Adult Health Nursing BScN 2nd Year Syllabus and Course Outline

Adult Health Nursing -I&II HEC Curriculum 

Adult Health Nursing BScN 2nd Year Syllabus and Course Outline

AHN, Adult Health Nursing  Manual , Basic Care Manual, BSc Clinical Manual, Nursing Manual, FON Manual, Nursing Services Administrative Manual. BScN 2nd Year , HEC, PNC, UHS, Syllabus,Course Outline, Clinical Objective.

Subject Semester Hours 

     In the 136 Credit hour program ,the 8 theory  Credit hours, 4theory, 3Clinical,1 Lab hours for both AHN I and AHN II there is no lab or clinical hours needed for this course.It belongs to Discipline Specific Course

Course Description

    This course aimed to furnish learners with the knowledge and skills to care for an adult patient admitted to the hospital with a disease condition. It emphasizes on effective utilization of nursing process to provide care to the client and facilitate them in restoration of optimum health. Assessment Tool has been utilized for recognizing the responses towards disease process on individuals and their families and plan care accordingly. Specific nursing skills and procedures necessary to care for ill patients are included. Learners are exposed to the variety of clinical settings to integrate theory into practice under supervision. 

 Course Objectives

By the end of the course, the learners will be able to: 

1. Discuss the disease process, medical and surgical management, including patient’s education for client’s experiencing following disorders: 

a. Haematology Disorders 

b. Immunological Disorders 

c. Fluid, Electrolyte and Acid Base Balance and Imbalance 

d. Cellular adaptation and aberrant cell growth 

e. Gastrointestinal Disorders 

f. Genitourinary Disorders 

 2. Discuss the purposes, indications and the nursing care of clients undergoing medical, surgical and diagnostic procedures related to the above-mentioned disorders. 

 3. Utilize nursing process when caring for adult clients and their families related to above-mentioned disorders. 

4. Integrate knowledge of pathophysiology, nutrition & pharmacology for clients experiencing the above-mentioned disorders. 5. Begin to recognize the need for integrating research-based information in the care of clients. 6. Demonstrate awareness of the importance of legal and ethical issues in nursing practice.

AHN I

Sr No	Topics
1.	UNIT I: Gastrointestinal Disorders: Review the anatomy and physiology of gastrointestinal system (GIT)+Discuss the causes, pathophysiology and manifestation of the following GIT disorders
2.	Discuss the diagnostic, medical and surgical management of the below mentioned disorders
3.	Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with GIT disorders
4.	Develop a teaching plan for a client experiencing disorders of the GIT
5.	Disorders of mouth and esophagus:Stomatitis+Oral cancer/tumour
6.	Salivary gland disorders
7.	Gastro esophageal reflux disorder+Hiatal hernia
8.	Achalasia+Diverticula
9.	Esophageal cancer/tumor
10.	Disorders of stomach  Gastritis+Ulcer disease
11.	Gastric carcinoma
12.	Disorders of small and large intestine: Irritable bowel syndrome+Hernias+Intestinal obstruction
13.	Hemorrhoids+Colorectal cancer+Appendicitis
14.	Peritonitis+Ulcerative colitis+Chron’s disease
15.	Anorectal abscess+Anal fissure+Anal fistula
16.	Alteration in hepatobiliary system:
17.	Pancreatitis+Pancreatic pseudocyst/abscess
18.	Pancreatic carcinoma
19.	Hepatic abscess+Cancer of liver+Cirrhosis of liver
20.	Cholecystitis+Cholilithiasis
21.	Cancer of gall bladder
22.	UNIT II: Fluid, Electrolyte, and Acid Base Balance & Imbalances Analyze the client’s status on the basis of physical examination findings+Identify clients at risk for fluid imbalances, acidosis and alkalosis
23.	Use laboratory data and clinical manifestations to determine the presence of fluid imbalances, acidosis and alkalosis.
24.	Apply appropriate nursing techniques to the client with fluid volume deficit and excess and acidosis and alkalosis
25.	Develop a teaching plan to prevent above mentioned problems.
26.	Fluid volume excess+Fluid volume deficit
27.	Respiratory Acidosis and Alkalosis
28.	Metabolic Acidosis and Alkalosis
29.	UNIT III: Genitourinary Tract (Gut) Disorders Review the anatomy& physiology of GUT+Discuss the causes, pathophysiology and manifestation of the following GUT disorders
30.	Discuss the diagnostic, medical and surgical management.Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with genitourinary disorders.Develop a teaching plan for a client experiencing disorders of the genitourinary:Urinary tract infections+Renal abscess & tuberculosis
31.	Glomerulunephritis (immunologic disorder)+Urethral strictures, hydroureter and hydronephrosis
32.	Urinary incontinence/ Retention & Urinary Calculi
33.	Acute & Chronic Renal failure
34.	Urinary Bladder and Renal cell carcinoma
35.	UNIT IV: Reproductive Disorders Female Reproductive Disorders:Review the anatomy & physiology of female reproductive system+Discuss the function of the supporting ligaments and pelvic floor muscles in maintaining the position of the pelvic organs
36.	Discuss the alteration in estrogen and progesterone levels as a cause of dysfunctional menstrual cycle.Discuss the causes, pathophysiology and manifestation of the following female reproductive disorders.Discuss the diagnostic, medical and surgical management of the below mentioned disorders.Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with reproductive disorders.Develop a teaching plan for a client experiencing disorders of the reproductive system :Reproductive tract Infections
37.	Menstrual Disorders+Dysfunctional uterine bleeding
38.	Menopause+Endometriosis
39.	Pelvic inflammatory disease+Uterine prolapse
40.	Cystocele+Rectocele
41.	Fistulas+Infertility
42.	Ectopic Pregnancy+Abortion
43.	Hydatidiform mole+Ovarian cyst
44.	Ovarian tumor and cancer
45.	Uterine tumor/ fibroids +Breast cancer
46.	Male Reproductive Disorders:Discuss the structure & function of male reproductive system.Discuss the causes, pathophysiology and manifestation of the following male reproductive disorders.Discuss the diagnostic, medical and surgical management of the below mentioned disorders.Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with male reproductive disorder. Develop a teaching plan for a client experiencing disorders.f the reproductive system :Benign prostate hypertrophy+Erectile dysfunction
47.	Prostate and testicular cancer
48.	Infertility in male
49.	UNIT V: Haematology Disorders Discus the causes, manifestations and associated mechanisms of anemia
50.	Describe the pathogenesis of hemolytic disease of the newborn
51.	Discuss the lymph proliferative disorders associated with Hodgkin disease and non-Hodgkin’s lymphomas+Discuss the mechanism of drugs induced and idiopathic thrombocytopenia
52.	Discuss the diagnostic, medical and surgical management of the below mentioned disorders+Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with hematological disorders
53.	Develop a teaching plan for a client experiencing disorders of the hematology:Sickle cell anaemia.+Immunohemolytic Anaemia
54.	Iron deficiency anaemia +Vitamin B12 deficiency anaemia
55.	Folic acid deficiency anaemia+Aplastic anaemia
56.	Polycythemia
57.	Leukemia +Hodgkin disease & Non Hodgkin lymphoma
58.	Autoimmune and thrombotic Thrombocytopenic purpura+DIC
59.	UNIT VI: Cellular Adaptation & Aberrant Cell Growth Identify the goals of cancer therapy
60.	Discuss different treatment modalities available for Cancer
61.	Discuss chemotherapy and radiation therapy, their types, indication, side effects and nursing care
62.	Discuss different types of cancer surgeries and nursing care of patients undergoing cancer surgery.
63.	Discuss end of life care (palliative and hospice care.
64.	UNIT VI: Immunological Disorders Discuss Immunologic disorders
65.	Discuss the diagnostic, medical and surgical management of the below mentioned disorders
66.	Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with immunological disorders.Develop a teaching plan for a client experiencing disorders of the immunology:HIV/ AIDS
67.	Hypersensitivity and autoimmunity disorders

