Pathophysiological Processes for Nursing 2

Course Number:

NRS 235

Transcript Title:

Pathophysiological Processes for Nursing 2

Created:

Apr 30, 2024

Updated:

May 01, 2024

Total Credits:

2

Lecture Hours:

20

Lecture / Lab Hours:

0

Lab Hours:

0

Satisfies Cultural Literacy requirement:

No

Satisfies General Education requirement:

No

Grading Options

A-F

Default Grading Options

A-F

Repeats available for credit:

0

Suggested Outcome Assessment Strategies

The determination of assessment strategies is generally left to the discretion of the instructor. Here are some strategies that you might consider when designing your course: writings (journals, self-reflections, pre writing exercises, essays), quizzes, tests, midterm and final exams, group projects, presentations (in person, videos, etc), self-assessments, experimentations, lab reports, peer critiques, responses (to texts, podcasts, videos, films, etc), student generated questions, Escape Room, interviews, and/or portfolios.

Department suggestions: exams, case scenario, concept maps

Course Activities and Design

The determination of teaching strategies used in the delivery of outcomes is generally left to the discretion of the instructor. Here are some strategies that you might consider when designing your course: lecture, small group/forum discussion, flipped classroom, dyads, oral presentation, role play, simulation scenarios, group projects, service learning projects, hands-on lab, peer review/workshops, cooperative learning (jigsaw, fishbowl), inquiry based instruction, differentiated instruction (learning centers), graphic organizers, etc.

Course Content

Outcome #1: Identify and interpret current, reliable information about selected pathophysiological processes.

• Cardiac, vascular Disorders
• Respiratory Disorders,
• Gastrointestinal Disorders
• Renal and Bladder Disorders
• Endocrine Disorders
• Neurological Disorders

Outcome #2: Utilize clinical understanding to choose and analyze targeted nursing assessments, considering clinical manifestations, developmental factors, relevant social determinants of health, and potential complications of various pathophysiological conditions across all age groups.

