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Thursday, October 13, 2011

CLINICAL SPECIALITY – II MEDICAL SURGICAL NURSING- NEPHRO-UROLOGY NURSING, M.Sc. Nursing

Placement : II Year

Hour of Instruction
Theory : 150 Hours
Practical : 950 Hours
Total : 1100 Hours
Course Description
This course is designed to assist students in developing expertise and indepth
understanding in the field of Nephro and urological Nursing. It will
help students to develop advanced skills for nursing intervention in various
nephro and urological conditions. It will enable the student to function as
nephro and urology nurse practitioner/specialist and provide quality care. It
will further enable the student to function as educator, manager, and
researcher in the field of nephro and urology nursing

Objectives
At the end of the course the students will be able to:
1. Appreciate trends and issues related to nephro and urological
nursing
2. Describe the epidemiology, etiology, pathophysiology and diagnostic
assessment of nephro and urological conditions
3. Perform physical, psychosocial & spiritual assessment
4. Assist in various diagnostic, therapeutic and surgical interventions
5. Provide comprehensive nursing care to patients with nephro and
urological conditions
6. Describe the various drugs used in nephro and urological conditions
and nurses responsibility
7. Demonstrate skill in handling various equipments/gadgets used for
patients with nephro and urological conditions
8. Appreciate team work & coordinate activities related to patient care.
9. Practice infection control measures.
10. Identify emergencies and complications & take appropriate measures
11. Assist patients and their family to cope with emotional distress, grief,
anxiety and spiritual needs
12. Discuss the legal and ethical issues in nephro and urological nursing
13. Identify the sources of stress and manage burnout syndrome among
health care providers
14. Appreciate the role of alternative system of medicine in the care of
patient
15. Incorporate evidence based nursing practice and identify the areas of
research in the field of nephro and urological nursing
16. Teach and supervise nurses and allied health workers.
17. Design a layout of kidney transplant unit and dialysis unit
18. Develop standards of nephro urological nursing practice

Course Content
Unit Hours Content
I 5 Introduction
�� Historical development: trends and issues in the field of nephro
and urological nursing.
�� nephro and urological problems
�� Concepts, principles and nursing perspectives
�� Ethical and legal issues
�� Evidence based nursing and its application in nephro and
urological nursing(to be incorporated in all the units)

II 5 Epidemiology
�� Major health problems- urinary dysfunction, urinary tract
infections, Glomuerular disorders, obstructive disorders ad other
urinary disorders
�� Risk factors associated with nephro and urological conditions
conditions- Hereditary, Psychosocial factors, smoking, alcoholism,
dietary habits, cultural and ethnic considerations
�� Health promotion, disease prevention, life style modification and
its implications to nursing
Alternate system of medicine/complementary therapies

III 5 Review of anatomy and physiology of urinary system
�� Embryology
�� Structure and functions
�� Renal circulation
�� Physiology of urine formation
�� Fluid and electrolyte balance
�� Acid base balance
�� Immunology specific to kidney

IV 20 Assessment and diagnostic measures
�� History taking
�� Physical assessment, psychosocial assessment
�� Common assessment abnormalities-dysurea, frequency, enuresis,
urgency, hesistancy, hematuria, pain, retention, burning on
urination, pneumaturia, incontinence, nocturia, polyurea, anuria,
oliguria,
�� Diagnostic tests-urine studies, blood chemistry, radiological
procedures-KUB, IVP,nephrotomogram, retrograde pylogram, renal
arteriogram, renalultrasound, CT scan, MRI, cystogram, renal
scan, biopsy, endoscopy-cystoscopy, urodynamics studiescystometrogram,
urinary flow study, sphincter electromyography,
voiding pressure flow study, videourodynamics, Whitaker study
Interpretation of diagnostic measures
Nurse’s role in diagnostic tests

V 5 Renal immunopathy/Immunopathology
�� General Concept of immunopathology
�� Immune mechanism of glomerual vascular disease
�� Role of mediater systems in glomerula vascular disease

VI 15 Urological Disorders and Nursing Management
�� Etiology, clinical manifestations, diagnosis, prognosis, related
pathophysiology, medical , surgical and nursing management of
�� Urinary tract infections- pyelonephritis, lower urinary tract
infections,
�� Disorders for ureters, bladder and urethera
�� Urinary tract infections-
�� Urinary dysfunctions- urinary retention, urinary incontinence,
urinary reflux,
�� Bladder disorders- neoplasms, calculi, neurogenic bladder, trama,
congenital abnormalities
�� Benign prostrate hypertrophy(BPH)
�� Ureteral disorders: ureteritis, ureteral trauma, congenital
anomalies of ureters
�� Uretheral disorders- tumours, trauma, congenial anomalies of
ureters,

