CENTRAL TEXAS COLLEGE

Department of Nursing

LEARNING GUIDE
Principles of Clinical Decision-Making
RNSG 1331

Fall 2006

Instructors: Mary Aigner

Pamela Hadnot,
Marilyn Hicks
Revised 08/06 MA/PH
 CENTRAL TEXAS COLLEGE
Department of Nursing

Table of Contents

Unit Page

I. Care of Clients with Fluid & Electrolytes Imbalances.................................1

II. Preoperative and Postoperative Nursing Care.........................................................................3

III. Care of Clients with Acute & Chronic Pain.............................................................................6

IV. Care of Clients with Respiratory Disorders.............................................................................8

V. Care of Clients with Peripheral Vascular Disorders...............................................................10

VI. Care of Clients with Infectious Disorders..............................................................................13

VII. Care of Clients with Immunologic Disorders........................................................................15

*** Central Texas College District does not discriminate in admissions or access to, or treatment or
employment in, its programs and activities on the basis of race, color, religion, national origin,
gender, disability, and age or veterans status.

i
 Unit 1: Fluid and Electrolytes

Functional Health Patterns: Metabolic – Nutrition

Unit 1: Learning Activities
Required Readings:

1. Adams, et al. (2005): Chapter 44 (especially pages 651-667)

2. Dudek (2001): Chapter 6 (especially pages 129-157)
3. Kee (2002): Pages 64-65, 647
4. Lewis, et al. (2004): Chapter 16 (especially pages 330-358)
5. Perry, et al. (2005) Chapter 40 (especially pages 1134-1197)

Recommended Video Viewings:

1. Body Fluids: The Clinical Balance, Part I
2. Body Fluids: The Clinical Balance, Part II
3. Assessing Fluids & Electrolytes

Computer Assisted Instruction:

Moodle
Objectives
Upon completion of this unit, the student will be able to:

1. define the following terms:

acidosis albumin alkalosis

ascites circulatory overload dependent edema
diffusion electrolytes extracellular fluid (ECF)
fluid spacing fluid/electrolyte imbalances hydrostatic pressure
hypertonic hypotonic hypervolemia
hypovolemia interstitial intracellular fluid (ICF)
intravascular isotonic oncotic pressure
osmosis osmolality osmotic pressure
paracentesis parenteral pH
plasma sodium/water imbalance solute
thoracentesis transcellular space buffers
acid base balance

2. define these processes involved in the regulation of movement of water and electrolytes
between the body fluid compartments: 1) diffusion, 2) osmosis, 3) filtration, 4) hydrostatic
pressure, 5) oncotic pressure, and 6) osmotic pressure.

3. discuss the function, distribution, movement, and regulation of fluid and electrolytes in the
body including composition of major body fluid compartments.

1
4. describe the etiology, risk factors, laboratory findings, clinical manifestations, and
collaborative management (including nursing) of the following disorders: 1) water excess
and deficit, 2) sodium and volume imbalances; hypernatremia and hyponatremia, 3)
potassium imbalances; hyperkalemia and hypokalemia, 4) magnesium imbalances;
hypermagnesemia and hypomagnesemia, 5) calcium imbalances; hypercalcemia and
hypocalcemia, and 6) phosphate imbalances; hyperphosphatemia and hypophosphatemia.

5. describe the regulation of acid-base balance in the body, including the roles of buffers (the
lungs and the kidneys). Be able to discuss major acid-base imbalances including metabolic
acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis.

6. use the nursing process to:

a. collect assessment data related to the client’s fluid, electrolyte, and acid-base
balances.
b. identify examples of nursing diagnoses, outcomes, and interventions for clients with
altered fluid, electrolyte, or acid-base balance.
c. develop a teaching plan to maintain fluid and electrolyte balances.
d. plan implementation measures to correct imbalances of fluids and electrolytes.
e. describe how to evaluate the effect of nursing and colloraborative interventions on the
client’s fluid, electrolyte, or acid-base balance.

