Living With Ongoing Health Challenges

Content of this course will be evidenced based.  Exemplars may vary.

I.             VARIABLES

Physiological Variable

                Metabolism

                ·               alteration in metabolism (introduction)

                Exemplar:

                                diabetes mellitus

                Oxygenation       

                ·               alteration in respiratory functioning (introduction)

                Exemplars:

                                COPD (emphysema, chronic bronchitis, asthma)

                                Pneumonia

                Circulation

                ·               alteration in circulatory functioning (introduction)

                Exemplars:

                                angina

                                coronary artery disease

                                MI

                                CHF

                Cellular Dynamics

                ·               fluid and electrolytes, acid/base balance

                Exemplar:

                                self induced water intoxication

                Elimination

                ·               alteration in urological/bowel functioning (introduction)

                Exemplars:

                                glomerulonephritis

                                pyelonephritis

                                UTI

                Mobility

                ·               alteration in mobility (introduction)

                Exemplar:

                                rheumatoid arthritis

                Reproduction

                Neuro-sensory

                ·               alteration in neuro-sensory functioning (introduction)

                Exemplars:

                                intro to dementia, delirium, cognitive impairment

                                CVA (focus on motor & sensory alterations)

                                chronic pain

                Protection

                ·               measures to prevent an alteration in skin integrity

Psychosocial Variable

                Integration

                ·               Assessment of self-concept (self-esteem, self-ideal, body-image, identity, sexuality),
                                emotions (affect, mood, patterns), & cognition (thought processes, insight, memory,
                                judgment).

                Relatedness

                ·               Roles (conflict, overload, expectations)

                ·               Further discussion of problem-solving in psychiatric nursing

                Exemplars:

                                withdrawal (schizophrenia)

                                hopelessness (depression)

                                grief

                                death & dying

                                powerlessness

                                special communication approaches for people with CVA, aphasia

                                MSE (as tool for assessment)

                                anxiety, stress

                                stigma

Cultural Variable

·               Integration of culture of diversity into concept exemplar

·               Continued awareness and development of cultural sensitivity

Spiritual Variable

                Purpose - meaning

                Interconnectedness

                Faith

                Forgiveness

                Religion

                Creativity

                Transcendence

Developmental Variable

                Growth

                Lifespan

                Transitions

II.            CURRICULAR THREADS

Health Promotion

                ·               preventive health practices related to various ongoing health challenges

·               promoting health practices to enable the person to increase control over and enhance one’s

                own health

                Exemplar:            

                                early psychosis intervention

Professionalism/Caring

                ·               DCPN and College policies

                ·               discussion in seminar: ethical issues, Mental Health Act, client's rights

                ·               role of RPN

                ·               documentation

                ·               Standards of Practice

                ·               caring attributes (6 “C”s)

                ·               problem solving/rationale for decision-making

                ·               legal aspects of psychiatric nursing practice

III.          RELATED PHARMACOLOGY

                ·               antidepressants                    }

                ·               antipsychotics                      }  Overview  

                ·               antiparkinsonians                }             

                ·               antilipids

                ·               bronchodilators

                ·               diuretics

                ·               cardiotonics

                ·               insulins

                ·               oral hypoglycemics

                ·               anti-inflammatories (NSAID)

                ·               anticoagulant

                ·               antibiotics             } Overview

IV.          THERAPEUTIC RELATIONSHIPS

                ·               links with philosophy/conceptual framework and related concepts

                ·               documentation

                ·               intro to interviewing

                ·               review the nurse-client relationship

                ·               Egan Model of communication

                ·               links between the nurse-client relationship and the Egan Model

                ·               probing and summarizing

                ·               reluctant and resistant clients

                ·               review assertiveness as necessary

                ·               conflict resolution (review)

                ·               theory/practice re: reporting off

                ·               roleplaying and videotaping with/without actors using, as scenarios, a variety of lived

                                experiences discussed in Concepts as well as lived experiences from clinical

V.            CARING PRACTICE

                ·               positioning

                ·               chest auscultation

                ·               use of TED stockings/application of tensors

                ·               measuring intake and output

                ·               care of the indwelling urinary catheter

                ·               application of condom drainage

                ·               discontinuing a urinary catheter

                ·               oxygen therapy (low-flow system: nasal -cannula, simple face mask, high-flow systems)

                ·               administration of oral, topical, inhalant and nebulizing medications

                ·               administration of enemas and rectal suppositories

                ·               preparation and administration of subcutaneous injections, intradermal injections

                ·               care of the body after death

                ·               isolation techniques

                ·               collecting specimens (sputum, stool, urine)

                ·               glucometers

                ·               pulse oximetry

                ·               intradermal injections