WALLA WALLA COMMUNITY COLLEGE

NURSING EDUCATION

BEGINNING NURSING CONCEPTS II

NURS 102

Spring Quarter 2009

Every effort is made to ensure accuracy in the syllabus at the time of printing. However,
the Walla Walla Community College Nursing Education Program reserves the right to
change any provision or requirement that is necessitated by circumstances arising during
the course. All changes will be provided in writing.

NURS 102 Syllabus 1

Spring 2009

Final, 3.23.09
 COURSE OUTLINE

Course Identifier: NURS 102

Title: Beginning Nursing Concepts II

Credits: 6

Class Hrs Per Wk: 6

Catalog Description: A continuation of NURS 101. The focus is on providing care to clients of
all ages experiencing normal life processes or common/chronic disease
processes in selected body systems.

Prerequisites: NURS 101 and 111

Corequisites: NURS 112 and 197

Teaching Format:
Lecture/Discussion
Critical Thinking Activities
Small Group Activities
Audio-visual
Computer-based Learning Activities

Location: Walla Walla Campus Room 1706

Clarkston Campus Room 2107

Course Topics: Normal Maternal-Newborn

Cardiac I
Peripheral Vascular
Gastrointestinal
Special Senses
Women's Health

Evaluation Devices: Activities

Unit Tests
Comprehensive Final
ATI Tests

NURS 102 Syllabus 2

Spring 2009

Final, 3.23.09
Course Competencies:

Critical Thinking

1. Demonstrate critical thinking in the use of the nursing process.

2. Demonstrate use of management/leadership principles in the delivery of
client/patient care.

Caring

3. Perform interventions in a safe and effective manner.

4. Use therapeutic communication.

Professional Behaviors

5. Demonstrate professional behaviors.

NURS 102 Syllabus 3

Spring 2009

Final, 3.23.09
 FACULTY CONTACT LIST

NOTE: Students are encouraged to contact the faculty member responsible for the content area or
clinical experience that they have a question about. Contact your faculty advisor for academic
concerns and advising.

Walla Walla Campus: Nursing Office: 509-527-4240

Clarkston Campus: Nursing Office: 509-758-1702

Director of Nursing Education: Marilyn D. Galusha, RN, MSN

Walla Walla-based Instructors Office Email addresses

Number
Kathy Adamski, RN, MN 527-4244 kathleen.adamski@wwcc.edu
(Level I Lead Instructor) Cell: 200-0904
Carolyn Dinkmeier, RN, MN 527-4248 carolyn.dinkmeier@wwcc.edu
( Evening Program Lead Instructor) Cell: 301-1678
Brenda Anderson, RN, MN 527-4327 brenda.anderson@wwcc.edu
Cell: 240-4084
Grace Hiner, RN, MN 527-4421 grace.hiner@wwcc.edu

Clarkston-based Instructors

Carol McFadyen, RN, Ph.D. 758-1728 carol.mcfadyen@wwcc.edu

(Clarkston Lead Instructor)
Todd Carpenter, RN, BSN 758-1787 todd.carpenter@wwcc.edu

Stephanie Macon-Moore, RN, BSN 758-1202 stephanie.maconmoore@wwcc.

(Evening section facilitator) edu
Hawa Al-Hassan, RN, BSN 758-1702 hawa.al-hassan@wwcc.edu
(Evening section facilitator)

Office Hours for instructors may be found on the Level I Bulletin Board

NURS 102 Syllabus 4

Spring 2009

Final, 3.23.09
 BEGINNING NURSING CONCEPTS I
NURS 102

Grading Criteria & Distribution of Points:

CONTENT POINTS

Normal Maternal-Newborn (4 classes) 12

Women’s Health 3
Special Senses (2 classes, Ear, Eye) 6
Gastrointestinal (4 classes) 12
Cardiac I (4 classes) 12
Peripheral Vascular 3
Sub-Total: Class Activities 48
ATI PN Maternal-Newborn (60 questions) 20
ATI PN Nutrition (60 questions) 20
ATI PN Pharmacology (60 questions) 20
3 unit tests (9 questions per 3-hour lecture period) 144
Final Test (5 questions per 3-hour lecture period) 80
Sub-Total: Tests Only 284
Total Points available 332

(All content will be taught via ITV. Faculty will travel part of the time weather permitting.)

**Students must attain 75% or greater cumulative score on tests to achieve a passing grade in
NURS 102. Activity points will accumulate as achieved, however, they will not be added to the
grade until the end of the quarter and will be added only if the test score is a minimum of 75%.

Course Expectations:

1. Follow all policies as outlined in Nursing Student Handbook

2. If absent from class, no points shall be awarded for missed in-class learning activities
3. All assignments must be accounted before progression regardless of score achieved.
4. Late papers will receive a one-point deduction per school day when turned in after the
due date and /or time (i.e. beginning of class or as stated).

