Medical Surgical Nursing

CLINICAL SPECIALITY – I
MEDICAL SURGICAL NURSING

Placement: 1st Year
Theory: 150 Hours
Practical: 650 Hours
Total : 800 Hours
Course Description
This course is common for the students undergoing clinical speciality-II in neuro science nursing/cardiovascular &
thoracic nursing/critical care nursing/oncology nursing/orthopaedic and rehabilitation nursing/nephro & urology
nursing, gastroenterology nursing/ geriatric nursing.
It is designed to assist students in developing expertise and in depth knowledge in the field of medical Surgical
Nursing. It will help students to appreciate the patient as a holistic individual and develop skill to function as a
specialized Medical-Surgical Nurse. It will further enable the student to function as educator, manager and researcher
in the field of Medical – Surgical Nursing.
Objectives
At the end of the course the students will be able to:
1. Appreciate the trends & issues in the field of Medical – Surgical Nursing as a speciality.
2. Apply concepts & theories related to health promotion.
3. Appreciate the client as a holistic individual.
4. Perform physical, psychosocial assessment of Medical – Surgical patients.
5. Apply Nursing process in providing care to patients.
6. Integrate the concept of family centered nursing care with associated disorder such as genetic, congenital and long-
term illness.
7. Recognize and manage emergencies with Medical- Surgical patients.
8. Describe various recent technologies & treatment modalities in the management of critically ill patients.
9. Appreciate the legal & ethical issues relevant to Medical – Surgical Nursing.
10. Prepare a design for layout and management of Medical – Surgical Units.
11. Appreciate the role of alternative systems of Medicine in care of patients.
12. Incorporate evidence based Nursing practice and identify the areas of research in the field of Medical – Surgical
Nursing.
13. Recognize the role of Nurse practitioner as a member of the Medical – Surgical health team.
14. Teach Medical – Surgical Nursing to undergraduate nursing students & in-service nurses.
Time (Hrs) Teaching Learning Assessment

