Revised 8/2020

NSG 252 - Complex Health Care Concepts (4 CR.)

Course Description

Focuses on nursing care of diverse individuals and families integrating complex health concepts. Emphasizes clinical judgment, patient-centered care and collaboration. Lecture 4 hours. Total 4 hours per week.

General Course Purpose

The purpose of this course is to apply complex health concepts that relate to the client and family across the lifespan.

Course Prerequisites/Corequisites

Prerequisites: BIO 141 and BIO 142 or BIO 231 and 232. ENG 111, PSY 230, SDV 101 or 100 BIO 150 or BIO205, CST 110 or 115 or 126 or 229, required Elective ENG 112 or HIS 101 or MTH 154 or MTH 245, NSG 100, NSG 106, NSG 130, NSG 152, NSG 170 and NSG 200, NSG 210, NSG 211

Corequisites: HUM Elective (see college catalog), NSG 230, NSG 270

Course Objectives

Upon completing the course, the student will be able to:

  • Provide patient-centered care promoting therapeutic relationships, caring behaviors, and self-determination across the lifespan for diverse populations of individuals with complex health needs
  • Practice safe nursing care that minimizes risk of harm across systems and client populations with complex health needs
  • Integrate clinical judgment in the management of care for multiple, complex clients across the lifespan.
  • Practice professional behaviors that encompass the legal/ethical framework while incorporating self-reflection, leadership and a commitment to recognize the value of life-long learning
  • Manage client care through quality improvement processes, information technology, and fiscal responsibility to meet client needs and support organizational outcomes
  • Demonstrate principles of collaborative practice within nursing and interdisciplinary teams fostering mutual respect and shared decision-making to achieve optimal outcomes of care
  • Manage the principles of pharmacology to the identified concepts for clients with complex conditions across the lifespan.
  • Manage the appropriateness, accuracy, and client response to pharmacology principles for clients with complex conditions.

Major Topics to Be Included

  • Fluid & Electrolyte Concept
    • Fluid and electrolyte principles
    • Risk factors related to altered fluid and electrolyte levels
    • Prevention of altered fluid and electrolyte levels
    • Fluid and electrolyte diagnostic testing
    • Clinical judgment related to altered fluid and electrolyte levels
    • Pharmacology: Erythropoietin stimulating agents, Phosphate binders
    • Exemplars: acute kidney injury & chronic renal failure
  • Acid--Base Concept
    • Acid--base principles
    • Risk factors related to altered acid-base balance
    • Prevention of altered acid-base balance
    • Acid-base diagnostic testing
    • Clinical judgment related to altered acid-base balance
    • Pharmacology: Sodium Bicarbonate
    • Exemplars: metabolic acidosis and alkalosis, respiratory acidosis and alkalosis
  • Intracranial Regulation Concept
    • Intracranial regulation principles
    • Risk factors related to altered intracranial regulation
    • Prevention of altered intracranial regulation
    • Intracranial regulation diagnostic testing
    • Clinical judgment related to altered intracranial regulation
    • Pharmacology: Anti-epileptic drugs: Phenytoin, Valproic acid, Levetiracetam,Lamotrigine, Topiramate, Gabapentin, Lacosamide; Anticoagulants, HMG-CoA reductase inhibitors, Tissue Plasminogen activator (tPa), Antihypertensive medications, Benzodiazepines (ex. Lorazepam, clonazepam), Barbiturates (ex. Phenobarbital), Skeletal Muscle Relaxants (ex. Cyclobenzaprine), Osmotic diuretic (mannitol)
    • Exemplars: Cerebral Vascular Accident (CVA), seizures (across the lifespan), Traumatic brain injury
  • Mobility Concept
    • Mobility principles
    • Risk factors related to altered mobility
    • Prevention of altered mobility
    • Mobility diagnostic testing
    • Clinical judgement related to altered mobility
    • Pharmacology: Anti-Parkinson drugs
    • Exemplars: spinal cord injury (across the lifespan, including spina bifida), Parkinson's disease, Multiple sclerosis
  • Inflammation Concept
    • Inflammatory principles
    • Risk factors related to altered inflammation
    • Prevention of altered inflammation
    • Inflammation diagnostic testing
    • Clinical judgment related to altered inflammation
    • Pharmacology: Osmotic laxatives (ex. Lactulose), Narcotics (ex. Hydromorphone), Proton Pump Inhibitors (ex. Pantoprazole), Octapeptides (ex. Octreotide), Insulin, Antiemetics, Antibiotics, Antifungals, Albumin
    • Exemplars: hepatitis, cirrhosis, pancreatitis, cholecystitis
  • Infection Concept
    • Infection principles
    • Risk factors related to infection
    • Prevention of infection
    • Infection diagnostic testing
    • Clinical judgment related to infection
    • Pharmacology: Vasopressors, Antibiotics
    • Exemplars: Sepsis across the lifespan
  • Tissue Integrity Concept
    • Tissue integrity principles
    • Risk factors related to altered tissue integrity
    • Prevention of altered tissue integrity
    • Tissue integrity diagnostic testing
    • Clinical judgment related to altered tissue integrity
    • Pharmacology: Fluid resuscitation, Proton pump Inhibitors, Silver sulfadine cream and other topical creams
    • Pharmacological interventions: topical treatment of burns
    • Exemplars: burns
  • Perfusion Concept
    • Perfusion principles
    • Risk factors related to altered perfusion
    • Prevention of altered perfusion
    • Perfusion diagnostic testing
    • Clinical judgment related to altered perfusion
    • Hemodynamic monitoring
    • Chest tube management
    • Management of a client with a pacing device
    • Pharmacology: Cardiac Glycoside (Digoxin), Calcium Channel Blockers (ex. Adenosine), Digoxin immune fab, ASA, Beta Blockers, Calcium channel blockers, Thrombolytics, Angiotensin Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, Vasodilators (Nitrates), Epinephrine, Antidysrhythmic (ex. Lidocaine, Amiodarone), Muscarinic antagonist (Atropine), Tissue Plasminogen Activator (tPa), Heparin, Beta-1 agonist (Dobutamine), Inotrope (ex. Dopamine), Vasopressor (ex. Norepinephrine), Diuretics (Loop, Potassium Sparing, Thiazide), Opioids (ex. Morphine), Colloids, Albumin
    • Exemplars: shock (all types), Multiple Organ Dysfunction Syndrome (MODS), arrhythmias, congenital defects (infant/child)
  • Gas Exchange Concept
    • Gas exchange principles
    • Risk factors related to altered gas exchange
    • Prevention of altered gas exchange
    • Gas exchange diagnostic testing
    • Clinical judgment related to altered gas exchange
    • Ventilation: mechanical, continuous positive airway pressure, bilevel airway pressure
    • Pharmacology: Neuromuscular blocking agents, Corticosteroids, Xanthine
    • Exemplars: Acute Respiratory Distress Syndrome (ARDS), pneumothorax
  • Metabolism Concept
    • Metabolism principles
    • Risk factors related to altered metabolism
    • Prevention of altered metabolism
    • Metabolism diagnostic testing
    • Clinical judgement related to altered metabolism
    • Exemplars: Adrenocortical dysfunction, pituitary dysfunction