Testing: Failure to take a test at the scheduled time will result in an automatic reduction of 5% of
the available score from the earned score. (See p. 18 of the Nursing Student Handbook).

Grading Scale – See Nursing Student Handbook

NURS 102 Syllabus 5

Spring 2009

Final, 3.23.09
Assessment Technologies Institute (ATI) Testing

• Three (3) proctored computerized mastery examination will be administered this

quarter: PN Maternal-Newborn, PN Nutrition, PN Pharmacology

• Prior to taking each content mastery examination, each student must complete a non-
proctored, online practice test and achieve a score of 90%. This non-proctored, online
practice test can be taken more than once however, a 90% must be achieved.

• In order to be admitted to the proctored exam, you will need to submit a copy of your
non-proctored, online practice test individual score to Kathy/Carolyn/Carol (front page
only).

• An ATI “Proficiency Level II” must be achieved. This is considered minimum

competency.

• Failure to achieve a “Proficiency Level II” on the first proctored exam shall require
remediation prior to retesting.

• Failure to achieve a “Proficiency Level II” prior to the end of Spring quarter will result
in an Incomplete “I” grade contract.

• Failure to clear the “I” grade contract by the end of the first two weeks of the next
quarter will result in the conversion of the “I” grade to a C- and the student will not be
allowed to progress.

• The points available on the ATI Content Mastery Tests will be allocated on a curved
scale basis. Points will be prorated with the highest percentage score earning 100% of
the available points.

NURS 102 Syllabus 6

Spring 2009

Final, 3.23.09
 NORMAL MATERNAL-NEWBORN (CLASS #1)

Topic Objectives Assignments/Comments

Introduction 1. Identify the goals of maternal newborn care and the roles of the providers of care Leifer (5th ed.)
Ch. 1, pp. 6-7
2. Calculate estimated date of delivery (EDD) using: Ch. 4, pp. 44 – 77
Antepartum • Nagele’s Rule
EDD • McDonald’s Rule

Signs of 3. Differentiate between presumptive, probable, and positive signs of pregnancy Leifer (5th ed.)
Pregnancy Box 4-3, p. 48
4. Relate the physiologic and psychosocial changes during pregnancy to variations in
Assessment assessment of the pregnant client Leifer (5th ed.)
• Reproductive system Table 4-6, pp. 73 - 76
• Breasts
• Systemic changes
• Management of common discomforts of pregnancy
Fetal Development Leifer (5th ed.)
5. Describe the development of the fetus during each month of pregnancy and factors
Ch. 3, pp. 31 – 40
that effect fetal development
• Organogenesis
• Critical Period
• Teratogens

6. Identify the assessment measures completed during prenatal care Leifer (5th ed.)
• Health assessment Table 4-2, p. 53
• Laboratory and diagnostic testing
• Physical examination
• Risk assessment

Nutritional Needs 7. Describe the nutritional needs of the pregnant mother and assessment measures
indicating adequate nutrition
Weight gain pattern and Assessment of nutrient intake

NURS 102 Syllabus 7

Spring 2009
Final, 3.23.09
 NORMAL MATERNAL-NEWBORN (CLASS #2)

Topic Objectives Assignments/Comments

Postpartum 1. Describe the physiologic changes that occur during the postpartum period Leifer (5th ed.)
Physiologic needs • Involution Ch. 9, pp. 199-214
• Lochia
• Perineum/episiotomy
• Systemic changes
• Changes in vital signs
• Breasts/lactation

2. Complete an assessment of a postpartum client and document assessment findings

Assessment/ Leifer (5th ed.)
using correct terminology
Documentation Box 9 – 1, p. 201
• Health History Box 9 – 2, p. 211
• Laboratory data
• Physical assessment
• Psychosocial assessment

Nursing care plan 3. Develop a nursing care plan to meet the needs of the postpartum client Leifer (5th ed.)
• Pain Nursing Care Plan 9 -1, pp. 209 - 212
• Risk for Infection
• Sleep Pattern Disturbance
• Alteration in Nutrition
• Alteration in Elimination
• Altered Tissue Perfusion (peripheral), Risk for
• Altered Sexuality Patterns, Risk for
• Altered Parenting, Risk for
Medications
4. Identify the actions, therapeutic effect, and nursing implications for medications
given in the postpartum period
• Oxytoxics
• Pain medications
• Stool softeners/Laxatives
• Rubella vaccine
• RhoGam

NURS 102 Syllabus 8

Spring 2009
Final, 3.23.09
 NORMAL MATERNAL-NEWBORN (CLASS #3)

