Syllabus Information

1. General information

Adult Clinical Nursing is a compulsory subject, which is integrated by four subjects: Clinical Nursing I and Clinical Nursing II (second year), Clinical Nursing III (third year) and Clinical Nursing IV (fourth year) of the Nursing degree , with a total of 28 ECTS.

Upon passing the subject, the student will achieve the learning results indicated in this program, so the contents include knowledge of: physiopathology, physical assessment, diagnostic tests, combined treatment and special procedures, nursing, nursing diagnoses, as well as the planning and evaluation of specific nursing interventions for each patient

It is recommended that the student has knowledge of:

• Fundamentals of the Nursing Process and its stages.
• Management of nursing diagnoses according to NANDA, NIC, NOC.
• Anatomophysiological knowledge.
• Systematics of literature reviews.
• Skills in the use of basic software

These approaches and goals are aligned with the following SDGs of the United Nations 2030 Agenda, so that the acquisition of the learning results of the subject provides training and competence to contribute to some extent to their achievement: Goal 3: Health and wellness; Goal 5: Gender equality.

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2. Learning results

Upon completion of the subject, the student will be able to:

• Describe the aetiology, clinical manifestations, treatment and nursing interventions in hydroelectrolyte and acid-base imbalances
• Know the aetiology as well as the assessment, treatment and nursing care of patients with pain, oncologic processes, in shock, with inflammatory and infectious processes, sepsis, in hemorrhagic syndrome and in acute wound care
• Describe the nursing process to the surgical patient in the preoperative, intraoperative and postoperative periods.
• Apply the nursing process as a methodology for patient care based on practical clinical cases or assumptions
• Develop technical skills in therapies and nursing care.
• Know the nursing care systematics using the NANDA-NIC-NOC methodology.

3. Syllabus

MODULE 1: General. Pathophysiology and health patterns

Topic 1. Concept of Clinical Nursing.

Topic 2. Water-electrolyte balance. Distribution of liquids and electrolytes in the organism. Intakes and losses Alterations of water and electrolyte balance. Water balance. Treatment with parenteral fluids.

Topic 3. Pathophysiology of acid-base balance disorders. Identification and classification of acid-base balance disorders. Symptoms and nursing care.

Topic 4. Nursing care of the patient with hemorrhagic syndrome. Concept of haemorrhage. Classification. Aetiology. Symptoms Haemostasis techniques. Treatment and care.

Topic 5. Inflammation: Concept. Pathophysiology and classification. Symptoms Pharmacology of local inflammation: Symptoms and nursing care.

Topic 6. Infection Concept. Pathogenic microorganisms. Epidemiological chain Host defence reactions. Diffusion mechanisms in the organism. Symptoms Manifestations of local infection (phlegmon, abscess). Nosocomial infections: concept, preventive measures to avoid the transmission of the infection. Nursing process of a patient with infection. Sampling for microbiological culture

Topic 7. Septicaemia Concept. Aetiology. Pathophysiology Symptoms Diagnosis. Complications. Sepsis: concept and early diagnosis Severe sepsis; Nursing process to the septicaemia patient. Haemocultures technique

Topic 8. Patient in shock. Concept. Types of shock Pathophysiology Evolution. Diagnosis. Treatment. Nursing process to the patient in shock.

Topic 9: - Oncology: Concept of cancer and metastasis Etiopathogenesis. Tumour biology Symptoms General syndrome Early detection signs Classification of tumours. Treatment. Nursing care for oncologic patients

MODULE 2.

A) Nursing care for the surgical patient: Perioperative nursing. Concept of surgery Classification of the types of surgery. Informed consent.

Topic 10. Preoperative nursing care Nursing process: Initial assessment, nursing diagnoses (more frequent preoperative diagnoses), result planning, nursing interventions, result evaluation. Preoperative teaching Nursing interventions in the immediate preoperative period. Transfer of the patient to the operating room.

Topic 11. Intraoperative nursing care Surgical department: location and description. Disinfection. Functions of the surgical team. Basis of surgical scrubbing. Positioning of the surgical gown. Preparation of the instrument table. Basic surgical instruments. Sutures. Concept of ligation and suture. Choice of suture material. Types of needles. Types of suture threads.

Topic 12. Anesthesia. Concept and types of anesthesia. Anesthesia administration techniques. Basic monitoring of anesthesia. Nursing care during anesthesia. Potential anaesthetic complications.

Topic 13. Postoperative nursing care. Postoperative care unit. Admission and nursing care in the immediate postoperative period. Nursing process to the hospitalized postoperative patient: Admission to the hospitalization and care in the first hours after surgery. Main nursing diagnoses related to surgery in the postoperative period Postoperative follow-up until discharge. Surgical wound care. Types of surgical wounds. Surgical site infection prevention measures. Cure of the surgical wound. Types of drains. Removal of sutures.

B. Nursing care of the patient with acute pain

Topic 15. Pain. Physiology of pain. Assessment and treatment of pain. Nursing process to the patient with pain.

