University of the Cordilleras Baguio City College of Nursing Course Syllabus I. COURSE CODE: NCM 103 II. COURSE NAME: Care of Clients with Problems in Oxygenation, Fluid and Electrolyte Balance, Nutrition and Metabolism and Endocrine III. COURSE DESCRIPTION: This course deals with the principles and techniques of nursing care management of sick clients across lifespan with emphasis on the adult and the older person, population group in any setting with alterations/problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocrine function. PLACEMENT: 3rd year, 1st semester CREDIT: 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical); 144 lecture hours; 306 RLE hours PRE-REQUISITE: NCM 102 IV.UC-PVMO PHILOSOPHY : UC believes that education is the foundation of a progressive nation in the rearing of the youth towards civil efficiency and the development of moral character that the benefits of higher education should be made accessible to everyone who deserves it. VISION : UC envisions itself as a community of scholars aggressively involved in the pursuit of knowledge who help preserve Filipino culture and values to act positively by training them to think critically and creatively. MISSION : UC’s mission is to provide functional knowledge and skills, dynamic interaction and leadership in various disciplines for a better quality of life.
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University of the CordillerasBaguio City
College of Nursing
Course Syllabus
I. COURSE CODE: NCM 103
II. COURSE NAME: Care of Clients with Problems in Oxygenation, Fluid and Electrolyte Balance, Nutrition and Metabolism and Endocrine
III. COURSE DESCRIPTION: This course deals with the principles and techniques of nursing care management of sick clients across lifespan with emphasis on the adult and the older person, population group in any setting with alterations/problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocrine function.
PLACEMENT: 3rd year, 1st semester
CREDIT: 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical); 144 lecture hours; 306 RLE hours
PRE-REQUISITE: NCM 102
IV.UC-PVMO
PHILOSOPHY : UC believes that education is the foundation of a progressive nation in the rearing of the youth towards civil efficiency and the development of moral character that the benefits of higher education should be made accessible to everyone who deserves it.
VISION : UC envisions itself as a community of scholars aggressively involved in the pursuit of knowledge who help preserve Filipino culture and values to act positively by training them to think critically and creatively.
MISSION : UC’s mission is to provide functional knowledge and skills, dynamic interaction and leadership in various disciplines for a better quality of life.
OBJECTIVES:1. Develop an environment conducive to inquiry.2. Empower constituents in the quest for progress.3. Contribute to appreciation of historical and cultural heritage.4. Actively involve in the molding of a national identity.5. Deeper sense of moral and spiritual values.
6. Expand scholarship to a wider segment.7. Update curricula to keep abreast of change.8. Community involvement and research intensified.
CO1 Utilize the nursing process in the care of individuals, families in community and hospital settings.
Assess with client/s his/her/their condition/health status through interview, physical examination, interpretation of laboratory findings.
Identify actual and at-risk nursing diagnosis Plan appropriate nursing interventions with
client/s and family for identified nursing diagnosis
Implement plan of care with client/s and family. Evaluate the progress of his/her/their client’s
condition and outcomes of care.
3 2 3 3 3 3 3 3 3 3 3 3
CO2 2. Ensure a well organized and accurate documentation system;
3 3 3 3 3 3 3 3 3 3 3 3
CO3 3. Relate with client/s and their family and the health team appropriately;
3 3 3 3 3 3 3 3 3 3 3 3
CO4 4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and,
3 3 3 3 3 3 3 3 3 3 3 3
CO5 5. Promote personal and professional growth of self and others.
3 3 3 3 2 3 3 3 3 3 3 3
VI. COURSE CONTENT
OBJECTIVES INTERMEDIATE COMPETENCIES
COURSE CONTENT TEACHING-LEARNING ACTIVITIES
TIME FRAM
E
GRADINGPERIOD
ASSESSMENT TOOL
At the end of the lecture discussion, the students will be able to:1. Utilize the
nursing process in the care of individuals, families with problems in oxygenation in community and hospital settings;
2. Ensure a well organized and accurate documentation system;
3. Relate with client/s and their family and the health team appropriately;
4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and,
5. Promote personal and professional growth of self and others.
1. Identify risk factors among clients that contribute to the development of problems in Oxygenation- cardiovascular risk factors (modifiable and non-modifiable).