Topic Objectives Assignments/Comments

Newborn 1 Relate the changes in physiologic function that occur at birth to assessment and care Leifer (5th ed.)
Physiologic of the newborn Ch. 9, pp. 215–234
function Respiratory system Ch. 12, pp. 279–303
Circulatory system
Thermoregulation
GI system
Renal function
Hepatic function
Immunologic function
Neurologic function

Assessment/ 2 Complete an assessment of the newborn and document findings using correct
Documentation terminology
• Physical Assessment
• Gestational Age assessment
• Behavioral Assessment

Medications 3. Identify the actions, therapeutic effects, and nursing implications of medications
given to the newborn Leifer (5th ed.) p. 151
• Vitamin K
• Erythromycin ointment

Teaching Plan 4. Develop a teaching plan to meet the needs of parents of a newborn
• Daily care
• Sleeping
• Crying
• Circumcision care
• Continued Health Maintenance
• Car safety
• Meeting the nutritional needs of the newborn
 Breast feeding
 Bottle feeding

NURS 102 Syllabus 9

Spring 2009
Final, 3.23.09
 NORMAL MATERNAL-NEWBORN (CLASS #4)
Topic Objectives Assignments/Comments
Preparation for 1. Identify the components of childbirth education classes Leifer (5th ed.)
Childbirth • Expectations during labor & delivery Ch. 7, pp. 154-156
• Managing discomfort during labor
 Conscious relaxation
• Managing discomfort during labor
Controlled breathing
Cutaneous stimulation
Focusing
Intrapartum Care • Medications
Leifer (5th ed.)
Signs of Labor 2. Identify the signs of labor Ch. 6, pp. 115-150
• Preliminary
• True vs.: False Labor
Labor Progress
3. Discuss the effect on labor progress for the following components of labor:
• Passage
• Passenger
• Powers
Maternal / Fetal • Psyche
Response
4. Describe the maternal and fetal response during each stage of labor
• First Stage
 Latent Phase Leifer (5th ed.)
 Active Phase Table 6 – 3, p. 140-141
 Transition
• Second Stage
• Third Stage
• Fourth Stage
Danger Signs
5. Describe nursing interventions related to pain control measures during labor VCE Assignment Due Today!
• Epidural

NURS 102 Syllabus 10

Spring 2009
Final, 3.23.09
 6. Identify the fetal and maternal danger signs during labor and delivery

WOMEN’S HEALTH

Topic Objectives Assignments/Comments

Review of A&P 1. Review the anatomy and physiology of the female reproductive tract, including the Lewis, et al. (7th ed.)
physiology of menstruation Ch. 51, pp. 1325-1342 (Esp figs 51-3, 51-4,
51-5)
Contraception 2. Describe the teaching needed for correct use of contraceptive Methods
Mechanical Barrier methods Leifer, (5th ed.)
Hormonal Contraceptives Ch. 11, pp. 260-266
Vaginal Spermicides
Leifer, (5th ed.)
Infertility 3. Define infertility and describe the nurse’s role in working with infertile couples Ch. 11, pp. 268-272
Lewis, et al. (7th ed.)
Diagnostic Testing 4. Discuss the nursing care of the women undergoing diagnostic testing for reproductive Ch. 54, pp. 1382-1383
disorders
• Pelvic exam/ Pap smear Lewis, et al. (7th ed.)
• Schiller’s Test Ch. 51,pp. 1338-1341, Table 51-12
• Colposcopy
• Cervical/Endometrial Biopsy
• Cervical Conization
• Ultrasound
Lewis, et al. (7th ed.)
Health Promotion 5. Describe health promotion activities for the women experiencing menopause Ch. 51, pp. 1330-1331
• Gerontological Considerations Ch. 51, p. 1340, Table 51-12

GYN Surgery 6. Use the nursing process to provide care to a client undergoing GYN surgery
Laporoscopy Lewis, et al. (7th ed.)
Dilatation & Curettage (D&C) Ch. 54, pp. 1404-1409
Hysterectomy, Vaginal, Abdominal
Anterior & Posterior Repair (A&P Repair)

Endometriosis 7. Compare and contrast the signs and symptoms, medical management and nursing care Lewis, et al. (7th ed.)
of the client with Endometriosis vs. Pelvic Inflammatory Disease (PID) Ch. 54, pp. 1395-1398

NURS 102 Syllabus 11

Spring 2009
Final, 3.23.09
Sexually 8. Identify the cause, treatment and prevention of the following sexually transmitted Lewis, et al. (7th ed.)
Transmitted Disease diseases (STD) Ch. 11, pp. 254-258
Syphilis
Gonorrhea
Herpes
Chlamydia
Human Papilloma Virus
Trichimonas
Candidiasis
HIV/AIDS Lewis, et al. (7th ed.)
Ch. 54, pp. 1400-1404
Warning signs of 9. Identify warning signs of cervical, ovarian, endometrial cancer
cancer
Lewis, et al. (7th ed.)
Breast Self 10. Describe the method for teaching breast self examination (BSE) to a client Ch. 11 pp. 250-251and Skill 11-1
Examination

