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

Pathophysiology applied at Nursing (2019/2020)

Course code
4S000090
Credits
9
Coordinator
Laura Cuzzolin

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

Learning outcomes

The course introduces the student to the basic concepts of major diseases and the fundamental pathogenetic processes, allowing them to correlate cellular homeostatic mechanisms to alterations of the organ functions and clinical manifestations of disease. Students will understand the basic principles of pharmacology, especially in pharmacokinetic and pharmacodynamic mechanisms, and the benefit and risk profile of the drugs. The course will helps students to develop an approach oriented to prevention, assessment and management of respiratory, urinary and intestinal function alteration and the multidimensional assessment of pain. PHARMACOLOGY: The course aims to provide general knowledge about the functions and the use of drug therapy, in the fields of pharmacodynamics, pharmacokinetics, pharmacoepidemiology and pharmacovigilance. Concepts of pharmacology are essential to the development of the nurse's own skills in management and control of drug therapies, as well in patient education. This course is preparatory to the study of the individual classes of drugs, which starts with anti-inflammatory and antibacterial drugs and will be completed in the clinical pharmacology module. SEMEIOTICS AND PHYSIOPATHOLOGY: The course introduces the student to the fundamental concepts of pathophysiology and semiotics, implicated in the activation of organ damage and in the development of the main diseases. The information necessary for understanding the set of events leading to the disease will be selected using a practical approach. Any further details will be reserved for the lessons that specifically deal with the organ and the apparatus. Every fundamental alteration will be explored within a specific organ and the different peculiar manifestations of the organ itself will be clarified. The lessons will also include the semeiotic part, describing the objective signs that characterize diseases. The treatment of semeiotics will be performed after treating the pathophysiology of the various organs. At the end of the course, students must be able to know the general mechanisms that lead to the disease and to identify their characteristics. CLINICAL NURSING I and II: The course offers the contents and the assistance methodology related to person's needs and to "fundamental" nursing care. The course will helps students to develop an approach oriented to prevention, assessment and management of respiratory, urinary and intestinal function alteration and the multidimensional assessment of pain. During teaching, frontal teaching methods will be privileged associated with sessions of application of the contents treated in care situations (guided exercises, video projections, clinical case analysis, testimony readings will be used to analyze and reflect on the perceptions and needs of the patients and family members). GENERAL PATHOLOGY: The course develops the preparatory contents for understanding the basic mechanisms of diseases. The following contents will be covered: the general principles and disorders of homeodynamics of complex systems, the main pathogenic esogenous and endogenous factors, biological damage, responses to damage, with particular reference to inflammation, the processes of healing and chronicity, immunity , haemostasis and thrombosis, vascular pathology and notions of general oncology. The course aims to help the student to understand the essential links between clinical analysis and fundamental mechanisms, facilitating the reading of the conceptual basis of the disease.

Syllabus

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MM: FARMACOLOGIA GENERALE
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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. The market of drugs in Italy. Leaflet of a drug. Off-label use. International Classification System of drugs. Defined Daily Dose (DDD). 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: SEMEIOTICA E FISIOPATOLOGIA
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- concept of cellular homeostasis - physiopathology of the hemopoietic, respiratory, gastrointestinal, urinary and cardiovascular apparatuses
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MM: INFERMIERISTICA CLINICA
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------------------------ MM: Infermieristica clinica 1 ------------------------ Urinary phaseout: the signs and symptoms more frequent in urination and major alterations a) assessment of urinary function and diagnostic procedures b) urinary tract infection (UTI) c) chronic and acute urinary retention: care interventions and acute management protocol d) care management of people with bladder catheter Pressure ulcers - Prevention - Treatment ------------------------ MM: Infermieristica clinica 2 ------------------------ 1) Objective examination: methods, concept of head-to-feet evaluation 2) Intestinal elimination: the most frequent signs and symptoms in intestinal disorders and the main alterations 3) Breathing: general assessment and definition of the main alterations; oxygen therapy 4) Pain: a method to ascertain acute and chronic pain
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MM: PATOLOGIA GENERALE
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The program in brief They will be explained: The general concepts of illness, disease and etio-pathology; the cell-based disease; oncology elements; immunity and inflammation Detailed program 1) Generalities a) Introduction to general pathology: fields and discipline purposes b) The disease: definition; causes (determinants, adjuvants, occasional); pathogenesis; course (recurrence, relapse); outcomes (healing, chronic, death); diagnosis (signs and physical examination, symptoms and medical history). 2) Cell pathology a) General concepts: the disease as the expression of cell damage? b) Degenerative changes of the cells: Causes (genetic, nutritional, from chemical, physical, from lack of oxygen, by living agents). reversible cell damage, irreversible cell death. morphological cell changes related to the damage: various aspects of degeneration and necrosis c) Modifications to steady-state cell: stationary phones were molecular changes (hypertrophy, atrophy, atrophy) and their causes cellular changes (hyperplasia, hypoplasia, aplasia) and their causes d) Alterations of cellular differentiation processes: Metaplasia, anaplasia, dysplasia 3) Oncology Definition of neoplastic cells, benign and malignant tumors, Natural history of cancer: advancement, growth, progress, general effects on body. Metastasis 4) Inflammation a) General concepts: utility of the inflammatory process b) 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). c) Chronic inflammation: Causes; pathogenetic mechanisms; granuloma and granulomatous diseases.

Assessment methods and criteria

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MM: FARMACOLOGIA GENERALE
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Learning evaluation of the topics related to general pharmacology is made inside the written exam of "Pathophysiology applied at Nursing": 15 questions with multiple-choice answers (2 correct between 5) or semi-structured are provided.
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MM: SEMEIOTICA E FISIOPATOLOGIA
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Written multiple choices test
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MM: INFERMIERISTICA CLINICA
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------------------------ MM: Infermieristica clinica 1 ------------------------ Written test ------------------------ MM: Infermieristica clinica 2 ------------------------ written exam with closed questions with multiple choice answers and / or open questions with short answer
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MM: PATOLOGIA GENERALE
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Written examination with questions with multiple answers.

Reference books
Author Title Publisher Year ISBN Note
Marina Vanzetta Roberto Leone Maurizio Volterrani Farmaci e infermiere. Un prontuario per la somministrazione McGraw-Hill Education 2013
Anna Maria DI Giulio, Silvano Gabriele Cella Farmacologia generale e speciale per le lauree sanitarie (Edizione 2) Piccin 2018 9788829929429
Taglialatela Conforti Cuzzolin Leone Mattioli Moretti Pignataro Vanzetta Farmacologia per le lauree triennali e magistrali II Edizione (Edizione 2) Sorbona 2019
Amoroso A., Riggio O., Afetra A., Costantino S., Picardi A., Vettore L. Semeiotica pratica Antonio Delfino Editore 2013
Saiani-Brugnolli Trattato di medicina e infermieristica Sorbona 2017
Pontieri GM Patologia e Fisiopatologia Generale per i corsi di laurea in professioni sanitarie (ristampa aggiornata) Edizioni Piccin, Padova 2007




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