King Khalid University Medical Surgical Nursing 1 Course Syllabus Course Title: Medical - Surgical Nursing I Course Number: NURS 313 Credit Hours: 6(3+3) Actual Contact Hours: 12(3+9) Pre-requisite: NURS 211 & NURS 221 Concurrent :- Placement: Fifth Level Course Description: Nursing Department This course focuses on the biopsychosocial responses of actual and high-risk conditions that affect individual's functional health patterns. These conditions may be acute or chronic. The focus will be on alteration in selected functional health patterns such as fluid and electrolytes, vascular, respiratory, cardiac, oncology, and gastrointestinal systems. The students will be exposed to the techniques of health education, motivation, and teaching methodologies to adults and their families. The nursing process will be used as a framework to formulate nursing diagnosis and to identify nursing interventions. The interventions are directed toward promoting, maintaining, and restoring the health of adults and their families. The clinical part provides students with the opportunity to care for adult with an alteration in functional health patterns in a variety of hospital settings utilizing the nursing process. Students are expected to develop clinical decision-making, critical thinking, communication skills, psychomotor skills, and teaching learning strategies in keeping up with current literature, moral principles and integrated knowledge from theory into practice. 1
Course Objectives: Upon successful completion of the course, the student should be able to: 1. Utilize basic communication techniques to facilitate interactions with culturally diverse adult clients. 2. Identify common medical-surgical conditions affecting the adult. 3. Utilize the nursing process to assist in developing a plan of care for selected medical-surgical conditions. 4. Identify criteria for setting priorities in planning for the individual client with a medical and/or surgical condition. 5. Discuss the etiology, Pathophysiology, risk factors, signs, symptoms, diagnostic tests, and medical/surgical management for selected disease processes of selected body systems. 6. Assess the patient/family responses to the medical/surgical interventions used in their care. 7. Provide health education that addresses disease/illness prevention, health promotion, and health restoration. 8. Follow the legal and ethical considerations for the client with medical and /or surgical health condition. 9. Implement basic concepts from allied sciences and nursing in assisting clients as holistic human beings to meet their needs. 10. Utilize the nursing process for their patient nursing care. 11. Develop critical thinking, and problem solving skills in dealing with selected alterations in health status. 12. Follow basic infection control measures for transmission of communicable diseases to the client with medical and surgical conditions 13. Apply the steps and procedures in the discharge planning process for a client with medical and surgical conditions. 14. Utilize appropriate communication skills and develop responsible behavior in dealing with peers, faculty, health team members, patients, patients families, and others. 15. Provide accurate documentation for all nursing actions. 16. Demonstrate acceptable level of competency in selected psychomotor skills necessary for the care of adult clients with medical and surgical conditions. 17. Assume responsibility for safe professional nursing practice. 18. Implement a teaching plan with a wellness focus for adult client. Courses Contents Nursing Process o Assessment o Diagnosis o Planning 2
o Implementation o Evaluation Preoperative Concepts and Nursing Management o Preoperative Nursing Management o Surgical Classifications o Informed consent o Psychosocial nursing assessment & intervention o General physical assessment o Preoperative nursing interventions o Immediate preoperative nursing intervention o Intraoperative Nursing Management o Intraoperative nurses o Patient position on the operating table o Intraoperative complications o Postoperative Nursing Management o Nursing management in the post anesthesia care unit o Nursing process: The patient recovering from surgery Fluid & Electrolytes: Balance & Disturbance o Fundamental concepts of fluid and electrolytes o Regulation of body fluid components o Laboratory test for evaluation fluid status o Homeostatic mechanisms o Fluid volume imbalances o Electrolyte imbalance o Acid- Base disturbance o Parenteral fluid therapy Vascular System o Anatomic & physiologic overview o Health history & clinical manifestations o Diagnostic evaluation o Doppler ultrasound o Exercise test o Angiography o Contrast phlebography o Arteriosclerosis & atherosclerosis o Peripheral arterial occlusive disease o Aortic aneurysm Thoracic and Abdominal o Nursing process: the patient with peripheral arterial insufficiency o Arterial embolism o Management of venous disorders, o Deep Vein Thrombosis o Thrombophlebitis o Phlebothrombosis o Chronic venous insufficiency 3
o Leg ulcers o Varicose veins o Management of patient with hypertension o Nursing process: patient with hypertension Cardiovascular system o Assessment of cardiovascular function o Anatomy and physiology o Health history & clinical manifestations o Cardiac symptoms o Findings of physical examination o Diagnostic evaluation o Cardiac catheterization o Dysrhythmias and conduction problems o ECG interpretation o Nursing process for patient with Dysrhythmias. o Coronary vascular disorders Coronary atherosclerosis Angina pectoris Myocardial infarction o Nursing process for patient with myocardial infarction. o Structural, infectious, or inflammatory cardiac disorders Mitral stenosis (definition, clinical manifestation, and Mitral regurgitation (definition, clinical manifestation, and Aortic stenosis (definition, clinical manifestation, and Aortic regurgitation (definition, clinical manifestation, and Cardiomyopathies (definition, clinical manifestations, and Nursing process: patient with cardiomyopathy. Rheumatic endocarditis (definition, clinical manifestation, and Pericardidtis (definition, clinical manifestation, and Complication from heart diseases Acute pulmonary edema Congestive heart failure Nursing process: patient with congestive heart failure Respiratory System: o Assessment of respiratory function o Anatomy and physiology overview o Assessment: health history sings and symptoms o Diagnostic evaluation 4
