Professional Documents
Culture Documents
3rd YrMedical Surgical Nursing
3rd YrMedical Surgical Nursing
3rd YrMedical Surgical Nursing
Course Description - The purpose of this course is to acquire knowledge and proficiency in caring for
patients with medical and surgical disorders in varieties of health care settings and at home.
Specific objectives - At the end of the course the student will be able to:
1. Provide care for patients with disorders of ear nose and throat.
2. Take care of patients with disorders of eye.
3. Plan, implement and evaluate nursing management of patients with neurological disorders.
4. Develop abilities to take care of female patients with reproductive disorders.
5. Provide care of patients with burns, reconstructive and cosmetic surgery.
6. Manage patients with oncological conditions
7. Develop skill in providing care during emergency and disaster situations
8. Plan, implement and evaluate care of elderly
9. Develop ability to manage patients in critical care units.
• 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
• Drugs used in treatment
of disorders of ear nose
and throat
• Role of nurse
Communicating with
hearing impaired and
mute.
• Nursing procedures
Oesophagostomy,
Tracheostomy,
II T=15 Describe the Nursing management of • Lecture • Essay type
P=02 etiology, path patient With disorders • Discussion • Short answers
physiology, clinical of eye • Explain using • Objective type
manifestations • Review of anatomy and Charts, using • Assessment of
diagnostic measures physiology of the eye- Models, films. Slides skills with
and management of • Nursing assessment – • Demonstration check list
patients with history and Physical practice session • Assessment of
disorders of eye. assessment • Case discussions/ patient
• Etiology, seminar management
pathophysiology, • Health education problem
clinical manifestations, • Supervised clinical
diagnosis, treatment practice
nursing management of • Drug book /
eye disorders: presentation
2
Refractive errors • Visit to eye bank
Eyelids-infection, • Participation in eye-
tumors and camps
deformities
Conjunctiva-
inflammation
Infection and
bleeding
Cornea-
inflammation and
Infection
Lens-Cataracts
Glaucoma
Disorder of the
uveal tract,
Ocular tumours
• Disorders of posterior
chamber and retina:
retinal and vitreous
problems
• Retinal detachment
• Ocular emergencies and
their prevention
• Drugs used in treatment
of disorders of eye
• Blindness
• National blindness
control program
• Eye Banking
• Eye prostheses and
rehabilitation
• Role of a nurse-
Communication with
visually impaired
patient, Eye camps
• Special therapies
• Nursing procedures: eye
irrigation, assisting with
removal of foreign
body.
III T=17 Describe the Nursing management of • Lecture discussion • Essay type
P=02 etiology, patho – patient With • Explain using • Short answers
physiology clinical neurological disorders Charts, graphs • Objective type
manifestations, • Review of anatomy and • Models, films, slides • Assessment of
diagnostic measures physiology of the • Demonstration skills with
and nursing neurological system • Practice session check list
management of • Nursing Assessment • Case discussions/ • Assessment of
patients with History and physical Seminar patient
neurological and neurological management
• Health education
disorders assessment and problem
• Supervised clinical
Glasgow coma scale practice
• Etiology, Path • Drug book/
physiology, clinical presentation
3
manifestations, • Visit to rehabilitation
diagnosis, treatment drugs used in
modalities and medical treatment of
& surgical nursing disorders of eye
management of center
neurological disorders
• Congenital
malformations
• Headache
• Head Injuries
• Spinal injuries
• Paraplegia
• Hemiplegia
• Quadriplegia
• Spinal cord
compression Herniation
of intervertebral disc
• Tumors of the brain &
spinal cord
• Intra cranial and
cerebral aneurysms
• Infections: Meningitis,
Encephalitis, brain
abscess,
neurocysticercosis
• Movement disorders:
Chorea Seizures /
Epilepsy
• Cerebro vascular
accidents (CVA)
• Cranial / spinal
neuropathies – Bell’s
palsy, trigeminal
neuralgia, Peripheral
Neuropathies; Guillan-
Barr’e syndrome
Myasthenia gravis
Multiple sclerosis,
Degenerative diseases,
Peripheral neuritis TIA
¾ Delirium Dementia
¾ Alzheimer’s disease
¾ Parkinson’s disease
• Management of
unconscious patients
and patients with stroke
• Drugs used in treatment
of neurological
disorders
• Role of the nurse in
communication with
patient having
neurological deficit
4
• Rehabilitation of
patients with
neurological deficit
• Role of nurse in long
stay facility
(institutions) and at
home Special therapies
Nursing procedures:
GCS, assisting with
diagnostic procedures
and rehabilitation
