Ncm 106

ATENEO DE DAVAO UNIVERSITY College of Nursing

COURSE SYLLABUS (2008)

NURSING 106 CARE OF CLIENTS ACROSS THE LIFESPAN WITH PROBLEMS IN INFLAMMATORY AND IMMUNOLOGIC REACTIONS, CELLULAR ABERRATIONS, ACUTE BIOLOGIC CRISIS, INCLUDING EMERGENCY AND DISASTER NURSING AND IV THERAPY

Prepared by: CID BENEDICT PABALAN, RN MAYCHELLE ANCOG, RN VIRGINCITA BARREDO, RN

NCM 106

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

D A Y

H R S

Topics I.

Immunologic/Inflammatory Reactions

A. Review of the Immune System: 1. Components of the Immune System Antigens Immune Cells -Major histocompatibility Complex -Monocytes, Macrophages, and Dendritic cells -B lymphocytes -Immunoglobulins -T lymphocytes -Natural Killer Cells 2. The Lymphoid Organs

Objectives

Activities

After each 3-hour session, the students will be able to:

Enumerate components of immune system define each type

the the and

Define cytokines, the functions and the immune response process

Distinguish the types of 3. Cytokines and the Immune immunity Response

References Textbooks:

Horwitz M.E. (2000). Stem cell Viewing of a short transplantation for video clip on the inherited immune system immunodeficiency disorders Lecture-discussion Cotran R.S., Kumar V., Collins T. (1999). Pathologic basis of diseases (6th ed., pp. 195216). Philadelphia: W.B. Saunders. Porth C.M. (2002). Pathophysiology: Concepts of Altered Health States (6th ed., pp. 331-395). Philadelphia: Lippincott Williams and Wilkins

Evaluation Paper and pen quiz

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

cultures Websites/URLs: 4. Humoral immunity, cellular Identify the different immunity, acquired immunity, factors that affect the and active and passive immune system immunity. 5. Regulation of the Immune Differentiate the Response immune system of individuals across the 6. Transfer of Immunity from life span mother to Infant 7. Immune Response in the Elderly

Center for Disease Control and Prevention, Divisions of HIV/AIDS prevention-basic statistics www.cdc.gov/hiv/st ats.htm Kimball’s biology pages: A description of T and B cells with some illustrations http://www.ultranet. com/~jkimball/Biolo gyPages/B/B_and_ Tcells.html National Institutes of Health Web site on the immune system http://rex.nci.nih.go v/PATIENTS/INFO _TEACHER/books helf/NIH_immune/in dex.html

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

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

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

Differentiate acute inflammation from chronic inflammation

Identify significant data that should be obtained necessary to be used as the basis of rendering patient care and management

C. Principles and techniques of physical examination in all age groups, deviations from normal Inspection: Types of skin lesions Primary lesions: 1. MACULE 2. PAPULE 3. NODULE 4. TUMOR 5. PLAQUE 6. VESICLE 7. BULLAE 8. PUSTULE 9. WHEAL 10. BURROW 11. TELANGIECTASIA

Define each type of physical examination technique Demonstrate proper palpation and inspection techniques Distinguish each type of lesion in terms of appearance and other characteristics

Interactive Role Play

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

Palpation: -Turgor -Tenderness -masses -body temperature

Photo presentation of each

Paper and pen moving quiz

D. Diagnostic responsibilities

tests

and

A. Non-invasive -Urinalysis -C and S -X-Ray B. Invasive -CBC -Antistreptolysin titer -Biopsy -Blood Chemistry -Lumbar tap -ELISA -Western blot -Immunoelectrophoresis

Nursing

Define each diagnostic test Identify the indications for each test

Lecture-discussion Simulation (Lumbar tap)

Paper and pen quiz

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

E. Pathophysiologic Mechanisms

Lecturediscussion

Immunodeficiency Disease Define 1. Humoral (B-cell) Immunodeficiency immunodeficiency -Transient Hypogammaglobulinemia of Infancy -Primary B-cell Immunodeficiencies -Secondary B-cell Immuodeficiencies Trace the pathophysiologic 2. Cellular (T-cell) Immunodeficiencies process of each -Primary T-cell Immunodeficiencies disorder through -Secondary T-cell Immuodeficiencies diagram representation 3. Combined T-Cell and B-Cell Define each -Immunodeficiencies immunologic disorder