Diagnostic 11. Describe the nursing care of clients undergoing diagnostic procedures of the breast Lewis, et al. (7th ed.)
Procedures Mammography Ch. 52, pp. 1344-1348
Ultrasonography
Breast Biopsy

Benign Breast 12. Describe the nursing care of clients with benign breast disorders
Disorders
Lewis, et al. (7th ed.)
NCP for breast 13. Use the nursing process to develop a nursing care plan for a client with a malignant Ch. 52, pp. 1356-1360
malignancy lesion in the breast

NURS 102 Syllabus 12

Spring 2009
Final, 3.23.09
 SPECIAL SENSES: DISORDERS OF THE EYE

Topic Objectives Assignments/Comments

Review of A & P 1. Apply knowledge of the anatomy and physiology of the eye to care for the client with Lewis, et al. (7th ed.)
vision disorders Ch. 21 & 22 (eyes only) pp 398-437
• Structures
• Vision
• Age related considerations

Assessment 2. Describe variations from normal assessment data indicating eye or visual disorders Silvestri, (3rd ed.)
using correct terminology. (Saunders NCLEX-PN)
• History Ch. 54. pp 795-822. (eyes only)
• Clinical manifestations
 Blurred vision
 Diplopia Doenges et al (11ed.)
 Photopsia (Nurse’s Pocket Guide)
 Floaters “Sensory perception disturbed (specify)”
 Scotomata
 Photophobia
 Pain
 Loss of Vision
• Examination
 Outer structures
 Visual acuity
 Near vision
 Visual fields
 Eye movements
 Color vision
Diagnostic Tests  PERRLA

3. Describe the significance of findings from selected diagnostic tests to care of the client
with disorders of the eye
• Visual examination

NURS 102 Syllabus 13

Spring 2009
Final, 3.23.09
 • Intraocular pressure
• Fluorescein staining
Medications • Slit lamp
Doenges et al (11ed.)
4. Identify the actions, therapeutic effects, and nursing implications in the administration (Nurse’s Pocket Guide)
of ophthalmic medications “Risk for ineffective management of
• Topical Anesthetics therapeutic regimen, needs”
• Topical Steroids
Silvestri, (3rd ed.)
• Antiinfective Agents
(Saunders NCLEX-PN)
• Antibiotic-Steroid Combinations Ch. 55, pp 823-833
• Topical Antiviral Review Eye medications
• Adrenergics
• Beta Blockers
• Miotics
• Mydriatics & cycloplegics
Nursing Care and • NSAIDs
Interventions Doenges et al (11ed.)
5. Relate the clinical manifestations and care of the client to the following disorders of (Nurse’s Pocket Guide)
Health Promotion & the eye “Anxiety”
Health Maintenance • Infections/inflammation of the eye
• Strabismus
• Cataracts
• Glaucoma
• Retinal problems
Teaching Plan
• Macular degeneration
• Trauma & chemical burns
Doenges et al (11ed.)
Nursing Care Plan 6. Develop an age appropriate teaching plan to meet the learning needs of a client (Nurse’s Pocket Guide)
undergoing ocular surgery. “Powerlessness”
7. Develop a plan of care to meet the needs of a client with low or loss of vision
• Learning needs & barriers to learning
• Safety VCE Assignment Due Today !
Health Promotion • Adaptive Devices
• Community Resources

NURS 102 Syllabus 14

Spring 2009
Final, 3.23.09
 8. Discuss health promotion activities to prevent the loss of vision

NURS 102 Syllabus 15

Spring 2009
Final, 3.23.09
 GASTROINTESTINAL #1

Topic Objectives Assignments/Comments

Assessing Clients 1. Review anatomy and physiology of the gastrointestinal system Lewis, et al. (7th ed.)
with Complaints of Ch. 39 Overview only , omit Liver,
the GI System 2. Identify specific topics to consider during a health history assessment interview Biliary Tract & Pancreas

3. Describe physical assessment techniques used to evaluate GI and nutritional status

4. Identify abnormal findings that may indicate impairment in the GI system

5. Identify specific diagnostic studies used to evaluate and/or diagnose gastrointestinal Lewis, et al. (7th ed.)
dysfunction Ch. 40 pp. 960-968

6. Describe nursing considerations related to a client receiving enteral or parenteral

nutritional support
Bring calculator
7. Calculate enteral feeding formulas

NURS 102 Syllabus 16

Spring 2009
Final, 3.23.09
 GASTROINTESTINAL (CLASS #2)

