Ateneo de Zamboanga University

College of Nursing
Course Syllabus NCM 118 (CARE OF CLIENTS WITH LIFE-THREATENING CONDITIONS, ACUTELY ILL/ MULTI ORGAN PROBLEMS, HIGH ACUITY AND EMERGENCY SITUATION)

COURSE TITLE CARE OF CLIENTS WITH LIFE-THREATENING CONDITIONS, ACUTELY ILL/ MULTI ORGAN PROBLEMS, HIGH ACUITY AND EMERGENCY SITUATION
COURSE CODE NCM 118
COURSE This course deals with concepts, principles, theories and techniques of nursing care of sick adult clients with life-threatening conditions, acutely ill/ multi-organ problems, high
DESCRIPTION acuity and emergency situation toward health promotion, disease prevention, restoration and maintenance and rehabilitation. The learners are expected to provide safe,
appropriate and holistic nursing care to groups of clients with health problems and special needs utilizing the nursing process.
PREREQUISITES NCM 116
COURSE CREDIT Theory: 4 units (72 hours); RLE: Skills Lab. 1 unit – 51 hours; Clinical 4 units – 204 hours
PLACEMENT Fourth Year, First Semester

PROGRAM 1. Apply knowledge of physical, social, natural & health sciences & humanities in practice of nursing.
OUTCOME 2. Provide safe, appropriate and holistic care to individuals, families, population groups and communities utilizing nursing process.
3. Apply guidelines & principles of evidence-based practice in the delivery of care.
4. Practice nursing practice in accordance with existing laws, legal, ethical & moral principles
5. Communicate effectively in speaking, writing and presenting using culturally-appropriate language.
6. Document to include reporting up-to-date client care accurately and comprehensively.
7. Work effectively in collaboration with inter-, intra- and multi-disciplinary and multi-cultural teams.
8. Practice beginning management and leadership skills in the delivery of client care using s systems approach.
9. Conduct research with an experienced researcher.
10. Engage in lifelong learning with a passion to keep current with national and global developments in general, and nursing and health developments in particular.
11. Demonstrate responsible citizenship and pride of being a Filipino.
12. Apply techno-intelligent care systems and processes in health care delivery.
13. Adopt the nursing core values in the practice of the profession.

LEVEL OUTCOMES At the end of the fourth year, given groups of clients (individuals, families, population groups and communities) with health problems and special needs, the learners demonstrate
safe, appropriate and holistic are utilizing the nursing process and can assume first level entry positions in any field of nursing.

COURSE OUTCOMES 1. Apply knowledge of physical, social, natural & health sciences & humanities in the care of group of clients’ with life-threatening conditions,
acutely ill/ multi-organ problems, high acuity and emergency situation.
2. Provide safe, appropriate and holistic nursing care of group of clients’ with life-threatening conditions, acutely ill/ multi-organ problems,
high acuity and emergency situation utilizing the nursing process.
3. Apply guidelines & principles of evidence-based practice in the care of group of clients’ with life-threatening conditions, acutely ill/ multi-
organ problems, high acuity and emergency situation.
4. Practice nursing practice in accordance with existing laws, legal, ethical & moral principles nursing in the care of group of clients’ with life-
 threatening conditions, acutely ill/ multi-organ problems, high acuity and emergency situation.
5. Communicate effectively in speaking, writing and presenting using culturally-appropriate language in the care of group of clients’ with life-
threatening conditions, acutely ill/ multi-organ problems, high acuity and emergency situation.
6. Document to include reporting up-to-date client care accurately and comprehensively in the care of group of clients’ with life-threatening conditions,
acutely ill/ multi-organ problems, high acuity and emergency situation.
7. Work effectively in collaboration with inter-, intra- and multi-disciplinary and multi-cultural teams in the care of group of clients’ with life-
threatening conditions, acutely ill/ multi-organ problems, high acuity and emergency situation.
8. Practice beginning management and leadership skills in the care of group of clients’ with life-threatening conditions, acutely ill/ multi-
organ problems, high acuity and emergency situation.
9. Conduct research with an experienced researcher in the care of group of clients’ with life-threatening conditions, acutely ill/ multi-organ problems,
high acuity and emergency situation.
10. Engage in lifelong learning with a passion to keep current with national and global in the care of group of clients’ with life-threatening conditions,
acutely ill/ multi-organ problems, high acuity and emergency situation.
11. Demonstrate responsible citizenship and pride of being a Filipino.
12. Apply techno-intelligent care systems and processes in the care of group of clients’ with life-threatening conditions, acutely ill/ multi-organ
problems, high acuity and emergency situation.
13. Adopt the nursing core values in the delivery of the care of group of clients’ with life-threatening conditions, acutely ill/ multi-organ problems,
high acuity and emergency situation.