7. demonstrate critical thinking in the use of the nursing process in the framework for the care
of clients with fluid and electrolyte imbalances in structured settings within the community.

8. use therapeutic communication with clients, families, and members of interdisciplinary

treatment teams in providing care for clients with fluid and electrolyte imbalances.

9. describe caring, ethical, and legal issues in providing care for clients with fluid and
electrolyte imbalances.

10. identify the following for clients (or family) with fluid and electrolyte imbalances:

a. dietary modifications
b. psychosocial stressors
c. learning needs to formulate a teaching plan
d. gerontological considerations
e. multicultural considerations.

11. identify the generic name, trade name, action, usual dosage range, therapeutic effect, toxic
effects, side effects, contraindications, essential nursing assessments, and essential client
teaching for the following medications and intravenous fluids:

a. isotonic solutions: sodium chloride or 0.9% NaCl (normal saline), 5% D (dextrose) in

water, Lactated Ringer’s

2
b. hypotonic solutions: 0.45% NS (normal saline), 2.5% D/W (dextrose in water), 5% D
(dextrose) in 0.45% NS, Normosol M
c. hypertonic solutions: 5% D in NS, 5% D in lactated Ringer’s, 5% D in 0.33% NS,
10% D in water
d. potassium supplements
e. potassium removing resin: Kayexalate (sodium polystyrene sulfonate)
f. calcium supplements

3
 Unit 2: Perioperative and Postoperative Nursing Care

Functional Health Patterns: Health Perception – Health Management

Unit 2: Learning Activities

Required Readings:

1. Adam, et al. (2005): Chapter 20 (pages 241-255)

2. Dudek (2001): Chapter 16 (page 485)
3. Kee (2002): Pages 83-85, 654, 731-733
4. Lewis, et al. (2004): Chapters 17, 18, 19 (pages 360-414)
5. Perry, et al. (2005): Pages 1593-1643
Required Video Viewings:

1. Assessing the Adult: Head to Toe

2. Basic Clinical Skills, Pre-op and Post-op Care
3. Basic Skills: Surgical Drains
4. Surgical Asepsis

Computer Assisted Instruction:

Moodle
Objectives
Upon completion of this unit, the student will be able to:

1. define the following terms:

Suffixes: -ectomy, -otomy, - lysis, -plasty, -orrhaphy, -oscopy, -ostomy

Preoperative Phase: ambulatory surgery elective surgery informed consent

emergency surgery same-day admission

Intraoperative Phase: anesthesia care provider holding area spinal anesthesia

Anesthesiologist
Conscious sedation
malignant hypertension
nurse anesthetist (CRNA)
function of scrub nurse
regional anesthesia
surgeon local anesthesia
surgical suite epidural block
function of circulating nurse
operating room (OR)
perioperative nurse
general anesthesia

Postoperative Phase: airway obstruction fast tracking wound dehiscence

atelectasis hiccoughs wound evisceration
bronchospasm hypothermia pulmonary edema
delayed awakening hypoventilation analgesia (PCA)
emergence delirium hypoxemia epidural analgesia

4
patient-controlled PACU (Post Anesthesia Care Unit)

5
2. describe and discuss the following aspects of preoperative care:

a. the common purposes and settings of surgery.

b. the purpose and components of the nursing assessment.
c. the significance of data related to the client’s health status and operative risk.
d. the purpose and components of informed consent for surgery.
e. the role of the nurse in the physical, psychological, and educational preparation of the
surgical client.
f. the day-of-surgery preparations.
g. the purposes and types of preoperative medications.
h. the special considerations of preparation for the older adult.

3. describe and discuss the following aspects of intraoperative (care:

a. the three different areas of the surgical department and proper attire for each area.
b. the physical environment of the operating room and the holding area.
c. the functions of the members of the surgical team.
d. the needs experienced by the client undergoing a surgical procedure.
e. the role of the perioperative nurse managing the care of the surgical client.
f. the basic principles of aseptic technique as used in the operating room.
g. the importance of safety when positioning clients.
h. the different between the different types of anesthesia (general, regional, and local)
including advantages, disadvantages, and the rational for the choice of anesthesia.
i. the basic techniques used to induce and maintain general anesthesia.
j. the techniques used for administering local and regional anesthesia.

