatment
8. Define tonsillitis, describing symptoms, treatment, and nursing care of patients 4. Potential Complications
with this conditions. B. Adenoviral Infections
9. Define tonsillectomy. 1. Types
10. Discuss pre & post-op nursing care for the patient having a T&A. 2. Symptoms
11. Explain the post-op diet after T&A. 3. Treatment
12. Define laryngitis, including causes, symptoms, and treatment. C. Pharyngitis
13. Identify etiology and predisposing factors of cancer of the larynx. 1. Types
14. List symptoms of cancer of the larynx. 2. Symptoms
15. Describe procedures/tests used to diagnose cancer of the larynx. 3. Treatment
16. Describe a partial and total larynegectomy. D. Tonsillitis
17. Discuss post-op nursing measures for a patient after a total larynegectomy. 1. Symptoms
18. List drugs used in disorders of the throat. 2. Treatment
19. State the common types of solutions used for throat gargles. 3. Nursing Care
20. Demonstrate the proper procedure for using throat sprays; discuss necessary E. Care of Patient with T&A
safety precautions. 1. Definition
2. Nursing Care
Written: 09/90
a. Pre-op Care
Reviewed: 09/93; 07/99; 10/09; 03/13
Revised: 07/95; 07/97; 07/01; 07/03; 07/05; 06/07; 03/11 b. Post-op Care
c. Post-op Diet
F. Obstructive Sleep Apnea (OSA)
1. Etiology
2. Causes

15
3. S/J 2. Causes
4. Dx 3. Symptoms
5. Tx 4. Diagnosis
6. Prevention 5. Treatment
G. Laryngitis a. Surgery
1. Definition b. Radiation
2. Causes c. Nursing Implications
3. Symptoms III. Drug Therapy and Nursing Measures
4. Treatment A. Indications for Medications
H. Cancer of the Larynx B. Throat Gargles and Lozenges
1. Etiology C. Throat Sprays and Precautions

16
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40; Thompson, Ch. 18; Lecture/Discussion; Handouts;
Care of the Patient with a Renal Disorder Transparencies
Lesson: 1 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Physiology of the Renal System Integrated: Geriatrics 1 Hour; Anatomy 1 Hour
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Relationship
II. Vocabulary
1. Describe the relationship of the urinary system with other body III. Kidney Function/Control
systems. A. Glomerular Functions
2. Define the word list pertaining to the urinary system. B. Tubule Reabsorption
3. Discuss functions of the kidneys. C. Tubule Excretion of Urine
4. Identify the major renal hormones and their role in kidney function D. BP Regulation
and fluid & electrolyte balance. E. Erythropoietin Production
5. Name three ways in which the kidneys adjust body chemistry. (RBCs)
6. Name two functions of the urinary bladder and recognize the F. Calcium/Phosphate Regulation
amount of urine normally contained in the bladder before G. Control (Hormones)
distention occurs. 1. ADH
6. Describe the pathways of renal blood and urine flow. 2. Aldosterone
7. Explain gerontologic changes that occur in the urinary system. IV. Chemistry
A. Excretion of Metabolic
Products/Wastes
B. Water Balance
C. Acid-Base Balance
(Electrolytes)
V. Functions of the Bladder
A. Storage of Urine
B. Voiding
VI. Renal Blood Flow
VII. Urine Flow
VIII. Gerontologic Changes

Written: 09/90
Reviewed: 09/93, 08/98; 10/14
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10; 10/12

17
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40; Lecture/Discussion; PowerPoint Presentation; Handouts
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 2 Integrated: Nutrition 0.5 Hour
Title: Tests and Examinations Pertaining to the
Renal System
Time: Theory 2.5 Hours