VII 25 Glomueral disorders and nursing management
�� Etiology, clinical manifestations, diagnosis, prognosis, related
pathophysiology, medical , surgical and nursing management of
�� Glomueralo nephritis- chronic, acute , nephritic syndrome
�� Acute Renal failure and chronic renal failure.
�� Renal calculi
�� Renal tumours-benign and malignant
�� Renal trauma
�� Renal abscess
�� Diabetic nephropathy
�� Vascular disorders
�� Renal tuberculosis
�� Polycystic
�� Congenital disorders
�� Hereditary renal disorders

VIII 10 �� Management of Renal emergencies
�� Anuria
�� Acute Renal failure
�� Poisoning
�� Trauma
�� Urine retention
�� Acute graft rejection
�� Hematuria
�� Nurse’s role
IX 10 Drugs used in urinary disorders
�� Classification
�� Indications, contraindications, actions and effects, toxic effects
�� Role of nurse

X 10 Dialysis
�� Dialysis- Historical, types, Principles, goals
• Hemodialysis- vascular access sites- temporary and permanent
• Peritoneal dialysis
�� Dialsyis Procedures- steps, equipments, maintenance,
�� Role of nurse- pre dialysis, intra and post dialysis
�� Complications-
�� Counseling
�� patient education
�� Records and reports

XI 10 �� Kidney transplantation
�� Nursing management of a patient with Kidney transplantation
�� Kidney transplantations- a historical review
�� Immunology of graft rejections
�� The recipient of a renal transplant
�� Renal preservations
�� Human Leucocytic Antigen(HLA) typing matching and cross
matching in renal transplantation
�� Surgical techniques of renal transplantations
�� Chronic renal transplant rejection
�� Complication after KTP: Vascular and lymphatic, Uroloical,
cardiovascular, liver and neurological, infectious complication
�� KTP in children and management of pediatric patient with KTP
�� KTP in developing countries
�� Results of KTP
�� Work up of donor and recipient for renal transplant
�� Psychological aspect of KTP and organ donations
�� Ethics in transplants
�� Cadaveric transplantation

XII 5 �� Rehabilitation of patient with nephrological problems
�� Risk factors and prevention
�� Rehabilitation of patients on dialysis and after kidney transplant
�� Rehabilitation of patients after urinary diversions
�� Family and patient teaching

XIII 10 Pediatric urinary disorders
�� Etiology, clinical manifestations, diagnosis, prognosis, related
pathophysiology, medical , surgical and nursing management of
children with Renal Diseases -UTI, ureteral reflux, glomerulo
nephritis, nephrotic syndrome infantile nephrosis, cystic kidneys,
familial factors in renal diseases in childhood, Haemolytic uraemic
syndrome. Benign recurrent haemturia, nephropathy, wilms’
tumour

XIV 5 Critical care units- dialysis , KTP unit
�� Philosophy, aims and objectives
�� Policies, staffing pattern, design and physical plan of Dialysis and
KTP units
�� Team approach, functions
�� Psychosocial aspects in relation to staff and clients of ICU, dialysis
unit
�� In-service education
�� Ethical and legal issues

XV 5 �� Quality assurance in nephrological nursing practice
�� Role of advance practioner in nephrological nursing
�� Professional practice standards
�� Quality control in nephrological nursing
�� Nursing audit

Practicals
Total = 960 Hours
1 Week = 30 Hours
S. No. Deptt./ Unit No. of Week Total Hours
1 Nephrology Ward 6 180 Hours
2 Pediatrics 2 60 Hours
3 Critical Care Unit 2 60 Hours
4 Urology Ward 6 180 Hours
5 Dialysis Unit 4 120 Hours
6 Kidney Transplantation Unit 2 60 Hours
7 URO OT 2 60 Hours
8 Emergency Wards 2 60 Hours
9 Uro Nephro OPDs 4 120 Hours
10 Diagnostic Labs 2 60 Hours
Total 32 Weeks 960 Hours

Procedures observed
I. Procedures Observed
1. CT Scan
2. MRI
3. Radiographic studies
4. Urodynamics
5. Hemodialysis
6. Renal Surgeries

II. Procedures Assisted
1. Blood transfusion
2. I V cannulation therapy
3. Arterial Catheterization
4. Insertion of central line/cvp line
5. Connecting lines for dialysis
6. Peritoneal dialysis
7. Renal biopsy
8. Endoscopies- Bladder, urethra

III. Procedure Performed
1. Health assessment
2. Insertion of uretheral and suprapubic catheters
3. Urine analysis

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