0

CURRICULUM
OF
NURSING

4-YEAR DEGREE PROGRAMME

(4th Semester)

SCHEME OF STUDIES
FOR BS NURSING (SESSION 2021-2025)
Semester IV

Serial# Course Title Credit Hours Page. No

1 Adult Health Nursing-II 8 (4-4) 1
2 Pathophysiology II 3 (2-1) 16
3 Health Assessment-II 3 (2-1) 22
4 Pharmacology II 2 (2-0) 26
5 English-IV 2 (2-0) 34
6 Nursing Ethics 1 (1-0) 37
7 Developmental Psychology 2 (2-0) 44
Total 21.00
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ADULT HEALTH NURSING-II 8 CH

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.
Teaching/Learning Strategies:
Lectures, discussions, role-plays, clinical conferences, skills demonstrations
/return demonstrations, group work/videos, tutorials, presentations and viva
examinations.
Evaluation Criteria
Test(s) = 15%
Case Presentation (Group) = 15%Scenario based Tutorial = 20% Skill
Performance exam = 20%Final Exam = 30%
Total = 100%

UNIT OBJECTIVES
UNIT I: Orthopedic Nursing
This unit will assist the learners in effective utilization of nursing process in delivering
care to patients with musculo-skeletal problems. The course places emphasis on the
important concepts applicable in musculo-skeletal conditions and rehabilitation of
patients.
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By the end of this unit, learners will be able to:

1. 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.
4. Use nursing concepts in identifying potential complications associated with musculo-
skeletal disorders.
5. Utilize nursing process in delivering care, promoting and maintaining the optimal
wellness of clients with musculo-skeletal disorders.
6. Collaborate with other members of the health care team in health teaching and
discharge planning.
7. Incorporate relevant research findings in designing a plan of care for clients with
musculo-skeletal disorders.
8. Understands and performs Neuro-Muscular assessment independently on patients
having musculo-skeleton disorder.
9. Demonstrate pre and post operative nursing care in patients with Musculo-skeletal
surgeries.
 Soft tissue injury
 Fracture.
 Amputation.
 Paget’s disease and Gout.

 Osteomylitis.
 Osteoarthritis
 Osteoperosis
 Rheumatoid Arthritis
 Bone tumors.
 Tuberculosis.

UNIT II: Endocrine Nursing

Care of clients with disorders of Pituitary Gland
This unit gives an introduction to the endocrine system. Disorders of anterior and
posterior pituitary gland are discussed with a focus on physiology and disorders of
secretion of growth hormone. Both hypo-secretary and hyper-secretary disorders are
dealt with here. By the end of this unit, the learners will be able to:
1. Discuss treatment modalities of patients with pituitary gland disorders.
2. Utilize nursing process in the provision of care for patients with disorder of pituitary
gland and for patients undergoing surgery of the gland.
3. Discuss the impact of various endocrine disorders on patients andtheir families
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Care of clients with disorders of Diabetic

In this unit, learners will gain an understanding of pathogenesis of different types of
diabetes mellitus. Acute and chronic complications of diabetes mellitus will be
discussed along with medical and nursing management of clients. Research related
to this disorder and its treatment will be discussed. Client education and home
management will also be the focus areas of this unit.
1. Discuss the preparation for patients undergoing diagnostic tests/procedures for a
patient with diabetes.
2. Identify pathogenesis and manifestations of the acute and chroniccomplications
of diabetes mellitus.
3. Assess: Hypo and Hyperglycemic conditions.
4. Discuss the medical and pharmacological treatment for a diabeticclient.
5. Discuss the purpose and plan of diet for diabetic clients.
6. Describe the nursing management of a newly diagnosed diabeticclient.
7. Describe the nursing management of a diabetic client who hasKetoacidosis,
Hypoglycemia, and who is undergoing surgery
8. Explain the psychological impact of diabetes mellitus on the client andhis family.
9. Explain the nursing responsibilities in the long-term management ofthe diabetic
client.
Care of client with Thyroid gland disorders
This unit deals with review of structure of thyroid gland and patient emphasis on
physiology and hormone production. This information is integrated while discussing
the disorders of thyroid hormone secretion i.e. hypo and hyper-thyroidism. Moreover,
goiter is also discussed in this unit.

By the end of this unit the learners will be able to:

1. Demonstrates understanding of medical and surgical management ofpatients with

thyroid disorders.
2. Describe pre and post-operative care of thyroidectomy.
3. Identify potential complications of thyroid disorders and describeappropriate
measures in that regard.
4. Explain the complications of thyroidectomy.
Care of patients with Parathyroid disorders
In this unit, learners learn about the function of parathyroid hormone and effect of
impaired hormone secretions on body. They are expected to apply this information
while discussing the disorder of parathyroid gland.
By the end of this unit the learners will be able to:
1. Describe treatment modalities of patients with parathyroid disorders.
2. Utilize nursing process in provision of care to patients with disordersof parathyroid
gland.
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Care of patients with disorders of Adrenal gland

In this unit, the focus is on the hormones secreted by the adrenal medulla and
adrenal cortex. Their significance to life is discussed. Various disorders of hyper
secretion and hypo secretion of hormones of adrenal cortex and medulla are
discussed.
By the end of this unit the learners will be able to:

1. Integrate the disorders associated with adrenal cortex and medulla.

2. Describe treatment modalities of patients with adrenal gland
disorders.
3. Utilize the nursing process in the provision of care to patients withadrenal gland
disorder.
4. Review effects and side effects of gluco-corticoid therapy and planclient teaching
accordingly.
5. Explain the systemic effects of short and long term use of
corticosteroid therapy.
UNIT III: Neurological Nursing
Increased ICP (Intra cranial pressure) and Head Injury

This unit will assist learners in applying nursing knowledge to the care of a patient
with increased ICP and head injury, in an acute care setting.
By the end of this unit the learners will be able to:

1. Review anatomy and physiology of brain and its protective structures.

2. Differentiate between primary and secondary head injuries and
demonstrate an understanding of the related pathophysiology.
3. Anticipate major complications that may result from head injuries.
4. Utilize nursing process in caring for a patient, with head injury.

Spinal Cord Injury

This unit aims at helping learners understand the physical, physiological and
psychological sequel of spinal cord injuries. Unit will also focus on preventive and
curative care of patients with intervertebral disc herniation.
By the end of this unit the learners will be able to:

1. Review basic anatomy and physiology of spinal cord and its protectivestructures.
2. Describe various mechanisms of injury that may be involved in spinalcord injury.
3. Relate pathophysiological changes that take place after a partial orcomplete cord
transaction.
4. Identify life threatening complications that may result from spinal cordinjury.
5. Appreciate the need for prompt interventions in case of a patient withspinal shock
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and autonomic dysreflexia.

6. Describe the nursing care of a patient with spinal cord injury in anemergency
and acute care setting.
7. Explain briefly the rehabilitative needs of patients with Spinal cord injury.
8. Identify the causes and mechanism of injury involved in intervertebraldisc
herniation.
9. Describe the role of nurses in surgical and non-surgical management ofa patient with
intervertebral disc herniation.
10. Discuss the importance of maintaining proper body mechanics inpreventing
intervertebral disc herniation.

Cerebro Vasular Accident (CVA)

This unit will help learners understand the needs of patients with CVAs depending
upon the extent location and manifestations of CVAs. It will also focus on the
distinguishing features of CVAs and TIAs and their respective nursing care.

By the end of this unit the learners will be able to:

1. Utilize nursing process in caring for the patient with CVA.

Infections/Inflammations of CNS (Central Nervous System)Meningitis/

Encephalitis/ Brain abscess
This unit focuses on the alterations in intracranial dynamics, resulting from
infections/inflammation of CNS and the role of nurses in preventing and managing
complications associated with meningitis, encephalitis and brain abscess.
By the end of this unit the learners will be able to:

1. Describe alterations in intracranial dynamics resulting from infectiousdisorders of

Central Nervous System (CNS).
2. Differentiate between the etiology, manifestations and diagnosticmarkers
of meningitis, encephalitis and brain abscess.
3. Discuss the pharmacological and nursing management of patients withinflammations
and infections of CNS.

Epilepsy/Seizures

This unit aims at increasing learners understanding of clinical and social sequel of
epilepsy and the role of nurses in managing patients with epilepticdisorder.
1. Use nursing process to provide care to patients with various seizuresdisorders.
2. Demonstrate an understanding of the side effects and nursing care ofsome common
antiepileptic drugs.
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3. Appreciate the psychological effects of epilepsy for a patient and family.