OBJECTIVES PLAN OF LESSON


E. Retrograde Pyelogram
Upon completion of this unit, the student will be able to: I. Diagnostic Tests 1. Purpose and Description
A. Urinalysis 2. Preparation
1. Describe urinary laboratory tests and their purposes. 1. Constituents F. Cystoscopy
2. Describe the blood analysis that is of importance to the disorders a. Normal 1. Purpose and Description
of the urinary system. b. Abnormal a. Inspection
3. Discuss x-ray and endoscopic procedures, including their purposes 2. Observations b. Biopsy
and preparation of patient. a. Amount c. Treatment
4. List the nurse’s responsibilities in managing urinary functions and b. Color 2. Preparation of Patient
differentiate the importance of each. c. Clarity 3. Complications
5. Discuss the assessment and general management of the patient B. Urine Culture & Sensitivity G. Radioactive Renogram and Renoscan
with a urological disorder. C. Concentration & Dilution H. Renal Biopsy
6. Evaluate the effects of renal disease on other systems/organs of the (Specific Gravity) IV. Nursing Assessment and Management
body. D. Creatinine Clearance/24Urine A. Preparing Patient for Tests
E. Residual Urine Volume B. Collecting Specimens
F. Bladder Scan C. Observing Patient for Reactions
G. I&O/Other Nursing Procedures D. Measuring and Recording I&O
II. Blood Analysis E. Observing Character of Urine
A. BUN & Creatinine F. Comfort Measures/Pain Management
B. Electrolytes V. Assessment
III. X-Ray and Endoscopic Procedures A. Symptoms
A. IVP 1. Voiding – Times, Pain, Color,
1. Purpose and Description Means of Encouraging Void
2. Preparation 2. Edema & Hypernatremia
B. KUB a. Extremities
1. Purpose and Description b. Eyes – Periorbital
2. Preparation 3. Hypocalcemic Tetany – Seizure
C. Cystourethrography Precautions
D. Renal arteriography 4. Hypokalemia – Confusion,
Written: 09/90 Listlessness, Hypotension, Change
Reviewed: 09/93, 08/98; 10/14
in Pulse, Muscle Cramping
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10; 10/12

18
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40; Lecture/Discussion; PowerPoint Presentation; Handouts
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 2 Integrated: Nutrition 0.5 Hour
Title: Tests and Examinations Pertaining to the
Renal System
Time: Theory 2 Hours (Continued)
PLAN OF LESSON

5. Weight – Fluid Retention C. Infection Prevention


6. Anemia/Occult Blood 1. Do Not Open Closed Drainage
7. Urine Without Order
a. Color 2. Use Aseptic Technique
b. Clarity D. Comfort Measures
c. Odor 1. Itching – Clean Skin, Ointments
d. Content (Therapeutic Baths)
8. Frequent BP Measurements 2. Dry Skin – Lotion, Clean, Neat
a. Sluggish Bed, Change Position
b. Headaches 3. Odor – Disease Process; Combat
B. Fluid Management by Ventilation, Sprays,
1. I&O – Specific, Accurate Cleanliness, Closed Drainage
2. Limit – Edema, Kidney 4. Dryness of Mouth – L & G Swabs,
Failure Mouthwash, Saliva Spray, Lip
3. Fluids Moisturizer
a. Water 5. Pain
b. Gelatin a. Sitz Bath
c. Carbonated Beverages b. Dilute Urine by FF
d. Low Potassium – c. Medications (Pyridium)
Apple, Pear, Peach, 6. Complications of Immobility -
Cranberry, Pineapple Urinary Stasis, Potassium
e. High Potassium – Imbalance, and Infection
Grapefruit, Tomato, 7. Embarrassment and Fears
Tangerine, Prune, a. Matter of Fact Attitude
Tea, Coffee b. Do not Expose
4. Assistance c. Encourage to Talk
a. Bedpan/Urinal/BSC in 8. Appearance
Reach a. General Edema
b. Understand Reason b. Keeping Patient Well
c. Space Fluids Groomed
Written: 09/90 d. Hard Candy, Ice II. Systemic Effects of Renal Disease
Reviewed: 09/93, 08/98; 10/12; 10/14
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10

