UNIVERSITY OF FLORIDA



UNIVERSITY OF FLORIDA

COLLEGE OF NURSING

COURSE SYLLABUS

Spring - 2012

COURSE NUMBER NGR 6248, Section IF65

COURSE TITLE Adult Acute Care Nurse Practitioner 3

CREDITS 03

PLACEMENT DNP Program: Adult Acute Care Nurse (ACNP) Practitioner Track

PREREQUISITES NGR 6243: Adult Acute Care Nurse Practitioner 2

NGR 6243L: Adult Acute Care Nurse Practitioner 2

Current ACLS certification

CO-REQUISITES NGR 6248L: Adult Acute Care Nurse Practitioner 3

|FACULTY |OFFICE |PHONE |OFFICE HOURS |

|Lori Thomas, PhD, ARNP, ACNP-BC/ANP-BC |HPNP 3225 |(352) 273-6390 |Tuesdays |

|Clinical Assistant Professor |Gainesville |(352) 284-1641 |1000am–1200noon and |

|thomala@ufl.edu | | |by appointment |

|DEPARTMENT CHAIR | | | |

|Joyce Stechmiller, PhD, ARNP, ACNP-BC, FAAN |HPNP 3230 |(352) 273-6394 | |

|Associate Professor |Gainesville | |By appointment |

|stechjk@ufl.edu | | | |

COURSE DESCRIPTION

This is one of two courses that provides the student with in-depth knowledge of advanced nursing practice management of acutely and critically ill adults from diverse populations. Emphasis is on the utilization of relevant theories, critical thinking, and evidence-based knowledge to formulate differential diagnoses, diagnoses, treatment plans, and optimal outcome parameters for physiologically unstable adults who have complex acute and critical health problems, are technologically dependent, and are at high risk for developing complications. The focus of this course is complex endocrine, neurologic, gastrointestinal and commonly occurring health care problems in acutely and critically ill adults.

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

1. Apply knowledge from health, psychological, and social sciences to formulate management plans for adults from diverse backgrounds with selected complex acute and critical health care problems.

2. Develop appropriate differential diagnoses and diagnoses based on analysis and interpretation of hypothetical data including history, presenting symptoms, physical findings, and diagnostic information for adults with complex acute and critical health care problems.

3. Formulate treatment plans, with emphasis on safety, cost, invasiveness and efficacy, for adults with selected acute and critical health care problems.

4. Formulate treatment plans based on current scientific rationale, evidence-based and practice guidelines and standards of care for adults with selected complex acute and critical health care problems.

5. Propose parameters to evaluate the effectiveness of management plans in achieving optimal outcomes for adults with selected complex acute and critical health care problems.

6. Discuss collaborative processes of the interdisciplinary health care team in facilitating the acutely and critically ill client’s progress toward maximum functional health.

7. Critique research related to complex health care problems.

8. Analyze diversity issues related to adults with complex acute and critical health care problems.

9. Discuss client and family issues related to end of life care.

COURSE SCHEDULE

Day Hours Time Rooms

Weekly 3 Student Option Online lectures and learning experiences

CLASS TIME AND PREPARATION

This is a 3 credit hour theory course. In order to be successful, it is expected that students will need to spend at least 3 hours weekly preparing for each hour of academic credit, which translates to weekly class/web preparation time of 9 hours (including weeks with no classroom meeting due to holidays).

COURSE MANAGEMENT SYSTEM

Sakai is the course management system that you will use for this course. Sakai system entry is accessed by using your Gatorlink account name and password at . There are e-Learning Tutorials and Help links on the UF/ELearning in Sakai – My Workspace opening page. If you have technical questions call the UF Computer Help Desk at 352-392-HELP or send email to helpdesk@ufl.edu.

It is important that you regularly check your Gatorlink account email for College and University wide information and the course Sakai site for announcements and notifications.

Course websites are generally made available on the Friday before the first day of classes.

The student is responsible for accessing the course web page several times per week. Important announcements and online materials related to the course activities and requirements will be frequently updated.

ATTENDANCE

This is an online course. Students may be expected to attend on-campus or synchronous classes periodically. Students are expected to participate in the activities and discussions as listed in the course syllabus and on the course web-site. Timeframes for the posting and receiving of materials are listed in the course materials on the course web-site. Make-up exams may not be available in all courses.

ACCOMMODATIONS DUE TO DISABILITY

Each semester, students are responsible for requesting a memorandum from the Disability Resource Center to notify faculty of their requested individual accommodations. This should be done at the start of the semester.

STUDENT HANDBOOK

Students are to refer to the College of Nursing Student Handbook for information about College of Nursing policies, honor code, and professional behavior.