Disorders of Neuromuscular Transmission.
Myasthenia Gravis (MG)/Gullien Barrie Syndrome (GBS) (Tutorial)

This unit will assist learners in understanding their role as nurses in assessing and
managing patient with common neuromuscular disorders and in identifying
complications associated with it.

 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 diagnosticprocedures to
rule out MG and GBS.
 Identify major complications associated with Myasthenic Crises andCholinergic
Crisis.
 Utilize effective nursing process in caring for patients with
neuromuscular transmission disorder.

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.
By the end of this unit the learners will be able to:
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 patientwith trigeminal
neuralgia.
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 forpatients with
various types of headaches.
 Describe nursing responsibilities in caring and teaching of a patientwith headaches.
Chronic Neurological Disorders
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1. Parkinson’s disease
This unit will help learners in understanding Parkinson’s disease, its etiology,
pathophysiology and manifestations and emphasizes on the role of a nurse in
managing patients in hospital setting and out patient setting and family teaching. By
the end of this unit the learners will be able to:
 Discuss the medical surgical management.
 Utilized nursing process to extend care to a patient with Parkinson’sdisease.
 Appreciate patient and family needs for teaching and home
management.

2. Alzheimer’s Disease
This unit describes the etiology, pathophysiology, manifestations of Alzheimer’s
disease with emphasis on understanding the social and psychological aspects in
caring for patients with this disorder. By the end of this unit the learners will be able
to:
 Define Alzheimer ’s disease.

 Discuss its etiology and pathophysiology

 Identify signs and symptoms exhibited by patient with Alzheimer’sdisease
 Appreciate the social and psychological sequel for patient withAlzheimer’s disease.

3. Brain damage and special states of altered consciousness.

By the end of this unit the learners will be able to:
 Describe various causes of Brain damage classified as: Anoxia/Hypoxia and
perfusion failure.
 Explain the pathophysiological mechanism of anoxic and ischemic brain injury
 Discuss 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 Legal issues involved in caring for
a patient with brain damage

UNIT IV: Cardiovascular Disorders:

By the end of the unit learners will be able to:

1. Review the anatomy& physiology of cardiovascular system.

2. Discuss the causes, Pathophysiology and manifestation of the following
cardiovascular disorders
3. Discuss the diagnostic, medical and surgical management of the below mentioned
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disorders
4. Basic ECG (Electro Cardiogram) interpretation
5. Apply nursing process including assessment, planning, implementation and
evaluation of care provided to the clients with cardiovascular disorders
6. Develop a teaching plan for a client experiencing disorders of the cardiovascular and
lymphatic system

A. Disorders of the Arterial circulation

 Atherosclerosis and Aneurysm
1. Review the anatomy & physiology of blood vessels
2. Use Poiseulle’s & Laplace’s laws to explain the factors affectingblood flow
3. Discuss the role of low density lipoprotein in terms of lipidtransport and development
of atherosclerosis
4. List risk factor in atherosclerosis

5. Describe the mechanisms involved in the development ofatherosclerosis

6. Discuss the causes and mechanisms involved in the
development of aneurysm
7. Differentiate among Berry’s, aortic and dissecting aneurysm
8. Discuss medical, surgical and nursing management of patients.
B Disorders of the venous circulation:
 Varicose veins and venous thrombosis
1. Review the factors assisting venous return of blood from lowerextremities.
2. Discuss the relation of muscle pump and the effects of gravity inthe development of
varicose vein
3. Discuss the risk factors and manifestation associated withvenous thrombosis
4. Discuss medical, surgical and nursing management of patientswith disorders in
venous circulation
C. Alteration in blood pressure: Hypertension
Define hypertension
Discuss the role of cardiac output and peripheral vascular resistancein the mechanism of
hypertension
3. Discuss the risk factors contributing in the development ofhypertension
4. Discuss pathophysiology and clinical manifestations of HTN(hypertension)
5. Discuss medical and nursing management of patients withHTN.
D. Alteration in cardiac function:
1. Infectious disorders: Pericardiatis, Myocardiatis and Endocardiatis:
 Review the anatomy & physiology of pericardium, myocardium & endocardium
 Discuss the causes, pathophysiology and manifestation ofpericardiatis, myocardiatis
and endocardiatis.
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 Discuss the causes, pathophysiology and manifestation ofcardiomyopathies.

 Discuss medical, surgical and nursing management of
patients with alterations in cardiac infections and myopathies.
E. Coronary heart diseases:
1. Describe blood flow in the coronary circulation and relate if tothe metabolic needs
of the heart
2. Discuss the pathophysiological changes and clinical
manifestation in patients with Coronary Artery Disease (CAD)
 Myocardial ischemia (angina & its types)
 Myocardial infarction
3. Discuss medical, surgical and nursing management of patients suffering from
coronary artery diseases.
F. Valvular disorders:
1. Discuss the alteration in hemodynamic function of the heart that occurs with valvular
disease
2. Differentiate the effects of stenotic and regurgitant mitral & aortic valvular heart
disease on cardiovascular function.
G. Heart failure:
1. Discuss the factors effecting cardiac performance in the light of Frank starling law i.e.
pre load, after load and cardiac contractility
2. Describe the pathological mechanism underlying the manifestation of congestive
heart failure
3. Differentiate between:
 Systolic versus diastolic failure
 Right side versus left side failure
4. Discuss the clinical manifestation of congestive heart failure
5. Discuss medical, surgical and nursing management of patients with heart failure
H. Disorders of Cardiac Conduction and Rhythm:
1. Review the anatomy & physiology of cardiac conduction system
2. Review the electrical activity of the conduction system on anElectrocardiography
(ECG) tracing.
3. Describe the mechanism for dysrhythmia generation
 Discuss the different types of dysrhythmias.
 Discuss various heart blocks
 Discuss medical, surgical and nursing management ofpatients
with disorders of cardiac conduction and rhythm.
Heart Blocks and Pacemaker
In this unit learners will review the basic interpretation of electrocardiogram including
different types of arrhythmia. Moreover focus will be on nursing and medical
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management of clients with pacemaker. At the completion of the session, learners

will be able to:
1. Discuss the different kinds of heart blocks.
2. Discuss the care of clients with temporary and permanentpacemaker.

UNIT V: Pulmonary Nursing

By the end of the session learners will be able to:

1. Review the anatomy & physiology of upper respiratory tract

2. Discuss the causes, Pathophysiology and manifestation of the following respiratory
tract disorders
3. Discuss the diagnostic, medical and surgical management of the below mentioned
disorders
4. Apply nursing process including assessment, planning, implementation and
evaluation of care provided to the clients with respiratory disorders
5. Develop a teaching plan for a client experiencing disorders of the respiratory tract.
Upper respiratory tract infections:
 Sinusitis
 Pharyngitis
 Tonsillitis
Lower respiratory tract infections:
 Influenza
 Pneumonia
 Pulmonary T.B ( tuberculosis)
 Lung Abscess
Obstructive lung diseases:
 Asthma
 COPD ( Chronic obstructive pulmonary disease)
 Lung cancer
 Acute Respiratory failure
 Acute Respiratory Distress Syndrome
 Chest trauma

UNIT VI: Eye and ENT Nursing

Otitis media and Mastoiditis/Meinere’s Disease

In this unit learners will understand the care of a patient with Otitis media and
Meinere’s disease. They will learn the preventive measures related to Otitismedia,
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Mastoiditis and Meinere’s disease.

1. Review anatomy and physiology of External and Middle ear.
2. Differentiate between Otitis Externa and Otitis media.
3. Discuss the measures to prevent the spread of infection from the middle ear to the
Mastoid process.
4. Utilize nursing process while caring for patients with Otitis Media.

Epistaxis and Deviated Nasal Septum.

