INC Syllabus — Medical-Surgical Nursing: Detailed Course Description

Unit I — Introduction to Medical-Surgical Nursing

Overview

Key Topics

• Evolution and Trends in medical and surgical nursing — tracing how nursing practice has developed in response to advances in medicine, technology, and healthcare policy
• International Classification of Diseases (ICD) — familiarizing nurses with global disease coding systems used in clinical documentation
• Roles and Responsibilities of nurses in:
  • Outpatient departments — health screening, education, follow-up
  • In-patient units — continuous bedside care, monitoring
  • Intensive Care Units (ICU) — critical care management
• Medical and Surgical Asepsis — principles of infection prevention
  • Inflammation and infection: recognizing signs, understanding the body's defense mechanisms
  • Wound healing: stages (hemostasis, inflammation, proliferation, remodeling) and factors influencing healing (nutrition, blood supply, infection, age)
  • Wound care and dressing techniques
• Care of the Surgical Patient:
  • Pre-operative care — patient preparation, informed consent, bowel preparation, fasting guidelines, skin prep
  • Post-operative care — monitoring, pain management, complication prevention, discharge planning
• Alternative Therapies used alongside conventional medical-surgical treatment

Learning Outcomes

Teaching Methods & Assessment

Unit II — Intraoperative Care

Overview

Key Topics

• Organization and Physical Set-Up of the OT:
  • Classification of operating theaters (minor vs. major, specialty-specific)
  • OT design — zoning (restricted, semi-restricted, unrestricted), ventilation, laminar airflow
  • Staffing structure and members of the OT team (surgeon, anesthesiologist, scrub nurse, circulating nurse)
  • Duties and responsibilities of the nurse in OT
• Patient Positioning and Draping — correct positioning for common surgeries (supine, prone, lateral, lithotomy, Trendelenburg) to prevent complications like nerve injury, pressure ulcers
• Instruments, Sutures, and Suture Materials — identification and proper handling of surgical instruments; types of sutures (absorbable vs. non-absorbable) and suturing materials
• Disinfection and Sterilization of Equipment — methods including autoclaving, chemical sterilization, UV irradiation
• Preparation of Sets for common surgical procedures (dressing sets, suture sets, laparotomy sets)
• Scrubbing Procedures — proper surgical hand scrub technique, gowning, masking, and gloving (sterile technique)
• Patient Monitoring during surgical procedures — vital signs, fluid balance, anesthesia-related parameters
• Maintenance of the Therapeutic Environment in OT — temperature, humidity, infection control
• Assisting in Major and Minor Operations — role differentiation between scrub and circulating nurse, specimen handling
• Prevention of Accidents and Hazards in OT — fire safety, instrument counts, electrical safety
• Anesthesia:
  • Types: General, Regional (spinal, epidural, nerve block), Local
  • Methods of administration
  • Effects and stages (induction, maintenance, emergence)
  • Equipment and drugs used
• Legal Aspects in the operating room — informed consent, documentation, accountability

Learning Outcomes

Teaching Methods & Assessment

Unit III — Nursing Care of Patients with Shock, Fluid & Electrolyte Imbalances, and Pain

Overview

Key Topics

• Fluid and Electrolyte Management:
  • Types of imbalances: hypovolemia, hypervolemia, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, etc.
  • Clinical recognition, lab interpretation, and nursing interventions
  • IV fluid therapy — types of solutions (isotonic, hypotonic, hypertonic), IV access, fluid balance monitoring
• Shock:
  • Types: Hypovolemic, Cardiogenic, Distributive (septic, anaphylactic, neurogenic), Obstructive
  • Pathophysiology: decreased tissue perfusion leading to cellular hypoxia
  • Signs and symptoms: hypotension, tachycardia, altered consciousness, decreased urine output
  • Nursing management: positioning, oxygen therapy, fluid resuscitation, medication administration, monitoring
• Pain:
  • Pain assessment tools (VAS, NRS, FACES scale)
  • Types of pain: acute vs. chronic, nociceptive vs. neuropathic
  • Nursing management plans: pharmacological (analgesics, NSAIDs, opioids) and non-pharmacological (positioning, heat/cold, distraction, relaxation)

