LAMAR STATE COLLEGE -ORANGE. Upward Mobility Nursing Department. Division of Allied Health. SYLLABUS FOR RNSG PATHOPHYSIOLOGY

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1 LAMAR STATE COLLEGE -ORANGE Upward Mobility Nursing Department Division of Allied Health SYLLABUS FOR RNSG PATHOPHYSIOLOGY (3 Credit Hours) Spring 2010 INSTRUCTOR: Stephenie Thibodeaux, RN, MSN Office: 234 AHB Cell Stephenie.thibodeaux@lsco.edu NURSING SECRETARY: Crystal Compton Office: 200 AHB

2 OFFICE HOURS: Posted on office door and by appointment. COURSE DESCRIPTION: The focus of this course is a comprehensive study of underlying concepts common to the major pathophysiologic processes of the body across the lifespan. The course will explore the influence of psychoneuroimmunologic mechanisms and the interaction of intrinsic and extrinsic environmental forces upon the structure and function of body systems. Factors which contribute to altered physiologic functioning and the body s adaptive and compensatory mechanisms will be examined. Emphasis is placed on pathophysiological concepts essential for understanding the rationale for preventive and therapeutic nursing interventions in health and illness. Variables affecting physiological functioning, including age, lifestyle, culture, and gender will be studied. CREDIT TRANSFER: Students must check in advance with the particular college to which they plan to transfer credit. Students who plan to transfer to a BSN program should contact that program and get a commitment in writing that this course is transferable. This course is transferable to any other Texas College that has the same Workforce Education Course Manual (WECM) course number. PRE-REQUISITES: LVN/LPN course completion BIOL 2401 Anatomy and Physiology I BIOL 2402 Anatomy and Physiology II REQUIRED TEXTBOOK: Porth, C.M. (2007). Essentials of pathophysiology: concepts of altered health states. Second Edition. Philadelphia: Lippincott Williams & Wilkins. Prezbindowski, K.S. (2007). Study guide to accompany Porth s essentials of pathophysiology: concepts of altered health states. Second Edition. Philadelphia: Lippincott Williams & Wilkins. HIGHLY SUGGESTED TEXTBOOK: Hogan, M. A. (2008). Pathophysiology: review and rational. Second Edition. Upper Saddle River: Pearson, Prentis Hall.

3 COURSE OBJECTIVES: In accordance with the mission of Lamar State College-Orange and Texas WECM, this course develops in the student the particular skills, knowledge, and attitudes needed for success in the field of Associate Degree Nursing. Upon Completion of this course, the students will be able to: Demonstrate critical thinking skills as evidenced by the ability to analyze facts, synthesize factual information, and evaluate opinions in light of the facts presented throughout this course. Upon completion of RNSG 1311 the student will be able to discuss homeostasis as a mechanism for achieving and maintaining normal interaction of structure and function; relate the physiological system and its role in pathogenesis; and explain importance of pathophysiology in nursing practice.(ec 1,2,3,4,5) CRITICAL THINKING: Critical thinking is a process involving higher order thinking skills. These skills include, but are not limited to, application, analysis, synthesis, and evaluation of factual information Lamar State College-Orange Advances Critical Thinking Skills (LSC-O ACTS) through assignments of varying natures within the course that are designed to challenge and improve the student's critical thinking processes. A well cultivated critical thinker: Raises vital questions and problems, formulating them clearly and precisely; gathers and assesses relevant information, using abstract ideas to interpret it effectively; comes to well-reasoned conclusions and solutions, testing them against relevant criteria and standards; thinks open-mindedly within alternative systems of thought, recognizing and assessing, as need be, their assumptions, implications and practical consequences; and communicates effectively with others in figuring out solutions to complex problems. Paul, Richard & Elder, Linda. (2005) The Miniature Guide to Critical Thinking Concepts & Tools. Dillon Beach: The Foundation for Critical Thinking. Upon completion of RNSG 1311, the student will able to demonstrate the following competencies listed below: As Provider of Care 1. Assess the characteristics, concepts and processes related to individuals of various age groups and cultural backgrounds experiencing acute health deviations that are difficult to predict. (Cognitive; evaluation)

