Bachelor's degree in Nursing (to qualify as a nurse) (Vicenza)

Pathophysiology applied at Nursing (2016/2017)

Course code
4S000090
Credits
9
Coordinator
Claudio Sorio

Teaching is organised as follows:
Unit Credits Academic sector Period Academic staff
FARMACOLOGIA GENERALE 2 BIO/14-PHARMACOLOGY INF VI - 1° anno 2° sem Laura Cuzzolin
SEMEIOTICA E FISIOPATOLOGIA 2 MED/09-INTERNAL MEDICINE INF VI - 1° anno 2° sem Elena Zoico
INFERMIERISTICA CLINICA 3 MED/45-NURSING See the unit page See the unit page
PATOLOGIA GENERALE 2 MED/04-EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY INF VI - 1° anno 2° sem Claudio Sorio

Learning outcomes

The Course consists of four modules (General Pharmacology, Semeiotics and Physiopathology, Clinical Nursing, General Pathology) integrated to reach the objective of basic theoretical knowledge required for nursing practice. The learning outcomes are specified inside the different modules.
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MM: GENERAL PHARMACOLOGY
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The Course is targeted to give to the student basic knowledge and methodological instruments required to do nursing service in the management and monitoring of pharmacological therapies. The program covers also the study of basic principles of pharmacology, in particular pharmacokinetic and pharmacodynamic mechanisms, and introduces the student to the understanding and assessment of the risks and benefits of major therapeutic approaches.
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MM: SEMEIOTICS AND PHYSIOPATHOLOGY
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The course addresses the basic physiopathological concepts of the main diseases and the fundamental pathogenetic processes related to cell changes leading toward organ function, homeostatic mechanisms and eventually overt clinical manifestations of a disease.
Another objective of the course is the recognition of the main signs and symptoms of such alterations, favoring their interpretation.
One of the major aim of the teaching course is to favor the comprehension of an approach oriented to the definition of problems together with problem solving procedures by the evaluation of choices of disease prevention related to main organ functions and to an appropriate recognition and multidisciplinary assessment and solving procedures of acute and chronic pain symptoms.
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MM: CLINICAL NURSING
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The aim of the course is to develop a problem-solving approach to the choice of prevention and management interventions for body care impairment, respiratory, urinary and intestinal function, detection and multidimensional assessment of pain.-
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MM: GENERAL PATHOLOGY
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The course will develop some arguments of General Pathology preparatory to the understanding of the basic mechanisms of disease. The General Pathology comes at a critical point, the intersection between basic and clinical science. The course was aimed at establishing essential links between clinical and fundamental mechanisms, facilitating the understanding of the conceptual basis of disease.

Syllabus

The Course program consists of the programs of the individual teaching modules.
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MM: GENERAL PHARMACOLOGY
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GENERAL PRINCIPLES OF PHARMACOLOGY. Definition of drug, medicinal product, generic drug, biosimilar, galenic and magistral preparations. Origin of drugs and the process of drug development. Symptomatic, curative, preventive and substitutive drugs. Different actions of drugs: systemic or local, direct or indirect, primary or secondary, collateral, early or late onset. Pharmacokinetics: absorption (mechanisms, routes of administration, formulations), distribution (plasma protein binding, tissue vascularization, blood-brain barrier and placental transfer of drugs), biotransformation reactions and excretion of drugs, pharmacokinetic parameters (bioavailability, volume of distribution, elimination half-life, clearance). Pharmacodynamics: general mechanisms of action, receptor definition, drug-receptor interaction, agonism and antagonism, affinity and intrinsic activity of drugs. ADVERSE DRUG REACTIONS AND TOXICOLOGY. Clinical risks related to drug use: therapeutic errors and classification of adverse drug reactions. Pharmacovigilance: spontaneous reporting and the role of nurse. Drug dependence. Embryo-fetal toxicity. PHARMACOTHERAPY. The concepts of risk/benefit and cost/benefit applied to drug treatments. “Placebo” and “Compliance” definitions. Dosage, maximum dose, effective dose, posology, therapeutic index. Therapeutic plasma levels of drugs, peak concentrations, therapeutic range, accumulation, toxic concentrations. Therapeutic drug monitoring. Drug interactions. Variability in drug response: therapeutic problems in neonates and children, elderly, patients with renal or hepatic insufficiency. Antimicrobial therapy: selective toxicity, spectrum of action, bacteriostatic and bactericidal activity, microbial resistance. Pharmacological characteristics and adverse effects of the most important groups of antibiotics, antifungals and antivirals. Non-steroidal antiinflammatory drugs and paracetamol.
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MM: SEMEIOTICS AND PHYSIOPATHOLOGY
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Basic cell function mechanisms: contribution of O2, nutrients and elimination of metabolites, maintaining fluid and electrolyte balance and acid-base equilibrium. Anemias due to nutritional deficiency and hemoglobinopathies. Body fluid and electrolyte balance: maintaining volume and distribution of fluids and their alterations: overhydration syndromes and dehydration, intra-extracellular fluid equilibrium (isotonic, hypertonic and hypotonic), maintaining fluid and electrolyte balance and acid-base. Semiotics of hydroelectrolyte imbalances. Endocrine system: hormones with major metabolic activity and the circle adjustment and volumes, hyper and hypofunction of the main endocrine glands and response to stress; diabetes mellitus, hyper- and hypoglycemia. Elements of symptoms related to endocrine diseases. Respiratory system: ventilation, alveolar-capillary diffusion of gases, alveolar ventilation-perfusion. Respiratory failure. Semeiotics of respiratory system. Cardiovascular system: control of vascular tone and blood pressure, high blood pressure (notes on the pathophysiological hypotheses), ischemic heart disease, right and left heart failure and cardiogenic shock. Semeiotics of the cardiovascular system. Urinary system: main kidney diseases and on chronic renal failure. Digestive System: malnutrition, portal hypertension (brief notes), ascites. Elements of digestive symptomatology.
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MM: CLINICAL NURSING
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Physical examination: the methods, the concept of head-standing assessment. Physical examination of skin and appendages, chest and lungs, abdomen , vascular function.
Body care: assessment of the ability of body care and management of body care impairment. Cleansing principles. Hygiene activities and care of the body in the bathroom or bedside. Oral hygiene.

