NRS-410V – Pathophysiology and Nursing Management of Clients’ Health
NRS-410V
Pathophysiology and Nursing Management of Clients’ Health Course Syllabus
Version 12.0
Pathophysiology and Nursing Management of Clients’ Health
Course Code Type Duration Credit Hours
NRS-410V v:1 Credit Based 35 Days 3.0
2.0
Course Description
This course is designed to enhance the working RN’s existing understanding of the pathophysiological processes of disease as they affect clients across the lifespan. The interrelationship of structural and functional reactions of cells and tissues to genetic alterations and injurious agents provide the foundation for comprehending clinical manifestations and treatment protocols. Critical thinking and nursing management are enhanced through the use of case studies that integrate nutritional and pharmacological concepts. The understanding of environmental and biological risk factors provides the nurse with the knowledge to provide health promotion and prevention education.
Pre-Requisites
None
Co-Requisites
None
NRS-410V
Course Materials
Topic 1: Cardiorespiratory Complexities
Description
Objectives:
Evaluate functions of the cardiac and respiratory systems based on
Develop a health promotion with a restoration teaching plan for a patient with cardiorespiratory complexities.
Develop a method for patient education to prevent hospital
Study Materials
Pathophysiology: Clinical Applications for Client Health
Description:
Read Chapter 1 in Pathophysiology: Clinical Applications for Client Health.
Patient Perceived Impact of Nurse-Led Self-Management Interventions for COPD: A Systematic Review of Qualitative Research
Description:
Read “Patient Perceived Impact of Nurse-Led Self-Management Interventions for COPD: A Systematic Review of Qualitative Research,” by Baker and Fatoye, from International Journal of Nursing Studies (2019).
Severe Asthma in Primary Care: Identification and Management
Description:
Read “Severe Asthma in Primary Care: Identification and Management,” by Trevor and Chipps, from American Journal of Medicine (2018).
Acute Myocardial Infarction
Description:
Read “Acute Myocardial Infarction,” by Reed, Rossi and Cannon, from The Lancet (2017).
Evaluating the Effectiveness of an Online Cardiac Rehabilitation Resource
(www.svhhearthealth.com.au) in Improving Knowledge and Confidence for Patients With Newly Diagnosed Cardiac Conditions: A Pre-Experimental Pilot Study
Description:
Read “Evaluating the Effectiveness of an Online Cardiac Rehabilitation Resource (www.svhhearthealth.com.au) in Improving Knowledge and Confidence for Patients With Newly Diagnosed Cardiac Conditions: A Pre-Experimental Pilot Study,” by Molan, Emmanuel, Langley and Holloway, from Heart, Lung and Circulation, 2019.
A Nursing Care of Patients After Cardiac Arrest in the Course of Myocardial Infarction
Description:
Read “A Nursing Care of Patients After Cardiac Arrest in the Course of Myocardial Infarction,” by Kaminska and Krzeminska, from Journal of Education, Health and Sport (2018).
Tasks
home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.
Subjective Data
Is very anxious and asks whether she is going to
Denies pain but says she feels like she cannot get enough
Says her heart feels like it is “running “
Reports that she is exhausted and cannot eat or drink by
Objective Data
Height 175 cm; Weight 5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal
Intervention
The following medications administered through drug therapy control her symptoms:
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:
Describe the clinical manifestations present in Mrs.
Discuss whether the nursing interventions at the time of her admissions were appropriate for J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
Describe a method for providing education for J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Topic 2: Neurological, Perceptual, and Cognitive Complexities
Description
Objectives:
Evaluate functions of the neurological, perceptual, and cognitive systems based on
Propose an intervention for a patient with a cognitive
Study Materials
This Is Our Life Now. Our New Normal: A Qualitative Study of the Unmet Needs of Carers of Stroke Survivors
Description:
Read “‘This Is Our Life Now. Our New Normal’: A Qualitative Study of the Unmet Needs of Carers of Stroke Survivors,” by Denham et al., from PLOS ONE (2019).