This unit will emphasize on care of patients with Epistaxis and deviated Septum.
Learners will also learn about emergency care of patients with Epistaxis at home.
By the end of this unit the learners will be able to:
1. Review the anatomy and physiology of nose.
2. Discuss the nursing care of patients with deviated nasal septum.
3. Explain the emergency care of a patient with epistaxis.
Tonsillitis.
This unit will focus on care of a patient with tonsillitis and the criteria for surgical
interventions. Learners will understand the care of patients with tonsillectomy.
By the end of this unit the learners will be able to:
1. Review the anatomy and physiology of throat.
2. Discuss the important nursing care of a patient with tonsillitis.
3. Identify the signs and symptoms of tonsillitis.
4. Discuss the criteria for tonsillectomy.
5. Utilize nursing process for a patient undergoing surgery.
Laryngitis.
Learners will learn about role of a nurse in taking care of patients with laryngitis. This
unit will also help learners learn about speech therapy and resources available for
speech therapy after laryngectomy.
By the end of this unit the learners will be able to:

1. Explain the important nursing care of a patient with laryngitis.

2. Utilize nursing process while caring for patient with a patientundergoing
laryngectomy.
3. Describe the speech therapy and resources available in the countryfor speech
therapy after laryngectomy.
Infections/Inflammations of the eye.
This unit will assist learners to learn about different infectious conditions of eye. It will
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also provide learners an opportunity to utilize nursing process while caring for
patients with different eye infections in hospital and community setting.
By the end of this unit the learners will be able to:

1. Review anatomy and physiology of eye.

2. Differentiate between the sign and symptoms of different eyeinfections.
3. Utilize nursing process while caring for patients with differentinfections.
4. Discuss different medical treatment for Blephaaritis, Hordeolum,Chalazia Trachoma
and conjunctivitis.
Glaucoma/Retinal Detachment.
This unit will focus on preventive and curative care of patients with Glaucoma. This
unit will also focus on care of a patient with RetinalDetachment.
By the end of this unit the learners will be able to:

1. Identify the causes of Glaucoma.

2. Describe different diagnostic procedures and signs and symptomspresent in a
person with Glaucoma.
3. Utilize the nursing process while taking care of a patient withGlaucoma.
4. Discuss different causes of retinal detachment.
5. Explain the signs and symptoms a person would develop after havinga detached
retina.
6. Describe the role of nurses in caring for patients with detached retina.

Cataract
This unit aims at helping learners to learn about different changes take place in the
eye while developing cataract and focus on nursing care of patients with cataract.
By the end of this unit the learners will be able to:

1. Identify the causes of cataract.

2. Utilize nursing process while caring for patient with cataract.
3. Discuss the role of nurses in helping patients after surgical
interventions.
4. Explain home care of a patient with surgical interventions.

Burns
The unit places emphasis on the need for the diversity of nursing care required in
immediate and the intermediate post burn period with major emphasis on the
concepts of fluid and electrolyte imbalances.
At the completion of this unit, learners will be able to:

1. Define burns.
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2. Discuss problems of impaired skin integrity.

3. Describe various types of burns and their causative agents.
4. Classify the size and depth of a burn.
5. Demonstrate understanding of the Pathophysiology of a major burnsinjury.
6. Discuss the nursing care of a burn-injured patient in immediate post-burn period.
7. Demonstrate a basic understanding of the management of cardiacarrest in an in-
patient care setting.
8. Demonstrate an understanding of the commonly used drugs in themanagement
of cardiac arrest.
9. Describe the complications of Cardio Pulmonary Resuscitation (CPR).
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, Neurologicaland 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 teachingprovided 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 testscarried out for
 14

clients.

 Demonstrates an understanding of the psychological needs of patientsand their

families during hospitalization and surgery.
 Discuss the possible reaction that a family member may exhibit whenconfronted 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 patientswith Musculo-skeletal
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 withthe abnormal
rhythms.
17. Identify signs of increased ICP in-patients with neurological conditions.
18. Observe the Emergency room systems and apply the concepts oftriage.
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)

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

process. Philadelphia: Davis.

3. Hunt, J. O., Hendrata, M. V., and Myles, P. S. (November/December, 2001). Quality

of life 12 months aftercoronary artery bypass graft surgery. (Vol. 29) Heart and lung.
401- 411.
4. Ignatavicius, D., & Workman, M. (2002). Medical surgical nursing (4th ed.)Critical
thinking for collaborative carePhiladelphia: Saunder.
5. Ross, & Wilson, K. J. (2002). Anatomy and physiology in health and illness. (7th ed.).
Hong Kong: Livingstone.
6. Sole, M. L., Lamborn, M. L., & Hartshorn, J. C. (2001). Introduction to critical care
nursing (3rd ed). .New York: Saunders.
7. Smeltzer, S. C., & Bare, B. G. (2000). Text book of medical-surgical nursing (9th ed.).
Philadelphia: Lippincott.
8. Then, A. a. K., I. A. (September/October, 2001). Acute myocardial infarction with
angiographically normal coronary arteries. (Vol. 29)Heart and lung, 348-350.
9. Thompson, J. M., McFarland, G. K., Hirsch, J. E., & Tucker, S. M. (2002a). Clinical
nursing (5th ed). London: Mosby.
10. Thompson, J. M., McFarland, G. K., Hirsch, J. E., & Tucker, S. M. (2002b). Burns (5th
ed.) Clinical nursing. London: Mosby.
11. Tortora, G. J. G., S. R. (2000). Principles of anatomy and physiology
(9th. ed). New York: John Wiley & Sons Inc.
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PATHOPHYSIOLOGY-II 3 CH
Course Description:
This course provides learners with the opportunities to build on, the concepts and
knowledge about the endocrine & neurological related disorders and their impact on
the functional status of the body. It also deals with the responses of the body that
participate in manifestation of disease. The usefulness of knowledge, skills and
attitudes to the nurse in his/her problem solving in the hospital, school, community or
home is the determining factor in the selection and integration of the content.
Course Objectives:
On completion of this course, learners will be able to:

1. Describe the factors in the environment, which contribute to producechanges in

Physiological processes.
2. Discuss the relationship of normal body function with altered
physiological mechanisms in disease process.
3. Integrate the knowledge of the basic principles of Pathophysiology in ahospital and
community environment.

Teaching/Learning Strategies:
Pre-reading, lectures, lab work, group discussion, quiz, guest lectures, case base
learning, field visits, self study and pre/post tests, etc.
Evaluation Criteria:
Test (s) 40%
Lab performance 15%
Group presentation 15%
Final 30%

COURSE SCHEDULE

DAY/DATE TOPIC FACULTY

Unit I: Genetic Disorders

UNIT II: Endocrine & Metabolic

Disorders
UNIT III: Disorders of Neurological
system
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Unit IV Disorder of SpecialSenses

(Eye & ear)

Unit V Disorder of Cardiovascular

system
UNIT VI:
Alteration in Musculoskeletal support
and movement. (Trauma &Injury)

UNIT OBJECTIVES:

UNIT I: Genetic Disorders

This unit will provide an overview of the genetic disorders with especial emphasis on
some chromosomal disorders. i.e. Down’s syndrome, Turners syndrome and
Kleinfelters’s syndrome.
At the end of this unit each learners will be able to:
Objective:
1. Differentiate between Genetic & Congenital disorder
2. Define the following terminologies related to genetic disorders:
 Trisomy

 Monosomy
 Polysomy
3. Discuss the Chromosomal defects with special emphasis onaneuploidy
4. Describe the pathophysiology and the clinical manifestation of thefollowing
genetics disorders.
 Down’s syndrome
 Turner’s syndrome
 Kleinfelters syndrome

UNIT II: Endocrine & Metabolic Disorders

This unit gives an overview of the endocrine and metabolic control mechanism &
some common disorders of the endocrine glands.
Objectives:
1. Review the hypothalamic pituitary control mechanism of hormonesecretions in
the body.
Differentiate between hypo & hyper function of the endocrine glands.
 18

A. Disorders of Growth Hormone:

In this session learners will discuss the functions and disorders of the growth
hormone.
Objective:
1. Discuss the functions of growth hormone
2. Discuss the disorders of Growth hormones(Gigantism, Acromegaly & Dwarfism)
B. Disorders of endocrine pancreas (Diabetes Mellitus):
In this session, learners will gain an understanding of pathogenesis of different types
of diabetes mellitus. Differences between Type 1 and 2 diabetes mellitus, acute and
chronic complications of diabetes mellitus will bediscussed.
Objectives:
1. Review of Anatomy & Physiology of endocrine pancreas.
2. Briefly discuss the classification of diabetes mellitus (DM)
3. Discuss etiology, pathophysiology, and clinical manifestations of Type 1DM & Type 2
DM.
4. Identify the main differences between Type 1 & Type 2 DM.
5. Identify pathogenesis and manifestations of the acute and chroniccomplications
of diabetes mellitus.

