Portland Community College | Portland, Oregon

Course Number:
NRS 111
Course Title:
Foundations of Nursing in Chronic Illness I
Credit Hours:
Lecture Hours:
Lecture/Lab Hours:
Lab Hours:
Special Fee:

Course Description

This course introduces assessment and common interventions (including technical procedures) for clients with chronic illnesses common across the life span in major ethnic groups. The client's and family's "lived experience" of the condition is explored. Clinical practice guidelines and research evidence are used to guide clinical judgments in care of individuals with chronic conditions. Multidisciplinary team roles and responsibilities are explored in the context of delivering safe, high quality health care to individuals with chronic conditions (includes practical and legal aspects of delegation). Cultural, ethical, legal and health care delivery issues are explored through case scenarios and clinical practice. Case exemplars include children with asthma, adolescents with a mood disorder, adults with type 2 diabetes, and older adults with dementia. The course includes class room and clinical learning experiences. Prerequisites: NRS 110. Prerequisites/concurrent: (NRS 230 or NRS 231) and (NRS 232 or NRS 233).

Intended Outcomes for the course

1. Conduct a health assessment that is family-centered and both developmentally and culturally     appropriate and interpret, and use the resulting health data focusing on:

  • mental and functional status, ADLs and IADLs,
  • coping/adaptive strategies used by client/family,
  • lived experiences of chronic illness, including recognition of stigma and its impact on

                vulnerability and maintaining health,

  • impact of condition on family functioning, and
  • specific lab value interpretation and medication concerns such as polypharmacy.

2. Provide safe and effective, developmentally and culturally appropriate care to clients with chronic illness including:

  • safely and effectively assisting clients with ADLs & IADLs,
  • identifying and providing for comfort needs (physical and emotional),
  •  teaching clients/families about interventions for managing symptoms such as chronic pain and fatigue,
  • teaching clients about self-assessment and self-management in highly prevalent chronic conditions such as (but not limited to)  congestive heart failure, dementia, type 2 diabetes, depression, and
  • addressing basic questions about prognosis of illness.

3. Develop and implement a family-centered plan of care for a client with a chronic illness that incorporates evidence-based intervention strategies, assessment data, child and family developmental considerations, and demonstrates a deep understanding of the client€™s perspective and illness experience within the framework of exacerbation, trajectory, and plateau.

4. Apply ANA Code of Ethics in the care of persons with a chronic illness or disability.
5. Identify roles and functions of members of the health care team in order to provide care for the chronically ill.
6. Use therapeutic communication skills in the development of therapeutic relationships with clients and families.
7. Recognize potential legal and ethical issues related to client autonomy across the lifespan in at risk populations.

Course Activities and Design


Outcome Assessment Strategies

Clinical evaluation
Multiple choice exams
Lab performance evaluation
Group Case Study
Patient Teaching Project

Course Content (Themes, Concepts, Issues and Skills)

Themes, Concepts & Issues:
Assessment of client's abilities and needs
Chronic health conditions
View of illness from client perspective
Vulnerable populations
Evidence based practice
Effect of illness on client and family
Safety during care of clients
Assessing and responding to mental health conditions
Legal and ethical aspects of care
Medication administration-various routes, including mathematics
related to calculating dosages and delivery rates
Sterile technique procedures
Tube feedings
Diabetes care-Insulin, CBG
Wound care-focus on chronic wounds
Focused assessments-pain, chronic cardiovascular, respiratory,
Computer based documentation