Sr No	Topics
1.	UNIT I: Orthopedic Nursing Relate the normal anatomy and physiology of the musculo-skeletal system to alterations of normal structures and functions
2.	Display the ability to assist in carrying out diagnostic procedures related to the musculo-skeletal system and also recognizes and reports the abnormalities in the results.
3.	Identify the needs of the client, with different types of tractions and amputation+Use nursing concepts in identifying potential complications associated with musculo-skeletal disorders.Utilize nursing process in delivering care, promoting and maintaining the optimal wellness of clients with musculo-skeletal disorders.Understands and performs Neuro-Muscular assessment independently on patients having musculo-skeleton disorder.Demonstrate pre and post operative nursing care in patients with Musculo-skeletal surgeries. Soft tissue injury+Fracture.+Amputation.
4.	Paget’s disease and Gout
5.	Osteomylitis+Osteoarthritis
6.	Osteoperosis+Rheumatoid Arthritis
7.	Bone tumors+Tuberculosis
8.	UNIT II: Endocrine Nursing Identify pathogenesis and manifestations of the acute and chronic complications of diabetes mellitus. Assess: Hypo and Hyperglycemic conditions. Discuss the medical and pharmacological treatment for a diabetic client.
9.	Discuss the purpose and plan of diet for diabetic clients. Describe the nursing management of a newly diagnosed diabetic client.
10.	Describe the nursing management of a diabetic client who has Ketoacidosis, Hypoglycemia, and who is undergoing surgery
11.	The psychological impact of diabetes mellitus on the client and his family. The nursing responsibilities in the long-term management of the diabetic client. Demonstrates understanding of medical and surgical management of patients with thyroid disorders.
12.	Describe pre and post-operative care of thyroidectomy. Identify potential complications of thyroid disorders and describe appropriate measures in that regard.
13.	Explain the complications of thyroidectomy. Treatment modalities of patients with parathyroid disorders.
14.	Utilize nursing process in provision of care to patients with disorders of parathyroid gland.  Integrate the disorders associated with adrenal cortex and medulla. Describe treatment modalities of patients with adrenal gland disorders. Utilize the nursing process in the provision of care to patients with adrenal gland disorder. Review effects and side effects of gluco-corticoid therapy and plan client teaching accordingly. Explain the systemic effects of short and long term use of corticosteroid therapy.
15.	UNIT III: Neurological Nursing Increased ICP (Intra cranial pressure) and Head Injury Review anatomy and physiology of brain and its protective structures. Differentiate between primary and secondary head injuries and demonstrate an understanding of the related pathophysiology. Anticipate major complications that may result from head injuries. Utilize nursing process in caring for a patient, with head injury.
16.	Spinal Cord Injury Review basic anatomy and physiology of spinal cord and its protective structures. Various mechanisms of injury that may be involved in spinal cord injury. Relate pathophysiological changes that take place after a partial or complete cord transaction. Identify life threatening complications that may result from spinal cord injury. Appreciate the need for prompt interventions in case of a patient with spinal shock and autonomic dysreflexia. Describe the nursing care of a patient with spinal cord injury in an emergency and acute care setting. Rehabilitative needs of patients with Spinal cord injury. Identify the causes and mechanism of injury involved in intervertebral disc herniation. Describe the role of nurses in surgical and non-surgical management of a patient with intervertebral disc herniation. Discuss the importance of maintaining proper body mechanics in preventing intervertebral disc herniation.
17.	Cerebro Vasular Accident (CVA) Utilize nursing process in caring for the patient with CVA. Infections/Inflammations of CNS (Central Nervous System) Meningitis/ Encephalitis/ Brain abscess Describe alterations in intracranial dynamics resulting from infectious disorders of Central Nervous System (CNS). Differentiate between the etiology, manifestations and diagnostic markers of meningitis, encephalitis and brain abscess.
18.	Discuss the pharmacological and nursing management of patients with inflammations and infections of CNS.
19.	Epilepsy/Seizures Use nursing process to provide care to patients with various seizures disorders. Demonstrate an understanding of the side effects and nursing care of some common antiepileptic drugs. Appreciate the psychological effects of epilepsy for a patient and family.
20.	Disorders of Neuromuscular Transmission. Myasthenia Gravis (MG)/Gullien Barrie Syndrome (GBS) (Tutorial) Relate the normal physiology of neuro-muscular transmission to the pathophysiological mechanisms involved in GBS and MG. Distinguish the signs and symptoms of MG and GBS. Describe nurses’ role in caring for patients undergoing diagnostic procedures to rule out MG and GBS.
21.	Identify major complications associated with Myasthenic Crises and Cholinergic Crisis. Utilize effective nursing process in caring for patients with neuromuscular transmission disorder.
22.	Pain and painful disorders related to nervous system. This unit focuses on the etiology, Pathophysiology, manifestations and nursing care of a patient with headache and facial pain.
23.	1. Trigeminal Neuralgia Review the basic anatomy of trigeminal nerve and its main division. Explain the etiology and Pathophysiology of trigeminal neuralgia. Recognize the clinical manifestations of trigeminal neuralgia. Identify the diagnostic techniques used to rule out the above disorder. Explain medical and surgical management of the same. Utilized nursing process in providing care and teaching to a patient with trigeminal neuralgia.
24.	2. Migraine / Headache. Classify the various types of headaches according to their etiology and pathophysiology. Describe dietary and other precipitants of migraine headache. Explain the pharmacological and symptomatic treatment used for patients with various types of headaches. Describe nursing responsibilities in caring and teaching of a patient with headaches.
25.	Chronic Neurological Disorders  Parkinson’s disease Discuss the medical surgical management. Utilized nursing process to extend care to a patient with Parkinson’s disease. Appreciate patient and family needs for teaching and home management.
26.	2. Alzheimer’s Disease Define Alzheimer ’s disease. Discuss its etiology and pathophysiology Identify signs and symptoms exhibited by patient with Alzheimer’s disease Appreciate the social and psychological sequel for patient with Alzheimer’s disease.
27.	3.Brain damage and special states of altered consciousness. Various causes of Brain damage classified as: Anoxia/Hypoxia and perfusion failure. The pathophysiological mechanism of anoxic and ischemic brain injury General signs and symptoms manifested by a patient with brain damage. Demonstrate an understanding of special states of altered consciousness: Persistent vegetative state locked in syndrome and brain stem death. Discuss the essential state involved in brain stem death criteria.  Discuss general nursing interventions and ethical
