Medical Surgical Nursing

(Adult including Geriatrics) II

Placement : Third Year Time : Theory 120 hours

Practical 270 hours

Course Description : The purpose of this course is to acquire knowledge and develop proficiency in caring for patients with medical and
surgical disorders in varieties of health care settings and at home.

Unit Time Learning Objectives Content Teaching Learning Activity Assessment

(Hrs) method
I 15 Describe the Nursing management of patient with disorders of
Essay type
etiology, patho- Ear Nose and Throat Lecture Discussion
physiology,
Review of anatomy and physiology of the Ear Nose Short answers
clinical Explain using Charts,
manifestations, and Throat
graphs Objective type
diagnostic
Nursing assessment- History and Physical
measures and Models, films, slides Assessment of
management of assessment
patients with Demonstration skills with
Etiology, Pathophysiology , clinical manifestations,
disorders of Ear check list
Nose and Throat diagnosis, treatment modalities and medical & Practice session Assessment of
Surgical nursing management of Ear Nose &
Throat disorders: Case discussions/ patient
o External ear: deformities otalgia, foreign bodies, management
and tumours Seminar problem
o Middle Ear Impacted wax, Tympanic membrane
Health education
perforation, otitis media, otosclerosis, mastoiditis,
tumours Supervised clinical
o Inner ear Menieres Disease, labyrinthitis,
ototoxicity, tumours practice
 o Upper airway infections Common cold, sinusitis,
Drug book/ presentation
ethinitis, rhinitis, pharyngitis, tonsillitis and
adenoiditis, peritonsilar abscess, laryngitis
Upper respiratory airway epistaxis,

Nasal obstruction, laryngeal obstruction, cancer of

the larynx
Cancer of the oral cavity

Speech defects and speech therapy

Deafness

Prevention, control and rehabilitation

Hearing Aids, implanted hearing devices

Special Therapies
Nursing procedures
Drugs used in treatment of disorders of Ear Nose and
Throat
Role of nurse Communicating with hearing impaired
and muteness.
II 15 Nursing management of patient with disorder of eye
Describe the Lecture Discussion Essay type
Review of anatomy and physiology of the eye
etiology,
Explain using Charts, Short answers
Patho physiology,
Nursing Assessment - History and Physical
clinical graphs
Objective type
manifestations, assessment
Models, films, slides
diagnostic
measures and
Etiology, Pathophysiology , clinical manifestations, Demonstration Assessment of
management of
patients with diagnosis, treatment modalities and medical & skills with
Practice session
disorders of eye. Surgical nursing management of eye disorders: check list
o Refractive errors
Case discussions/ Assessment of
o Eyelids-infection, tumours &
deformities Seminar patient
o Conjunctiva - inflammation and management
Health education
infection, bleeding problem
o Cornea-inflammation and infection
Supervised clinical
o Lens-Cataracts
o Glaucoma practice
o Disorder of the uveal tract,
Drug book/
o Ocular tumours
o Disorders of posterior chamber & presentation
retina :
Visit to eye bank
retinal and vitreous problems
o Retinal detachment
Participation in eye-
o Ocular emergencies and their prevention
camps
Blindness

National blindness control program

o Eye Banking
o Eye prostheses and Rehabilitation
Role of nurse - Communication with visually impaired
patient, Eye camps
Special Therapies
Nursing procedures
Drugs used in treatment of disorders of eye.
III 16 Nursing management of patient with neurological
Describe the Essay type
disorders Lecture Discussion
etiology, patho-
Review of anatomy and physiology of the Short answers
physiology, Explain using Charts,
clinical neurological system
graphs Objective type
manifestations,
Nursing Assessment - History and Physical and
diagnostic Models, films, slides Assessment of
measures & neurological
nursing Demonstration skills with
Etiology, Pathophysiology , clinical manifestations,
management of check list
patients with diagnosis, treatment modalities and medical & Practice session Assessment of
neuro-logical Surgical nursing management of neurological
disorders disorders Case discussions/ patient
management
Congenital malformations Seminar problem
Headache Health education

Head Injuries Supervised clinical

practice
Spinal Injuries:
Drug book/ presentation
o Paraplegia
o Hemiplegia
Visit to rehabilitation
o Quadraplegia
centre
Spinal cord compression-herniation of
intervertebral disc
Tumors of the brain & spinal cord

