F.L.

VARGAS COLLEGE
Bagay Road, Caritan Centro
Tuguegarao City, Cagayan Valley
COLLEGE OF HEALTH SCIENCES

Course Name : CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND ELECTROLYTE BALANCE, NUTRITION AND METABOLISM AND ENDOCRINE
Course Code : NCM 103
Course Description : This course deals with the principles and techniques of nursing care management of sick clients across lifespan with emphasis on the adult and
the older person,
population group in any setting with alterations/problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism and endocrine
function.
Course Credit : 8 units lecture; 6 units RLE (1 unit skills lab, 5 units Clinical)
Contact Hours/ Semester : 144 lecture hours; 306 RLE hours
Pre-requisite : NCM 102
Placement : 3
rd
year, 1
st
semester
Course Objectives : At the end of the course and given relevant actual clients with problems in oxygenation, fluid and electrolyte balance, nutrition and metabolism,
and endocrine
function, the student should be able to:
1. Utilize the nursing process in the care of individuals, families in community and hospital settings.
Assess with client/s his/her/their condition/health status through interview, physical examination, interpretation of laboratory
findings.
Identify actual and at-risk nursing diagnosis
Plan appropriate nursing interventions with client/s and family for identified nursing diagnosis
Implement plan of care with client/s and family.
Evaluate the progress of his/her/their clients condition and outcomes of care.
2. Ensure a well organized and accurate documentation system;
3. Relate with client/s and their family and the health team appropriately;
4. Observe bioethical concepts/principles, core values and nursing standards in the care of clients; and,
5. Promote personal and professional growth of self and others.

OBJECTIVES INTERMEDIATE
COMPETENCIES
COURSE CONTENT TEACHING-LEARNING
ACTIVITIES
VALUES
INTEGRATION
TIME
FRAME
EVALUATION
At the end of the lecture
discussion, the students
will be able to:
1. Utilize the nursing
process in the care of
1. Identify risk factors among
clients that contribute to the
development of problems in
Oxygenation- cardiovascular
risk factors (modifiable and
The different risk factors among clients that
contribute to the development of problems in
oxygenation:
Current respiratory problems
History of respiratory disease


Pre-tests
Case Analysis
Small Group


Assertiveness
Cooperation
Participation


2.5 hours

After the discussion, the
students will be able to
identify the modifiable and
non-modifiable risk factors
individuals, families
with problems in
oxygenation in
community and
hospital settings;
2. Ensure a well
organized and
accurate
documentation
system;
3. Relate with client/s
and their family and
the health team
appropriately;
4. Observe bioethical
concepts/principles,
core values and
nursing standards in
the care of clients;
and,
5. Promote personal
and professional
growth of self and
others.

non-modifiable).

Lifestyle (smoking, alcoholism, exercise
patterns)
Presence of cough
Presence of Chest Pain
Lung Cancer
Cardiovascular disease
Stroke
Tuberculosis
Obesity
Dietary assessment
Medication history
Learning
Lecture Discussion
Post test


Sensitivity

that contribute to the
development of problems
in oxygenation.
2. Identify significant
subjective data from client
history related to problems
in oxygenation.
a. Chief complaints
b. Relevant information, to include eleven
functional patterns
Health perception management pattern
Nutritional/metabolic pattern
Elimination pattern
Activity/exercise patterns
Cognitive/perceptual pattern
Sleep-rest pattern
Self-perception-self-concept pattern
Role relationship pattern
Sexuality-reproductive pattern
Coping-stress tolerance pattern
Value-belief pattern

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Postl test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours

The students should be
able to identify significant
subjective data from
clients history by
enumerating the possible
chief complaints and
recording relevant
information guided by the
eleven functional patterns.
3. Enumerate the principles
and techniques of physical
examination in assessing
the oxygenation status in
newborn, children, adults.
a. Inspection- gas exchange, perfusion
b. Palpation- gas exchange, perfusion
c. Percussion- gas exchange
d. Auscultation- gas exchange- heart sound, breath
sounds, deviations, fluid transport

Demonstration
Return
Demonstration
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