19
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 40; Lecture/Discussion; Transparencies; Handouts
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 3 Integrated: Fundamentals 0.5 Hour
Title: Management of the Patient with a Catheter
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Reasons for Catheterization
A. Collect Sterile Specimen
1. State reasons for catheterization. B. Drain the Bladder/Kidney
2. Discuss the assessment and management of a patient with an C. Maintain Accurate Output and
indwelling urethral catheter, including irrigation. Note its usual Residual
purpose and insertion/removal technique. D. Prepare Patient for Surgical
3. Describe straight catheterization, purposes, and care. Procedure
4. Discuss the assessment and management of an indwelling ureteral E. Assist Incontinent Patients in
catheter, including irrigation; note usual purpose. Bladder Training
5. Explain cystostomy (suprapubic) catheterization, insertion, F. Dilate Strictures
purposes, and care. G. Splint the Ureter/Urethra
6. Discuss the assessment and management of the patient with a II. Catheter Care (Foley, Straight,
nephrostomy tube. Ureteral, Suprapubic,
7. Discuss infection-control issues related to catheterization. Nephrostomy)
A. Insertion
B. Drainage
C. Irrigation
D. Catheter Care
E. Removal
F. Nursing Care
G. Infection Control

Written: 09/90
Reviewed: 09/93, 08/98; 10/12; 10/14
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10

20
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 23 & 40; Lecture/Discussion; Handouts
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 4 Integrated: Fundamentals 0.5 Hour
Title: The Patient with Urinary Incontinence
Time: Theory 0.5 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Incontinence C. Nursing Care
A. Anesthesia 1. Change Immediately
1. Describe the causes and types of urinary incontinence. B. Unconscious 2. Wash and Dry Skin
2. Discuss nursing care and management of the patient with C. Dementia 3. Antiseptic Powder/Ointment
incontinence. D. Interference with Nerves 4. Protective Ointment
3. Discuss management of the immobile patient who is incontinent. E. Prolapse/Relaxation of 5. Prevent Odor
4. Discuss the management of the ambulatory patient who is Perineum/Urethra V. Ambulatory Patient
incontinent. F. Others A. Individualized Choice
5. Discuss issues in caring for the incontinent patient at home. II. Types 1. Protect Skin
6. Explain neurogenic bladder, including assessment, treatment, and A. Stress 2. Cost Effective
nursing management. B. Urge 3. Convenient
C. Overflow 4. Can be Worn Under Clothes
D. Functional 5. Does Not Leak
E. Neurogenic 6. Comfortable
III. Nursing Management B. Male – External Drain, Urinal
A. Establish Schedule C. Female – Protective Pads
B. Space Fluid VI. Home Care
C. Record Time and Amount A. Problem of Incontinence
D. Bladder Training/Retraining B. Fear and Uncertainty
E. Foley/Other Clamps C. Long-term Aspects
F. Scheduling D. Expense
G. I&O E. Patient/Family Teaching
H. External Drain/Urinal/Briefs F. Catheterization Procedure
(Male)
I. Briefs (Female)
J. Kegel Exercises
K. Skin Care
L. Emotional Support
IV. Immobile Patient
Written: 09/90 A. Condom Cath (Male)
Reviewed: 09/93, 08/98; 10/12; 10/14
B. Briefs/Padding (Women)
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10

21
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40 & 48; Lecture/Discussion; Handouts; Transparencies
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 5 Integrated: N/A
Title: Urinary Obstruction
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Causes of Urinary Obstruction B. Treatment
A. Tumor VI. Bladder Tumor
1. Describe the causes of urinary obstruction. B. Stone A. Benign vs. Malignant
2. Discuss hydronephrosis. C. Cyst B. Symptoms
3. Discuss urinary stones, types, signs and symptoms, pain D. Kink C. Diagnosis by Cystoscopy and Biopsy
management, and nursing care. E. Stenosis D. Tx/Surgery
4. Discuss kidney stone occurrence and prevention. F. Spasm or Stricture E. Nursing Care
5. Describe tumors of the kidney and their significance. G. Acquired VII. Benign Prostatic Hyperplasia (BPH)
6. Explain urethral strictures. II. Hydronephrosis A. Definition/Etiology
7. Discuss tumors of the bladder, including their significance, A. Definition and Etiology B. S/s & Dx
treatment, and nursing care and nursing management. B. Symptoms C. Treatment/Management
8. Discuss BPH, including its incidence, signs & symptoms, C. Complications D. Screening: BPH vs. CA
diagnostic tests, treatment options, and nursing management. D. Treatment VIII. Prostate Cancer
9. Discuss prostate cancer, including its incidence, signs & III. Renal Calculi (Stones) A. Incidence
symptoms, diagnostic tests, treatment options, and nursing A. Etiology & Types B. S/s & Dx
management. B. S/S and Assessment C. Treatment Including TURP
10. Summarize prostate cancer-related statistics, as reported by the C. Removal D. Nursing Management
American Cancer Society (ACS), and the recommended 1. Transurethral E. ACS Statistics
preventive/screening measures. 2. Suprapubic F. Prevention/Screening
3. Percutaneous
D. Tx & Prevention
1. Force Fluids
2. Strain Urine
3. Report Symptoms
4. Modify Diet
IV. Tumor of Kidney
A. Usually Malignant
B. Symptoms
Written: 09/90 C. Treatment
Reviewed: 09/93, 08/98; 10/12; 10/14
V. Urethral Strictures
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10
A. Symptoms