IV T=15 • Describe the Nursing management of • Lecture discussion • Essay type
P=02 etiology, patient s With disorders • Explain using • Short answers
pathophysiology, of female reproductive Charts, graphs • Objective type
clinical system Models, films, slides • Assessment of
manifestation, • Review of anatomy and • Demonstration / skills with
diagnostic physiology of the Practice session check list
measures and female reproductive • Case discussions/ • Assessment of
nursing system Seminar patient
management of • Nursing assessment- • Heath education management
patients with history and physical • Supervised clinical problem
disorders of assessment practice
female • Breast self examination • Drug book/
reproductive • Etiology, presentation
system. pathophysiology,
• Describe concepts clinical manifestations,
of reproductive diagnosis, treatment
health and family modalities and medical
welfare & surgical nursing
programmes management of disorder
of female reproductive
system
Congenital
abnormalities of female
reproductive system
• Sexuality and
Reproductive Health
• Sexual Health
Assessment
• Menstrual Disorders-
Dysmenorrhea,
Amenorrhea,
Premenstrual Syndrome
• Abnormal Uterine
Bleeding; Menorrhagia,
Metrorrhagia
• Pelvic inflammatory
disease-
• Ovarian and fallopian
tube disorders;
Infections Cysts,
Tumours
• Uterine and cervical
5
disorders;
Endometriosis, polyps,
Fibroids, Cervical and
uterine tumours,
• Uterine displacement,
Cystocele/ urethrocele/
rectocele
• Vaginal disorders;
Infections and
Discharges, fistulas
• Vulvur disorders;
Infection, cysts,
Tumours
• Diseases of breast
Deformities Infections
Cysts and Tumours
• Menopause and
hormonal replacement
therapy
• Infertility
• Contraception; types
Methods risk and
effectiveness
Spacing methods
-Barrier methods
- Intra uterine devices
- Hormonal post
conceptional methods
etc.
Terminal methods
sterilization
• Emergency
contraception methods
• Abortion-natural,
medical and surgical
abortion-MTP Act
• Toxic shock Syndrome
• Injuries and trauma;
sexual violence
• Drugs used in treatment
of gynecological
disorders Special
therapies vaginal
douche PAP smear
• Nursing procedures
assisting with
diagnostic and
therapeutic procedures,
• self-examination of
breast.
• National family welfare
programme
6
V T=08 Describe the Nursing management of • Lecture discussion • Essay type
P=02 etiology, patho patients With Burns, • Explain using • Short answers
physiology, clinical reconstructive and Charts, graphs • Objective type
manifestations, Cosmetic surgery Models, films, slides • Assessment of
diagnostic measures • Review of anatomy and • Demonstration skills with
and nursing physiology of the skin • Practice session check list
management of and connective tissues • Case discussion/ • Assessment of
patients with burns, various deformities Seminar patient
reconstructive and • Nursing assessment- • Health education management
cosmetic surgery History and physical problem
• Supervised clinical
examination & practice
assessment burns fluid • Drug book /
and electrolytes loss presentation
• Etiology, Classification,
pathophysiology,
clinical manifestations,
diagnosis, treatment
modalities and medical
& surgical and nursing
management of Burns
with special emphasis
of fluid replacement
therapy. Reconstructive
surgery
• Types of surgeries-
reconstructive,
cosmetic; for burns
congenital deformities,
injuries and cosmetic
purposes
• Role of nurse
• Legal Issues,
• Rehabilitation
• Special therapies
• Psycho social aspects
• Nursing procedures,
drugs used in treatment
of burns, reconstructive
and cosmetic surgeries.
VI T=13 Describe the Nursing management of • Lecture discussion • Essay type
P=02 etiology, patho patients With • Explain using • Short answers
physiology, clinical oncological conditions • Charts, graphs • Objective type
manifestations, • Structure & models, films, slides • Assessment of
diagnostic characteristics of • Demonstration skills with
manifestations, normal & cancer cells • Practice session check list
diagnostic measures • Nursing Assessment- • Case discussion/ • Assessment of
and nursing history and physical Seminar patient
management of assessment management
• Health education
patients with • Prevention, Screening problem
• Supervised clinical
oncology for early detection, practice
warning signs of cancer • Drug book/
• Epidemiology, etiology, presentation
7
classifications,
pathophysiology,
staging, clinical
manifestations,
diagnosis treatment
modalities and medical,
surgical & nursing
management of
malignant diseases
• Common malignancies
of various body system;
Brain Oral cavity,
larynx lung liver
stomach and colon,
breast cervix, ovary,
uterus, Sarcoma, renal,
bladder, prostate
leukemia and
lymphomas,
• Oncological
emergencies.