C. Disorders of Thyroid Gland & Parathyroid gland:

This unit deals with the review of structure of thyroid gland and parathyroid gland with
emphasis on hormone production and action. This information is integrated while
discussing the disorders of thyroid and parathyroid gland
Objectives:
1. Review the Anatomy and Physiology of thyroid gland and parathyroidgland and
hypothalamic pituitary thyroid feed back system.
2. Discuss the disorders associated with Thyroid gland i.e. hyporthyroidism
 goiter (non-toxic)
 cretinism
 Myxedema
3. Discuss the disorders associated with Thyroid gland i.e hyperthyroidism
 Grave’s disease
 Goiter (toxic)
4. Discuss the mechanism of action of parathyroid hormone
(parathormone and calcitonin)
5. Explain the effects of hypo and hyper parathyroidism on the bodysystems such
as Renal and musculoskeletal system

D. Disorders of Adrenal gland

 19

In this unit the focus is on the hormone secreted by the adrenal cortex and the
importance of these hormones to vital functions of the body. Disorders related to
hyper secretion and hypo secretion of the adrenal cortex are discussed.
Objectives:
1. Review the Anatomy and Physiology of the Adrenal gland
2. Discuss the functions of adrenal cortex hormones (corticosteroid)
3. Discuss the following
 Cushing’s syndrome
 Addison’s disease.

UNIT III: Disorders of Neurological System

In this unit the learners will gain an understanding of the alteration of sensory
function involving dysfunction of the general sense includes Pain, and special
senses i.e. eye & ear. Alteration of the neurological function that is cerebro-vascular
accident ( CVA’s & Stroke ) will also be discussed

A. Pain
At the completion of this unit learners will be able to
1. Review the concept of somatosensory pathway.
2. Describe the function of Nociceptors in response to pain information.

3. Describe the function of endogenous analgesic mechanism as theyrelate to

transmission of pain information.
4. Describe the proposed mechanism of pain relief associated with theuse of heat, cold
& TENS i.e. Transcutaneous electrical nerve stimulation.
B. Disorders of Neurological function
At the completion of this unit learners will be able to:

1. Review the major vessels in the cerebral circulation.

2. Review the, blood brain, & brain cerebrospinal fluid barrier.
3. Explain the degeneration of the nervous tissue that cause alteration incerebral blood
flow (stroke).
 Risk factors and types of stroke
 Transient Ischemic Attacks (TIAS)

UNIT-IV Disorder of Special Senses (Eye & ear)

At the completion of this unit learners will be able to:

1. Review the A & P of eye & ear

2. Discuss some common visual & auditory dysfunction
 20

 Glaucoma
 Tinnitus & hearing Loss

UNIT-V Cardiomuscular System

UNIT VI: Alteration in Muscloskeletal support and movement.(Trauma &

Injury):
This session learners will study about the trauma of skeletal structures. This session
will also cover the pathological processes of metabolic bone disease and inflammatory
joint diseases. At the end of this unit each learners will beable to:
UNIT V: Degenerative Disorders
In this unit the learners will gain an understanding of the degenerative disorders of
the cardiac vascular, nervous and respiratory system. At the completion of this unit
learners will be able to:
A. Cardiovascular Disorders:
1. Review the following structure that support the cardiac
metabolism i.e.
 coronary circulation ( collateral arteries)
 heart action i.e. conduction system ,myocardial contractionand relaxation
2. Explain the mechanism of blood vessels obstruction in
atherosclerosis
3. Discuss the factors effecting cardiac performance in the light of Frank Starling and
Lapcalce’s law i.e. preload, after load, & contractility.
4. Eexplain the pathophysiological changes in patients with ischemic heart diseases
i.e.
 myocardial ischemia (angina & its types)
 myocardial infarction
References:
1. Carol, Porth M. (2000). Pathophysiology concept of altered healthstates (new ed).
Philadelphia: J. B. Lippincott
2. Sue, Huether E. (2000). Understanding pathophysiology New York:Mosby.
3. Tortora, G. J., & Anagnostakos, N. P. (2000). Principles of anatomyand physiology
New York:Harper & Row.
4. Wilson, Sylvia A. Price & Lorraine M. (1997). Clinical concepts ofdisease
processes (5th ed). Mosby.

PATHOPYHSIOLOGY LAB EVALUATION CRITERIA

Learners will get cumulative 30 %marks at the completion of all the labsessions.
 21

A. LAB PERFORMANCE

The evaluation of lab performance will be done on the following basis:-

- Safe handling of chemicals and apparatus.
- Observation
- Interpretation of results.
- Cleanliness.
Lab schedule for Pathophysiology
Lab 1 Study the Pathway of Transmission of Cardiac Impulse
and effect of temperature effect of drugs on the
transmission of cardiac impulse & contractility
Lab 2 Respirator Volumes and Capacity
 22

HEALTH ASSESSMENT II 2 CH
Course Description:
An introduction to the content and skills needed to assess the basic health status of
individuals of varying ages. These skills can be applied to nursing care in a wide
variety of clinical settings. This course emphasizes history taking and physical
examination skills.
Course Objectives:
By the completion of this course learners will be able to:

1. Systematically assess the health status of an individual by obtaining acomplete health

history using interviewing skills appropriately.
2. Utilize proper techniques of observation and physical examination inassessing
various body systems.
3. Differentiate normal from abnormal findings.
4. Record findings in an appropriate manner.
5. Demonstrate an awareness of the need to incorporate health
assessment as part of their general nursing practice skills.
6. Apply knowledge of growth & development, anatomy, physiology, &psychosocial
skills in assessment & analysis of data collected.
Teaching/Learning Strategies:
Pre readings, experiential learning, videotaping, role playing, lecture/discussion,
quizzes, demonstration, movies & lab practice.
Evaluation Criteria:
Midterm 30%
Performance Exam 30%
Final Exam 40%
Total 100%

UNIT OBJECTIVES:

UNIT I: Assessment of the Peripheral Vascular andMusculoskeletal

Systems
By the end of the unit, learners will be able to:
1. Discuss the patient health history question necessary to perform the assessment of
Peripheral Vascular System (PVS) and MusculoskeletalSystem (MS) system.
2. Discuss critical observations to assess PVS.
3. Assess musculoskeletal functions including muscles strength, symmetry, size,
contour, ROM and its characteristics.
4. Document findings.
 23

5. List the changes in the given systems that are characteristics of aging process.

UNIT II: Assessment of the Mental Status and Sensory NeuroSystem

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

1. Perform mental status examination of a client.

2. Assess cranial nerve, sensory, sense of proprioception and cerebellar functions and
deep tendon reflexes.
3. Document findings.
4. List the changes in the nervous system that are characteristics of theaging process.

UNIT III: Assessment of Cardio Vascular System

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

1. Describe the components of health history that should be elicited duringthe

assessment of cardiovascular system.
2. Identify the landmarks of the chest.
3. Describe the following:
 Pulse rate, rhythm and pulsation characteristics
 PMI
 Heart sounds
 Discuss systolic and diastolic murmurs
4. Assess the cardiovascular system systematically.
5. Document findings.
6. List the changes in cardiovascular system that is characteristics of agingprocess.

UNIT IV: Assessment of Thorax and Lungs

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

1. Describe the components of health history that should be elicited duringassessment of

respiratory system.
2. Describe the following:
 Chest contour and symmetry
 Respiratory rate and pattern
 Tactile fremitus
 Chest expansion
 Density of lung fields
 Diaphragmatic excursion
 Auscultated lung sounds
3. Assess the respiratory system including inspection, palpation,
percussion and auscultation.
4. Document findings.
 24

5. List the changes in respiratory system that are characteristics of agingprocess.

UNIT V: Assessment of the Eyes, & Ears

By the end of the unit, learners will be able to

1. Identify the component of health history necessary for the examination of eye & ear.
2. Describe the following:

 Eye structure and position

 Upper and lower eyelids
 Gross visual perception
 Characteristics of the cornea, sclera, pupil, and lens fundi.
 Peripheral fields
 Color, shape, and location of auricle
 External ear canal and tympanic membrane
 Gross hearing
3. Perform the examination of eye and ear of a healthy patient.
4. Document findings.
5. List the changes in eye and ear that are characteristics of agingprocess.

