JACKSONVILLE UNIVERSITY

KEIGWIN SCHOOL OF NURSING

NUR 454
A CONCEPTUAL APPROACH TO
PATHOPHYSIOLOGY FOR NURSES

Summer 2018

Revised 7/25/13
Curriculum committee approval 7/25/13

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Course Number: NUR 454

Course Title: A Conceptual Approach to Pathophysiology for Nurses

Placement in Curriculum: Senior Year

Faculty: Jennifer Willison MSN, RN, ACNP

Assistant Clinical Professor of Nursing

Catalog Description: NUR 454: A CONCEPTUAL APPROACH TO PATHOPHYSIOLOGY FOR NURSES (3)

Three credit hours. Pathophysiological concepts related to disease and common health problems are
presented. Emphasis is placed on normal physiologic functioning and changes that occur with disease.
Interrelationships among concepts are explored as well as local and systemic manifestations of common
disorders. Assignments stimulate nurses to critically analyze pathophysiological processes and related medical
and nursing management for specific health problems of individuals across the lifespan.

Course Objectives: Upon completing the course, the student will be able to:

1. Apply pathophysiology theory and concepts in the analysis of patient-centered case studies and
continuing education (CE) literature related to common health problems.

2. Critically analyze specific disease processes in terms of etiology, pathogenesis, morphology, diagnostic
and assessment data, and patient-centered medical and nursing management.

3. Discuss the importance of genomics, genetics, culture, ethnic and social factors that influence the
development of disease and related ethical/legal implications.

4. Evaluate caring, compassionate, and culturally appropriate care that values patient/family preferences
and needs.

5. Integrate medical and nursing best practices in the management of patient care, discharge health
education and follow-up plan for individuals across the lifespan.

6. Demonstrate effective communication and interpersonal skills in discussion boards, chat room
interactions, emails, and written assignments.

7. Apply current evidence-based professional literature to support class discussions and analysis of written
assignments.

8. Examine the effect common health problems have on patient safety, quality and cost-effectiveness of
health care and explore solutions to improve patient outcomes.

9. Engage in learning by examining reliable sources for evidence-based clinical practice, participating
constructively in class activities and completing course assignments in a timely, professional manner.

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Topical Outline: Theory related to the etiology, pathology, and clinical management of the following
pathophysiological processes are examined:

Unit I: Cellular Function and Disorders

Cellular Adaptation, Metabolism, Injury and Death
Genomics/Genetics and Congenital Disorders
Cellular Growth and Neoplasia

Unit II: Integrative Function and Disorders

Stress and Adaptation
Fluid and Electrolyte Balance and Edema
Physiology of Sleep and Sleep Disorders

Unit III: Physiologic Responses to Injury

Inflammation; Wound Healing; Wound Management
Innate and Adaptive Immunity and Immune Disorders
Hemostasis and Coagulation Disorders

Unit IV: Cardiopulmonary Function and Disorders

Acid Base Balance
Cardiovascular Perfusion and Disorders
Pulmonary Ventilation/Oxygenation Function and Disorders

Unit V: Nutrition and Regulation of Food Intake and Energy Metabolism

Hunger, Appetite and Food Intake
Obesity and Metabolic Syndrome
Anorexia, Starvation and Cachectic Syndromes

Unit VI: Neural Function and Disorders

Pain and Pain Management
Cognitive and Memory Impairment

Teaching Strategies:

Reading Assignments: Textbook, Nursing Journal Articles

Lecture
PowerPoint Presentations and Internet Links to Related Audiovisuals
Discussion Board Activities
Interactive Tutorials
Patient Case Analyses
Class Discussion/ Group Activities
Films and Videos

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Evaluation Methods: Each student will be evaluated using the following methods:

Exams (6 @ 75 points each) 450 points

Patient Case Analyses (2 @ 35 points each) 70 points

Nursing Journal CE Assignments (4 @ 20 points each) 80 points

Total 600 points

Final Grade: The course grade will be determined by summing the number of points. A cumulative average
of 75% must be obtained on the 6 written exams to successfully pass this course. Exams will be
recorded to the nearest 10th and rules of rounding will determine final exam average. Regardless of
points earned, failure to achieve the 75% exam average will result in a grade of D or F.