28.	UNIT IV: Cardiovascular Disorders: Review the anatomy& physiology of cardiovascular system. The causes, Pathophysiology and manifestation of the following cardiovascular disorders The diagnostic, medical and surgical management of the below mentioned disorders
29.	Basic ECG (Electro Cardiogram) interpretation Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with cardiovascular disorders Develop a teaching plan for a client experiencing disorders of the cardiovascular and lymphatic system .
30.	A. Disorders of the Arterial circulation Atherosclerosis and Aneurysm Review the anatomy & physiology of blood vessels Use Poiseulle’s & Laplace’s laws to explain the factors affecting blood flow Discuss the role of low density lipoprotein in terms of lipid transport and development of atherosclerosis
31.	List risk factor in atherosclerosis Describe the mechanisms involved in the development of atherosclerosis Discuss the causes and mechanisms involved in the development of aneurysm
32.	Differentiate among Berry’s, aortic and dissecting aneurysm Discuss medical, surgical and nursing management of patients.
33.	B Disorders of the venous circulation: Varicose veins and venous thrombosis The factors assisting venous return of blood from lower extremities. The relation of muscle pump and the effects of gravity in the development of varicose vein
34.	The risk factors and manifestation associated with venous thrombosis Medical, surgical and nursing management of patients with disorders in venous circulation
35.	C. Alteration in blood pressure: Hypertension Define hypertension The role of cardiac output and peripheral vascular resistance in the mechanism of hypertension
36.	The risk factors contributing in the development of hypertension Pathophysiology and clinical manifestations of HTN (hypertension) Medical and nursing management of patients with HTN.
37.	D. Alteration in cardiac function: Infectious disorders: Pericardiatis, Myocardiatis and Endocardiatis: The anatomy & physiology of pericardium, myocardium & endocardium
38.	The causes, pathophysiology and manifestation of pericardiatis, myocardiatis and endocardiatis. The causes, pathophysiology and manifestation of cardiomyopathies. Medical, surgical and nursing management of patients with alterations in cardiac infections and myopathies.
39.	E. Coronary heart diseases: Blood flow in the coronary circulation and relate if to the metabolic needs of the heart The pathophysiological changes and clinical manifestation in patients with Coronary Artery Disease (CAD)
40.	Myocardial ischemia (angina & its types)
41.	Myocardial infarction Discuss medical, surgical and nursing management of patients suffering from coronary artery diseases.
42.	F. Valvular disorders: The alteration in hemodynamic function of the heart that occurs with valvular disease Differentiate the effects of stenotic and regurgitant mitral & aortic valvular heart disease on cardiovascular function.
43.	G. Heart failure: Discuss the factors effecting cardiac performance in the light of Frank starling law i.e. pre load, after load and cardiac contractility Describe the pathological mechanism underlying the manifestation of congestive heart failure
44.	Differentiate between: Systolic versus diastolic failure Right side versus left side failure
45.	Discuss the clinical manifestation of congestive heart failure Discuss medical, surgical and nursing management of patients with heart failure
46.	H. Disorders of Cardiac Conduction and Rhythm: The anatomy & physiology of cardiac conduction system The electrical activity of the conduction system on an Electrocardiography (ECG) tracing. Describe the mechanism for dysrhythmia generation
47.	The different types of dysrhythmias. Various heart blocks Medical, surgical and nursing management of patients with disorders of cardiac conduction and rhythm.
48.	Heart Blocks and Pacemaker The different kinds of heart blocks.               The care of clients with temporary and permanent pacemaker
49.	UNIT V: Pulmonary Nursing The anatomy & physiology of upper respiratory tract The causes, Pathophysiology and manifestation of the following respiratory tract disorders Discuss the diagnostic, medical and surgical management of the below mentioned disorders
50.	Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with respiratory disorders Teaching plan for a client experiencing disorders of the respiratory tract.
51.	Upper respiratory tract infections: Sinusitis Pharyngitis Tonsillitis
52.	Lower respiratory tract infections: Influenza Pneumonia Pulmonary T.B ( tuberculosis)
53.	Lung Abscess Distress Syndrome Chest trauma
54.	Obstructive lung diseases: Asthma COPD ( Chronic obstructive pulmonary disease) Lung cancer Acute Respiratory failure Acute Respiratory
55.	UNIT VI: Eye and ENT Nursing Otitis media and Mastoiditis/Meinere’s Disease . Review anatomy and physiology of External and Middle ear. Differentiate between Otitis Externa and Otitis media. Discuss the measures to prevent the spread of infection from the middle ear to the Mastoid process. Utilize nursing process while caring for patients with Otitis Media. 100
56.	Epistaxis and Deviated Nasal Septum. Review the anatomy and physiology of nose. Discuss the nursing care of patients with deviated nasal septum. Explain the emergency care of a patient with epistaxis.
57.	Tonsillitis. Review the anatomy and physiology of throat. Discuss the important nursing care of a patient with tonsillitis. Identify the signs and symptoms of tonsillitis.
58.	Discuss the criteria for tonsillectomy. Utilize nursing process for a patient undergoing surgery.
59.	Laryngitis. Explain the important nursing care of a patient with laryngitis. Utilize nursing process while caring for patient with a patient undergoing laryngectomy. Describe the speech therapy and resources available in the country for speech therapy after laryngectomy.
60.	Infections/Inflammations of the eye. Review anatomy and physiology of eye. Differentiate between the sign and symptoms of different eye infections. 101 Utilize nursing process while caring for patients with different infections. Discuss different medical treatment for Blephaaritis, Hordeolum, Chalazia Trachoma and conjunctivitis.
61.	Glaucoma/Retinal Detachment. Identify the causes of Glaucoma. Describe different diagnostic procedures and signs and symptoms present in a person with Glaucoma. Utilize the nursing process while taking care of a patient with Glaucoma.
62.	Discuss different causes of retinal detachment. Explain the signs and symptoms a person would develop after having a detached retina. Describe the role of nurses in caring for patients with detached retina.
63.	Cataract Identify the causes of cataract. Utilize nursing process while caring for patient with cataract. Discuss the role of nurses in helping patients after surgical interventions. Explain home care of a patient with surgical interventions.
64.	Burns Define burns. Discuss problems of impaired skin integrity. Describe various types of burns and their causative agents.
65.	Demonstrate an understanding of the commonly used drugs in the management of cardiac arrest. Describe the complications of Cardio Pulmonary Resuscitation (CPR).
66.	Classify the size and depth of a burn. Demonstrate understanding of the Pathophysiology of a major burns injury.
67.	Discuss the nursing care of a burn-injured patient in immediate post-burn period. Demonstrate a basic understanding of the management of cardiac arrest in an in-patient care setting.