22
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40; Lecture/Discussion; Handouts
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 6 Integrated: N/A
Title: Assessment and Management of the Patient
Having Surgery of the Urinary Tract
Time: Theory 0.5 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Post-Op Management
A. Operative Approach
1. Discuss the assessment of the patient who has had surgery of the B. Catheters/Drains
urinary tract. C. Complications
2. Discuss the nursing management of the patient who has had D. Skin Protection/Prevention of
surgery of the urinary tract. Infection
1. Frequent Dressing Changes
2. Protective Ointment
3. Sterile Techniques
E. Positioning
1. Soft Drains, Hard Drains
a. Do Not Compress
b. Do Not Pull Out
c. Drainage
2. Observe for Pneumothorax
3. Splint Incision
4. Use Pillows
F. General Post-Op Care
II. Pain Management

Written: 09/90
Reviewed: 09/93; 10/12; 10/14
Revised: 07/95, 08/96, 08/98, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10

23
Unit: Medical Surgical Nursing Implementation: Linton, Ch. 26 & 40; Lecture/Discussion; Handouts; Transparencies
Care of the Patient with a Renal Disorder Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Lesson: 7 Integrated: N/A
Title: Assessment and Management of the Patient with
Urinary Diversion
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Ileal Conduit IV. Nursing Points
A. Physiology A. Skin Protection
1. Explain the ileal conduit, necessity, and the nursing care and B. Nursing Care B. Dressing Changes
advantages/disadvantages. 1. NG Tube C. Appliance Fit
2. Discuss the ureterosigmoidostomy, nursing care, and 2. Dressings D. Patient Adjustment
advantages/disadvantages. 3. Signs of Infection/ E. Infection
3. Discuss other urinary diversion options, including the cutaneous Peritonitis F. Patient Responsibility
ureterostomy, and continent pouches (e.g. Kock and Indiana). 4. Signs of Skin Breakdown G. Early Ambulation
4. Examine additional nursing points related to care of the patient 5. Stoma Bleeding or H. Fear
with urinary diversion. Separation I. Patient/Family Teaching
5. Review the care specific to a nephrostomy and a cystostomy 6. Open Drainage J. Referral to Ostomy Association
6. Summarize the overall care of an ostomy site, including the stoma. 7. Advantages K. Enterostomal Therapy (ET) Nurse
II. Ureterosigmoidostomy V. Nephrostomy/Cystostomy
A. Physiology A. Purpose
B. Nursing Care B. Specific Care
1. Observe and Chart Stool B. General Nursing Care
2. Low Residue Diet 1. Securely Anchored
3. Anal Skin Care 2. Sterile, Closed Drainage
4. Assess Drainage Amount 3. Frequent Dressing Changes
and Color 4. I&O
5. Watch Electrolytes 5. Record Separate Drainage
6. Exercises to Improve 6. Color and Appearance
Sphincter Control 7. Keep Free from Obstruction
7. Force Fluids a. External: Pressure
8. No Enemas b. Internal: Clots, Mucus
9. Advantages 8. Drainage Below Level of Bed
III. Other Options 9. Force Fluids
Written: 09/90 A. Physiology
Reviewed: 09/93; 10/12; 10/14
B. Care
Revised: 07/95, 08/96, 08/98, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10

