Adult Health Nursing (): ADULT HEALTH NURSING-II

At the end of the Adult Health Nursing II, the learners will be able to:

1. Demonstrate an ability to utilize nursing process in extending holistic care to adult patients with a variety of Cardiovascular, Respiratory, Endocrine, Musculo-skeletal, Neurological and ENT (Ear, Nose and Throat) related disorders.
2. Describe the risk factors, etiology, signs & symptoms and integrate Pathophysiology of various disease processes using a nursing framework, (Functional Health pattern) to assess patient’s needs and problems.
3. Discuss the need of using relevant research findings in designing appropriate nursing care for the patients.
4. Demonstrate an awareness of legal and ethical standards in caring for patients with various disorders in a variety of acute and intermediate care settings.

Orthopedic Nursing

This unit will assist the learners in effective utilization of nursing process in delivering care to patients with musculo-skeletal problems. The course places emphasis on the important concepts applicable in musculo-skeletal conditions and rehabilitation of patients.

By the end of this unit, learners will be able to:

1. Relate the normal anatomy and physiology of the musculo-skeletal system to alterations of normal structures and functions.
2. Display the ability to assist in carrying out diagnostic procedures related to the musculo-skeletal system and also recognizes and reports the abnormalities in the results.
3. Identify the needs of the client, with different types of tractions and amputation.
4. Use nursing concepts in identifying potential complications associated with musculo-skeletal disorders.
5. Utilize nursing process in delivering care, promoting and maintaining the optimal wellness of clients with musculo-skeletal disorders.
6. Collaborate with other members of the health care team in health teaching and discharge planning.
7. Incorporate relevant research findings in designing a plan of care for clients with musculo-skeletal disorders.
8. Understands and performs Neuro-Muscular assessment independently on patients having musculo-skeleton disorder.
9. Demonstrate pre and post operative nursing care in patients with Musculo-skeletal surgeries.

• Soft tissue injury
• Fracture.
• Amputation.
• Paget’s disease and Gout.
• Osteomylitis.
• Osteoarthritis
• Osteoperosis
• Rheumatoid Arthritis
• Bone tumors.
• Tuberculosis.

Endocrine Nursing

Care of clients with disorders of Pituitary Gland

This unit gives an introduction to the endocrine system. Disorders of anterior and posterior pituitary gland are discussed with a focus on physiology and disorders of secretion of growth hormone. Both hypo- secretary and hyper-secretary disorders are dealt with here. By the end of this unit, the learners will be able to:

1. Discuss treatment modalities of patients with pituitary gland disorders.
2. Utilize nursing process in the provision of care for patients with disorder of pituitary gland and for patients undergoing surgery of the gland.
3. Discuss the impact of various endocrine disorders on patients and their families

Care of clients with disorders of Diabetic

In this unit, learners will gain an understanding of pathogenesis of different types of diabetes mellitus. Acute and chronic complications of diabetes mellitus will be discussed along with medical and nursing management of clients. Research related to this disorder and its treatment will be discussed. Client education and home management will also be the focus areas of this unit.

1. Discuss the preparation for patients undergoing diagnostic tests/ procedures for a patient with diabetes.
2. Identify pathogenesis and manifestations of the acute and chronic complications of diabetes mellitus.
3. Assess: Hypo and Hyperglycemic conditions.
4. Discuss the medical and pharmacological treatment for a diabetic client.
5. Discuss the purpose and plan of diet for diabetic clients.
6. Describe the nursing management of a newly diagnosed diabetic client.
7. Describe the nursing management of a diabetic client who has Ketoacidosis, Hypoglycemia, and who is undergoing surgery
8. Explain the psychological impact of diabetes mellitus on the client and his family.
9. Explain the nursing responsibilities in the long-term management of the diabetic client.

Care of client with Thyroid gland disorders

This unit deals with review of structure of thyroid gland and patient emphasis on physiology and hormone production. This information is integrated while discussing the disorders of thyroid hormone secretion i.e. hypo and hyper-thyroidism. Moreover, goiter is also discussed in this unit.

By the end of this unit the learners will be able to:

1. Demonstrates understanding of medical and surgical management of patients with thyroid disorders.
2. Describe pre and post-operative care of thyroidectomy.
3. Identify potential complications of thyroid disorders and describe appropriate measures in that regard.
4. Explain the complications of thyroidectomy.

Care of patients with Parathyroid disorders

In this unit, learners learn about the function of parathyroid hormone and effect of impaired hormone secretions on body. They are expected to apply this information while discussing the disorder of parathyroid gland.

By the end of this unit the learners will be able to:

1. Describe treatment modalities of patients with parathyroid disorders.
2. Utilize nursing process in provision of care to patients with disorders of parathyroid gland.

Care of patients with disorders of Adrenal gland

In this unit, the focus is on the hormones secreted by the adrenal medulla and adrenal cortex. Their significance to life is discussed. Various disorders of hyper secretion and hypo secretion of hormones of adrenal cortex and medulla are discussed.