The different risk factors among clients that contribute to the development of problems in oxygenation:
b. Special procedures – endotrcheal/tracheal suctioning and care, humidication, IPPB, ventilator assist
3. Cardiac a. Surgical procedures –
coronary aretery bypass, pacemaker insertion, valve replacement, repair of congenital abnormality, insertion of ventricular assist device, heart plansplant
b. Special procedures – laser therapy, basic life support, advance life support
3.1Vasculara. Surgical procedures –
endarterectomy, aneurysmectomy, insertion of intravascular stents
b. Special procedures – application of antiembolic stockings
3.2Blood forming organsa. Surgical procedures – bone
marrow aspiration, bone marrow transplant
b. Special procedures – blood component transfusion, reverse isolation
Prelim Exam
Quiz (Objective)
Role Play Analysis
At the end of the lecture discussion, the students will be able to:
1. Utilize the nursing process in the care of
10. Identify risk factors among clients that contribute to the development of problems in Fluid and Electrolytes.
Potential factors for exceeding renal reserve capacity, dietary habits to include salt intake, hypertension, infection, diabetes.
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
1.5 hours
MIDTERM
individuals, families with problems in Fluids and electrolyte imbalances in community and hospital settings.
2. Ensure a well organized and accurate documentation system;
3. Relate with client/s and their family and the health team appropriately;
4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and,
5. Promote personal and professional growth of self and others.
Group Discussion
Group Presentation/ Report
Output Presentation
Prioritization of Nursing DiagnosisNCP Analysis Presentation
11. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.
Inspection- signs of dehydration, overhydration
Palpation- edema, ascites, neck vein filling, hand vein filling, neuromuscular irritability, characteristic of pulse
Percussion- abdomen for presence of air, fluid
Auscultation- rates
Demonstration Return
Demonstration Lecture
Discussion Post test
2 hours
12.Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in
a. Diagnostic tests Non-invasive: electrolyte
determination, intake and output, KUB-IVP and ultrasound
Invasive – biopsyb.Weightc. Vital Signs
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
1.5 hours
13.Determine the Patho-physiologic Mechanisms of Fluid and electrolyte imbalances.
a. Volume impairment – fluid volume deficit, fluid volume excess, third space fluid shift
b. Osmotic imbalances – hyponatremia, hypernatremia
c. Ionic concentration problems – hypo- and hyperkalemia; hypo and hyperchloremia; hypo- and hypermagnesemia; hypo- and hyperphosphatemia
d. Acid and base imbalances – metabolic acidosis and alkalosis; respiratory acidosis and alkalosis
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
12 hours
14.Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Fluid and electrolyte imbalance.
a. Risk for fluid volume deficitb. Fluid volume excessc. Fluid volume deficitd. High risk for injury related to
electrolyte deficit/excesse. High risk for injury related to
acid/base imbalancef. Altered urinary elimination
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
2 hours
g. Impaired integumentary integrity
Oral Graded Recitation
15. Identify principles of various modalities of management of clients with problems in fluid and electrolyte imbalances taking into consideration the following levels of care:a. Health
promotiveb. Disease
preventivec. Curative and
restorative
a. Fluid Volume Deficit Determination and
management of cause Hydration Blood transfusion as
needed Drug therapy –
electrolyte Supportive management Prevention of infection Prevention of
complication Prevention of
psychosocial problems Rehabilitation
b. Fluid Volume Excess Determination and
management of cause Drug therapy – diuretics,
electrolytes Dietary restriction –
sodium Supportive management Prevention of infection Prevention of
complication Prevention of
psychosocial problems Rehabilitation
c. Electrolyte Deficit – hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia Determination and
management of cause Drug therapy –
electrolyte replacement Dietary management
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
12 hours
Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
d. Electrolyte Excess – hyperkalemia, 11ypercalcaemia, hypermagnesemia, hyperphosphatemia Determination and
management of cause Drug therapy –
electrolyte replacement Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
e. Metabolic Alkalosis – Base bicarbonate exces Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
a. Metabolic Acidosis- base bicarbonate deficit
Determination and management of cause
Drug therapy Dietary management Supportive management
Reaction Paper
Prevention of complication
Prevention of psychosocial problems
Rehabilitationf. Respiratory Alkalosis –
carbonic and acid deficit Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
g. Respiratory Acidosis – carbonic acid excess Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
Group
PresentationCase Analysis
16. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients in fluid and electrolyte imbalances.