Intra cranial & cerebral aneurysms

 Infections :
o Meningitis, Encepha-litis, Brain abscess,
neurocysticercosis
Movement disorders
o Chorea
o Seizures
o Epilepsies

Cerebro Vascular Accidents (CVA)

Cranial, Spinal Neuropa-thies - Bells palsy,

trigeminal neuralgia
Peripheral Neuropathies; Guillain-Barre Syndrome

Myasthenia gravis

Multiple sclerosis

Degenerative diseases
o Delirium
o Dementia
o Alzheimers disease
o Parkinsons disease
Management of unconscious patients & patients
with stroke
Role of the nurse in communicating with patient
 having neurological deficit
Rehabilitation of patients with neurological deficit
Role of nurse in long stay facility (institutions) and at
home
Special Therapies
Nursing procedures
Drugs used in treatment of neurological disorders.
IV 16 Nursing management of patients with disorders of
Describe the Lecture Discussion Essay type
female reproductive system
etiology, patho-
Review of anatomy and physiology of the female Explain using Charts, Short answers
physiology,
clinical reproductive system graphs
Objective type
manifestations,
Nursing Assessment - History and Physical Models, films, slides
diagnostic
Assessment of
measures & assessment
Demonstration
nursing skills with
Breast Self Examination
management of check list
Practice session
patients with
Etiology, Pathophysiology , clinical manifesta- Assessment of
disorders of
Case discussions/
female tions, diagnosis, treatment modalities and medical patient
reproductive & Surgical nursing management of disorder of Seminar management
system female reproductive system problem
Health education
Congenital abnormalities of female reproductive
Describe concepts Supervised clinical
system
of reproductive practice
Sexuality & Reproductive Health
health & family
Drug book/ presentation
welfare
Sexual Health Assessment
programme
 Menstrual Disorders; Dysmenorrhea, Amenorrhea,
Premenstrual Syndrome
Abnormal Uterine Bleeding; Menorrhagia,
Metrorrhagia
Pelvic Inflammatory Disease

Ovarian and fallopian tube disorders; infections,

cysts, tumours
Uterine & cervical disorders; Endometriosis,
polyps, Fibroids, Cervical & uterine tumours,
uterine displacement, Cystocele/
Urethrocele/Rectocele
Vaginal disorders; Infections, cysts, tumours

Diseases of breasts; Deformities, Infections, Cysts

and Tumours
Menopause and Hormonal Replacement Therapy

Infertility

Contraception ; Types Methods, Risk and

effectiveness
o Spacing Methods
- Barrier methods, Intera Uterine Devices,
Hormonal, Post Conceptional Methods, etc
 o Terminal methods
- Sterilization
Emergency Contraception methods

Abortion Natural, Medical & surgical abortion

MTP Act
Toxic Shock Syndrome

Injuries & Trauma; Sexual violence

Special Therapies
Nursing procedures
Drugs used in treatment of gynaecological disorders
National family welfare programme
V 10 Nursing management of patients with Burns,
Describe the Lecture Discussion Essay type
reconstructive & cosmetic surgery
etiology, patho-
Review of anatomy and physiology of the skin & Explain using Charts, Short answers
physiology,
clinical connective tissues and various deformities graphs
Objective type
manifesta-tions,
Nursing Assessment - History and Physical Models, films, slides
diagnostic
Assessment of
measures & assessment & Assessment of burns & fluid and
Demonstration
nursing electrolyte loss skills with
management of check list
Etiology, Classification, Pathophysiology, clinical Practice session
patients with
Assessment of
Burns, manifestations, diagnosis, treatment modalities and
Case discussions/
reconstruc-tive medical & Surgical nursing management of Burns patient
and cosmetic & Re-constructive and Cosmetic surgery; Seminar management
surgery problem
Types of Re-constructive and Cosmetic surgery; for Health education
 burns, congenital deformities, injuries & cosmetic
Supervised clinical
purposes
practice
Role of Nurse
Drug book/ presentation
Legal aspects