This Is Not Only About Memory: A Systematic Review on Neuropsychology Heterogeneity in Alzheimer’s Disease
Description:
Read “This Is Not Only About Memory: A Systematic Review on Neuropsychology Heterogeneity in Alzheimer’s Disease,” by Martorelli, Sudo, and Charchat-Fichman, from Psychology and Neuroscience (2019).
The Relationship Between Thyroid Function and Cerebral Blood Flow in Mild Cognitive Impairment and Alzheimer’s Disease
Description:
Read “The Relationship Between Thyroid Function and Cerebral Blood Flow in Mild Cognitive Impairment and Alzheimer’s Disease,” from PLOS ONE (2019).
Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A
Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures
Description:
Read “Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures,” by Guillen et al., from Frontiers in Psychiatry (2019).
Poststroke Seizure: Optimizing Its Management
Description:
Read “Poststroke Seizure: Optimizing Its Management,” by Michael Y Xu, from Stroke and Vascular Neurology (2019).
Antibiotics, Gut Microbiota, and Alzheimer’s Disease
Description:
Read “Antibiotics, Gut Microbiota, and Alzheimer’s Disease,” by Angelucci, Cechova, Amlerova and Hort, from Journal of Neuroinflammation (2019).
Experimental Necrotizing Enterocolitis Induces Neuroinflammation in the Neonatal Brain
Description:
Read “Experimental Necrotizing Enterocolitis Induces Neuroinflammation in the Neonatal Brain,” by Biouss et al., from
Journal of Neuroinflammation (2019).
Tasks
Case Study: Mr. M.
Description:
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. M., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.
Case Scenario
Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.
Objective Data
Temperature: 37.1 degrees C
BP 123/78 HR 93 RR 22 Pox 99%
Denies pain
Height: 69.5 inches; Weight 87 kg
Laboratory Results
WBC: 19.2 (1,000/uL)
Lymphocytes 6700 (cells/uL)
CT Head shows no changes since previous scan
Urinalysis positive for moderate amount of leukocytes and cloudy
Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:
Describe the clinical manifestations present in Mr. M.
Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for
When performing your nursing assessment, discuss what abnormalities would you expect to find and
Describe the physical, psychological, and emotional effects M.’s current health status may have on him. Discuss the impact it can have on his family.
Discuss what interventions can be put into place to support M. and his family.
Topic 3: Elimination Complexities
Description
Objectives:
Evaluate functions of systems related to
Examine the nurse’s role of supporting the patient’s psychological and emotional
Recommend resources to assist in patient
Study Materials
Read “Pathophysiological, Molecular and Therapeutic Issues of Nonalcoholic Fatty Liver Disease: An Overview,” by Marchisello et. al., from International Journal of Molecular Sciences2019.
Nephrotoxicity of Iodinated Contrast Media: From Pathophysiology to Prevention Strategies
Description:
Read” Nephrotoxicity of Iodinated Contrast Media: From Pathophysiology to Prevention Strategies,” by Faucon, Bobrie, and Clement, from European Journal of Radiology (2019).
Acute Pancreatitis: A Comparative Study to Assess the Clinical Outcome of Acute Pancreatitis in Relation With Major Etiologies
Description:
Read “Acute Pancreatitis: A Comparative Study to Assess the Clinical Outcome of Acute Pancreatitis in Relation With Major Etiologies,” by Abibasi and Abid, from Professional Medical Journal (2019).
Management of Hypertriglyceridemia Induced Acute Pancreatitis
Description:
Read “Management of Hypertriglyceridemia Induced Acute Pancreatitis,” by Garg and Rustagi, from BioMed Research International (2018).
Variceal Bleeding in Alcoholic Liver Cirrhosis – A Short Review
Description:
Read “Variceal Bleeding in Alcoholic Liver Cirrhosis – A Short Review,” by Sanjeevi, Rizwan, and Subhashini, from
Drug Intervention Today (2019).