Topic Objectives Assignments/Comments

Nursing Care for 1. Discuss the etiology, pathophysiology, and clinical manifestations of common Lewis, et al. (7th ed.)
Children and Adults oral inflammations and infections Ch. 42
with Common
Conditions of the 2. Describe pathophysiology and nursing management for a child with cleft lip/cleft Leifer (5th ed.)
Mouth and pallet pp. 326-327
Esophagus
3. Describe clinical manifestations and nursing implications related to
oral/esophageal CA

4. Describe pathophysiology, clinical manifestations and nursing management of

clients experiencing gastroesophageal reflux disease

5. Describe pathophysiology, clinical manifestations and nursing management of

clients with a hiatal hernia

Pharmacology 6. Discuss drugs affecting gastrointestinal secretions

Related to GI system
7. Discuss emetic and antiemetic agents

8. Discuss laxatives and antidiarrheal agents

NURS 102 Syllabus 17

Spring 2009
Final, 3.23.09
 GASTROINTESTINAL (CLASS #3)

Topic Objectives Assignments/Comments

Care of the Client 1. Differentiate between acute and chronic gastritis – include pathophysiology and Lewis, et al. (7th ed.)
with Problems of the nursing management Ch. 42
Stomach and Upper
Small Intestine 2. Compare and contrast gastric and duodenal ulcers (peptic ulcer disease) including Leifer (5th ed.)
pathophysiology, nursing management and collaborative therapy Ch. 27

3. Explain etiology, clinical manifestations, and nursing management of an upper

gastrointestinal bleed, gastric perforation, and dumping syndrome

4. Describe clinical manifestations of gastric cancer

5. Compare and contrast various types of hernias

6. Describe pathophysiology, clinical manifestation and nursing management for an

adult/child with a gastric outlet obstruction

7. Discuss placement and management of various gastric/intestinal tubes (NG, Salem

Sump, Blakemore)

NURS 102 Syllabus 18

Spring 2009
Final, 3.23.09
 GASTROINTESTINAL (CLASS #4)

Topic Objectives Assignments/Comments

Care of the Client 1. Explain common etiologies, collaborative care and nursing management of Lewis, et al. (7th ed.)
(child/adult) Lower diarrhea and constipations Ch. 43
Gastrointestinal
Problems 2. Discuss common causes of acute abdominal pain and nursing management of a Leifer (5th ed.)
client following abdominal surgery Ch. 27 (limit to topics identified)

3. Compare and contrast ulcerative colitis and Crohn’s disease including

pathophysiology, clinical manifestations, complications and nursing management

4. Discuss causes of bowel obstructions – include collaborative care and nursing

management

5. Discuss the nursing implications and psychosocial response for a client

experiencing colorectal cancer – ostomies

6. Differentiate between diverticulosis and diverticulitis

7. Describe various types of malabsorption syndromes

8. Describe various anorectal conditions with related nursing management

VCE Assignment Due Today !

NURS 102 Syllabus 19

Spring 2009
Final, 3.23.09
 SPECIAL SENSES: DISORDERS OF THE EAR

Topic Objectives Assignment/Comments

Anatomy and 1. Apply knowledge of the anatomy and physiology of the ear to care for the Lewis, et al. (7th ed.)
Physiology client with hearing or balance disorders Ch. 21 pp. 407-415
• Outer ear Ch. 22 pp. 437-446
• Middle ear
• Inner ear Silvestri, (3rd ed.)
• Age related considerations (Saunders NCLEX-PN)
Ch. 54 pp. 804-811
2. Describe variations in assessment data for the client with disorders of Ch. 55 pp. 828-829
Assessment/ clinical manifestations
Diagnostic Testing • Hearing loss - types
• Otalagia
• Otorrhea
• Tinnitus
• Vertigo
History and Diagnostic procedures
• Hearing
• Pneumatoscopy
• Tuning Fork tests
• Audiometry
• Vestibular
• Balance, gait & past pointing
• Electronystagmography
• Caloric test
Health Promotion 3. Identify the common causes of hearing loss. Develop a plan to prevent or
decrease the incidence of hearing loss in children and adults

4. Define ototoxicity and list common medications that are ototoxic

NURS 102 Syllabus 20

Spring 2009
Final, 3.23.09
 5. Discuss nursing interventions and the rationale for the interventions used in the
care of client with problems of the:
• Outer Ear.
 Infections/inflammations
 Cerumen impaction
 Foreign bodies
• Middle Ear
 Otitis media – acute, chronic, and serous
 Tympanic membrane rupture
 Mastoiditis
 Otosclerosis
 Foreign bodies
• Inner Ear
 Tinnitus and hearing loss
 Labyrinthitis
 Meniere’s disease
 Acoustic Neuroma
Nursing Care Plan
6. Develop a nursing care plan for the client undergoing surgery of the ear:
• Tympanoplasty & myringotomy
• Stapedectomy
• Mastoidectomy
• Cochlear implants
Communication with
the hearing impaired 7. Describe the variations in communication for the hearing impaired client who
is hospitalized.

