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

Pathophysiology applied at Nursing (2017/2018)

Course code
4S000090
Credits
9
Coordinator
Barbara Rossi

Teaching is organised as follows:
Unit Credits Academic sector Period Academic staff
FARMACOLOGIA GENERALE 2 BIO/14-PHARMACOLOGY INF TN - 1° anno 2° sem Ugo Moretti
SEMEIOTICA E FISIOPATOLOGIA 2 MED/09-INTERNAL MEDICINE INF TN - 1° anno 2° sem Cristiano Fava
INFERMIERISTICA CLINICA 3 MED/45-NURSING See the unit page See the unit page
PATOLOGIA GENERALE 2 MED/04-EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY INF TN - 1° anno 2° sem Barbara Rossi

Learning outcomes

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MM: FARMACOLOGIA GENERALE
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Aim of the unit of General Pharmacology within the course of Application Physiopathology at Nursing is to give basics related to mechanism and use of drugs, with reference to pharmacodynamic, pharmacokinetic, pharmacoepidemiology and pharmacovigilance. Basic concepts in pharmacology are preparatory for the nurse’s role in the management and surveillance of pharmacological therapies an in patient’s education in the use of drugs. The general pharmacology module is preparatory to the study of each class of drugs, which starts from the anti-inflammatory and antibacterial drugs in this module and will be completed in clinical pharmacology module.
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MM: SEMEIOTICA E FISIOPATOLOGIA
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The course introduces the student to the basic concepts of major diseases and the fundamental pathogenetic processes correlate to cell changes, the organ function, homeostatic mechanisms, and clinical manifestations of disease. It is also proposed the study of the basic principles of pharmacology, in particular pharmacokinetic and pharmacodynamic mechanisms and introduces the student to understand and assess the benefit and risk profile of medicines. It is also proposed to develop in the student an approach oriented to the definition of the problems, the choice of prevention interventions and alterations management of respiratory function and elimination, the recognition and multidimensional assessment of pain.
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MM: INFERMIERISTICA CLINICA
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------------------------ MM: Infermieristica clinica 1 ------------------------ The Clinical Nursing I and II course aims to provide students with basic and clinical care content and methodology regarding the areas of need of the assisted person and primary nursing care. In particular, identifying, assessing needs and problems arising from basic function deficiencies, planning and implementation of evaluation work. It is also proposed to develop in the student an approach oriented to the definition of problems, to the choice of interventions for the prevention and management of changes in respiratory function and elimination, to the detection and multidimensional assessment of pain. Teaching methods will be preferred during the teaching process, associated with moments of application of the content treated to help situations (guided exercises, video projections, clinical case analysis, testimony readings to analyze and reflect upon perceptions and needs of patients and family). ------------------------ MM: Infermieristica clinica 2 ------------------------ The Clinical Nursing I and II course aims to provide students with basic and clinical care content and methodology regarding the areas of need of the assisted person and primary nursing care. In particular, identifying, assessing needs and problems arising from basic function deficiencies, planning and implementation of evaluation work. Teaching methods will be preferred during the teaching process, associated with moments of application of the content treated to help situations (guided exercises, video projections, clinical case analysis, testimony readings to analyze and reflect upon perceptions and needs of patients and family).
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MM: PATOLOGIA GENERALE
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The course introduces the student to the basic concepts of major diseases and the fundamental pathogenetic processes correlate to cell changes, the organ function, homeostatic mechanisms, and clinical manifestations of disease. It is also proposed the study of the basic principles of pharmacology, in particular pharmacokinetic and pharmacodynamic mechanisms and introduces the student to understand and assess the benefit and risk profile of medicines. It is also proposed to develop in the student an approach oriented to the definition of the problems, the choice of prevention interventions and alterations management of respiratory function and elimination, the recognition and multidimensional assessment of pain.