Pantomime for the distinct signs and symptoms

Paper and pen quiz

-Severe Combined Immunodeficiency -Ataxia-Telangiectasia -Wiskott-Aldrich Syndrome

Enumerate the different signs and symptoms of each disorder

4. Disorders of Phagocytosis Primary Disorders of Phagocytosis -Job syndrome -Chediak-Higashi Syndrome Secondary Disorders of Phagocytosis

Enumerate the possible complications of each disorder Formulate appropriate nursing diagnoses for each disorder

5. Stem cell transplantation Enumerate appropriate nursing interventions for each disorder

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

-Its effect on the Kidneys -Arthrus Reaction -Serum sickness Type 4-Cell Mediated -Cellular changes -Hyperseisitivity Disorders -Allergic Contact dermatitis -Hypersensitivity Pneumonitis LATEX ALLERGY Transplantation Immunopathology Host-Versus-Graft Disease Graft-Versus-Host Disease Autoimmune Disease Immunologic Tolerance Mechanism of Autoimmune Disease Heredity and Gender Failure of T-Cell-Mediated Suppression Molecular Mimicry Superantigens Rheumatoid arthritis Systemic Lupus Erythematosus Idiopathic Thrombocytopenia Purpura Autoimmune hemolytic anemia. Grave’s disease Hashimoto’s Thyroiditis Myasthenia Gravis Celiac disease Pemphigous

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

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

Early Management Treatment Psychosocial Issues Prevention of HIV Infection HIV Infection in pregnancy and in infants Discuss the vertical and children transmission of HIV

from mother to child and recommended prevention measures Cite problems with diagnosis of HIV infection in the infant

F. Nursing Taxonomy/Development Criteria 1. 2. 3. 4. 5. 6.

of

Compare the progress of HIV Infection in infants and children with HIV infection in adults Diagnoses Formulate appropriate Group formulation Outcome nursing diagnoses for of Nursing Car Plan each disorder

Impaired skin Integrity Activity Intolerance Potential for Infection Disturbances in Self-concept Ineffective Family Coping Social isolation

G. Principles of Various Modalities of Management 1. health promotion 2. disease prevention 3. Curative 4. Restorative

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

Define each principle of modalities of management

Cite examples of each principle H. Pharmacologic Actions Identify the 1 versus 45 (from 1 Therapeutic use, side effects, pharmacologic indications, contraindication, nursing management for versus 1 million responsibilities immunologic disorders game) a. Antibiotics

Individual NCP making With the 5 BEST ursing interventions

Identify the mechanism

Paper and pen quiz

b. c. d. e. f. g. h.

Antifungal agents Anticholinergic agents Adrenergic Agents Anti-inflammatory agents Corticosteroids Immunologic agents Vaccines

I. Nursing Responsibilities for surgical and special procedures

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

specific Define each type of Photo presentation special and surgical of nursing procedure procedures

Thyroidectomy Incision and drainage, etc. Safe and nursing care 1. 2. 3. 4.

Paper and pen quiz Return demonstration

comprehensive

perioperative Enumerate appropriate nursing responsibilities perioperatively Simulation care during the

Assessment and perioperative period Techniques in assisting the surgical team during the operation Principles of safety, comfort and privacy during the perioperative period Nursing responsibilities during the perioperative period

A. Surgical Procedures-debridement, incision and drainage, excision B. Special procedures: 1. Universal Precaution 2. Reverse Isolation 3. Medical Asepsis

Define the following: 1.Universal Precaution 2.Reverse Isolation 3.Medical Asepsis

Lecture demonstration

4. Surgical Asepsis

4.Surgical Asepsis Demonstrate the proper technique of each procedure

J. Bioethics: Principles and application of Identify the different bioethics in the care of the clients ethical concerns in -Patient’s rights patient care -Confidentiality -The Informed Consent -Advance Directive -Issues in patients with AIDS Formulate a discharge K. Appropriate discharge plan including plan specific for each health education disorder L. Accurate documentation

recording

Identify the guidelines and in accurate recording and documentation

Role-play

III. CELLULAR ABERRATIONS A. Review Physiology

of

Trace the normal cell cycle the

Cellular

1. The cell cycle 2. Differentiation 3. Proliferation

Video clip presentation of the cell cycle

Define terms in the cellular aberration concept

B. Characteristics of Benign and Malignant neoplasms 1. Terminology Differentiate each 2. Neoplasm defined term if 3. Benign appropriate 4. Malignant -cancer cell characteristics -Invasion and metastasis -Tumor Growth -General effects

Cotran R.S., Kumar V., Collins T. (1999). Pathologic basis of diseases (6th ed., pp. 90-91, 260-327). Philadelphia: W.B. Saunders.