UNIT VI: Assessment of an Elderly Client

By the end of the unit, learners will be able to
1. Describe the variations in history taking for an elderly client.
2. Differentiate health assessment variations for elderly clients.
3. Identify any differing examination techniques or skills for elderly client

UNIT VII: Assessment of Pediatric Client

By the end of the unit, learners will be able to:
1. Describe the component of a thorough pediatric history, includingdifferences for
developmental levels.
2. Differentiate health assessment norms for infants, and children.
3. Identify common examination techniques/skills for pediatric healthassessment.
References:
1. Bicklay, L. S. (1999). Bates’ guide to physical examination andhistory taking (7th
ed).Philadelphia: J. B. Lippincott.
2. Cox, C. H. (1997). Clinical applications of nursing diagnosis (3rd ed).
3. DeGowin, R. L., & Brown, D. D. (2000). Degowin’s diagnosticexamination (7th ed.).
New York: McGraw-Hill.
4. Fuller, J. & Schaller Ayers, J. (2000). Health Assessment: A Nursingapproach. (3rd
ed.). Philadelphia: J. B. Lippincott.
 25

5. Jarvis, C. (1996). Physical examination & health assessment (2nd

ed).Philadelphia: Saunders.
6. McFarland, G. K, et. al. (1997). Nursing diagnosis and interventionplanning for
patient care chapter 1 & 2 (3rd ed).
7. Munro, J. F., & Campbell, I. W. (2000). Macleod’s clinical
th
examination (10 ed). Edinburgh: Churchhill Livingstone.
8. Thompson, B. (1991). Clinical manual of health assessment. (4thed).St. Louis:
Mosby.

9. Weber, J. R. (2001). Nurses' handbook of health assessment (4thed).

Philadelphia: Lippincott.
10. Wilson, S. F; Giddens J. F. (2001). Health assessment for nursingpractice (2nd
ed).St. Louis: Mosby.

COURSE SCHEDULE

UNIT I: Assessment of Peripheral Vascular & Musculoskeletal system

LAB : PVS & MS
UNIT II: Mental Status & Sensory Neuro I
LAB: Mental Status & Sensory Neuro I
UNIT III: Cardiovascular system
LAB: Cardiovascular system
UNITIV: Thorax & Lungs
LAB: Thorax & Lungs
UNIT V: Eyes/Ears
Lab: Eyes & Ears
UNIT VI: Assessment of an elderly client
Lab: Assessment of elderly client
UNIT VII: Assessment of Pediatric client
Lab: Assessment of pediatric client
 26

PHARMACOLOGY-II 2 CH
Course Description:
The course emphasizes on knowledge about drugs, their classification, therapeutic
effects, anticipated reactions, toxic effects, and abuse. At this level, the emphasis is
on application of concepts to patient care situations, including patient assessment,
drug dosage calculations and administration, patient and family teaching and
documentation of patient responses to specific medications.
Course Objectives:
By the end of the course, each learner will be able to
1. Apply conceptual knowledge about the drugs used in CV, Respiratory, CNS, ANS &
EENT and endocrine disorders and their mechanisms of action.
2. Calculate drug dosage calculations accurately when administering oral and parental
medications.
3. Explain the rationale for using a particular drug/s for a patient.
4. Select appropriate nursing interventions for drugs given in clinicalsituations.
5. Impart teaching to the patient/family regarding medications, based on their needs.
6. Utilize nursing process to evaluate the need for and the effectiveness of the drug/s
given to the patients.
7. Integrate the knowledge of legal and ethical issues in administration ofdrug.
8. Incorporate relevant research findings with guidance in development of new drug/s
as a foundation for nursing practice.
9. Incorporate cognitive, interpersonal and technical skill derived from the humanities,
natural and behavioral sciences when administrating medication to clients, keeping
in mind principles of different drugs.
10. Begin to understand alternative therapies in medicine.
11. Utilize an advanced level of English Language in classroom and clinical setting for
Pharmacology.
Teaching/Learning Strategies:
Lecture/handouts, self-directed learning, drug cards and quiz.
Evaluation Criteria:
Test (s) 40%
Presentation on categories of medicine 20%
Final Exam 40%
 27

COURSE SCHEDULE:
Date/ Unit Topics Faculty
Time Name
Unit I  Drugs effecting endocrine system(thyroid,
anti thyroid, para thyroid)
 Drug effecting endocrine system
steroid and diabetic and anti diabeticdrugs

Unit II  Drugs affecting Nervous System

 Critical care drugs, Anesthetics,
antiepileptic,antiparkinsons, antimigraine
& analgesic dosage
calculation
 Drug Dosage calculations (adrenergicand
CNS)

 Drugs affecting sympathetic nervous

system (ANS)
UNIT III  Adrenergic and antiadrenergic drugs
 Akeletol muscle relaxants and CNS
stimulants
 Drugs affecting parasympatheticsystem
UNIT IV
(cholinergic andanticholinergic)

 Drugs affecting Cardiovascular

Unit V system
 Critical care s & dosage calculation ofdrug

 Drugs affecting Respiratory system

Unit VI
 Critical care & dosage calculation ofdrugs

 Drugs affecting Opthalmic/ENT

Unit VII system
 Critical care & dosage calculation ofdrugs

UNIT OBJECTIVES:
Unit I: Drugs used in Endocrine Disorders
This unit would discuss/describe the types of drugs used to treat problems
associated with endocrine disorders. It also deals with their mechanism of action,
nursing action required to ensure safety of clients using thesedrugs.
 28

A. Antidiabetic Drugs
By the completion of this section the learners will be able to:
1. Review disease process of Diabetes mellitus.
2. Discuss the role of Insulin in metabolic process.
3. Discuss different types of anti-diabetic agents with their mode of action,side effects
and care.
4. List the principles of therapy for all anti-diabetic agents.
5. State reasons for combinations of insulin and oral hypoglycaemicagents.
6. Calculate drug dosage accurately.
B. Corticosteroids
By the completion of this section the learners will be able to:

1. Review the Anatomy & Physiology of adrenal glands.

2. Discuss the action, indication, side effects and contraindication ofexogenous
corticosteroids.
3. List few commonly used corticosteroids.
4. Differentiate between short term and long-term corticosteroid therapy.
5. Discuss the action, indication, side effects and contraindication ofexogenous
androgen therapy.
6. Discuss the consequences of abusing anabolic steroids.
7. Identify few names of anabolic steroids.
8. Apply nursing process for the clients using corticosteroids / androgenstherapy.
9. Calculate drug dosage accurately.
C. Thyroid and Antithyroid Drugs
By the completion of this section the learners will be able to:
1. Review the physiologic effects of thyroid hormone.
2. Identify effects of hypo and hyper secretions of thyroid hormone.
3. Discuss actions, indications, side effects and contraindications ofthyroid and anti-
thyroid drugs.
4. Integrate the influence of thyroid and anti-thyroid drugs on the
metabolism of other drugs.
5. Teach clients self-care activities related to the use of thyroid and anti-thyroid
drugs.
6. Calculate drug dosages accurately.
C. Hypothalamus and Pituitary Drugs
By the completion of this unit learners will be able to:
1. Discuss the clinical uses of major hypothalamus and pituitaryhormones
2. Identify commonly used drugs and hormone replacement
3. State the major nursing consideration in the care of client receivingspecific
hypothalamic and pituitary hormones
4. Calculate the drug dosage accurately for oral and parental drug/hormone used for
 29

hypothalamus and pituitary replacements

Unit II: Drugs used for Nervous System Disorders

This unit would discuss/describe the types of drugs used to treat problems
associated with autonomic nervous system disorders. It also deals with their
mechanism of action, nursing action required to ensure safety of clients using these
drugs.
A Anesthetic drugs
This unit would discuss/describe the types of drugs used to anesthetize the patient. It
also deals with their mechanism of action, nursing action required to ensure safety
of clients using these drugs.
By the completion of this section the learners will be able to:
1. Define the term anesthesia and anesthetic agents
2. Differentiate between different types of anesthesia
3. Identify the stages of general anesthesia
4. Describe Characteristics of general and local anesthetic agents.
5. Identify most commonly used anesthetic agents
6. Discuss factors considered when choosing anesthetic agents.
7. Compare general and local anesthesia in terms of administration,client’s safety
and nursing care.
8. Discuss the rationale for using adjunctive drugs before and duringsurgical
procedures.
9. Describe the nursing role in related to anesthetics and adjunctivedrugs.
10. Discuss the action, indication and side effects of neuro-muscularblocking agent
11. Calculate the drug dosage of injectable anesthetic agent

B: Anti-Convulsants
By the completion of this section the learners will be able to:

1. Discuss the pharmacokinetics, side effects and adverse reactions,therapeutic

plasma phenytoin level
2. Identify the contraindications and drug interactions.
3. Explain the nursing interventions, including client teaching related tothe use of anti-
convulsants.
4. Calculate the drug dosage accurately for oral and parental
anticonvulsants drug.
C: Anti-Parkinson’s
By the completion of this section the learners will be able to:
1. Describe the action of anticholinergic drugs and dopaminergic drugsin treatment of
Parkinsonism.
 30

2. Differentiate between the types of commonly used anti-Parkinson’sdrugs.

3. Describe the side effects of anti-Parkinson drugs.
4. Discuss the nursing interventions including clients teaching of drugsused in the
treatment of Parkinson’s disease
5. Calculate the drug dosage accurately for oral and parental antiParkinson’s drugs
D: Anti Migraine and drugs for Trigeminal neuralgia
By the completion of this session learners will be able to

1. Discuss the action, contraindication and side effects of Antimigraineand

Trigeminal neuralgia
2. Identify most commonly used drugs for migraine and Trigeminalneuralgia
3. State the major nursing care if client is using Anti migraine andTrigeminal neuralgia.
4. Calculate the drug dosage accurately for oral anti migraine and drugsfor trigeminal
neuralgia.