Syllabus

MM: FARMACOLOGIA GENERALE
Basic principles in Pharmacology and introduction to the drugs in the market Definition of drug, active substance, pharmaceutical product, vehicle, eccipient, the placebo effect Evaluation of the drugs’ efficacy: the randomized clinical trial Different sources of drugs. How the drugs enter in the market Bioequivalent and biosimilar drugs The italian market for drugs. The drug prescription: fascia A e C, OTC and SOP drugs, different type of prescriptions Indications and contraindications. The off-label use How to measure the drug use: the DDD Pharmacodynamic Basic principles of the mechanism of action of drugs (drug’s receptor, drug-receptor interaction: agonism and antagonism) Pharmacokinetic Drug’s absorption. Main characteristics of different drug administration routes: advantages and disadvantages. The bioavailability of drugs. Food-drugs interactions The drugs’ distribution in the body. Factors that can influence the drugs’ distribution: the blood-brain and placentar barriers Characteristics of drug metabolism. Enzyme induction and inhibition Drug’s clearance. Factors that may alter influence drug’s clearance Definition and meaning of dose, maximum dose, daily dose, dosing, therapeutic index, clearance, half-life, peak blood levels, therapeutic range, toxic concentrations, accumulation Relationship between plasma concentrations of drugs and their action Factors to be taken into account in determining the dose of a drug, and in the case of repeated administrations, the dosing interval. How to calculate pharmaceutical doses. Pharmacotherapy Basics of risk/benefit and cost/benefit analyses for drugs. Adverse drug reactions: mechanisms and risk factors. The spontaneous reporting system of adverse drug reactions: regulation and role for nurses Antibacterial drugs: general issues and characteristics of the main classes of antibacterial drugs Basics of antivirals and vaccines Non-steroidal anti inflammatory drugs (NSAIDs).

MM: SEMEIOTICA E FISIOPATOLOGIA
Basic needs of the cells: contribution of O2, nutrients and elimination of metabolites, maintaining fluid and electrolyte balance and acid-base intake. Anemia: in particular deficiency anemia, and hemoglobinopathies iporigenerative. • Body fluid and electrolyte balance: maintaining volume and distribution of fluids and their alterations: syndromes overhydration and dehydration, intra-extracellular fluid equilibrium, intra and extracellular buffer systems, maintaining fluid and electrolyte balance and acid-base. Semiotics of hydro electrolytic 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 the endocrine symptomatology. • Respiratory system: a change in ventilation, alveolar-capillary diffusion of gases, the report alveolar ventilation-perfusion. Respiratory failure. Signs of respiratory symptomatology. • Cardiovascular system: control of vascular tone and blood pressure, high blood pressure, ischemic heart disease, right and left heart failure and shock. Semiotics of the heart. • Urinary system: very brief about kidney disease and on the chronic renal failure. • Digestive System: malnutrition, portal hypertension, ascites. Elements of digestive symptomatology • Suffering of the central nervous system as a result of metabolic disorders.

MM: INFERMIERISTICA CLINICA
MM: Clinical nursing 1. Breathing General assessment and definition of major alterations Hypoxia, dyspnoea, cyanosis, cough, hematoma, bronchial, sputum and orthopedic obstruction A) Assessment of breathing B) Basic interventions to promote respiration and mucus clarence. Oxygen therapy. Pain A) pain patterns, B) Classification of pain based on etiopathogenesis and localization, C) Achieving chronic and acute pain: guiding principles, assessing pain size, measuring instruments, D) pain from diagnostic / therapeutic and relief procedures E) non-pharmacological interventions.
MM: Infermieristica clinica 2. Body care and nursing management of the self-care deficit. Urinary elimination: nursing assessment and management. Particular focus will be on urinary incontinence, urinary retention and bladder catheter. Objective Examination: methodology and content about data observation, normality indicators, interpretation and main changes. The focus will be on the following devices or organs: head and neuromotor, chest, cardio-respiratory and vascular system, tegumentary and abdomen

MM: PATOLOGIA GENERALE
Introduction to general pathology. Concepts of homeostasis and functional reserve organ. The disease: definition, causes; concept of pathogenesis. • cellular pathology: General concepts: steady state cell and tissue and its alterations: a) degenerative changes in the cells and cell death. b) Amendments of volumetric cells and their causes c) numerical modifications of cells and their causes d) Alterations of cellular differentiation processes. • Inflammation: General concepts: inflammation as a reaction of the body to harmful agents Types of inflammation: a) Acute inflammation: - General and fundamental moments Features. - Outline of chemical mediators of inflammation - Particular aspects of acute inflammation, and their consequences on the organism - Evolution of acute inflammation b) Chronic inflammation: - Features and pathogenetic mechanisms - The granulomas. - Useful and harmful effects of inflammation - General Manifestations of inflammation • The healing process of a wound: Phases of wound healing: coagulation, formation of granulation tissue scarring. Complications of the healing process: infection, dehiscence, keloid formation. • General oncology: - General characteristics of tumors: benign and malignant tumors. - The neoplastic cell: structural and functional aspects and give the guest mechanisms - Study the causes of cancer: epidemiological and experimental data - Overview of main chemical carcinogens, physical and biological - Overview of genes involved in the determinism of cancer. - Natural history of cancer: initiation, promotion, progression, metastasis - Mechanisms of defense against cancer: relationship between immunity and cancer. - Systematics of neoplasms. • General Hemostasis: General observations about the normal hemostatic mechanisms. A) Deficit of haemostatic mechanisms: bleeding causes of hemorrhage; local manifestations and general of bleeding disorders B) Thrombosis: General characteristics and pathogenesis of venous and arterial thrombosis; Consequences of thrombosis: angina and heart attack embolism signs. • Immunology - Immune response: natural immunity and specific immunity. organs primary and secondary lymphoid. NK cells. - B cells and T. - Concept of antigen. - Antibodies. - Overview of immune deficiencies - Autoimmunity: causes and and examples of autoimmune diseases. - The hypersensitivity reactions: General mechanisms of local and generalized hypersensitivity reactions: Examples of the most common hypersensitivity reactions.