Porth C.M. (2002). Pathophysiology: Concepts of Altered Health States (6th ed., pp. 149-178). Philadelphia: Lippincott Williams and Wilkins Related Web sites:

C. General Pathophysiology of Trace the Cellular Aberration pathophysiologic process of cellular Lecture-discussion aberration through diagram representation Identify the prevalence of different cancers in different local and international regions

American Cancer Society www.cancer.org CA: A cancer journal for Clinicians www.ca-journal.org National Cancer Institute www.nci.nih.gov

Paper and pen quiz

Epidemiology: Local & International a. b. c. d. e.

Collage making

lung breast uterine prostate colorectal

D. Carcinogenesis and Causes of Cancer Oncogenesis Risk factors: 1. Gender and site 2. Age 3. Race and ethnicity 4. Genetics 5. Hormonal Factors 6. Immunologic Factors 7. Oncogenic Viruses 8. Drugs and Chemicals 9. Radiation -ionizing -UV -electromagnetic -radon 9. Lifestyle -smoking -nutrition/diet -obesity

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

-viruses -psychosocial factors

contribute to the cancer risk through increased exposure to carcinogenic agents F. Significant subjective data from the client Identify significant - family history subjective data that - chief complaints should be obtained - functional patterns necessary to be used Role-play - psychosocial and as the basis of behavioral assessment rendering patient care and management G. Principles and techniques of physical Lectureexamination in all age groups, deviations demonstration from normal Identify each technique of physical examination Group presentation 1. Breast-Self examination 2. Testicular Examination Identify the indication 3. Digital Rectal Examination and contraindication of each technique

Case analysis Return demonstration

Demonstrate each technique of physical examination The 9 Danger Signs [ CAUTION UP ]

H. Diagnostic responsibilities

tests

and

Lung Cancer A. Chest X-Ray B. Sputum Cytology

Define the danger signs of cancer Nursing

Define each diagnostic test Identify the indications for each test

Breast Cancer A. Mammogram

Jingle making contest

Identify the possible

Photo presentation with lecturediscussion

Paper and pen quiz

B. Clinical Breast Exam C. MRI D. Tissue Sampling Uterine Cancer A. transvaginal sonography B. hysteroscopy C. sonohysterography D. Biopsy Punch Cervical Cancer A. Pap smear with staging

Prostate Cancer A. Digital rectal examinanition B. Prostate-Specific Antigen

Colorectal cancer A. B. C. D.

Fecal Occult blood test Sigmoidoscopy Colonoscopy Double- contrast barium enema

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

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

I. Pathophysiologic Mechanisms leading to manifestations A. B. C. D. E. F. G. H. I. J. K. L.

Lung Cancer Breast Cancer Uterine Cancer Colorectal Cancer Prostate Cancer Non-Hodgkin Lymphoma Kidney Cancer (Renal Cell) Melanoma Basal Cell carcinoma Thyroid Cancer Leukemia Brain Cancer

Lecture-discussion Define each type of (Story-telling style) cancer Trace the pathophysiologic process of each disorder through diagram representation Enumerate the different signs and symptoms of each disorder Enumerate the possible complications of each disorder Formulate appropriate nursing diagnoses for each disorder Enumerate appropriate nursing interventions for each disorder

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

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

Paper and pen quiz

J. Nursing Taxonomy/Development Criteria

of

Diagnoses Formulate appropriate Group Outcome nursing diagnoses for formulation of NCP each disorder

A. B. C. D.

Potential for Infection Disturbance in Body Image Activity Intolerance Potential for alteration in nutrition; less than body requirements E. Alteration in oral Mucous Membrane Integrity F. Alteration in Comfort G. Fluid Volume Deficit

K. Principles of Various Modalities of Management Against CANCER 1. Health promotion 2. disease prevention 3. Curative 4. Restorative