TOPICAL OUTLINE

A. Each specific health problem listed below is addressed focusing on hospitalized acutely and critically ill adults and using the following approach as relevant:

1. Symptom cluster presentation

2. Objective findings: physical exam, history, diagnostic testing

3. Diagnosis/Differential diagnoses

4. Therapeutic plan

a. Evidence-based practice

b. Standards of care (practice guidelines)

c. Health promotion and Disease prevention, including screening tests

d. Safety

e. Cost

5. Acuity scoring system

6. Appropriate outcome parameters

7. Use of interdisciplinary collaboration and referral

8. Legal and ethical issues

9. Diversity issues

10. Pharmacotherapeutics

11. Health promotion and prevention of complications

12. Client and family issues related to end of life care

13. Elderly adult client issues

14. Genomics

B. Specific Health Problems

1. Trauma

a. Overview and Emergency stabilization

b. Major systems:

i. Head and spinal cord

ii. Chest

iii. Abdominal

iv. Musculoskeletal

c. Blast and crushing injuries

d. Major burns

e. Shock

f. Compartment syndrome

2. Endocrine Health Care Problems

a. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)

b. Thyroid Storm

c. Adrenal crises

d. Diabetes:

i. Diabetic ketoacidosis

ii. Diabetic hyperglycemic hyperosmolar coma

iii. Hypoglycemia

3. Neurologic Health Care Problems

a. Altered levels of consciousness

b. Cerebrovascular disease

c. Meningitis

d. Encephalopathic seizures

4. Gastrointestinal Health Care Problems

a. GI mucosal injuries

b. Hepatic Failure

c. Peritonitis

d. Mesenteric Ischemia

e. Pancreatitis

f. Bowel obstruction and acute paralytic ileus

5. Transplantation Health Care

a. Selection and care of the donor

b. Common problems

i. Immunosuppression

ii. Rejection

iii. Infection

6. End of life issues

a. Psychological

b. Sociological

c. Cultural

d. Ethical-legal

TEACHING METHODS

Online lecture, case studies, and audiovisuals.

LEARNING ACTIVITIES

Class participation, written assignments, and scheduled examinations.

EVALUATION

|ASSIGNMENT/EXAM |PERCENTAGE |

|Exam 1 |30 |

|Exam 2 |30 |

|Exam 3 |30 |

|Critique assignment |10 |

|Total |100 |

*See specific assignment guidelines on course website

FACULTY FEEDBACK

Students may expect timely faculty feedback as follows:

•Written assignments will be graded within ten (10) business days of receipt.

•Response to emails received by faculty via the course Sakai email system will be sent within three (3) business days of receipt.

EXAMS

The three (3) objective exams are proctored. Make up exams will not be offered. Faculty will work with students who experience extenuating circumstances preventing examination attendance on an individual basis. The exams will be held on the scheduled dates (see schedule) and will be administered via ProctorU, a live proctoring service, to ensure a secure testing environment.

Examinations account for 90% of the student’s course grade.

Compliance with the University of Florida Honor Code is expected.

Examination Information:

✓ Examinations are in electronic format and are timed.

✓ Students are responsible for scheduling examinations with ProctorU during the scheduled dates and timeframes listed on the course schedule.

✓ Failure to complete a scheduled examination will result in a score of zero percent (0%) for that examination.

✓ Students with extenuating circumstances related to performance examination participation must contact the lead course faculty at their location prior to the date that the examination is scheduled. The faculty will then make an effort to accommodate all reasonable requests.

✓ Each student computer must be in compliance with Policy S1.04, Student Computer Policy and must contain a web cam, microphone, and speakers.

✓ Each examination will cost $22.50 per exam.

✓ Students go to the website and click on “How To Get Started”. This will permit students to create an account and test out their system.

✓ Once an instructor makes an exam available, students go online to ProctorU to schedule and pay for the exam session. Students must provide a valid email address and phone number where they can be reached during an exam.

✓ CON IT Support office will oversee this process and provide technical assistance.

GRADING SCALE/QUALITY POINTS

A 95-100 (4.0) C 74-79* (2.0)

A- 93-94 (3.67) C- 72-73 (1.67)

B+ 91- 92 (3.33) D+ 70-71 (1.33)

B 84-90 (3.0) D 64-69 (1.0)

B- 82-83 (2.67) D- 62-63 (0.67)

C+ 80-81 (2.33) E 61 or below (0.0)

NOTE: Students must earn a minimum of 74% overall to pass the course.