NCM 118 SYLLABUS ( )

WEEK LEARNING OUTCOMES CONTENT TEACHING LEARNING STRATEGIES TA ASSESSMENT RESOURCES

CLASSROOM RLE (SKILLS LAB., TASK /S TOOL
HOSPITAL.,COMMUNITY)
Integrate relevant principles of Responses to Altered Ventilatory
social, physical, natural and Functions Papers and
health sciences and 1. Assessment Pencil Test
humanities in a given health o Subjective Data Lecture-
and nursing situations based • History discussion Instant
on epidemiological profile. Feedback
o Objective Data
• Physical assessment
• Diagnostic studies/ procedures
a. Non-invasive – Oximetry
b. Invasive
 - ABG
- Pulmonary Capillary
Wedge Pressure
- Pleural Fluid Analysis
- Pulmonary Angiography
- Ventilation-Perfusion
(V/Q) scan
- Capnography
2. Nursing Diagnosis
3. Planning for Health
Restoration and Maintenance
4. Alterations in Ventilation
 Acute and Chronic
Obstructive Pulmonary
Disease
 Pulmonary Embolism
 Acute Respiratory Distress
Syndrome / Acute Lung Injury
 Respiratory Failure
 Pneumonia
 Community Acquired
 Ventilator Acquired
 Respiratory Pandemics
 Pulmonary Hypertension
 Pneumothorax
5. Implementation
 Medical /Surgical
management
 Mobilization of Secretions
 Artificial Airway
Management
 Administering Oxygen
Therapy
 Mechanical Ventilation
 Thoracic Surgeries
 Lung Transplantation
 Pharmacologic Management
 Complementary and
Alternative Medicines
 Nutritional and Diet Therapy
 Tube feedings
 Fluid therapy
  High CHON, High Calorie
Supplements
6. Client Education
7. Evaluation of the Outcome of
Care
8. Reporting and Documentation
of Care

B. Responses to Altered Tissue

Perfussion
1. Assessment
 Subjective Data
- Nursing History
 Objective Data
- Physical Assessment
- Diagnostic Assessment
a. Non-invasive
 ECG
 Echocardiography
b. Invasive
 Cardiac Catheterization
 Central Venous
Pressure (CVP)
 Pulmonary Artery
Pressure (PAP)
 Intra-arterial Blood
Pressure Monitoring
 Left arterial Pressure
Monitoring
2. Nursing Diagnosis
3. Planning
4. Alteration in Perfusion
a. Acute Ischemic Heart
Disease
b. Heart Failure
c. Cardiogenic Shock
d. Coronary Arterial Disease
e. Hypertensive Crisis
f. Cardiomyopathy
g. Arrhythmias
5. Implementation
 Medical/ Surgical
Management
  Recanalization
 Palliative Care for End-Stage
Heart Failure
 Percutaneous Transluminal
Angioplasty
 Pacemakers
 Cardioversion
 Ablation
 CABG
 IABP
 Heart Transplantation
 Pharmacological
Management
 Complimentary /
Alternative Therapies
6. Patient Education

C. Responses to Metabolic-
Gastrointestinal and Liver
Alterations
1. Assessment
 Subjective Data
- Nursing History
 Objective Data
- Physical Assessment
- Diagnostic Assessment
a. Non-invasive
 Guaiac Test
 Hepatobilliary Scan CBG
b. Invasive
 Blood Gucose Monitoring
 Esophago-
gastroduodenoscopy
(EGD)
 Endoscopic Retrograde
Cholangio-
pancreatography (ERCP)
 Percutaneous
Transhepatic
Cholagiography (PTC)
 Liver Biopsy
 Serum Blood Studies
2. Nursing Diagnosis
3. Planning
4. Metabolic - Gastrointestinal and
Liver Alterations
 Acute GI Bleeding
 Intra-abdominal Hypertension
and Abdominal Compartment
Syndrome
 Liver Failure
 Acute Pancreatitis
 Bariatric
 Diabetic Ketoacidodis
 Hyperglycemia
 Hyperosmolar Non-Ketotic
Acidosis
5. Implementation
 Medical/ Surgical
Management
 Volume Restoration
 Nasogastric suction tubes
 Esophagogastric Balloon
Tamponade Tubes Billroth 1
and 11
 Transjugular Intrahepatic
Portosystemic Shunt
 Liver Transplantation
 Reverse Hydration
 Reverse Ketoacidosis
 Electrolyte Replacement
 Rapid Hydration
 Pharmacologic
Managemnt
 Complimentary/
Alternative Therapy
6. Client Education
7. Evaluation of the Outcome of
Care
8. Reporting and documentation of
Care