24
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40; Clayton, Stock, & Cooper, Ch. 42 & 46; Lecture/
Care of the Patient with a Renal Disorder Discussion; Handouts; Transparencies
Lesson: 8 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: Infections Integrated: Pharmacology 0.5 Hour
Time: Theory 2 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Identifying Factors VII. Glomerulonephritis (Nephritis, Bright’s
A. Secondary Disease)
1. Discuss the identifying factors common to all who have renal B. Foreign Bodies Predispose A. Acute Nephritis
infections. C. Identify Cause 1. Etiology
2. Summarize the effects of tuberculosis on the kidney. D. Increase Fluid Intake 2. S/s & Dx
3. Discuss pyelonephritis (acute and chronic), its symptoms, E. Antibiotics 3. Treatment
treatment, and prognosis. II. Tuberculosis 4. Prognosis
4. Define and list symptoms, diagnosis, and medical management of A. Less Common, Secondary B. Chronic Nephritis
cystitis, including UTI prevention. B. Possible Nephrectomy 1. Etiology
5. Discuss urethritis and its cause, symptoms, and treatment. C. Rest 2. S/s & Dx
6. Differentiate between acute and chronic nephritis, list symptoms, D. Treatment 3. Treatment
treatment, and prognosis. III. Acute Pyelonephritis VIII. Nephrotic Syndrome (Nephrosis)
7. Discuss nephrotic syndrome, its symptoms, nursing considerations A. Causes A. S/s & Dx
and prognosis. B. S/s and Dx B. Nursing Care
8. Discuss trauma of the bladder. C. Treatment C. Prognosis
9. Explain the incidence and progression of polycystic renal disease. IV. Chronic Pyelonephritis VIII. Other Conditions
10. List the general pharmacological considerations in caring for a A. Causes A. Trauma
patient with a urinary tract infection (UTI). B. S/s and Dx 1. Grades
C. Treatment 2. Symptoms
V. Cystitis 3. Nursing Care
A. Causes B. Polycystic Renal Disease/Polycystic
B. S/s & Dx Kidney
C. Treatment 1. Etiology
D. UTI Prevention 2. S/s & Dx
VI. Urethritis 3. Prognosis
A. Causes IX. Pharmacological Considerations
B. S/s & Dx
C. Treatment
Written: 09/90
Reviewed: 09/93, 08/98; 10/14
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10; 10/12

25
Unit: Medical Surgical Nursing Implementation:Linton, Ch. 40; Lecture/Discussion; Handouts; Transparencies; Clinical
Care of the Patient with a Renal Disorder Rotation to Hemodialysis Unit
Lesson: 9 Evaluation: Class Participation, Quizzing, Written Test, Application in Patient Care
Title: The Patient with Renal Failure Integrated: Nutrition 0.5 Hour
Time: Theory 2.5 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of this unit, the student will be able to: I. Prevention
A. Occurrence and Cause
1. Discuss the prevention of renal disease. B. Reporting
2. Discuss renal disease, including pathology, symptoms, prognosis, assessment, C. Education
treatment, and nursing management. II. Renal Failure (Acute & Chronic)
3. Describe, in detail, the effects of renal failure on the bodily systems. A. Pathology
4. Describe, in detail, the substitutes for kidney function, including hemodialysis, B. Symptoms
peritoneal dialysis, and transplant. 1. Urine
5. Compare and contrast the procedures and nursing care for the patient receiving 2. Blood/F & E Imbalance
hemodialysis and peritoneal dialysis. 3. BP
6. Describe the process of renal transplantation, reasons for transplant, medical 4. Skin/Appearance
management, and patient teaching, especially related to infection/rejection 5. CNS: Thought Processes
prevention and the importance of immunosuppressant therapy. 6. GI
7. Discuss general nutritional considerations for the patient in renal failure. 7. Effects on Other Bodily Systems
C. Prognosis
D. Assessment (H&P)
E. Treatment and Management
1. General
2. Fluid Intake and Diet
3. Activity
4. Comfort Measures
a. Skin Care
b. Pruritus Control
5. Anemia
a. Prevention
Written: 09/90 b. Treatment
Reviewed: 09/93, 08/98; 10/14
6. Infection
Revised: 07/95, 08/96, 08/00, 10/02; 08/04; 10/04; 12/06; 10/08; 01/10; 10/12
a. Prevention
b. Treatment

