Learning Guide

CENTRAL TEXAS COLLEGE Department of Nursing

LEARNING GUIDE Principles of Clinical Decision-Making RNSG 1331

Fall 2006

Instructors: Mary Aigner Pamela Hadnot, Marilyn Hicks Revised 08/06 MA/PH

CENTRAL TEXAS COLLEGE Department of Nursing Table of Contents Unit

Page

I.

Care of Clients with Fluid & Electrolytes Imbalances.................................1

II.

Preoperative and Postoperative Nursing Care.........................................................................3

III.

Care of Clients with Acute & Chronic Pain.............................................................................6

IV.

Care of Clients with Respiratory Disorders.............................................................................8

V.

Care of Clients with Peripheral Vascular Disorders...............................................................10

VI.

Care of Clients with Infectious Disorders..............................................................................13

VII.

Care of Clients with Immunologic Disorders........................................................................15

*** Central Texas College District does not discriminate in admissions or access to, or treatment or employment in, its programs and activities on the basis of race, color, religion, national origin, gender, disability, and age or veterans status.

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Unit 1: Fluid and Electrolytes Functional Health Patterns: Metabolic – Nutrition Unit 1: Learning Activities Required Readings: 1. 2.

3. 4.

5.

Adams, et al. (2005): Chapter 44 (especially pages 651-667) Dudek (2001): Chapter 6 (especially pages 129-157) Kee (2002): Pages 64-65, 647 Lewis, et al. (2004): Chapter 16 (especially pages 330-358) Perry, et al. (2005) Chapter 40 (especially pages 1134-1197)

Recommended Video Viewings: 1. Body Fluids: The Clinical Balance, Part I 2. Body Fluids: The Clinical Balance, Part II 3. Assessing Fluids & Electrolytes Computer Assisted Instruction: Moodle Objectives Upon completion of this unit, the student will be able to: 1. define the following terms: acidosis ascites diffusion fluid spacing hypertonic hypovolemia intravascular osmosis paracentesis plasma thoracentesis acid base balance

albumin circulatory overload electrolytes fluid/electrolyte imbalances hypotonic interstitial isotonic osmolality parenteral sodium/water imbalance transcellular space

alkalosis dependent edema extracellular fluid (ECF) hydrostatic pressure hypervolemia intracellular fluid (ICF) oncotic pressure osmotic pressure pH solute buffers

2. define these processes involved in the regulation of movement of water and electrolytes between the body fluid compartments: 1) diffusion, 2) osmosis, 3) filtration, 4) hydrostatic pressure, 5) oncotic pressure, and 6) osmotic pressure. 3. discuss the function, distribution, movement, and regulation of fluid and electrolytes in the body including composition of major body fluid compartments.

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4. describe the etiology, risk factors, laboratory findings, clinical manifestations, and collaborative management (including nursing) of the following disorders: 1) water excess and deficit, 2) sodium and volume imbalances; hypernatremia and hyponatremia, 3) potassium imbalances; hyperkalemia and hypokalemia, 4) magnesium imbalances; hypermagnesemia and hypomagnesemia, 5) calcium imbalances; hypercalcemia and hypocalcemia, and 6) phosphate imbalances; hyperphosphatemia and hypophosphatemia. 5. describe the regulation of acid-base balance in the body, including the roles of buffers (the lungs and the kidneys). Be able to discuss major acid-base imbalances including metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. 6. use the nursing process to: a. collect assessment data related to the client’s fluid, electrolyte, and acid-base balances. b. identify examples of nursing diagnoses, outcomes, and interventions for clients with altered fluid, electrolyte, or acid-base balance. c. develop a teaching plan to maintain fluid and electrolyte balances. d. plan implementation measures to correct imbalances of fluids and electrolytes. e. describe how to evaluate the effect of nursing and colloraborative interventions on the client’s fluid, electrolyte, or acid-base balance. 7. demonstrate critical thinking in the use of the nursing process in the framework for the care of clients with fluid and electrolyte imbalances in structured settings within the community. 8. use therapeutic communication with clients, families, and members of interdisciplinary treatment teams in providing care for clients with fluid and electrolyte imbalances. 9. describe caring, ethical, and legal issues in providing care for clients with fluid and electrolyte imbalances. 10. identify the following for clients (or family) with fluid and electrolyte imbalances: a. b. c. d. e.

dietary modifications psychosocial stressors learning needs to formulate a teaching plan gerontological considerations multicultural considerations.

