Upon completion of this course, students will be able to:
1. Apply concepts learned in prerequisite theory courses to the analysis
of needs of patients with unstable acute illness & severe chronic illness.
2. Apply Orem's Self-care Deficit Theory to clinical scenarios involving
patients with multiple self-care deficits.
3. Apply adult development concepts to the design of nursing systems for
4. Collaborate with other vocational nursing students in solving problems
related to hypothetical clinical scenarios where the VN assumes the
5. Compare and contrast effects of pathophysiological processes in older
adults with their effects in younger adults and children.
6. Predict the effects of medications on older adults, including effects
on functional status.
7. Describe common clinical syndromes encountered in adults & older adults
including typical nursing, medical and allied health care & pharmacologic
therapies such as in:
a. Acute renal failure and end-stage renal disease.
b. Degenerative neurologic and muscular disorders.
c. Musculoskeletal diseases.
d. Electrolyte imbalances.
e. Integumentary disorders (especially those common to the elderly).
f. Immune system disorders of complex, acute and terminal outcomes.
g. Respiratory disorders of complex and often terminal outcomes.
h. Cardiac and vascular disorders often leading to chronic and sometimes
acute and terminal outcomes.
i. Bowel disorders leading to altered body image and chronic outcomes.
j. Hepatobiliary disorders leading to chronic and often terminal outcomes
8. Formulate plans of care for patients in hypothetical scenarios with a
focus on diagnostics, labs and monitoring or responses to treatment.
9. Design brief tutorials for patients with chronic illness and those
cared for in their homes.
10. Resolve hypothetical ethical dilemmas related to organ transplant and
end of life issues (especially those common in the frail elderly).
11. Compare and contrast strategies and techniques employed in the care
of younger adults and children with of caring for the elderly.
12. Create a presentation of a community health promotion agency located
in our county and deliver it to peers for review and discussion.
Topics and Scope of Advanced Theory includes the following:
1. Mental Health Nursing
Assessment, intervention and evaluation of common disorders and
monitoring of responses to psychotropic drugs.
2. Leadership Role in the VN scope of practice.
Includes team leading role in skilled nursing and preceptee role in
preparation for entry level job as new graduate.
3. Care of the gerontological patient in a variety of health settings.
Changes of aging in normal physiologic processes.
Losses, sexuality issues, special concerns with pharmacologic and
4. End Stage Renal Disease and Organ Transplants.
Special care, diet, diagnostics, dialysis, drugs and overall nursing
care and treatment plan (including: consents, costs, criteria, and
transplant care and concerns related to drugs and complications.
5. Advanced level of gerontological concepts with clinical experience in
home care & skilled nursing in the community.
6. Community health nursing concepts and care of the chronically ill.
Reimbursement issues and governmental regulations, special care needs
of patients suffering from a variety of conditions on seizure meds
and having rehabilitative needs.
7. Vocational relationships and professional organizations.
a. BVNPT (Board of Vocational Nursing) roles/disciplinary hearing.
b. Teamleadership and conflict resolution.
c. Delegation to unlicensed personnel
d. Intershift reports and "getting & transcribing" of Dr.'s orders.
8. Common Chronic Illness problems related to degenerative disorders of
the neurologic system.
Parkinsons, Alzheimers, Myasthenia gravis, and Multiple sclerosis to
name a few, including nursing care and treatment plans.
9. Advanced monitoring of fluid & electrolyte status of patients
10. Chronic Illness including degenerative disorders related to the
muscular system and repetitive work injuries.
11. Advanced immunology theory.
a. AIDS: the current trends and treatments.
b. Hypersentitivity: allergy categories and treatment options.
12. Common gerontologic and chronic illness concerns related to skin
breakdown, current wound care, incontinence categories & treatment
13. Cardiovascular disorders with a focus on cardiogenic shock, heart
failure, pacemakers, and current trends in cardiology.
14. Critical thinking, priority setting, case study review for performing
quick data base collection and 5 minute assessment guidelines.
15. Peripheral Vascular disorders and relationship to culture and aging.
16. Common pulmonary problems: review of pneumonia, asthma, ARDS, and
cancer of the lung/head& neck leading to tracheostomy.
17. Public health issues: TB what's current in trends and treatment.
18. Gastrointestinal system with a focus on malabsorption syndromes and
stoma care resulting from ulcerative disease processes.
19. Hepatic and pancreatic disorders with a focus on hepatitis categories:
what's new in trends and treatment. Drug therapies and relationships
with blood glucose monitoring and pancreatic enzyme replacement.
20. Hematologic disorders reviewed with a focus on DIC, Sickle cell,
hodgkin's and non-hodgkins, leukemias and anemias (nursing care and
common treatment and drug therapy, monitoring of labs/diagnostics).
21. Emergency medical care with focus on burns & their categories for
treatment, first aid, disasters, CPR, poisonings and prevention
22. Preceptorship theory with focus on teacher/learner roles, leadership,
conflict resolution, self evaluation process, critical thinking and
priority setting for entry level new graduate role.
ESSENTIALS OF MEDICAL-SURGICAL NURSING, 4th ed., by S.C. deWit, W.B.
Saunders, Philadelphia (1998).
PHARMACOLOGY: A NURSING APPROACH, 3rd ed., by Kee & Hayes, W.B. Saunders
CARING FOR THE ELDERLY, 2nd ed., by M.A. Anderson & J.V. Braun, F.A.
Davis, Philadelphia (1999).
NRV 53 Syllabus.