8. Compare and contrast the different types of hearing aids and the common
problems encountered with each type
Psychosocial Needs
9. Describe the psychosocial needs of the individual and family experiencing
hearing loss and the nurses role in providing assistance to these individuals

NURS 102 Syllabus 21

Spring 2009
Final, 3.23.09
 CARDIAC I (CLASS # 1)

Topic Objectives Assignments/Comments

Function of the Heart 1. Apply knowledge of the anatomy & physiology of the cardiac system to care of the Lewis et al. (7th ed.)
client with cardiac disorders Ch. 32, pp. 739-760
• Blood flow
• Regulation of impulses
• Normal sinus rhythm
• Age related changes
2. Identify significance of variations from normal assessment findings for both the adult
Assessment and child with cardiac disease
• S1 and S2
• S3 and S4
• Murmurs

Laboratory/ 3. Describe nursing interventions to prepare a client for and/or in response to findings
Diagnostic Studies from common laboratory and diagnostic studies:
EKG/ Holter Monitoring
Echocardiogram
Cardiac catheterization
Silvestri (3rd ed.)
4. Identify the actions, side effects, and nursing implications for the following classes of (Saunders NCLEX-PN)
Medication medications: Review all the cardiovascular
Beta-Adrenergic Receptor Blockers (Beta Blockers) medications that we will be
atenolol (Tenormin) covering in the 4 cardiac
propranolol (Inderal) lectures
Calcium Channel Blockers Chapter 51 begins on page 729,
 diltiazem (Cardizem) and the practice questions
 verapamil (Calan) begin on page 739.
digoxin (Lanoxin) Davis Drug Guide is also a
good resource.
Anticoagulants
 heparin & lovenox
 warfarin (Coumadin)

NURS 102 Syllabus 22

Spring 2009
Final, 3.23.09
 CARDIAC I (CLASS # 2)
Topic Objectives Assignments/Comments
Hypertensive 1. Compare & contrast the etiology & pathophysiology of the various types of hypertensive Lewis, et al. (7th ed.)
Vascular Disease diseases: Ch. 33, pp. 761-783
• Primary HTN and Secondary HTN
Health
Promotion 2. Identify health promotion measures to reduce the risk of developing hypertension.
Teaching
3. Develop a teaching plan for a client with newly diagnosed hypertension.
• Lifestyle Modifications
• Medications
Diuretics
 chlorothiazide (Diuril)
 furosemide (Lasix)
 spironolactone (Aldactone)
Angiotensin Converting Enzyme (ACE) Inhibitors
Angiotensin Receptor Blockers (ARBs)
Calcium Channel Blockers
Beta-Adrenergic Blockers
Vasodilators
hydralazine (Apresoline)
sodium nitroprusside (Nipride)

4. Describe the pathophysiology and clinical manifestations of congestive heart failure. Lewis, et al. (7th ed.)
Congestive Heart • Left sided failure Ch. 35, pp. 821-837
Failure (CHF) • Right sided failure

5. Differentiate the nursing & collaborative management of the patient with acute
congestive heart failure (CHF) & pulmonary edema versus chronic congestive heart
failure.
6. Identify the actions, side effects, & nursing implications of medications used for a client
with (CHF):
• ACE Inhibitors; ARBs
• Diuretics

NURS 102 Syllabus 23

Spring 2009
Final, 3.23.09
 • digoxin (Lanoxin)
• Vasodilators: sodium nitroprusside (Nipride); nitroglycerin
• Beta-Adrenergic Blockers

CARDIAC I (CLASS # 3)

Topic Objectives Assignments/Comments

Coronary Artery 1. Describe the pathophysiology and clinical manifestations of coronary artery disease and Lewis, et al. (7th ed.)
Disease (CAD) lipoprotein disorders Ch. 34, pp. 784-819

Health promotion 2. Discuss health promotion measures for the client at risk for coronary artery disease:
Assignment:
Teaching 3. Develop a teaching plan for a client with coronary artery disease or lipoprotein RISKO Paper: Due at
disorder(s) beginning of cardiac class
4. Differentiate between angina pectoris and myocardial infarction.
# 3, before start of
lecture.
5. Describe the nursing management of the patient following a myocardial infarction.
Include psychosocial needs of the client. See attached handout for the
RISKO Paper criteria and for
Medications 6. Identify the actions, side effects, and nursing implications for the following medications: the RISKO form at the END
• Platelet Aggregation Inhibitors OF THIS SYLLABUS.
 aspirin
 plavix
• Lipid Lowering Agents
 atorvastatin (Lipitor)
 lovastatin (Mevacor)
 simvastatin (Zocor)
• Nitrates--Nitroglycerin
• Angiotensin-Converting Enzyme Inhibitors
 captopril (Capoten)
 enalapril (Vasotec)
• Morphine
• Fibrinolytics
 Activase
 Retavase

