Remedios Trinidad Romualdez Medical Foundation

College of Nursing
Tacloban City

COURSE OUTLINE IN NURSING CARE MANAGEMENT 106

COURSE NAME: Nursing Care Management 106

COURSE DESCRIPTION: This course deals with the principles and techniques of
nursing care management of sick clients across the lifespan with emphasis on the
adult and the older person with alteration/ problems in Cellular Aberration, Acute
Biologic Crisis, including Emergency and Disaster Nursing and IV therapy.

PLACEMENT: Fourth Year, First Semester

CREDIT: Lecture 6 Units
RLE 5 Units
PRE-REQUISITE: NCM 104 and NCM 105
COURSE OBJECTIVE:
At the end of the semester, and given actual clients, with problems in Cellular
Aberration, Acute Biologic Crisis and Emergency and Disaster Nursing, the students
will be able to:
1. Utilize the nursing process in the care of the individual, families in the
communities and hospital settings
1.1 Assess with the client his/ her/ their condition/ health status through
interview, physical examination, interpretation of laboratory findings.
1.2 Identify actual and potential nursing diagnosis
1.3 Plan appropriate nursing interventions with clients and family for
identified nursing diagnosis
1.4 Implements plan of care with client and family
1.5 Evaluate the progress of her/ his/ their condition and outcome of care.
2. Ensure a well-organized and accurate documentation system
3. Relate with client/s and the family the heath team appropriately
4. Observe bioethical concepts, principles, core values and nursing standards in
the care of the clients
5. Promote personal and professional growth of self and others.

LEARNING TOPICS DAT TIME/ INSTRUCT

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OBJECTIVES E HOUR
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Given an adult Orientation to NCM 106
client: middle, old, UNIT I. CELLULAR ABBERATION Aug. 9am -12nn Ma. C.
old-old, with A. Nature of the Problem 4, 3 hrs. Sekito
Cellular B. Etiology 2016
Aberration, the 1. Multistep Processes of Carcinogenesis
student will be 2. Factors inhibiting tumor growth
able to utilize the 3. Factors affecting rate of tumor growth
nursing process 4. Roles of Oncogenes
to: 5. Most susceptible
a. Genetic factors
Describe the b. Precancerous lesions
etiology of c. Chronic irritation
common Cellular d. Immunologic factors
Disorders. e. Drug effects
f. Environmental factors
Discuss the role of 1. Ionizing radiation
oncogenes and 2. Effects of the sun
suppressor genes 3. Air pollutions
in cancer 4. Chemical pollutants
development.

INSTRUCT
LEARNING TOPICS DAT TIME/
 OBJECTIVES E HOUR OR
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Describe the g. Lifestyle practices Aug. 9am -12nn Ma. C.
Multistep 1. Smoking, tobacco use 5, 3 hrs. Sekito
Processes of 2. Nutrition, sexual practices/ virtues 2016
Carcinogenesis 3. Psychosocial facto9rs
h. Theories of carcinogenesis
Compare the C. Epidemiology
cancer 1. Gender and sex
development 2. Age
processes of 3. Race
initiation and 4. Geographical factors
promotion. 5. Factors affecting prognosis
D. Physiology
1. Normal cell proliferation
Describe the a. Characteristics of normal cells
epidemiological b. Mitosis
factors related to c. Cell Cycle time
Cancer. 2. Normal alteration in cell growth
3. Normal cell differentiation

Distinguish the E. Pathophysiology Aug. 9am -12nn Ma. C.

features of normal 1. Classify and naming neoplasms 11, 3 hrs. Sekito
cells from those of 2. Methods of classifying of degree of 2016
benign tumors and malignancy
cancer cells. 3. Types of neoplasm
a. Benign tumors vs. malignant
proliferative patters
Correctly interpret b. Patterns of Proliferative cell growth
cancer grading b.1 hyperplasia
and staging b.2 metaplasia
reports. b.3 dysplasia
b.4 anaplasia
b.5 neoplasia
Describe the 4. Clinical manifestations of cancer
pathophysiology a. Local effects
of common b. Systemic/ psychophysiological effects
cellular disorders. 1. Anorexia-cachexia syndrome
2. Pain
Explain the 3. Hematologic alterations
common sites of 4. Infections
distant metastasis 5. Paraneoplastic syndromes
for cancer and 6. Physical stress
how metastasis 7. Psychological stress
contributes to 8. Metastasis
death from cancer. a. Types of metastasis
b. Sites of metastasis