11. identify the generic name, trade name, action, usual dosage range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessments, and essential client teaching for the following medications and intravenous fluids: a. isotonic solutions: sodium chloride or 0.9% NaCl (normal saline), 5% D (dextrose) in water, Lactated Ringer’s

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b. hypotonic solutions: 0.45% NS (normal saline), 2.5% D/W (dextrose in water), 5% D (dextrose) in 0.45% NS, Normosol M c. hypertonic solutions: 5% D in NS, 5% D in lactated Ringer’s, 5% D in 0.33% NS, 10% D in water d. potassium supplements e. potassium removing resin: Kayexalate (sodium polystyrene sulfonate) f. calcium supplements

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Unit 2: Perioperative and Postoperative Nursing Care Functional Health Patterns: Health Perception – Health Management Unit 2: Learning Activities Required Readings: 1. Adam, et al. (2005): 2. Dudek (2001): 3. Kee (2002): 4. Lewis, et al. (2004): 5. Perry, et al. (2005): Required Video Viewings: 1. 2. 3. 4.

Chapter 20 (pages 241-255) Chapter 16 (page 485) Pages 83-85, 654, 731-733 Chapters 17, 18, 19 (pages 360-414) Pages 1593-1643

Assessing the Adult: Head to Toe Basic Clinical Skills, Pre-op and Post-op Care Basic Skills: Surgical Drains Surgical Asepsis

Computer Assisted Instruction: Moodle Objectives Upon completion of this unit, the student will be able to: 1. define the following terms: Suffixes: -ectomy, -otomy, - lysis, -plasty, -orrhaphy, -oscopy, -ostomy Preoperative Phase:

ambulatory surgery emergency surgery

elective surgery informed consent same-day admission

Intraoperative Phase: anesthesia care provider Anesthesiologist Conscious sedation malignant hypertension nurse anesthetist (CRNA) function of scrub nurse regional anesthesia Postoperative Phase: airway obstruction atelectasis bronchospasm delayed awakening emergence delirium

holding area spinal anesthesia surgeon local anesthesia surgical suite epidural block function of circulating nurse operating room (OR) perioperative nurse general anesthesia

fast tracking hiccoughs hypothermia hypoventilation hypoxemia

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wound dehiscence wound evisceration pulmonary edema analgesia (PCA) epidural analgesia

patient-controlled

PACU (Post Anesthesia Care Unit)

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2. describe and discuss the following aspects of preoperative care: a. b. c. d. e.

the common purposes and settings of surgery. the purpose and components of the nursing assessment. the significance of data related to the client’s health status and operative risk. the purpose and components of informed consent for surgery. the role of the nurse in the physical, psychological, and educational preparation of the surgical client. f. the day-of-surgery preparations. g. the purposes and types of preoperative medications. h. the special considerations of preparation for the older adult. 3. describe and discuss the following aspects of intraoperative (care: a. b. c. d. e. f. g. h.

the three different areas of the surgical department and proper attire for each area. the physical environment of the operating room and the holding area. the functions of the members of the surgical team. the needs experienced by the client undergoing a surgical procedure. the role of the perioperative nurse managing the care of the surgical client. the basic principles of aseptic technique as used in the operating room. the importance of safety when positioning clients. the different between the different types of anesthesia (general, regional, and local) including advantages, disadvantages, and the rational for the choice of anesthesia. i. the basic techniques used to induce and maintain general anesthesia. j. the techniques used for administering local and regional anesthesia. 4. describe and discuss the following aspects of postoperative care: a. the components of an initial postanesthesia assessment. b. The responsibility of the nurse in admitting clients to the postanesthesia care unit (PACU). c. The etiology of potential problems of clients in the PACU as well as the nursing assessment and management of these problems. d. The initial nursing assessment and management of a client after transfer from the PACU to the general care unit. e. The etiology of potential problems of clients in the postoperative period as well as the nursing assessment and management of these problems. f. The discharge teaching that will be needed by the postoperative client. 5. demonstrate the use of the nursing process in the framework for the care of clients in the preoperative, intraoperative, and postoperative periods. 6. use therapeutic communication with clients, families and members of interdisciplinary teams in providing perioperative care.

