ATENEO DE DAVAO UNIVERSITY College of Nursing

COURSE SYLLABUS (2008)

NURSING 106 CARE OF CLIENTS ACROSS THE LIFESPAN WITH PROBLEMS IN INFLAMMATORY AND IMMUNOLOGIC REACTIONS, CELLULAR ABERRATIONS,

ACUTE BIOLOGIC CRISIS, INCLUDING EMERGENCY AND DISASTER NURSING AND IV THERAPY

Prepared by:

CID BENEDICT PABALAN, RN MAYCHELLE ANCOG, RN

VIRGINCITA BARREDO, RN

NCM 106

Placement: 4th Year, 1st Semester Time Allotment: 144 lecture hours Course Description: NCM 106 deals with the principles and techniques of nursing care management of sick clients across the lifespan in varied settings, with alterations/problems in inflammatory and immunologic function, cellular aberration, acute biologic crisis, including emergency and disaster nursing IV therapy. Values to be integrated: 1. Value for life 2. Respect for patients’ rights 3. Value for family support 4. Culture and Gender Sensitivity 5. Respect for all religions 6. Professionalism 7. Genuine nursing care 8. Self-discipline 9. Being sensitive to the feelings of others

D A Y

HRS

Topics Objectives Activities References Evaluation Values

I. Immunologic/Inflammatory Reactions

A. Review of the Immune System: 1. Components of the Immune

System Antigens Immune Cells -Major histocompatibility Complex -Monocytes, Macrophages, and Dendritic cells -B lymphocytes -Immunoglobulins -T lymphocytes -Natural Killer Cells 2. The Lymphoid Organs 3. Cytokines and the Immune Response

After each 3-hour session, the students will be able to: Enumerate the components of the immune system and define each type Define cytokines, the functions and the immune response process Distinguish the types of immunity

Viewing of a short video clip on the immune system Lecture-discussion

Textbooks: Horwitz M.E. (2000). Stem cell transplantation for inherited immunodeficiency disorders Cotran R.S., Kumar V., Collins T. (1999). Pathologic basis of diseases (6th ed., pp. 195-216). Philadelphia: W.B. Saunders. Porth C.M. (2002). Pathophysiology: Concepts of Altered Health States (6th ed., pp. 331-395). Philadelphia: Lippincott Williams and Wilkins

Paper and pen quiz

The following values shall be incorporated in NCM 106: 1. Self-awareness 2.Value for life 3. Respect for patients’ rights 4. Value for family support 5. Culture and Gender Sensitivity 6. Respect for all religions and

4. Humoral immunity, cellular immunity, acquired immunity, and active and passive immunity. 5. Regulation of the Immune Response 6. Transfer of Immunity from mother to Infant 7. Immune Response in the Elderly

Identify the different factors that affect the immune system Differentiate the immune system of individuals across the life span

Websites/URLs: Center for Disease Control and Prevention, Divisions of HIV/AIDS prevention-basic statistics www.cdc.gov/hiv/stats.htm Kimball’s biology pages: A description of T and B cells with some illustrations http://www.ultranet.com/~jkimball/BiologyPages/B/B_and_Tcells.html National Institutes of Health Web site on the immune system http://rex.nci.nih.gov/PATIENTS/INFO_TEACHER/bookshelf/NIH_immune/index.html

cultures 7. Professionalism 8. Genuine nursing care 8. Self-discipline 9. Being sensitive to the feelings of others

8. The Inflammatory Response Acute Inflammation -Vascular Response -Cellular Response -Acute Phase Response -Inflammatory Mediators -Inflammatory Exudates Chronic Inflammation

B. Significant subjective data from the client

- family history - chief complaints - functional patterns

psychosocial and behavioral assessment C. Principles and techniques of physical examination in all age groups, deviations from normal

Inspection: Types of skin lesions Primary lesions: 1. MACULE 2. PAPULE 3. NODULE 4. TUMOR 5. PLAQUE 6. VESICLE 7. BULLAE 8. PUSTULE 9. WHEAL 10. BURROW