Learning Outcomes

Teaching Methods & Assessment

Unit IV — Nursing Management of Patients with Respiratory Problems

Overview

Key Topics

• Anatomy and Physiology Review of the respiratory system
• Nursing Assessment:
  • History taking, physical assessment (inspection, palpation, percussion, auscultation)
  • Diagnostic tests: spirometry, ABG, chest X-ray, CT scan, bronchoscopy, sputum culture
• Common Respiratory Problems:
  • Upper Respiratory Tract Infections (URTI) — rhinitis, sinusitis, pharyngitis, tonsillitis, laryngitis
  • Chronic Obstructive Pulmonary Disease (COPD) — emphysema and chronic bronchitis; pathophysiology, management (bronchodilators, steroids, oxygen therapy, pulmonary rehab)
  • Pleural Effusion and Empyema — fluid in pleural space; thoracentesis nursing care
  • Bronchiectasis — permanent airway dilation; postural drainage
  • Pneumonia — bacterial, viral, aspiration; antibiotic therapy, respiratory support
  • Lung Abscess — localized infection with pus formation
  • Cysts and Tumors — benign and malignant lung neoplasms
  • Chest Injuries — pneumothorax, hemothorax, rib fractures; chest tube management
  • Acute Respiratory Distress Syndrome (ARDS) — diffuse lung injury, mechanical ventilation management
  • Pulmonary Embolism — thrombus lodged in pulmonary arteries; anticoagulation therapy, monitoring
• Health Behaviours to Prevent Respiratory Illness — smoking cessation, vaccination, environmental controls

Learning Outcomes

Teaching Methods & Assessment

Unit V — Nursing Management of Patients with Disorders of the Digestive System

Overview

Key Topics

• Anatomy and Physiology Review of the GI system
• Nursing Assessment — history, physical exam, GI investigations (endoscopy, colonoscopy, imaging)
• Common GI Disorders:
  • Oral cavity — lips, gums, teeth disorders
  • GI Tract disorders — bleeding, infections, inflammation, tumors, obstruction, perforation, peritonitis
  • Peptic and Duodenal Ulcer — H. pylori, NSAIDs; medical management (PPIs, antacids) and surgical (vagotomy, gastrectomy)
  • Malabsorption Syndromes, Appendicitis, Hernias
  • Hemorrhoids, Fissures, Fistulas
  • Pancreatic disorders — inflammation, cysts, tumors
  • Liver disorders — inflammation, cysts, abscess, cirrhosis, portal hypertension, hepatic failure, tumors
  • Gallbladder — inflammation (cholecystitis), cholelithiasis (gallstones), tumors
• Gastric Decompression, Gavage and Stoma Care
• Different Feeding Techniques — nasogastric, nasojejunal, PEG feeding; enteral and parenteral nutrition
• Alternative Therapies and Drugs used in digestive system disorders

Learning Outcomes

Teaching Methods & Assessment

Unit VI — Nursing Management of Patients with Cardiovascular Problems

Overview

Key Topics

• Anatomy and Physiology Review of the cardiovascular system
• Nursing Assessment — history, physical assessment; invasive (cardiac catheterization, hemodynamic monitoring) and non-invasive procedures (ECG, echocardiography, stress testing)
• Disorders of the Vascular System:
  • Hypertension — classification, management (lifestyle, pharmacology), nursing care
  • Arteriosclerosis and Atherosclerosis — lipid deposition, plaque formation
  • Raynaud's Disease — vasospastic disorder of peripheral vessels
  • Aneurysm — types, surgical management
  • Peripheral Vascular Disorders
• Coronary Artery Diseases:
  • Coronary Atherosclerosis
  • Angina Pectoris — stable, unstable, Prinzmetal's; nitrate therapy, nursing care
  • Myocardial Infarction (MI) — STEMI/NSTEMI; thrombolytics, PCI, nursing management, cardiac rehabilitation
• Valvular Disorders — Congenital and Acquired (stenosis, regurgitation); surgical options including valve repair/replacement
• Rheumatic Heart Disease — Pericarditis, Myocarditis, Endocarditis, Cardiomyopathies
• Cardiac Dysrhythmias and Heart Block — ECG interpretation, antiarrhythmic drugs, pacemakers
• Congestive Heart Failure (CHF) — left vs. right heart failure, medical management (diuretics, ACE inhibitors, beta-blockers)
• Corpulmonale, Pulmonary Edema, Cardiogenic Shock
• Cardiac Tamponade — pericardiocentesis nursing care
• Cardiopulmonary Arrest — emergency response, BLS/BCLS protocols