• Treatment Modalities –
Immuno therapy
Chemotherapy,
Radiotherapy Gene
therapy Stem cells &
Bone Marrow
transplants. other forms
of treatment
• Surgical interventions
• Psychosocial aspects of
cancer
• Rehabilitation &
Palliative care;
symptom and pain
Management –
nutritional support
• Home care, Hospice
care, Stoma care
• Psycho social aspects
• Nursing procedures and
Assisting with
diagnostic and
therapeutic procedures
8
VII T=10 • Describe Nursing management of • Lecture discussion • Short answers
organization of patient in EMERGENCY • Explain using • Objective type
emergency and & DISASTER situations • Charts, graphs • Assessment of
disaster care Disaster Nursing • Models, films, slides skills with
services • Concepts and principles • Demonstration check list
• Describe the role of Disaster Nursing • Practice session • Assessment of
of nurse in disaster • Causes and types of • Case discussion/ patient
management disaster: Natural and Seminar management
• Describe the role man-made Earthquakes, • Health education problem
of nurse in floods, epidemics,
• Supervised clinical
management of Cyclones, fire,
practice
Emergencies Explosion, Accidents
• Disaster
Violence, Terrorism;
management drills
Bio-chemical war
• Drug book/
• Policies related to
presentation
emergency/ disaster
Management;
International, national,
state, institutional
• Disaster preparedness:
Team, guidelines,
protocols, equipments,
resources Coordination
and involvement of
community, various-
government
departments, and non-
government.
Organizations and
International agencies
• Role of nurse in disaster
management
• Legal aspects of disaster
nursing
• Impact on Health and
after effects; post
Traumatic Stress
Disorder
• Rehabilitation; physical,
psychosocial Social,
Financial, Relocation
Emergency Nursing
Concept, priorities
principle and
• Scope of emergency
nursing
• Organization of
emergency services:
physical setup, staffing,
equipment and supplies,
protocols, Concepts of
triage and role of triage
nurse
9
• Coordination and
involvement of different
departments and
facilities
• Nursing Assessment-
History and physical
assessment
• Etiology,
pathophysiology,
clinical manifestations,
diagnosis, treatment
modalities and medical
& surgical nursing
management of patient
with medical and
surgical Emergency
• Principles of emergency
management
• Common Emergencies;
• Respiratory
Emergencies
• Cardiac Emergencies
• Shock and Hemorrhage
• 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 Emergences
• Violence, Abuse,
Sexual assault
• Cardio pulmonary
Resuscitation
• Crisis Intervention
• Role of the nurse;
Communication And
inter personal Relation
• Medico-legal Aspects;
10
VIII T=10 • Explain the Nursing care of the • Lecture discussion • Essay type
concept and elderly • Explain using • Short answers
problems of • Nursing Assessment- Charts, graphs • Objective type
ageing History and physical • Models, films, slides • Assessment of
• Describe nursing assessment • Demonstration skills with
care of the elderly • Ageing; • Practice session check list
• Demography; Myths and • Case discussion/ • Assessment of
realities Seminar patient
• Concepts and theories of • Health education management
ageing • Supervised clinical problem
• Cognitive Aspects of practice
Ageing • Drug book/
• Normal biological presentation Visit to
ageing old age home
• Age related body
systems changes
• Psychosocial Aspects of
Aging
• Medications and elderly
• Stress & coping in older
adults
• Common Health
problems & Nursing
Management;
• Cardiovascular,
Respiratory,
Musculoskeltal,
• Endocrine, genito-
urinary, gastrointestinal
• Neurological, Skin and
other Sensory organs
• Psychosocial and Sexual
• Abuse of elderly
• Role of nurse for care of
elderly: ambulation,
nutritional,
communicational,
psychosocial and
spiritual
• Role of nurse for
caregivers of elderly
• Role of family and
formal and non formal
caregivers Use of aids
and prosthesis (hearing
aids, dentures,)
• Legal & Ethical issues
• Provisions and
Programmes of elderly;
Privileges. Community
programs and health
services;
11
• Home and institutional
care
IX T=10 • Describe Nursing management of • Lecture discussion • Essay type
P=05 organization of patient in critical care • Explain using • Short answers
critical care units units Charts, graphs • Objective type
• Describe the role • Nursing Assessment- • Models, films, slides • Assessment of
of nurse in History and • Demonstration skills with
management of Physical assessment • Role plays check list
patients critical • Classification • Counseling • Assessment of
care units • Principles of critical • Practice session patient
care nursing • Case discussion/ management
• Organization; physical Seminar problem
setup, Policies, staffing • Health education
norms, • Supervised clinical
• Protocols, equipment practice
and supplies • Drug book/
• Special equipments; presentation
ventilators, cardiac
monitors, defibrillators,
• Resuscitation
equipments
• Infection Control
protocols
• Nursing management of
critically ill patient;
• Monitoring of critically
ill patient
• CPR-Advance Cardiac
life support
• Treatments and
procedures.