11. TELANGIECTASIA

Differentiate acute inflammation from chronic inflammation Identify significant data that should be obtained necessary to be used as the basis of rendering patient care and management Define each type of physical examination technique Demonstrate proper palpation and inspection techniques Distinguish each type of lesion in terms of appearance and other characteristics

Interactive Role Play

Secondary Lesions: 1. SCALE 2. CRUST 3. ATROPHY 4.LICHENIFICATION 5. EROSION 6. EXCORIATION 7. FISSURE 8. ULCERATION 9. SCAR 10. ESCHAR 11. KELOIDS 12.PETECHIAE, PURPURA, AND ECCHYMOSES

Palpation: -Turgor -Tenderness -masses -body temperature

Photo presentation

of each

Paper and pen moving

quiz

D. Diagnostic tests and Nursing responsibilities

A. Non-invasive

-Urinalysis -C and S -X-Ray

B. Invasive -CBC -Antistreptolysin titer -Biopsy -Blood Chemistry -Lumbar tap -ELISA -Western blot -Immunoelectrophoresis

Define each diagnostic test Identify the indications for each test Identify the possible complications for each test Identify the appropriate nursing responsibilities for each test

Lecture-discussion Simulation (Lumbar tap)

Paper and pen quiz

E. Pathophysiologic Mechanisms Immunodeficiency Disease 1. Humoral (B-cell) Immunodeficiency -Transient Hypogammaglobulinemia of Infancy -Primary B-cell Immunodeficiencies -Secondary B-cell Immuodeficiencies 2. Cellular (T-cell) Immunodeficiencies -Primary T-cell Immunodeficiencies -Secondary T-cell Immuodeficiencies 3. Combined T-Cell and B-Cell -Immunodeficiencies

Define immunodeficiency Trace the pathophysiologic process of each disorder through diagram representation Define each immunologic disorder

Lecture-

discussion Pantomime for the distinct signs and

symptoms

Paper and pen quiz

-Severe Combined Immunodeficiency -Ataxia-Telangiectasia -Wiskott-Aldrich Syndrome 4. Disorders of Phagocytosis Primary Disorders of Phagocytosis -Job syndrome -Chediak-Higashi Syndrome Secondary Disorders of Phagocytosis 5. Stem cell transplantation

Enumerate the different signs and symptoms of each disorder Enumerate the possible complications of each disorder Formulate appropriate nursing diagnoses for each disorder Enumerate appropriate nursing interventions for each disorder

Allergic and Hypersensitivity Disorders Hypersensitivity Reactions

Type 1- Immediate/Anaphylactic Reaction -Time of onset -Common Signs snd Symptoms -Role of IgE -Specific Conditions: Asthma and other allergies -Atopic Disorders ] Type 2- Cytotoxic, antibody dependent -Time of Onset -Common signs and symptoms -Specific Comditions: Blood transfusion Reactions Rh Incompatibilities Type 3-Immune-Complex Mediated -antigen-antibody mechanism

-Its effect on the Kidneys -Arthrus Reaction -Serum sickness Type 4-Cell Mediated -Cellular changes -Hyperseisitivity Disorders -Allergic Contact dermatitis -Hypersensitivity Pneumonitis LATEX ALLERGY

Transplantation Immunopathology Host-Versus-Graft Disease Graft-Versus-Host Disease Autoimmune Disease Immunologic Tolerance Mechanism of Autoimmune Disease Heredity and Gender Failure of T-Cell-Mediated Suppression Molecular Mimicry Superantigens

Rheumatoid arthritis Systemic Lupus Erythematosus Idiopathic Thrombocytopenia Purpura Autoimmune hemolytic anemia. Grave’s disease Hashimoto’s Thyroiditis Myasthenia Gravis Celiac disease Pemphigous

Acquired Immunodeficiency Syndrome The AIDS Epidemic Transmission of HIV Infection Pathophysiology of AIDS Diagnosis of HIV Infection Classification of HIV Infection Phases of HIV Infection Clinical Course Opportunistic Infections Respiratory Manifestations Gastrointestinal Manifestations Nervous System manifestations Cancer and Malignancies Wasting Syndrome Metabolic Manifestations