D. Responses to Altered
Elimination
1. Assessment
 Subjective Data
- Nursing History
  Objective Data
- Physical Assessment
- Diagnostic Assessment
a. Non-invasive
 Urinalysis
 24-Urine Collection
 Renal Ultrasound
b. Invasive
 Serum Studies
Intravenous
Pyelography
2. Nursing Diagnosis
3. Planning
4. Elimination - Renal alterations
 Renal Failure (Acute and
Chronic)
5. Implementation
 Medical/ Surgical
Management
 Fluid Resuscitation
 Peritoneal Dialysis
 Hemodialysis
 Continuous Renal
Replacement Therapy
(CRRT)
 Pharmacologic Managemnt
 Diet and Nutrition
Management
 Electrolytes Restrictions
 Fluid Restrictions
 High CHO Diet
 Complimentary/ Alternative
Therapy
 “Halamang Gamot”
6. Client Education
7. Evaluation of the Outcome of
Care
8. Reporting and documentation
of Care

E. Responses to Altered Perception

1. Assessment
 Subjective Data
 - Nursing History
 Objective Data
 Diagnostic Assessment
a. Brain Imaging Techniques
- CT;
- MRI;
- PET;
- Cerebral Angiography
- Cerebral Perfusion
- Intracranial Pressure
Monitoring
b. Pulse Wave forms
c. Assessment of Cerebral
Perfusion- CPP
d. Assessment od Cerebral
Oxygenation
- Jugular Venous Oximetry
- Partial Brain Tissue
Oxygenation Monitoring
e. Non-Invasive
- Transcranial Doppler
- Continuous EEG
- Near Infrared
Spectroscopy
 Neurological Assessment
a. Level of Consciousness
b. Cranial Nerve Testing
c. Cerebellar Testing
d. Sensory Assessment
e. Motor Assessment
f. Reflexes
2. Nursing Diagnosis
3. Planning
4. Neurologic Alterations
 Traumatic Alterations
 Acute Ischemic stroke
 Traumatic spinal Cord Injury
5. Implementation
 Medical/ Surgical
Management
 Bleeding Management
 Evacuation of Blood clots
 Pharmacologic Management
 Diet and Nutrition
 Management
 Antioxidants
 Phytochemical
 Complimentary/ Alternative
Therapy
6. Client Education
7. Evaluation of the Outcome of
Care
8. Reporting and documentation
of Care

F. Multisystem Problems
1. Shock
2. Systemic Inflammatory
Responses syndrome (SIRS)
3. Multi Organ Dysfunction
Syndrome (MODS)
 Assessment
- clinical Manifestations and
effects
- Sequential Organ Failure
Assessment (SOFA)
- Diagnostic studies
 Nursing Diagnosis
 Planning
 Implementation
 Collaborative care
 Drug therapy
 Nursing management
 Evaluation

G. Emergency Nursing
1. Assessment
 Triage
 Five-Level of Emergency
Severity Index (ESI)
 Primary survey
 Secondary survey
 History
2. Plan/ Implementation and
Evaluation
 Medical Emergencies
a. Airway. Breathing,
Circulation (ABC)
 - Foreign Body Obstruction
- inhalation Injury
- Anaphylaxis
- Thoracic Emergency
Trauma
- Cardiac Arrest
- External Hemorrhage
b. Disability (D)
- Head injury
- Stroke
 Environmental Emergency
a. Heat Related emergencies
b. Submersion Injuries
c. Stings and Bites
d. Poisoning
e. Drowning and Near
Drowning
f. Diving
g. Lighting