4. describe and discuss the following aspects of postoperative care:

a. the components of an initial postanesthesia assessment.

b. The responsibility of the nurse in admitting clients to the postanesthesia care unit
(PACU).
c. The etiology of potential problems of clients in the PACU as well as the nursing
assessment and management of these problems.
d. The initial nursing assessment and management of a client after transfer from the
PACU to the general care unit.
e. The etiology of potential problems of clients in the postoperative period as well as the
nursing assessment and management of these problems.
f. The discharge teaching that will be needed by the postoperative client.

5. demonstrate the use of the nursing process in the framework for the care of clients in the
preoperative, intraoperative, and postoperative periods.

6. use therapeutic communication with clients, families and members of interdisciplinary teams
in providing perioperative care.

6
7. describe caring, ethical, and legal issues in providing perioperative care.

8. use computer assisted instructions to acquire information to be used in planning, decision-

making, and problem solving for perioperative care.

9. identify the following for clients (or family) regarding perioperative care:

a. learning needs that can be used to develop a teaching plan.

b. dietary modifications.
c. psychosocial stressors and coping mechanisms of clients.
d. gerontological considerations.
e. multicultural considerations.

10. identify the generic name, trade name, classification, action, usual dosing range, therapeutic
effect, toxic effects, side effects, contraindications, essential nursing assessments, and
essential client teaching for the following medications:

Preoperative: benzodiazepines narcotics H2 receptor antagonists

antacids antiemetics anticholinergics
Intraoperative:

a. intravenous agents: barbiturates, nonbarbiturate hypnotics

b. inhalation agents: volatile liquids, gaseous agents
c. anesthesia adjuncts: narcotics, sedative-hypnotics, muscle relaxants, antiemetics
d. dissociative anesthetics
e. local anesthetics: topical application, local infiltration, regional injection

Postoperative:

a. opiod antagonists: naloxone (Narcan)

b. benzodiazepine antagonist: flumazenil (Ronazicon)
c. anticholinesterase: neostigmine
d. Patient-Controlled Analgesia (PCA)

7
 Unit 3: Care of Clients with Acute and Chronic Pain

Functional Health Patterns: Health Perception – Health Management

Unit 3: Learning Activities
Required Readings:

Adams, et al. (2005): Chapter 19 (especially pages 220-240)

Lewis, et al. (2004): Chapter 9 (especially pages 131-159)
Perry, et al. (2005) Chapter 42 (especially pages 1228-1270)

Recommended Video Viewings:

Narcotics for Pain Control

Nursing Diagnosis in the Acute Care Hospital, Alteration in Comfort, Acute Pain

Computer Assisted Instructions:

Moodle
Objectives
Upon completion of this unit, the student will be able to:

1. define the following terms:

acute pain addiction chronic nonmalignant pain

dependence dermal stimulation anticipatory guidance
distraction imagery and hypnosis conditioning
endorphins equanalgesic dose malignant pain
neuropathic pain nociceptive pain relaxation
acupressure titration pain perception
patient-controlled analgesia (PCA) nerve blocks
referred pain transcutaneous electrical nerve stimulation (TENS)
tolerance WHO analgesic ladder pain

2. define, describe, and differentiate between:

a. pain and pain modulation.

b. nociceptive and neuropathic pain.
c. dependence, addiction, and tolerance

3. explain the physical and psychological effects of unrelieved pain.

4. describe nonpharmacologic therapies and their role in pain management.

5. use the nursing process to:

a. collect and interpret subjective and objective data obtained during a

8
 comprehensive pain assessment.
b. plan interventions and coordination of multidisciplinary pain management therapies.

6. explain the nurse’s role and responsibility in pain management.