For more information on grades and grading policies, please refer to University’s grading policies:



REQUIRED TEXTS

Gabrielli, A., Layon, A.J., Yu, M. (Eds.). (2009). Civetta, Taylor, & Kirby’s Critical Care (4th ed.).

Philadelphia: Lippincott Williams & Wilkins. (ISBN #978-0-7817-6869-6).

Marino, P. (2007). The ICU Book (3rd ed.). New York: Lippincott, William & Wilkins.

(ISBN # 078174802X).

AND

All texts required for all previous courses

Approved: Academic Affairs Committee: 12/07

Faculty: 01/08

UF Curriculum: 10/08

NGR 6248: ACNP III

Spring 2012 Weekly Class Schedule

Faculty lecturers: R. Reischman (RR) and L. Thomas (LT)

*See course website for assignment guidelines

|DATE |TOPIC |READINGS |

|WEEK 1: January 9-13 |Introduction to course (LT) |Gabrelli, Layon & Yu (GLY): 72, 73, 83 |

| |Trauma 1 (LT) |Marino (M): none |

| |Overview & Emergency stabilization |Additional readings as posted on website |

| |Major systems: | |

| |Head & spinal cord | |

| |Chest | |

|WEEK 2: January 16-20 | |

| |ML King Holiday |

|WEEK 3: January 23-27 |Trauma 2 (LT) |GLY: 75, 76, 85, 88, 175 |

| |Major systems: |M: none |

| |Abdominal Musculoskeletal |Additional readings as posted on website |

| |Blast and crushing injuries | |

| |Major burns | |

| |Compartment syndrome | |

|WEEK 4: |Endocrine 1 (RR) |GLY: 162 &163 |

|January 30-February 3 |Endocrinopathy in the ICU |M: none |

| | |Additional readings as posted on website |

| |60 & Disordered Glucose Metabolism | |

|WEEK 5: February 6-10 |Endocrine 2 (RR) |GLY: 164-166 |

| |Adrenal Gland |M: 48 |

| |Pheochromocytoma |Additional readings as posted on website |

| |Thyroid | |

|WEEK 6: February 13-17 |Shock (LT) |GLY: 55, 56, 58, 59, 60 & 61 |

| | |M: none |

| | |Additional readings as posted on website |

|WEDNESDAY February 15 |EXAM #1 (covers weeks 1, 3, 4 & 5) |

|WEEK 7: February 20-24 |Neuro 1 (LT) |GLY: 27, 28 & 29 |

| |Neuro monitoring |M: none |

| |Neuro Imaging |Additional readings as posted on website |

|WEEK 8: February |Neuro 2 (LT) |GLY: 84, 108, 114 & 148 |

|27-March 2 |Cerebrovascular-Stroke |M: none |

| |Neuro Infections |Additional readings as posted on website |

| |Status Epilepticus | |

|WEEK 9: | |

|March 5-9 |Spring Break Week |

|WEEK 10: |GI I (RR) |GLY: 152, 153, 158 & 159 |

|March 12-16 |Upper & Lower GI Bleed |M: none |

| |GI Motility |Additional readings as posted on website |

| |Mesenteric Ischemia | |

NGR 6248: ACNP III

Spring 2012 Weekly Class Schedule

Faculty lecturers: R. Reischman (RR) and L. Thomas (LT)

*See course website for assignment guidelines

|DATE |TOPIC |READINGS |

|WEEK 11: |GI 2 (RR) |GLY: 154 |

|March 19-23 |Liver Failure |M: none |

| |Peritonitis |Additional readings as posted on website |

|WEEK 12: |Special Topics: |GLY: 102, 103 |

|March 26-30 |Obesity (LT) |M: none |

| |Gerontology (RR) |Additional readings as posted on website |

|WEDNESDAY | |

|March 28 |EXAM #2 (covers weeks 6, 7, 8, 10 &11) |

|WEEK 13: |End of Life (LT) |GLY: 3, 4, 5 & 6 |

|April 2-6 |Psychological |M: none |

| |Sociological |Additional readings as posted on website |

| |Cultural | |

| |Ethical-Legal | |

|WEEK 14: |Independent work on critique |Text and other current literature as needed |

|April 9-13 | | |

|WEDNESDAY |CRITIQUE ASSIGNMENT* DUE |

|April 11 | |

|WEEK 15: |Transplant (RR) |GLY: 90 |

|April 16-20 |Overview |M: none |

| | |Additional readings as posted on website |

|WEEK 16: |Transplant (RR) |GLY: 91 & 93 |

|April 23-27 |Heart |M: none |

| |Liver |Additional readings as posted on website |

|WEDNESDAY |EXAM #3 (covers weeks 12, 13, 15 & 16) |

|May 2 | |

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