• Transitional care
• Ethical and Legal
Aspects
• Communication with
patient and family
• Intensive care records
• Crisis Intervention
• Death and Dying-
coping with
• Drugs used in critical
care unit
• Nursing procedures;
Monitoring of patients
in, assisting in
therapeutic and
diagnostic procedures,
CPR, ACLS
12
X T=4 Describe the Nursing management of • Demonstration • Essay type
etiology, patients adults including • Practice session • Short answers
pathophysiology, elderly with • Case discussion/ • Objective type
clinical occupational and Seminar • Assessment of
manifestations, industrial disorders • Health education skills with
assessment, • Nursing Assessment- • Supervised clinical check list
diagnostic measures History and physical practice • Assessment of
and management of assessment • Disaster patient
patients with • Etiology, management drills management
occupational and pathophysiology, problem
• Drug book/
industrial health clinical manifestations, presentations
disorder diagnosis, diagnosis,
treatment modalities
and medical & surgical
nursing management of
occupational and
industrial health
disorders
• Role of nurse Special
therapies, alternative
therapies Nursing
procedures Drugs used
in treatment of
Occupational and
Industrial disorders
Student References –
1. Black J.M. Hawk, J.H. (2005) Medical Surgical Nursing Clinical Management for Positive
Outcomes. (7thed) Elsevier.
2. Brunner S. B., Suddarth D.S. The Lippincott Manual of Nursing practice J.B.Lippincott. Philadelphia.
Suggested references
1. Lewis, Heitkemper&Dirksen (2000) Medical Surgical Nursing Assessment and Management of
Clinical Problem (6 thed) Mosby.
2. Black J.M. Hawk, J.H. (2005) Medical Surgical Nursing Clinical Management for Positive
Outcomes. (7thed) Elsevier.
3. Brunner S. B., Suddarth D.S. The Lippincott Manual of Nursing practice J.B.Lippincott. Philadelphia.
4. Colmer R.M. (1995) Moroney’s Surgery for Nurses (16 thed) ELBS.
5. 5. Shah N.S. (2003) A P I textbook of Medicine, The Association of Physicians of India Mumbai.
6. Satoskar R.S., Bhandarkar S.D. & Rege N.N. (2003) Pharmacology and Pharmacotherapeutics (19
thed) Popular Prakashan, Mumbai.
7. Phipps W.J., Long C.B. & Wood N.F. (2001) Shaffer’s Medical Surgical Nursing B.T.Publication
Pvt. Ltd. New Delhi.
8. 11 Haslett C., Chilvers E.R., Hunder J.A.A. &Boon, N.A. (1999) Davidson’s Principles and Practice
of Medicine (18 thed) Churchill living stone. Edinburgh.
9. 13 Walsh M. (2002) Watson’s Clinical Nursing and Related Sciences (6thed) Bailliere Tindall
13
Edinburgh.