CLINICAL OBJECTIVES 

During medical/surgical rotation learners are expected to apply the nursing process and critical thinking in delivering holistic nursing care to the clients with Oncological, Hematological, Immunological, Gastrointestinal and Genitourinary Disorders. Learners will utilize recommended assessment tools for clients’ assessment during clinical. 

1. Utilize the nursing process in providing care to the sick adult in the hospital. 

a) Collect data from the client and family, nursing kardex, patient’s charts, nursing notes and health team members. 

b) Integrate the knowledge of diagnostic tests in the process of data collection. 

c) Collect data necessary to determine nursing care needs of the patient 

 d) Set priority or needs for nursing care. 

e) Develop a plan to meet the identified nursing needs of a client 

 f) Adults the plan of care as necessary. 

2. Use a sound knowledge base in proving nursing care to adults in the hospital. 

3. Apply scientific principles in providing nursing care of adults. 

4. Identify the effects of sickness and hospitalization of adults and their families. 

5. Identify and plan out nursing intervention to meet the physiological and psychosocial and spiritual needs of the clients and families. 

6. Implement care according to priority order. 

7. Provide perioperative nursing care to client undergoing surgery. 

8. Evaluate the expected outcomes and revise the nursing care plan on an ongoing basis. 

 9. Provide for the comfort and safety of adults in the hospital

10. Demonstrate the ability to communicate effectively with the patient and /or the family 

 Communicate effectively with patient using verbal and non-verbal methods 

 Explain nursing actions appropriately to the patient or family 

 Carry out nursing procedure safely and correctly 

 Use correct procedures 

 Ensure patient safety 

 Perform skills with dexterity 

 Maintain accurate records and reports 

a. Record comprehensive patient data 

b. Report the significant patient data to appropriate personnel 

11. Assess, plan, implement and evaluate health teaching related to medical and surgical conditions of patients.

12. Integrate theoretical knowledge and participate in care of clients undergoing following diagnostic procedures: 

a. Upper and lower GI (Gastro Intestinal) endoscopies 

b. Ultrasound 

c. Barium studies 

d. Biopsy (liver) 

e. Cystoscopy 

f. Paracenthesis 

g. CT( Computed Tomography) scan 

h. Pathological Lab test 

i. IVP ( Intravenous pyelography) j. X- rays k. Gastric analysis 

13. Integrate knowledge of pathophysiology, nutrition & pharmacology for clients experiencing the various disorders. 

 14. Begin to recognize the need for integrating research-based information in the care of clients 

15. Demonstrate awareness of the importance of legal and ethical issues in nursing practice 

16. Demonstrate the role of a nurse as a health educator.

Clinical skills checklist 

 IV medication 

 Tube feeding and insertion 

 Catheterization 

 Ostomy care

ADULT HEALTH NURSING-II 

    This course provides opportunities to learners to give safe & competent care for patients with various cardiovascular, respiratory, endocrine, musculoskeletal, Neurological and ENT disorders. They are assisted in development of critical thinking and nursing judgment while caring for a wide variety of patients including those who require long term care with emphasis on patient teaching and discharge planning. 

 Course Objectives

    At the end of the Adult Health Nursing II, the learners will be able to: 

 1. Demonstrate an ability to utilize nursing process in extending holistic care to adult patients with a variety of Cardiovascular, Respiratory, Endocrine, Musculo-skeletal, Neurological and ENT (Ear, Nose and Throat) related disorders. 

2. Describe the risk factors, etiology, signs & symptoms and integrate Pathophysiology of various disease processes using a nursing framework, (Functional Health pattern) to assess patient’s needs and problems. 

3. Discuss the need of using relevant research findings in designing appropriate nursing care for the patients. 

4. Demonstrate an awareness of legal and ethical standards in caring for patients with various disorders in a variety of acute and intermediate care settings.  

AHN II

 

