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Adult Health Nursing (): Adult Health Nursing-I

This course aimed to furnish learners with the knowledge and skills to care for an adult patient admitted to the hospital with a disease condition. It emphasizes on effective utilization of nursing process to provide care to the client and facilitate them

Course Objectives

By the end of the course, the learners will be able to:

  1. Discuss the disease process, medical and surgical management, including patient’s education for client’s experiencing following disorders:
  2. Haematology Disorders
  3. Immunological Disorders
  4. Fluid, Electrolyte and Acid Base Balance and Imbalance
  5. Cellular adaptation and aberrant cell growth
  6. Gastrointestinal Disorders
  7. Genitourinary Disorders
  8. Discuss the purposes, indications and the nursing care of clients undergoing medical, surgical and diagnostic procedures related to the above-mentioned disorders.
  9. Utilize nursing process when caring for adult clients and their families related to above-mentioned disorders.
  10. Integrate knowledge of pathophysiology, nutrition & pharmacology for clients experiencing the above-mentioned disorders.
  11. Begin to recognize the need for integrating research-based information in the care of clients.
  12. Demonstrate awareness of the importance of legal and ethical issues in nursing practice.
Teaching/Learning Strategies:

Lecture / discussion, role-play, case study, video, group presentation, skills demonstration, tutorials and small group discussions.

UNIT I

Gastrointestinal Disorders:

By the end of the session learners will be able to:

  1. Review the anatomy and physiology of gastrointestinal system (GIT)
  2. Discuss the causes, pathophysiology and manifestation of the following GIT disorders
  3. Discuss the diagnostic, medical and surgical management of the below mentioned disorders
  4. Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with GIT disorders
  5. Develop a teaching plan for a client experiencing disorders of the GIT
Disorders of mouth and esophagus:
    • Stomatitis
    • Oral cancer/tumour
    • Salivary gland disorders
    • Gastro esophageal reflux disorder
    • Hiatal hernia
    • Achalasia
    • Diverticula
    • Esophageal cancer/tumor

Disorders of stomach

  • Gastritis
  • Ulcer disease
  • Gastric carcinoma

Disorders of small and large intestine:

  • Irritable bowel syndrome
  • Hernias
  • Intestinal obstruction
  • Hemorrhoids
  • Colorectal cancer
  • Appendicitis
  • Peritonitis
  • Ulcerative colitis
  • Chron’s disease
  • Anorectal abscess
  • Anal fissure
  • Anal fistula
Alteration in hepatobiliary system:
  • Pancreatitis
  • Pancreatic pseudocyst/abscess
  • Pancreatic carcinoma
  • Hepatic abscess
    • Cancer of liver
    • Cirrhosis of liver
    • Cholecystitis
    • Cholilithiasis
    • Cancer of gall bladder

UNIT II

Fluid, Electrolyte, and  Acid Base Balance & Imbalances

By the end of the session learners will be able to:

  1. Analyze the client’s status on the basis of physical examination findings
  2. Identify clients at risk for fluid imbalances, acidosis and alkalosis
  3. Use laboratory data and clinical manifestations to determine the presence of fluid imbalances, acidosis and alkalosis.
  4. Apply appropriate nursing techniques to the client with fluid volume deficit and excess and acidosis and alkalosis
  5. Develop a teaching plan to prevent above mentioned problems.
    • Fluid volume excess
    • Fluid volume deficit
    • Respiratory Acidosis and Alkalosis
    • Metabolic Acidosis and Alkalosis

Unit III

Genitourinary Tract (Gut) Disorders

By the end of the session learners will be able to:

  1. Review the anatomy& physiology of GUT
  2. Discuss the causes, pathophysiology and manifestation of the following GUT disorders
  3. Discuss the diagnostic, medical and surgical management of the below mentioned disorders
  4. Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with genitourinary disorders
  5. Develop a teaching plan for a client experiencing disorders of the genitourinary.
    • Urinary tract infections
    • Renal abscess & tuberculosis
    • Glomerulunephritis (immunologic disorder)
    • Urethral strictures, hydroureter and hydronephrosis
    • Urinary incontinence/ Retention & Urinary Calculi
    • Acute & Chronic Renal failure
    • Urinary Bladder and Renal cell carcinoma

UNIT IV

 Reproductive Disorders

By the end of the session learners will be able:

Female Reproductive Disorders:
  1. Review the anatomy & physiology of female reproductive system
  2. Discuss the function of the supporting ligaments and pelvic floor muscles in maintaining the position of the pelvic organs
  3. Discuss the alteration in estrogen and progesterone levels as a cause of dysfunctional menstrual cycle.
  4. Discuss the causes, pathophysiology and manifestation of the following female reproductive disorders
  5. Discuss the diagnostic, medical and surgical management of the below mentioned disorders
  6. Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with reproductive disorders
  7. Develop a teaching plan for a client experiencing disorders of the reproductive system
    • Reproductive tract Infections
    • Menstrual Disorders
    • Dysfunctional uterine bleeding
    • Menopause
    • Endometriosis
    • Pelvic inflammatory disease
    • Uterine prolapse
    • Cystocele
    • Rectocele
    • Fistulas
    • Infertility
    • Ectopic Pregnancy
    • Abortion
    • Hydatidiform mole
    • Ovarian cyst
    • Ovarian tumor and cancer
    • Uterine tumor/ fibroids
    • Breast cancer
Male Reproductive Disorders:
  1. Discuss the structure & function of male reproductive system
  2. Discuss the causes, pathophysiology and manifestation of the following male reproductive disorders
  3. Discuss the diagnostic, medical and surgical management of the below mentioned disorders
  4. Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with male reproductive disorders
  1. Develop a teaching plan for a client experiencing disorders of the reproductive system
    • Benign prostate hypertrophy
    • Erectile dysfunction
    • Prostate and testicular cancer
    • Infertility