PRACTICAL
Time: 270 hrs
Critical Care unit 2 • Provide care to • Monitoring of patients in • Provide care to I • Assess each
critically ill ICU assigned patient skill with
patients • Maintain flow sheet • Observation report of checklist
• Counsel and • Care of patient on Critical care unit • Assess
families for grief ventilators • Drugs book. performance
and bereavement • Perform Endotracheal with rating scale
suction • Evaluation of
• Demonstrates use of observation
ventilators, cardiac report
monitors etc. • Completion of
• Collect specimens and activity record
interprets ABG analysis
• Assist with arterial
puncture
• Maintain CVP line
• Pulse oximetry
• CPR-ALS
• Defibrillators
• Pace makers
• Bag-mask ventilation
• Emergency tray/ trolley-
Crash Cart
• Administration of drugs
Infusion pump
Epidural
Intra thecal
Intracardiac
• Total parenteral therapy
• Chest physiotherapy
• Perform active & passive
exercise
• Counsel the patient and
family in dealing with
grieving and
bereavement
16
Causality/ 1 • Provide care to • Practice ‘triage”. • Observation • Assess
emergency patients in • Assist with assessment, • Report of Emergency Performance
emergency and examination, Unit with rating scale
disaster situation investigations & their • Evaluation of
• Counsel patient interpretations, in observation
and families for emergency and disaster report
grief and situations • Completion of
bereavement • Assist in documentations activity record
• Assist in legal
procedures in emergency
unit
• Participate in managing
crowd
• Counsel patient and
Families in grief and
bereavement
EVALUATION
Internal Assessment:
Theory: Maximum marks 25
Periodical 25
Midterm 50
Pre-final 75
Total Marks 150
External Assessment:
(University Exam)
Theory 75 Marks
Practical 50 Marks
17
Nursing care plan
1. Patients Biodata:
Name, address, age, sex, religion, marital status, occupation, source of health care, date of admission,
provisional diagnosis, date of surgery if any
2. Presenting complaints:
Describe the complaints with which the patient has come to hospital
3. History of illness
History of present illness – onset, symptoms, duration, precipitating / alleviating factors
History of past illness – illnesses, surgeries, allergies, immunizations, medications
Family history – family tree, history of illness in family members, risk factors, congenital problems,
psychological problems.
4. Economic status of the family:
Monthly income & expenditure on health ,marital assets ( own pacca house car, two wheeler, phone,
TV etc…)
5. Psychological status:
Ethnic background,( geographical information, cultural information) support system available.
6. Personal habits:
Consumption of alcohol, smoking, tobacco chewing, sleep, exercise, and work elimination, nutrition.
7. Physical examination with date and time
8. Investigations
Date Investigation done Normal value Patient value Inference
9. Treatment
Sr. Drug: Dose Frequency Action Side effect & Nursing
No. (pharmacological Time Drug responsibility
name) interaction
18
12. Evaluation of care
Overall evaluation, problem faced while providing care prognosis of the patient and conclusion
Care plan evaluation
Sr. No. Contents Marks
1 History taking 03
2 Assessment and nursing diagnosis 05
3 Planning of care 05
4 Implementation and evaluation 08
5 Follow up care 02
6 Bibliography 02
Total 50
19
FORMAT FOR CASE PRESENTATION
Patients Biodata:
Name, address, age, sex, religion, marital status, occupation, source of health care, date of admission,
provisional diagnosis, date of surgery if any
Presenting complaints:
Describe the complaints with which the patient has come to hospital
History of illness
History of present illness – onset, symptoms, duration, precipitating / alleviating factors
History of past illness – illnesses, surgeries, allergies, immunizations, medications
Family history – family tree, history of illness in family members, risk factors, congenital problems,
psychological problems.
Economic status:
Monthly income & expenditure on health ,marital assets ( own pacca house car, two wheeler, phone, TV
etc…)
Psychological status:
Ethnic background,( geographical information, cultural information) support system available.
Personal habits:
Consumption of alcohol, smoking, tobacco chewing, sleep,exercise, work elimination, nutrition.
Physical examination with date and time
Investigations
Date Investigation done Normal value Patient value Inference
Treatment
Sr. Drug: Dose Frequency Action Side effect & Nursing
No. (pharmacological Time Drug responsibility
name) interaction
Description of disease
Definition, related anatomy physiology, etiology, risk factors, clinical features, management and nursing
care
Clinical features of the disease condition
Clinical features present in the book Description of clinical features of patient Pathophysiology
20
Nursing process:
Patient name: Date: Ward:
Date Assessment Nursing Objective Plan of Rationale Implemen Evaluation
diagnosis care tation
Discharge planning:
It should include health education and discharge planning given to patient.
Evaluation of care
Overall evaluation, problem faced while providing care prognosis of the patient and conclusion
21
EVALUATION FORMAT FOR HEALTH TALK
22
CLINICAL EVALUATION PERFORMA
Name of the Student : ___________________________________________________________
Year : ______________
Area of Clinical Experience : ___________________________________________________________
Duration of posting in weeks : ___________________________________________________________
Name of the Supervisor : ___________________________________________________________
23
Grade
Excellent = 80-100 %
Very good = 70 % and above
Good = 60 = 69 %
Satisfactory = 50- 59 %
Poor = Below 50 %
Student’s Remark:
24