Sr No	Topics
1.	UNIT I: Orthopedic Nursing Relate the normal anatomy and physiology of the musculo-skeletal system to alterations of normal structures and functions
2.	Display the ability to assist in carrying out diagnostic procedures related to the musculo-skeletal system and also recognizes and reports the abnormalities in the results.
3.	Identify the needs of the client, with different types of tractions and amputation+Use nursing concepts in identifying potential complications associated with musculo-skeletal disorders.Utilize nursing process in delivering care, promoting and maintaining the optimal wellness of clients with musculo-skeletal disorders.Understands and performs Neuro-Muscular assessment independently on patients having musculo-skeleton disorder.Demonstrate pre and post operative nursing care in patients with Musculo-skeletal surgeries. Soft tissue injury+Fracture.+Amputation.
4.	Paget’s disease and Gout
5.	Osteomylitis+Osteoarthritis
6.	Osteoperosis+Rheumatoid Arthritis
7.	Bone tumors+Tuberculosis
8.	UNIT II: Endocrine Nursing Identify pathogenesis and manifestations of the acute and chronic complications of diabetes mellitus. Assess: Hypo and Hyperglycemic conditions. Discuss the medical and pharmacological treatment for a diabetic client.
9.	Discuss the purpose and plan of diet for diabetic clients. Describe the nursing management of a newly diagnosed diabetic client.
10.	Describe the nursing management of a diabetic client who has Ketoacidosis, Hypoglycemia, and who is undergoing surgery
11.	The psychological impact of diabetes mellitus on the client and his family. The nursing responsibilities in the long-term management of the diabetic client. Demonstrates understanding of medical and surgical management of patients with thyroid disorders.
12.	Describe pre and post-operative care of thyroidectomy. Identify potential complications of thyroid disorders and describe appropriate measures in that regard.
13.	Explain the complications of thyroidectomy. Treatment modalities of patients with parathyroid disorders.
14.	Utilize nursing process in provision of care to patients with disorders of parathyroid gland.  Integrate the disorders associated with adrenal cortex and medulla. Describe treatment modalities of patients with adrenal gland disorders. Utilize the nursing process in the provision of care to patients with adrenal gland disorder. Review effects and side effects of gluco-corticoid therapy and plan client teaching accordingly. Explain the systemic effects of short and long term use of corticosteroid therapy.
15.	UNIT III: Neurological Nursing Increased ICP (Intra cranial pressure) and Head Injury Review anatomy and physiology of brain and its protective structures. Differentiate between primary and secondary head injuries and demonstrate an understanding of the related pathophysiology. Anticipate major complications that may result from head injuries. Utilize nursing process in caring for a patient, with head injury.
16.	Spinal Cord Injury Review basic anatomy and physiology of spinal cord and its protective structures. Various mechanisms of injury that may be involved in spinal cord injury. Relate pathophysiological changes that take place after a partial or complete cord transaction. Identify life threatening complications that may result from spinal cord injury. Appreciate the need for prompt interventions in case of a patient with spinal shock and autonomic dysreflexia. Describe the nursing care of a patient with spinal cord injury in an emergency and acute care setting. Rehabilitative needs of patients with Spinal cord injury. Identify the causes and mechanism of injury involved in intervertebral disc herniation. Describe the role of nurses in surgical and non-surgical management of a patient with intervertebral disc herniation. Discuss the importance of maintaining proper body mechanics in preventing intervertebral disc herniation.
17.	Cerebro Vasular Accident (CVA) Utilize nursing process in caring for the patient with CVA. Infections/Inflammations of CNS (Central Nervous System) Meningitis/ Encephalitis/ Brain abscess Describe alterations in intracranial dynamics resulting from infectious disorders of Central Nervous System (CNS). Differentiate between the etiology, manifestations and diagnostic markers of meningitis, encephalitis and brain abscess.
18.	Discuss the pharmacological and nursing management of patients with inflammations and infections of CNS.
19.	Epilepsy/Seizures Use nursing process to provide care to patients with various seizures disorders. Demonstrate an understanding of the side effects and nursing care of some common antiepileptic drugs. Appreciate the psychological effects of epilepsy for a patient and family.
20.	Disorders of Neuromuscular Transmission. Myasthenia Gravis (MG)/Gullien Barrie Syndrome (GBS) (Tutorial) Relate the normal physiology of neuro-muscular transmission to the pathophysiological mechanisms involved in GBS and MG. Distinguish the signs and symptoms of MG and GBS. Describe nurses’ role in caring for patients undergoing diagnostic procedures to rule out MG and GBS.