Briefly trace the history of the AIDS epidemic State the virus responsible for AIDS and explain how it differs from other viruses Describe the mechanisms of HIV transmission and relate them to the need for public awareness and concern regarding the spread of AIDS Describe the diagnosis of AIDS Describe the alterations in immune function that occur in persons with AIDS List the 3 stages of HIV infection and describe the symptoms, psychosocial issues, and management concerns for each stage

Early Management Treatment Psychosocial Issues Prevention of HIV Infection

HIV Infection in pregnancy and in infants and children

Discuss the vertical transmission of HIV

from mother to child and recommended prevention measures Cite problems with diagnosis of HIV infection in the infant Compare the progress of HIV Infection in infants and children with HIV infection in adults

F. Nursing Diagnoses Taxonomy/Development of Outcome Criteria

1. Impaired skin Integrity 2. Activity Intolerance 3. Potential for Infection 4. Disturbances in Self-concept 5. Ineffective Family Coping 6. Social isolation

G. Principles of Various Modalities of Management

1. health promotion 2. disease

prevention 3. Curative 4. Restorative

Formulate appropriate nursing diagnoses for each disorder Formulate SMART objectives and outcome criteria Enumerate appropriate nursing interventions for each disorder Define each principle of modalities of management Cite examples of each principle

Group formulation of Nursing Car Plan

Individual NCP making With the 5 BEST ursing interventions

H. Pharmacologic Actions Therapeutic use, side effects, indications, contraindication, nursing responsibilities

a. Antibiotics

Identify the pharmacologic management for immunologic disorders Identify the mechanism

1 versus 45 (from 1 versus 1 million game)

Paper and pen quiz

b. Antifungal agents c. Anticholinergic agents d. Adrenergic Agents e. Anti-inflammatory agents f. Corticosteroids g. Immunologic agents h. Vaccines

of action, indication, contraindication, adverse effects and side effects of each drug Enumerate the nursing responsibilities appropriate for each pharmacologic management

I. Nursing Responsibilities for specific surgical and special procedures Thyroidectomy Incision and drainage, etc. Safe and comprehensive perioperative nursing care 1. Assessment and care during the

perioperative period 2. Techniques in assisting the surgical

team during the operation 3. Principles of safety, comfort and privacy

during the perioperative period 4. Nursing responsibilities during the

perioperative period

A. Surgical Procedures-debridement, incision and drainage, excision

B. Special procedures: 1. Universal Precaution 2. Reverse Isolation 3. Medical Asepsis

Define each type of special and surgical procedure Enumerate appropriate nursing responsibilities perioperatively Define the following: 1.Universal Precaution 2.Reverse Isolation 3.Medical Asepsis

Photo presentation of nursing procedures Simulation Lecture demonstration

Paper and pen quiz Return demonstration

4. Surgical Asepsis

4.Surgical Asepsis Demonstrate the proper technique of each procedure

J. Bioethics: Principles and application of bioethics in the care of the clients -Patient’s rights -Confidentiality -The Informed Consent

-Advance Directive -Issues in patients with AIDS K. Appropriate discharge plan including health education

L. Accurate recording and documentation

Identify the different ethical concerns in patient care Formulate a discharge plan specific for each disorder Identify the guidelines in accurate recording and documentation

Role-play

III. CELLULAR ABERRATIONS

A. Review of the Cellular Physiology

1. The cell cycle 2. Differentiation 3. Proliferation

B. Characteristics of Benign and Malignant neoplasms

1. Terminology 2. Neoplasm 3. Benign 4. Malignant -cancer cell characteristics -Invasion and metastasis -Tumor Growth -General effects

C. General Pathophysiology of Cellular Aberration

Trace the normal cell cycle Define terms in the cellular aberration concept Differentiate each defined term if appropriate

Trace the pathophysiologic process of cellular aberration through diagram representation