Urinary function: assessment of urinary function and diagnostic procedure, most common signs and symptoms in urinary disorders
Assessment and management of:
- urinary tract infections (UTI)
- urinary incontinence
- chronic and acute urinary retention
Bladder Catheterization: placement, treatment, removal and prevention of catheter associated urinary tract infections.

Bowel function:
Assessment of bowel function and diagnostic procedures.
Most common signs and symptoms in intestinal disorders.
Assessment and management of:
- constipation (with deepening of laxatives)
- diarrhea
- fecal incontinence
Execution of enema.

Respiratory function: general assessment and definition of major disfuntion.
The management of oxygen therapy.

Pain: pain patterns and pain classification, chronic and acute pain assessment methods. Pain as a multidimensional symptom, assessment tools
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MM: GENERAL PATHOLOGY
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INTRODUCTION TO GENERAL PATHOLOGY. Fields and discipline purposes. The disease: definition, causes (determinants, adjuvants, occasional), pathogenesis, course (recurrence, relapse), outcomes (healing, chronic, death), diagnosis (signs and physical examination, symptoms and medical history). Cell pathology: general concepts, the disease as the expression of cell damage; degenerative changes of the cells: causes (genetic, nutritional, from chemical, physical, from lack of oxygen, by living agents); reversible and irreversible cell damage, cell death. Morphological cell changes related to the damage: various aspects of degeneration and necrosis. Modifications to steady-state cell: stationary phones, molecular changes (hypertrophy, atrophy, atrophy) and their causes, cellular changes (hyperplasia, hypoplasia, aplasia) and their causes. Alterations of cellular differentiation processes: metaplasia, anaplasia, dysplasia. ONCOLOGY. Definition of neoplastic cells. Benign and malignant tumors. Natural history of cancer: advancement, growth, progress, general effects on body. Metastasis. INFLAMMATION. General concepts: utility of the inflammatory process. Acute inflammation: local and general manifestations of inflammation, causes, pathogenetic mechanisms (vascular component, the white blood cell component and the chemical mediators). The exudate and types of inflammation (erythema, serous, catarrhal, purulent, fibrinous, hemorrhagic, necrotizing). The consequences on body (abscess, phlegmon, fistula, adhesion, synechiae, payments). Chronic inflammation: causes, pathogenetic mechanisms, granuloma and granulomatous diseases.

Assessment methods and criteria

The exam takes place in multiple choice quiz format. The task includes 65 questions with multiple-choice answers (1-2 correct between 4-5) referred to the programs of all modules: 20 for the module of Clinical Nursing, 15 for each of the other three modules. The exam is passed when the sufficiency (18 votes) is reached in all modules. In some cases, an oral integration will be possible.

Reference books
Author Title Publisher Year ISBN Note
Pontieri GM Patologia e Fisiopatologia Generale Piccin Editore, Padova 2002
PONTIERI-RUSSO-FRATI PATOLOGIA GENERALE (Edizione 3) PICCIN 2005
Conforti A., Cuzzolin L., Leone R., Moretti U., Pignataro G., Taglialatela M., Vanzetta M. Farmacologia per le professioni sanitarie Idelson-Gnocchi Sorbona 2015 978-88-7947-592-1
Giuseppe Pontieri Elementi di fisiopatologia generale per corsi di laurea in professioni sanitarie (Edizione 3) Piccin 2012
Curatore: G. Covi, G. Montesi Fisiopatologia. L'essenziale per la clinica e l'assistenza (Edizione 1) Editore: Idelson-Gnocchi 2008 9788879474702
Amoroso A, Costantino S, Afeltra A, Picardi A, Vettore L. Semeiotica pratica. Sussidio multimediale per l’apprendimento e la verifica delle principali manovre semeiologiche. Centro Scientifico Editore 2005




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