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

Define each principle of modalities of management

2 minute role play for each group

Cite examples of each principle

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

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

Lecturediscussion Quiz bowl style

5. 0xygen therapy 6. Prevention of Complications 7. Rehabilitation N. Pharmacologic Actions Therapeutic use, side indications, contraindication, responsibilities

management

effects, Identify nursing pharmacologic management cancer

1. Biotherapy Classification
Cytokines
Monoclonal Antibodies
Cellular Therapies
Immunodilators
Retinoids

the for

Identify the mechanism of action, indication, contraindication, adverse effects and side effects of each drug Distinguish classification

each

Enumerate the nursing responsibilities appropriate for each pharmacologic management

2. Chemotherapeutic Agents Classification
Cell cycle-specific
Cell cycle-nonspecific Categories
Alkalating agents
Antibiotic antineoplastic
Antimetabolite
Nitroureas

Paper and pen quiz





Plant derivatives Hormonal

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

H. Bioethics: Principles and application of Identify the different bioethics in the care of the clients ethical concerns in -Patient’s rights patient care -Confidentiality -The Informed Consent -Ethics of decision -Advance Directives Formulate a discharge plan specific for each disorder

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

Paper and pen quiz

Identify the guidelines in accurate recording and documentation O. Nursing Responsibilities for specific surgical and special procedures [Preoperatively and Postoperatively] -positioning -dos and donts Define each type of -bedside equipment special and surgical -activity structuring procedure Safe and nursing care

comprehensive

perioperative

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

Operating room simulation Enumerate appropriate Lecture-discussion

Paper and pen quiz Return demonstration

5. 6. 7. 8.

Assessment and care during the nursing responsibilities perioperative period perioperatively Techniques in assisting the surgical team during the operation Principles of safety, comfort and privacy during the perioperative period Nursing responsibilities during the perioperative period

Surgical Procedures: 1. Modified radical mastectomy (drainage/positioning) 2. Lobectomy (positioning) 3. Hysterectomy 4. Craniectomy 5. Transurethral resection of the prostate (cystoclysis) 6. Colostomy ( care ) 7. Bone Marrow and Peripheral Blood Stem Cell Transplantation Special procedures: 1. Radiation therapy 2. Cervical Implants 3. Reverse Isolation Identify the different P. Appropriate discharge plan including ethical concerns in health education patient care Q. Accurate documentation

recording

and Formulate a discharge plan specific for each disorder Identify the guidelines in accurate recording and documentation

Case analysis Paper and pen Quiz

III. Acute Biologic Crisis A. Standard Assessment of the Critically Ill -Focused History Taking -Discriminating Physical Examination AIRWAY BREATHING CIRCULATION HEMODYNAMIC STATUS

B. Pathophysiologic Mechanisms leading to manifestations 1. 2. 3. 4.

Cardiac Failure Acute Myocardial Infarction Acute Renal Failure Stroke

Identify the appropriate assessment technique for each type of acute biologic crisis

Video clip presentation of an emergency situation

Enumerate prioritization of the assessment process

Lecture-discussion Define each type of Video clip crisis presentation of specific situations Trace the showing the crisis pathophysiologic process of each disorder through diagram representation Enumerate the different signs and symptoms of each disorder Enumerate the possible complications of each disorder Formulate appropriate nursing diagnoses for each disorder

Porth C.M. (2002). Paper and Pathophysiology: Concepts of Altered pen quiz Health States (6th ed., pp. 500504,564-566,777781, 1163-1164, 1174-1178,14331437). Philadelphia: Lippincott Williams and Wilkins

Related web sites: Burns: http://www.bt.cdc.g ov/masscasualties/ pdf/burnsmasscasualties.pdf Food poisoning: http://www.health.vi c.gov.au/foodsafety /downloads/poison _prevent.pdf Red cross guidelines in chemical poisoning: http://www.redcross .org/static/file_cont

Enumerate appropriate nursing interventions for each disorder

157_lang0_67.pdf SARS and Emerging Infections Terrorism: http://www.bioterror ism.uab.edu/EI/sar s/sars.pdf

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

9. Extensive Burns (include staging and area computation) 10. Poisoning 11. Multiple Injuries 12`. Emerging illness (SARS, Avian Flu)