7. demonstrate critical thinking in the use of the nursing process as a framework for the care
of clients with pain in structured settings within the community.

8. describe caring, ethical, and legal issues in providing care for clients in pain.

9. identify the following for clients (or family) with pain:

a. dietary modifications.
b. learning needs that can be used to formulate a teaching plan.
c. psychosocial stressors and coping mechanisms of clients.
d. gerontological considerations.
e. multicultural considerations.

10. identify the generic name, trade name, classification, action, usual dosing range,
therapeutic effect, toxic effects, side effects, contraindications, essential nursing
assessments, and essential client teaching for the following medications:

Opioid Analgesics: morphine codeine Demerol Dilaudid

Methadone Vicodin Fentanyl

Opioid Antagonist: Narcan

Nonopioid: Tylenol (acetaminophen) aspirin/salicylates

NSAIDS (non-steroidal anti-inflammatory drugs)
Ultram and Ultracet

Adjuvant drugs: corticosteroids antidepressants anticonvulsants

muscle relaxants adrenergic agonist anesthetics: local
anesthetics: systemic or oral psychostimulants

9
 Unit 4: Care of Clients with Disorders of
The Respiratory System

Functional Health Patterns: Activity - Exercise

________________________________________________________________________________
Unit 4: Learning Activities
Required Readings:

1. Adams, et al. (2005): Chapter 29 (especially pages 384-399)

2. Dudek (2001): Chapter 16 (especially pages 488-493)
3. Lewis, et al. (2004): Chapters 25 (especially pages 542-565), 26 (especially pages 568-
573), 27 (especially pages 592-607; 620-621; 627-633),
and 28 (especially pages 646-653)

Recommened Video Viewings:

Auscultation of Breath Sounds

Nursing Care Related to Respiratory Function
Acute Respiratory Failure

Computer Assisted Instruction:

Moodle

Objectives
Upon completion of this unit, the student will be able to:

1. define the following terms:

adventitious sounds compliance crackles

dyspnea elastic recoil fremitus
rhonchi surfactant tidal volume
ventilation wheezes pleural friction rub
apnea epistaxis atelectasis
chylothorax cor pulmonale empiric therapy
empyema flail chest hemothorax
pleural effusion pleurisy/pleuritis pulmonary edema
pulmonary embolism pulmonary hypertension thoracentesis
chest physiotherapy postural drainage Oxygen toxicity
Oxygen saturation (O2 Sat)

2. describe the structures and functions of the respiratory system including: 1) upper tract,
2) lower tract, and 3) chest wall.

3. identify respiratory defense mechanisms, the process of oxygenation, and the signs,

10
symptoms, and implications of inadequate oxygenation.

11
4. use the nursing process to:

a. describe the physical assessment of the respiratory system.

b. differentiate between normal and abnormal findings in the physical assessment.
c. understand and describe the purpose, significance of results, and nursing
responsibilities related to diagnostic studies of the respiratory system and related
disorders.
d. describe clinical manifestations of various respiratory disorders.
e. plan nursing management and interventions for the care of clients with respiratory
disorders.

5. demonstrate critical thinking in the use of the nursing process as a framework for the
care of clients with respiratory disorders in structured settings within the community.

6. use therapeutic communications with clients, families, and members of

multidisciplinary teams in providing care for clients with respiratory disorders.

7. describe caring, ethical, and legal issues in providing care for clients with respiratory
disorders.
8. identify the following for clients (or family) with respiratory disorders:

a. dietary modifications
b. psychosocial stressors
c. learning needs that can be used to formulate a teaching plan
d. gerontological considerations
e. multicultural considerations.

9. identify the generic name, trade name, action, usual dosage range, therapeutic effect, toxic
effects, side effects, contraindications, essential nursing assessment, and essential client teaching
for the following classes of medications:

a. antibuculotics
b. antibiotics (multiple subclasses)
c. bronchodilators
d. sympathomimetics
e. steroids – inhaled
f. corticosteroids
g. mucolytics

In addition, be familiar with one or two common medications within each of the above classes.

