Medical and surgical nursing 3

Module Clinical nursing in General medicine

The main nursing problems in the medical area:

• non-adhesion / ineffective therapeutic regimen management
• self-care of the patient: educational methodology
• management of hospital discharge
• The continuity of care

Atherosclerosis:

• assessment (signs and symptoms)
• collaboration in diagnostics
• management of drug therapy
• patient self-care education (healthy lifestyle, diet, sodium restriction, self-monitoring of BP, ....)
• Ischemic heart disease:

Ischemic heart disease:

• assessment (signs and symptoms)
• collaboration in diagnostics
• clinical care management of the patient 
• rehabilitation of the patient with ischemic heart disease
• management of drug therapy (TAO / NAO)
• patient self-care education (pain recognition, drug therapy, lifestyles, ....)

Heart failure:

• 
  
• assessment (signs and symptoms)
• collaboration in diagnostics
• clinical care management of the patient with heart failure (water overload)
• management of drug therapy
• patient self-care education (drug therapy, lifestyles, ....)

Cirrus of the liver:

• assessment (signs and symptoms)
  
• collaboration in diagnostics (ultrasound, liver biopsy, paracentesis, ....)
• clinical care management of the patient with liver cirrhosis (patient with ascites, hepatic encephalopathy, malnutrition, coagulation disorders, hepatorenal syndrome)
• management of drug therapy
• patient self-care education (drug therapy, lifestyles, diet, ....)

Chronic Obstructive Bronchopathy:

• assessment (signs and symptoms)
  
• collaboration in diagnostics (spirometry, pulse oximetry, and blood gas analysis)
• clinical care management of the COPD patient (tolerance to physical activity, nutritional status, sleep quality, respiratory rehabilitation, oxygen therapy, or other ventilatory support)
• management of drug therapy
• patient self-care education (drug therapy, lifestyles, diet, prevention of exacerbations, ....)

Bronchial asthma:

• assessment (signs and symptoms)
  
• collaboration in diagnostics (spirometry)
• care clinic for patients suffering from bronchial asthma (crisis management)
• management of drug therapy
• patient self-care education (drug therapy, lifestyles, ....)

Diabetes mellitus:

• assessment (signs and symptoms)
  
• collaboration in diagnostics
• clinical care management of the patient with diabetes mellitus (self-monitoring of blood glucose, recognition, and management of hyper/hypoglycemia, insulin therapy)
• management of drug therapy
• patient self-care education (drug therapy, lifestyles, diet, physical activity, prevention of complications, ...)

Rheumatic disease

• assessment (signs and symptoms)
  
• collaboration in diagnostics
• clinical care management of the patient (pain, rehabilitation)
• management of drug therapy
• patient self-care education (drug therapy, lifestyles, complication prevention, ...)

1. Berman A., Snyder S., & Jackson C. (2019). Nursing clinico. Tecniche e procedure di Kozier. Edises Hinkle J.L. & Cheever K.H. (2017). Brunner & Suddarth. Infermieristica medico-chirurgica (Vol. 1 e 2). CEA
   
2. Brugnolli A, Saiani L. Trattato di medicina e infermieristica. Un approccio di cure integrato. Casa Editrice Idelson - Gnocchi, Napoli, 2017. 
   

The assessments will be carried out at the end of the integrated course. The methodology will be communicated at the beginning of the lessons together with the bibliography and with the learning resources necessary for the preparation for the final evaluation.

The test will be written with multiple choice questions. The exam will be assessed according to the following criteria:

1. Not suitable: Poor or lacking knowledge and understanding of the topics; limited capacity for analysis and synthesis, frequent generalizations of the requested contents; inability to use technical language.
2. 18-20: Just sufficient knowledge and understanding of the topics, with obvious imperfections; just sufficient capacity for analysis, synthesis and autonomy of judgment; poor ability to use technical language.
3. 21-23: Sufficient knowledge and understanding of the topics; sufficient ability to analyze and synthesize with the ability to reason with logic and coherence the required contents; sufficient ability to use technical language.
4. 24-26: Fair knowledge and understanding of the topics; discrete ability to analyze and synthesize with the ability to rigorously argue the required contents; good ability to use technical language.
5. 27-29: Good knowledge and understanding of the required contents; good ability to analyze and synthesize with the ability to rigorously argue the required contents; good ability to use technical language.
6. 30-30L: Excellent level of knowledge and understanding of the required content with an excellent ability to analyze and synthesize with the ability to argue the required content in a rigorous, innovative and original way; excellent ability to use technical language

A 91-year-old patient with diabetes mellitus is hospitalized in the medical area. He lives with his daughter (married with two children) who is his primary caregiver. Blood tests show a very high glycated hemoglobin (HbA1c). The patient takes oral antidiabetics and is disoriented in time and space. You believe there may be a problem with ineffective treatment regimen management. Indicate, among those listed below, the intervention you think most appropriate at this stage.

1. I imposed a low-glucose diet in collaboration with the dietician
2. I report the information to the doctor so that he can set up insulin therapy
3. I call the main caregiver of the patient to inform me about the behaviors adopted at home
4. I program more glucostick during the day
5. I call the general practitioner to inform me about the patient's access to the clinic