C. Nursing Taxonomy/Development Criteria

of

Diagnoses Formulate appropriate Outcome nursing diagnoses for each disorder

5. Impaired Gas Exchange 6. Inability to sustain spontaneous ventilation 7. Dysfunctional Ventilatory Weaning Response 8. Decreased cardiac output 9. Altered tissue perfusion, systemic 10. Alteration in nutrition, less than body

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

NCP making

requirements 11. Fluid Volume Deficit 12. Activity Intolerance

D. Results/Implications Laboratory Exams

of

Diagnostic Define each diagnostic test

1. Non-Invasive: ECG, cardiac rhythms 2. Invasive: ABG, Hemodynamic monitoring, CVP, pulmonary capillary wedge pressure (PCWP)

Simulation ECG tracing Lecture-discussion

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

E. Principles of Management 1. Determination and management of Cause 2. Life saving interventions: Basic Life support Advanced Cardiac Life support First aid Measures Fluid Resuscitation

Lecture-discussion

Paper and pen quiz

Lecture-discussion

Paper and pen quiz

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

3. Life Maintaining Interventions: Define life maintaining -Airway management and care of intervention patients with ventilator -Parenteral fluid administration Identify the indications

(blood and blood component therapy -Interventions for hemodynamic instability -Continuous hemodynamic monitoring -Interventions for Nueral Regulation -Fluid and Electrolyte Problems -Nutrition -Perioperative Problems 4. Psychosocial and behavioral interventions: -measures to relieve anxiety -fear, depression - critical care concerns: -immobility, -sleep deprivation -sensory overload -body image alterations -grieving -sexuality -spirituality 5. Supportive management 6. Prevention of complication 7. Rehabilitation-pulmonary, cardiac, neurologic

F. Pharmacologic Actions Therapeutic use, side indications, contraindication, responsibilities 1. 2. 3. 4.

Analgesics Narcotics Corticosteroids Antihypertensive

for each Enumerate the interventions for each

Identify the indications for each Psychosocial and behavioral interventions

Lecture-discussion

Enumerate the interventions for each Psychosocial and behavioral intervention

Lecture-discussion

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

Drug study

5. Vasopressors 6. Antibiotics 7. Parenteral fluids

drug Distinguish classification

each

Enumerate the nursing responsibilities appropriate for each pharmacologic management G. Nursing Responsibilities for specific surgical and special procedures 1. Tracheostomy 2. Endotracheal Intubation 3. Cardiocentesis 4. Thoracotomy 5. Cut-down 6. Aneurysm clipping 7. Defibrillation & Cardioversion [Preoperatively and Postoperatively] -positioning -dos and donts -bedside equipment -activity structuring

Safe and nursing care 9.

comprehensive

perioperative

Assessment and care during the perioperative period 10. Techniques in assisting the surgical team during the operation 11. Principles of safety, comfort and privacy during the perioperative period 12. Nursing responsibilities during the

Video presentation Define each type of Role-play special and surgical procedure

Enumerate appropriate nursing responsibilities perioperatively

clip

Paper and pen quiz

perioperative period H. Bioethics: Principles and application Identify the different of bioethics in the care of the clients ethical concerns in -Patient’s rights patient care -Confidentiality -The Informed Consent -Advance Directives I. Appropriate discharge plan including Formulate a discharge health education plan specific for each disorder J. Accurate documentation

recording

and Identify the guidelines in accurate recording and documentation

Role-play

Paper and pen quiz Case analysisi

IV. Disaster and Emergency

Paper and pen quiz

A. Definition of Emergency and Define emergency and other terminologies disaster terms

ROLE PLAY of A DISASTER

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

Define TRIAGE Identify objectives for triaging Differentiate START triage from MILITARY triage in terms of procedure protocol and indications

Video presentation

and Cone DC, Paper pen quiz MacMillan DS. Case simulation Mass-casualty triage systems: A hint of Science. Case analysis Jingle making for Acad Emerg Med mnemonics 2005, 12(8): 739741 [PubMed EMERGENCY Citation] ROOM tour Triage Coding http://remm.nlm.gov /radtriage.htm

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

Cut-out activity Identify the color Game ka na Ba? coding and patient classification process for each type of triaging