NURS 102 Syllabus 24

Spring 2009
Final, 3.23.09
 CARDIAC I (CLASS # 4)

Topic Objectives Assignments/Comments

Congenital Cardiac 1. Describe risk factors associated with congenital cardiac defects Leifer, (5th ed.)
Defects pp. 596-609 Skip section on
2. Differentiate between the pathophysiology and clinical manifestations for the Kawasaki Disease on page 606
Pathophysiology following congenital cardiac defects and 607
• Increased pulmonary blood flow ("Acyanotic")
 Atrial Septal Defect (ASD)
 Ventral Septal Defect (VSD) Silvestri (3rd ed.)
 Patent Ductus Arteriosis (PDA) (Saunders NCLEX-PN)
• Obstructive defect pp. 373 - 383
 Coarctation of the aorta
• Decreased pulmonary blood flow ("Cyanotic")
 Tetraology of Fallot
• Mixed
Transposition of the great arteries
CHF in child
3. Compare and contrast the pathophysiology and clinical manifestation and medical
management of congestive heart failure (CHF) in a child with CHF in an adult.

Family Coping 4. Discuss the role of the nurse in assisting the family with a child with a congenital cardiac Silvestri (3rd ed.)
Strategies defect to cope (Saunders NCLEX-PN)
•Meeting growth and developmental needs pp. 321-323
•Coping with a child with a life threatening condition

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 PERIPHERAL VASCULAR

Topic Objectives Assignments/Comments

Review of A & P 1. Apply knowledge of the anatomy and physiology of the Peripheral Vascular System in Lewis, et al. (7th ed.)
providing care to clients with disorders of this system. Ch. 38, pp. 892-924
• Arteries, capillaries, and veins
• Factors affecting blood flow Silvestri (3rd ed.)
 Diameter of the vessel (Saunders NCLEX-PN)
 Elastic recoil pp. 711-728.
 Viscosity of blood
 Age related considerations
Assessment
2. Describe variations in assessment data for the client with disorders of the Peripheral
Vascular System, and Arterial Disorders
• Clinical manifestations of vascular dysfunction
 Pain
 Intermittent claudication
 Rest pain
 Venous insufficiency
 Ischemic neuropathy
 Ulceration or gangrene
 Changes in skin color, temperature, and integrity
 Bruits
 Abdominal pulsations
• History
• Risk factors
• Physical examination
Pathophysiology Lewis et al (7th ed.)
Ch. 38
Review the pathophysiology and factors related to arteriosclerosis and atherosclerosis Review anatomy and physiology
of peripheral vascular system.

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Diagnostic Testing
4. Describe the nursing care of clients undergoing diagnostic testing and relate findings to
the care of clients with peripheral vascular disorders. Lewis et al (7th ed.)
• Common arterial diagnostic studies Ch. 38
• Common venous diagnostic studies
Medications Silvestri (3rd ed.)
5. Identify the actions, therapeutic effects and nursing implications of medications used to (Saunders NCLEX-PN)
treat peripheral vascular diseases. pp. 729-747
• Hypolipedemics
• Anticoagulants
• Vasodilators
• Antiplatelet aggregation agents
Arterial vs.: venous
disease Doenges et al (11ed.)
6. Differentiate pathophysiology, assessment and medical management of arterial vascular
(Nurse’s Pocket Guide)
disease from venous vascular disease. Include:
Nursing Diagnosis:
Aneurysms “ Ineffective Tissue Perfusion,
Buerger's Disease Peripheral”
Raynaud's Phenomenon
Venous Thrombosis
Health Maintenance Varicose Veins

7. Describe the goals of medical management of peripheral arterial and venous vascular Information located throughout
disease and health maintenance activities to meet the goals. chapters assigned
• Diet
• Lifestyle Doenges et al (11ed.)
• Medications (Nurse’s Pocket Guide)
• Safety Nursing Diagnosis:
• Prevention of complications “ Knowledge Deficit”,

Develop a teaching plan for a client with peripheral vascular disease Nursing Diagnosis:
Readiness model for Smoking Cessation “Ineffective Health
Maintenance”
• Nursing Diagnosis of patients with Peripheral Arterial Disease of the Lower
Extremities

NURS 102 Syllabus 27

Spring 2009
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 Pre-Class Assignment for Cardiac Class # 3: RISKO Paper
(Total Points Possible = 3 points)

1. Complete an American Heart Association “RISKO” form using your own data as much as possible. The RISKO form is
attached.
• If you do not know your cholesterol and HDL numbers and are unable to have it done, your instructor will provide you
with some numbers.
• For this paper, you will be your own “client”.