26
D. Management
III. Hemodialysis E. Nursing Care
A. Preparation F. Patient/Family Teaching
B. Lifeline G. Advantages & Disadvantages
C. Procedure V. Renal Transplant
D. Management A. Process
E. Nursing Care B. Etiology/Reasons
F. Patient/Family Teaching C. Medical Management
G. Advantages & Disadvantages D. Post-op Care
IV. Peritoneal Dialysis E. Immunosuppressant Therapy for
A. Preparation Prevention of Rejection
B. Lifeline F. Patient Teaching
C. Procedure VI. Nutritional Considerations

27
Unit: Medical Surgical Nursing Implementation: Linton, Quizzing, Transparencies
Disorders of the Reproductive System Lecture/Discussion
Lesson: 1 Evaluation: Application in Patient Care, Written Test, Class Participation,
Title: Introduction: The Female Reproductive Pattern Integrated: N/A
Time: Theory 1 Hour

OBJECTIVES PLAN OF LESSON

Upon completion of the unit the student will: I. Structures of Female Reproductive A. Perineal Care, Sitz bath, Safe
System and the Function of Each Sex
1. Describe the structures and functions of the Structure
female reproductive system. II. Age-Related Changes in the
2. Describe age-related changes in the female Female Reproductive System
reproductive system. III. The Nurse and the Gynecology
3. Discuss the emotional support given a patient Patient
who has a gynecologic problem. A. Emotional Support
4. Describe and discuss the normal physiology of B. Patient Teaching
the menstrual cycle and hormonal regulation C. Anatomy and Physiology
during the cycle. Applied
5. Describe pre-menstrual syndrome. IV. Menstrual Cycle
6. Discuss the physiology, occurrence, symptoms A. Physiology
of, and emotional reactions to menopause. B. Adolescent
7. Name the disorders of menstruation and V. Pre-Menstrual Syndrome
describe the symptoms of each. A. Physical
8. Discuss fertility and infertility and the tests done B. Psychological
to determine the possible causes of infertility in VI. Menopause
male and female. A. Physiology
9. List the points to remember in patient teaching. B. Emotional Reaction
C. Treatment
VII. Disorders
A. Dysmenorrhea
B. Menorrhagia
C. Metrorrhagia
VIII. Fertility and Infertility
A. Physiology and Causes
1. Male
2. Female
B. Diagnosis
Written: 09/90 C. Treatment
Reviewed: 09/93, 08/98, 04/02; 10/06; 04/08; 04/14
IX. Patient Teaching
Revised: 07/95, 08/96, 08/00, 04/04; 10/10; 8/12

28
Unit: Medical Surgical Nursing Implementation: Linton
Disorders of the Reproductive System Lecture/Discussion, Quizzing, Transparencies,
Lesson: 2 Evaluation: Application in Patient Care, Written Test, Class Participation,
Title: The Female With a Disorder of the Reproductive System Integrated: Pharmacology 0.5 Hour
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON


V. Ectopic Pregnancy
Upon completion of this unit the student will: I. Introduction A. Implantation
A. Objective 1. Tubes
1. Discuss the objective and attitude of treatment B. Attitude 2. Abdominal
for the woman with a gynecologic problem. II. Diagnostic Procedure B. Treatment
2. Describe the patient’s preparation for a A. Gynecologic Exam 1. Shock
gynecologic examination. B. Preparing the Patient 2. Peritonitis
3. Describe the assessment of a patient with a C. The Exam
disturbance of sexual structures or reproductive D. Nurse’s Responsibility
function. E. Tests
4. Discuss the pre-operative and post-operative 1. Pap
management of a patient with a D & C. 2. Cervical Biopsy
5. Define ectopic pregnancy and discuss treatment III. Assessment
of this disorder. A. Fear
B. Symptoms
C. History
D. Explanation
E. Psychology
IV. Dilation & Curettage (D&C)
A. Types of Abortions
1. Spontaneous
2. Threatened
3. Incomplete
4. Missed
5. Habitual
6. Therapeutic
B. Pre-op Care
C. Post-op Care