3 hours The students will be able to
perform the proper
techniques in physical
examination and apply the
principles in correctly
assessing the newborn,
children, and adults
oxygen status by
comparing any deviations
from normal findings.
4. Identify results and
implications of
diagnostic/laboratory
examinations of clients
with reference to
problems in Oxygenation.
Screening procedure- peak flow meter
Diagnostic Procedures
Non-invasive:
Pulmonary: e.g. sputum microscopy, chest x-
ray, pulmonary function tests, smoke analyzer
Fagerstrom test standardized degree of
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test
Assertiveness
Cooperation
Participation
Sensitivity

2.5 hours Given actual laboratory
results of a patient, the
student should be able to
identify deviations from
normal findings.
nicotine dependence
Cardiac: ultrasound, ECG, 2-D echo, stress test
Vascular: Doppler ultrasonography
Blood: pulse oximeter
Invasive:
Pulmonary: bronchoscopy, ABG, 3horacentesis,
pulmonary angiography
Cardiac: CO determination, cardiac
catheterization, CVP, hemodynamics
monitoring, enzyme levels, Serum, Cholesterol
Vascular: angiography
Blood: CBC and bone marrow biopsy

5. Determine the Patho-
physiologic mechanisms of
the Alterations in
oxygenation

a. Alteration in gas exchange ventilator
dysfunction, impaired perfusion
b. Alteration in cardiac performance heart rate
problems, impaired stroke volume secondary
to altered preload, afterload, myocardial
contractility
c. Alteration in vascular integrity transport
network impairment
d. Alteration in oxygen carrying capacity of the
blood- decreased circulating erythrocytes
(anemia), increased circulating erythrocytes
(polycythemia)
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

16 hours The students should be
able to determine the
patho-physiologic
mechanisms in the
different oxygenation
problems.
6. Enumerate Nursing
diagnoses taxonomy
pertinent to
problems/alteration in
Oxygenation.

a. Ineffective breathing pattern
b. Ineffective airway clearance
c. Impaired gas exchange
d. Inability to sustain spontaneous
ventilation
e. Dysfunctional 3entilatory weaning
response
f. Decreased cardiac output (CO)
g. Altered tissue perfusion systemic
h. Impaired gas exchange related to
altered O2 carrying capacity of blood
due to decreased
erythrocytes/hemoglobin
i. Activity intolerance related to
malnutrition tissue hypoxia
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students should be
able to identify possible
nursing diagnoses
taxonomy pertinent to the
derived assessment data to
pertinent problems in
oxygenation.
7. Identify principles of various
modalities of management
of clients with problems in
oxygenation taking into
a. For altered pulmonary function:
Airway patency
Oxygen therapy
Adequate ventilation
Pre-tests
Case Analysis
Small Group
Learning
Assertiveness
Cooperation
Participation
Sensitivity
4 hours The students should be
able to apply the various
principles in the
management of clients
consideration the following
levels of care:
1. Health promotive
2. Disease
preventive
3. Curative and
restorative

Drug therapy
Hydration
Removal of secretion
Prevention of infection
Prevention of complications
Prevention of psychosocial problems
Rehabilitation
b. For cardiac function
Hemodynamics monitoring
O2 therapy
Drug therapy
Hydration
Prevention of infection
Prevention of complications
Prevention of psychosocial problems
Rehabilitation
c. Oxygen carrying capacity of the blood
Blood component replacement
O2 therapy
Drug therapy
Hydration
Prevention of infection
Prevention of complications
Lecture Discussion
Post test

with problems in
oxygenation in the
actual clinical nursing
practice.
The students should be
able to provide the
patients/clients with the
proper teachings on
health promotion,
disease prevention and
curative and health
restoration.
8. Enumerate
Pharmacologic actions,
therapeutic uses, side
effects, indications,
contraindications, and
nursing responsibilities in
administering medications
clients with oxygenation
problems.

a. Pulmonary
Bronchodilators
Expectorants
Antitussives
Antihistamines
b. Cardiac
Sympathomymetic agents
Sympatholytic agents
Anti-anginal agents
Anti- arrhythmic agents
Angiotensin converting enzyme inhibitors
Antilipemic agents
Anticoagulant agents
Thrombolytics
Peripheral vascular agents
c. Blood
Hematinics
Vitamin supplements

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students should be
able to enumerate the
different pulmonary,
cardiac, blood medications,
with their corresponding
pharmacologic actions,
therapeutic uses, side
effects, indications and
contraindications and
nursing responsibilities in
the different medications
of clients with oxygenation
problems.
9. List the purposes,
indications, nursing
responsibilities for the
surgical and special
procedures in alterations in
oxygenation.