12
 Unit 5: Care of Clients with Cardiovascular Disorders

Functional Health Patterns: Activity - Exercise

Unit 5: Learning Activities

Required Readings:

1. Adams, et al., (2005): Chapters 21 (pages 258-283), 24, (pages 312-326),

27 (pages 355-368)
2. Dudek (2001): Chapters 4 (pages 68-98), 18 (pages 547-600)
3. Kee (2002): Pages 120-124, 290-292
4. Lewis, et al., (2004): Chapters 32 (pages 777-798), 37 (pages 912-942)

Required Videos for Viewing:

TBA

Computer Assisted Instruction:

Moodle
Objectives

Upon completion of this unit, the student will be able to:

1. define the following terms:

essential hypertension anticoagulant isolated systolic hypertension

arteriosclerosis obliterans
thrombolytic agents
aneurysm
endovascular graft
venous stasis ulcers
arterial occlusive disease
thromboangitis obliterans
endarterectomy pulmonary embolism
varicosities hypertensive emergency
aortic dissection arteriospastic disease
pulmonary infarction thrombophlebitis
secondary hypertension angioplasty
embolectomy intermittent claudication
varicose veins orthostatic hypotension

2. discuss the pathophysiology of the following cardiovascular disorders:

a. peripheral arterial disease

b. peripheral venous disease
c. peripheral arterial disease of the lower extremities (**??different from a???)
d. Buerger’s disease
e. Raynaud’s phenomenon
f. superficial thrombophlebitis
g. deep vein thrombosis (DVT)
h. venous leg ulcers

13
i. pulmonary emboli
j. hypertension

14
 3. describe the anatomic location and function of the following cardiac structures: 1)
pericardial layers, 2) atria, 3) ventricles, 4) semilunar valves, and 5) atrioventricular valves.

4. understand and describe the following:

a. coronary circulation and the areas of heart muscle supplies by each blood vessel.
b. the normal sequence of events involves in the conduction pathways of the heart.
c. structure and functions of the arteries, capillaries, and veins
d. mechanisms involved in the regulation of blood pressure.
e. the pathophysiology associated with primary hypertension.
f. the clinical manifestations and complications of hypertension.
g. the pathophysiology, clinical manifestations, and collaborative care of: 1) aortic
aneurysm repair, 2) aortic dissection, and 3) surgical management of peripheral arterial
disease of the lower extremities.
h. the etiology, pathophysiology, and major risk factors of peripheral arterialdisease.

5. differentiate between the pathophysiology, clinical manifestations, and collaborative care

for thromboangiitis obliterans (Buerger’s disease) and Raynaud’s phenomenon.

6. differentiate between the pathophysiology, risk factors, clinical manifestations, and

collaborative care for superficial thrombophlebitis and deep vein thrombosis.

7. discuss the pathophysiology, clinical manifestations, nursing management, and

collaborative care for: 1) venous leg ulcers, 2) pulmonary emboli, and 3) hypertensive
crisis.

8. use the nursing process to:

a. describe the physical assessment (and techniques used in the assessment) of the
cardiovascular system.
b. identify significant subjective and objective data related to the cardiovascular
system.
c. describe the purpose, significance of results, and nursing responsibilities of
invasive and noninvasive diagnostic studies.
d. develop teaching plans for the management of hypertension and other
cardiovascular disorders.

9. demonstrate critical thinking in the use of the nursing process as a framework for the
care of clients with cardiovascular disorders in structure settings in the
community.

10. use therapeutic communication with clients, families, and members of the
multidisciplinary team in providing care for clients with cardiovascular disorders.

11. describe caring, ethical, and legal issues in providing care for clients with cardiovascular

15
 disorders.

12. identify the following for clients with cardiovascular disorders:

a. dietary modifications.
b. psychosocial stressors and coping mechanisms.
c. learning needs that can be used to formulate a teaching plan.
d. gerontological considerations.
e. multicultural considerations.

