CCOG for NRS 221 Spring 2024

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

Course Description

Expands on the major concepts of family care giving, symptom management, and end-of-life care in the context of nursing interventions with patients and families. Explores ethical issues related to advocacy, self-determination, and autonomy. Includes developing complex skills associated with the assessment and management of concurrent illnesses and conditions within the context of client and family preferences and needs. Covers skills related to enhancing communication and collaboration as a member of an inter-professional team and across healthcare settings. Exemplars include patients with chronic mental illness and addictions as well as other chronic conditions and disabilities affecting functional status and family relationships. Prerequisites: NRS 112, NRS 231 and NRS 233.

Intended Outcomes for the course

Upon completion of the course students will be able to:

1. Conduct a health assessment that is in-depth, evidence-based, family-centered, and both developmentally and culturally appropriate.

2. Interpret health data focusing on:

  • functional issues associated with complexities of co-morbid conditions in relation to ADLs and IADLs,
  • manifestations of psychiatric diagnoses and their impact on patient self-care,
  • psychosocial issues and the impact of the illness on  individual development and family function,
  • the patient's personal, social and cultural interpretation of the meaning of the illness and the impact on the patient's family,
  • capacity for and engagement in self care,
  • and opportunities for health behavior change.

2. Apply evidence-based nursing practices in support of patient and family in self-health care management across the lifespan to:

  • establish meaningful relationships with patients/families,
  • support patient and family in development of  self-health care management,
  • address caregiver needs for preparedness and predictability with regards to the management of symptoms/manifestations for specific disorders,
  • and assess family strengths and resources, caregiver role strain, and capacity to provide care.

3. Incorporate measures to enhance quality of life in the plan of care by facilitating the patient in developing their personal definition of quality of life and addressing patient needs for preparedness and predictability.

4. Identify and use community resources to provide support for the patient and family caregiving by:

  • supporting the client in negotiating the health care settings,
  • assessing appropriateness of resources in meeting the patient/family needs, (e.g. accessibility, financial feasibility, acceptability),
  • and developing inter-professional collaborations for the provision of care.

5. Communicate with 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 patients.

6. Utilize nursing- and inter-professional based-knowledge of death and dying trajectories to support patients/families across the life-span who are experiencing transitions at the end of life (EOL) including:

  • 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,
  • and using appropriate assessment techniques for individuals and families experiencing life threatening illness.

7. Analyze the impact of health care delivery system issues, policy and financing on individual and family health care needs for chronic illness and end of life care by:

  • comparing basic funding mechanisms,
  • identifying decision-making issues for chronic care based on funding resources,
  • and assessing appropriateness of resources in meeting the patient/family needs, (e.g. accessibility, financial feasibility, acceptability).

Course Activities and Design

Discussion groups

Required Readings
Clinical evaluation
Multiple choice exams
Lab performance evaluation

Outcome Assessment Strategies

Clinical performance evaluation

Papers/Project Rubrics
Multiple choice exams
Lab performance evaluation

Course Content (Themes, Concepts, Issues and Skills)

Themes, Concepts & Issues:


Complexity in chronic illness

Symptom management



Case management

Chronic mental illness

Substance abuse

End of life care

Ethical/Legal issues


Evidence-based best practices, ( e.g. core measures and National Patient Safety Goals (NPSG) and Clinical guidelines)


Skills: This is not an exhaustive list but is a minimum skill set to be completed anytime throughout  NRS 221, NRS 222 or NRS 224

Intravenous Therapy and Regulation: Central lines

Central Line Intermittent IV Therapy via Secondary Infusion (piggyback)

PCA (patient controlled analgesia) pump

 Central Venous Access Devices

 Peripheral IV Direct Medications (IV push)

TPN administration and maintenance

Blood Administration

Chest Tube Maintenance

Telemetry: Cardiac Dysrhythmias  

Tracheostomy Care

Tracheostomy Suctioning

Post Mortem Care

Epidural maintenance (classroom theory)

Ventilator/ETT (classroom theory)

Code Roles


Chronic Pain Advanced Interventions

Advanced Wound Care