Rehabilitation

Special therapies
o Psycho social aspects
Nursing procedures
Drugs used in treatment of Burns, reconstructive and
cosmetic surgery
VI 10 Nursing management of patients with oncological
Describe the Lecture Discussion Essay type
conditions
etiology, patho-
Structure & characteristics of normal & cancer cells Explain using Charts, Short answers
physiology,
clinical graphs
Nursing Assessment - History and Physical Objective type
manifestations,
Models, films, slides
diagnostic assessment
Assessment of
measures &
Prevention, Screening, Early detection, Warning Demonstration
nursing skills with
management of signs of cancer check list
Practice session
patients with
Epidemiology, Etiology, Classification, Patho- Assessment of
oncology
Case discussions/
physiology, Staging, clinical manifestations, patient
diagnosis, treatment modalities and medical & Seminar management
Surgical nursing management of oncological problem
Health education
conditions
 Common malignancies of various body systems ; Supervised clinical
Oral, larynx, lung, Stomach & Colon, Liver, practice
Leukemias & lymphomas, Breast, Cervix, Ovary,
Drug book/ presentation
Uterus, Sarcoma, Brain, Renal, Bladder, Prostate
etc
Oncological emergiences

Modalities of treatment
o Immunotherapy
o Chemotherapy
o Radiotherapy
o Surgical Interventions
o Stem cell and Bone marrow transplants
o Gene therapy
o Other forms of treatment
Psychosocial aspects of cancer

Rehabilitation

Palliative care; Symptom and Pain Management,

Nutritional support
Home care

Hospice care

Stomal Therapy
 Special therapies
o Psycho social aspects

Nursing procedures

VII 10 Nursing management of patient in Emergency & Teaching Learning Activity

Describe Essay type
Disaster situations
Lecture Discussion
organization of Disaster Nursing :
Short answers
emergency &
Concepts & principles of Disaster Nursing Explain using Charts,
disaster care
Objective type
services graphs
Causes and Types of Disaster : Natural and Man-
Models, films, slides Assessment of
made
Describe the role
o Earthquakes, Floods, Epidemics, Cyclones skills with
Demonstration
of nurse in o Fire, Explosion, Accidents check list
disaster o Violence, Terrorism; bio-chemical, War
Practice session Assessment of
management
Policies related to emergency/disaster management;
patient
Case discussions/
International, national, state, institutional management
Seminar problem
Describe the role Disaster preparedness:
Health education
of nurse in
Team, Guidelines, protocols, Equipments,
management of
Supervised clinical
common Resources
Emergencies practice
Coordination and involvement of; Community,
Disaster management
various govt. departments, non-govt. organizations
& International agencies Drills
Role of nurse: working Drug book/ presentation
 Legal Aspects of Disaster Nursing

Impact on Health and after effects; Post Traumatic

Stress Disorder
Rehabilitation; physical, psycho-social, Financial,
Relocation
Emergency Nursing
Concept, priorities, principles & scope of
emergency nursing
Organization of emergency services: physical setup,
staffing, equipment and supplies, protocols,
Concepts of triage & role of triage nurse
Coordination & involvement of different
departments & facilities
Nursing Assessment- History and Physical
assessment
Etiology, Pathophysiology , clinical manifestations,
diagnosis, treatment modalities and medical &
Surgical nursing management of patient with
medical & surgical Emergency
Principles of emergency management

Common Emergencies;
 Respiratory Emergencies

Cardiac Emergencies

Shock & Haemorrhage

Pain

Poly-Trauma, road accidents, crush injuries, wound

Bites

Poisoning; Food, Gas, Drugs & chemical poisoning

Seizures

Thermal Emergencies
Heat stroke & Cold injuries
Pediatric Emergencies

Psychiatric Emergencies

Obstetrical Emergencies

Violence, Abuse, Sexual assault

Cardio Pulmonary Resuscitation

Crisis Intervention
 Role of the nurse; Communication & Inter personal
Relations
Medico-Legal Aspects;
VIII 10 Nursing care of the elderly Teaching Learning Activity
Explain the Essay type
Nursing Assessment History & Physical Lecture Discussion
concept and
Short answers
problems of aging assessment
Explain using Charts,
Ageing; Objective type
graphs
Describe nursing
Demography; Myths and realities Models, films, slides Assessment of
care of the elderly
skills with
Concepts & theories of ageing Demonstration
check list
Cognitive Aspects of Ageing Practice session Assessment of
patient
Normal biological ageing Case discussions/
management
Seminar problem
Age related body systems changes
Health education
Psychosocial Aspects of Ageing
Supervised clinical
Medications and elderly
practice
Stress & coping in older adults Drug book/ presentation