o Upper respiratory tract disorders Upper airway infections Common cold Acute sinusitis Chronic sinusitis Rhinitis Acute pharyngitis Chronic pharyngitis Tonsillitis and adenoiditis Laryngitis Nursing process: patient with upper airway infection. o Lower reparatory tract disorders Atelectasis Acute tracheobronchitis Pneumonia Nursing process: patient with pneumonia. o Chronic obstructive pulmonary disease o Nursing process: patient with (COPD) o Chronic bronchitis o Emphysema o Asthma o Acute reparatory failure o Pulmonary embolism o Pneumothorax o Respiratory care modalities o Oxygen therapy o Chest physiotherapy o Airway management (upper airway obstruction, endotracheal intubation,) Tracheostomy Digestive and gastrointestinal system: o Anatomy and physiology over view o Health history o Physical examination findings o Clinical manifestations o Diagnostic evaluation o Management of patient with oral and esophageal disorder Disorders of the jaw Parotits Disorders of esophagus Achalasia Gastroesophagel reflux Hiatus hernia Diverticulum's Perforation 5
Foreign bodies Nursing process: patient with esophageal problems o Nutritional modalities o Nasogastric and nasoentric tube feedings o Nursing process: patient undergoing tube feedings o Gasrostomy o Nursing process: patient with Gasrostomy o Total Parenteral Nutrition (TPN) o Nursing process: patient-receiving TPN Gastric and duodenal disorders o Nursing process: patient with peptic ulcer o Gastric surgeries o Nursing process: patient undergoing gastric surgeries o Intestinal and rectal disorders o Constipation o Diarrhea o Fecal incontinence o Irritable bowel syndrome o Appendicitis o Ulcerative colitis o Small bowel obstruction o Large bowel obstruction o Ano-rectal disorders Hematological disorders: o Anatomy and physiology overview o Hematological studies o Management of hematological disorders Anemia Iron-deficiency A Plastic anemia Megaloplastic anemia Sickle cell anemia Thalassemia G6PD deficiency Nursing process: patient with anemia Leukemia Polycythemia Lymphomas Thrombocytopenia Hemophilia Vitamin K deficiency Oncology Nursing: o Epidemiology o Pathophysiology of malignant process 6
o Detection and prevention of cancer o Diagnosis of cancer and related nursing consideration o Management of cancer Surgery Radiotherapy Chemotherapy Bone marrow transplantation o Nursing process: patient with cancer Hospital Practice for General procedures o Health history o Apply the universal precaution of infection control o Bed making and patient hygiene o Check vital signs o Preparation of the medication tray Medication distributions Given injections; IM, IV, SC, ID Using medication cards Ensuring 7 medication rights o Taking samples; blood, urine, sputum, stool, ect.. o Preparation of dressing cart o Wound care o Range of motion o Breathing exercises o Urinary catheterization o Reporting & recording o Health education Hospital Practice for Specific procedures o Scrubbing, Gowning and Gloving o Isolation precautions o Perform neurological assessment (Glasgow Coma, Scale) o Positioning o Assessment and management of pain o Perform eye and ear assessment o Weighing the patient o Urine and blood analysis for blood sugar o Assess and manage nutritional alterations o Assessment and management of integumentary system disorders o Care of patient with cardiac disorders and hypertension o Care of patient with respiratory disorders o Care of patient with orthopedic disorders o Care of patient with GIT disorders 7
o Care of patient with urinary & renal disorders o Care of patient with coma o Care of patients in the pre & post-operative periods Teaching / Learning strategies: Lecture Assigned reading. Case study and other preparation for class. Audio - visual material. Group discussion and class activity. Class Lecture/discussion. Class writings. Computer Assignments. Clinical field training Written Assignment Discussion Demonstration Role Model and role-play. Audio visuals Case studies Nursing care plans Required Materials: Uniform Name tag Penlight Black/blue and Red Pens Pencil and rubber Scissors Watch with second hand Stethoscope Measuring tape NANDA Pocket Terminology / abbreviation she Clinical Training settings: Lab. training Medical and surgical wards (Female) Operating Room Out-Patient Clinics Evaluation criteria: Class participation and assignments 10 % Mid-term examination 30 % Clinical Evaluation 30 % Final Written Examination 30 % 8
Evaluation criteria for Clinical Practice: (30%) Punctuality and professional conducts Nursing Round Comprehensive Nursing Care Plan Daily work sheet Patient Teaching Plan Weekly clinical evaluation Final Clinical Exam Recommended Textbooks Janet, R. W. and Jane, E. K. (2006): Health Assessment in Nursing, third ed. Philadelphia: Lippincott Williams & Wilkins. Lewis, S; Heitkemper, M, M; Dirksen, S.R; O'Brien, B.J.and Bucher, L. (2007): Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 7 th ed. London: Mosby company. Nancy, M. H. (2003): Medical-Surgical Care Planning, fourth ed. Philadelphia: Lippincott Williams & Wilkins. Nettina.M.S. (2005): Lippincott Manual of Nursing Practice, 8 th ed. Philadelphia: Lippincott Williams & Wilkins. Smeltzer, C.A; Bare, Hinkle, J.L. and Cheever, H. (2006): Brunner and Suddarth's Textbook of Medical-Surgical Nursing.11 th ed. Philadelphia: Lippincott Williams & Wilkins. Suzanne C. Smeltzer & Brenda G. Bane (2006): Textbook of Medicalsurgical Nursing, (11 th ed) Lippincott, Philadelphia. New York. Bathimore. Note: In addition to recommended texts, students are encouraged to use references related to pharmacology, Pathophysiology, nutrition, and nursing concepts 9