1. Safe and comprehensive perioperative nursing
care
1.1 Assessment and care during the
perioperative period
1.2 Techniques in assisting the surgical team
during the operation
1.3 Principles of safety, comfort and privacy
during the perioperative period
1.4 Nursing responsibilities during the
perioperative period
Preoperative physical,
psychological, spiritual preparation
Intraoperative circulating nurse
functions, scrub nurse functions
Postoperative airway, breathings,
circulation priorities. Meeting the
physical, psychological and spiritual
needs of the cliet.
2. Pulmonary
a. Surgical procedures tracheostomy,
thoracostomy, lung resection, lobectomy,
pneumonectomy, thoracoplasty,
decortications
b. Special procedures endotrcheal/tracheal
suctioning and care, humidication, IPPB,
ventilator assist
3. Cardiac
a. Surgical procedures coronary aretery bypass,
pacemaker insertion, valve replacement,
repair of congenital abnormality, insertion of
ventricular assist device, heart plansplant
b. Special procedures laser therapy, basic life
support, advance life support
3.1 Vascular
a. Surgical procedures endarterectomy,
aneurysmectomy, insertion of intravascular
stents
b. Special procedures application of
antiembolic stockings
3.2 Blood forming organs
a. Surgical procedures bone marrow
aspiration, bone marrow transplant
b. Special procedures blood component
transfusion, reverse isolation
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students will be able to
list the different surgical
and special procedures for
clients with oxygenation
problems and identify the
nursing responsibilities in
each procedure.
At the end of the lecture
discussion, the students
will be able to:
1. Utilize the nursing
process in the care of
individuals, families
with problems in
Fluids and electrolyte
imbalances in
community and
hospital settings.
2. Ensure a well
organized and
accurate
documentation
system;
3. Relate with client/s
and their family and
the health team
appropriately;
4. Observe bioethical
concepts/principles,
core values and
nursing standards in
the care of clients;
and,
5. Promote personal and
professional growth of
self and others.
10. Identify risk factors
among clients that
contribute to the
development of problems in
Fluid and Electrolytes.
Potential factors for exceeding renal reserve
capacity, dietary habits to include salt intake,
hypertension, infection, diabetes.
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test
Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours After the discussion, the
students will be able to
identify the modifiable and
non-modifiable risk factors
that contribute to the
development of problems
in fluid and electrolyte
imbalances.
11. Enumerate the
principles and techniques of
physical examination in
newborn, children, adults,
deviations from normal.

Inspection- signs of dehydration, overhydration
Palpation- edema, ascites, neck vein filling, hand
vein filling, neuromuscular irritability,
characteristic of pulse
Percussion- abdomen for presence of air, fluid
Auscultation- rates
Demonstration
Return
Demonstration
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students will be able to
perform the proper
techniques in physical
examination and apply the
principles in correctly
assessing the newborn,
children, and adults fluids
and electrolyte balance
status by comparing any
deviations from normal
findings.
12. Identify results and
implications of
diagnostic/laboratory
examinations of clients
with reference to
problems in
a. Diagnostic tests
Non-invasive: electrolyte determination, intake
and output, KUB-IVP and ultrasound
Invasive biopsy
b. Weight
c. Vital Signs
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours Given actual laboratory
results of a patient, the
student should be able to
identify deviations from
normal findings.
13. Determine the Patho-
physiologic Mechanisms of
Fluid and electrolyte
imbalances.
a. Volume impairment fluid volume deficit, fluid
volume excess, third space fluid shift
b. Osmotic imbalances hyponatremia,
hypernatremia
c. Ionic concentration problems hypo- and
hyperkalemia; hypo and hyperchloremia; hypo-
and hypermagnesemia; hypo- and
hyperphosphatemia
d. Acid and base imbalances metabolic acidosis
and alkalosis; respiratory acidosis and alkalosis