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7. describe caring, ethical, and legal issues in providing perioperative care. 8. use computer assisted instructions to acquire information to be used in planning, decisionmaking, and problem solving for perioperative care. 9. identify the following for clients (or family) regarding perioperative care: a. b. c. d. e.

learning needs that can be used to develop a teaching plan. dietary modifications. psychosocial stressors and coping mechanisms of clients. gerontological considerations. multicultural considerations.

10. identify the generic name, trade name, classification, action, usual dosing range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessments, and essential client teaching for the following medications: Preoperative: benzodiazepines antacids Intraoperative: a. b. c. d. e.

narcotics antiemetics

H2 receptor antagonists anticholinergics

intravenous agents: barbiturates, nonbarbiturate hypnotics inhalation agents: volatile liquids, gaseous agents anesthesia adjuncts: narcotics, sedative-hypnotics, muscle relaxants, antiemetics dissociative anesthetics local anesthetics: topical application, local infiltration, regional injection

Postoperative: a. b. c. d.

opiod antagonists: naloxone (Narcan) benzodiazepine antagonist: flumazenil (Ronazicon) anticholinesterase: neostigmine Patient-Controlled Analgesia (PCA)

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Unit 3: Care of Clients with Acute and Chronic Pain Functional Health Patterns: Health Perception – Health Management Unit 3: Learning Activities Required Readings: Adams, et al. (2005): Chapter 19 (especially pages 220-240) Lewis, et al. (2004): Chapter 9 (especially pages 131-159) Perry, et al. (2005) Chapter 42 (especially pages 1228-1270) Recommended Video Viewings: Narcotics for Pain Control Nursing Diagnosis in the Acute Care Hospital, Alteration in Comfort, Acute Pain Computer Assisted Instructions: Moodle Objectives Upon completion of this unit, the student will be able to: 1. define the following terms: acute pain addiction chronic nonmalignant pain dependence dermal stimulation anticipatory guidance distraction imagery and hypnosis conditioning endorphins equanalgesic dose malignant pain neuropathic pain nociceptive pain relaxation acupressure titration pain perception patient-controlled analgesia (PCA) nerve blocks referred pain transcutaneous electrical nerve stimulation (TENS) tolerance WHO analgesic ladder pain 2. define, describe, and differentiate between: a. pain and pain modulation. b. nociceptive and neuropathic pain. c. dependence, addiction, and tolerance 3. explain the physical and psychological effects of unrelieved pain. 4. describe nonpharmacologic therapies and their role in pain management. 5. use the nursing process to: a. collect and interpret subjective and objective data obtained during a 8

comprehensive pain assessment. b. plan interventions and coordination of multidisciplinary pain management therapies. 6. explain the nurse’s role and responsibility in pain management. 7. demonstrate critical thinking in the use of the nursing process as a framework for the care of clients with pain in structured settings within the community. 8. describe caring, ethical, and legal issues in providing care for clients in pain. 9. identify the following for clients (or family) with pain: a. b. c. d. e. 10.

dietary modifications. learning needs that can be used to formulate a teaching plan. psychosocial stressors and coping mechanisms of clients. gerontological considerations. multicultural considerations.

identify the generic name, trade name, classification, action, usual dosing range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessments, and essential client teaching for the following medications:

Opioid Analgesics:

morphine Methadone

Opioid Antagonist:

Narcan

Nonopioid:

codeine Vicodin

Demerol Fentanyl

Dilaudid

Tylenol (acetaminophen) aspirin/salicylates NSAIDS (non-steroidal anti-inflammatory drugs) Ultram and Ultracet

Adjuvant drugs:

corticosteroids antidepressants muscle relaxants adrenergic agonist anesthetics: systemic or oral

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anticonvulsants anesthetics: local psychostimulants

Unit 4: Care of Clients with Disorders of The Respiratory System Functional Health Patterns: Activity - Exercise ________________________________________________________________________________ Unit 4: Learning Activities Required Readings: 1. 2. 3. and 28

Adams, et al. (2005): Chapter 29 (especially pages 384-399) Dudek (2001): Chapter 16 (especially pages 488-493) Lewis, et al. (2004): Chapters 25 (especially pages 542-565), 26 (especially pages 568573), 27 (especially pages 592-607; 620-621; 627-633), (especially pages 646-653)

Recommened Video Viewings: Auscultation of Breath Sounds Nursing Care Related to Respiratory Function Acute Respiratory Failure Computer Assisted Instruction: Moodle Objectives Upon completion of this unit, the student will be able to: 1.

define the following terms:

adventitious sounds dyspnea rhonchi ventilation apnea chylothorax empyema pleural effusion pulmonary embolism chest physiotherapy Oxygen saturation (O2 Sat)

compliance elastic recoil surfactant wheezes epistaxis cor pulmonale flail chest pleurisy/pleuritis pulmonary hypertension postural drainage

crackles fremitus tidal volume pleural friction rub atelectasis empiric therapy hemothorax pulmonary edema thoracentesis Oxygen toxicity

2.

describe the structures and functions of the respiratory system including: 1) upper tract, 2) lower tract, and 3) chest wall.