E. Skeletal Muscle Relaxants

By the completion of this section the learners will be able to:
1. Discuss common symptoms/disorders for which skeletal musclerelaxants
are used.
2. Describe uses and effects of skeletal muscle relaxants.
3. Differentiate between centrally acting and peripherally acting musclerelaxants
4. Describe non-pharmacologic interventions to relieve muscle spasmand spasticity.
5. Apply the nursing process with clients experiencing muscle spasm orspasticity.
6. Calculate the drug dosages accurately.

UNIT III: Drugs used for Autonomic Nervous System Disorders

Drugs affecting Sympathetic Nervous System (Adrenergic & Anti-Adrenergic
drugs)
This unit would discuss/describe the types of drugs used to treat problems
associated with autonomic nervous system disorders. It also deals with their
mechanism of action, nursing action required to ensure safety of clients using these
drugs.
By the completion of this section the learners will be able to:

1. Differentiate effects of stimulation of alpha & beta-adrenergic receptors.

2. List characteristics of adrenergic and anti-adrenergic drugs in terms of effects on
body tissues, indications for use, adverse effects, nursing process implications,
principles of therapy and observations of clients responses.
3. List commonly used over the counter preparation that contains adrenergic drugs.
4. Discuss principles of therapy & nursing process for using adrenergic and anti-
adrenergic drugs.
 31

5. Discuss the nursing care including teaching client about safe and effective use of
these classes of drugs.
6. Calculate drug dosage calculations accurately.
UNIT IV: Drugs Affecting Parasympathetic Nervous System
(CHOLINERGIC & ANTI- CHOLINERGIC DRUGS)
In this unit, the learners would discuss / describe the effect of drugs on
Parasympathetic nervous system. This unit will also help learners to integrate the
knowledge of drug to use to treat problems associated with parasympathetic
nervous system. It also deals with their mechanism of

action, nursing action required to ensure safety of clients using thesedrugs.

By the completion of this section the learners will be able to:

1. List characteristics of Cholinergic & Anti-Cholinergic drugs in terms of effects on

body tissues, indications for use, adverse effects, nursing process implications,
principles of therapy and observations of client’s responses.
2. Discuss antidotes for cholinergic drugs & Anti-Cholinergic drugs.
3. Describe signs and symptoms of cholinergic drugs & Anti-Cholinergicdrug
overdose.
4. Describe major nursing care needs of clients receiving these classesof drugs.
5. Discuss principles of therapy & nursing process for using Cholinergic& Anti-
Cholinergic drugs.
6. Teach the client about safe and effective use of these classes ofdrugs.
7. Calculate the drug dosage accurately for oral and parental drugaffecting
parasympathetic nervous system.

UNIT V: Drugs Affecting the Cardio-Vascular System

In this unit, learners will gain an understanding of the drugs used to treatcommon
disorders of the CVS, their pharmaco-kinetics and nursing measures.
A. Cardiac Glycosides and Antiairythmic Drugs
By the end of this unit learners will be able to:
1. Review inotropic, chronotropic and dromotropic effects of
cardiovascular drugs.
2. Describe the therapeutic effects and therapeutic uses of digoxin.
3. Discuss digitalization.
4. Discuss the signs and symptoms of early moderate and severedigoxin toxicity.
5. Describe the nursing care related to digoxin toxicity.
6. Discuss pharmacological management of arrythmias.
7. Discuss nursing implication in relation to antiarrythmic drugs.
 32

8. Calculate the drug dosage accurately while administering oral andperenteral

medication.

B. Anti Anginal and Anti-Hypertensive Drugs

By the end of this unit learners will be able to:
1. Discuss the main classes of drugs that are used for treating AP.
2. Discuss the nursing responsibility of each class of drugs.

3. Discuss the pharmacological management of hypertension and

hypertensive crisis.
4. Discuss the nursing responsibility related to antihypertensive drugs.
5. Calculate the drug dosage accurately while administering oral andparenteral
medications.

C. Thrombolytic Therapy
1. Discuss the main classification of thrombolytic therapy.
2. discus the action of different thrombolytic therapy
3. Discuss the nursing responsibility during thrombolytic therapy

UNIT VI: Drugs Affecting the Respiratory System

In this unit, learners will be able to gain knowledge about the drugs affecting
respiratory system, their mechanism of action, indication side effects and nursing
consideration.
By the end of the unit learners will be able to:
1. Define antihistamine, Decongestant, antitussive and expectorant
2. List the drug groups that are used for the COPD and Asthma.
3. Explain the therapeutic effects, side effect, Toxic level and nursingconsideration.
4. Calculate the drug dosage accurately while administering oral andparenteral
medications.

A Anti Tuberculosis Drugs

In this unit, learners will be able to gain knowledge about drug used in the treatment
of tuberculosis, their mechanism of action, indication, side effects and nursing
consideration. By the end of the unit learners will be able to:
1. Discuss the characteristics of anti-tubercular drugs i.e.:
- Mechanism action.
- Indication
- Contraindication.
 33

2. Discuss Primary and Secondary management of TSB drugs.

3. Describe the rationale for multiple drug therapy in treatment of TB
4. Discuss appropriate nursing implication for client receiving anti-
tuberculin therapy.
5. Calculate the drug dosage accurately while administering oral andparenteral
medications.

Unit VII: Drugs used in Ophthalmic/ENT Disorders

This unit would discuss/describe the types of drugs used to treat problems
associated with ENT/Eye. It also deals with their mechanism of action, nursing action
required to ensure safety of client using these drugs.
By the completion of this section the learners will be able to:

1. Review ocular structure that influence drug therapy

2. Discuss different categories of drugs used in E ENT disorders
3. Review the proper methods of instilling the EEN drops
4. Utilize nursing process while taking care of clients using drugsrelated to EENT
disorders.
5. Calculate drug dosage calculations accurately.
References:
1. Chrousos, G. P. & Margioris, A. N. (2001). Adrenocorticosteriods &adrenocortical
antagonistic.
2. Clayton, B. D. & Stock, Y. N. ((2001). Basic pharmacology fornurses. 12th ed
London: Mosby.
3. Mccuistion, L. E. G., R. J. (2002a). Drugs affecting the endocrine system. In real-
world nursing survival guide: Pharmacology. London:Saunders.
4. Mccuistion, L. E. G., R. J. (2002b). Psychotherapeutic agents in drugs affecting the
nervous system. In real-world nursing survival guide: Pharmacology. London:
Saunders.
5. Riens, B. S., & Evans, M. E. (2002). Pharmacological aspects ofnursing care
(6th ed.). New York: Delmar.
6. Shives, L. R. (2002). Basic concepts of psychiatric mental healthnursing. (5th ed
). Philadelphia: F. A. Davis.
7. Tracy, M. F., Lindaquist, R., Watanuki, S., Sendelbach, S., Kreitzer,
M. J., Berman, B., & Savik, MS. (2003, May/June). Nurse attitudes towards the use
of complementary and alternative therapies in critical care. Heart & lung. The journal
of acute & critical care., 32, 179-209.
 34

ENGLISH-IV 2 CH

ANNEXURE - A

Unit Objectives:

Unit I Reflective WritingUnit Description:

This unit focuses on Reflective writing in medical context .The course
builds on learner’s skills in documenting reflections in an organized form.
Unit Objectives:
By the end of this unit, students will be able to:
1. Read and analyze a reflective text
2. Use word and phrases to express their own thoughts
3. Use appropriate sentence structure
4. Narrate and analyze incidents
5. Use basic level of reflections.