Common Health Problems & Nursing Visit to old age home

Management;
 Cardiovascular, Respiratory, Musculoskeletal,

Endocrine, genitor-urinary, gastrointestinal

Neurological, Skin and other Sensory organs

o Psychosocial and Sexual
o Abuse of elderly

Role of nurse for care of elderly: ambulation,

nutritional, communicational, psychosocial &
spiritual
Role of nurse for caregivers of elderly

Role of family and formal and non formal

caregivers
Use of aids & prosthesis (hearing aids, dentures,

Legal & Ethical Issues

Provisions & Programmes for elderly; privileges,

Community Programs and health services;
Home & institutional care

IX 10 Nursing management of patient in critical care units Teaching Learning Activity

Describe Essay type
Nursing Assessment History & Physical Lecture Discussion
organization of
Short answers
critical care units assessment
 Describe the role Classification Explain using Charts, Objective type
of nurse in graphs
Principles of critical care nursing Assessment of
management of
Models, films, slides
patients critical skills with
Organization; Physical setup, Policies, staffing
care units check list
Demonstration
norms,
Assessment of
Protocols, equipment and supplies Role plays
patient
management
Special equipments; ventilators, cardiac monitors, Counseling
problem
defibrillators,
Practice session
Resuscitation equipments
Case discussions/
Infection Control Protocols
Seminar
Nursing management of critically ill patient; Health education

Monitoring of critically ill patient Supervised clinical

practice
CPR-Advance Cardiac Life support
Drug book/ presentation
Treatments & procedures

Transitional care

Ethical & Legal Aspects

Communication with patient and family

 Intensive care records

Crisis Intervention

Death & Dying-coping with

Drugs used in critical care unit

X 8 Nursing management of patients adults including

Describe the Essay type
elderly with Occupational and Industrial disorders
etiology, patho-
Nursing Assessment History & Physical Short answers
physiology,
clinical assessment
Objective type
manifestations,
Etiology, Pathophysio-logy, clinical manifesta-
assessment,
Assessment of
diagnostic tions, diagnosis, treatment modalities and medical
measures & & Surgical nursing manage-ment of occupational skills with
management of and industrial health disorders check list
patients with
Role of nurse Assessment of
occupational
and industrial Special Therapies, alternative therapies patient
health disorder Nursing procedures management
Drugs used in treatment of Occupational & Industrial problem
disorders
 Medical Surgical Nursing II Practical
(Adult and Geriatrics) II
Placement : Third Year
Time : Theory 120 hrs
Practical 270 hrs
Clinical Training 430 hrs

Duration (in Objectives of Posting Assessment methods

Areas wks) Skills to be developed Assignments

ENT 1
Provide care to Perform examination Provide care to Assess each skill
patients with ENT of ear, nose and throat 2-3 assigned with checklist
disorders patients
Assist with diagnostic Assess
Counsel and Nursing care
procedures performance with
educate patient plan -1 rating scale
Assist with therapeutic
and families
Observation Evaluation of
procedures
reports of OPD observation report
Instillation of drops
of OPD
Maintain drug
Perform/assist with Completion of
book
irrigations activity record
Apply ear bandage

Perform tracheostomy
care
 Teach patients &
families
Ophtha- 1
Provide care to Perform examination Provide care to Assess each skill
mology
patients with Eye of eye 2-3 assigned with checklist
disorders patients
Assist with diagnostic Assess
Counsel and Nursing care
procedures performance with
educate patient plan -1 rating scale
Assist with therapeutic
and families
Observation Evaluation of
procedures
reports of OPD observation report
Perform/assist with
& Eye bank of OPD /Eye bank
irrigations
Maintain drug Completion of
Apply eye bandage
book activity record
Apply eye drops/
ointments
Assist with foreign
body removal
Teach patients &
families
Neurology 2
Provide care to Perform Neurological Provide care to Assess each skill
patients with assigned 2-3 with checklist
Examination
neurological patients with
Assess
disorders neurological
 disorders performance with
Counsel and Use Glasgow coma
rating scale
Case study/ case
educate patient scale
3.Evaluation of
and families presen-tation
Assist with diagnostic
1 case study &
procedures health teaching
Maintains drug
Assist with therapeutic Completion of
book
procedures activity record
Health
Teach patients &
Teaching-1
families
Participate in
rehabilitation program
Gyne- 1
Provide care to Assist with Provide care to Assess each skill
cology
ward patients with gynecological 2-3 assigned with checklist
gynecological patients
Examination Assess
disorders
Nursing care
performance with
Counsel and Assist with diagnostic
plan -1 rating scale
educate patient procedures
Maintain drug Evaluation of care
and families
Assist with therapeutic
book plan
procedures
Completion of
Teach patients families
activity record
Teaching self Breast
Examination
 Assist with PAP smear
collection
Burns 1
Provide care to Assessment of the Provide care to Assess each skill
Unit
patients with burns patient 1-2 assigned with checklist
Burns o Percentage of burns patients
Assess
o Degree of burns
Counsel and Nursing care
performance with
Fluid & electrolyte
educate patient plan -1 rating scale
and families replacement therapy
Observation Evaluation of care
o Assess
o Calculate reports of Burns plan and
o Replace unit observation report
o Record intake/output
Completion of
Care of Burn wounds
activity record
o Bathing
o Dressing