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

12 hours The students should be
able to determine the
patho-physiologic
mechanisms in the
different fluid and
electrolyte imbalances.
14. Enumerate Nursing
diagnoses taxonomy
pertinent to
problems/alteration in
Fluid and electrolyte
imbalance.
a. Risk for fluid volume deficit
b. Fluid volume excess
c. Fluid volume deficit
d. High risk for injury related to electrolyte
deficit/excess
e. High risk for injury related to acid/base
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test
Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students should be
able to identify possible
nursing diagnoses
taxonomy pertinent to the
derived assessment data to
pertinent problems in fluid
imbalance
f. Altered urinary elimination
g. Impaired integumentary integrity
and electrolyte imbalances.
15. Identify principles of various
modalities of management
of clients with problems in
fluid and electrolyte
imbalances taking into
consideration the following
levels of care:
a. Health promotive
b. Disease preventive
c. Curative and
restorative

a. Fluid Volume Deficit
Determination and management of
cause
Hydration
Blood transfusion as needed
Drug therapy electrolyte
Supportive management
Prevention of infection
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
b. Fluid Volume Excess
Determination and management of
cause
Drug therapy diuretics, electrolytes
Dietary restriction sodium
Supportive management
Prevention of infection
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
c. Electrolyte Deficit hyponatremia,
hypokalemia, hypocalcemia,
hypomagnesemia, hypophosphatemia
Determination and management of
cause
Drug therapy electrolyte replacement
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
d. Electrolyte Excess hyperkalemia,
7ypercalcaemia, hypermagnesemia,
hyperphosphatemia
Determination and management of
cause
Drug therapy electrolyte replacement
Dietary management
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

12 hours The students should be
able to apply the various
principles in the
management of clients
with problems in fluid
and electrolyte
imbalance in the actual
clinical nursing practice.
The students should be
able to provide the
patients/clients with the
proper teachings on
health promotion,
disease prevention and
curative and health
restoration.
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
e. Metabolic Alkalosis Base bicarbonate exces
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
a. Metabolic Acidosis- base
bicarbonate deficit
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
f. Respiratory Alkalosis carbonic and acid
deficit
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
g. Respiratory Acidosis carbonic acid excess
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
16. Enumerate
Pharmacologic actions,
therapeutic uses, side effects,
indications, contraindications,
and nursing responsibilities in
administering medications
clients in fluid and electrolyte
imbalances.

a. Fluid
Parenteral fluids
Hypotonic
Hypertonic
Isotonic
b. Electrolyte
Sodium
Potassium
Calcium
Magnesium
Phosphate
c. diuretics
Potassium-sparing
Potasium-losing
Osmotic diuretics
d. Vitamin D supplements
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2.5 hours The students should be
able to enumerate the
different medications in
managing clients with fluid
and electrolyte imbalances,
with their corresponding
pharmacologic actions,
therapeutic uses, side
effects, indications and
contraindications and
nursing responsibilities in
the different medications.
17. List the purposes,
indications, nursing
responsibilities for the
surgical and special
procedures in alterations in
fluid and electrolyte
imbalances.

Renal dysfunction
a. Major surgical procedures
nephrectomy, nephrostomy,
cystectomy, uterostomy, renal
transplants, urinary diversion
b. Special procedures- peritoneal dialysis,
hemodialysis, bladder training,
cystoclysis/bladder irrigation
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2.5 hours The students will be able to
list the different surgical
and special procedures for
clients with fluid and
electrolyte imbalance and
identify the nursing
responsibilities in each
procedure.
At the end of the lecture
discussion, the students
will be able to:
1. Utilize the nursing
process in the care of
individuals, families
with problems in
nutrition and
metabolism in
community and
hospital settings.
2. Ensure a well
organized and
accurate
documentation
system;
3. Relate with client/s
and their family and
the health team
18. Identify risk factors
among clients that
contribute to the
development of problems
in Nutrition and
Metabolism.
Risk factors related to malnutrition, obesity.