Unit II ReadingUnit Description:

This unit focuses on analytical reading. The course builds on the learner’sskills to
read and analyze the text critically.
Unit Objectives:
By the end of this unit, students will be able to:
1. Comprehend texts
2. Identify the main ideas
3. Understand the writer’s point of view
4. Analyze different parts of the text.

Unit III Grammar and StructuresUnit Description:

This unit focuses on using grammar and written structure appropriately. The course
builds on learner’s skills in using grammar and written structure.
Unit Objectives:
By the end of this unit students will be able to

1. Identify basic sentence structure

2. Avoid sentence fragments
3. Add information to an independent clause
4. Learn ways to connect sentences
5. Avoid run-on sentences and the comma splice
6. Understand and use complex prepositions.
 35

Unit IV APA Style of WritingUnit Description:

This unit introduces students to the writing style described in the publication manual
of the American Psychological Association. This unit enhances learner’s skills in
using APA style of writing.
Unit Objectives:
By the end of this unit, students will be able to:

1. Understand the difference between a reference list and citation;

2. Know the difference between quotation-summary-paraphrase.
3. Cite references for:
- one work by one author
- one work by multiple authors
- two or more works within the same parentheses
- personal communication
- specific parts of a source.

Unit V Oral PresentationUnit Description:

This unit focuses on developing presentations skills of the learners. Thiswill assist
them how to make presentations in their academic and professional environment.

Unit Objectives:
By the end of this unit, students will be able to:
1. Understand elements of a good presentation
2. Know how to make well organized and clear presentation
3. Focus on the purpose
4. Understand the significance of the audience
5. Develop clarity and accuracy in presenting information
6. Handle questions raised by the audience
7. Make effective presentations
References:
1. American Psychological Association. Retrieved April 08, 2006, from
http://www.apa.org/
2. Barnet, S., & Bedan, H. (1996).Current issues and enduring questions: A guide to
critical thinking argument with reading (4th ed.).Boston: Bedford.
3. Curationis. (2002). Reflective journal writing: how it promotes
reflective thinking in clinical nursing education: a students'
perspective. Retrieved April 4, 2006 from http://www.accelerated-learning-
online.com/research/reflective-journal-writing-promotes- reflective-thinking-
clinical.asp
 36

4. Eastwood, J. (2004). Oxford practice grammar. Karachi: Oxford University Press.

5. Gelfand, H., & Charles J. Walker, J. C. (Eds.). (2001). Mastering APA style:
Instructor’s resource guide (5th ed.).Washington: American Psychological
Association.
6. Gelfand, H., & Charles J. Walker, J. C. (Eds.). (2001). Mastering APA style:
Student's work book and training guide (5th ed.). Washington: American
Psychological Association.
7. Glendinning, E. H., & Holmstrom, B. (2004). Study teaching: A course in reading
skills for academic purposes (2nd ed.). Cambridge: Cambridge University Press.
8. Hecker, T., Amon, J., & Nickoli, E,.(2001) Reflective Writing in Nursing. Retrieved
April 10, 2006 from
http://www.cariboo.bc.ca/Disciplines/eng309/nursing/nursing.htm
9. Howe, D. H., Kirkpatrick,T. A., & Kirkpatrick, D. L.(2004). English for undergraduates.
Karachi: Oxford University Press.
10. Moon, J. A. (1999). Reflections in learning and professional development. London:
Kogan Page.
11. Maker, J., & Lenie. M. (1996). Academic reading with active critical thinking.
Cambridge: Wadsworth.
12. Murphy, R. (1989).Grammar in use: Reference and practice for intermediate
students of English. New York: Cambridge UniversityPress.
13. Parks, A. F., Levernier, J. A. C., & Hollowell, I. M. (2001). Structuring paragraphs
and essays: A guide to effective writing (5th ed.). Boston: Bedford/St. Martin’s.
14. Rinvolucri, M. (2004). Grammar games: Cognitive effective and drama activities for
EFL students. Cambridge: Cambridge University Press.
15. Ruetten, M. K. (2004). Focus on writing: Developing composition skills through
instruction and practice 1. Singapore: Learners Publishing.
16. Smaley, R. L., Ruetten, M. K., & Kozyrer, J. R. (2004). Focus on Writing: Refining
composition skills through instruction and practice 2. Singapore: Learners Publishing
 37

NURSING ETHICS 1 CH
Course Description:
This course is designed to provide the learner with an over view of basic concepts of
ethics, its theory, principles, and norms. This course will raise awareness of factors
that needs to consider when dealing with ethical decisions and affirm nursing as an
ethically responsible profession. It will also provide a forum for learner to reflect upon
issues or ethical dilemma which they identify during their clinical practice.
Course Objectives:
By the completion of the course, learners will be able to:
1. Define ethical principles in health care.
2. Discuss ethical, moral and professional responsibilities of the nurse.
3. Discuss the nurse’s individual liability with in the ethical scope ofnursing practice.
4. Identify ethical concern at the clinical area and discuss alternatives forthe identified
ethical concerns.
5. Discuss the changing health environment for the role of nurse indelivery of ethical
nursing care
Teaching/Learning/strategies:
Interactive lectures, small group discussions, role play, group presentation,debate
and case-studies discussion.
Course Expectations:
- Attendance as per policy.
- Active participation in class.
- Take examination as scheduled

Evaluation Criteria:
Debate 20%
Diary-Journal (monthly) 20
Final Exam 40
Case based classroom test 20%
Total 100%

UNIT OBJECTIVES:

Unit I Introduction to Nursing Ethics

1. Define the terms: ethics, nursing ethics and bio-ethics, value, belief,morals, attitude,
conflict, dilemma, ethical dilemma
2. Discuss importance of ethics in nursing
3. Review criteria of a profession
 38

4. Develop Characteristics of a Professional Nurse

Unit II Value Set

1. Define Value &value clarification
2. List types of values
3. Identify personal, societal, organizational professional and moralvalues
4. Explain modes of value transmission
5. Recognize value conflicts and its implication to nursing practice.
6. List advantages of value clarification in nursing profession.
7. Develop professional values
8. Discuss implication of Nursing Care Ethics in Divers Society.

Unit III Ethical Principles and Theories

1. Discuss ethical principles in health care in the light of ethical theories.
2. Discuss the ethical dilemmas face by nurses and client.
3. Discuss the strategies to resolve ethical dilemma in daily nursingpractice.
4. List steps of ethical decision-making

Unit IV Confidentiality and Informed consent

1. Define confidentiality and informed consent
2. Discuss the importance of confidentiality & consent
3. List ethical and legal elements of informed consent
4. Discuss the process informed consent.
5. Discuss nurse’s roles and responsibilities in consent process
6. Implication of case consultation in nursing ethics.

Unit V Bills of Rights

1. Define rights & bills of right.
2. List the types of rights.
3. Describe the role of nurse in relation to bills of right.
4. Explain patient’s bills of right in a tertiary care health facility.

Unit VI Code of Ethics

1. Define code & code of ethics.
2. List the function & elements of ethical code
3. Explain code of ethics by ICN and Pakistan Nursing Council
4. Compare code of ethics by ICN and Pakistan Nursing Council
5. Discuss application of code of ethics in clinical settings.
6. Define Nursing Pledge in relation to code of ethics.
Unit VII Professional Autonomy and Ethics
 39

1. Define profession, professional, autonomy, accountability and unity.

2. Discuss the characteristics of professional nurse.
3. Relate the code of ethics to professional status.
4. Discuss the professional autonomy and ethics.
5. Relate accountability to professional status.
6. Discuss the concept of unity and its relationship to professional statusin nursing.
7. Relate Nursing ethics to standards of nursing practice.

