School of Health Sciences Faculty: E-mail: CE Office Phone #: CE Office Fax #:

(416) 675-6622 Ext. 4868 (416) 675-2015

COURSE OUTLINE ACADEMIC YEAR 2012-2013

It is the student's responsibility to retain course outlines for possible future use in support of applications for transfer credit to other educational institutions. This material is the property of Humber College Institute of Technology and Advanced Learning and may be printed for course reference. This material shall not be photocopied or reproduced, in any other format, for any other purpose. Copyright 2012-2013.

PROGRAM: COURSE NUMBER/NAME: PRE-REQUISITE(S): PRE-REQUISITE FOR:

NEPHROLOGY NURSING

CONTINUING EDUCATION, NURSING

NEPH 201 ONLINE NEPHROLOGY NURSING II

RN - CNO CERTIFICATE OF COMPETENCE

NEPHROLOGY NURSING I - NEPH 101 NEPHROLOGY III - NEPH 301 PATIENT ASSESSMENT (POST 107) or EQUIVALENT IS REQUIRED PRIOR TO CLINICAL TO COMPLETE THE NEPHROLOGY NURSING CERTIFICATE

CREDIT VALUE: TOTAL HOURS: DIRECTOR, CONTINUING EDUCATION: APPROVED BY: I COURSE DESCRIPTION

4 60 Pamela Richardson RN BA MA(Ed) pamela.richardson@humber.ca ASSOCIATE DEAN

This course is designed to provide additional theory in nephrology nursing. Emphasis will be on the care of the patient with End-Stage Renal Disease (ESRD) and the application of peritoneal dialysis based on current management with Intermittent Peritoneal Dialysis (IPD), Continuous Ambulatory Peritoneal Dialysis (CAPD), and Continuous Cyclic Peritoneal Dialysis (CCPD). In addition, infection control, peritonitis, nutritional aspects and special population groups will be presented. Opportunities to increase an understanding of adult education, counselling and developmental tasks of the special renal populations will be discussed. Students will have an opportunity to examine and critically analyze current issues affecting nephrology nursing practice and examine chronic complications and psychosocial adaptation to chronic disease.

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LEARNING OUTCOMES Upon completion of this course, the student will be able to: A. Core Outcomes 1. 2. 3. Incorporate knowledge acquired from Nephrology Level 1. Discuss the presentation of chronic uremic syndrome. Apply the principles of peritoneal dialysis to the current methods of peritoneal dialysis. Discuss the complications of peritoneal dialysis. Apply principles of learning to the individual requiring instruction in the performance of home peritoneal dialysis. Describe the nursing management of special population groups requiring peritoneal dialysis, (geriatric, pediatric patients, ESRD secondary to diabetes mellitus). Discuss aspects of adaptation to chronic disease and coping strategies. Develop counselling strategies for the individual and family members involved in peritoneal dialysis programmes.

4. 5.

6.

7. 8.

B.

Generic/Employability Skills Outcomes 9. 10. Describe the pathophysiology of End-Stage Renal Disease. Discuss the advantages and disadvantages of the current methods of peritoneal dialysis. Examine nursing skills related to the performance of peritoneal dialysis. Develop an awareness of the personal value system and its significance related to ethical issues of peritoneal dialysis. Review current literature in ESRD and management with peritoneal dialysis. Deliver a clear concise presentation of specific topics relating to the renal client.

11. 12.

13.

14.

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COURSE CONTENT
Topic No. No. of Hours

Topic

Resources

1 2

Introduction to Nephrology Nursing II Pathophysiology presentation diagnosis and management: Glomerulopathies - Mechanisms of Glomerulopathies - Classification of Glomerulopathies - Specific types of Glomerulopathies - Nephrotic Pattern with Hematuria - Hematuria with Nephrotic Pattern Heredity - Cystic disorders - Metabolic disorders - Other Other - Hypertensive Disorders - Obstructive Disorders - Infective Disorders - Cardiac Related Online Discussion

1 6

End Stage Renal Disease (ESRD) Uremia Manifestations Endocrine Disturbances Complications Associated With Uremic Syndrome

Case Studies

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Topic No.