Unit Content Activities method
Theory Practical
I 5 Introduction: • Seminar
 Essay Type
􀂉 Historical development of Medical- Surgical Nursing in
• Debate
India.
 Short
􀂉 Current status of health and disease burden in India. • Case Presentations
􀂉 Current concept of health. Answers
• Exposure to
􀂉 Trends & issues in Medical – Surgical Nursing.
􀂉 Ethical & cultural issues in Medical – Surgical Nursing. scientific conferences
􀂉 Rights of patients.
• Field visits
􀂉 National health policy, special laws & ordinances
relating to older
people.
􀂉 National goals.
􀂉 Five year plans.
􀂉 National health programs related to adult health.
II 20 Health Assessment of patients • Lecture cum
 Essay Type
􀂉 History taking.
discussion
􀂉 Physical examination of various systems.
 Short
􀂉 Nutritional assessment. • Seminar
􀂉 Related investigations and diagnostic assessment. Answers
• Case Presentations
III 5 Care in hospital settings: • Lecture cum
 Essay Type
􀂉 Ambulatory care.
discussion
􀂉 Acute and Critical care.
 Short
􀂉 Long term care. • Seminar
􀂉 Home Health Care. Answers
• Panel discussion
􀂉 Characteristics, care models, practice settings,
interdisciplinary team. • Exposure to
􀂉 Hospitalization- effects of hospitalization on the patient scientific conferences
& family.
• Field visits
􀂉 Stressors & reactions related to disease process.
􀂉 Nursing care using Nursing process approach.
IV 10 Management of patients with disorders of Gastro • Lecture cum
 Essay Type
intestinal tract
discussion
􀂉 Review of anatomy and physiology.
 Short
􀂉 Common Disorders-etiology, Patho physiology, Clinical • Seminar
manifestations, complications, prognosis. Answers
􀂉 Health assessment- History taking, physical
examination, investigation and diagnostic assessment. • Debate
􀂉 Treatment modalities and trends.
􀂉 Nursing management.
􀂉 Related research studies.
􀂉 Evidence based nursing practice.
􀂉 Rehabilitation and follow-up.
V 10 Management of patients with disorders of nervous • Lecture cum
 Essay Type
system
discussion
 Short
􀂉 Common Disorders- etiology, Patho physiology, Clinical • Seminar
• Debate
􀂉 Health assessment-History taking, physical
examination, • Case Presentations
investigation and diagnostic assessment.
VI 10 Management of patients with disorders of • Lecture cum
 Essay Type
respiratory system
discussion
 Short
manifestations, complications, prognosis. • Case Presentations Answers
• Exposure to
examination,
investigation and diagnostic assessment. scientific conferences
• Field visits
VII 10 Management of patients with disorders of cardio • Lecture cum
 Essay Type
vascular system
discussion
 Short
examination, • Exposure to
scientific conferences
􀂉 Nursing management. • Field visits
VIII 5 Management of patients with disorders of blood • Lecture cum
 Essay Type
discussion
􀂉 Common Disorders- etiology, Patho physiology, Clinical
 Short
manifestations, complications, prognosis. • Seminar
􀂉 Health assessment-History taking, physical Answers
examination,
investigation and diagnostic assessment. • Exposure to
􀂉 Related research studies • Field visits
􀂉 Evidence based nursing practice
􀂉 Rehabilitation and follow-up
IX 10 Management of patients with disorders of genito • Lecture cum
 Essay Type
urinary system
discussion
 Short
X 10 Management of patients with disorders of • Lecture cum
 Essay Type
endocrine system
discussion
 Short
XI 10 Management of patients with disorders of • Lecture cum
 Essay Type
musculo-skeletal
discussion
system
 Short
􀂉 Review of anatomy and physiology. • Seminar
􀂉 Common Disorders- etiology, Patho physiology, Clinical Answers
manifestations, complications, prognosis.
􀂉 Health assessment-History taking, physical • Exposure to
examination,
􀂉 Treatment modalities and trends. • Field visits
XII 8 Management of patients with disorders of • Lecture cum
 Essay Type
integumentory system
discussion
 Short
examination, • Debate
􀂉 Nursing management. • Exposure to
􀂉 Rehabilitation and follow-up. • Field visits
XIII 5 Management of patients with disorders of Eye and • Lecture cum
 Essay Type
ENT
discussion
 Short
􀂉 Common Disorders-etiology, Patho physiology, Clinical • Seminar
XIV 8 Management of patients with disorders of • Lecture cum
 Essay Type
reproductive system
discussion
 Short
examination, • Debate
􀂉 Nursing management. • Exposure to
􀂉 Rehabilitation and follow-up. • Field visits
XV 8 Geriatric nursing • Lecture cum
 Essay Type
􀂉 Nursing Assessment-History and Physical assessment.
discussion
􀂉 Ageing;
 Short
􀂉 Demography; Myths and realities. • Seminar
􀂉 Concepts and theories of ageing. Answers
􀂉 Cognitive Aspects of Ageing.
􀂉 Normal biological ageing. • Debate
􀂉 Age related body systems changes.
􀂉 Psychosocial Aspects of Aging.
􀂉 Medications and elderly. • Exposure to
􀂉 Stress & coping in older adults.
􀂉 Common Health Problems & Nursing Management;
􀂉 Psychosocial and Sexual. • Field visits
􀂉 Abuse of elderly.
􀂉 Role of nurse for care of elderly: ambulation, nutritional,
communicational, psychosocial and spiritual.
􀂉 Role of nurse for caregivers of elderly.
􀂉 Role of family and formal and non formal caregivers.
􀂉 Use of aids and prosthesis (hearing aids, dentures,
􀂉 Legal & Ethical Issues.
􀂉 Provisions and Programmes for elderly; privileges,
Community
Programs and health services;
􀂉 Home and institutional care.
􀂉 Issues, problems and trends.
XVI 8 Management of patients with communicable and • Lecture cum
 Essay Type
sexually
discussion
transmitted diseases:
 Short
􀂉 Review of immune system. • Seminar
􀂉 Common Disorders of immune system – HIV/AIDS. Answers
􀂉 Review of infectious disease process.
􀂉 Communicable Diseases- etiology, Patho physiology, • Debate
Clinical
manifestations, complications, prognosis.
􀂉 Health assessment-History taking, physical • Exposure to
examination,
􀂉 Treatment modalities and trends. • Field visits
XVII 8 Emergency, trauma and multi-system organ • Lecture cum
 Essay Type
failure
discussion
􀂉 DIC (disseminated intravascular coagulation)
 Short
􀂉 Trauma, burns, poisoning • Seminar
􀂉 Etiology, Patho physiology, Clinical manifestations, Answers
complications,
prognosis. • Debate
examination,
investigation and diagnostic assessment. • Exposure to
• Treatment modalities and trends. scientific conferences
• Nursing management.
• Field visits
• Related research studies.
• Evidence based nursing practice.
• Rehabilitation and follow-up.
Practical
Total = 660 Hours
1 Week = 30 Hours
S.No Dept/Unit No. of Week Total Hours
.
1. General Medical Ward 4 120
2. General Surgical Ward 4 120
3. ICUs 4 120
4. Oncology 2 60
5. Ortho 2 60
6. Cardio 2 60
7. Emergency Department 2 60
8. Neuro 2 60
Total 22 Weeks 660 Hours
Student Activities:
• Clinical presentations
• History taking
• Health Assessment
• Nutritional Assessment
• Health Education related to disease conditions
• Case studies
• Project work
• Field visits
Essential Nursing Skills

