2020/2021

2021/2022

DM270

MED/45 ()

DEPARTMENT OF PUBLIC HEALTH, NEUROSCIENCE, EXPERIMENTAL AND FORENSIC MEDICINE

NURSING

PERCORSO COMUNE

2°

3

45 lesson hours

Italian

WRITTEN AND ORAL TEST

BOZZANI SIMONA MARIA GIUSEPPINA (titolare) - 3 ECTS

The required and recommended knowledge includes the contents of the 1st year disciplines: General Nursing, Theories of nursing and relational educational foundations; Clinical Nursing I and Clinical Nursing II; ethics and deontology; professional organization. They are also required basic knowledge of the disciplines of the 1st year: anatomy, physiology, and clinical pathology, microbiology and immunology.

The purpose of this teaching is to analyze the care aspects relating to the adult / elderly person with medical conditions. The course is based on the nursing skills identified by the Tuning Educational Structures in Europe Project which in the 2nd year provide the ability to know and apply problem solving and decision making. In particular, the course provides the student with the contents that contribute to achieving the skills required for the 2nd year of the course. The organization of the contents will be implemented starting from the basic needs of the person and from the healthy and protective lifestyles, coming to understand the modification of the vital and functional capacities linked to the diseases of greatest epidemiological response today, such as diabetic, hepatic, respiratory diseases, renal, cerebrovascular. The understanding of the methods implemented by the person, caregiver and family to recover the greatest possible autonomy to meet health needs will be fundamental. Implement repair care and diagnostic and therapeutic treatments in collaboration with other health professionals. The communicative aspects - relational, ethical conduct and safety will be declined crosswise inside of care.

Introduction: maintenance care and repair The reception of the person at a health care or territorial structure: the course of treatment of the person subject to hospitalization for diseases of internal medicine field; informed consent to treatments and nursing care: forms of consent, legal foundations, responsibilities; Identification of the patient at the time of reception and in all phases of assistance.
Discharge planning and continuity of care VITAL NEED: EATING AND DRINKING APPROPRIATELY.
Changing the vital need for power in the person who is fed through the natural ways (orally) that changes due to the emergence / presence of diabetes, chronic respiratory, cerebral ischemic, chronic liver and kidney. Drug-food interactions, beverages, alcohol, drugs, cigarette smoking.
Modification of the vital need for food in a person who feeds artificially. Assistance to the person in artificial nutrition: Parenteral Nutrition and Parenteral Nutrition Total Assistance to the person in artificial nutrition.
Enteral nutrition through GNT and through PEG. Oral care in the person with GNT or PEG. VITAL NEED: ELIMINATION FOR ALL THE EMUNTORIES.
Assessment of the person aimed at identifying the possible factors that can influence urinary elimination: factors related to lifestyles and the state of health and disease. Assistance to the person undergoing blood and instrumental diagnostic evaluation of renal function and the administration of contrast medium. Prevention and treatment of situations that can induce renal insufficiency: dehydration / hypovolemia poorly controlled arterial hypertension, calorie protein malnutrition, urinary tract infections (particularly in the presence of a bladder catheter). Healthcare activities related to the control and monitoring of the hydroelectrolytic balance: assessment and care management of the state of dehydration, assessment and care management of the state of excess volume of liquids. Containment and prevention of falls risk related to cognitive impairment secondary to azotemia and acid base balance alteration. Monitoring for signs and symptoms of metabolic acidosis. Precautions in administering drugs orally and parenterally in the person with impaired renal function and consequent impairment of the need for urinary elimination. Interventions in collaboration with other professionals for the planning of proper nutrition and hydration in the impairment situation of urinary elimination related to acute or chronic kidney failure. Management of fatigue related to erythropoietin deficiency anemia: changes in the level of physical activity and strength of the person, maintenance of physical activity strategies with rest intervals. Promotion of hygienic care for the prevention of itching and lesions of the skin and mucous membranes related to azotemia. VITAL NEED: BREATHING NORMALLY. Assessment of the person aimed at identifying possible factors that can influence the state of oxygenation and the degree of respiration: factors related to lifestyles, health and disease.
Assistance to the person undergoing blood and instrumental diagnostic evaluation of respiratory function
Containment and prevention of falls risk related to cognitive impairment secondary to hypoxia / hypercapnia and acid-base balance alteration (EGA, NIV, Oxygen therapy). Interventions and care in case of dyspnoea, acute and chronic hypoxia, bronchial obstruction. Interventions and care in the management of long-term oxygen therapy (OTLT). Educational interventions in the use of non-mechanical ventilation at home. Education in the correct application of inhalation therapy and use of the spacer in the case of aerosol therapy, metered-dose inhalers (MDI), dry powder inhalers (DPI). Assistance to the person undergoing thoracentesis due to impaired breathing resulting from pleural effusion. Educational strategies to facilitate the adhesion of the person with COPD to the therapeutic program: a comprehensive approach to respiratory rehabilitation. VITAL NEED TO SLEEP AND REST. Sleep disturbance: sleep apnea syndrome and NIV care management.
PAIN: Pharmacological and non-pharmacological interventions to reduce pain during procedures. VITAL NEED TO MOVE AND MAINTAIN AN ADEQUATE POSITION.
The changes that cerebrovascular, chronic respiratory, diabetic, hepatic, chronic renal pathologies lead to the need to move and maintain an adequate position in the adult and the elderly: the prevalent clinical problems, maintenance and repair treatments.
VITAL NEED TO COMMUNICATE WITH OTHERS AND LEARNING. Information and education to be given to the person / caregiver / family, on the healthy and protective lifestyle to be adopted in case of diabetic, hepatic, renal, cerebral ischemic, chronic respiratory diseases. Information and education to be given to the person / caregiver / family on the self-administration of insulin and low molecular weight heparin. VITAL NEED TO PROVIDE PERSONAL HYGIENE AND PROTECT THE INTEGUMENTS: staging of Pressure Injuries according to NPUA / EPUAP (concept recovery). Prevention and classification systems (concepts recovery); Prevention of injury and nutritional screening (recovery concepts); Physical characteristics of an injury; Healing monitoring and pain assessment systems; Dressings for the treatment of pressure sores: general recommendations for the choice of dressing according to scientific evidence and general characteristics of the products; Wound Bed Preparation and the principles of TIME; Diabetic foot. TREATMENTS: DIAGNOSTIC AND THERAPEUTIC REQUIREMENTS (not included in the previous topics) Blood sampling, blood culture, exploratory punctures, intramuscular injections: technique, scientific principles, recommendations for execution, nursing responsibilities. Nursing responsibility and competence in drug administration. Transfusions.