3.

identify respiratory defense mechanisms, the process of oxygenation, and the signs, 10

symptoms, and implications of inadequate oxygenation.

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4.

use the nursing process to: a. describe the physical assessment of the respiratory system. b. differentiate between normal and abnormal findings in the physical assessment. c. understand and describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the respiratory system and related disorders. d. describe clinical manifestations of various respiratory disorders. e. plan nursing management and interventions for the care of clients with respiratory disorders.

5. demonstrate critical thinking in the use of the nursing process as a framework for the care of clients with respiratory disorders in structured settings within the community. 6. use therapeutic communications with clients, families, and members of multidisciplinary teams in providing care for clients with respiratory disorders. 7. describe caring, ethical, and legal issues in providing care for clients with respiratory disorders. 8. identify the following for clients (or family) with respiratory disorders: a. b. c. d. e.

dietary modifications psychosocial stressors learning needs that can be used to formulate a teaching plan gerontological considerations multicultural considerations.

9. identify the generic name, trade name, action, usual dosage range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessment, and essential client teaching for the following classes of medications: a. b. c. d. e. f. g.

antibuculotics antibiotics (multiple subclasses) bronchodilators sympathomimetics steroids – inhaled corticosteroids mucolytics

In addition, be familiar with one or two common medications within each of the above classes.

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Unit 5: Care of Clients with Cardiovascular Disorders Functional Health Patterns: Activity - Exercise Unit 5: Learning Activities Required Readings: 1. 2. 3. 4.

Adams, et al., (2005): Chapters 21 (pages 258-283), 24, (pages 312-326), 27 (pages 355-368) Dudek (2001): Chapters 4 (pages 68-98), 18 (pages 547-600) Kee (2002): Pages 120-124, 290-292 Lewis, et al., (2004): Chapters 32 (pages 777-798), 37 (pages 912-942)

Required Videos for Viewing: TBA Computer Assisted Instruction: Moodle Objectives Upon completion of this unit, the student will be able to: 1.

define the following terms:

essential hypertension arteriosclerosis obliterans thrombolytic agents aneurysm endovascular graft venous stasis ulcers arterial occlusive disease thromboangitis obliterans 2.

anticoagulant endarterectomy varicosities aortic dissection pulmonary infarction secondary hypertension embolectomy varicose veins

isolated systolic hypertension pulmonary embolism hypertensive emergency arteriospastic disease thrombophlebitis angioplasty intermittent claudication orthostatic hypotension

discuss the pathophysiology of the following cardiovascular disorders: a. b. c. d. e. f. g. h.

peripheral arterial disease peripheral venous disease peripheral arterial disease of the lower extremities (**??different from a???) Buerger’s disease Raynaud’s phenomenon superficial thrombophlebitis deep vein thrombosis (DVT) venous leg ulcers

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i. pulmonary emboli j. hypertension

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3. describe the anatomic location and function of the following cardiac structures: 1) pericardial layers, 2) atria, 3) ventricles, 4) semilunar valves, and 5) atrioventricular valves. 4.

understand and describe the following: a. coronary circulation and the areas of heart muscle supplies by each blood vessel. b. the normal sequence of events involves in the conduction pathways of the heart. c. structure and functions of the arteries, capillaries, and veins d. mechanisms involved in the regulation of blood pressure. e. the pathophysiology associated with primary hypertension. f. the clinical manifestations and complications of hypertension. g. the pathophysiology, clinical manifestations, and collaborative care of: 1) aortic aneurysm repair, 2) aortic dissection, and 3) surgical management of peripheral arterial disease of the lower extremities. h. the etiology, pathophysiology, and major risk factors of peripheral arterialdisease.

5.

differentiate between the pathophysiology, clinical manifestations, and collaborative care for thromboangiitis obliterans (Buerger’s disease) and Raynaud’s phenomenon.