· Health assessment
· Triage
· CPR
· Pulse oximetry
EVALUATION BASIS
Theory
1. Test paper - Mid Term - = 50 marks
Pre-final - = 75 marks
2. Other Assignment Seminar = 100 marks
Project work = 100 marks
-----------------------------------
Total - 325 marks
Internal Assessment Total marks out of 25

External Assessment Total marks out of 75
Practical Experience Assignments

Case study : 02 (50 marks each) 50 x 2 = 100
Case Presentation : 02 (50 marks each) 50 x 2 = 100
Care Plan : 03 (50 marks each) 50 x 3 = 150
Clinical Performance Evaluation : 03 (100 marks each) 100 x 3 = 300
650
Internal Assessment Total marks out of 100
External Assessment Total marks out of 100
REFERENCE BOOKS:
1. Abraham P.H; Marks S.C; Hutchings R.T ,Mcminn's Colour Atlas Of Human Anatomy,5 th Ed,2003, Mosby
2. Richard l.Drake; Wayne Vogl; Adam W.M.Mitchell, Grays Anatomy For Students Companion, 2005, Churchill Livingstone
3. Evelyn C.Pearce, Anatomy And Physiology For Nurses, 16th Ed, Jaypee
4. Doug Elliott; Leanne M.Aitken; Wendy Chaboyer, Accn`S Critical Care Nursing, 2007, Elseiver
5. Marilynn E.Doenges; Mary Frances Moorhouse; Joesph T.Burley, Application Of Nursing Process And Nursing Diagnosis : An
Interactive Text For Diagnostic Reasoning, 2nd Ed, 2005, Jaypee
6. Basavanthappa,B.T. Medical Surgical Nursing, 2003, Jaypee
7. Jaya kurvilla, Essentials Of Critical Care Nursing, 2007, Jaypee
8. Frances Donovan Monahan; Judith K.Sands; Marianne Neighbors, Phipps Medical Surgical Nursing : Health And Illness
Prespectives, 8th Ed, 2007, Mosby
9. Onila Salins, Medical Surgical Nursing Specialities, 2003, Jaypee
10. Rekha Sharma, Diet Management, 3rd Ed, 2004 , Elseiver
11. Seth.S.D Ed, Textbook Of Pharmacology, 2nd Ed, 1999, Elsevier
12. Ben Greenstein; Dinah Gould, Trounces Clinical Pharmacology For Nurses, 7 th Ed, 2004, Churchill Livingstone
13. Prema,T.P; Graicy,K.F, Essentials Of Neurological And Neurosurgical Nursing, 2002, Jaypee
14. Norman Noah, Controlling Communicable Disease, 2006, Tata Mc Graw Hill
15. Who, Symptom Relief In Terminal Illness, 1999, A.I.T.Bs
16. Barbara Aehlert,R.N, Pocket Reference For Ecgs Made Easy, 3rd Ed, 2006, Elseiver
17. John r.hampton, 150 Ecg Problems, 2nd Ed, 2003, Churchill
18. Neena Khanna, Illustrated Synopsis Of Dermatology And Sexually Transmitted Disease, 2005, Peepe
19. Praveen Kumar; Michael Clark, Kumar And Clark Clinical Medicine, 2005, 6 th Ed, Elsever
20. Joyce m. Black; Jane Hokanson Hawks, Medical Surgical Nursing - Clinical Management For Positive Outcomes, 7 th Ed, 2005,
Saunders
21. Suzanne c.smeltzer; l. Hinkle; kerry h. Cheever, Brunner & Suddarth's Textbook Of Medical Surgical Nursing, 11 th Ed, 2008,
Wolterskluwer
22. Agarwal A.K; Singal R.K Eds., Emergency Medicine, 2005, Jaypee
23. Charlotte Elliopoulos, Gerontological Nursing, 6th Ed, 2005, Lippincott Williams & Wilkins
24. Carol Mattson Porth, Essentials Of Pathophysiology : Concepts Of Altered Health States, 2 nd Ed, 2007, Lippincott Williams &
Wilkins
25. Janet weber; jane k. Kelley, Health Assessment In Nursing, 3 rd Ed, 2007, Lippincott Williams & Wilkins
26. Carolyn Jarvis, Physical Examination & Health Assessment, 5th Ed, 2008, Saunders Elsevier
27. Carolyn Jarvis, Physical Examination & Health Assessment, 5th Ed, 2008, Saunders Elsevier,
28. Emily Hansen; Gary Easthope, Lifestyle In Medicine, 2007, Roultedge
29. Tom C.Nguyen; Oscar J.Abilez, Practicl Guide To The Care Of The Surgical Patient, 2007, Mosby
30. Narayan H Nayak, Guidelines To Practice Of Emergence Medicine, 2 nd Ed, 2008, Elsever
31. 1. Black M.J., Hawks H.J., “Medical Surgical Nursing, Clinical Management for positive
32. outcome” 7th Ed., Sauders, Elsevier.
33. 2. Smeltzer, Bare Brunner and Suddarths Medical Surgical Nursing.
34. 3. The Lippincott Mannual of Nursing practice, Lippincott.
35. 4. MANN, RUSSELL, WILLIAMS, Bailey & Love’s short practice of Surgery.
36. 5. Potter & Perry Fundamentals of Nursing, Elsevier.
37. 6. Urdan Bavic, Thelan, Essentials of critical care Nursing.
38. 7. Urban, A.N., Greenlac K.K. “Guidelines for critical care Nursing Mosby
39. 8. Wood L.S., Freelicher S.E fetal cardiac Nursing. Lippincott Williams & Wilkings.
40. 9. Gulanic, Klopp, Galnes fetal Nursing care plans nursing diagnosis and intervention.
41. 10. Lewis, Collier & Heitkemper Medical Surgical Nursing assessment and management of
42. clinical problems.
M.Sc. NURSING : CLINICAL SPECIALITY – I
PROFORMA & GUIDELINE FOR CASE STUDY
Area :- (Maximum Marks – 50)
01. Selection of patient.