Learning Outcomes

Teaching Methods & Assessment

Unit VII — Nursing Management of Patients with Disorders of Blood

Overview

Key Topics

• Anatomy and Physiology of Blood — components, hematopoiesis, blood groups
• Nursing Assessment — history, physical assessment, diagnostic tests (CBC, peripheral smear, bone marrow biopsy)
• Hematological Disorders:
  • Anemia and Polycythemia — types, etiologies, management
  • Bleeding Disorders — clotting factor defects (hemophilia), platelet defects (thrombocytopenia)
  • Thalassemia — genetic hemoglobin disorder; transfusion therapy, iron chelation
  • Leukemia and Leukopenia — bone marrow malignancies; chemotherapy nursing care
  • Agranulocytosis — severe neutrophil deficiency; infection prevention
  • Lymphomas — Hodgkin's and Non-Hodgkin's
  • Myelomas — plasma cell malignancy; pain management, bone protection
• Health Education on Blood Donation

Learning Outcomes

Teaching Methods & Assessment

Unit VIII — Nursing Management of Patients with Disorders of the Endocrine System

Overview

Key Topics

• Anatomy and Physiology of the Endocrine System
• Nursing Assessment — history, physical assessment
• Endocrine Disorders:
  • Thyroid Disorders — Hyperthyroidism (Graves' disease), Hypothyroidism (Hashimoto's), goiter; antithyroid drugs, thyroidectomy nursing care
  • Parathyroid Disorders — Hyper/Hypoparathyroidism; calcium management
  • Adrenal Disorders — Addison's disease, Cushing's syndrome, pheochromocytoma; steroid therapy nursing
  • Pituitary Disorders — Hyper/Hypo-pituitarism; tumors; hormone replacement
  • Diabetes Mellitus — Type 1, Type 2, gestational; pathophysiology (insulin deficiency/resistance), complications (DKA, HHS, neuropathy, retinopathy, nephropathy, angiopathy), insulin therapy, oral hypoglycemics, dietary management (diabetic diet), blood glucose monitoring, patient education on self-care

Learning Outcomes

Teaching Methods & Assessment

Unit IX — Nursing Management of Patients with Disorders of the Integumentary System

Overview

Key Topics

• Anatomy and Physiology of the Skin
• Nursing Assessment — history and physical assessment of skin lesions (type, distribution, color, texture)
• Infections and Infestations:
  • Dermatitis — contact, atopic, seborrheic
  • Dermatoses — infectious and non-infectious
  • Acne vulgaris, Allergies, Eczema, Pemphigus
  • Psoriasis — chronic autoimmune skin disorder; topical/systemic treatment
  • Malignant Melanoma — staging, surgical excision, nursing care
  • Alopecia — types and management
• Special and Alternative Therapies in skin care
• Medicated Bath — therapeutic baths (oatmeal, bleach, tar) for dermatological conditions
• Drugs used in Integumentary System Disorders
• Home Care Planning — wound care, sun protection, medication compliance

