REPUBLIC OF THE PHILIPPINES VISAYAS STATE UNIVERSITY College of Nursing VISCA, B AYBAY, LEYTE Telephone: (053) 563-7226 NCM

106 COURSE OUTLINE CARE OF CLIENTS AC ROSS THE LIFESPAN WITH PROBLEMS IN CELLULAR ABERRATIONS, ACUTE BIOLOGIC CRISIS, INCLUDING EMERGANCY AND DISASTER NURSING DATE June 11 & June 18 TOPIC I. MUSCULO SKELETAL FUNCTION A. Anatomic & Physiologic Overview 1. Skeletal System 2. Artic ular System 3. Skeletal Muscle System B. Assessment 1. Health History 2. Physica l Assessment C. Diagnostic Evaluation 1. Radiographic Studies 2. CT 3. MRI 4. Ar thrography 5. Bone Densitometry 6. Bone Scan 7. Arthroscopy 8. Arthrocentesis 9. EMG 10. Biopsy D. Clients With A Cast - Casting materials - Arm casts - Leg cas ts - Body or spica casts - Caring for a client with a cast E. Caring for a Clien t with Splints and Braces F. Caring for a Client with an External Fixator G. Cli ents in Traction - Principles of effective traction - Skin traction - Skeletal t raction - Caring for a client in traction I. Common Problems with the Musculoske letal System 1. Acute Low Back Pain 2. Bursitis & Tendinitis 3. Loose Bodies LEC TURER ALMERIA June 19 CALUNGSOD

June 25 June 26 4. Impingement Syndrome 5. Carpal Tunnel Syndrome 6. Ganglion 7. Dupuytren s Syndrom e 8. Corns 9. Callus 10. Ingrown Toenail 11. Hammer Toe 12. Hallux Valgus 13. Pe s Cavus 14. Morton s Neuroma 15. Flatfoot 16. Osteoporosis 17. Osteomyelitis 18. Ost eomalacia 19. Paget s Disease 20. Bone Tumors 21. Contusions, Sprains and Strains 22 . Joint dislocations 23. Sports Injuries - Rotator cuff tears - Epicondylitis Lateral & medial collateral ligament injury - Anterior & posterior cruciate liga ment injury - Rupture of the Achilles tendon 22. Fractures - Types - Kinds - Fra cture healing 23. Amputation II. CELLULAR ABERRATIONS A. Review of the Cellular Physiology 1. The Cell Cycle 2. Differentiation 3. Proliferation B. Characterist ics of Benign & Malignant Neoplasms 1. Terminology 2. Neoplasm 3. Benign 4. Mali gnant - Cancer cell characteristics - Invasion & metastasis - Tumor growth - Gen eral effects C. General Pathophysiology of Cellular Aberration D. Epidemiology ( Local & International) a. Lung cancer b. Breast cancer c. Uterine cancer d. Pros tate cancer MENESES DE LOS SANTOS

July 2 & July 3 e. Colorectal cancer E. Carcinogenesis & Causes of Cancer Oncogenesis Risk Facto rs: 1. Gender & Site 2. Age 3. Race & Ethnicity 4. Genetics 5. Hormonal Factors 6. Immunologic Factors 7. Oncogenic Viruses 8. Drugs & Chemicals 9. Radiation Ionizing - UV - Electromagnetic - Radon 10. Lifestyle F. Significant Subjective Data from the Client - Family history - Chief complaints - Functional patterns Psychosocial & behavioural assessment G. Principles & Techniques of Physical Ex amination in All Age Group, Deviations from Normal 1. Breast Self-Examination 2. Testicular Self-Examination 3. Digital Rectal Examination H. Diagnostic Tests & Nursing Responsibilities 1. Lung Cancer - Chest X-ray - Sputum cytology 2. Brea st Cancer - Mammogram - Clinical breast exam - MRI - Tissue Sampling 3. Uterine Cancer - Transvaginal sonography - Hysteroscopy - Sonohysterography - Biopsy pun ch 4. Cervical Cancer - Pap smear with staging 5. Prostate Cancer - Digital rect al examination - Prostate-specific antigen 6. Colorectal Cancer - Fecal occult b lood test - Sigmoidoscopy - Colonoscopy PEREZ

- Double-contrasted barium enema 7. Other tests - Tumor markers - Radioisotope s can - MRI July 9, July 10 & I. Pathophysiologic Mechanisms Leading to Manifestat ions July 16 1. Lung Cancer 2. Breast Cancer 3. Uterine Cancer 4. Colorectal Can cer 5. Prostate Cancer 6. Non-Hodgkin s Lymphoma 7. Kidney Cancer 8. Melanoma 9. Bas al Cell Carcinoma 10. Thyroid Cancer 11. Leukemia 12. Childhood Cancers - Glioma - Neuroma - Wilm s Tumor - Retinoblastoma - Ewing s Sarcoma - Osteosarcoma July 17 J. N ursing Diagnoses Taxonomy/Development of Outcome Criteria 1. Potential for Infec tion 2. Disturbance in Body Image 3. Activity Intolerance 4. Potential for Alter ation in Nutrition; Less than Body Requirements 5. Alteration in Oral Mucous Mem brane Integrity 6. Alteration in Comfort 7. Fluid Volume Deficit K. Principles o f Various Modalities of Management Against Cancer 1. Health promotion 2. Disease prevention 3. Curative 4. Restorative L. Principles of Management 1. Cancer Sta ging - TNM Classification - Clinical Staging - Metastatic Spread 2. Prevention o f Infection 3. Hydration 4. Blood Component Replacement 5. Oxygen Therapy 6. Pre vention of Complications 7. Rehabilitation M. Pharmacologic Actions (Therapeutic use, Side effects, Indications, Contraindications, ALMERIA MENESES July 23 & July 24 CALUNGSOD