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1 hour After the discussion, the
students will be able to
identify the modifiable and
non-modifiable risk factors
that contribute to the
development of problems
in nutrition and
metabolism.
19. Identify significant
subjective data from client
history related to problems
in nutrition and
metabolism.

a. Chief complaints
b. Relevant information, to include eleven
functional patterns
Health perception management pattern
Nutritional/metabolic pattern
Elimination pattern
Activity/exercise patterns
Cognitive/perceptual pattern
Sleep-rest pattern
Self-perception-self-concept pattern
Role relationship pattern
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students should be
able to identify significant
subjective data from
clients history by
enumerating the possible
chief complaints and
recording relevant
information guided by the
eleven functional patterns
appropriately;
4. Observe bioethical
concepts/principles,
core values and
nursing standards in
the care of clients;
and,
5. Promote personal and
professional growth of
self and others.
Sexuality-reproductive pattern
Coping-stress tolerance pattern
Value-belief pattern

20. Enumerate the
principles and techniques of
physical examination in
newborn, children, adults,
deviations from normal.

3.3 Gastrointestinal function IPPA
Inspection- color, texture of skin,
mucous membrane, growth patterns,
scars, masses
Auscultation- bowel sounds, bruits
Palpation focus on GIT for presence of
masses, ascites, rebound tenderness,
distention
Percussion liver span, masses
Demonstration
Return
Demonstration
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours The students will be able to
perform the proper
techniques in physical
examination and apply the
principles in correctly
assessing the newborn,
children, and adults
nutritional and metabolic
status by comparing any
deviations from normal
findings.
21. Identify results and
implications of
diagnostic/laboratory
examinations of clients
with reference to
problems in Nutrition and
Metabolism.

a. Non-invasive: ultrasound of the abdomen, stool
culture
b. Invasive: to include: barium swallow,
esophagoscopy, biopsy, cytology examination,
gastric secretion analysis, endoscopy
(gastroscopy, duodenoscopy),
proctosigmoidoscopy and rectal examination
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours Given actual laboratory
results of a patient, the
student should be able to
identify deviations from
normal findings.
22. Determine the Patho-
physiologic mechanisms of
the Alterations in Nutrition
and Metabolism.

a. Disturbances in ingestion problems in buccal
cavity and esophagus
b. Disturbances in digestion peptic acid disease,
gastritis and gastric cancer
c. Disturbances in absorption malnutrition,
malabsorption syndrome and inflammatory
bowel conditions
d. Disturbances in elimination bowel obstruction,
hemorrhoids, diarrhea and constipation.
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

12 hours The students should be
able to determine the
patho-physiologic
mechanisms in the
different nutritional and
metabolic problems.
23. Enumerate Nursing
diagnoses taxonomy
pertinent to
problems/alteration in
Nutrition and Metabolism.

a. Alteration in nutrition less than body requirement
b. Alteration in nutrition more than body
requirement
c. Alteration in oral mucous membrane integrity
d. Alteration in comfort: epigastric pain/abdominal
pain
e. Fluid volume deficit
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours The students should be
able to identify possible
nursing diagnoses
taxonomy pertinent to the
derived assessment data to
pertinent problems in
nutrition and metabolism.
24. Identify principles of various
modalities of management
of clients with problems in
Nutrition and Metabolism
A. Disturbances in ingestion
Determination and management of
cause
Drug therapy
Pre-tests
Case Analysis
Small Group
Learning
Assertiveness
Cooperation
Participation
Sensitivity
12 hours The students should be
able to apply the various
principles in the
management of clients
taking into consideration
the following levels of care:
4. Health promotive
5. Disease
preventive
6. Curative and
restorative

Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
B. Disturbances in digestion
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
C. Disturbances in absorption
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
D. Disturbances in elimination
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
E. Disturbances in hepatic, biliary and
pancreatic functions
Determination and management of
cause
Drug therapy
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation
Lecture Discussion
Post test

with problems in
nutrition and
metabolism in the actual
clinical nursing practice.
The students should be
able to provide the
patients/clients with the
proper teachings on
health promotion,
disease prevention and
curative and health
restoration.
25. Enumerate
Pharmacologic actions,
therapeutic uses, side
effects, indications,
contraindications, and
nursing responsibilities in
administering medications
clients with Nutrition and
Metabolism problems.