Discuss the F. Health Promotion and Maintenance Aug. 9am -12nn Ma. C.
expected 1. Cancer prevention and control 12, 9 hrs Sekito
assessment data 2. Prevention, screening, and early 18,
for selected detection &19,
cellular disorders. of Common Cancers: 2016
a. Cancer of the Brain and Central
Develop a concept Nervous system
map on the b. Breast Cancers
Assessment data, c. Cervical Cancer
Nursing Diagnosis, d. Colorectal Cancers
Nursing e. Gastrointestinal Cancers
intervention and f. Genitourinary Cancers
desired outcomes g. Gynecologic Cancers
of common h. Head and Neck Cancer
cancers. i. Leukemia
j. Malignant Lymphoma

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OBJECTIVES E HOUR
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k. Lung Cancer
l. Multiple Myeloma
m. Skin Cancer
n. Bone Cancer

Discuss diagnostic G. Treatment Modalities

test findings for Collaborative Care Management
selected cellular 1. Prevention/ health promotion
disorders a. Avoidance of known or potential
carcinogens Aug. 9am- Mrs. E.
12nn
Discuss the b. Modification of associated factors 25, Rances
nursing c. Removal of At Risk tissues 2016 3 hrs
management of a d. Chemoprevention
client e. Gene therapy
experiencing a 2. Diagnostic test
cellular disorder. a. Laboratory test
b. Cytology
Identify expected c. Radiologic test
outcomes for the 1) X-ray and scanning procedure
client 2) Radioisotopes studies
experiencing a 3) Ultrasound
cellular disorder 4) Biopsy
5) Endoscopy
6) Other diagnostic methods
3. Surgical management
a. Nursing management of the patient
undergoing surgery
Discuss the Peri- 1) Diagnostic phase
operative nursing a) diagnostic surgery
management of b) cytologic specimens
clients with c) needle biopsy
cellular disorder. d) excisional biopsy and incisional
biopsy
2) Preoperative phase
a) surgery as treatment
b) surgery for recurrence and
metastasis
c) palliative surgery
d) reconstructive surgery
e) preventive surgery
3) Postoperative phase
a) nursing management of
surgical
client
b) assess discharge needs Aug. Mrs. E.
Discuss the 4. Immunotherapy and Biotherapy/ 26, 9am- Rances
nursing Biologic therapy 2016 12nn
management of a. Principles and underlying biotherapy 3 hrs
clients with b. Types of biologic responses modifiers
cellular disorder 1) Interferon
receiving 2) Interleukin 2 (IL-2)
Immunotherapy. 3) Hematopoietic Growth factors
4) Granulocyte Colony- stimulating
Factors (G-CSF)
5) Granulocyte Macrophage
Colony- Stimulating (GM-CSF)
6) Erythropoietin
7) Monoclonal antibodies
8) Vaccines
9) Anti-Angiogenesis Agents
c. Toxic and side effects of Biologic
Agents