Unit VIII Ethical Dilemma in Professional Practice

1. Define dilemma and professional obligation
2. Identify common areas of negligence and nurses’ liability in theseareas.
3. Discuss nurses’ advocacy in various scenarios and clinical casesrelated to
a. Life support equipment
b. Selling body parts
c. Risk management and occupational hazards.
d. Documentation of nursing care.
e. Employment issues
f. Medical malpractice lawsuit

Unit-IX: International Health Organizations and Nursing

Organizations

1. Identify Nursing Organization all over the world

2. Discuss function of International Council of Nursing
3. Discuss the role of World Health Organization
4. Elaborate the functions of Pakistan Nursing Association, Federationand Council

Clinical Objectives:
1. Learners are required to apply ethical concept in clinical setting (FON,AHN,
Advanced Concepts of Nursing and CHN)
2. Demonstrate characteristics of a professional nurse.
3. Explore and demonstrate respect patients’ / families values and
beliefs’ clinical setting
4. Develop professional values.
5. Integrate nursing code of ethics and ethical principles in clinicalsetting.
6. Observes the consent process in clinical setting
7. Demonstrate respect for rights of patients and others
8. Identify ethical concerns/issues in clinical setting and discuss
alternatives for identified ethical concern.
9. Practice standard format for documentation of nursing care.
COURSE SCHEDULE
 40

Date/Time Topic Faculty

Introduction to Nursing Ethics
Value Set
Ethical principles and theories
Informed consent and Confidentiality
Debate
Bills of Right
Code of ethics
Professional Autonomy and Ethics
Case based test

Ethical dilemma in Professional Practice

International Health Organizations andNursing
Organizations
Final Examination

GUIDELINE FOR DEBATE (20%)

Each group will choose a topic. Please take prior appointment for your group for
topic submission. All members are required to come for finalization of topic.
Each group will have two teams. One team will present arguments in favor of topic
(Pro team). The other team will present arguments in opposition to the topic. (Con
team)
Each group will be required to submit reference file on the of debate.
Each team will have 20 minutes
A member from Pro team presents arguments. 3 minutes A member from
Con team will present argument. 3 minutes. Question and
Answers for both group 10 minutes.
Conclusion from both teams 2 minutes each.

Suggested Topics for Debate:

1. Patients have right to live and die.

2. Abortions should be legalized.
3. Clients have right to know about their disease and prognosis.
4. Placebos should be permitted in Health care.
5. Clients have right to receive and refuse treatment.
6. Who deserves the priority for treatment? A child aged 5 years or a55-year elderly
man.
7. Who should make the decisions patient or family or health team
 41

8. Society benefit vs patients’ benefit (e.g. aids).

9. Should organs be sold or not
10. Should family be present during CPR/procedures or not
11. Should the culture be respected or not while caring (When conflictwith medicine)
12. Should learners practice / learn on patients or not.
13. Who should take care the spiritual need? Nurse or spiritual leader?
14. Should the literature be used from any source with outacknowledgement or not.
GUIDELINE FOR DIARY-JOURNAL (20%)
The purpose of the diary is

 To show that you recognize ethical and legal problems in yourpractice

 To show that you understood what you read in your required self-selected reading
 To show how it affected your thoughts, feelings, and actions inyour nursing
practice.

The Diary-Journal is a log of the ethical/legal aspects of your practicewith

patients during the semester. It contains 4 things:

1. The learners have to choose one of the patients that you care for as a learners in
your clinical courses per week. For each of these patients, identify at least one
ethical or legal issue related to their nursing care and describe it fully in your journal,
giving the relevant details of the legal or ethical nursing problem in the patient's
situation.
2. Learners are required to read text listed for each class, to explore articles and books
of their choosing, and to self-select the reading material. In your journal state what
you read and the date when you read it. Then give a summary of what you read and
write down how it affected your thoughts, feelings, values or actions in your practice
witha specific patient during the following week.
3. At the end of journal, learners have to choose 1 of the nursing ethical obligation
identified in one of the patient situations which have been written in journal. Then
carefully describe the ethical or moral responsibilities, rights, and obligations we
have in the situation. Give citations from additional readings to support the answer.
State the lessons learned from this experience.

References:
1. Aiken T. D & Catalano, J. L (1994) Legal, Ethical and Political Issuesin Nursing.
Philadelphia F. A. Davis
2. Austin, W (2001) using the Human Rights Paradigm, in Health Ethics:The problems
& The possibilities. Nursing Ethics 8(3) pg 183-193.
3. Bandman & Bandman (1995). Nursing Ethics through the life span(3rd ed.) New-
York: Appleton & Lange.
4. Barnes, J (2002) when, Life ever should The State Be Able to medicate or mentally
ill person against her will [on-line]. Available: http:// can. gser.
 42

edu/sba/docket/mentally-ill.htm.
5. Beauchamp T. L. and Childress, J. F (2002) Principles of Bio medical Ethics (5th ed)
New-York Oxford
6. Breier-Mackie, S (2001) patient Antomony & Medical Paternity: Can nurses help
doctor to listen to patient. Nursing Ethics. (6) pg 510-519
7. Burkhardt, M. A. & Nathaniel, A. K. (1998). Ethics & Issue: In Contemporary Nursing.
Delmar: ITP.
8. Carter. M. (1999) Betrayard of Trust. Nursing Times. August 11, 95(32) pg. 34-35.
9 Chally, P. M. (1998). Decision making in practice. American Journalof Nursing, 6
(98). pg. 17-20
10. DeLaune, S. C. & Ladner, P. K. (1998). Fundamentals of NursingStandards &
Practise. Delmar, ITP.
11. Davis, A. J. and Aroskar, M. A., (1991). Ethical dilemmas and nursingpractice. (3rd
ed.)
12. Gallagher, E. Etall. (1998). “To enrich bio-ethics, add one part socialto one part
clinical.
13. Bio-ethics & society: Constructing the ethical enterprise. Englewoodcliffs, NJ:
Prentice hall. pg 166-191.
14. Glen; S & Jownally; S (1995) Privacy. A key Nursing concept.British Journal of
Nursing. Vol 4 (2) pg 69-72.
15. Green, C. (1999) Confidentiality & the law. Nursing times. February 5 (7) pg.53-55.
16. Gulley, S (1999). Dealing with the dilemmas of confidentiality. Nursing Times.
January 6, 95(11).
17 Hallstrom, I. & Elander, G. (2001). Needs During Hospitalization: Defination &
Description made by patient. Nursing Ethics. 8(5) pg 409-417.
18. Hyder, A.a. & Nadeem, S, (2001) Health Ethics in Pakistn: A Literature Review of its
present state. Journal of Health Population Nutrition. March 19 (1) 6-11
19 Joy Curtis, M. B. (1992). Ethics in Nursing (3rd ed.)
20. Kenworthy, N., Snowley, G., & Gilling, C. (1992). Common Foundation studies in
Nursing: Churchill Living Stone: New York.
21. Kozier, & Erb, G. (1995). Fundamentals of Nursing: Concepts and procedures, (5th
ed.) California. Addison-Wesley.
22. Mc Hale, J., Gallagher, A & Marson, I (2001). The U.K Human Rights Act 1998:
Implication for Nurses. Nursing Ethics 8 93) pg. 221-232.
23. Merakou.K, Dalla-Vorgia.P, Garanis-Papadatos.T, Kourea- Kremastinou. J (2001),
Satisfying patients’ rights: A hospital patient survey. Nursing Ethics 8 (6) pg.499-
507.
24. Merakou, K., Dalta Vorgia, P., Garanis Papadatos, T. & Kourea Kremastinon, J.
(2001) satisfying patient’s Rights: A Hospital patient survery. Nursing Ethics. 8 (6)
pg. 499-507
25. Moazam, F (2000) Families Patient & Physician in Medical Decisionmaking: A
Pakistani
26. Perspective Hasting Center Report November-December pg. 28-37.
27. Neal, K. (2000). Can nurses refuse to care for a patient? NursingTimes
 43

January 27, 96 (4) pg. 31.

28. Potter, P. A & Perry, A. G. (2003). Basic Nursing: Essential forPractice. 5th (ed).
Mosby.
29. Potter, P. & Perry. A (1993). Fundamental of Nursing: Concept,Process & Practice,
3rd ed. Toronto. Mosby.
30. Pattison, S (2001). Are Nursing codes of practice Ethical. Nursing Ethics. 8 (1) pg 5-
17.
31. Raja, A. J. & Wikler, D (2001). Developing Bio Ethics in Developing countries. J.
Health Population Nutrition. 19 (1): 4-5
32. Roger, B (2002). Honesty and Ethics in the professions; Gallup Poll results. AAOHN
Journal .April 50 (4) pg 167-169
33. Thiel. G. V. & Delden J. V. (2001) The principles of Respect for autonomy in
the care of nursing home Residents. Nursing Ethics 8 (5)pg. 419-431.