SCHOOL OF NURSING



SCHOOL OF NURSING COLUMBIA UNIVERSITY

SYLLABUS - FALL 2001

M8771 - DIAGNOSIS AND MANAGEMENT OF ILLNESS IN ADULT II

Credits: 3 credits

PREREQUISITE: M6720, M8786, M8787, M8770, M8772, M8773

COREQUISITE: M8776

COURSE LEVEL: Third semester for ANP/GNP majors

TEACHING FACULTY: Course coordinator

Jo Anne Staats MS, ANP

305-7327

jastaats@

DESCRIPTION: Utilizing a systems approach, the diagnosis and management of health problems encountered in Primary Adult Care are studied.

OBJECTIVES: Upon completion of this course, the student will be able to:

1. Analyze historical, physical, and laboratory findings to develop

a differential diagnosis.

2. Design a plan of care that considers the physical and pyscho-

social needs of the patient.

3. Evaluate the individualized plan of care and modify

accordingly.

4. Integrate knowledge of current research findings into

clinical practice.

5. Articulate the role of the NP in illness management.

6. Describe laboratory tests needed for diagnosis.

7. Interpret laboratory tests.

8. Discuss medications appropriate for treatment, including

actions, dosage, and side effects.

9. Discuss appropriate management techniques.

10. Explain rationale for treatment.

11. Incorporate health prevention and promotion strategies

in the above objectives.

12. Incorporate health care maintenance in management plan.

METHODOLOGY: Lecture, discussion, case studies, outside readings and assignments.

EVALUATION: 3 examinations 25% each

3 review articles (see attached description) 25%

Required Texts:

Goroll, A.H., Mulley, A.G. (2000). Primary Care Medicine: Office Evaluation and Management of the Adult Patient, Lippincott, Williams & Wilkins.

Suggested Texts:

Fauci, A., Braunwald, E., et al. (Eds) (1998). Harrison=s principles of internal medicine. (14th

ed.), New York: McGraw-Hill.

Habif, T.P., et al. (2001). Skin disease diagnosis and treatment. Mosby.

Additional Readings

See individual topics for specific readings.

Additional readings may be assigned at the discretion of the lecturer.

TOPICAL OUTLINE

DATE TOPIC LECTURER

9/10 Genitourinary J. Staats

9/17 Genitourinary J. Staats

9/24 Hematology J. Smolowitz

10/1 Dermatology Tok-Celebi

10/8 Exam 1

End of Life J. Staats

10/15 Ophthalmology E. Cafasso

10/22 Neurology TBA

10/29 Neurology J. Staats

11/5 Holiday

11/12 Exam 2

Infectious Disease J. Staats

11/19 Infectious Disease J. Staats

11/26 Musculoskeletal J. Staats

12/3 Musculoskeletal J. Staats

12/10 Exam 3

Licensure, Certification, Resumes J. Staats

CLINICAL REVIEW ARTICLES

PURPOSE: Providers must keep up-to-date with current research. There are many ongoing studies that affect the way we practice. The best way to remain on the Acutting edge= is to read the major peer-reviewed journals. When reading the studies you should be able to evaluate the quality of the study and its relevance to your practice.

ASSIGNMENT: You must find 3 clinical research articles from peer-reviewed journals and critique them. They must be related to the topic that has been covered in the lectures prior to the due date of the article. The studies must have been published within the past 2 years. Each critique should be 1-2 pages long.

FORMAT:

Introduction: What is the study looking at? 20%

Methods: Sample size, design 20%

Study validity: Is the study valid? Well designed? Do

conclusions make sense? 20%

Relevance to practice: Will this study affect your practice?

If not, why? If so, how and why? 40%

DUE DATES:

October 1 Article #1

October 29 Article #2

November 26 Article #3

GENITOURINARY #1

STDs, UTIs, RENAL DISEASE

Required Reading

Goroll: Chapters 124,125, 127, 133, 135, 136, 137, 140, 141, 142

Birnbaum, N.R., Goldschmidt, R.H., Buffett, W.O. (1999). Resolving the common clinical dilemmas of syphilis. American Family Physician, 59 (8) 2233-44.