6.

differentiate between the pathophysiology, risk factors, clinical manifestations, and collaborative care for superficial thrombophlebitis and deep vein thrombosis.

7.

discuss the pathophysiology, clinical manifestations, nursing management, and collaborative care for: 1) venous leg ulcers, 2) pulmonary emboli, and 3) hypertensive crisis.

8.

use the nursing process to: a. describe the physical assessment (and techniques used in the assessment) of the cardiovascular system. b. identify significant subjective and objective data related to the cardiovascular system. c. describe the purpose, significance of results, and nursing responsibilities of invasive and noninvasive diagnostic studies. d. develop teaching plans for the management of hypertension and other cardiovascular disorders.

9.

demonstrate critical thinking in the use of the nursing process as a framework for the care of clients with cardiovascular disorders in structure settings in the

community. 10.

use therapeutic communication with clients, families, and members of the multidisciplinary team in providing care for clients with cardiovascular disorders.

11.

describe caring, ethical, and legal issues in providing care for clients with cardiovascular

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disorders. 12.

identify the following for clients with cardiovascular disorders: a. dietary modifications. b. psychosocial stressors and coping mechanisms. c. learning needs that can be used to formulate a teaching plan. d. gerontological considerations. e. multicultural considerations.

13. identify the generic name, trade name, action, usual dosage range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessments, and essential client teaching for the following medications: Antihypertensive:

See Chapter 32, Table 32-8, page 787 to 790 diuretics adrenergic direct vasodilators Ganglionic blockers angiotensin inhibitors Calcium channel blockers beta blockers

Electrolytes: potassium chloride Anticoagulant:

heparin

Low molecular weight heparin: Antiplatelet agents:

potassium phosphate pentoxifylline (Trental)

warfarin (Coumadin)

enoxaprin (Lovenox)

dalteparin (Fragmin)

acetylsalicyclic acid (aspirin) ticlopidine (Ticlid)

dipyridamole (Persantin) clopidogrel (Plavix)

Thrombolytic: altephase (Activase) Anticoagulant Antibodies:

Vitamin K

Protamine sulfate

________________________________________________________________________________

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Unit 6: Care of Clients with Infectious Disorders Functional Health Patterns: Health perception – Health Management Learning Activities Required Readings: 1. 2. 3. 4.

Adams, et al. (2005): Chapter 32 (pages 455-458) Dudek (2001): Chapter 17 (pages 537-539) Lewis, et al. (2004): Chapter 12 (pages 216-218; Table 12-15), 23 (pages 495-496), 42 (pages 1104-1116), 44 (pages 1172-1177), 51 (pages 1392-1394) Perry, et al. (2005): Pages 1482-1565

Required Videos for Viewing: Anti-infective Medication Therapy Implications: Assessment of an Infection Hepatitis B: The Enemy Within Hepatitis C: The Silent Scourge Infection Prevention: Breaking the Chain of Infection Computer Assisted Instruction: Moodle Objectives Upon completion of this unit, the student will be able to: 1.

define the following terms:

inflammation pathogens antibiotic antipyretic 2.

discuss the pathophysiology of the following disorders: a. b. c. d. e.

3.

VRE (Vancomycin-resistent enterococci) MRSA (Methicillin-resistant staphylococcus aureus) vaccines anti-inflammatory jaundice cystitis

Hepatitis A, B, C, D, E, and G Herpes Simplex #1 and #2 Herpes Zoster Methicillin-resistant staphylococcus aureus (MRSA) Vancomycin-resistant enterococci (VRE)

Describe and discuss:

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a. b. c. d. e. f.

the cellular adaptive mechanisms of sublethal injury the causes and mechanisms of lethal cell injury the components and functions of the mononuclear phagocyte system the inflammatory response, including vascular and cellular responses and exudates formation local and systemic manifestations of inflammation and their physiologic bases the pharmacologic, dietary, and nursing management of inflammation

4.

differentiate among types of cell necrosis.

5.

describe the signs and symptoms that may occur with the different types of jaundice.

6.

differentiate among the types of viral hepatitis, including etiology, pathophysiology, clnical manifestations, complications, and collaborative care, including nursing management.

7.

identify factors contributing to the high incidence of sexually transmitted diseases.

8.

explain the etiology, clinical manifestations, and diagnostic abnormalities of genital herpes.