Learning Outcomes

Teaching Methods & Assessment

Unit X — Nursing Management of Patients with Musculoskeletal Problems

Overview

Key Topics

• Anatomy and Physiology of the Musculoskeletal System
• Nursing Assessment — history, physical assessment, diagnostic tests (X-ray, CT, MRI, bone scan, arthroscopy)
• Musculoskeletal Trauma:
  • Dislocation, Fracture (types, healing stages, management — conservative and surgical)
  • Sprain, Strain, Contusion
  • Amputation — stump care, prosthetic fitting, phantom limb pain
• Musculoskeletal Infections and Tumors:
  • Osteomyelitis — bone infection; antibiotic therapy, surgical debridement
  • Benign and Malignant Tumors — bone tumors
• Orthopedic Modalities:
  • Cast care — neurovascular monitoring, skin care under cast
  • Splint application
  • Traction — types (skin, skeletal) and nursing care
  • Crutch walking — teaching different gaits
• Musculoskeletal Inflammation:
  • Bursitis, Synovitis, Arthritis (osteoarthritis and rheumatoid arthritis) — pharmacological (NSAIDs, DMARDs) and non-pharmacological management
• Special and Alternative Therapies
• Metabolic Bone Disorders:
  • Osteoporosis — prevention, bisphosphonate therapy, fall prevention
  • Osteomalacia — vitamin D deficiency; supplementation
  • Paget's Disease — abnormal bone remodeling
• Spinal Column Defects and Deformities:
  • Tumors, Prolapsed Intervertebral Disc, Pott's Spine (spinal tuberculosis)
• Rehabilitation and Prosthesis
• Replacement Surgeries — hip/knee arthroplasty; pre/post-operative nursing care
• Health Education on Bone Healing

Learning Outcomes

Teaching Methods & Assessment

Unit XI — Nursing Management of Patients with Communicable Diseases

Overview

Key Topics

• Overview of Infectious Diseases and the Infectious Process — chain of infection (agent, host, environment), modes of transmission
• Nursing Assessment — history, physical assessment, diagnostic tests (cultures, serology, PCR)
• Specific Communicable Diseases:
  • Tuberculosis (TB) — DOTS therapy, contact tracing, Mycobacterium tuberculosis; Tuberculosis Control and Management Module
  • Diarrheal Diseases and Hepatitis A–E — oral-fecal route transmission, rehydration therapy, hepatitis B vaccination
  • Typhoid — Salmonella typhi; antibiotic management, enteric precautions
  • Herpes, Chickenpox, Smallpox, Measles, Mumps, Influenza — viral diseases; antiviral therapy, vaccine-preventable diseases
  • Meningitis — bacterial/viral; lumbar puncture, antibiotic therapy, droplet precautions
  • Gas Gangrene — anaerobic infection; wound care, surgical debridement
  • Leprosy (Hansen's Disease) — multibacillary/paucibacillary; MDT therapy, stigma reduction
  • Dengue, Plague, Malaria, Chikungunya, Swine Flu, Filariasis — vector-borne diseases; mosquito control, antimalarial therapy
  • Diphtheria, Pertussis, Tetanus, Poliomyelitis — vaccine-preventable diseases; EPI (Expanded Programme on Immunization)
  • COVID-19 — SARS-CoV-2; respiratory precautions, PPE use, isolation protocols, vaccination
• Special Infection Control Measures:
  • Notification — mandatory disease reporting to public health authorities
  • Isolation — types (droplet, airborne, contact, protective/reverse barrier)
  • Quarantine — legal and ethical aspects
  • Immunization — national immunization schedules, cold chain management

Learning Outcomes

Teaching Methods & Assessment

Course Summary Table

Assessment Methods Used Across the Course

• Short Answer Questions — knowledge and comprehension testing
• OSCE (Objective Structured Clinical Examination) — practical skill evaluation in a structured station format
• MCQ (Multiple Choice Questions) — broad content testing
• Essay — in-depth conceptual understanding
• Case Reports/Case Discussions — clinical reasoning and application
• Care Plans and Nursing Care Plans — integrated patient-centered planning
• Drug Records and Drug Book Presentation — pharmacology knowledge
• Skill Demonstrations — hands-on competency verification (scrubbing, gavage, insulin injection, crutch walking, dressing, etc.)
• BLS/BCLS Evaluation — emergency response certification
• Visit Reports — reflective learning from clinical exposure
• Health Education Submissions — patient teaching competency