02. Demographic data of the patient.
03. Medical history past and present illness.
04. Comparison of the patient’s disease with book picture.
a) Anatomy and physiology.
b) Etiology.
c) Patho physiology.
d) Signs and symptoms.
e) Diagnosis - provisional & final
f) Investigations
g) Complications & prognosis.
05. Management:- Medical or Surgical
a) Aims and objectives.
b) Drugs and Medications.
c) Diet.
06. Nursing Management (Nursing Process approach)
a) Aims and objectives.
b) Assessment and specific observations.
c) Nursing diagnosis.
d) Nursing care plan (Short term & long term with rationale.)
e) Implementation of nursing care with priority.
f) Health teaching.
g) Day to day progress report & evaluation.
h) Discharge planning.
07. Drug Study.
08. Research evidence.
09. Summary and conclusion.
10. Bibliography.
EVALUATION CRITERIA FOR CASE STUDY.
(Maximum Marks – 50)

S.N Criteria Marks Allotted Marks Obtained Total
1 Assessment 5
2 Theoretical knowledge about disease 5
3 Comparative study of the patient’s 10
disease & book picture
4 Management: Medical or Surgical. 5
5 Nursing Process 15
6 Drug study 3
7 Summary & conclusion including 5
research evidence
8 Bibliography 2
Total 50
Signature of Student Signature of Clinical supervisor
M Sc NURSING: CLINICAL SPECIALITY – I

PROFORMA & GUIDELINE FOR CASE PRESENTATION
I] Patient Biodata
Name,
Age,
Sex,
Religion,
Marital status,
Occupation,
Source of health care,
Date of admission,
Provisional Diagnosis,
Date of surgery if any.
II] Presenting complaints
Describe the complaints with which the child has been brought to the hospital
III] Socio-economic status of the family:
Monthly income,
expenditure on health,
food,
education etc.
IV] History of Illness (Medical & Surgical)
i) History of present illness –
onset,
symptoms,
duration,
precipitating/aggravating factors
ii) History of
past illness surgery,
allergies,
medications etc.
iii) Family history –
Family tree,
history of illness in the family members,
risk factors,
congenital problems,
psychological problems etc.
V] Diagnosis: (Provisional & confirmed).