C. Adult life support

Topic 16. Initial care of the critically ill patient in the out-of-hospital setting.

D. Nursing care in wound care.

Topic 17. Nursing care in traumatic wounds.

E. Intoxications.

Topic 18. Care of the acutely intoxicated patient.

Content of SEMINARS

Problem solving and case studies (10 hs)

• Water balance calculation and interpretation
• Nursing management of patients with water and electrolyte imbalance
• Care of the patient with metabolic disorder
• Nursing process to the surgical patient in the preoperative and postoperative period.
• Nursing care of the patient with pain.

Laboratory practices type 6 (25 hs)

• Intravenous therapy: cannulation of peripheral veins.
• Hemodynamic monitoring, central venous catheters. Central Venous Pressure Monitoring and Interpretation
• Subcutaneous reservoirs (implantable systems): management and care.
• Alternative routes of drug administration: intranasal route, intraosseous route.
• Oxygen therapy and ventilation.
• Management of life-threatening wounds.
• Clinical case of a health problem, in which the student has to plan the care integrating the knowledge of the second year subjects
• Wound care and suturing.
• Basic surgical instruments.
• Instrumented basic life support.
• ECOE I.
• ECOE II.

4. Academic activities

The objective of these activities in the field of Clinical Nursing is to develop a comprehensive nursing process for adults who have or are at risk of suffering from a health disorder and the teaching-learning methodology used aims to make the student an active and responsible subject of their own learning.

• Master classes will be developed using an expository and participative teaching methodology (35h.).
• In addition, there will be problem solving sessions and case studies (10h.).
• Laboratory practices in small groups, for the learning of technical skills and the development of collaborative abilities among students, which allows for continuous evaluation by the teacher (25h.)

A tutorial follow-up of all students will be carried out by the teaching staff of the subject.

5. Assessment system

Type of tests and their value on the final grade and evaluation criteria for each test.

The evaluation of the subject will be carried out in the "Continuous" mode throughout the term, with the option of a "Global" evaluation at the end of the term or in the case of failing the continuous evaluation.

The student will be required to demonstrate achievement of the learning results through the following assessment activities:

• Written exam on the contents of the theoretical program and seminars: 75%.
• Individual work (optional): 15%.
• Objective Structured Clinical Evaluation (ECOE) (mandatory): 10%.

CONTINUOUS ASSESSMENT

First midterm exam: it is a voluntary and eliminatory test. It will consist of a multiple-choice questionnaire, with questions related to the theoretical contents of the thematic units and theoretical contents of the seminars. The topics eliminated in the midterm exam will also be considered eliminated in the final written exam (official) of the 1st and 2nd call. To pass this test, students must obtain 7 points out of 10. The dates will be announced in due time and will be held at the end of the module corresponding to each group.

Second midterm exam: it is a voluntary and eliminatory test. It will consist of a multiple-choice questionnaire, with questions related to the theoretical contents of the thematic units and the theoretical contents of the seminars. To pass this test, students must obtain 7 points out of 10. The dates will be announced in due time and will be held at the end of the module corresponding to each group.

Attendance and participation in the seminars is mandatory. Only one seminar can be missed, after two absences, the student must in June (on the same date as the official exam), a practical exam on the contents of the seminars. In this test the student must demonstrate that they has achieved the skills and competencies. The evaluation of the learning results of these practical activities will be carried out on a continuous basis. The grade will be “pass”/”fail”. If the grade is “fail”, the student will be able to perform the practice until they reach the required skills. In the event of failing or not having completed them , as indicated above, the student must take a practical exam on the contents of these seminars.

In order to pass the subject, the student must pass the seminar evaluation and the written exam.  The average of the grade of the two midterm grades will not be used to pass (the grade of each midterm must be equal to or higher than 7 to pass).

The grade of the individual work and the structured objective clinical evaluation will be added to the average of the two written exams, forming the final grade.

GLOBAL ASSESSMENT

The final written exam (75%): It will be carried out in case of opting for the global evaluation. It will be carried out in the official calls (1st and/or 2nd). It may contain short answer questions, essay questions and multiple choice questions from the entire syllabus including the continuous evaluation activities. This final exam is passed with 5 out of 10. This call may be used by students who have not eliminated the midterm exams of the continuous evaluation.

The practical exam on the contents of the seminars. It will be held on the date of the two official calls. They must be taken by students who have not taken the seminars on a continuous basis or have not obtained a passing grade.

Individual work (15%). This evaluable activity consists of several optional individual assignments (preparation of a topic, critical readings of articles, search for information in scientific sources, critical analysis of different sources of information, resolution of questionnaires) that will be proposed throughout the term and that will be chosen according to the teacher's criteria.

Objective Structured Clinical Evaluation (10%). The ECOE is a practical exam in which clinical competencies are evaluated: anamnesis (medical history), examination, clinical management (diagnosis, treatment and follow-up), communication skills, technical and preventive skills.