Interactive lessons with the slide support and / or movies; exercises in plenary and / or in small groups of care situations that reproduce the main clinical pictures of the medical area, in order to develop the critical clinical-care reasoning necessary to plan nursing care.

Saiani L, Brugnolli A. (2017) Trattato di Medicina e Infermieristica. Un approccio di cure integrate. Napoli: Idelson Gnocchi. Saiani L, Brugnolli A. (2014) Trattato di cure infermieristiche. II edizione. Napoli: Idelson-Gnocchi.-Smeltzer S., Bare B., Hinkle J.L. (2010) Brunner Suddarth infermieristica medico – chirurgica. Casa editrice Ambrosiana. Milano-V. Henderson, Principi fondamentali della assistenza infermieristica- Appunti delle lezioni BISOGNO VITALE: ALIMENTARSI E BERE IN MODO ADEGUATO-RNAO (2004) Somministrazione di insulina sottocutanea in adulti con diabete di tipo 2. Traduzione a cura di Centro Studi EBN.ADI, AMD, SID. La Terapia medica nutrizionale nel Diabete Mellito. Raccomandazioni 2013-2014Ripa P., Sala E., Trobbiani T. (2007) Gli alimenti e i farmaci INSERTO REDAZ. allegato al n. 2/2007 Infermiere a Pavia. Ford E.S., Li C., Cunningham T.J., Croft J.B. (2014) Associations between antioxidants and all-cause mortality among US adults with obstructive lung function. British Journal of Nutrition. 112(10):1662-1673 Lenartova P., Habanova M., Mrazova J., Chlebo P., Wyka J. (2016) Analysis of visceral fat in patients with chronic obstructive pulmonary disease (COPD). Roczniki Państwowego Zakładu Higieny. 67(2):189-196Alauddin Md., Shirakawa H., Koseki T., Kijima N., Ardiansyah, Budijanto S., Islam J., Goto T., Komai M. (2016) Fermented rice bran supplementation mitigates metabolic syndrome in stoke-prone spontaneously hypertension rats. Complementary and alternative medicine. 16:442Aquilani R., Sessarego P., Iadarola P., Barbieri A., Boschi F. (2011) Nutrition for brain recovery after ischemic stroke: an added value to rehabilitation. Nutrition in clinical practice. 26(3):339-345Plow M., Moore S.M., Kirwan J.P., Frost F., Katzan I., Jaeger S., Alberts J. (2013) Randomized controllo pilota study of a SystemCHANGE TM weight management intervention in stroke survivor: rationale and protocol. Trilas. 14:130Lin M.P., Ovbiagele B., Markovic D., Towfighi A. 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(2015) La nutrizione artificiale, entrale e parenterale, nel paziente diabetico. Giornale Italiano di diabetologia e metabolismo. 35:60-68BISOGNO VITALE: RESPIRARE NORMALMENTE GOLD – agg.2015 Riabilitazione respiratoria nei soggetti con BPCO- Quesiti Clinico- Assistenziali – anno 2, n.10, agosto 2010. Editore Zadig MilanoCPAP nell’adulto - “Quesiti clinico-assistenziali” n. 3/ 2012 - Editore Zadig MilanoPuntura arteriosa – “Quesiti clinico-assistenziali” n. 3/ 2012 – Editore Zadig MilanoLa Dispnea - Quesiti Clinico- Assistenziali - anno 5, n.6, ottobre 2014. Editore Zadig Milano. DOLORE Song M, Li N, Zhang X, Shang Y, Yan L, Chu J, Sun R, Xu Y (2018) Music for reducing the anxiety and pain of patients undergoing a biopsy: A meta-analysis. Journal of Advanced Nursing. 74:1016-1029, Shabanloei R., Golchin M., Esfahani A., Dolatkhah R., Rasoulian M. (2010) Effects of music therapy on pain and anxiety in patients undergoing bone marrow biopsy and aspiration. 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The final assessment consists of two parts: written -Evidence integrated with the clinical nursing in surgery module consists of a test of 30 multiple choice questions: 15 related to surgical nursing clinical form and 15 related to clinical medicine nursing module. The test is passed if the score of each individual module is equal to 9/15. Passing the written test allows access to the oral test. - oral test - interview. It consists in the discussion of a medical area care situation in relation to which we evaluate the student's ability to apply the nursing process to identify care priorities and knowledge of the specific content of the module. The oral test is passed if the score is positive (≥18 / 30). The overall evaluation is given by the mathematical average between the two tests expressed out of thirty

Scientific papers presented in the classroom and suitable for the study are published on the portal KIRO http://idcd.unipv.it