a. Fluid Parenteral fluids Hypotonic Hypertonic Isotonic
b. Electrolyte Sodium Potassium Calcium Magnesium Phosphate
c. diuretics Potassium-sparing
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
2.5 hours
Potasium-losing Osmotic diuretics
d. Vitamin D supplements
Midterm Exam
Quiz (Objective)
Role Play Analysis
Group Discussion
Group Presentation/ Report
17. List the purposes, indications, nursing responsibilities for the surgical and special procedures in alterations in fluid and electrolyte imbalances.
4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and,
5. Promote personal and professional growth of self and others.
Sexuality-reproductive pattern
Coping-stress tolerance pattern
Value-belief pattern
Output Presentation
Oral Graded Recitation
Prioritization of Nursing Diagnosis
NCP Analysis Presentation
20. Enumerate the principles and techniques of physical examination in newborn, children, adults, deviations from normal.
3.3Gastrointestinal function – IPPA Inspection- color, texture
of skin, mucous membrane, growth patterns, scars, masses
Auscultation- bowel sounds, bruits
Palpation – focus on GIT for presence of masses, ascites, rebound tenderness, distention
Percussion – liver span, masses
Demonstration Return
Demonstration Lecture
Discussion Post test
1.5 hours
21.Identify results and implications of diagnostic/laboratory examinations of clients with reference to problems in Nutrition and Metabolism.
a. Non-invasive: ultrasound of the abdomen, stool culture
b. Invasive: to include: barium swallow, esophagoscopy, biopsy, cytology examination, gastric secretion analysis, endoscopy (gastroscopy, duodenoscopy), proctosigmoidoscopy and rectal examination
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
1.5 hours
22. Determine the Patho-physiologic mechanisms of the Alterations in Nutrition and Metabolism.
a. Disturbances in ingestion – problems in buccal cavity and esophagus
b. Disturbances in digestion – peptic acid disease, gastritis and gastric cancer
c. Disturbances in absorption – malnutrition, malabsorption syndrome and inflammatory bowel conditions
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
12 hours
d. Disturbances in elimination – bowel obstruction, hemorrhoids, diarrhea and constipation.
Reaction Paper
23.Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in Nutrition and Metabolism.
a. Alteration in nutrition less than body requirement
b. Alteration in nutrition more than body requirement
c. Alteration in oral mucous membrane integrity
d. Alteration in comfort: epigastric pain/abdominal pain
e. Fluid volume deficit
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
1.5 hours
24. Identify principles of various modalities of management of clients with problems in Nutrition and Metabolism taking into consideration the following levels of care:
4. Health promotive
5. Disease preventive
6. Curative and restorative
A. Disturbances in ingestion Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
B. Disturbances in digestion Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
C. Disturbances in absorption Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
12 hours
complication Prevention of
psychosocial problems Rehabilitation
D. Disturbances in elimination Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
E. Disturbances in hepatic, biliary and pancreatic functions Determination and
management of cause Drug therapy Dietary management Supportive management Prevention of
complication Prevention of
psychosocial problems Rehabilitation
25. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with Nutrition and Metabolism problems.