Identify the prevalence of different cancers in different local and international regions

Video clip presentation of the cell cycle Lecture-discussion

Cotran R.S., Kumar V., Collins T. (1999). Pathologic basis of diseases (6th ed., pp. 90-91, 260-327). Philadelphia: W.B. Saunders. Porth C.M. (2002). Pathophysiology: Concepts of Altered Health States (6th ed., pp. 149-178). Philadelphia: Lippincott Williams and Wilkins Related Web sites: American Cancer Society www.cancer.org CA: A cancer journal for Clinicians www.ca-journal.org National Cancer Institute www.nci.nih.gov

Paper and pen quiz

Epidemiology: Local & International

a. lung b. breast c. uterine d. prostate e. colorectal

D. Carcinogenesis and Causes of Cancer

Oncogenesis Risk factors:

1. Gender and site 2. Age 3. Race and

ethnicity 4. Genetics 5. Hormonal Factors 6. Immunologic

Factors 7. Oncogenic

Viruses 8. Drugs and

Chemicals 9. Radiation -ionizing -UV -electromagnetic -radon 9. Lifestyle -smoking -nutrition/diet -obesity

Describe the role of proto-oncogenes and anti-oncogens in the transformation of a normal life line to a cancer cell line Name the steps in the transformation of normal cells to cancer cells by carcinogens Identify the risk factors to cancer Identify the preventive measures to specific risk factors State how lifestyle can

Collage making

-viruses -psychosocial factors

contribute to the cancer risk through increased exposure to carcinogenic agents

F. Significant subjective data from the client - family history - chief complaints - functional patterns - psychosocial and

behavioral assessment

G. Principles and techniques of physical examination in all age groups, deviations from normal

1. Breast-Self examination 2. Testicular Examination 3. Digital Rectal Examination

The 9 Danger Signs [ CAUTION UP ]

Identify significant subjective data that should be obtained necessary to be used as the basis of rendering patient care and management Identify each technique of physical examination Identify the indication and contraindication of each technique Demonstrate each technique of physical examination Define the danger signs of cancer

Role-play Lecture-demonstration Group presentation Jingle making contest

Case analysis Return demonstration

H. Diagnostic tests and Nursing responsibilities Lung Cancer

A. Chest X-Ray B. Sputum Cytology

Breast Cancer

A. Mammogram

Define each diagnostic test Identify the indications for each test Identify the possible

Photo presentation with lecture-discussion

Paper and pen quiz

B. Clinical Breast Exam C. MRI D. Tissue Sampling

Uterine Cancer

A. transvaginal sonography B. hysteroscopy C. sonohysterography D. Biopsy Punch

Cervical Cancer

A. Pap smear with staging

Prostate Cancer

A. Digital rectal examinanition B. Prostate-Specific Antigen

Colorectal cancer

A. Fecal Occult blood test B. Sigmoidoscopy C. Colonoscopy D. Double- contrast barium enema

Other tests: A. Tumor markers B. Radioisotope scan C. MRI

complications for each test Identify the appropriate nursing responsibilities for each test

I. Pathophysiologic Mechanisms leading to manifestations A. Lung Cancer B. Breast Cancer C. Uterine Cancer D. Colorectal Cancer E. Prostate Cancer F. Non-Hodgkin Lymphoma G. Kidney Cancer (Renal Cell) H. Melanoma I. Basal Cell carcinoma J. Thyroid Cancer K. Leukemia L. Brain Cancer

Define each type of cancer Trace the pathophysiologic process of each disorder through diagram representation Enumerate the different signs and symptoms of each disorder Enumerate the possible complications of each disorder Formulate appropriate nursing diagnoses for each disorder Enumerate appropriate nursing interventions for each disorder

Lecture-discussion (Story-telling style)

Paper and pen quiz

Childhood Cancers Medullablastoma Glioma Neuroblastoma Wilm’s Tumor Retinoblastoma Ewing’s Sarcoma Osteosarcom