Grade Low Points High Points

A 549 600
A- 537 548
B+ 525 536
B 489 524
B- 477 488
C+ 465 476
C 429 464
C- 417 428
Failure Below This Level
D+ 405 416
D 369 404
D- 357 368
F Below 357

Testing Policy: Students must adhere to Jacksonville University, Keigwin School of Nursing policy for testing. Late
admittance to exams is at the discretion of the instructor. Once exams reviews are completed there will be no
change in test grades. Refer to the JU Keigwin School of Nursing Handbook.

Required Textbooks:

American Psychological Association. (2010). Publication manual of the American Psychological

Association (6th ed.). Washington, DC: American Psychological Association. ISBN-10: 1-4338-

0561-8

Porth, C. (2015). Essentials of pathophysiology: Concepts of altered health states (4th ed.). Philadelphia:

Lippincott Williams & Wilkins. ISBN 978-1-4511-9080-9

Recommended Supplemental Material:

Porth, C. (2015). Study guide for essentials of pathophysiology (4th ed.). Philadelphia: Lippincott

Williams & Wilkins. ISBN 9781451192933

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Classroom Policies:

Policies regarding attendance, tardiness, examinations, promotion and written assignments are stated in the
School of Nursing Handbook. EACH STUDENT IS RESPONSIBLE FOR KNOWING THESE POLICIES AND
ADHERING TO THEM.

Honor Code:

Integration of professional values in nursing education is essential for the development of ethical conduct and
for the ability of nurses to function in health care systems. To underscore the importance of truth, honesty, and
accountability, students, faculty, and staff in the Jacksonville University School of Nursing adhere to the
following honor code:
“I do not lie, cheat, steal, or condone those who do.” Egregious academic misconduct will result in dismissal
from the School of Nursing.

Academic Integrity Misconduct:

Students are responsible for reading and adhering to the Jacksonville University Academic Integrity
Misconduct Policy. This policy can be found on page 101 of the JU Academic Catalog:
http://www.ju.edu/academics/Pages/Academic-Catalog

Learning Disabilities Statement:

Any student with a visible or non-visible disability who requests “reasonable accommodation” to his or her
condition should provide medical and/or psychological documentation of the disability to the Student Life Office
and refer to the information in the JU catalogue and SON Handbook for additional information regarding
student disabilities. A student with a learning disability should weigh carefully with his/her advisor the
requirements of the nursing program in order to ascertain its suitability, given the nature of the disability.

Portfolio:

At the end of the program, it is a requirement of Nursing Synthesis (NUR 423) for each student to submit a
collection of papers that demonstrate improvement according to program objectives. Therefore, please be
advised to keep copies of graded papers throughout the program.

Changes to the Syllabus:

Faculty reserves the right to make changes to the syllabus. Any changes will be clearly announced and posted.
Students should be actively participating and are responsible for noting these changes and communicate
concerns or questions regarding changes in a timely manner.

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 Dates Classroom Schedule Required Reading
Week 1: Course Overview – Review of Syllabus Cellular Adaption, Metabolism,
Injury and Death
Tuesday Unit I: Cellular Function and Disorders Chapter 1 p. 1-11, 13-16;
5/1/18 Chapter 2 p. 31-48
PPT Cellular Metabolism
Genomics/Genetics and
Congenital Disorders:
Chapter 5 p. 87-105;
Chapter 6 p. 106-128
Genetics Jeopardy Part 1 & Part 2
Article: McLafferty. E. (2012).
Genetics, mitosis and meiosis.
Nursing Standard, 26(48), 35-
42.
Friday PPT Genomics and Genetics
5/4/18
Cellular Growth and Neoplasia
PPT Neoplasia
Chapter 7 p. 129-157

UNIT I: Optional Study Guide Activities:

Cellular Adaption, Metabolism, Injury and Death
Chapter 1: A, B, F
Genomics/Genetics and Congenital Disorders
Chapter 5: A, B, C, D, F;
Chapter 6: A, B, C, D, F
Cellular Growth and Neoplasia
Chapter 2: A, B, C, D, F
Chapter 7: A, B, C, D, E, G