2. (Lifestyle) Describe your “clients” current lifestyle with regard to:

• Stressors
• Typical daily diet
• Typical exercise (or lack of it) program

3. (RISKO Interpretation) Interpret the RISKO profile, using the guidelines of “What Your Score Means” for your
“client.”

4. (Recommendations) Develop a lifestyle plan for your “client”. Include specific recommendations you would make for this
“client” with regard to identified risk factors. Include areas of:
• Stress Management
• Diet
• Exercise

**On your paper, please use the following headings:

• Lifestyle
• RISKO Interpretation
• Recommendations/ Lifestyle Plan

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**Grading will be based on how well the above three aspects are discussed. Length of paper is 2-4 pages, single spaced. Hint: If
paper is less than 2 pages, it probably does not reflect good critical thinking. If paper is more than 4 pages, it
probably needs to be more concise.
**This paper is due on the day of cardiac lecture # 3, before start of lecture. Late papers will be deducted one point per day late.

RISKO Form--Retrieved & Slightly Modified 3/17/08

http://www.nursece.com/onlinecourses/933.html

Calculating Heart Disease Risk

Nurses can help their clients develop increased awareness of potentially modifiable factors that increase
the risk of developing heart disease by having them calculate their own level of risk. The American Heart Association's
RISKO scale, which is based on data collected in the long-term Framingham Heart Study, is a popular tool for this
purpose. It has been most useful for education of healthy individuals who are currently free of heart disease but may be
at risk of developing heart disease in the next few years.

Systolic Blood Pressure Systolic Blood Pressure

If you ARE NOT taking antihypertensives If you ARE taking antihypertensives
Blood Pressure Points Blood Pressure Points
<125 0 <117 0
126-136 2 118-123 2
137-148 4 124-129 4
149-160 6 130-136 6
161-171 8 137-144 8
172-183 10 145-154 10

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 Serum Cholesterol:
HDL (Circle Your Point Below)
184-194 25 30 12
35 40 50 155-168
60 70 8012
TOTAL
195-206 14
140
207-218 2 1 0
16 0 0 0 0 0
160 3 2 1 0 0 0 0 0
180 4 3 2 1 0 0 0 0
200 4 3 2 2 0 0 0 0
220 5 4 3 2 1 0 0 0
240 5 4 3 3 1 0 0 0
260 5 4 4 3 2 1 0 0
280 Weight 5 5 4 4 3 2 1 0
300 6 5 4 4 3 2 1 0
Height A B C D
340 6 5 5 4 3 2 1 0
4'8" <139 140-161 162-184 185+
4'9" <140 400 141-1626 163-185 5
6 5
186+ 4 3 2 2
4'10" <141 142-163 164-187 188+
4'11" <143 144-166 167-190 191+
5'0" <145 146-168 169-193 194+
5'1" <147 148-171 172-196 197+
5'2" <149 150-173 174-198 199+
5'3" <152 153-176 177-201 202+
5'4" <154 155-178 179-204 205+
5'5" <157 158-182 183-209 210+
5'6" <160 161-186 187-213 214+
5'7" <165 166-191 192-219 220+
5'8" <169 170-196 197-225 226+
5'9" <173 174-201 202-231 232+
5'10" <178 179-206 207-238 239+
5'11" <182 183-212 213-242 243+
6'0" <187 188-217 218-248 249+
6'1" <191 192-222 223-254 255+
Points: A=0 B=1 C=2 D=4

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 Smoking

Do not smoke 0 points

Smoke < 1 pack/day 2 points

Smoke 1 pack/day 5 points

Smoke 2 or more packs/day 9 points

Total Score (Add up all your points from the 4 sections above): __________

What Your TOTAL SCORE Means:

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Spring 2009
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 Note: If you're diabetic, you have a greater risk of heart disease. Add 7 points to your total score.

0-2 You have a low risk of heart disease for a person of your age and sex.

You have a low-to-moderate risk of heart disease for a person of your age and sex. That's good, but there's room
3-4
for improvement.
You have a moderate-to-high risk of heart disease for a person of your age and sex. There's considerable room
5-7 for improvement in some areas.

You have a high risk of developing heart disease for a person of your age and sex. There's a lot of room for
8 - 15
improvement in all areas.

16 & You have a very high risk of developing heart disease for a person of your age and sex. You should act now to
over reduce your risk factors.

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