Antiemetics Anticoagulants Hematinics agents Laxatives and stool
b. Special procedures – parenteral hyperalimentation; feeding per nasogastric, jejunostomy, gastrostomy tubes; colostomy care and irrigation, dietary planning for common GT and endocrine problems; administering medications via NGT, J tube, G tube; hot sitz bath
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
2.5 hours
At the end of the lecture discussion, the students will be able to:1. Utilize the
nursing process in the care of individuals, families with problems in endocrine functioning in community and hospital settings.
2. Ensure a well organized and accurate documentation system;
3. Relate with client/s and their family and the health team appropriately;
4. Observe bioethical concepts/principl
27. Identify risk factors among clients that contribute to the development of problems in Endocrine Function.
Risk factors related to endocrine hypo or hyper-functioning.
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
1.5 hours
28. Identify significant subjective data from client history related to problems in endocrine functioning.
A. Chief complaintsB. Relevant information, to
include eleven functional patterns Health perception
Invasive: e.g. percutaneous transhepatic cholangiogram, liver function test, serum thyroxine and triiodothyronine test, iodine 131 uptake, blood sugar tests (fasting blood sugar –FBS), random blood sugar (RBS), glycosylated hemoglobin (Hgb), two-hour post prandial blood glucose, endocrine assay.
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
2.5 hours
31. Determine the a. Hypo- and Hyperfunction of the Pre-tests 10
Patho-physiologic mechanisms of the Alterations in endocrine functioning.
pituitary organb. Hypo- and Hyperfunction of the
hypothalamusc. Hypo- and Hyperfunction of the
thyroid organd. Hypo- and Hyperfunction of the
parathyroid organe. Hypo- and Hyperfunction of the
adrenal organf. Hypo- and Hyperfunction of the
gonadsg. Problems in glucose
metabolism – hypoglycemia and hyperglycemia (IDM, NIDDM)
Case Analysis Small Group
Learning Lecture
Discussion Post test
hours
32.Enumerate Nursing diagnoses taxonomy pertinent to problems/alteration in endocrine functioning.
a. Alterations in nutrition less than body requirement
b. Fluid volume deficitc. Activity intolerance
Pre-tests Case Analysis Small Group
Learning Lecture
Discussion Post test
1.5 hours
33. Enumerate Pharmacologic actions, therapeutic uses, side effects, indications, contraindications, and nursing responsibilities in administering medications clients with endocrine problems.
NCM 103 Grade: (NCM 103 Lecture Final Grade x 8) + ((NCM 103 RLE x6) 14
AT CO 1 CO2 CO3 CO4Quiz(Essay and Recall)
50% 50% 50% 50%
Group Presentation 25% 25% 25% 25%Case Study Presentation
230% 23% 23% 23%
Film Analysis/Reaction
2% 2% 2% 2%
Total 100% 100% 100% 100%
X. REFERENCES:
1. Commission on Higher Education Memorandum No. 14 Series of 20092. Nettina S.,(2001), The Lippincott’s Pocket Manual of Nursing Practice, New York: Lippincott 3. Marieb, E., (2006), Essentials of Human Anatomy and Physiology, Pearson Education South Asia PTE. LTD. 4. Brunner, L. and Suddarth, D., (2008), Textbook of Medical-Surgical Nursing, Philadelphia: Lippincott 5. Black, J and Hawks, J., (2008), Medical Surgical Nursing: Clinical Management for Positive Outcomes, Philadelphia: Lippincott6. Lemone, P. and Burke, K., (2004) Medical Surgical Nursing: Critical Thinking in Client Care, NJ: Pearson Prentice Hall7. Sharon Lewis, (2007) Medical Surgical Nursing: Assessment and Management of Clinical Problems, Mosby
Prepared by: Evaluated by: Approved by: Noted by:
Mr. Michael Joel C. Piduca, RN, MAN Eddieson Pasay-an,Ph.D,RN Dr. Marian Grace Gascon Dr. CLEOFAS BASAEN