21.	Identify major complications associated with Myasthenic Crises and Cholinergic Crisis. Utilize effective nursing process in caring for patients with neuromuscular transmission disorder.
22.	Pain and painful disorders related to nervous system. This unit focuses on the etiology, Pathophysiology, manifestations and nursing care of a patient with headache and facial pain.
23.	1. Trigeminal Neuralgia Review the basic anatomy of trigeminal nerve and its main division. Explain the etiology and Pathophysiology of trigeminal neuralgia. Recognize the clinical manifestations of trigeminal neuralgia. Identify the diagnostic techniques used to rule out the above disorder. Explain medical and surgical management of the same. Utilized nursing process in providing care and teaching to a patient with trigeminal neuralgia.
24.	2. Migraine / Headache. Classify the various types of headaches according to their etiology and pathophysiology. Describe dietary and other precipitants of migraine headache. Explain the pharmacological and symptomatic treatment used for patients with various types of headaches. Describe nursing responsibilities in caring and teaching of a patient with headaches.
25.	Chronic Neurological Disorders  Parkinson’s disease Discuss the medical surgical management. Utilized nursing process to extend care to a patient with Parkinson’s disease. Appreciate patient and family needs for teaching and home management.
26.	2. Alzheimer’s Disease Define Alzheimer ’s disease. Discuss its etiology and pathophysiology Identify signs and symptoms exhibited by patient with Alzheimer’s disease Appreciate the social and psychological sequel for patient with Alzheimer’s disease.
27.	3.Brain damage and special states of altered consciousness. Various causes of Brain damage classified as: Anoxia/Hypoxia and perfusion failure. The pathophysiological mechanism of anoxic and ischemic brain injury General signs and symptoms manifested by a patient with brain damage. Demonstrate an understanding of special states of altered consciousness: Persistent vegetative state locked in syndrome and brain stem death. Discuss the essential state involved in brain stem death criteria.  Discuss general nursing interventions and ethical
28.	UNIT IV: Cardiovascular Disorders: Review the anatomy& physiology of cardiovascular system. The causes, Pathophysiology and manifestation of the following cardiovascular disorders The diagnostic, medical and surgical management of the below mentioned disorders
29.	Basic ECG (Electro Cardiogram) interpretation Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with cardiovascular disorders Develop a teaching plan for a client experiencing disorders of the cardiovascular and lymphatic system .
30.	A. Disorders of the Arterial circulation Atherosclerosis and Aneurysm Review the anatomy & physiology of blood vessels Use Poiseulle’s & Laplace’s laws to explain the factors affecting blood flow Discuss the role of low density lipoprotein in terms of lipid transport and development of atherosclerosis
31.	List risk factor in atherosclerosis Describe the mechanisms involved in the development of atherosclerosis Discuss the causes and mechanisms involved in the development of aneurysm
32.	Differentiate among Berry’s, aortic and dissecting aneurysm Discuss medical, surgical and nursing management of patients.
33.	B Disorders of the venous circulation: Varicose veins and venous thrombosis The factors assisting venous return of blood from lower extremities. The relation of muscle pump and the effects of gravity in the development of varicose vein
34.	The risk factors and manifestation associated with venous thrombosis Medical, surgical and nursing management of patients with disorders in venous circulation
35.	C. Alteration in blood pressure: Hypertension Define hypertension The role of cardiac output and peripheral vascular resistance in the mechanism of hypertension
36.	The risk factors contributing in the development of hypertension Pathophysiology and clinical manifestations of HTN (hypertension) Medical and nursing management of patients with HTN.
37.	D. Alteration in cardiac function: Infectious disorders: Pericardiatis, Myocardiatis and Endocardiatis: The anatomy & physiology of pericardium, myocardium & endocardium
38.	The causes, pathophysiology and manifestation of pericardiatis, myocardiatis and endocardiatis. The causes, pathophysiology and manifestation of cardiomyopathies. Medical, surgical and nursing management of patients with alterations in cardiac infections and myopathies.
39.	E. Coronary heart diseases: Blood flow in the coronary circulation and relate if to the metabolic needs of the heart The pathophysiological changes and clinical manifestation in patients with Coronary Artery Disease (CAD)
40.	Myocardial ischemia (angina & its types)