Estimated Glomerular Filtration Rate Decline and Risk of End-Stage Renal Disease in Type 2 Diabetes
Description:
Read “Estimated Glomerular Filtration Rate Decline and Risk of End-Stage Renal Disease in Type 2 Diabetes,” by Megumi et al., from PLOS ONE (2018).
Diagnostic Dilemmas in a Girl with Acute Glomerulonephritis: Answers
Description:
Read “Diagnostic Dilemmas in a Girl with Acute Glomerulonephritis: Answers,” by Falix et al., from Pediatric Nephrology (2018).
Screening and Management of Hepatitis C: Use Education to Dispel the Myths About the Disease and Increase Screening and Treatment
Description:
Read “Screening and Management of Hepatitis C: Use Education to Dispel the Myths About the Disease and Increase Screening and Treatment,” by Pilger and Costanzo, from American Nurse Today (2018).
A Clinical Review of Autoimmune Hepatitis
Tasks
Health History and Medical Information
Health History
Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:
Height: 68 inches; weight 5 kg 2. BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:
Describe the clinical manifestations present in Mr.
Describe the potential health risks for obesity that are of concern for C. Discuss whether bariatric surgery is an appropriate intervention.
Assess each of C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception,
health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
Explain the staging of end-stage renal disease (ESRD) and contributing factors to
Consider ESRD prevention and health promotion Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these Consider aspects such as devices, transportation, living conditions, return-to-employment issues.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Topic 3 DQ 1
Description:
Discuss how elimination complexities can affect the lives of patients and their families. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. Provide an example.
Topic 3 DQ 2
Topic 4: Cellular and Immunological Complexities
Description
Objectives:
Discuss characteristic findings for a cellular
Discuss characteristic findings for an immunological
Explain how the nursing process is utilized to provide safe and effective care for patients across the life
Study Materials
Description:
Read “Management and Outcomes of Patients Presenting With Sepsis and Septic Shock to the Emergency Department During Nursing Handover: A Retrospective Cohort Study,” by Alsolamy et al., from BMC Emergency Medicine (2018).
A Descriptive, Cross-Sectional Study Examining Treatment Burden in People Living With HIV
Description:
Read “A Descriptive, Cross-Sectional Study Examining Treatment Burden in People Living With HIV,” by Schreiner, Perazzo, Currie, Daly, and Webel, from Applied Nursing Research (2019).
Biologic Therapies for Cancer
Description:
Read, “Biological Therapies for Cancer,” located on the National Cancer Institute website.
Targeted Therapy
Description:
Read “Targeted Therapy,” located on the Breast Center page of the Johns Hopkins Medicine website.
Visualizing Gene-Expression Patterns
Description:
View “Visualizing Gene-Expression Patterns,” located on the Howard Hughes Medical Institute (HHMI) website.
Cells of the Immune System
Description:
View “Cells of the Immune System,” located on the Howard Hughes Medical Institute (HHMI) website.
Antibiotics – Seven Wonders of the Microbe World
Description:
View “Antibiotics – Seven Wonders of the Microbe World,” by OpenLearn from the Open University (2011), located on the YouTube website.
Cloning an Army of T Cells for Immune Defense
Description:
View “Cloning an Army of T Cells for Immune Defense,” from the Howard Hughes Medical Institute (HHMI) website.
Inflammation and Repair
Description:
Explore the Inflammation and Repair page of the Pathology Guy website.
Tasks
Benchmark – Nursing Process: Approach to Care
Description:
The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.
Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:
Describe the diagnosis and staging of
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in
Explain how the American Cancer Society (ACS) might provide education and What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.
You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Topic 5: Musculoskeletal, Metabolism, and Multisystem Complexities
Description
Objectives:
Describe pathophysiological changes and abnormal findings associated with musculoskeletal, metabolic, and multisystem health
Evaluate a research-based nursing intervention or treatment tool for the management of
Study Materials
Description:
Read “Osteoporosis Is Neglected,” from Osteoporosis and Bone Physiology, located on the University of Washington website.