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

Identify different hospital operation plans in local and international hospitals

D. Types of Emergency with appropriate nursing interventions 8. Airway obstruction 9. Myocardial Infarction 10. Near drowning 11. Hemorrhage 12. Head/Chest/abdominal Trauma 13. Poisoning and Overdose 14. Hypo/Hyperthermia 15. Snake bite/Animal bites 16. Nitrogen Narcosis 17. Fractures 18. Spinal cord Injury

Photo presentation Define each type pf emergency

Paper and pen quiz

Lecture-discussion

Enumerate the signs and symptoms Identify the appropriate medical and nursing actions for each

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

Interview hospital admin. For prepared hospital operations plan

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

Showing of Crash card

Moving Exam Paper and pen quiz

Enumerate the structures and contents of a crash cart F. Personal Equipment

G. Hazardous Materials

H. Decontamination

Protective Identify the types of Photo presentation Personal Protective with discussion Equipment and indications for each Enumerate hazardous materials Identify the possible effects of each hazardous material to health

Collage

Discussion

Identify decontamination measures I.

Biologic Warfare and Biologic Identify biologic agents warfares and agents Enumerate appropriate management and protocol for warfares

J. Blast Injuries

Define blast injuries Identify appropriate medical and nursing actions for each

K. Natural Disasters

Define different natural disasters Identify appropriate

Knowledge sharing Lecture-discussion Role-play

action plans for specific natural disasters

L. Stress Reactions Define specific types of stress reaction -Post Traumatic -Stress Disorder Critical Incident Enumerate appropriate Stress management nursing actions for -Debriefing each M. Special Emergency Photo sharing Procedures Lecture-discussion 1. 2. 3. 4. 5. 6. 7.

Tracheostomy Endotracheal Intubation Cardiocentesis Thoracotomy Cut-down Aneurysm clipping Defibrillation & Cardioversion

N. Nursing Responsibilities for specific Define each type of surgical and special procedures special and surgical [Preoperatively and procedure Postoperatively] -positioning -dos and donts -bedside equipment Enumerate appropriate -activity structuring nursing responsibilities perioperatively Safe and comprehensive perioperative nursing care Assessment

and

care

during

the

Paper and pen quiz

Dummy simulation Lecture Demonstration

Simulation Lecture Discussion Lecture Demonstration

Paper and pen quiz Return demonstration

perioperative period Techniques in assisting the surgical team during the operation Principles of safety, comfort and privacy during the perioperative period Nursing responsibilities perioperative period

during

the

O. Universal Precaution Application in an Identify universal emergency set-up Precaution principles Cite examples of cases needing universal precaution Demonstrate the correct steps in universal precaution

V. IV THERAPY A. Philosophy B. Definition C. Basic Foundation of IV Therapy 1. Historical background of IV therapy 2. Ethico-legal aspects of IV therapy 2.1 Role of ANSAP 2.2 Difference between RA 9173 and RA 7160 3. Standards of IV therapy

D. Review of Anatomy and Physiology of the vascular system E. Peripheral and Integumentary System

F. Fluid and Elecrolyte therapy 1. Types of Fluids/ Solution and uses 2. Drug Interaction with IV fluids 3. Handling of IV solutions, blood products and components

Discuss the importance of Intravenous Parenteral Therapy for the patient as well as the nurse.

Lecture-discussion

Illustration and pinpointing the different IV therapy access points

Describe the roles and responsibilities of nurses in IV therapy. Recognize the ethicolegal implications of IV Therapy. Identify the roles and functions of ANSAP.

Obtain and submit a copy of the Standard operating procedure(SOP) from local hospital about IV therapy.

Present the difference between RA 9163 to RA 7160 in terms of IV Therapy requirements

*Powerpoint presentation of the anatomy of the vascular, peripheral Identify and discuss the and integumenary parts and functions of system the vascular, peripheral and integumentary systems. Enumerate the types of fluids/solutions and identify the indication for each

G. Nursing process in IV therapy Utilize the nursing process in the care of Clients undergoing IV

Paper and Pen Quiz

Lecturedemonstration

Moving Exam

therapy. H. Venipuncture Technique on Adult & children -Prescribed cannula and indications of each -Color, gauge -Ideal period of usage of an IV set, indications -Process in keeping a set sterile I.

Complications of IV therapy

J. Infection Control & Microbiology Principles K. Demonstration of Procedure Documentation of Activity

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

Returndemonsration with an IV Therapy Certified Clinical Instructor