41.	Myocardial infarction Discuss medical, surgical and nursing management of patients suffering from coronary artery diseases.
42.	F. Valvular disorders: The alteration in hemodynamic function of the heart that occurs with valvular disease Differentiate the effects of stenotic and regurgitant mitral & aortic valvular heart disease on cardiovascular function.
43.	G. Heart failure: Discuss the factors effecting cardiac performance in the light of Frank starling law i.e. pre load, after load and cardiac contractility Describe the pathological mechanism underlying the manifestation of congestive heart failure
44.	Differentiate between: Systolic versus diastolic failure Right side versus left side failure
45.	Discuss the clinical manifestation of congestive heart failure Discuss medical, surgical and nursing management of patients with heart failure
46.	H. Disorders of Cardiac Conduction and Rhythm: The anatomy & physiology of cardiac conduction system The electrical activity of the conduction system on an Electrocardiography (ECG) tracing. Describe the mechanism for dysrhythmia generation
47.	The different types of dysrhythmias. Various heart blocks Medical, surgical and nursing management of patients with disorders of cardiac conduction and rhythm.
48.	Heart Blocks and Pacemaker The different kinds of heart blocks.                       The care of clients with temporary and permanent pacemaker
49.	UNIT V: Pulmonary Nursing The anatomy & physiology of upper respiratory tract The causes, Pathophysiology and manifestation of the following respiratory tract disorders Discuss the diagnostic, medical and surgical management of the below mentioned disorders
50.	Apply nursing process including assessment, planning, implementation and evaluation of care provided to the clients with respiratory disorders Teaching plan for a client experiencing disorders of the respiratory tract.
51.	Upper respiratory tract infections: Sinusitis Pharyngitis Tonsillitis
52.	Lower respiratory tract infections: Influenza Pneumonia Pulmonary T.B ( tuberculosis)
53.	Lung Abscess Distress Syndrome Chest trauma
54.	Obstructive lung diseases: Asthma COPD ( Chronic obstructive pulmonary disease) Lung cancer Acute Respiratory failure Acute Respiratory
55.	UNIT VI: Eye and ENT Nursing Otitis media and Mastoiditis/Meinere’s Disease . Review anatomy and physiology of External and Middle ear. Differentiate between Otitis Externa and Otitis media. Discuss the measures to prevent the spread of infection from the middle ear to the Mastoid process. Utilize nursing process while caring for patients with Otitis Media. 100
56.	Epistaxis and Deviated Nasal Septum. Review the anatomy and physiology of nose. Discuss the nursing care of patients with deviated nasal septum. Explain the emergency care of a patient with epistaxis.
57.	Tonsillitis. Review the anatomy and physiology of throat. Discuss the important nursing care of a patient with tonsillitis. Identify the signs and symptoms of tonsillitis.
58.	Discuss the criteria for tonsillectomy. Utilize nursing process for a patient undergoing surgery.
59.	Laryngitis. Explain the important nursing care of a patient with laryngitis. Utilize nursing process while caring for patient with a patient undergoing laryngectomy. Describe the speech therapy and resources available in the country for speech therapy after laryngectomy.
60.	Infections/Inflammations of the eye. Review anatomy and physiology of eye. Differentiate between the sign and symptoms of different eye infections. 101 Utilize nursing process while caring for patients with different infections. Discuss different medical treatment for Blephaaritis, Hordeolum, Chalazia Trachoma and conjunctivitis.
61.	Glaucoma/Retinal Detachment. Identify the causes of Glaucoma. Describe different diagnostic procedures and signs and symptoms present in a person with Glaucoma. Utilize the nursing process while taking care of a patient with Glaucoma.
62.	Discuss different causes of retinal detachment. Explain the signs and symptoms a person would develop after having a detached retina. Describe the role of nurses in caring for patients with detached retina.
63.	Cataract Identify the causes of cataract. Utilize nursing process while caring for patient with cataract. Discuss the role of nurses in helping patients after surgical interventions. Explain home care of a patient with surgical interventions.
64.	Burns Define burns. Discuss problems of impaired skin integrity. Describe various types of burns and their causative agents.
65.	Demonstrate an understanding of the commonly used drugs in the management of cardiac arrest. Describe the complications of Cardio Pulmonary Resuscitation (CPR).
66.	Classify the size and depth of a burn. Demonstrate understanding of the Pathophysiology of a major burns injury.
67.	Discuss the nursing care of a burn-injured patient in immediate post-burn period. Demonstrate a basic understanding of the management of cardiac arrest in an in-patient care setting.