Diabetes Self-Management and Glycemic Control: The Role of Autonomy Support From Informal Health Supporters
Description:
Read “Diabetes Self-Management and Glycemic Control: The Role of Autonomy Support From Informal Health Supporters,” by Lee, Piette, Heisler, Janevic, and Rosland, from Health Psychology (2019).
Depressive Symptoms and Diabetes Management From Late Adolescence to Emerging Adulthood
Description:
Read “Depressive Symptoms and Diabetes Management From Late Adolescence to Emerging Adulthood,” by Baucom, Turner, Tracy, Berg, and Wiebe, from Health Psychology (2018).
Osteoporosis
Description:
Read “Osteoporosis,” located on the National Institute of Aging website.
What Is Diabetes
Description:
Read “What Is Diabetes?” located on the Diabetes Research Institute Foundation website.
Osteogenesis Imperfecta Type VI
Description:
Read “Osteogenesis Imperfecta Type VI,” located on the National Center for Advancing Translational Sciences website.
Can Metabolic Pathways Be Therapeutic Targets in Rheumatoid Arthritis?
Description:
Read “Can Metabolic Pathways Be Therapeutic Targets in Rheumatoid Arthritis?” by Sanchez-Lopez, Cheng, and Guma, from Journal of Clinical Medicine (2019).
Accuracy of Self-Reported History of Autoimmune Disease: A Pilot Study
Description:
Read “Accuracy of Self-Reported History of Autoimmune Disease: A Pilot Study,” by O’Rourke et al., from PLOS ONE
(2019).
An Integrated Therapy Approach for the Management of Obesity-Associated Disorders: A Case Report
Tasks
Summarize the main idea of the research findings for a specific patient population. The research presented must include clinical findings that are current, thorough, and relevant to diabetes and nursing
Provide a descriptive and reflective discussion of how the new tool or intervention can be integrated into nursing Provide evidence to support your discussion.
Explain why psychological, cultural, and spiritual aspects are important to consider for a patient who has been diagnosed with Describe how support can be offered in these respective areas as part of a plan of care for the patient. Provide examples.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Topic 5 DQ 1
Description:
Describe some of the more common pathophysiological changes and abnormal findings associated with musculoskeletal, metabolic, and multisystem health dysfunctions. Explain what symptoms are associated with the findings and how these affect patient function.
Topic 5 DQ 2
Description:
Explain the risk factors for osteoporosis. What can a nurse do to help manage this health condition to restore the patient to optimal health?
Grade Scale
Final Grade Column
Letter Grade GPA Value Minimum (%) Maximum (%)
A 4.0 95.0 100.0
A- 3.7 92.0 94.99
B+ 3.3 90.0 91.99
B 3.0 87.0 89.99
B- 2.7 84.0 86.99
C+ 2.3 80.0 83.99
C 2.0 76.0 79.99
D 1.0 72.0 75.99
F 0.0 0.02 71.99
I 0.0 0.0 0.01
Grade Categories
Assignments (%) Points Percentile
Case Study: Mr. M. 120.0 —
Benchmark – Nursing Process: Approach to Care 250.0 —
Case Study: Mrs. J. 120.0 —
Case Study: Mr. C. 120.0 —
CLC – Evidence-Based Practice Project: Intervention Presentation on Diabetes
150.0
—
Discussion Question (%) Points Percentile
Topic 4 DQ 1 8.0 —
Topic 5 DQ 1 8.0 —
Topic 2 DQ 1 8.0 —
Topic 1 DQ 2 8.0 —
Topic 2 DQ 2 8.0 —
Topic 3 DQ 2 8.0 —
Topic 3 DQ 1 8.0 —
Topic 4 DQ 2 8.0 —
Topic 5 DQ 2 8.0 —
Topic 1 DQ 1 8.0 —
Participation (%) Points Percentile
32.0 —
Participation (%) Points Percentile
32.0 —
Participation (%) Points Percentile
32.0 —
Participation (%) Points Percentile
32.0 —
Participation (%) Points Percentile
32.0 —
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