Cite the early warning signs of cancer in children Discuss possible concerns of adult survivors of childhood cancer

J. Nursing Diagnoses Taxonomy/Development of Outcome Criteria

A. Potential for Infection B. Disturbance in Body Image C. Activity Intolerance D. Potential for alteration in nutrition; less

than body requirements E. Alteration in oral Mucous Membrane

Integrity F. Alteration in Comfort G. Fluid Volume Deficit

K. Principles of Various Modalities of Management Against CANCER

1. Health promotion 2. disease

prevention 3. Curative 4. Restorative

Formulate appropriate nursing diagnoses for each disorder Formulate SMART objectives and outcome criteria Enumerate appropriate nursing interventions for each disorder Define each principle of modalities of management Cite examples of each principle

Group

formulation of NCP 2 minute

role play for each group

M. Principles of Management 1. Cancer Staging: Cancer naming Mnemonics TNM classification Clinical staging Metastatic Spread 2. Prevention of Infection 3. Hydration 4. Blood component replacement

Distinguish each type o cancer staging Define each principle of management Enumerate appropriate nursing responsibilities and interventions for each principle of

Lecture-discussion

Quiz bowl style

Paper and pen quiz

5. 0xygen therapy 6. Prevention of Complications 7. Rehabilitation N. Pharmacologic Actions

Therapeutic use, side effects, indications, contraindication, nursing responsibilities

1. Biotherapy Classification

� Cytokines � Monoclonal Antibodies � Cellular Therapies � Immunodilators � Retinoids

management Identify the pharmacologic management for cancer Identify the mechanism of action, indication, contraindication, adverse effects and side effects of each drug Distinguish each classification Enumerate the nursing responsibilities appropriate for each pharmacologic management

2. Chemotherapeutic Agents Classification

� Cell cycle-specific � Cell cycle-nonspecific

Categories � Alkalating agents � Antibiotic

antineoplastic � Antimetabolite � Nitroureas

Paper and pen quiz

� Plant derivatives � Hormonal

Special considerations in chemotherapeutic drugs preparation 1. Proper attire 2. Chemo drug handling

H. Bioethics: Principles and application of bioethics in the care of the clients -Patient’s rights -Confidentiality

-The Informed Consent -Ethics of decision -Advance Directives

Identify Special considerations in chemotherapeutic drugs preparation Identify the different ethical concerns in patient care Formulate a discharge plan specific for each disorder Identify the guidelines in accurate recording and documentation

Video clip presentation showing scenes for medical series shows (i.e. House, MD, Grey’s anatomy)

Paper and pen quiz

O. Nursing Responsibilities for specific surgical and special procedures [Preoperatively and Postoperatively] -positioning -dos and donts -bedside equipment -activity structuring Safe and comprehensive perioperative nursing care

Define each type of special and surgical procedure Enumerate appropriate

Video clip presentation showing scenes for medical series shows (i.e. House, MD, Grey’s anatomy) Operating room simulation Lecture-discussion

Paper and pen quiz Return demonstration

5. Assessment and care during the perioperative period

6. Techniques in assisting the surgical team during the operation

7. Principles of safety, comfort and privacy during the perioperative period

8. Nursing responsibilities during the perioperative period

Surgical Procedures: 1. Modified radical mastectomy

(drainage/positioning) 2. Lobectomy (positioning) 3. Hysterectomy 4. Craniectomy 5. Transurethral resection of the prostate

(cystoclysis) 6. Colostomy ( care ) 7. Bone Marrow and Peripheral Blood Stem Cell Transplantation Special procedures: 1. Radiation therapy 2. Cervical Implants 3. Reverse Isolation

nursing responsibilities perioperatively

P. Appropriate discharge plan including health education

Q. Accurate recording and documentation

Identify the different ethical concerns in patient care Formulate a discharge plan specific for each disorder Identify the guidelines in accurate recording and documentation

