Portland Community College | Portland, Oregon

Course Number:
NRS 221
Course Title:
Chronic II
Credit Hours:
Lecture Hours:
Lecture/Lab Hours:
Lab Hours:
Special Fee:

Course Description

This course builds on foundations of nursing in Chronic Illness I. Chronic Illness II expands the student's knowledge related to family care giving, symptom management and end of life concepts. These concepts are a major focus and basis for nursing interventions with patients and families. Ethical issues related to advocacy, self determination, and autonomy are explored. Complex skills associated with the assessment and management of concurrent illnesses and conditions are developed within the context of client and family preferences and needs. Skills related to enhancing communication and collaboration as a member of an interdisciplinary team are further explored. Exemplars include patients with chronic mental illness and addictions as well as other chronic conditions and disabilities affecting functional status and family relationships. The course includes classroom and clinical learning experiences. Prerequisite: Completion of first year Nursing courses.

Intended Outcomes for the course

By the end of the course, the student will be able to:
1.conduct a health assessment that is in-depth, evidence-based, family-centered, and both developmentally and culturally appropriate interpret health data, focusing on: functional issues associated with complexities of co-morbid conditions in relation to adl€™s and iadl€™s; manifestations of psychiatric diagnoses and their impact on client selfcare; psychosocial issues and the impact of the illness on  individual development and family function; the client€™s personal, social and cultural interpretation of the meaning of the illness and the impact on the client€™s family; capacity for and engagement in self care; and, opportunities for health behavior change.
2.develop and use evidence-based interventions, individualized to client and family needs, specifically to: establish meaningful relationships with clients/families; support client and family in development of capacity for self-health care management; address caregiver needs for preparedness,
predictability and enrichment; manage symptoms/manifestations for specific disorders;
3.incorporate measures to enhance quality of life in the plan of care by:facilitating client in personal definition of quality of life, and addressing client needs for preparedness, predictability and enrichment.
4.identify and use community resources to provide support for the client and family caregiving by:supporting the client in negotiating the health care system; and accessing appropriateness of resources in meeting the client/family needs, (e.g. Accessibility, financial feasibility, acceptability).
5.communicate, as appropriate, with all agencies involved in patient care to assure continuity of care across settings (e.g. Schools, day
care, adult foster care, etc.) By:negotiating with others to modify care; and advocating for clients.
6.support patients and families across the life-span who choose palliative care or are experiencing transitions at the end of life by: negotiating with others to develop or modify patient care;describing the epidemiology of dying: where, when, how people die; dying trajectories across the lifespan;using developmentally and culturally appropriate communication with patients and families at eol;using appropriate assessment techniques for individuals and families experiencing life threatening illness; and, assessing family capacity to provide care, caregiving strain, strengths, and resources.
7.analyze impact of health care delivery system issues, policy and financing on individual and family care by: comparing basic funding mechanisms for chronic illness; identifying decision-making issues for chronic care based on funding resources; and accessing appropriateness of resources in meeting
the client/family needs, (e.g. Accessibility, financial feasibility, acceptability).

Course Activities and Design


Outcome Assessment Strategies

Clinical performance evaluation
multiple choice exams
lab performance evaluation
project and participation evaluation

Course Content (Themes, Concepts, Issues and Skills)

Evidence based care
family centered care
individual and family development
cultural care
interpretation of data
symptom management
self determination/autonomy
interdisciplinary team work
chronic illness conditions
disabilities-effect on
wound vac
chest tubes
central lines
*2nd intention wound care
wet-moist drsg
medication infusion
professional boundaries
computer based documentation