Perform active &

passive exercises
Practice medical &
surgical asepsis
Counsel & Teach
patients and families
Participate in
rehabilita-tion program
Onologly 1
Provide care to Screen for common Provide care to Assess each skill
Unit
patients with can-cers-TNM 2-3 assigned with checklist
Cancer classification patients
Assess
Counsel and Assist with diagnostic Nursing care
performance with
educate patient procedures plan -1 rating scale
and families o Biopsies
Observation Evaluation of care
o Pap smear
o Bone-marrow report of cancer plan and
aspiration unit observation report
Breast examination Completion of
activity record
Assist with therapeutic
procedures
Participates in various
modalities of treatment
o Chemotherapy
o Radiotherapy
o Pain management
o Stomaltherapy
o Hormonal therapy
o Immuno therapy
o Gene therapy
o Alternative therapy
Participating palliative
care
 Counsel and teach
patients families
o Self Breast
Examination
o Warning signs

Participate in rehabili-
tation program
Critical 2
Provide care to Monitoring of patients Provide care to Assess each skill
care unit
critically ill in ICU 1 assigned with checklist
patients patient
Maintain flow sheet Assess
Counsel patient Observation
performance with
Care of patient on
and families for report of rating scale
grief and ventilators Critical care
Evaluation of
bereavement unit
Perform Endotracheal
observation report
Drugs book
suction
Completion of
Demonstrates use of
activity record
ventilators, cardiac
monitors etc.
Collect specimens and
interprets ABG
analysis
Assist with arterial
puncture
 Maintain CVP line

Pulse oximetry

CPR ALS

Defibrillators

Pace makers

Bag-mask ventilation

Emergency tray/trolly-
Crash Cart
Administration of
drugs
o Infusion pump
o Epidural
o Intra thecal
o Intracardiac
Total parenteral
therapy
Chest physiotherapy

Perform active &

passive exercises
 Counsel the patient and
family in dealing with
grieving and
bereavement
Casualty/ 1
Provide care to Practice triage Observation Assess
Emergenc
y patients in report of performance with
Assist with assessment,
emergency and Emergency unit rating scale
disaster situation examination, investiga-
Evaluation of
tions & their interpreta-
Counsel patient
tions, in emergency & observation report
and families for disaster situations
Completion of
grief and
Assist in
bereavement activity record
documentations
Assist in legal
procedures in
emergency unit
Participate in managing
crowd
Counsel patient &
families in grief and
bereavement

Placement : Clinical Training Time : 9 weeks

Areas Duration (in Objective Skills Assessment

 week)
Medical ward 2 Provide comprehensive care to Integrated Practice Assess clinical performance with
patients with medical and rating scale
surgical
Surgical ward 2 conditions including
emergencies
Critical care unit /ICCU 1
Casualty/Emergency Assist with common operations
2
Operation Theatre
(Eye, ENT, Neuro)
Scheme of University Examination for Medical Surgical Nursing

Theory

There shall be one theory paper of three hours duration carrying 100 marks. Distribution of type of questions and marks for Medical
Surgical Nursing shall be as given under.

Distribution of Type of Quest0ions and Marks for Medical Surgical Nursing- II,

Type of Questions No. of Questions Marks Sub-total

Long Essay (LE) 2 10 20
Short Essay (SE) 10 5 50
Short Answer (SA) 10 3 30
Total Marks 100

Practical and Viva Voce

Internal Assessment University Total
Examination
Medical - Surgical Nursing- II 50 50 100

Note: All practical examinations must be held in the respective clinical areas.
One internal and one external examiner should jointly conduct practical /clinical examination for each student.