nr324 adult health i learning plan - pearson · pdf filenr-324/329 adult health i learning...

NR324 ADULT HEALTH I

NR-324/329 Adult Health I Learning Plan.docx Revised December 2016 LLS 1

Learning Plan

PURPOSE 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 Unit # 1 Pathophysiologic Mechanisms of Disease

Fluid & Electrolyte Imbalance Acid-Base Imbalance

Application of Chamberlain Care

Through Experiential Learning

Upon completion of this unit, the student will

1. Identify alterations in health

for an individual with fluid and electrolyte and acid-base imbalances. (COs 4, 8/ NCLEX – 4)

Student Preparation: Pathophysiology review

a. Structure b. Function

Health Condition (Physiological Integrity: Adaptation & Reduction of Risk Potential)

1. Extracellular Fluid Volume Imbalances a. Deficit & excess

Chamberlain Care provides a framework for student learning by addressing: Holistic Health Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the fluid or electrolyte status.



2. Develop individualized nursing

care for patients experiencing fluid & electrolyte and acid-base imbalances (COs 1, 2, 3, 4, 6, 8/ NCLEX – 4)

3. Apply the nursing process

when caring for patients with fluid and electrolyte and acid-base imbalances. (COs 1, 3, 4, 6, 7, 8/ NCLEX – 1, 4, Nursing Process)

4. Identify the health promotion 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

Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model.

Unit 2 Unit # 2 Problems of Oxygenation: Ventilation

Respiratory System Alterations



Upon completion of this unit, the student will be able

1. Identify alterations in health for an individual with



Chamberlain Care provides a framework for student learning by addressing: Cultural Humility:



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)

4. Identify the health promotion 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

i. Clinical manifestations and complications ii. Laboratory findings

b. Upper airway obstruction i. Clinical manifestations and complications ii. Laboratory findings

2. Non-infectious lower respiratory alterations a. Cystic fibrosis


b. Lung cancer i. Clinical manifestations and complications ii. Laboratory findings

3. Obstructive pulmonary disorders a. Asthma

i. Clinical manifestations and complications ii. Laboratory findings b. Bronchitis (Acute & Chronic)

i. Clinical manifestations and complications ii. Laboratory findings c. Emphysema


4. Infectious respiratory alterations a. Upper respiratory infections (URI)


b. Influenza i. Clinical manifestations and complication

ii. Laboratory findings c. Pneumonia

i. Clinical manifestations and complications

Appreciate impact of genetics and genomics in transmission of disease Holistic Health Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the respiratory system. Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model.

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.



ii. Laboratory findings 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.

Evaluation - Patient will actively participate in pulmonary toilet and increase activity as tolerated will maintaining Droplet Precautions until culture results are obtained.

Unit 3 Unit # 3 Problems of Oxygenation: Perfusion Cardiovascular Systems Alterations



Upon completion of this unit, the student will be able to:

1. Identify alterations in health for an individual with 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



A. Health Condition – (Physiological Integrity: Adaptation & Reduction of Risk Potential)

1. Perfusion Alterations a. Hypertension

i. Clinical Manifestations and complications ii. Diagnostic findings

b. Coronary Artery Disease/Acute Coronary Syndrome i. Clinical Manifestations and complications ii. ii. Diagnostic findings

i. Clinical Manifestations and complications ii. ii. Diagnostic findings

d. Dysrhythmias i. Clinical Manifestations and complications ii. Diagnostic findings

e. Inflammatory and Structural Heart Disorders

Chamberlain Care provides a framework for student learning by addressing: Holistic Health Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the cardiovascular system. Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model.

Exemplar of the Nursing Concepts and the Nursing Process Applied:

Health Promotion and Maintenance



– 1,4, Nursing Process)

4. Identify the health promotion needs for patients with cardiovascular system alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX – 1, 4, Nursing Process)


f. Vascular Disorders i. Clinical Manifestations and complications

ii. Diagnostic 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

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

Unit 4 Unit # 4 Problems of Oxygenation: Transport Hematologic System Alterations




1. Identify alterations in health for an individual with hematologic system



Chamberlain Care provides a framework for student learning by addressing the following: Holistic Health



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)

4. Identify the health promotion

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 i. Clinical manifestations and complications ii. Laboratory findings

b. Lymphocytic: Chronic


c. Multiple Myeloma


3. Lymphoma a. Hodgkin’s and Non-Hodgkin’s Lymphoma i. Clinical manifestations and complications ii. Treatment preferences

Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the hematologic system. Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model. 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