13. identify the generic name, trade name, action, usual dosage range, therapeutic effect,
toxic effects, side effects, contraindications, essential nursing assessments, and essential client
teaching for the following medications:

Antihypertensive: See Chapter 32, Table 32-8, page 787 to 790

diuretics adrenergic direct vasodilators
Ganglionic blockers angiotensin inhibitors
Calcium channel blockers beta blockers

Electrolytes: potassium chloride potassium phosphate

Anticoagulant: heparin pentoxifylline (Trental) warfarin (Coumadin)

Low molecular weight heparin: enoxaprin (Lovenox) dalteparin (Fragmin)

Antiplatelet agents: acetylsalicyclic acid (aspirin) dipyridamole (Persantin)

ticlopidine (Ticlid) clopidogrel (Plavix)

Thrombolytic: altephase (Activase)

Anticoagulant Antibodies: Vitamin K Protamine sulfate

________________________________________________________________________________

16
 Unit 6: Care of Clients with Infectious Disorders

Functional Health Patterns: Health perception – Health Management

Learning Activities
Required Readings:

1. Adams, et al. (2005): Chapter 32 (pages 455-458)

2. Dudek (2001): Chapter 17 (pages 537-539)
3. Lewis, et al. (2004): Chapter 12 (pages 216-218; Table 12-15), 23 (pages 495-496),
42 (pages 1104-1116), 44 (pages 1172-1177),
51 (pages 1392-1394)
4. Perry, et al. (2005): Pages 1482-1565

Required Videos for Viewing:

Anti-infective Medication Therapy Implications: Assessment of an Infection

Hepatitis B: The Enemy Within
Hepatitis C: The Silent Scourge
Infection Prevention: Breaking the Chain of Infection

Computer Assisted Instruction:

Moodle

Objectives
Upon completion of this unit, the student will be able to:

1. define the following terms:

inflammation VRE (Vancomycin-resistent enterococci)

pathogens MRSA (Methicillin-resistant staphylococcus aureus)
antibiotic vaccines anti-inflammatory
antipyretic jaundice cystitis

2. discuss the pathophysiology of the following disorders:

a. Hepatitis A, B, C, D, E, and G
b. Herpes Simplex #1 and #2
c. Herpes Zoster
d. Methicillin-resistant staphylococcus aureus (MRSA)
e. Vancomycin-resistant enterococci (VRE)

3. Describe and discuss:

17
 a. the cellular adaptive mechanisms of sublethal injury
b. the causes and mechanisms of lethal cell injury
c. the components and functions of the mononuclear phagocyte system
d. the inflammatory response, including vascular and cellular responses and
exudates formation
e. local and systemic manifestations of inflammation and their physiologic bases
f. the pharmacologic, dietary, and nursing management of inflammation

4. differentiate among types of cell necrosis.

5. describe the signs and symptoms that may occur with the different types of jaundice.

6. differentiate among the types of viral hepatitis, including etiology, pathophysiology,

clnical manifestations, complications, and collaborative care, including nursing
management.

7. identify factors contributing to the high incidence of sexually transmitted diseases.

8. explain the etiology, clinical manifestations, and diagnostic abnormalities of genital

herpes.

9. demonstrate critical thinking in the use of the nursing process as a framework for the care
of clients with the disorders listed in objective 2.

10. use therapeutic communication with clients, families, and members of the
multidisciplinary team in providing care for clients with infectious disorders.

11. describe caring, ethical, and legal issues in providing care for clients with infectious
disorders.

12. identify the following for clients with infectious disorders:

a. dietary modifications
b. psychosocial stressors and coping mechanisms.
c. learning needs that can be used to formulate a teaching plan.
d. gerontological considerations.
e. multicultural considerations.