4 2. Differentiate adaptive and maladaptive responses in clients experiencing acute health deviations. (Cognitive; analysis) 3. Assess the effects of acute health deviation on the individual and/or family. (Cognitive; evaluation) This course will also provide the student with the opportunity to: 1. Discuss selected central concepts related to physiology, pathophysiology, and psychopathology including: (EC 1,2,3,4,5) a. Stress, coping, and adaptation. b. Cellular injury/repair and inflammation. c. Infection. d. Psychoneuroimmunologic mechanisms. e. Fluid and electrolyte and acid/base imbalances. f. Malignant neoplastic growth. g. Mechanisms of pain. 2. Explore the mechanisms of disease involving the major organ systems of the body: (EC 1,2,3,4,5) a. Immune. b. Cardiovascular. c. Respiratory. d. Renal and urinary. e. Endocrine. f. Neurological. g. Gastrointestinal. h. Musculoskeletal.

5 3. Analyze internal and external environmental factors that influence the development of and the individual s adaptive and compensatory responses to pathophysiologic processes. (EC 2,3,4) 4. Examine the dynamics of and the interrelationships among body defenses in response to altered physiologic functioning. (EC 2, 3,4,5) 5. Explain the significance of selected laboratory and diagnostic findings as they relate to central pathophysiologic concepts and diseases of major organ systems. (EC 2,3,4,5) 6. Analyze the influences of age and development on central pathophysiologic concepts and diseases of the major organ systems. (EC 1,2,3,4,5) 7. Apply knowledge of pathophysiology to simulated clinical situations. (EC 1,2,3,4,5) 8. State the need for self-direction, independent learning, and self-evaluation. (EC 1,2,3,4,5) 9. Utilize critical thinking abilities and problem-solving skills to analyze central pathophysiological concepts and diseases of the major organ systems. (EC 1,2,3,4,5) SCANS ATTACHED EVALUATION METHOD: Each lecture topic will have accompanying written assignments, quizzes, discussion, case studies and/or videos. Assignments Assignments will comprise 20% of the course grade. Assignments come from the text book and must be typed in Microsoft Word or Word pad and uploaded to the website during the appropriate time frame to receive credit for work done. Answer the questions in complete sentences and include the chapter and question number. There are no provisions for late work. Quizzes There are four online quizzes. The quiz average will comprise 15% of the course grade. Each quiz may be taken two times within the time window and the computer will record the highest grade.

6 Discussion Board Posting There will be five topics posted by the instructor and each student must make one post responding to the topic posted by the instructor and one response to another student s post for a total of two postings for each topic. There will be five topics posted by the instructor and 10 postings for each student. These 10 postings by the student will comprise 15% of the course grade. Postings should include medical references or nursing references. You may use the nursing links from the library website for reference material. Please answer all parts of the discussion question to get complete credit for the question. Exams The midterm exam will comprise 20% on the course grade and the final exam will comprise 30% of the course grade. Exams must be taken on the scheduled date. Both exams will be online and on a specific date and at a specific time. Students should work independently on exams. There is no provision for make up or late exams. 1. Assignments (10) 20% 2. Discussion board postings (10) 15% 2. Quizzes (4) 15% 3. Midterm exam 20% 4. Comprehensive Final Examination 30% Total 100% ADDITIONAL EVALUATIVE POLICIES: All course assignments are expected to be submitted in a timely manner. There are no provisions for make up work or late work for quizzes, assignments or exams. Each student is responsible for submitting his/her own work. The grading scale for this course is: = A = B = C = D (not considered passing)