Topic

Resources

No. of Hours

4 5 6

Pharmacology Diet Therapy Peritoneal Dialysis - Intermittent Peritoneal Dialysis (IPD) - Continuous Ambulatory Peritoneal Dialysis (CAPD) - Anatomy & Physiology-Peritoneum - Membrane Permeability - Transport Mechanism - Models of Peritoneal Dialysis - Ultrafiltration Profile Factors Affecting Dialysis Efficiency - Factors Related to Technique - Dialysate Composition - Drug Effects - Microcirculatory Effects - Interstitial Factors and Fluid Films - Mesothial Factors - Ultrafiltration Factors - Other Factors Clinical Application of Peritoneal Dialysis Access - Acute Catheter Implantation - Nursing Assessment & Management - Discontinuing Acute Dialysis Indwelling Catheters - Catheter Design - Patient Preparation - Implantation Technique - Complications - Nursing Assessment & Management - Long Term Complications - Surgical Implantation

Online Discussion Online Discussion Online Discussion

3 2 3

Online Discussion

Online Discussion

Online Discussion

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Topic No.

Topic

Resources

No. of Hours

10 11 12

Clinical Application of Peritoneal Dialysis Risks Associated With Dialysis Clinical Application of Peritoneal Dialysis Modalities Intermittent Peritoneal Dialysis (IPD) - Concepts - Patient Selection - IPD Clinical Management - Automated Peritoneal Dialysis - Complications Associated With Acute IPD and Management - Complications Associated With Chronic IPD and Management - Nursing Management CAPD Concepts and Advantages - Clearance Factors - Ultrafiltration Rate - Glucose Absorption - Fluid & Electrolyte Balance - Control of Hypertension - Control of Anemia - Patient Selection - Contraindications - Continuous Cyclic Peritoneal Dialysis CAPD Clinical Application CAPD Self-Care Approach Nutritional Assessment and Peritoneal Dialysis - Components of Nutritional Assessments - Alterations in Metabolism with Peritoneal Dialysis - Nutritional Management

Online Discussion Case Studies Case Studies

2 2 3

13

Case Studies

14 15 16

Online Discussion Case Studies Online Discussion

2 2 3

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Topic No.

Topic

Resources

No. of Hours

17

18

19

Infection Control in Peritoneal Dialysis - Asepsis - High-Risk Populations Peritonitis - Incidence - Clinical Presentation - Clinical Course - Pathogenesis - Causative Organism - Diagnosis - Treatment - Complications of Peritonitis - Mortality - Prevention - Nursing Management Peritoneal Dialysis In Special Populations: Diabetes Mellitus Population Adaptation to Chronic Disease and Dialysis - Stresses - Coping Mechanism - Theories of Adaptation - Resources Counselling For Dialysis Populations - Counselling - Family dynamics Current Methods of Peritoneal Dialysis - biochemical - physiological - psychological - economical

Online Discussion Case Studies

7 Discussion Case Studies Discussion 2

20

21

Group Discussion Discussion

22

The topics, their order, and length of time spent on each may vary depending on the interest and needs of each group

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EVALUATION PROCEDURE
Type of Assignment Learning Outcome # Date Due Weighting %

1. 2. 3. 4.

Participation Assignment Mid-Term Exam Final Exam TOTAL:

10% 15% 25% 50% 100%

Assignments received after the scheduled dates are subject to a late penalty of 20%. The student will not have the opportunity to write the mid-term test if she/he is absent on the assigned day of the test. The final comprehensive examination will then be assigned a greater weight, (i.e. if the mid-term test is worth 20%, and the final comprehensive is worth 70%, then the final comprehensive examination will be worth 90% of the total grade). A final grade of 60% must be obtained to successfully complete the NEPH 201 course. If a grade of 50-59% is obtained, the student is eligible to write a supplemental exam. To write this exam the student must make arrangements with the instructor. Current Provincial registration to practice from the College of Nurses is required for this course see critical path/schedule. Failure to show proof of current registration will lead to a final grade of zero. If temporary registration is submitted, final grades will be held for three months then will revert to a zero grade.
To obtain an electronic copy for submission: Step-By-Step Guide How To Print Your Nursing Registration Information
These instructions are to guide nurses who are registered in Ontario. Print this page to have it beside you as you go through the steps. 1. Visit the College of Ontario Nurses web site, at http://www.cno.org/ 2. Under the section Find a Nurse, click on the button titled Search for a nurse. 3. At the Welcome page, you will be prompted to acknowledge reading and understanding the Terms of Use, and also to enter a security validation phrase. After this click on the button titled Start Searching. 4. At the Search by Name page, place your cursor in the First Name field, and type in your first name. 5. Next, place your cursor in the Last Name field, and type in your last name. 6. It is not necessary to type in your Facility or City.

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7. It is suggested to leave the fields Type and Class as is, which reads All. 8. Click on the button titled Search. 9. A Results page will display. One or more names may be displayed. The name(s) should appear in a different colour, and is a clickable link. Recognize and click on your name. 10. The next screen is titled Nurse Details. There is a Print button in the top right area of the screen. Click on the Print button. (not your web browser's print button, instead use the print button on the CNO web page). 11. A new browser window should open. This is the page to print and fax into the College. The page displays a date stamp as to when the information was obtained. The following type of information is visible on this page. a. your name

b. whether you are entitled to practice c. your category, class, registration number, status

d. your registration history and e. your contact information

12. Print this page, either using your web browser's print icon, or simply right-click your mouse and select Print.

PLAGIARISM
PLAGIARISM is a serious academic offence. Students are encouraged to reveiw this with their instructor if there is any question or concern regarding plagiarism in assignments and academic papers. Students are encouraged to submit their written work to an Electronic Plagiarism Detection Service to support their learning and offer opportunities for them to review their assignments for appropriate citation of sources prior to submitting the assignment. When an instructor has reason to suspect that an individual piece of work has been plagiarized, the instructor shall be permitted to submit that work to any plagiarism detection service.

REQUIRED TEXTS AND OTHER LEARNING MATERIALS

American Nephrology Nurses Association, (2007). Contemporary nephrology nursing. 3rd Edition. Janel Parker, Editor. Additional References Koeppen, B.M. (2007). Renal physiology. 4th Edition. St. Louis. Mosby. Smith, T. (2007). 2nd Edition. Renal nursing. Philadelphia. London. Bailliere. Tindall. Journals American Journal of Nursing Nursing 2004
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Journal of Advanced Nursing Nephrology Nursing Journal

American Journal of Kidney Diseases

ANNA Journal

VI

DELIVERY FORMAT This is a online course with internet support utilizing Blackboard. Lectures Presentations Discussions

VII

POLICIES AND PROCEDURES It is the students responsibility to be aware of the Colleges Academic Regulations and Rights. Refer to the CE Nursing policies and procedures for supplementary tests, examinations or projects.
http://parttimestudents.humber.ca/ce_student_handbook.pdf

http://fulltimestudents.humber.ca/academicregulations.htm VIII ACADEMIC CONCERNS/APPEALS Students having an academic concern or questioning an academic decision should first discuss the matter directly with their professor; then with the program coordinator if the issue cannot be resolved; then with the Dean (or designate) if the prior two steps were unsuccessful. Reference should be made to the Colleges Academic Complaint and Appeal Policy. IX PRIOR LEARNING ASSESSMENT AND RECOGNITION (PLAR) Course credits may be granted in recognition of prior learning. Application is made through the office of the Registrar. Visit our web site at www.humber.ca for an application form. Click on admissions and registration and follow the instructions. Click on your future. A fee will be charged for each challenge/exemption.
Challenge Exam Portfolio Skills Test Interview Other (Specify) Not Available For PLAR

DISCLAIMER While every effort is made by the professor to cover all material listed in the outline, the order, content, and/or evaluation may change in the event of special circumstances (e.g. time constraints due to inclement weather, sickness, closure, technology/equipment problems or changes, etc.). In any case, students will be given appropriate notification in writing, with approval from the Dean (or designate) of the School. It is the responsibility of each student to be knowledgeable of the Humber Academic
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Regulations, the Program Academic Regulations and the Charter of Rights.