Written: 09/90
Reviewed: 09/93, 08/98, 04/02; 10/06; 04/08; 04/14
Revised: 07/95, 08/96, 08/00, 04/04; 10/10; 8/12

29
Unit: Medical Surgical Nursing Implementation: Linton
Disorders of the Reproductive System Lecture/Discussion, Quizzing, Transparencies,
Lesson: 2 Evaluation: Application in Patient Care, Written Test, Class Participation,
Title: The Female With a Disorder of the Reproductive System Integrated: Pharmacology 0.5 Hour
Time: Theory 2 Hours (continued)

OBJECTIVES PLAN OF LESSON

VI. Infections
Upon completion of this unit the student will: A. Vaginitis C. Ovarian Tumors
1. PH Balance 1. Cysts
6. Identify the types of infections occurring in the 2. Trichomonas a. Symptoms
female reproductive system and the treatment 3. Herpes Genitalis b. Treatment
and management of the patient with an infection. 4. Chlamydia D. Vaginal Cancer
7. Define endometriosis and discuss the treatment 5. Patient Teaching E. Vulvar Cancer
of this disorder. B. Perineal Pruritis 1. Incidence
8. Discuss the treatment and management of benign C. Cervicitis 2. Symptoms
tumors of the reproductive system and malignant D. P.I.D. 3. Treatment
lesions of the vulva. 1. Treatment 4. Management
9. Discuss the management of the patient with 2. Management IX. Gynecologic Surgery
gynecologic surgery. 3. Vaginal Culture A. Psychological
10. Discuss the management of vaginal fistula. VII. Endometriosis B. Pre-Operative Care
11. Describe the conditions resulting from relaxed A. Definition C. Post-Operative Care
public muscles, its treatment, and nursing B. Symptoms D. Inoperable
management. C. Treatment X. Fistula
12. Turn in med cards on the medications handout VIII. Tumors A. Site
(to instructor). A. Benign B. Etiology
1. Fibroid C. Results
a. Symptoms D. Treatment
b. Treatment E. Management
B. Uterine Cancer F. Inoperable
1. Cervical XI. Pelvic Relaxation
a. Symptoms A. Cystocele
Written: 09/90 b. Treatment B. Rectocele
Reviewed: 09/93, 08/98, 04/02; 10/06; 04/08; 04/14
2. Fungus C. Uterine Prolapse
Revised: 07/95, 08/96, 08/00, 04/04; 10/10; 8/12
a. Symptoms XII. Sexual Assault (Rape)
b. Treatment A. SANE
B. Rape kit

30
Unit: Medical Surgical Nursing Implementation: Linton; Lecture, Case Studies
Disorders of the Reproductive System Quizzing,
Lesson: 3 Evaluation: Application in Patient Care, Written Test, Class Participation
Title: The Male With a Disorder of the Reproductive System Integrated: Pharmacology 0.5 Hour
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Review of Anatomy


II. Assessment
1. Discuss the assessment of a patient with a A. Reasons
disorder of the male reproductive system. B. Symptoms
2. Discuss cancer of the prostate. C. Other Disorders
3. Define disorders of the testes and adjacent III. Prostate Cancer
structures. A. Symptoms
4. Discuss male sterilization and its reversal. B. Treatment and Management
5. Discuss the infectious diseases of the male 1. Pre-Op Care
reproductive system. 2. Post-Op Care
6. Discuss the pharmacologic considerations of C. Prognosis
the male with a reproductive disorder. IV. Disorders
A. Cryptorchidism
B. Epididymitis
C. Torsion
D. Hydrocele
E. Varicocele
F. Cancer of the Testes
V. Vasectomy
VI. Infectious
A. Balanitis
B. Prostatitis

Written: 09/90
Reviewed: 09/93, 08/98, 04/02; 10/06; 04/08; 04/14
Revised: 07/95, 08/96, 08/00, 04/04; 10/10; 8/12