7 = F (not considered passing) POLICY ON A GRADE INCOMPLETE: The grade of "I" may be given when any requirement of the course, including the final examination, is not completed with instructor approval..arrangements to complete deficiencies in a course must by made with the instructor. Incomplete work must be finished during the next long semester, if not, the Admissions and Records Office must change an "I" grade to the grade of "F". The course must then be repeated, if credit is desired. An "I" grade also automatically becomes an "F" if the student registers for the course before removing the deficiencies and receiving a grade change. The instructor may record the grade of "F" for a student who is absent from the final examination and/or is not passing the course. METHODS OF LEARNING: Learning in this course is a mutual endeavor. Faculty will help students structure learning and build critical thinking and problem-solving skills. Throughout the course students are responsible for monitoring and assessing their own learning. Faculty and students share responsibility for assessing the effectiveness of learning according to the purposes, criteria, and standards of this course. Learning is a student-centered process. Essential to this process are assignments, study, and preparation, which assist students in building a foundation for analysis and application of major course concepts. Faculty will assist students in developing critical and effective reading, writing, and communication skills. A variety of resources are provided for student learning which include selfinstructional modules, media review, and computer assisted instruction. CLASSROOM POLICIES: Classroom policy requires that no food or drink be consumed during class, no beepers or phones allowed during class. Disruptive behavior will be dealt with on an individual basis. This includes orientation. ATTENDANCE/SELF-DIRECTED LEARNING: Students enrolled in RNSG 1311 are health care providers/professionals. Thus, in making a professional commitment to health care as a career, students are expected to conduct themselves as adult learners, displayed in attendance patterns, conduct in class, and in being active, continual, self-reliant, autonomous, independent learners. Students are expected to read assignments, answer objectives, use the library, participate in class, and complete other learning activities in pursuit of the classes' aims and objectives of the individual units of study. The student should be prepared for the consequences of failure to meet attendance and self-directed learning expectations. This is an online class and

8 attendance can be understood as using the website to review material, turn in assignments, take quizzes and exams and participate in the discussion board. WITHDRAWALS AND DROPS: Never attending or ceasing to attend classes or failure to use the website DOES NOT constitute a withdrawal or drop. You remain registered until you file a Drop/Withdrawal Form at the Registrar's Office by the appropriate deadlines. Failure to act in a timely manner will result in an "F" grade for the course. It is the student's responsibility to turn in all Drop/Withdrawal Forms and follow up to ensure that they were processed as desired. INSTRUCTOR-INITIATED DROP: Faculty may initiate withdrawal of students for academic failure, excessive absenteeism due to illness; excessive absenteeism for reasons other than illness, or academic dishonesty. The student must contact the instructor to discuss options. If a course drop is agreed upon, and the student is unable to come to campus to complete the drop in person, the instructor may initiate the drop. ACADEMIC HONESTY: Academic dishonesty will not be tolerated. Academic dishonesty includes but is not limited to the following: 1. Cheating-the act of looking on another person s paper or computer to obtain an answer during an examination. 2. Plagiarism-to take and use as one s own the ideas or writings of another, without giving that person credit. 3. The submission for credit of someone else s work as your own. Students may work together on assignments but each student must do his own work and submit his own work. 4. Making written notes or taping examination questions during test review. According to the Lamar State College-Orange Student Handbook, any of these methods of academic dishonesty are grounds for immediate dismissal from the institution. Also, according to the Lamar State College-Orange Student Handbook, p. 52, unauthorized use of university computer account(s), computer data files, and/or

