PURPOSE NR324 ADULT HEALTH I Learning Plan This learning plan expands upon the key concepts identified for the course and guide faculty teaching the pre-licensure BSN curriculum in all locations. Readings and assignments contained within the newly aligned course shells support learners mastery of this content and the course outcomes. NCLEX TEST PLAN Integrated Processes: Nursing Process, Caring, Communication & Documentation, Teaching/Learning, and Culture & Spirituality 1 Safe and Effective Care Environment - (Management of Care, Safety and Infection Control) 2 Health Promotion and Maintenance 3 Psychosocial Integrity 4 Physiological Integrity - (Basic Care and Comfort, Pharmacological & Parenteral Therapies, Reduction of Risk Potential, Physiological Adaptation) CONTENT OUTLINE Unit 1 student will fluid and electrolyte and acid-base imbalances. (COs 4, 8/ NCLEX 4) Unit # 1 Pathophysiologic Mechanisms of Disease Fluid & Electrolyte Imbalance Acid-Base Imbalance Health Condition (Physiological Integrity: Adaptation & Reduction of Risk Potential) 1. Extracellular Fluid Volume Imbalances a. Deficit & excess student learning by addressing: alterations in health of the fluid or electrolyte status. NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 1
care for patients experiencing fluid & electrolyte and acid-base imbalances (COs 1, 2, 3, 4, 6, 8/ NCLEX 4) when caring for patients with fluid and electrolyte and acid-base imbalances. (COs 1, 3, 4, 6, 7, 8/ NCLEX 1, 4, Nursing Process) needs for patients with fluid and electrolyte and acid-base imbalances. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4) 2. Electrolyte Imbalances a. Sodium and potassium b. Calcium, Phosphate, and Magnesium 3. Acid- Base Imbalances 1. Pathophysiologic process review 2. Respiratory Acidosis a. Clinical Manifestations and complications b. Laboratory findings 3. Respiratory Alkalosis a. Clinical Manifestations and complications b. Laboratory findings 4. Metabolic Acidosis a. Clinical Manifestations and complications b. Laboratory findings 5. Metabolic Alkalosis a. Clinical Manifestations and complications b. Laboratory findings B. Assessment - (Nursing Process/ Health Promotion & Maintenance) 1. Health Perception/Health Management Pattern a. Health and surgical history b. Current medications 2. Nutritional-Metabolic Pattern a. Dietary habits b. Tissue integrity 3. Elimination Pattern a. Bowel & bladder 4. Activity-Exercise Pattern Unit 2 student will be able Unit # 2 Problems of Oxygenation: Ventilation Respiratory System Alterations student learning by addressing: Cultural Humility: NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 2
respiratory system alterations. (COs 4, 8/ NCLEX 4) care for patients experiencing respiratory system alterations (COs 1, 2, 3, 4, 6, 8/ NCLEX 1, 3, 4) when caring for patients with respiratory system alterations. (COs 1, 3, 4, 6, 7, 8/ NCLEX 1, 4, Nursing Process) needs for patients with respiratory system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4) Health Condition - (Physiological Integrity: Adaptation & Reduction of Risk Potential) 1. Non-infectious upper respiratory alterations a. Obstructive sleep apnea b. Upper airway obstruction 2. Non-infectious lower respiratory alterations a. Cystic fibrosis b. Lung cancer 3. Obstructive pulmonary disorders a. Asthma b. Bronchitis (Acute & Chronic) c. Emphysema 4. Infectious respiratory alterations a. Upper respiratory infections (URI) b. Influenza i. Clinical manifestations and complication c. Pneumonia Appreciate impact of genetics and genomics in transmission of disease alterations in health of the respiratory system. Exemplar of the Nursing Concepts and the Nursing Process Applied: Safe and Effective Care Environment Assessment - Objective findings: Oxygen saturation- 90% on Room Air, strong productive cough with copious thick secretions, bilateral coarse rhonchi throughout, sputum culture results pending for Methicillin Resistant Staphylococcus Aureus (MRSA). Admitting diagnosis: Community acquired pneumonia, status post placement of permanent tracheostomy for treatment of laryngeal cancer. Diagnosis Gas Exchange, Impaired Plan Patient will maintain a minimum oxygen saturation of 93% while maintaining transmission based precautions pending receipt of sputum culture results. NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 3