Fitzpatrick, C.A. (1999). Herpes simplex infection. Journal of the American Academy of Nurse Practitioners. 11 (12) 539-48.

Lindsay, N.E. (2000). Asymptomatic bacteriuria - - important or not? New England Journal of Medicine. 343 (14)

GENITOURINARY #2

EPIDIDYMITIS, PROSTATITIS, BPH, ERECTILE DYSFUNCTION,

SCROTAL MASSES

Required Reading:

Goroll: Chapters 126, 131, 132, 138, 139, 143 (prostate only)

Barry, B.J. (2001). Prostate-specific-antigen testing for early diagnosis of prostate cancer. The New England Journal of Medicine. 344 (18) 1373-77.

D=epiro, N. (1999). Herbal update: saw palmetto and the prostate. Patient Care for the Nurse Practitioner. April 1999, 8-13.

Greek, G. (2000). Vasectomy. Postgraduate Medicine, 108 (2) 173-9

Sonpavde, G., Einhorn, L.H. (1999). What to do when you discover testicular cancer. Postgraduate Medicine. 105 (4).

.

HEMATOLOGY

ANEMIAS, BLEEDING DISORDERS, NEUTROPENIA

Required Readings:

Goroll: Chapters 77, 78, 79, 80, 81, 82, 83

Abramson, S.D., Abramson, N. (1999). >Common= uncommon anemias. American Family Physician, 59 (4) 851-860.

Brill, J. R., Baumgardner, D.J. (2000). Normocytic anemia. American Family Physician, 62 (10) 2255-66.

Little, D.R. (1999). Ambulatory management of common forms of anemia. American Family Physician, 59 (6) 1598-1606.

Smith, D.L. (2000). Anemia in the elderly. American Family Physician, 62 (7) 1565-74.

DERMATOLOGY

ACNE, CANCER, PAPULOSQUAMOUS ERUPTIONS

Required Readings

Habif: Chapters 2, 3, 4, 5, 8, 9, 16, 17, 18

Bertolino, A.P. (2000). Alopecia areata. Postgraduate Medicine, 107 (7) 81-90.

Edman, R.L., Wolfe, J.T. (2000). Prevention and early detection of malignant melanoma. American Family Physician, 62, 2277-84, 2285.

Krishnaswamy, G., Youngberg, G. (2001). Acute and chronic urticaria. Postgraduate Medicine, 109 (2) 107-23.

Zuber, T.J., Baddam, K. (2001). Superficial fungal infection of the skin. Postgraduate Medicine, 109 (1) 117-132.

END OF LIFE

Required readings:

Sachs, G.A. (2000). Sometimes dying still stings. JAMA 284 (19) 2423.

Lawlor, P.G., Fainsinger, R.L., Druera, E.D. (2000). Delirium at the end of life. JAMA 284 (19) 2427-2429.

Emanuel, E.J., Fairclough, D.L., Emanuel, L.L. (2000). Attitudes and desires related to euthanasia and physician-assisted suicide among terminally ill patients and their caregivers. JAMA 284 (19) 2460-2468.

Steinhauser, L.E., Christakis, N.A., Clipp, E.C., et al (2000). Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284 (19) 2476-2482.

Silveira, M.J., DiPiero, A., Gerrity, M.S., et al (2000). Patients= knowledge of options at the end of life. JAMA, 284 (19) 2483-2488.

Zerzan, J., Stearns, S., Hanson, L. (2000). Access to palliative care and hospice in nursing homes. JAMA, 284 (19) 2489-2494.

Meisel, A., Snyder,d L., Quill, T., et al. (2000). Seven legal barriers to end-of-life care. JAMA, 284 (19) 2495-2501.

Quill, T.E. (2000). Initiating end-of-life discussions with seriously ill patients. JAMA, 284 (19) 2502-2507.

Lynn, J. (2000). Learning to care for people with chronic illness facing the end of life. JAMA, 284 (19) 2508-2511.