9 computer facilities is considered a breach of conduct, and is not in keeping with the educational aims, purposes, and philosophy of the university and which subject student(s) to disciplinary action. Students subject to penalty due to academic dishonesty have the right to appeal to the department director, division chair and eventually to the dean and/or academic vice president before imposition of the penalty. Flagrant or repeated violation of academic honesty may be referred to the Dean of Student Services for further action. Any student who copies on a test or assignment or uses written information directly from another source will receive a grade of zero on that examination or assignment. Cheating on an examination or assignment would be grounds for removal from the class with a course grade of F. STUDENTS WITH DISABILITIES: Section 504 of the Rehabilitation Act of 1973states that: "No otherwise qualified person with a disability in the United States shall, solely by reason of disability, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance." It is not necessary for a student to disclose the nature of his/her disability. However, it may be necessary to provide appropriate documentation to the Office of Advising and Counseling should the student need special accommodations or modifications while attending classes at Lamar State College- Orange. The Advising and Counseling Office is located on the third floor of the Ron E. Lewis Library building and may be contacted at (409) EQUAL OPPORTUNITY/AFFIRMATIVE ACTION NOTICE; Lamar State College Orange is an equal opportunity/affirmative action educational institution. Topic: Cell Function and Growth discuss Cell and tissue characteristics and genetic and congenital disorders. Cell development Cell types Cell adaptation Cell injury Wound healing Genetic control of cell function Congenital disorders

10 Describe normal cell development and growth. Discuss cellular adaptation, injury, death and wound healing. Discuss various genetic and congenital disorders. Laboratory Activities: Complete the Cell function and growth workbook chapter Topic: Hematopoietic Function discuss blood cells and the hematopoietic systems. Plasma Erythrocyets Leukocytes Granulocytes Thrombosytes Hematopoiesis Diagnostic tests Discuss alterations in hemostasis, the red blood cell and alterations in oxygen transport, and disorders of white blood cells and lymphoid tissues. Blood coagulation Bleeding disorders Anemias Transfusinon therapy Leukemias Hodgkin's disease Multiple myeloma Describe the life cycle of a red blood cell. Laboratory Activities: Complete the Hematopoietic function workbook chapters Topic: Mechanisms of Infectious Disease discuss the agents of infectious disease Viruses Bacteria Spirochetes Mycoplasms Rickettsia and Chlamydia Fungi Parasites

11 Describe mechanisms of infection (portals of entry, etc.) Describe common clinical manifestations Explain fever and its effects Analyze laboratory and diagnostic test Complete blood count (CBC) Urinalysis Antibody titer Blood cultures and other specimen cultures List examples of consequences of infection (minor, serious, life-threatening illness) Compare/contrast the relation between immune system dysfunction and infectious diseases Laboratory Activities: Complete the Mechanisms of Infectious Diseases workbook chapters. Topic: Immune System Disorders discuss primary and secondary immune deficiencies Etiologies Consequences Describe Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome Transmission of HIV Laboratory findings Classification Clinical course Pathophysiology of HIV Complications Opportunistic infections Malignancies Nervous system Gastrointestinal Describe allergic and hypersensitivity disorders Types Mechanisms producing hypersensitivity Pathophysiology

12 Describe autoimmune disorders Major concepts Systemic lupus erythematosus (SLE) Pathophysiology Effects on body organs Clinical manifestation Laboratory Activities: Complete the Immune System Disorders workbook Chapters Topic: Alterations in Fluids, Electrolytes, and Acid Base Balance describe body fluid imbalances Deficit Excess Describe electrolyte imbalances gains and losses Sodium Potassium Effects of changes in ph on potassium balances Calcium Discuss causes and consequences of imbalances Discuss compensatory mechanisms Analyze laboratory and diagnostic findings Urine specific gravity Serum urea nitrogen Serum electrolyte Identify manifestations of imbalances Acid base imbalances Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Analyze compensation and correction of acid-base disturbances Discuss causes and consequences of imbalances Analyze laboratory findings

13 Arterial blood gases Laboratory Activities: Complete the Alterations in fluids, Electrolytes and Acid Base Balance workbook chapters. Topic: Alteration in Cardiovascular Function describe alterations in blood flow Discuss pathologic processes of arteries Atherosclerosis Risk factors Mechanisms of development Laboratory findings Lipoproteins Occlusive disease of lower extremities Discuss pathologic processes of veins Venous thrombosis Thrombophlebitis Venous insufficiency and stasis Mechanisms of development Risk factors Describe alterations in blood pressure Hypertension Risk factors Pathophysiology Effects on body organs Diagnosis Describe alterations in cardiac function Analyze alterations in cardiac rhythms ECG Normal conduction Factors that enhance and depress automaticity Normal sinus rhythm Causes of dysrhythmias