Week 2 Unit I Exam 1 (90 minutes) Unit 1 Exam - Cellular

Adaptation, Metabolism,
Tuesday Assignment Required Journal CE or Case Study Injury, and Death;
5/8/18 Genomics/Genetics and
Congenital Disorders;
Cellular Growth and
Unit II: Integrative Function and Disorders Neoplasia

Stress and Adaptation

PPT Stress and Adaptation Chapter 9 p. 206-222;
Chapter 34 p. 847-853

PPT Physiology of Sleep and Sleep Disorders Physiology of Sleep and Sleep
Disorders
Chapter 9 p. 214
Friday PPT Fluid and Electrolyte Balance and Edema Fluid and Electrolyte Balance
5/11/18 and Edema
PPT More on Electrolytes Chapter 8 p. 159-191;
Chapter 37 p. 918-923
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 UNIT 2: Optional Study Guide Activities:
Stress and Adaptation
Chapter 9: A, C, D, E;
Chapter 34 C part 2, F

Fluid and Electrolyte Balance and Edema Chapter 8 A (1-

45), C 1-2, D, E 1-9, G, H 1-10; Chapter 37 C, G

Optional Online documentary:

http://topdocumentaryfilms.com/stress-portrait-of-a-killer/

Week 3 Unit 2 Exam 2 (90 minutes) Unit 2 Exam – Physiology of

Sleep and Sleep Disorders;
Tuesday Assignment Required Journal CE or Case Study Stress and Adaptation; Fluid
5/15/18 and Electrolyte Balance and
Edema

Unit III Physiologic Responses to Injury Inflammation

PPT Inflammation Chapter 3 p. 49-70;
Chapter 11 p. 241-248
Woundopardy game
Friday Wound Healing: Wound
5/18/18 PPT Wound Healing: Wound Management Management
Chapter 4 p. 71-86

PPT Hemostasis and Coagulation Disorders Hemostasis and Coagulation

Disorders
Chapter 12 p. 261-276
Chapter 18 p. 436-440
UNIT III: Optional Study Guide Activities:
Inflammation
Chapter 3 A, B, C, D, E, G;
Chapter 11 A, C (1-13), E
Wound Healing: Wound Management:
Chapter 4 A, B, C, D, F
Hemostasis and Coagulation Disorders:
Chapter 12 A, B, C, D, E, F

Coagulation Quiz: Complete on Blackboard

Week 4: Unit III: Physiologic Responses to Injury continued Innate and Adaptive Immunity
and
Tuesday PPT Innate and Adaptive Immunity Chapter 15 p. 318-343;
5/22/18 Immune Disorders
PPT Immune Disorders Chapter 16 p. 344-374

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 UNIT III, con’t: Optional Study Guide Activities:
Immunity and Immune Disorders
Chapter 15 A, C (part 2), D, E, F;
Chapter 16 A, B, C, D, F

Friday Unit 3 Exam 3 (90 minutes) Unit 3 Exam – Inflammation,

5/25/18 Assignment Required Journal CE or Case Study Hemostasis and
Coagulation Disorders;
Wound Healing and Wound
Management; Immunity and
Immune Disorders

Unit IV: Cardiopulmonary Function and Cardiovascular Perfusion and

Disorders Disorders
Chapter 17 p. 375-386, 390-
PPT Cardiovascular Perfusion and Disorders 401;
Chapter 18 p. 402-411, 412-
413, 420-430;
Chapter 19 p. 446-468;
Chapter 20 486-500;
Chapter 24 p. 607-611;
Chapter 37 p. 930-940
Week 5: PPT Cardiovascular Perfusion and Disorders Pulmonary
(Continued) Ventilation/Oxygenation
Tuesday Function and Disorders
5/29/18 PPT Pulmonary Ventilation/Oxygenation Function Chapter 21 p. 513-538;
and Disorders Chapter 22 p. 544-551; 555-
559;
Chapter 23 p. 565-596

Friday PPT Acid Base Balance Acid Base Balance

6/1/18 Chapter 8 p. 191-203;
Chapter 26 p. 645-646

In Class activity: Understanding Hemodynamics Article:

Chapter 17 p. 378-381 Pruitt, B. (2010). Interpreting
ABGs: An inside look at your
patient’s status. Nursing,
40(7), 31-35. doi:
10.1097/01.NURSE.00003834
47.25412.d6

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 UNIT 4: Optional Study Guide Activities:
Cardiovascular Perfusion and Disorders
Chapter 17 A, B, C, D, E;
Chapter 18 A, B (figure 2) C, D, F;
Chapter 19 A, B, C, D, E, F;
Chapter 20 A, B (1-2), C, D, E;
Chapter 24 A (20-22), C, D (4,5);
Chapter 37 A (19-30), C, D (2), E (1, 5, 8, 9), F, G (1-8).
Pulmonary Ventilation/Oxygenation Function & Disorders
Chapter 21 A, B, C, D, E, F, G;
Chapter 22 A, E, F, G (1-2,4-7);
Chapter 23 A, B, C, D, E, G
Acid Base Balance
Chapter 8 A (46-57), E (10-12), G, H (11-20)
Week 6 Unit 4 Exam 4 (90 minutes) Unit Exam 4 –
Cardiovascular Perfusion
Tuesday Assignment Required Journal CE or Case Study and Disorders; Pulmonary
6/5/18 Ventilation/Oxygenation
Function and Disorders;
Acid-Base Balance

Unit V: Nutrition and Regulation of Food Intake Hunger, Appetite and Food
and Energy Metabolism Intake
Chapter 10 p. 223-229;
PPT Hunger, Appetite and Food Intake Chapter 28 p. 686- 689;
Chapter 33 p. 793-799
Friday Obesity and Metabolic
6/8/18 PPT Obesity and Metabolic Syndrome Syndrome
Chapter 10 p. 230-234;
METABOLIC SYNDROME Movie & Case Study Chapter 33 p. 802-805

Anorexia, Starvation and

PPT Anorexia, Starvation and Cachectic Syndromes Cachectic Syndromes
Chapter 10 p. 234-236;
Chapter 7 p. 144-146
UNIT 5: Optional Study Guide Activities:
Hunger, Appetite and Food Intake
Chapter 10 A, B, E (1-6, 8-9)
Chapter 33 B, C, F
Obesity and Metabolic Syndrome
Chapter 10 C (1-3) E (questions 1-6, 8);
Chapter 33 A (questions 22, 30, 33), C, F (1, 2)
Anorexia, Starvation and Cachectic Syndrome
Chapter 7 A (question 22), E (questions 7, 8);
Chapter 10 B, C (4), E (9)

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 Week 7 Unit 5 Exam 5 (90 minutes) Unit 5 Exam – Hunger,
Appetite and Food Intake;
Tuesday Assignment Required Journal CE or Case Study Obesity and Metabolic
6/12/18 Syndrome; anorexia,
Starvation and Cachectic
Syndromes

Unit VI: Neural Function and Disorders Cognitive and Memory

Impairment
PPT Cognitive and Memory Impairment: DELIRIUM Chapter 36 p. 897-902;
Chapter 37 p. 926-928; 938-
PPT Dementia and Neurocognitive Diseases 952.

Articles:
Somes, J, Donatelli, N.,
Barrett, J, & Wilmington, N.
(2010, September). Sudden
confusion and agitation:
Causes to investigate!
Delirium, dementia,
depression. Journal of
Emergency Nursing, 36(5),
486-488.
Resources: website:
http://www.alz.org/
Friday Unit VI: Neural Function and Disorders
6/15/18 Pain and Pain Management
PPT Pain and Pain Management Chapter 1 p. 18-19;
Chapter 35 p. 854-872, 875-
877
UNIT 6: Optional Study Guide Activities:
Cognitive and Memory Impairment
Chapter 36 A (question 27, 31-33), C, D (question 9), F
(questions 1-6, 10-11);
Chapter 37 A (questions 2-5, 18-30)
Pain and Pain Management
Chapter 35 A, B, C, D (questions 4-7), F
Week 8 Exam 6 (90 minutes) Unit 6 Exam – Cognitive and
Tuesday Memory Impairment;
6/19/18 Assignment Required Journal CE or Case Study Delirium, Dementia, Pain
and Pain Management

All readings are from the Porth text book unless otherwise noted.
Study Guide Activities are from Porth Study guide.