UNIT V

Haematology Disorders

By the end of the session learners will be able to:

  1. Discus the causes, manifestations and associated mechanisms of following anemia
  2. Describe the pathogenesis of hemolytic disease of the newborn
  3. Discuss the lymph proliferative disorders associated with Hodgkin disease and non-Hodgkin’s lymphomas
  4. Discuss the mechanism of drugs induced and idiopathic thrombocytopenia
  5. Discuss the diagnostic, medical and surgical management of the below mentioned disorders
  6. Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with hematological disorders
  7. Develop a teaching plan for a client experiencing disorders of the hematology.
    • Sickle cell anaemia.
    • Immunohemolytic Anaemia
    • Iron deficiency anaemia
    • Vitamin B12 deficiency anaemia
    • Folic acid deficiency anaemia
    • Aplastic anaemia.
    • Polycythemia
    • Leukemia
    • Hodgkin disease & Non Hodgkin lymphoma
    • Autoimmune and thrombotic Thrombocytopenic purpura
    • DIC

UNIT VII

 Immunological Disorders

By the end of the session learners will be able to:

  1. Discuss Immunologic disorders.
  2. Discuss the diagnostic, medical and surgical management of the below mentioned disorders
  3. Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with immunological disorders
  4. Develop a teaching plan for a client experiencing disorders of the immunology.
    • HIV/ AIDS
    • Hypersensitivity and autoimmunity disorders
CLINICAL OBJECTIVES

During medical/surgical rotation learners are expected to apply the nursing process and critical thinking in delivering holistic nursing care to the clients with Oncological, Hematological, Immunological, Gastrointestinal and Genitourinary Disorders. Learners will utilize recommended assessment tools for clients’ assessment during clinical.

  1. Utilize the nursing process in providing care to the sick adult in the hospital.
    1. Collect data from the client and family, nursing kardex, patient’s charts, nursing notes and health team members.
    2. Integrate the knowledge of diagnostic tests in the process of data collection.
    3. Collect data necessary to determine nursing care needs of the patient
    4. Set priority or needs for nursing care.
    5. Develop a plan to meet the identified nursing needs of a client
    6. Adults the plan of care as necessary.
  2. Use a sound knowledge base in proving nursing care to adults in the hospital.
  3. Apply scientific principles in providing nursing care of adults.
  4. Identify the effects of sickness and hospitalization of adults and their families.
  5. Identify and plan out nursing intervention to meet the physiological and psychosocial and spiritual needs of the clients and families.
  6. Implement care according to priority order.
  7. Provide perioperative nursing care to client undergoing surgery.
  8. Evaluate the expected outcomes and revise the nursing care plan on an ongoing basis.
  9. Provide for the comfort and safety of adults in the hospital
  1. Demonstrate the ability to communicate effectively with the patient and

/or the family

  • Communicate effectively with patient using verbal and non-verbal methods
  • Explain nursing actions appropriately to the patient or family
  • Carry out nursing procedure safely and correctly
  • Use correct procedures
  • Ensure patient safety
  • Perform skills with dexterity
  • Maintain accurate records and reports
  1. Record comprehensive patient data
  2. Report the significant patient data to appropriate personnel
  1. Assess, plan, implement and evaluate health teaching related to medical and surgical conditions of patients
  2. Integrate theoretical knowledge and participate in care of clients undergoing following diagnostic procedures:
  1. Upper and lower GI (Gastro Intestinal) endoscopies
  2. Ultrasound
  3. Barium studies
  4. Biopsy (liver)
  5. Cystoscopy
  6. Paracenthesis
  7. CT( Computed Tomography) scan
  8. Pathological Lab test
  9. IVP ( Intravenous pyelography)
  10. X- rays
  11. Gastric analysis
  1. Integrate knowledge of pathophysiology, nutrition & pharmacology for clients experiencing the various disorders.
  2. Begin    to   recognize    the    need    for    integrating    research-based information in the care of clients
  3. Demonstrate awareness of the importance of legal and ethical issues in nursing practice
  4. Demonstrate the role of a nurse as a health educator.

Clinical skills checklist

  • IV medication
  • Tube feeding and insertion
  • Catheterization
  • Ostomy care

UNIT VI

Cellular Adaptation & Aberrant Cell Growth

By the end of the session learners will be able to:

  1. Identify the goals of cancer therapy
  2. Discuss different treatment modalities available for Cancer
  3. Discuss chemotherapy and radiation therapy, their types, indication, side effects and nursing care
  4. Discuss different types of cancer surgeries and nursing care of patients undergoing cancer surgery.
  5. Discuss end of life care (palliative and hospice care.