Assessment methods and criteria

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MM: FARMACOLOGIA GENERALE
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Writing test with multiple choice questions
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MM: SEMEIOTICA E FISIOPATOLOGIA
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Writing exam (Multiple choice test), eventual oral exam Books: Pontieri G.M., Patologia Generale e Fisiopatologia Generale, 2007, Ed. Piccin II edizione: Padova. Howland R. D., Mycek M.J. Le basi della farmacologia, 2007, Zanichelli Anglani A. Farmacologia e Tossicologia, 1995, McGraw-Hill: Milano Clayton,Stock: Fondamenti di Farmacologia per infermieri II Ed. 2007, EdiSES - Napoli Cella S.G., Di Giulio A.M., Gorio A., Scaglione F. Farmacologia generale e speciale per le lauree sanitarie, 2010, Piccin Padova Saiani L. e Brugnolli A. (2011). Trattato di cure infermieristiche, Ed. Sorbona Napoli Miller M.J. Fisiopatologia. Principi della Malattia. Ed. Ambrosiana, Milano. Raffaele Antonelli Incalzi “Medicina Interna per scienze infermieristiche” 2012 by Piccin Nuova Libreria S.p.a. Padova http://emedicine.medscape.com/
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MM: INFERMIERISTICA CLINICA
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------------------------ MM: Infermieristica clinica 1 ------------------------ The evaluation of the course will be carried out both in written form with short-term open questions where it is required to motivate data, select data and support them, assist them and motivate them using sources and physiopathological mechanisms. Multiple-choice test questions, response questions "to completion" small situations with options of choice. Oral mode may also be proposed. The examination will be divided into 2 modules of Clinical Nursing I and II The final vote, if positive, may also include elements of active participation during the lessons and adherence to the pre-reading mandates of the text. MM: Clinical nursing 1 The contents of the evaluation relate to the topic: * Breathing - General assessment and definition of major alterations. Respiratory, evaluation and care management of hypoxia, dyspnoea, cyanosis, cough, hematoma, bronchial, sputum and orthopedic obstruction Basic interventions to facilitate respiration and clarary mucus ciliary (postural change, humidification, effective cough, position) Oxygen therapy, both hospital and long-term, systems and careers for delivery, attention, and monitoring elements on the patient. * Acute, Post-Operative, Procedural, Oncological and Chronic Pain - recurrent, breakthrough pain, chronic and acute pain detection, scales and instruments for measurement, pain from diagnostic / therapeutic and relief procedures and non-pharmacological interventions ------------------------ MM: Infermieristica clinica 2 ------------------------ Written test
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MM: PATOLOGIA GENERALE
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Writing test.

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
A. Conforti, L. Cuzzolin, R. Leone, U. Moretti, G. Pignataro, M. Taglialatela, M. Vanzetta Farmacologia per le professioni sanitarie (Edizione 1) Idelson-Gnocchi 2015 978-88-7947-592-1
Rossi F., Cuomo V., Riccardi C Farmacologia per le professioni sanitarie (Edizione 1) Edizioni Minerva Medica 2014 9788877117878
Giuseppe Pontieri Elementi di fisiopatologia generale per corsi di laurea in professioni sanitarie (Edizione 3) Piccin 2012
Regueiro Gonzales J.R. Immunologia - Biologia e Patologia del sistema immunitario Piccin 2012
Pontieri GM Patologia e Fisiopatologia Generale per i corsi di laurea in professioni sanitarie (ristampa aggiornata) Edizioni Piccin, Padova 2007




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