d. Tuberculosis Intervention - 1. Implement Droplet Precautions. 2. Encourage deep breathing and coughing q2 hours while awake. 3. Assist patient out of bed to chair at least BID. Unit 3 student will be able to: cardiovascular system alterations. (COs 4, 8/ NCLEX - 4) 2. Develop individualized nursing care for patients experiencing cardiovascular system alterations (COs 1, 2, 3, 4, 6, 8/ NCLEX 1, 3, 4) when caring for patients with fluid and electrolyte and acid-base imbalances. (COs 1, 3, 4, 6, 7, 8/ NCLEX Unit # 3 Problems of Oxygenation: Perfusion Cardiovascular Systems Alterations A. Health Condition (Physiological Integrity: Adaptation & Reduction of Risk Potential) 1. Perfusion Alterations a. Hypertension b. Coronary Artery Disease/Acute Coronary Syndrome ii. ii. d. Dysrhythmias e. Inflammatory and Structural Heart Disorders Evaluation - Patient will actively participate in pulmonary toilet and increase activity as tolerated will maintaining Droplet Precautions until culture results are obtained. student learning by addressing: alterations in health of the cardiovascular system. Exemplar of the Nursing Concepts and the Nursing Process Applied: Health Promotion and Maintenance NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 4
1,4, Nursing Process) needs for patients with cardiovascular system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 1, 4, Nursing Process) Unit 4 f. Vascular Disorders B. Assessment (Nursing Process/Health Promotion % Maintenance) 1. Health Perception/Health Management Pattern a. Health and surgical history b. Current medications 2. Nutritional-Metabolic Pattern a. Dietary habits Unit # 4 Problems of Oxygenation: Transport Hematologic System Alterations Assessment - Subjective finding: I enjoy eating at the Chinese buffet and have dinner there almost every day. Objective findings: 3+ bilateral pre-tibial edema, elevated serum potassium, occasional PVC s on telemetry Admitting diagnosis: heart failure and hyperkalemia Diagnosis Health Maintenance, Ineffective Plan - Patient will verbalize a commitment to maintaining a low sodium diet Intervention 1. Evaluate patient s baseline understanding of foods, and food preparation, that is lowest in sodium. 2. Identify barriers to obtaining/preparing foods that are low in sodium 3. Provide education on foods that are both low and high in sodium. Evaluation - Patient will foods accurately describe three foods that are low in sodium and three foods that are high in sodium prior to the time of discharge student will be able to: hematologic system student learning by addressing the following: NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 5
alterations. (COs 4, 8/NCLEX - 4) care for patients experiencing hematologic system alterations (COs 1, 2, 3, 4, 6, 8/NCLEX 1, 3, 4, Nursing Process) when caring for patients with hematologic system alterations. (COs 1, 3, 4, 6, 7, 8/NCLEX 1, 4, Nursing Process) needs for patients with hematologic system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4) A. Health Conditions (Physiological Integrity: Adaptation & Reduction of Risk Potential) 1. Anemia a. Nutrition-related b. Sickle cell c. Therapy-related 2. Leukemia a. Myelogenous: Chronic and Acute b. Lymphocytic: Chronic c. Multiple Myeloma 3. Lymphoma a. Hodgkin s and Non-Hodgkin s Lymphoma ii. Treatment preferences alterations in health of the hematologic system. Cultural Humility Relates nursing care to diverse ethnic and cultural influences on disease manifestations and treatment preferences. Unit 5 Unit #5 Problems of Digestion, Absorption, & Elimination Gastrointestinal System Alterations NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 6
student will be able to: gastrointestinal system alterations. (COs 4, 8/ NCLEX - 4) care for patients experiencing gastrointestinal system alterations (COs 1, 2, 3, 4, 6, 8/ NCLEX 1, 3, 4, Nursing Process) when caring for patients with gastrointestinal system alterations. (COs 1, 3, 4, 6, 7, 8/ NCLEX 1, 4, Nursing Process) needs for patients with gastrointestinal system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4) Unit 6 c. Metabolism d. Regulation A. Health Condition 1. Nutritional Alterations a. Malnutrition i. Types of malnutrition ii. Clinical Manifestations and complications i iv. Culturally competent care v. Gerontologic considerations b. Specialized Nutritional Support i. Oral feeding ii. Enteral nutrition iii. Parenteral nutrition iv. Clinical Manifestations and complications v. Diagnostic findings vi. Culturally competent care vii. Gerontologic considerations c. Eating Disorders 2. Obesity a. Genetic Impact b. Health risks Unit # 6 Pathophysiologic Mechanisms of Disease: Immune System Alterations student learning by addressing the following concepts in this unit: alterations in health of the gastrointestinal system. Cultural Humility Applies cultural humility to patient nutritional preferences and practices. Person Centered Provides person-centered, respectful care and education to patients with eating disorders and obesity. NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 7