Antiemetics
Anticoagulants
Hematinics agents
Laxatives and stool softeners
Antipruritus
Vitamin supplement
Antacids
Antihyperlipidemics
Antispasmodics
Antidiarrheal
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students should be
able to enumerate the
different pulmonary,
cardiac, blood medications,
with their corresponding
pharmacologic actions,
therapeutic uses, side
effects, indications and
contraindications and
nursing responsibilities in
the different medications
of clients with nutrition
and metabolism disorders.
26. List the purposes,
indications, nursing
responsibilities for the
surgical and special
procedures in alterations in
Nutrition and Metabolism.

a. Surgical procedures gastrostomy, gastrectomy,
colostomy, hemorrhoidectomy, gastrointestinal
bypass, ileostomy
b. Special procedures parenteral
hyperalimentation; feeding per nasogastric,
jejunostomy, gastrostomy tubes; colostomy care
and irrigation, dietary planning for common GT
and endocrine problems; administering
medications via NGT, J tube, G tube; hot sitz bath
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2.5 hours The students will be able to
list the different surgical
and special procedures for
clients with nutrition and
metabolism problems and
identify the nursing
responsibilities in each
procedure.
At the end of the lecture
discussion, the students
will be able to:
1. Utilize the nursing
process in the care of
individuals, families
with problems in
endocrine functioning
in community and
hospital settings.
2. Ensure a well
organized and
accurate
documentation
system;
3. Relate with client/s
and their family and
the health team
appropriately;
4. Observe bioethical
concepts/principles,
27. Identify risk factors
among clients that
contribute to the
development of problems
in Endocrine Function.
Risk factors related to endocrine hypo or hyper-
functioning.

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours After the discussion, the
students will be able to
identify the modifiable and
non-modifiable risk factors
that contribute to the
development of problems
in endocrine functioning.
28. Identify significant
subjective data from client
history related to problems
in endocrine functioning.
A. Chief complaints
B. Relevant information, to include eleven
functional patterns
Health perception management pattern
Nutritional/metabolic pattern
Elimination pattern
Activity/exercise patterns
Cognitive/perceptual pattern
Sleep-rest pattern
Self-perception-self-concept pattern
Role relationship pattern
Sexuality-reproductive pattern
Coping-stress tolerance pattern
Value-belief pattern
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2 hours The students should be
able to identify significant
subjective data from
clients history by
enumerating the possible
chief complaints and
recording relevant
information guided by the
eleven functional patterns
core values and
nursing standards in
the care of clients;
and,
5. Promote personal
and professional
growth of self and
others.

29. Enumerate the
principles and
techniques of physical
examination in
newborn, children,
adults, deviations
from normal in the
endocrine system.

Inspection- color, texture of skin, mucous
membrane, growth patterns, obesity
Auscultation bruit, heart sounds, breath
sounds
Palpation- organ-thyroid enlargement, masses,
edema
Percussion- fluid, edema
Others weight, delayed healing of wounds
Demonstration
Return
Demonstration
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours The students will be able to
perform the proper
techniques in physical
examination and apply the
principles in correctly
assessing the newborn,
children, and adults
endocrine functioning by
comparing any deviations
from normal findings.
30. Identify results and
implications of
diagnostic/laboratory
examinations of clients
with reference to
problems in endocrine
functioning.

a. Screening: glucose tolerance test
Non-invasive: e.g. GI x-ray, ultrasound
abdomen, Radio-iodine assay (RAI), protein
bound iodine (PBI), thyroid scan, free thyroxin
level, basal metabolic rate (BMR), thyroxine
stimulating hormone (TSH) test, OGTT (Glucose
tolerance test) urinalysis (glycosuria, ketonuria)
Invasive: e.g. percutaneous transhepatic
cholangiogram, liver function test, serum
thyroxine and triiodothyronine test, iodine 131
uptake, blood sugar tests (fasting blood sugar
FBS), random blood sugar (RBS), glycosylated
hemoglobin (Hgb), two-hour post prandial
blood glucose, endocrine assay.
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2.5 hours Given actual laboratory
results of a patient, the
student should be able to
identify deviations from
normal findings.
31. Determine the Patho-
physiologic mechanisms of
the Alterations in
endocrine functioning.