By the end of this unit the learners will be able to:

1. Integrate the disorders associated with adrenal cortex and medulla.
2. Describe    treatment    modalities    of   patients    with   adrenal    gland disorders.
3. Utilize the nursing process in the provision of care to patients with adrenal gland disorder.
4. Review effects and side effects of gluco-corticoid therapy and plan client teaching accordingly.
5. Explain   the   systemic   effects   of   short   and   long   term   use   of corticosteroid therapy.

Neurological Nursing

Increased ICP (Intra cranial pressure) and Head Injury

This unit will assist learners in applying nursing knowledge to the care of a patient with increased ICP and head injury, in an acute care setting.

By the end of this unit the learners will be able to:

1. Review anatomy and physiology of brain and its protective structures.
2. Differentiate   between   primary   and   secondary   head   injuries   and demonstrate an understanding of the related pathophysiology.
3. Anticipate major complications that may result from head injuries.
4. Utilize nursing process in caring for a patient, with head injury.

Spinal Cord Injury

This unit aims at helping learners understand the physical, physiological and psychological sequel of spinal cord injuries. Unit will also focus on preventive and curative care of patients with intervertebral disc herniation.

By the end of this unit the learners will be able to:

1. Review basic anatomy and physiology of spinal cord and its protective structures.
2. Describe various mechanisms of injury that may be involved in spinal cord injury.
3. Relate pathophysiological changes that take place after a partial or complete cord transaction.
4. Identify life threatening complications that may result from spinal cord injury.
5. Appreciate the need for prompt interventions in case of a patient with spinal shock and autonomic dysreflexia.
6. Describe the nursing care of a patient with spinal cord injury in an emergency and acute care setting.
7. Explain briefly the rehabilitative needs of patients with Spinal cord injury.
8. Identify the causes and mechanism of injury involved in intervertebral disc herniation.
9. Describe the role of nurses in surgical and non-surgical management of a patient with intervertebral disc herniation.
10. Discuss the importance of maintaining proper body mechanics in preventing intervertebral disc herniation.

Cerebro Vasular Accident (CVA)

This unit will help learners understand the needs of patients with CVAs depending upon the extent location and manifestations of CVAs. It will also focus on the distinguishing features of CVAs and TIAs and their respective nursing care.

By the end of this unit the learners will be able to:

1.    Utilize nursing process in caring for the patient with CVA.

Infections/Inflammations of CNS (Central Nervous System) Meningitis/ Encephalitis/ Brain abscess

This unit focuses on the alterations in intracranial dynamics, resulting from infections/inflammation of CNS and the role of nurses in preventing and managing complications associated with meningitis, encephalitis and brain abscess.

By the end of this unit the learners will be able to:

1. Describe alterations in intracranial dynamics resulting from infectious disorders of Central Nervous System (CNS).
2. Differentiate   between   the   etiology,   manifestations   and   diagnostic markers of meningitis, encephalitis and brain abscess.
3. Discuss the pharmacological and nursing management of patients with inflammations and infections of CNS.

Epilepsy/Seizures

This unit aims at increasing learners understanding of clinical and social sequel of epilepsy and the role of nurses in managing patients with epileptic disorder.

1. Use nursing process to provide care to patients with various seizures disorders.
2. Demonstrate an understanding of the side effects and nursing care of some common antiepileptic drugs.
3. Appreciate the psychological effects of epilepsy for a patient and family.

Disorders of Neuromuscular Transmission.

Myasthenia Gravis (MG)/Gullien Barrie Syndrome (GBS) (Tutorial)

This unit will assist learners in understanding their role as nurses in assessing and managing patient with common neuromuscular disorders and in identifying complications associated with it.

• • Relate the normal physiology of neuro-muscular transmission to the pathophysiological mechanisms involved in GBS and MG.
  • Distinguish the signs and symptoms of MG and GBS.
  • Describe nurses’ role in caring for patients undergoing diagnostic procedures to rule out MG and GBS.
  • Identify major complications associated with Myasthenic Crises and Cholinergic Crisis.
  • Utilize   effective   nursing   process   in   caring   for   patients   with

neuromuscular transmission disorder.

Pain and painful disorders related to nervous system.

This unit focuses on the etiology, Pathophysiology, manifestations and nursing care of a patient with headache and facial pain.

By the end of this unit the learners will be able to:

1. Trigeminal Neuralgia
   • Review the basic anatomy of trigeminal nerve and its main division.
   • Explain the etiology and Pathophysiology of trigeminal neuralgia.
   • Recognize the clinical manifestations of trigeminal neuralgia.
   • Identify the diagnostic techniques used to rule out the above disorder.
   • Explain medical and surgical management of the same.
   • Utilized nursing process in providing care and teaching to a patient with trigeminal neuralgia.
2. Migraine / Headache.
   • Classify the various types of headaches according to their etiology and pathophysiology.
   • Describe dietary and other precipitants of migraine headache.
   • Explain the pharmacological and symptomatic treatment used for patients with various types of headaches.
   • Describe nursing responsibilities in caring and teaching of a patient with headaches.