14 Cardiac dysrhythmias Sinoatrial rhythms Sinus bradycardia Sinus tachycardia Ventricular dysrhythmias Premature ventricular contractions Ventricular tachycardia Identify alterations in specific structures in the heart Coronary artery disease ischemic heart disease Compensatory mechanisms Myocardial infarction Laboratory findings Cardiac enzymes Complications Describe congestive heart failure Classification of heart failure Causes Compensatory mechanisms Signs and symptoms Laboratory Activities: Complete the Alteration in Cardiovascular Function workbook chapters. Topic: Alterations in cellular Differentiation: Neoplasia describe concepts of cell growth/characteristics of malignant cells Discuss characteristics of benign versus malignant neoplasms Invasion and metastasis Tumor growth General effects Analyze trends in incidence Identify relationship of age, culture, and gender Identify risk factors and lifestyle alterations to decrease risks Analyze diagnostic methods Pap smear

15 Biopsy Tumor markers Staging and grading Describe mechanisms by which malignant neoplasms cause signs and symptoms Discuss leukemias/lymphomas Types of leukemias (acute/chronic and cell type) Pathopysiology of leukemic cell proliferation Laboratory Activities: Complete the Alterations in Cellular Differentiation workbook chapters. Topic: Alterations in Respiratory Function describe obstructive lung disease Types Chronic bronchitis Pulmonary emphysema Cor Pulmonale Bronchial asthma Risk factors Effects on body organs Diagnosis Complications Describe restrictive lung disease Types Acute Respiratory Distress Syndrome ARDS, pulmonary edema Lung infection (bacterial and viral including tuberculosis) Atelectasis Pneumothorax Lung cancer Risk factors Causes and consequences of disorders Manifestations Discuss respiratory failure

16 Causes and consequences Laboratory Activities: Complete the Alterations in Respiratory Function Workbook chapters. Topic: Alterations in Endocrine Function discuss general aspects of altered endocrine function Hypofunction and hyperfunction Primary and secondary disorders Analyze diagnostic tests related to endocrine function Describe plasma hormone levels Urinary hormone and hormone metabolite excretions Radioimmunoassay Describe pituitary disorders Anterior adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH) (deficit or excess) Posterior antidiuretic hormone (ADH) (deficit or excess) Describe thyroid disorders Hypothyroidism Hyperthyroidism Describe parathyroid disorders Hypoparathyroidism Hyperparathyroidism Influence on calcium and bone metabolism Describe adrenal disorders Pheochromocytoma Cushing s Syndrome Addison s disease and acute adrenal crisis Discuss common clinical manifestations, effects on other body systems

17 Describe diabetes Mellitus Hormonal control of blood glucose Classification and etiology of diabetes mellitus Type 1 and 2 Risk factors Diagnostic tests Blood glucose Fasting blood glucose Glycosylated hemoglobin Urine ketones Acute complications Diabetes ketoacidosis Hypoglycemia Hyperosmolar Hyperglycemic nonketotic coma Chronic complications Vascular disorders Neuropathies Infections Laboratory Activities: Complete the Alterations in Endocrine Function workbook chapters. Topic: Alteration in Renal Function describe urinary tract infections Cystitis Pyelonephritis Describe obstructions of the urinary tract Calculi Benign prostatic hypertrophy Describe inflammation of the urinary tract Glomerulonephritis Discuss renal failure Acute Chronic Identify risk factors, causes, and consequences of alterations in function Identify compensatory mechanisms