a. Hypo- and Hyperfunction of the pituitary organ
b. Hypo- and Hyperfunction of the hypothalamus
c. Hypo- and Hyperfunction of the thyroid organ
d. Hypo- and Hyperfunction of the parathyroid
organ
e. Hypo- and Hyperfunction of the adrenal organ
f. Hypo- and Hyperfunction of the gonads
g. Problems in glucose metabolism hypoglycemia
and hyperglycemia (IDM, NIDDM)
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

10 hours The students should be
able to determine the
patho-physiologic
mechanisms in the
different endocrine
problems.
32. Enumerate Nursing
diagnoses taxonomy
pertinent to
problems/alteration in
endocrine functioning.
a. Alterations in nutrition less than body
requirement
b. Fluid volume deficit
c. Activity intolerance

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

1.5 hours The students should be
able to identify possible
nursing diagnoses
taxonomy pertinent to the
derived assessment data to
pertinent problems in
endocrine functioning.
33. Enumerate
Pharmacologic actions,
Corticosteroids
Alpha-adrenergic blocking agents
Pre-tests
Case Analysis
Assertiveness
Cooperation
2.5 hours The students should be
able to apply the various
therapeutic uses, side
effects, indications,
contraindications, and
nursing responsibilities in
administering medications
clients with endocrine
problems.

Beta-adrenergic blocking agents
Tyrosine inhibitors
Dopamine receptor antagonists
Glucocorticoids
Parathyroid hormone agents
Thyroid hormone agents
Insulin
Oral hypoglycemic agents

Small Group
Learning
Lecture Discussion
Post test

Participation
Sensitivity

principles in the
management of clients
with problems in
endocrine functioning in
the actual clinical
nursing practice.
The students should be
able to provide the
patients/clients with the
proper teachings on
health promotion,
disease prevention and
curative and health
restoration.
34. Identify principles of various
modalities of management
of clients with problems in
endocrine functioning
taking into consideration
the following levels of care:
a. Health promotive
b. Disease preventive
c. Curative and
restorative
Determination and management of cause
Drug therapy - diuretics, electrolytes
Dietary management
Supportive management
Prevention of complication
Prevention of psychosocial problems
Rehabilitation

Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

12 hours The students should be
able to enumerate the
different pulmonary,
cardiac, blood medications,
with their corresponding
pharmacologic actions,
therapeutic uses, side
effects, indications and
contraindications and
nursing responsibilities in
the different medications
of clients with endocrine
problems.
35. List the purposes,
indications, nursing
responsibilities for the
surgical and special
procedures in alterations in
endocrine functioning.

a. Surgical procedures thyroidectomy,
parathyroidectomy
b. Special procedures monitoring of
blood glucose levels; maintenance of
blood glucose diet, exercise, drugs
Pre-tests
Case Analysis
Small Group
Learning
Lecture Discussion
Post test

Assertiveness
Cooperation
Participation
Sensitivity

2.5 hours The students will be able to
list the different surgical
and special procedures for
clients with endocrine
problems and identify the
nursing responsibilities in
each procedure.
References:
1. Lippincott Williams & Wilkins. The Lippincott Manual of Nursing Practice 7
th
edition. 2001.
2. Marieb, Elaine N. Essentials of Human Anatomy and Physiology 8
th
edition. Pearson Education South Asia PTE. LTD. 2006
3. Brunner and Suddarth. Textbook of Medical-Surgical Nursing 12
th
edition. 2010





Prepared by: Recommending Approval:

FREIDA MICHELLE BONNIT-TAJA, RN, MAN KATLYN C. MANGUPAG, RN, MSN
Instructor OIC, COLLEGE OF HEALTH SCIENCES
Approved by:

MR. JOSEPH B. FURIGAY
Director for Instruction