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5. Bone Marrow and Stem Cell
Transplantation
 a. Types of Bone Marrow Transplants
b. Uses for Bone Marrow
Transplantation
c. Harvest Procedures
d. Preparative Regimens
e. Complications
f. Peripheral Stem Cell
Transplantation
g. Cord Blood Stem Cells
Identify priority 6. Gene Therapy
nursing diagnosis 7. Radiotherapy
of clients a. Principles
receiving b. How radiation therapy works
Radiotherapy. c. Types of radiotherapy
1) External beam radiotherapy
Discuss the 2) Brachytherapy ( Internal
nursing radiation)
management of a) Sealed-source
clients undergoing internal
external and radiotherapy
internal radiation b) Unsealed internal
therapy radiotherapy
d. Radiation safety standards
e. Treatment considerations for Sept. 9am- Ma. C.
radiation therapy 1, 12nn Sekito
f. Nursing Management of clients 2016 3 hrs
receiving radiation therapy
8. Chemotherapy
a. Principles
b. How chemotherapy Works
c. Goals of Chemotherapy
Classify d. Cell population growth
chemotherapeutic e. Cell-kill hypothesis
drugs according to f. Classification of Chemotherapeutic
their mechanism Drugs
of action. 1) Alkylating Agents
2) Antimetabolites
3) Antitumor Antibiotics
4) Plant Alkaloids (Mitotic
Inhibitors)
5) Nitrosoureas
Using schematic 6) Corticosteroids
diagram, illustrate 7) Hormones and Hormone
effect of Antagonists
Chemotherapy on g. Effect of Chemotherapy on
Normal tissues. Normal
Tissues
h. Treatment Plan
i. Evaluation Treatment Response
j. Criteria for Evaluating when to
Predict the toxic stop
effect of Chemotherapy
Chemotherapeutic 1) Complete Remission
Agents. 2) Partial Remission
3) Improvement
4) No response
5) Progression
k. Common Side effects/ Toxic
effects
of Chemotherapeutic
Agents
l. Methods of Administration
1) Oral
2) Intramuscular
3) Topical
4) Subcutaneous
5) Topical
6) Intravenous Chemotherapy
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OBJECTIVES E HOUR
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m. Vascular Access Devices
1) Silastic Right atrial
Catheters
2) Peripherally inserted Central
3) Venous Catheters and
Midline
Catheters
4) Implanted Infusion Ports
5) Infusion Pumps
n. Regional Chemotherapy
Administration
1) intra-arterial
2) intracavitary
3) intraperitoneal
4) intrathecal or
Intraventricular
5) Intravesical bladder
Identify priority Chemotherapy
nursing diagnosis o. Nursing Management of Clients
of clients Receiving Chemotherapy
receiving 1) Assessment
Chemotherapy. 2) Patient education
3) Management of Hair Loss
4) Counselling Regarding
Design a plan Sexual
nursing care to and Reproductive
clients Functions
experiencing 5) Nursing Diagnoses:
The side-effects/ a) Pain related to the
toxic effects of effects
Chemotherapeutic of the disease or its
Agents. treatment
b) Altered Nutrition
c) Ineffective
Management
of therapeutic
Regimen
d) Altered Oral Mucous
Membrane
e) Fatigue
f) Ineffective Individual
Coping
g) Body-image
disturbance
h) Altered Family
Processes
i) Risk for Infection
p. Guidelines for Safe Handling of Sept. 9am-
Ma. C.
Chemotherapeutic Agents 2, 12nn Sekito
1) Preparation 2016 3 hrs
2) Administration and
Exposure
to Excreta and Vomitus
during Administration
a) Disposal
b) Spills
c) Personnel
Recommend-
ation
H. Nursing Management of Oncologic treatment
1. Myelosuppression
2. Neutropenia
3. Thrombocytopenia
4. Anemia
5. Gastrointestinal Effects
a. nausea and vomiting
b. anorexia
 c. stomatitis
6. Integumentary Effects
a. alopecia
b. skin reaction
7. Effects on the Reproductive system

LEARNING TOPICS DAT TIME/ INSTRUCT

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OBJECTIVES E HOUR
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I. Complications Resulting from Cancer
1. Infection and pain
2. Oncologic Emergencies
a. Obstructive emergencies
1) Superior Vena Cava
Syndrome
2) Spinal Cord Compression
3) Third Space syndrome
4) Intestinal Obstruction
b. Metabolic emergencies
1) Syndrome of Inappropriate
Antidiuretic Hormones
Analyze the 2) Hypercalcemia
Psychological 3) Tumor Lysis Syndrome
Aspects of Cancer 4) Septic Shock and
Care Disseminated
Intravascular
Coagulation
c. Infiltrative Emergencies
Identify expected 1) Cardiac Tamponade
outcomes for 2) Carotid Artery Rupture
client experiencing J. Psychological Aspects of Cancer Care
a cellular disorder. 1. Providing support for clients
2. Promoting positive self-concepts
3. Promoting Coping throughout the
cancer
Continuum
Utilize the a. diagnosis and treatment
WHO Pain Ladder b. survivorship
As guide in c. recurrent disease and progression
the management d. terminal illness
of cancer pain. K. Management of Cancer Pain
1. Essential Components of Cancer Pain
Assessment
a. Location
b. Intensity
c. Quality
d. Pattern
e. Relief
f. Measures
2. Three-Step Analgesic Ladder (WHO)