Description of disease: Includes the followings
1. Definition.
2. Related anatomy and physiology
2. Etiology & risk factors
3. Path physiology
5. Clinical features.
VI] Physical Examination of Patient (Date & Time)
Physical examination: with date and time.
Clinical features present in the book Present in the patient
VII] Investigations
Date Investigation Results Normal value Inferences
done
VIII] Management - (Medical /Surgical)

a) Aims of management
b) Objectives of Nursing Care Plan
IX] Treatment:
S.N Drug (Pharmacological Dose Action Side effects & Nurse’s
o name) Frequency/ drug reaction responsibility
Time
· Medical or Surgical Management.
· Nursing management
X] Nursing Care Plan: Short Term & Long Term plan.
Assessment Nursing Objective Plan of care Rationale Implementatio Evaluatio
Diagnosis n n
XI] Discharge planning:
It should include health education and discharge planning given to the patient.
XII] Prognosis of the patient:
XIII] Summary of the case:
IVX] References:
EVALUATION CRITERIA FOR CASE PRESENTATION
Maximum Marks – 50)

1 Content Subjective & objective data 08
2 Problems & need Identified & Nsg. Care Plan 15
3 Effectiveness of presentation 5
4 Co-relation with patient & Book i. e. 10
research evidence.
5 Use of A. V. Aids 5
6 Physical arrangement 2
7 Group participation 3
8 Bibliography & references 2
Total 50
CLINICAL EVALUATION: COMPREHENSIVE NURSING CARE
(Maximum Marks – 100 each area.)
Name of the Student
Year: Duration of Experience:
S.N Criteria 1 2 3 4 5
I UNDERSTANDING OF PATIENT AS PERSON
A. Approach.
1. Rapport with patient/ family members.
2. Collects significant information.
B. Understanding of patient’s health problems.
1. Knowledge about disease condition.
2. Knowledge about investigations.
3. Knowledge about treatment.
4. Knowledge about progress of the patient.
II NURSING CARE PLAN
A. Assessment of the condition of the patient.
1. History taking – past & present health and illness.
2. Specific observation of the patient.
3. Nursing diagnosis.
B. Development of the short – term & long term Nursing care plans.
1. Identification of all problems in the patient/family.
2. Prioritization & implementation of the plans.
3. Evaluation of the care given & re-planning
III TECHNICAL SKILL
1.Economical & safe adaptation to the situation & available facilities.
2.Implements the procedure with skill speed & completeness.
IV RECORDING & REPORTING
1.Prompt, precise, accurate & relevant.
2.Maintenance of clinical experience file.
V HEALTH TEACHING
1.Incidental/ planned teaching with principles of teaching & learning.
2.Uses visual aids appropriately
VI PERSONALITY
1. Professional appearance (uniform, dignity, tact fullness interpersonal relationship,
punctuality etc.
2. Sincerely, honesty & Sense of responsibility.
Total Marks
Positive & Negative aspects.
Signature of Student Signature of Clinical supervisor
EVALUATION CRITERIA FOR NURSING CARE PLAN

(Maximum Marks – 50)
Name of the Student :
Date : ………………… Field placement :

1 History taking 6
2 Assessment of needs & problems 10
3 Nursing process 16
4 Implementation of care 10
5 Follow-up care 4
6 Bibliography 4
Total 50
N.B. : One Nursing Care Plan : 50 Marks
Remarks
Signature of Students ……… Signature of Supervisor
………

Medical Surgical Nursing

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CLINICAL SPECIALITY – I

MEDICAL SURGICAL NURSING

Time (Hrs) Teaching Learning Assessment

2. General Surgical Ward 4 120

Total 22 Weeks 660 Hours

Essential Nursing Skills

Internal Assessment Total marks out of 25

Practical Experience Assignments

01. Selection of patient.

EVALUATION CRITERIA FOR CASE STUDY.

(Maximum Marks – 50)

Signature of Student Signature of Clinical supervisor

M Sc NURSING: CLINICAL SPECIALITY – I

V] Diagnosis: (Provisional & confirmed).

VIII] Management - (Medical /Surgical)

XI] Discharge planning:

EVALUATION CRITERIA FOR CASE PRESENTATION

Maximum Marks – 50)

S.N Criteria Marks Allotted Marks Obtained Total

EVALUATION CRITERIA FOR NURSING CARE PLAN

S.N Criteria Marks Allotted Marks Obtained Total

N.B. : One Nursing Care Plan : 50 Marks

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