Case analysis

Paper and pen Quiz

III. Acute Biologic Crisis A. Standard Assessment of the Critically Ill -Focused History Taking -Discriminating Physical Examination AIRWAY BREATHING CIRCULATION HEMODYNAMIC STATUS B. Pathophysiologic Mechanisms leading to manifestations 1. Cardiac Failure 2. Acute Myocardial Infarction 3. Acute Renal Failure 4. Stroke

Identify the appropriate assessment technique for each type of acute biologic crisis Enumerate prioritization of the assessment process Define each type of crisis Trace the pathophysiologic process of each disorder through diagram representation Enumerate the different signs and symptoms of each disorder Enumerate the possible complications of each disorder Formulate appropriate nursing diagnoses for each disorder

Video clip presentation of an emergency situation Lecture-discussion Video clip presentation of specific situations showing the crisis

Porth C.M. (2002). Pathophysiology: Concepts of Altered Health States (6th ed., pp. 500-504,564-566,777-781, 1163-1164, 1174-1178,1433-1437). Philadelphia: Lippincott Williams and Wilkins Related web sites: Burns: http://www.bt.cdc.gov/masscasualties/pdf/burns-masscasualties.pdf Food poisoning: http://www.health.vic.gov.au/foodsafety/downloads/poison_prevent.pdf Red cross guidelines in chemical poisoning: http://www.redcross.org/static/file_cont

Paper and pen quiz

Enumerate appropriate nursing interventions for each disorder

157_lang0_67.pdf SARS and Emerging Infections Terrorism: http://www.bioterrorism.uab.edu/EI/sars/sars.pdf

5. Increased Intracranial Pressure 6. Metabolic Emergencies -DKA/HHNK 7. Massive Bleeding/Hypovolemic Shock 8. Extensive surgeries (include dehiscence and evisceration)

9. Extensive Burns (include staging and area computation) 10. Poisoning

11. Multiple Injuries 12`. Emerging illness (SARS, Avian Flu)

C. Nursing Diagnoses Taxonomy/Development of Outcome Criteria

5. Impaired Gas Exchange 6. Inability to sustain spontaneous

ventilation 7. Dysfunctional Ventilatory Weaning

Response 8. Decreased cardiac output 9. Altered tissue perfusion, systemic 10. Alteration in nutrition, less than body

Formulate appropriate nursing diagnoses for each disorder Formulate SMART objectives and outcome criteria Enumerate appropriate nursing interventions for each disorder

NCP making

requirements 11. Fluid Volume Deficit 12. Activity Intolerance

D. Results/Implications of Diagnostic Laboratory Exams

1. Non-Invasive: ECG, cardiac

rhythms 2. Invasive: ABG, Hemodynamic

monitoring, CVP, pulmonary capillary wedge pressure (PCWP)

Define each diagnostic test Identify the indications for each test Distinguish the implivation of each result Identify the possible complications for each test Identify the appropriate nursing responsibilities for each test

Simulation ECG tracing Lecture-discussion

E. Principles of Management

1. Determination and management of Cause

2. Life saving interventions: Basic Life support Advanced Cardiac Life support First aid Measures Fluid Resuscitation

Define each principle of modalities of management Perform each principle technique accurately

Lecture-discussion Paper and pen quiz

3. Life Maintaining Interventions: -Airway management and care of patients with ventilator -Parenteral fluid administration

Define life maintaining intervention Identify the indications

Lecture-discussion Paper and pen quiz

(blood and blood component therapy -Interventions for hemodynamic instability -Continuous hemodynamic monitoring -Interventions for Nueral Regulation -Fluid and Electrolyte Problems -Nutrition

-Perioperative Problems

for each Enumerate the interventions for each

4. Psychosocial and behavioral interventions:

-measures to relieve anxiety -fear, depression - critical care concerns: -immobility, -sleep deprivation -sensory overload -body image alterations -grieving -sexuality -spirituality

Identify the indications for each Psychosocial and behavioral interventions Enumerate the interventions for each Psychosocial and behavioral intervention

Lecture-discussion

5. Supportive management 6. Prevention of complication 7. Rehabilitation-pulmonary, cardiac,

neurologic

Lecture-discussion

F. Pharmacologic Actions

Therapeutic use, side effects, indications, contraindication, nursing responsibilities