1. Identify alterations in health for an individual with 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)


a. Structure b. Function c. Metabolism d. Regulation

A. Health Condition

1. Nutritional Alterations a. Malnutrition

i. Types of malnutrition ii. Clinical Manifestations and

complications iii. Diagnostic findings

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 3. Upper Gastrointestinal Problems

a. Nausea and Vomiting i. Gerontologic considerations

4. Esophageal Disorders a. Gastroesophageal Reflex Disease (GERD) b. Hiatal Hernia

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Holistic Health Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the gastrointestinal system. Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model. 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.



i. Gerontologic considerations 5. Disorders of the Stomach and Upper Small Intestine

a. Gastritis b. Peptic Ulcer Disease (PUD)

i. Gerontologic considerations c. Upper Gastrointestinal Bleeding

6. Lower Gastrointestinal Bleeding a. Diarrhea b. Fecal Incontinence c. Constipation d. Acute Abdominal Pain e. Chronic Abdominal Pain f. Irritable Bowel Syndrome (IBS) g. Abdominal Trauma

7. Inflammatory Disorders a. Appendicitis b. Inflammatory Bowel Disease (IBD)

i. Ulcerative Colitis ii. Crohn’s Disease

c. Gerontologic considerations d. Polyps of the Large Intestine e. Colorectal Cancer

i. Ostomy Surgery f. Diverticulosis g. Diverticulitis h. Hernias i. Malabsorption Syndrome j. Hemorrhoids

Unit 6 Unit # 6 Pathophysiologic Mechanisms of Disease: Immune

System Alterations






1. Identify alterations in health for an individual with 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

4. Inflammation and Wound Healing

a. Clinical manifestations and complications

b. Nursing and Collaborative Management

5. Genetics and Genomics

a. Gene Therapy

6. Hypersensitivity Reactions

a. Type I - Anaphylactic


b. Type II – Cytotoxic/Cytolytic


ii. Laboratory findings

c. Type III – Immune-Complex i. Clinical manifestations and complications


d. Type IV – Delayed hypersensitivity i. Clinical manifestations and complications


7. Atopic Reactions a. Dermatitis



b. Allergic Rhinitis i. Clinical manifestations and complications ii. Implications of chronic allergic responses

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Holistic Health 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. Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the immune system. Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model.



8. Immunodeficiency Disorders 9. Organ Transplantation 10. Human Immunodeficiency Virus (HIV) Infection


11. Nursing and Collaborative Management

12. Arthritis a. Osteoarthritis


iii. Nursing and Collaborative

Management

b. Rheumatoid Arthritis i. Clinical manifestations and complications

ii. Laboratory findings iii. Nursing and Collaborative

Management

c. Septic Arthritis i. Clinical manifestations and complications


Management

13. Systemic Lupus Erythematosus



Management

14. Scleroderma



Management

15. Gout





Management

Unit 7 Unit # 7 Problems Related to Movement: Musculoskeletal

System Alterations



Upon completion of this unit, the student will

1. Identify alterations in health for an individual with 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



A. Health Condition

1. Musculoskeletal Trauma/Orthopedic Surgery a. Soft Tissue Injuries

i. Type of Injury ii. Clinical Manifestations and complications

iii. Diagnostic findings iv. Age-based therapeutic treatment

b. Fractures

i. Type of Fracture ii. Clinical Manifestations and complications iii. Diagnostic findings

iv. Age-based therapeutic treatment

c. Amputations i. Clinical Manifestations and complications

ii. Diagnostic findings iii. Post-operative care and recovery

d. Surgical Interventions

i. Clinical Manifestations and complications ii. Diagnostic finding

iii. Post-operative care and recovery

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Holistic Health Applies the nursing process to provide holistic nursing care for the patient experiencing alterations in health of the musculoskeletal system. Person Centered Provides person-centered, respectful care and education to patients with musculoskeletal disorders and injuries. Care Focused Commits to being an engaged learner and following the Chamberlain Care Student Success Model.



alterations. (COs 1, 2, 3, 4, 7, 8/ NCLEX 2, 3, 4)

e. Osteomyelitis


f. Tumors i. Clinical manifestation of primary tumors and

metastatic bone disease ii. Diagnostics, and treatment options

Unit 8 Unit # 8 Wrap It Up!


Through Experiential Learning Upon completion of this unit, the 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

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

Chamberlain Care provides a framework for 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 self-care while preparing for final exam.



to adult patients and their families. (PO 3)

4. Apply critical thinking strategies to make good 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)

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