Chabot College
Nursing 60A, Page 7
Fall 2006
Chabot College Fall 2006
Course Outline for Nursing 60A
ADULT HEALTH 1
BIOPSYCHOSOCIAL PERSPECTIVES IN THE CARE OF THE ADULT CLIENT
IN THE HOSPITAL AND THE COMMUNITY
Catalog Description:
60A - Adult Health I - Biopsychosocial Perspectives in the 8.5 units
Care of the Adult Client in the Hospital and the Community
Emphasis on the use of the nursing process in the care of adults experiencing selected conditions requiring treatment in medical-surgical and psychiatric care settings. Theory and clinical practice highlight the role of the nurse as therapeutic agent (in both individual and group settings) in facilitating the client’s mind/body adaptation and return to as healthy a state as possible. Effects on cultural diversity, growth and development, and the importance of support systems in assisting patient’s response to illness in acute and community care agencies incorporated into health care strategies used by the nurse. Theory and clinical practice includes integration of biopsychosocial assessment skills, nutrition, pharmacological and crisis intervention concepts, legal-ethical issues, and anger management (directed inward or towards the environment) into the care of these patients. Prerequisites: Completion of Nursing 55, 56, 61, 69, 74, with a “C” or better. Satisfactory completion of or concurrent enrollment in Nursing 57, 58, 64, 75. 4hours lecture, 13 hours clinical.
[Typical contact hours: lecture 70, clinical 227.5]
Prerequisite Skills:
Before entering the course, the student should be able to demonstrate competency in the following theoretical concepts:
1. Identify and describe the scientific principles that form the basis for assessments and nursing interventions which assist the clients’ adaptation to the following conditions:
a. hypertension
b. cerebrovascular accident
c. diabetes mellitus
d. cancer
e. coronary artery disease
f. congestive heart failure
2. Discuss specific issues related to diverse cultural and racial populations across the life span and their impact on development and treatment of the following illnesses: hypertension, cerebrovascular accident, diabetes mellitus, cancer, coronary artery disease;
3. Describe and apply the components of the nursing process;
4. Discuss principles of safety involved in client care;
5. Identify and apply principles of medical asepsis and infection control;
6. Integrate concepts related to cultural diversity, spirituality and therapeutic communication in client care;
7. Describe principles of administration of medications with implications for the elderly client;
8. Discuss principles of mental health, defense mechanisms and stress management;
9. Application of basic organizational skills;
10. Apply principles of professionalism;
11. Discuss the implication of nursing care as it incorporates physical characteristics of human growth and development from infancy to middle adulthood;
12. Discuss the importance of cognitive maturation during childhood (Piaget);
13. discuss the application of nursing care to the several stages of emotional and psychosocial development according to Erikson and Freud;
14. Discuss application of nursing care to the physiological and psychological implications of menopause and mid-life crisis;
15. Identify the role of proteins, carbohydrates and fats in the diet;
16. Describe the function of vitamins and minerals in the human body;
17. Assess the nutritional adequacy of diets;
18. Calculate specific nutritional needs across the life span;
19. Formulate nutritional plans for the client who needs to gain, lose or maintain weight;
20. Identify methods of assessing body weight and nutritional status;
21. Describe specific nutritional needs for the client who has disorders of the gastrointestinal tract, cardiovascular disease, hepato-biliary disease, renal disease, or diabetes;
22. State the advantages and disadvantages of nutritional supplements;
23. Describe types and indications for therapeutic diets;
24. Discuss the impact of culture and spiritual beliefs on diet;
25. Interpret laboratory results as an indication of nutritional status;
26. Describe causes, presentation and collaborative management of the client who has an eating disorder;
27. Correctly articulate the values and purposes of the nursing process;
28. Correctly articulate the values and purposes for a conceptual framework in a nursing curriculum;
29. Describe techniques for identifying and writing care plan components - nursing diagnosis, goals, nursing orders, and evaluation;
30. Write a diagnostic statement, outcome criteria and nursing orders for a selected client;
31. Describe the key concepts of the theoretical framework selected by Chabot College Nursing Program as the basis for nursing process;
32. Identify behaviors and responses according to physiological mode, role function mode, self-concept mode, and interdependence mode;