1. Analgesics 2. Narcotics 3. Corticosteroids 4. Antihypertensive

Identify the pharmacologic management for each crisis Identify the mechanism of action, indication, contraindication, adverse effects and side effects of each

Lecture-discussion Drug study

5. Vasopressors 6. Antibiotics 7. Parenteral fluids

drug Distinguish each classification Enumerate the nursing responsibilities appropriate for each pharmacologic management

G. Nursing Responsibilities for specific surgical and special procedures

1. Tracheostomy 2. Endotracheal Intubation 3. Cardiocentesis 4. Thoracotomy 5. Cut-down 6. Aneurysm clipping 7. Defibrillation &

Cardioversion [Preoperatively and Postoperatively] -positioning -dos and donts -bedside equipment -activity structuring Safe and comprehensive perioperative nursing care 9. Assessment and care during the

perioperative period 10. Techniques in assisting the surgical

team during the operation 11. Principles of safety, comfort and privacy

during the perioperative period 12. Nursing responsibilities during the

Define each type of special and surgical procedure Enumerate appropriate nursing responsibilities perioperatively

Video clip presentation Role-play

Paper and pen quiz

perioperative period

H. Bioethics: Principles and application of bioethics in the care of the clients -Patient’s rights -Confidentiality -The Informed Consent -Advance Directives

I. Appropriate discharge plan including health education J. Accurate recording and documentation

Identify the different ethical concerns in patient care Formulate a discharge plan specific for each disorder Identify the guidelines in accurate recording and documentation

Role-play Paper and pen quiz Case analysisi

IV. Disaster and Emergency

A. Definition of Emergency and other terminologies

-Disaster -Trauma

Define emergency and disaster terms

ROLE PLAY of A DISASTER

Paper and pen quiz

B. Triage Definition Objectives 1. START Triage system (Simple Triage and Rapid System) Indication for use of START triage System

The Mnemonic/Procedure: Respiration Pulse/Perfusion Mental Status ADULT START Triage System PEDIATRIC START Triage System START Flow Chart Four Triage Categories/Color Coding Evacuation Prioritization according to category The Incident Command System

Define TRIAGE Identify objectives for triaging Differentiate START triage from MILITARY triage in terms of procedure protocol and indications Identify the color coding and patient classification process for each type of triaging

Video presentation Case simulation Jingle making for mnemonics EMERGENCY ROOM tour Cut-out activity Game ka na Ba?

Cone DC, MacMillan DS. Mass-casualty triage systems: A hint of Science. Acad Emerg Med 2005, 12(8): 739-741 [PubMed Citation] Triage Coding http://remm.nlm.gov/radtriage.htm

Paper and pen quiz Case analysis

2. MILITARY TRIAGE Indication of use for Military Triage 5 Categories of Severity 1. Black/ Expectant 2. Red/ Immediate 3. Yellow/Observation 4. Green/Wait (Walking wounded) 5. White/Dismiss C. Hospital Operations Plan

Identify different

hospital operation plans in local and international hospitals

Interview hospital admin. For prepared hospital operations plan

D. Types of Emergency with appropriate nursing interventions

8. Airway obstruction 9. Myocardial Infarction 10. Near drowning 11. Hemorrhage 12. Head/Chest/abdominal

Trauma 13. Poisoning and Overdose 14. Hypo/Hyperthermia 15. Snake bite/Animal bites 16. Nitrogen Narcosis 17. Fractures 18. Spinal cord Injury

Define each type pf emergency Enumerate the signs and symptoms Identify the appropriate medical and nursing actions for each