13. identify the generic name, trade name, classification, action, usual dosage range,
therapeutic effect, toxic effects, side effects, contraindications, essential nursing
assessments, and essential client teaching for the following medications:

Vaccines: Havrix Yagta Avaxim Hepatitis B vaccine

Antiviral or immune-modulating medications: a-Interferon

ribavirin (Virizole) Lamivudine (3TC) Famudovir

18
 immune globulin (IG) acyclovir
Antimicrobial medications: Vancomycin fluroquinolones

Antibioticsa: ceftriaxone (Rocephin) cefotaxime (Claforan)

cefepime (Maxipine) linezolid (Zyvox)

Unit 7: Care of Clients with Immunologic Disorders

Functional Health Patterns: Sleep and Rest Patterns

Unit 7: Learning Activities
Required Readings:

1. Adams, et al. (2005): Chapters 30 (especially pages 402-415), 33 (especially pages 416-
436)
2. Dudek (2001): Chapter 21 (especially pages 681-692)
3. Lewis, et al. (2004): Chapters 13 (especially pages 239-261), 14 (especially pages 264-
287), 57 (especially pages 1563-1569; 1573-1576), 59
(especially pages 1606-1608), 63 (especially pages 1724-1733;
1739-1746).

Recommended Video Viewings:

AIDS: No-Nonsense Answers

Anti-infective Medication Therapy (Antifungal, Antiviral, & Antitubercular Agents)
Multiple Sclerosis

Computer Assisted Instruction:

Moodle
Objectives
Upon completion of this unit, the student will be able to:

1. define the following terms:

antigen autoimmunity cell-mediated immunity

cytokines humoral immunity hypersensitivity reaction
immunocompetence immunodeficiency immunosuppressive therapy
antibodies opportunistic diseases postexposure prophylaxis
protease inhibitors viral load vaccine
passive immunity active immunity myasthenic crisis
CREST syndrome connective tissue disorders immunomodulators
Anaphylaxis vaccination/immunization

19
2. discuss the following disorders:

a. Systemic Lupus Erythematous (SLE)

b. Rheumatoid Arthritis
c. Systemic Sclerosis (Scleroderma)
d. Multiple Sclerosis
e. Guillian-Barre
f. Myasthenia Gravis
g. Human immunodeficiency virus (HIV) and Acquired Immunodeficiency
Syndrome (AIDS)

3. describe the functions and components of the immune system.

4. compare and contrast cell-mediated and humoral immunity responses.

5. identify the clinical manifestations and basic emergency management of an

anaphylactic reaction.

6. describe the etiology, pathophysiology, clinical manifestations, and treatment

modalies/collaborative care for selected immune disorders (see objective 2).

7. compare and contrast osteoarthritis and Rheumatoid Arthritis.

8. describe the nursing management for connective tissue disorders.

9. discuss vaccines, their purpose, methods and frequency of administration,

contraindications, effect on immunity, and societal effects.

10. use the nursing process to:

a. describe the physical assessment of immune disorders.

b. identify significant subjective and objective data related to the immune system.
c. describe the purpose, significance of results, and nursing responsibilities for
diagnostic studies of immune disorders.
d. develop teaching plans for the management of immune disorders and/or
connective tissue diseases.

11. demonstrate critical thinking in the use of the nursing process as a framework for clients
with immune disorders and/or connective tissue diseases in structured settings in the community.

12. discuss infection control techniques or measures associated with clients experiencing
threats to the immune system.

13. identify the following for clients with immune disorders:

a. dietary modifications

20
b. psychosocial stressors and coping mechanisms.
c. learning needs that can be used to formulate a teaching plan.
d. gerontological considerations.
e. multicultural considerations.

21
14. identify the generic name, trade name, action, usual dosage range, therapeutic effect,
toxic effects, side effects, contraindications, essential nursing assessments, and essential client
teaching for the following classes of medications:

A. antivirals
B. antibiotics (multiple subclasses)
C. antifungals
D. antimalarial
E. Antiprotozoal
F. Antihistamine
G. Bronchodilator
H. Non-steroidal Anti-inflammatory Drugs (NSAIDs)
I. Corticosteroids

Be familiar with common medications within each class listed above.

22