Clinical Objectives AHN 

1. Applies the nursing process and critical thinking in delivering Holistic nursing care to clients with various medical/surgical conditions in institutions and communities. 

2. Formulate Nursing Care plans while caring for all adult clients in the units. 

3. Incorporate cognitive, interpersonal and technical skills from the humanities, natural and behavioral sciences while providing nursing care to clients. 

4. Demonstrate awareness of legal and ethical standards when providing nursing care. 

5. Develop awareness for self-evaluation of effectiveness in dealing with clients with Endocrine, Cardio vascular, Respiratory, ENT, Neurological and Orthopedic disorders. 

6. Demonstrate the knowledge of pharmacology used to treat all medical surgical disorders. 

7. Demonstrate leadership abilities necessary to foster change in the delivery of care for the patients. 

8. Provide culturally sensitive and realistic teaching to clients and families in collaboration with other health team members. 

9. Incorporate research findings relevant to nursing practice. 

10. Collaborate with members of the health care team to promote and maintain optimum wellness of adult clients. 

11. Prepares and provide care for patients going for following diagnostic tests/examinations: 

 C.T. Scan 

 Cerebral Angiography 

 Lumber puncture 

 Mylogramme 

 Audimetric 

 Thyroid scanning. 

12. Document all assessments, nursing care and discharge teaching provided to the clients. 

SPECIFIC CLINICAL OBJECTIVES 

In the Med/Surgical rotations the learners will be able to: 

 Identifies the normal values and alterations in the diagnostic tests carried out for clients.

 Demonstrates an understanding of the psychological needs of patients and their families during hospitalization and surgery. 

 Discuss the possible reaction that a family member may exhibit when confronted with trauma, illness, and death and dying. 

13. Assist the following skills: 

 Lumber puncture 

 12 Lead ECG 

 Blood sugars 

 Eye and ear irrigation. 

 Eye bandaging. 

 Skin and Skeletal traction. 

 Application of Plaster, cast 

14. a) Develop Skills in preparing and assisting in skin tractions, Knee mobilizer and CPM b) Demonstrate pre and post operative nursing care in patients with Musculokeletal surgeries. 

15. Provide holistic care to the patients who are bed ridden and immobile. 

16. Identify normal sinus rhythm on cardiac monitor and differentiate it with the abnormal rhythms. 

17. Identify signs of increased ICP in-patients with neurological conditions. 

18. Observe the Emergency room systems and apply the concepts of triage. 

19. Differentiate the role and responsibilities of each individual in E.R. from other units. 

CLINICAL SKILLS LIST 

1. Trachesostomy care 

2. Suctioning (oral, nasal, tracheal) 

 3. Assist in procedures 

 4. Lumber puncture 

5. Thorcentesis 

6. Paracentesis 

7. Chest tube insertion 

8. Dressing 

9. ECG ( electro cardiogram

Book Reference 

1. Brune, B. (July 2001). Deep vein thrombosis prophylaxis: The effectiveness and implications of using below knee or thigh length graduated compression stocking. (Vol. 30). Heart and lung 277-284. 

2. Dolan, J. T. (1991). Critical care nursing: Clinical management through nursing process. Philadelphia: Davis.