31
Unit: Medical Surgical Nursing Implementation: Linton;
Disorders of the Reproductive System Lecture/Discussion, Quizzing
Lesson: 4 Evaluation: Application in Patient Care, Written Test, Class Participation
Title: The Patient with Breast Disease Integrated: Pharmacology 0.5 Hour
Time: Theory 1.5 Hours

OBJECTIVES PLAN OF LESSON

Upon completion of this unit the student will: I. Breast Disease D. Patient and Family Teaching
A. Incidence 1. Wound Care
1. Discuss the incidence and diagnosis of breast B. Risk Factors 2. Exercises
disease. C. Health Promotion 3. Skin Care
2. Identify the risk factors for developing breast D. Diagnosis 4. Attitudes
cancer. 1. Symptoms 5. Prosthesis
3. Identify methods of health promotion and a. Pain 6. Rehabilitation
prevention of breast cancer. b. Lumps IV. Complications
4. Describe the types of surgical intervention for c. Nipple Discharge A. Symptomatic Pain
malignant lesions of the breast. d. Appearance B. Local Infection
5. Describe the pre-op management of the patient 2. Self-examination C. Transitory Edema
having breast surgery. 3. Emotional Factors D. Lymphedema
6. Describe the post-op management of the patient 4. Examination by Physician E. Cellulitis
having breast surgery. a. Palpation V. Treatment of Metastatic Cancer
7. List the complications of breast surgery. b. Mammography A. Hormones
8. Name the various methods of treatment for c. Thermogram B. Radiotherapy
breast cancer. d. Ultrasound C. Chemotherapy
9. Describe cystic disease and discuss its importance. e. Incisional Biopsy VI. Fibrocystic Breast Disease
10. Discuss the etiology, surgical, medical and nursing f. Excisional Biopsy A. Symptoms
management of the patient with breast abscess g. Aspiration Biopsy B. Treatment
11. Discuss the pharmacologic considerations in II. Types of Surgery VII. Breast Abscess
treating women with breast disorders. III. Pre-op Surgery A. Cause
A. Pain Management B. Treatment
B. Prevention of infection C. Nursing Management
C. Promoting Mobility of Arm
and Shoulder

Written: 09/90
Reviewed: 09/93, 08/98, 04/02; 04/08; 04/14
Revised: 07/95, 08/96, 08/00, 04/04; 10/06; 10/10; 8/12

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Unit: Medical Surgical Nursing Implementation: Linton; Powerpoint presentation
Disorders of the Reproductive System Lecture/Discussion Quizzing,
Lesson: 5 Evaluation: Written Test, Class Participation
Title: The Patient with Venereal Disease Integrated: N/A
Time: Theory 2 Hours

OBJECTIVES PLAN OF LESSON b. Incidence


c. Symptoms
Upon completion of this unit the student will: I. Sexually Transmitted Infections d. Treatment
A. Cause e. Education
1. Name the common venereal diseases and their B. Statistics F. Trichomoniasis
causative agents. C. Assessment a. Incubation Period
2. Describe the symptoms and treatment of the six II. Common Disease b. Incidence
diseases listed above. A. Gonorrhea c. Symptoms
3. Name and describe the stages of syphilis. a. Incubation Period d. Treatment
4. Discuss the emotional and social repercussions b. Incidence e. Education
that may result from venereal disease. c. Symptoms G. Chancroid
d. Treatment a. Incubation Period
e. Education b. Incidence
B. Syphilis c. Symptoms
a. Incubation Period d. Treatment
b. Incidence e. Education
c. Symptoms H. AID/HIV
d. Treatment I. Hepatitis B Virus
e. Education J. Pubic Lice
C. Herpes Genitalis III. Repercussions
a. Incubation Period A. Nurse’s Attitude
b. Incidence B. Society’s Reaction
c. Symptoms
d. Treatment
e. Education
D. Chlamydia
a. Incubation Period
b. Incidence
c. Symptoms
d. Treatment
e. Education
Written: 09/90 E. Condylomata Acuminata
Reviewed: 09/93, 08/98, 04/02; 10/06; 04/08; 04/14
a. Incubation Period
Revised: 07/95, 08/96, 08/00, 04/04; 10/10; 8/12

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