Chronic Neurological Disorders

1. Parkinson’s disease

This unit will help learners in understanding Parkinson’s disease, its etiology, pathophysiology and manifestations and emphasizes on the role of a nurse in managing patients in hospital setting and out patient setting and family teaching. By the end of this unit the learners will be able to:

• • Discuss the medical surgical management.
  • Utilized nursing process to extend care to a patient with Parkinson’s disease.
  • Appreciate   patient   and   family   needs   for   teaching   and   home management.

2. Alzheimer’s Disease

This unit describes the etiology, pathophysiology,  manifestations of Alzheimer’s disease with emphasis on understanding the social and psychological aspects in caring for patients with this disorder. By the end of this unit the learners will be able to:

• • Define Alzheimer ’s disease.

• • Discuss its etiology and pathophysiology
  • Identify signs and symptoms exhibited by patient with Alzheimer’s disease
  • Appreciate the social and psychological sequel for patient with Alzheimer’s disease.

3. Brain damage and special states of altered consciousness.

By the end of this unit the learners will be able to:

• • Describe various causes of Brain damage classified as: Anoxia/Hypoxia and perfusion failure.
  • Explain the pathophysiological mechanism of anoxic and ischemic brain injury
  • Discuss general signs and symptoms manifested by a patient with brain damage.
  • Demonstrate an understanding of special states of altered consciousness: Persistent vegetative state locked in syndrome and brain stem death.
  • Discuss the essential state involved in brain stem death criteria.
  • Discuss general nursing interventions  and ethical Legal issues involved in caring for a patient with brain damage
  • Review anatomy and physiology of External and Middle ear.

 Eye and ENT Nursing

Otitis media and Mastoiditis/Meinere’s Disease

In this unit learners will understand the care of a patient with Otitis media and Meinere’s disease. They will learn the preventive measures related to Otitismedia, Mastoiditis and Meinere’s disease. Differentiate between Otitis Externa and Otitis media.
Discuss the measures to prevent the spread of infection from the middle ear to the Mastoid process.
Utilize nursing process while caring for patients with Otitis Media.
Epistaxis and Deviated Nasal Septum.
This unit will emphasize on care of patients with Epistaxis and deviated Septum. Learners will also learn about emergency care of patients with Epistaxis at home. By the end of this unit the learners will be able to: Review the anatomy and physiology of nose 
Discuss the nursing care of patients with deviated nasal septum.
Explain the emergency care of a patient with epistaxis.
Tonsillitis.
This unit will focus on care of a patient with tonsillitis and the criteria for surgical interventions. Learners will understand the care of patients with tonsillectomy.

5. 3. Discuss medical, surgical and nursing management of patients suffering from coronary artery diseases.
6. Valvular disorders:
   1. Discuss the alteration in hemodynamic function of the heart that occurs with valvular disease
   2. Differentiate the effects of stenotic and regurgitant mitral & aortic valvular heart disease on cardiovascular function.
7. Heart failure:
   1. Discuss the factors effecting cardiac performance in the light of Frank starling law i.e. pre load, after load and cardiac contractility
   2. Describe the pathological mechanism underlying the manifestation of congestive heart failure
   3. Differentiate between:
      • Systolic versus diastolic failure
      • Right side versus left side failure
   4. Discuss the clinical manifestation of congestive heart failure
   5. Discuss medical, surgical and nursing management of patients with heart failure
8. Disorders of Cardiac Conduction and Rhythm:
   1. Review the anatomy & physiology of cardiac conduction system
   2. Review the electrical activity of the conduction system on an Electrocardiography (ECG) tracing.
   3. Describe the mechanism for dysrhythmia generation
      • Discuss the different types of dysrhythmias.
      • Discuss various heart blocks
      • Discuss   medical,   surgical   and   nursing   management    of patients with disorders of cardiac conduction and rhythm.

Heart Blocks and Pacemaker

In this unit learners will review the basic interpretation of electrocardiogram including different types of arrhythmia. Moreover focus will be on nursing and medical management of clients with pacemaker. At the completion of the session, learners will be able to:

1. Discuss the different kinds of heart blocks.
2. Discuss the care of clients with temporary and permanent pacemaker.

Pulmonary Nursing

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

1. Review the anatomy & physiology of upper respiratory tract
2. Discuss the causes, Pathophysiology and manifestation of the following respiratory tract 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 respiratory disorders
5. Develop a teaching plan for a client experiencing disorders of the respiratory tract.

Upper respiratory tract infections:

• • • Sinusitis
    • Pharyngitis
    • Tonsillitis

Lower respiratory tract infections:

• • • Influenza
    • Pneumonia
    • Pulmonary T.B ( tuberculosis)
    • Lung Abscess

Obstructive lung diseases:

• • • Asthma
    • COPD ( Chronic obstructive pulmonary disease)
    • Lung cancer
    • Acute Respiratory failure
    • Acute Respiratory Distress Syndrome
    • Chest trauma