33. List at least two concepts related to Evidence Based Nursing;
34. Describe biopsychosocial theories of aging;
35. Identify and describe psychosocial concerns common to the elderly client;
36. Discuss the influence of ethnic origin on the client’s adaptation to the aging process;
37. Identify normal physiological changes which occur in the elderly client;
38. Adapt physical assessment skills to the elderly client;
39. Discuss age related changes of sensory loss;
40. Describe nursing interventions which assist the elderly client with adaptation to sensory losses;
41. Identify precipitating causes, symptoms and collaborative management of the elder who has been abused;
42. Explain the use of advance directives;
43. Describe the impact of chronic illness on the elderly client and the family support system;
44. Discuss the causes, symptoms and collaborative management of clients with dementia;
45. List five community resources for assisting the elderly client in adaptations of healthy living;
46. Adapt health teaching to special needs of the aging client;
47. Discuss ethical considerations in the care of elderly clients;
48. Describe the impact of aging on the pharmacodynamics of medications;
49. Outline concepts of pain assessment and management in the elderly client;
50. Cite causes, consequences and prevention of falls in the elderly client.
Before entering the course, the student should be able to demonstrate competency in the following clinical skills:
1. Hygienic care (bed bath, bed making, oral care);
2. Assessment of vital signs;
3. Nutritional care, including providing oral and enteral feedings;
4. Collection of specimens and analysis of findings;
5. Handwashing;
6. Principles of body mechanics;
7. Positioning/lifting/transferring the client to or from bed/chair;
8. Observe and document intake and output;
9. Assessment of thorax, skin, abdomen, oral cavity, and peripheral vascular system including normal physiological changes across the life span;
10. Administration of oxygen;
11. Administration of medications by oral, intramuscular, subcutaneous, topical and enteral routes;
12. Application of ace wraps;
13. Inspection of intravenous sites, including calculation of IV drip rates;
14. Basic principles of surgical asepsis;
15. Safe application of restraints;
16. Ability to work with chronically ill older clients of diverse cultural and racial background in the clinical area.
Expected Outcomes for Students:
Upon completion of the course, the student should be able to:
Theoretical Outcomes:
1. care for the patient experiencing illnesses with unpredictable outcomes;
2. analyze perioperative period (including operating room and post-anesthesia care);
3. identify alterations in body image:
a. eating disorders;
b. wounds;
c. “-ostomy”; etc.;
4. identify addictions:
a. effects on physiological status;
b. effects on psychosocial behaviors;
5. care for the suicidal client;
6. manage of clients with personality disorders;
7. use techniques for intervening with angry, aggressive, manipulative, or impulsive clients;
8. use appropriate aseptic technique in delivering safe patient care;
9. practice therapeutic communication in groups and with individuals experiencing illnesses with unpredictable outcomes;
10. apply principles of group dynamics in health care;
11. care for the client with alteration in thought processes:
a. psychoses;
b. dementias;
c. delirium;
12. identify effects of severe or panic levels of anxiety on the patient response to:
a. interpersonal situations;
b. physical conditions;
13. apply crisis intervention;
14. care for clients with:
a. peripheral vascular disease;
b. respiratory conditions;
c. gastrointestinal conditions;
d. cancer:
1) lung
2) breast
3) colon
e. acute vs. chronic pain;
15. demonstrate pharmacological interventions in:
a. physiological conditions:
1) peripheral vascular disease;
2) respiratory disease;
3) gastrointestinal diseases;
4) cancer;
5) acute vs. chronic pain;
b. perioperative care;
c. psychiatric conditions manifested by:
1) psychoses;
2) anxiety;
3) depression;
4) addictions;
5) mania;
6) personality disorders.
Clinical Outcomes:
1. use self as a therapeutic agent in the delivery of health care;
2. implement the nursing process in the care of patients with the following nursing diagnoses:
a. sensory/perceptual alteration;
b. altered thought processes;
c. anxiety;
d. altered body image;
e. sleep pattern disturbance;
f. alteration in nutrition;
g. impaired social interaction;
h. ineffective individual coping;
i. impaired gas exchange;
j. altered tissue perfusion;
k. ineffective airway clearance;
l. memory, impaired;
m. fluid volume deficit/overload;
n. risk for infection;
o. risk for injury;
p. risk of violence: self/others;
q. social isolation;
r. pain, acute or chronic;
s. self-care deficit;
3. use principles and methods of teaching involved in the care of the patient in acute and chronic settings;
4. define legal-ethical concepts as they relate to clients in psychiatric settings;
5. successfully demonstrate the following skills:
a. peripheral-vascular assessments;
b. ostomy care;
c. sterile dressing change;
d. surgical asepsis: scrubbing, gowning, gloving;
e. insertion and care of nasalgastric tube;
f. administration of intravenous fluids and medications;
g. assessment and care of portable suction devices.
Course Content:
1. Perioperative care
a. pre-operative
b. operative
c. post-operative
2. Care of the client with conditions affecting the following systems
a. Peripheral vascular
b. Respiratory
c. Gastrointestinal
3. Care of the client with
a. Cancer
1) lung
2) breast
3) colon
4. Care of the client with acute vs. chronic pain
5. Care of the client with disturbance in body image
a. Wounds
b. “Ostomy”
c. Eating disorders
6. Care of the client with psychological conditions
a. Psychoses
b. Dementia and delirium
c. Problems managing anger, impulsivity, manipulation, aggression
d. Depression
e. Mania
f. Addiction
g. Anxiety
7. Crisis theory and intervention
8. Concepts of group theory
a. Types of groups
b. Purposes of groups
c. Management of groups in medical-surgical and psychiatric settings
9. The nurse’s role in pharmacological interventions in selected physiological and psychiatric conditions
10. Legal-ethical considerations in psychiatric care
Methods of Presentation:
1. Lecture
2. Seminar/Discussion
3. Interactive Computer Simulation
4. Assignments to acute care and community-based agencies:
a. Medical-Surgical acute care
b. Psychiatric acute care
c. Adult Day Care
Assignments and Methods of Evaluating Student Progress:
1. Typical Assignments
a. Prepare in-class case study assignments
b. Write nursing care plans
c. Participate in small group discussions
d. Prepare workbooks
e. Participate in in-class presentations
f. Prepare nursing process notes
2. Methods of Evaluating Student Progress
a. Critical thinking exercises
b. Written papers
c. Written examinations
d. Nursing care plans
e. Process notes; process recordings
f. Written final exam
Textbooks (Typical):
Textbook of Medical Surgical Nursing. Phipps, Woods, C.V. Mosby, 2003
Psychiatric Mental Health Nursing. Townsend, Mary:F. A. Davis, 2003
Intravenous Mediations, Gahart, B. and Nazareno, Mosby, 2004
Special Student Materials:
1. Stethoscope
2. Student ID card
3. Lab Coat
4. Student uniform
5. Watch with sweep second hand
6. Goggles
7. Students will provide own transportation to and from health care facilities.
CT: Nsgotl60a.worddoc
Revised: 11/05