Nursing responsibilities) 1. Biotherapy - Cytokines - Monoclonal Antibodies - Ce llular Therapies - Immunodilators - Retinoids 2. Chemotherapeutic Agents a. Clas sification - Cell cycle-specific - Cell cycle-nonspecific b. Categories - Alkala ting agents - Antibiotic - Nitroureas - Plant derivatives - Hormonal N. Special Considerations in Chemotherapeutic Drugs Preparation 1. Proper attire 2. Chemo d rug handling O. Special Procedures 1. Radiation therapy 2. Cervical implants 3. Reverse isolation P. Appropriate Discharge Plan Including Health Education MIDTE RMS EXAM III. ACUTE BIOLOGIC CRISIS A. Standard Assessment of the Critically Ill - Focused history taking - Discriminating physical examination AIRWAY BREATHING CIRCULATION HEMODYNAMIC STATUS July 30 August 7, 13 DE LOS SANTOS B. Pathophysiologic Mechanisms Leading to Manifestations 1. Cardiac Failure 2. A cute Myocardial Infarction 3. Acute Renal Failure August 14 & August 4. Stroke 2 0 5. Increaased Intracranial Pressure 6. Metabolic Emergencies - DKA/HHNK 7. Mas sive Bleeding/Hypovolemic Shock 8. Extensive Injuries - Dehiscence - Evisceratio n 9. Extensive Burns - Staging - Area Computation CALUNGSOD

August 28 - IVF Replacement C. Nursing Diagnoses Taxonomy/Development of Outcome Criteria 1. Impaired Gas Exchange 2. Inability to Sustain Spontaneous Ventilation 3. Dysf unctional Ventilatory Weaning Process 4. Decreased Cardiac Output 5. Altered Tis sue Perfusion, Systemic 6. Alteration in Nutrition; Less than Body Requirements 7. Fluid Volume Deficit 8. Activity Intolerance D. Results/Implications of Diagn ostic Laboratory Exams 1. Non-invasive: ECG, cardiac rhythms 2. Invasive: ABG, H emodynamic Monitoring, CVP, Pulmonary Capillary Wedge Pressure (PCWP) & 3. Life Maintaining Interventions - Airway management & care of clients with a ventilato r - Interventions for hemodynamic instability - Continuous hemodynamic monitorin g - Interventions for neural regulation - Fluid & Electrolyte problems - Nutriti on E. Pharmacologic Actions (Therapeutic use, Side effects, Indications, Contrai ndications, Nursing responsibilities) 1. Analgesics 2. Narcotics 3. Corticostero ids 4. Antihypertensives 5. Vasopressors 6. Antibiotic 7. Parenteral fluids IV. DISASTER NURSING A. Definition of Emergency & Other Terminologies - Disaster - T rauma B. Triage - Definition - Objectives 1. START Triage System - Indication fo r use - Mnemonic/Procedure - ADULT START Triage System - PEDIATRIC START Triage System - START Flow Chart - Color Coding - Evacuation Prioritization According t o Category - Incident Command System 2. MILITARY TRIAGE - Indication for use - 5 Categories of Severity PEREZ August 29 September 3 MENESES September 4 PEREZ

September 10 D. The Crash Cart/E-Cart - Contents - A-Z Emergency Drugs E. Personal Protective Equipment F. Hazardous Materials G. Decontamination H. Biologic Warfare & Biolo gic Agents K. Blast Injuries J. Natural Disasters DE LOS SANTOS K. Stress Reactions - Post Traumatic Stress Disorder - Critical Incident Stress Management - Debriefing September 11 & V. IV THERAPY September 17 A. Philosophy B. Definition C. Basic Foundation of IV Therapy 1. Historical Background 2. Ethi co-legal Issues - Role of ANSAP - Difference between RA 9173 & RA 7160 3. Standa rds of IV Therapy D. Review of Anatomy & Physiology of the Vascular System E. Pe ripheral & Integumentary System F. Fluid & Electrolyte Therapy 1. Types of Fluid s/Solutions and Uses 2. Drug Interaction with IV Fluids 3. Handling of IV Soluti ons, Blood Products & Components G. Nursing Process in IV Therapy H. Venipunctur e Technique in Adult & Children - Prescribed cannula & indications of each color & gauge - Ideal period of usage of an IV set, Indications - Process in keeping a set sterile I. Complications of IV Therapy J. Infection Control & Microbiology Principles K. Demonstration of Procedure ALMERIA PREPARED BY: KRISHNA RAE Z. ALMERIA, RN, MAN