McPhee, S.J., Rabow, M.W., Pantilat, S.Z., et al (2000). Finding our way - perspectives on care at the close of life. JAMA, 284 (19) 2512-2513.

Daaleman, T.P., VandeCreek, L. (2000). Placing religion and spirituality in end-of-life care. JAMA, 284 (19) 2514-2517.

Crawley, L., Payne, R., Bolden, J., et al (2000). Palliative and end-of-life care in the African American community. JAMA 284 (19) 2518-2521.

OPHTHALMOLOGY

GLAUCOMA, COMMON VISUAL DISTURBANCES, DRY EYES,

EXCESSIVE TEARING, AGE-RELATED MACULAR DEGENERATION,

CATARACTS, CONJUNCTIVITIS, OPTIC NEURITIS

Required Readings:

Goroll: Chapters 198, 199, 200, 201, 202, 203, 205, 206, 207, 208

Shingleton, B.J., O=Donoghue, M.W. (2000). Blurred vision. The New England Journal of Medicine, 343 (8) 556-562.

Faye, E.E. (1998). Living with low vision. Postgraduate Medicine, 103 (5).

NEUROLOGICAL #1

PARKINSON=S, MS, ALZHEIMER=S, DEMENTIAS, SEIZURES

Required Readings:

Goroll: Chapters 168, 169, 170, 172, 173, 174

Adler, C.H., Ford, B., Freese, A., et al. (2000). Parkinson=s disease: Progress along the continuum of care. Patient Care for the Nurse Practitioner, December 2000, 26-52, 57.

Cooper, G., Rodnitzky, R. (2000). The many forms of tremor. Postgraduate Medicine, 108 (1) 57-70.

Hess, D.C. (2000). Multiple sclerosis: New help, new hope. Consultant, May 2000, 1085-96.

Santacruz, K.S., Swagerty, D. (2001). Early diagnosis of dementia. American Family Physician,

703-13, 717-8.

NEUROLOGICAL #2

TIA, CVA, BELL=S PALSY, TRIGEMINAL NEURALGIA,

DIZZINESS/VERTIGO, PERIPHERAL NERVE SYNDROMES,

TINNITUS, HEARING LOSS, SMELL/TASTE DISTURBANCE,

HEADACHE

Required Readings

Goroll: Chapters 165, 166, 171, 175, 176

Bromley, S.M. (2000). Smell and taste disorders: A primary care approach. American Family Physician,

Clinch, C.R. (2001). Evaluation of acute headaches in adults. American Family Physician, 63 (4) 685-92.

Furman, J.M., Cass, S.P. (1999). Benign paroxysmal positional vertigo. The New England Journal of Medicine, 341 (21) 1590-97.

Silberstein, S.D. Evidence-based guidelines for migraine headache. 42nd Annual Scientific Meeting of the American Headache Society.

INFECTIOUS DISEASES #1

OVERVIEW, HIV/AIDS

Required readings:

Goroll: Chapters 2, 13

Condoms and their use in preventing HIV infection and other STDs. Centers for Disease Control & Prevention, HIV & AIDS Prevention.

Committee on Climate, Ecosystems, Infectious Disease, and Human Health, National Research Council, Washington, DC (2001). Under the weather: climate, ecosystems, and infectious disease. Center for Disease Control: Emerging Infectious Diseases, 7(3) supplement.

Fauci, A.S. (1999). The AIDS epidemic; Considerations for the 21st century. The New England Journal of Medicine, 341 (14) 1046-1050.

Hughes, J.M. (2001). Emerging infectious diseases: a CDC perspective. CDC Emerging Infectious Diseases, 7 (3) supplement.

Levin, B.R., Stewart, F.M. (2001). Epidemiology, evolution, and future of the HIV/AIDS pandemic. CDC: Emerging Infectious Diseases, 7 (3) supplement.

Levy, S. B. (2001). Antibacterial household products: cause for concern. CDC: Emerging Infectious Diseases, 7 (3) supplement.