18 Analyze laboratory findings Serum creatinine Identify clinical manifestations Laboratory Activities: Complete the Alterations in Renal Function workbook chapters Topic: Alterations in Brain, Behavior, Mood and Motor Function discuss alterations in central nervous system Increased intracranial pressure and cerebral edema Causes Head injury Brain tumor Diagnosis Complications Describe CNS infections Meningitis Causes and consequences Cerebrovascular occlusive disease Types Transient ischemic attack (TIA) Stroke Risk factors Manifestations Consequences of stroke Identify alterations in motor function Spinal cord injury Classification and types of injury Effects on function Spinal reflex activity Ventilation Autonomic nervous system Degenerative and demyelinating disorders Types Alzheimer s disease Parkinson s disease Multiple sclerosis

19 Causes Pathophysiology Progression of disorder Effects on function Identify alterations in neurotransmission Types of neurotransmitters Process of electo-chemical neurotransmission Specific disruptions in the process of electo-chemical neurotransmission Schizophrenia Manic/depressive disorders Panic attack Discuss pain Experience of pain Somatogenic versus psychogenic pain Acute versus chronic pain Pain threshold and pain tolerance Neuro-anatomy of pain Afferent and efferent pathways Theories of pain Laboratory Activities: Complete the Alterations in Brain, Behavior, Mood and Motor Function workbook chapters Topic: Alterations in Digestive, Hepatic, Biliary, and Exocrine Pancreatic Function identify common manifestations of gastrointestinal tract disorders Anorexia Nausea Vomiting Bleeding (occult, hematemesis, melena) Identify effects of emotions on gastrointestinal functions Eating disorders Anorexia nervosa Bulimia syndrome Inflammatory conditions Types

20 Stomatitis Gastritis (acute and chronic) Diagnostic tests Hemaglobin Hematocrit Occult blood Consequences of chronic gastritis: pernicious anemia Discuss Diverticulitis Discuss Ulcerative colitis Discuss Cholecystitis (including cholelithiasis and choledocholithiasis) Discuss Pancreatitis Analyze diagnostic tests Serum amylase and lipase Describe causes, changes in structure and function, and clinical manifestations Discuss malignant diseases Types Oral Esophageal Colorectal Risk factors, changes in structure and function, and clinical manifestations Describe Peptic ulcer disease Risk factors Pathophysiology Complications Describe Hiatal hernia/esophagitis Causes, manifestations, and consequences Describe Obstructive disorders Common sites Causes Signs and symptoms Complications Describe Hepatic Disorders Types

21 Hepatitis A Hepatitis B Analyze laboratory findings Serum Bilirubin Enzymes Titers Identify causes, pathophysiology, and clinical manifestations Discuss alcoholic liver disease and cirrhosis Stages of development Pathophysiologic changes in cirrhosis Effects on other body systems Diagnostic studies Serum albumin Serum ammonia levels Portal hypertension Ascites Portosystemic shunts Laboratory Activities: Complete the Alterations in Digestive, Hepatic, Biliary and Exocrine Pancreatic Function workbook chapters Topic: Alterations in Skeletal Function describe disorders of bone metabolism osteoporosis Describe Degenerative joint disease osteoarthritis Identify risk factors, causes, and consequences of disorders Identify manifestations of the disorders of skeletal function Laboratory Activities: Complete the Alterations in Skeletal Function Workbook chapters.

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23 Lamar State College-Orange Associate of Applied Science Upward Mobility Nursing Program SCANS Skills Course Reading Writing Arithmetic/ Math Speaking/ Listening RNSG 1311 Pathophysiology Text Modules Homework Assignments Calculation of grades, formulas Lecture Discussion Assignments Tests Websites Assessments Documentation of Practicum, Bulletin Board discussion, Chat discussion, Private Mail Small group work Homework Tests Thinking Skills Homework Exams Small group work in lab Personal Qualities Completion of the course requirements, Group work, Practicum, Exams, Homework, Work with patients Workplace Competencies Knowledge of Disease Processes Management of resources, Equipment, Group work, Internet searching, Lecture and lab opportunities and exams. Basic Use of Computers Internet course, Word processing paperwork, Assignments

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