ACADEMIC POLICIES STANDARDS All written work should be clear, concise, and correct. PLAGIARISM AND CHEATING Plagiarism is the serious offence of academic fraud that involves using someone elses words and/or ideas in whole or in part from any printed or electronic media without documentation. Cheating is the serious offence of academic fraud that involves obtaining answers to exam and test questions through unauthorized means, such as hidden or electronic notes or copying from another student. Any student who plagiarizes or cheats will be required to meet with the Associate Dean, who may assign a grade of 0% and notify the Registrars Office that academic misconduct has occurred. On the second offence, the student may be withdrawn from the program, and an official notation of academic misconduct will be placed on the students academic record. For a complete description of Academic Misconduct, processes and penalties, please refer to section 12 of the Academic Regulations available on the Registrarial website. www.humber.ca/academic-regulations
DROPPING A COURSE

It is the responsibility of students who wish to drop this course to notify the teacher and the Office of the Registrar. Information regarding dropping a course is available in the Registrars Office, the divisional offices, and the Continuing Education Calendar and is outlined on the reverse side of the Continuing Education Admit to Class forms. STUDENT FILES/APPEAL PROCEDURES It is the students responsibility to keep copies of all their work in the course. Informal resolution process When students disagree with a grade or any academic decision, they should discuss the matter with the faculty member in an effort to reach a resolution. If this step is not successful, students should discuss the problem with the Coordinator. If the matter is still not resolved, the next person to contact is the Associate Dean. Formal resolution process
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Processes regarding formal requests for reassessment of in-course work and formal appeals of academic decisions are described in the Academic Regulations. STUDENTS WITH DISABILITIES Students who have, or suspect they may have, a disabling condition are strongly encouraged to register with Services for Students with Disabilities so that they may access accommodative service and resources. Disabling conditions include: learning disabilities; impairments of hearing, vision or mobility; mental illnesses or psychological conditions; Attention Deficit Disorder (ADD); brain injuries, and medical conditions. To register with Services for Students with Disabilities, visit room B112, or call 416-6756622, ext. 5180 for an appointment. ACADEMIC REGULATIONS Students have the responsibility for being aware of regulations. These regulations are available at course registration time and at any time throughout the semester from the Registrars Office or from the Humber website at http://www.humber.ca/academicregulations
STUDENT/FACULTY CONSULTATION OUTSIDE OF CLASSROOM HOURS

It is the responsibility of the teacher to be available for consultation with students outside of classroom hours. Teacher and student timetables may vary significantly; as a result, a consultation time will have to be arranged that is mutually agreeable to both the teacher and student. Arrangements to meet with a teacher outside of classroom hours should be made during regularly scheduled classes. EXTRA HELP a) The Writing Centre: The Writing Centre, located in GH202 in the Guelph-Humber building at the North Campus (416-675-6622, ext. 6258) and in F201 at the Lakeshore Campus (416-675-6622, ext. 3313), is available Monday to Friday to give students help with English outside class. Staff in the Writing Centre can explain points of grammar and provide practice exercises. They can also explain errors in writing and suggest ways for students to improve their writing. If the Writing Centre staffs are busy helping other students, an appointment for a quieter time can be made. Weekly appointments for extra help may also be arranged. Ask in the Centre about this semesters hours. b) Peer Tutoring: A peer tutor is a Humber student who can meet with students for one or two hours per week to help with the course. For a small administration fee ($10), students receive eight one-hour tutoring sessions. Apply for a tutor in Room B112 at the North Campus (416-675-6622, ext. 4616) or in Room A120 at the Lakeshore Campus (416-675-6622, ext. 3331.)

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- 12 This material shall not be photocopied or reproduced, in any other format, for any other purpose. Copyright 2012-2013.