Yu, K., Daar, E.S. (2000). Primary HIV infection; Current trends in transmission, testing, and treatment. Postgraduate Medicine, 107 (4) 114-22.

INFECTIOUS DISEASES #2

HERPES ZOSTER, WEST NILE VIRUS,

MONONUCLEOSIS, CHRONIC FATIGUE SYNDROME,

LYME DISEASE, TRAVEL MEDICINE

Required Readings:

Cohen, J.I. (2000). Epstein-Barr virus infection. The New England Journal of Medicine, 343 (7) 481-92.

Gilden, D.H., Kleinschmidt-DeMasters, B.K., LaGuardia, J.J., et al (2000). Neurologic complications of the reactivation of varicella-zoster virus. The New England Journal of Medicine, 342 (9) 635-645.

Godshall, S.E., Kirchner, J.T. (2000). Infectious mononucleosis. Postgraduate Medicine, 107 (7) 175-86.

Landow, K. (2000). Acute and chronic herpes zoster. Postgraduate Medicine, 107 (7) 107-18.

Prier, R., Solnick, J.V. (2000). Foodborne and waterborne infectious diseases. Postgraduate Medicine, 107 (4) 245-55.

Roberts, A., Kemp, C. (2001). Infectious diseases of refugees and immigrants. Journal of the Academy of Nurse Practitioners, 13 (1) 7-9.

Roberts, A., Kemp, C. (2001). Infectious diseases of refugees and immigrants: dengue fever. Journal of the American Academy of Nurse Practitioners, 13 (6) 243-45.

The New York City Department of Health (2001). West Nile virus surveillance and control: an update for healthcare providers in New York City. City Health Information, 20 (2) 1-8.

Wessely, S. (2001). Chronic fatigue: symptom and syndrome. Annals of Internal Medicine, 134 (9) 838-43.

Wright, D. (2001). Lyme disease. Journal of the American Academy of Nurse Practitioners, 13 (5) 223-25.

MUSCULOSKELETAL #1

OSTEOPOROSIS, RHEUMATOID ARTHRITIS, OSTEOARTHRITIS,

FIBROMYALGIA, POLYMYALGIA RHEUMATICA

Required Readings:,

Goroll: Chapters 144, 145, 146, 156, 157, 159, 161, 164

Brigden, N.L. (1999). Clinical utility of the erythrocyte sedimentation rate. American Family Physician, 60 (5) 1443-54.

National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center (2001). Osteoporosis in men. Website:

National Osteoporosis Foundation (2001). Patient info: Medications and osteoporosis. Website:

Ross, E.A., Szabo, N.J., Tebbett, I.R. (2000). Lead content of calcium supplements. JAMA, 284 (11) 1425-29.

South-Paul, J.E. (2001). Osteoporosis: Part I. Evaluation and assessment. American Family Physician, 63 (5) 897-912.

MUSCULOSKELETAL #2

GOUT, PAGET=S DISEASE, RAYNAUD=S, TMJ, LUPUS,

SCLERODERMA, JOINT PAIN, BACK PAIN

Required Readings:

Goroll: Chapters 147, 148, 150, 151, 153, 154, 155, 158, 163, 225

Budoff, J.E., Nirschl, R.P. (2001). Elbow complaints: key to effective examination. Consultant, April 1, 2001, 509-16.

Budoff, J.E., Nirschl, R.P. (2001). Office examination of the elbow: palpation and instability tests. Consultant, May 2001, 878-87.

Goolsby, M.J. (2001). Evaluating acute musculoskeletal complaints. Journal of the American Academy of Nurse Practitioners, 13 (5) 195-99.

Schmitt, M. (1999). Part 1: evaluation of the wrist and hand. Patient Care for the Nurse Practitioner, September 1999, 42-50.

Staiger, T.O., Paauw, D.S., Deyo, R.A., et al. (1999). Imaging studies for acute low back pain. Postgraduate Medicine, 105 (4) 161-76.

Korff, M.V., Moore, J.C. (2001). Stepped care for back pain: Activating approaches for primary care. Annals of Internal Medicine, 134 (9) 911-17.

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