• Peripheral vascular disease
  • Virchow’s Triad of factors that predispose to blood clotting (applies to both venous and arterial blood)
    • hypercoagulability
    • rough endothelium
    • stasis of blood
• Alterations in venous flow
  • valve incompetence
  • varicose veins and chronic venous insufficiency
  • thrombophlebitis and deep vein thrombosis, potential for pulmonary embolism
• Alterations in arterial flow
  • definitions: arteriosclerosis, atherosclerosis
  • atherosclerosis (including endothelial dysfunction)
  • peripheral arterial disease (PAD)
  • acute arterial occlusion
• Hypertension
  • definitions: systemic vascular resistance, afterload
  • primary versus secondary hypertension
• Low blood pressure
  • orthostatic hypotension
• Endocardial disorders
  • rheumatic heart disease
  • infective endocarditis
• Pericardial disorders
  • definitions: pericarditis, pericardial effusion, cardiac tamponade
• Cardiomyopathy
  • dilated versus hypertrophic (HCM) versus restrictive (RCM)
• Heart failure
  • definitions: preload, ejection fraction
• Coronary heart disease
  • myocardial oxygen supply and demand, factors that increase oxygen demand
  • myocardial ischemia versus myocardial infarction (include variations in clinical manifestations)
  • stable angina
  • acute coronary syndromes
• Valve disorders
  • definitions: stenosis, regurgitation (also known as incompetence, insufficiency)
• Congenital heart disease
  • acyanotic versus cyanotic
  • acyanotic defects
    • atrial septal defect
    • ventricular septal defect (initially acyanotic)
    • patent ductus arteriosus
    • coarctation of the aorta
  • cyanotic defect
    • tetralogy of Fallot
• Endocardial disorders
  • rheumatic heart disease
  • infective endocarditis
• Pericardial disorders
  • definitions: pericarditis, pericardial effusion, cardiac tamponade
• Cardiomyopathy
  • dilated versus hypertrophic (HCM) versus restrictive (RCM)
• Heart failure
  • definitions: preload, ejection fraction
  • heart failure with reduced ejection fraction (HFrEF; systolic) versus heart failure with preserved ejection fraction (HFpEF; diastolic)
  • compensatory mechanisms and ventricular remodeling
  • left heart failure versus right heart failure
• Introduction to cardiac dysrhythmias/arrhythmias (brief)
  • Note: Specific dysrhythmias/arrhythmias will be taught in acute nursing course. The focus here is on definitions and the general effects.
  • definitions: abnormal impulse generation, conduction defect
  • effect on cardiac output
• Shock: the fundamental concept
  • Note: The fundamental concept of shock is optional content in NRS 232 or 233. Individual programs can also opt to teach a more detailed presentation of shock. Each program can decide whether to teach the various types of shock in one presentation, or teach them in separate units.
• Anemias
  • overview and principles
    • definition of anemia, decreased oxygen-carrying capacity
    • clinical manifestations of anemia from any cause
  • specific types of anemia, with additional type-specific clinical manifestations
    • anemia from decreased RBC production
      • iron deficiency anemia
      • pernicious anemia
      • aplastic anemia
    • anemia of chronic kidney disease (CKD)
    • inherited hemolytic anemias
      • sickle cell anemia
    • anemia from extrinsic RBC destruction or loss
      • acute blood loss
      • hemolytic disease of the fetus and newborn
• Principles of Altered Pulmonary Function
  • Hypoventilation (hypercapnia)
    • Example (e.g., bacterial pneumonia)
  • Hyperventilation
    • Example (e.g., hyperventilation from anxiety)
  • Ventilation/perfusion mismatch (V/Q mismatch)
    • Pulmonary embolism
  • Altered mucus clearance
    • Example (e.g., cystic fibrosis)
  • Altered lung compliance
    • Example (e.g., fibrotic interstitial lung diseases)
• Infection or inflammation of the lung
  • Pulmonary tuberculosis (TB)
  • Pneumonias
    • causes of pneumonia
    • clinical manifestations of viral versus bacterial pneumonia
• Overview of obstructive and restrictive pulmonary disorders
  • Definitions of residual volume, obstructive disorders, restrictive disorders
• Obstructive pulmonary disorders
  • Obstruction from conditions of the wall of the lumen
  • Obstruction related to loss of lung parenchyma
  • Obstruction of the airway lumen
• Restrictive pulmonary disorders
  • Lung parenchyma disorders
  • Pleural space disorders
• Principles of endocrine pathophysiology
  • Primary versus secondary endocrine disorders
  • Types of endocrine disorders
    • Hyposecretion of hormones
    • Hypersecretion of hormones
• Diabetes mellitus
  • Prediabetes
  • Type 1 diabetes mellitus, including acute (brief) and long-term complications
  • Type 2 diabetes mellitus, including acute (brief) and long-term complications
  • Gestational diabetes mellitus
• Thyroid hormone disorders
• Adrenocortical hormone disorders
• Disorders of the esophagus, stomach and intestines
  • altered motility and secretion (diarrhea)
  • gastroesophageal reflux disease (GERD)
• Disorders of the pancreas
  • pancreatitis (acute and chronic)
• Disorders of the liver & gallbladder
  • hepatitis (viral types A, B, C and nonviral)
  • nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH)
  • cirrhosis
  • cholelithiasis and cholecystitis
• Disorders of the bladder and related structures (discussion of lifespan issues and male/female issues)
  • urinary incontinence (definitions of types)
  • definitions: enuresis, urinary retention
  • vesicoureteral reflux
  • cystitis
  • benign prostatic hyperplasia (BPH)
• Intrarenal disorders
  • definition: pyelonephritis
  • renal calculi and obstructive uropathy
  • glomerulonephritis
  • nephrotic syndrome
• Kidney failure
  • acute kidney injury (AKI) [formerly known as acute renal failure] (including prerenal, intrarenal, & postrenal etiologies)
  • chronic kidney disease (CKD) [formerly known as chronic renal failure]

Outcome #3: Educate individuals from various backgrounds and age groups about specific pathophysiological processes of disorders affecting the cardiac, respiratory, renal, neurological and endocrine systems.

• explaining how the risk factors relate to specific pathophysiological processes,
• describing selected pathophysiological processes in appropriate terms,
• explaining how the signs and symptoms relate to specific pathophysiological processes,
• explaining which signs and symptoms to report to a health professional, and
• explaining how developmental factors relate to pathophysiology, symptom experience, symptom reporting, and symptom management.

Outcome #4: Convey information proficiently to fellow healthcare professionals about specific pathophysiological processes, with a particular emphasis on; cardiac, respiratory, renal, neurological and endocrine disorders.

• using appropriate technical language,
• clarifying technical details of pathophysiological processes, and
• prioritizing and reporting pertinent information regarding a patient’s status.

Suggested Texts and Materials

• Capriotti, T.M. (2020) Pathophysiology: Introductory concepts and clinical perspectives. (2nd ed.) Philadelphia, PA: FA Davis.