Photo presentation Lecture-discussion

Paper and pen quiz

E. The Crash Cart/E-Cart -Contents of the Crash cart - A-Z Emergency Drugs -Defibrillator -Oxygen Saturation Monitor

Define what a crash cart is Identify the use of a crash cart

Showing of Crash card

Moving Exam Paper and pen quiz

F. Personal Protective

Equipment

G. Hazardous Materials H. Decontamination I. Biologic Warfare and Biologic

agents J. Blast Injuries K. Natural Disasters

Enumerate the structures and contents of a crash cart Identify the types of Personal Protective Equipment and indications for each Enumerate hazardous materials Identify the possible effects of each hazardous material to health Identify decontamination measures Identify biologic warfares and agents Enumerate appropriate management and protocol for warfares Define blast injuries Identify appropriate medical and nursing actions for each Define different natural disasters Identify appropriate

Photo presentation with discussion Collage Discussion Knowledge sharing Lecture-discussion Role-play

L. Stress Reactions -Post Traumatic -Stress Disorder Critical Incident Stress management -Debriefing

action plans for specific natural disasters Define specific types of stress reaction Enumerate appropriate nursing actions for each

M. Special Emergency Procedures

1. Tracheostomy 2. Endotracheal Intubation 3. Cardiocentesis 4. Thoracotomy 5. Cut-down 6. Aneurysm clipping 7. Defibrillation &

Cardioversion

Photo sharing Lecture-discussion Dummy simulation Lecture Demonstration

Paper and pen quiz

N. Nursing Responsibilities for specific surgical and special procedures [Preoperatively and Postoperatively] -positioning -dos and donts -bedside equipment -activity structuring Safe and comprehensive perioperative nursing care Assessment and care during the

Define each type of special and surgical procedure Enumerate appropriate nursing responsibilities perioperatively

Simulation Lecture Discussion Lecture Demonstration

Paper and pen quiz Return demonstration

perioperative period Techniques in assisting the surgical team during the operation

Principles of safety, comfort and privacy during the perioperative period

Nursing responsibilities during the perioperative period

O. Universal Precaution Application in an emergency set-up

Identify universal Precaution principles

Cite examples

of cases needing universal precaution

Demonstrate

the correct steps in universal precaution

V. IV THERAPY

A. Philosophy

B. Definition

C. Basic Foundation of IV Therapy 1. Historical background of IV

therapy 2. Ethico-legal aspects of IV

therapy 2.1 Role of ANSAP 2.2 Difference between RA 9173 and RA 7160

3. Standards of IV therapy

D. Review of Anatomy and Physiology of the vascular system

E. Peripheral and Integumentary System F. Fluid and Elecrolyte therapy

1. Types of Fluids/ Solution and uses

2. Drug Interaction with IV fluids 3. Handling of IV solutions, blood

products and components

G. Nursing process in IV therapy

Discuss the importance of Intravenous Parenteral Therapy for the patient as well as the nurse. Describe the roles and responsibilities of nurses in IV therapy. Recognize the ethico-legal implications of IV Therapy.

Identify the roles and functions of ANSAP.

Present the difference between RA 9163 to RA 7160 in terms of IV Therapy requirements Identify and discuss the parts and functions of the vascular, peripheral and integumentary systems. Enumerate the types of fluids/solutions and identify the indication for each

Utilize the nursing process in the care of Clients undergoing IV

Lecture-discussion Obtain and submit a copy of the Standard operating procedure(SOP) from local hospital about IV therapy. *Powerpoint presentation of the anatomy of the vascular, peripheral and integumenary system Lecture-demonstration

Paper and Pen Quiz Illustration and pinpointing the different IV therapy access points Moving Exam

H. Venipuncture Technique on Adult &

children -Prescribed cannula and indications of each -Color, gauge -Ideal period of usage of an IV set, indications -Process in keeping a set sterile I. Complications of IV therapy J. Infection Control & Microbiology

Principles K. Demonstration of Procedure

Documentation of Activity

therapy. Identify the appropriate sites for Venipuncture. Describe the steps in the procedure for performing a venipuncture using selected techniques Demonstrate function, usage, care and maintenance of supplies and equipment utilized in the administration of IV therapy Observe principles of strict asepsis during the actual implementation of the intravenous therapy practice.

Return-demonsration with an IV Therapy Certified Clinical Instructor