9.

demonstrate critical thinking in the use of the nursing process as a framework for the care of clients with the disorders listed in objective 2.

10.

use therapeutic communication with clients, families, and members of the multidisciplinary team in providing care for clients with infectious disorders.

11.

describe caring, ethical, and legal issues in providing care for clients with infectious disorders.

12.

identify the following for clients with infectious disorders: a. b. c. d. e.

13.

dietary modifications psychosocial stressors and coping mechanisms. learning needs that can be used to formulate a teaching plan. gerontological considerations. multicultural considerations.

identify the generic name, trade name, classification, action, usual dosage range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessments, and essential client teaching for the following medications: Vaccines:

Havrix

Yagta

Avaxim

Antiviral or immune-modulating medications: ribavirin (Virizole) Lamivudine (3TC)

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Hepatitis B vaccine a-Interferon Famudovir

immune globulin (IG) acyclovir Antimicrobial medications: Vancomycin

fluroquinolones

Antibioticsa: ceftriaxone (Rocephin) cefotaxime (Claforan) cefepime (Maxipine) linezolid (Zyvox)

Unit 7: Care of Clients with Immunologic Disorders Functional Health Patterns: Sleep and Rest Patterns Unit 7: Learning Activities Required Readings: 1. 2. 3. (especially 1739-1746).

Adams, et al. (2005): Chapters 30 (especially pages 402-415), 33 (especially pages 416436) Dudek (2001): Chapter 21 (especially pages 681-692) Lewis, et al. (2004): Chapters 13 (especially pages 239-261), 14 (especially pages 264287), 57 (especially pages 1563-1569; 1573-1576), 59 pages 1606-1608), 63 (especially pages 1724-1733;

Recommended Video Viewings: AIDS: No-Nonsense Answers Anti-infective Medication Therapy (Antifungal, Antiviral, & Antitubercular Agents) Multiple Sclerosis Computer Assisted Instruction: Moodle Objectives Upon completion of this unit, the student will be able to: 1.

define the following terms:

antigen cytokines immunocompetence antibodies protease inhibitors passive immunity CREST syndrome Anaphylaxis

autoimmunity humoral immunity immunodeficiency opportunistic diseases viral load active immunity connective tissue disorders vaccination/immunization

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cell-mediated immunity hypersensitivity reaction immunosuppressive therapy postexposure prophylaxis vaccine myasthenic crisis immunomodulators

2.

discuss the following disorders: a. Systemic Lupus Erythematous (SLE) b. Rheumatoid Arthritis c. Systemic Sclerosis (Scleroderma) d. Multiple Sclerosis e. Guillian-Barre f. Myasthenia Gravis g. Human immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)

3.

describe the functions and components of the immune system.

4.

compare and contrast cell-mediated and humoral immunity responses.

5. identify the clinical manifestations and basic emergency management of an anaphylactic reaction. 6. describe the etiology, pathophysiology, clinical manifestations, and treatment modalies/collaborative care for selected immune disorders (see objective 2). 7.

compare and contrast osteoarthritis and Rheumatoid Arthritis.

8.

describe the nursing management for connective tissue disorders.

9. discuss vaccines, their purpose, methods and frequency of administration, contraindications, effect on immunity, and societal effects. 10.

use the nursing process to: a. describe the physical assessment of immune disorders. b. identify significant subjective and objective data related to the immune system. c. describe the purpose, significance of results, and nursing responsibilities for diagnostic studies of immune disorders. d. develop teaching plans for the management of immune disorders and/or connective tissue diseases.

11. demonstrate critical thinking in the use of the nursing process as a framework for clients with immune disorders and/or connective tissue diseases in structured settings in the community. 12. discuss infection control techniques or measures associated with clients experiencing threats to the immune system. 13.

identify the following for clients with immune disorders: a. dietary modifications

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b. psychosocial stressors and coping mechanisms. c. learning needs that can be used to formulate a teaching plan. d. gerontological considerations. e. multicultural considerations.

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14. identify the generic name, trade name, action, usual dosage range, therapeutic effect, toxic effects, side effects, contraindications, essential nursing assessments, and essential client teaching for the following classes of medications: A. B. C. D. E. F. G. H. I.

antivirals antibiotics (multiple subclasses) antifungals antimalarial Antiprotozoal Antihistamine Bronchodilator Non-steroidal Anti-inflammatory Drugs (NSAIDs) Corticosteroids

Be familiar with common medications within each class listed above.

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