student will be able to: immune system alterations. (COs 4, 8/ NCLEX - 4) care for patients experiencing immune system alterations (COs 1, 2, 3, 4, 6, 8/NCLEX 1, 3, 4, Nursing Process) when caring for patients with immune system alterations. (COs 1, 3, 4, 6, 7, 8/ NCLEX 1, 4, Nursing Process) needs for patients with immune system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4) A. Health Conditions 1. Hypersensitivity Reactions a. Type I - Anaphylactic b. Type II Cytotoxic/Cytolytic c. Type III Immune-Complex d. Type IV Delayed hypersensitivity 2. Atopic Reactions a. Dermatitis b. Allergic Rhinitis ii. Implications of chronic allergic responses student learning by addressing the following concepts in this unit: 1. Describe the impact of stress on the immune function of an individual (and a nursing student) and develop a person plan to manage stress 2. alterations in health of the immune system. Unit 7 Unit # 7 Problems Related to NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 8
student will musculoskeletal system alterations. (COs 4, 8/ NCLEX - 4) care for patients experiencing musculoskeletal system alterations (COs 1, 2, 3, 4, 6, 8/ NCLEX 1, 3, 4, Nursing Process) when caring for patients musculoskeletal system alterations (COs 1, 3, 4, 6, 7, 8/ NCLEX 1, 4, Nursing Process) 4. Identify the health promotion needs for patients with musculoskeletal system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4) A. Health Condition Movement: Musculoskeletal System Alterations 1. Musculoskeletal Trauma/Orthopedic Surgery a. Soft Tissue Injuries i. Type of Injury i i iv. Age-based therapeutic treatment b. Fractures i. Type of Fracture ii. Clinical Manifestations and complications i iv. Age-based therapeutic treatment c. Amputations iii. Post-operative care and recovery d. Surgical Interventions ii. Diagnostic finding iii. Post-operative care and recovery e. Osteomyelitis f. Tumors NR324 ADULT HEALTH I student learning by addressing the following concepts in this unit: alterations in health of the musculoskeletal system. Person Centered Provides person-centered, respectful care and education to patients with musculoskeletal disorders and injuries. NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 9
i. Clinical manifestation of primary tumors and metastatic bone disease ii. Diagnostics, and treatment options Unit 8 Unit # 8 Wrap It Up! student will be able to: 1. Provide effective professional nursing care for adult patients and their families in acute care settings using the nursing process. (PO 1) (NCLEX 1, 2, 3, 4) 2. Participate in health maintenance and health restoration activities as members of the health care team. (PO 2) (NCLEX 2) 3. Demonstrate effective communication skills necessary for collaboration with other health team members and for providing professional nursing care to adult patients and their families. (PO 3) 4. Apply critical thinking strategies to make good A. Professional Nursing Roles Impacting Adult Health and Wellness a. Adult Health Promotion and Education (Health Promotion & Maintenance; Culture) i. Individual ii. Family iii. Community iv. Societal/Global b. Professional Association and Organizations c. Research d. Community and Political Activity (Culture) B. Module refresher student learning by addressing: Extraordinary Nursing: Review the concepts and experiences from the course and develop a professional foundation for adult health nursing. Visit the Center for Academic Success and apply principles of selfcare while preparing for final exam. NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 10
clinical decisions in the adult patient clinical setting. (PO 4) (NCLEX 1, 2, 3, 4) 5. Assume responsibility and accountability for identifying own personal, educational, and professional goals. (PO 5) 6. Relate knowledge and principles of legal, ethical, and professional standards to clinical practice in the acute care setting, with adult patients and their families. (PO 6) (NCLEX 1) 7. Exhibit behaviors consistent with professional nursing roles and responsibilities while providing cost-effective nursing care to individuals and families. (PO 7)/NCLEX 1, 2, 3, 4) NR324 Adult Health I Learning Plan.docx Revised June 2016 SAJ-LS 11