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 ASSIGNMENT GUIDELINES

WORKBOOK ASSIGNMENTS & ACTIVITIES

Along with the assigned reading, there are specific workbook assignments in Porth’s Study Guide for Essentials of
Pathophysiology to assist you in learning the content in each unit/topic. These assignments/activities are for your benefit
only and are not submitted to the instructor.

PATIENT CASE ANALYSIS ASSIGNMENT (2 @ 35 points each)

Purpose: The purpose of this assignment is to encourage you to analyze pathophysiological processes and mechanisms
of human disease, identify clinical signs and symptoms and diagnostic data consistent with the pathology of common
health problems and determine appropriate medical treatment and nursing care based on best practices found in the
literature. This assignment emphasizes critical thinking and problem-solving through the correlation of cellular and multi-
system pathology with related assessment and diagnostic data, medical treatment and nursing management.

Directions: Each student will have the opportunity to earn a total of 70 points by completing two (2) Patient Case
Analysis assignments from the six (6) units. The two case studies must be from two different units and not from the same
units that you selected for your CE assignment. You will find a schedule of assignment due dates in the course calendar.

The answers to the questions should be complete and include professional literature to support each answer. You
should include at least 3 current references (< 5 years old) of which 2 must be journal articles. References should
include current nursing journals and other professional health related literature. The assignment should be uploaded
electronically into blackboard under the appropriate assignment link.

The paper should be typed using APA format. APA format requires that you use correct grammar and spelling and
double-space your entire paper. Please include the following rubric at the end of your paper.

The Patient Case Analysis assignment will be graded using the following criteria:
Patient Case Analysis Assignment Possible Earned Score
Grading Criteria Score
Answers to Questions 30

 Demonstrates comprehensive critical analysis of pathology,

assessment and diagnostic data, medical and nursing
management (points accrued in case study)
Format 5

 Answers are supported by references 3

 Follows APA format 2
Total Score 35

NURSING JOURNAL CE ASSIGNMENTS (4 @ 20 points each)

Purpose: The nursing journal CE assignments are to help you learn the content and study for Unit exams. You will find a
schedule of when each CE assignment is due in the course calendar. Each student will have the opportunity to earn a total
of 80 points by completing four (4) CE assignments from the six (6) units, one from four different units. The CE journal
articles are identified for each unit. You cannot choose a CE assignment and a patient case analysis from the same unit.

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Directions: Choose one of the CE journal articles posted on blackboard and write a two-three page summary of the article
including key points about the pathology of the disease, nursing and medical management and application of information
to your professional nursing practice. Submit the assignment with summary, reference citation, answers and rubric in one
document. The CE questions are on Blackboard as quizzes, you will have 2 attempts to get the best score you can. Please
complete the quiz associated with the article you choose when you submit the article summary. In addition, the paper
should be typed using APA format and journal article needs to be cited appropriately. APA format requires you use
correct grammar and spelling and double-space your entire paper.

You should supplement your summary by citing at least one other reference to support your analysis, your textbook
can be used as this reference. The assignment should be uploaded electronically into blackboard under the appropriate
assignment link.

Most of these articles can be found through the JU library Ovid database – search by Journals, then year, vol. and issue
number. The journal article and test are listed separate in the Ovid database, save a copy of each to your desktop. If you
do not find the article in Ovid, go to Proquest or EBSCO host databases. You do not need to pay for the articles.

Please include the following rubric at the end of your paper.

The Nursing Journal CE assignment will be graded using the following criteria:
Nursing Journal CE Assignment Possible Earned Score
Grading Criteria Score
Summary 10

 Key Points regarding pathophysiology, patient-centered 8

medical and nursing management and application to
nursing practice
 APA format and references 2
CE Test 10

Total Score 20

The 2 patient case analyses and the CE journal assignments are due on exam days before the exam starts. There are a total of
6 assignments due per student throughout the semester. There are additional instructions on blackboard.

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