MEDICAL SURGICAL NURSING

(ADULT INCLUDING GERIATRICS) I

Placement : Second Year

Theory: 210 hours

Practical: 720 hours

Course Description - The purpose of this course is to acquire knowledge and develop
proficiency in caring for patients with medical surgical disorders in varieties of health
care settings and at home.
Specific objectives At completion of the course the student is able to:
a. Describe the causes, signs and symptoms, treatment and prevention of medical
surgical conditions.
b. Demonstrate skill in carrying out nursing techniques and procedures in keeping with
scientific principles.
c. Discuss nursing process and provide nursing care to patients with various medical
surgical conditions.
Unit
I

Time
Hrs
15

Learning
Objective
Understand the trends in
medical & surgical
nursing
Describe the role of a
Nurse in caring for adult
patients in hospital &
Community
Describe the concept of
Medical Surgical asepsis

Contents
INTRODUCTION
Introduction to Medical
Surgical Nursing
Evaluation & trends of
medical & surgical nursing
Review of concepts of health
& illness, diseases concepts,
its causes- Classification of
diseases, International
classification of Diseases
(ICD-10 or later
version)Acute, chronic, &
terminal stages of illness
Review of concept of
compressive Nursing care in
medical Surgical Condition
based on Nursing Process.
Role of nurse, patients &
family in care of adult patients.
Role & responsibility of
nurse in medical surgical
settings:
- Outpatient department
- In patient department
- Intensive care units
- Home & community settings
Introduction to medical
surgical sepsis

Teaching
Learning
Activities
Lectures & Discussion
Demonstrations
Practice sessions
Supervised Clinical
practice

Assessment
Methods
Short answers
Objective type
Skill assessment
with check list

II

15

III

20

Inflammation and Infection

Immunity
Wound healing
Care of surgical patients.
Preoperative
Intraoperative
Postoperative
Demonstrations
- Surgical asepsis
- Dressings
- Care of wound drainage
- Preoperative preparation of
patients.
Common sign and symptoms
Describe the common
and management
sign and symptoms of
- Fluid & electrolyte
problems and their
imbalance
specific nursing
- Vomiting
management
- Dyspnea and cough,
respiratory difficulty and
obstructions
- Fever
- Shock
- Unconsciousness, syncope
- Pain
- Incontinence
- Edema
- Age related problemsGeriatric problem.
Describe the Etiology
Nursing management of
pathophysiology clinical
patients (adults including
manifestation & diagnostic elderly) with respiratory
measures & management
problems
of patients (adult
Review of Anatomy &
including elderly) with
Physiology of respiratory
disorder of respiratory
system.
system
Nursing Assessment
History & Physical
assessment
Etiology, Pathophysiology,
Clinical manifestations,
diagnosis, treatment
modalities & Medical,
surgical, Nutritional &
nursing including elderly
with:
Upper Respiratory tract
infections
Bronchitis
Asthma
Emphysema
Empyma
Atelectasis
Chronic obstructive
Pulmonary

Lectures & Discussion

Case discussions/
seminar

Short answers
Objective type

Lectures & Discussion

charts, graphs models,
films and slides
Demonstrations
Practice sessions
Case discussions/
Seminar
Clinical Practice
Drug book
Exposure to procedure- X
ray MRI Endoscopy

Essay type
Short answers
Objective type of
questions
Assessment of
skills with
assessment of
patients with
Clinical work
Management
problem

Diseases (COPD)
Bronchiectasis
Pneumonia
Pulmonary tuberculosis
Lung abscess
Pleural effusion
Cysts & Tumors
Chest injuries
Respiratory arrest
insufficiency
Pulmonary embolism
Special therapies,
alternative therapies Nursing
Procedures Drugs used in
treatment of respiratory
disorders.

IV

30

Demonstrations
- Respiratory assessment
assisting in procedures of X
ray chest, MRI, lung Biopsy,
bronchoscopy
- Thoracentesis, - care of
patients with chest drainage
& change of chest drainage
Care of patients on
ventilators & weaning
nebulisation
Describe the etiology,
Nursing management of
Pathophysiology, clinical
patient (Adults including
manifestation, diagnostic
elderly) with disorders of
measures and
Digestive system
management of patients
Review of Anatomy &
(Adults including elderly)
Physiology of digestive
with disorders of Digestive
system
system
Nursing Assessment history
& physical assessment
Etiology, pathophysiology,
clinical manifestation,
diagnosis, treatment
modalities and medical,
surgical, Nutritional &
nursing management
Disorders of oral cavity
Oral cavity
- Lips, gums, tongue, salivary
and teeth
-esophagus inflammation,
stricture, obstruction,
- bleeding & esophageal tumour
Stomach & Duodenum hiatus
hernia, gastritis, peptic &
duodenal ulcer, bleeding,
tumour pyloric stenosis

Lectures & Discussion

Charts, graphs models,
films and slides
Demonstrations
Practice sessions
Case discussions
Seminars
Clinical practice
Drug book
Exposure to related
procedures Health
Education Supervised
clinical practice Drug
Book / Presentation

Essay type
Short answers
Objective type
Skill assessment
with check list
Clinical work
assessment of
patient
management

-Food allergy & poisoning

Small intestinal
inflammation and infection
Ulcerative colitis, enteritis,
malabsorbtion syndrome,
Obstruction, tumors
perforation,
Large Intestinal disorders
Colitis inflammations &
infection, obstruction,
Tumors, lump Hernias
Appendix
Inflammation, mass, abscess,
rupture
Anal & Rectum
Fistulas,fissures,Hemorroides
Peritonitis/ acute abdominal
Pancreas; inflammation,
cyst, abscess, tumours
Liver- Inflammation, cyst,
cirrhosis, abscess, portal
hypertension, hepatic failure
and tumors
Biliary tract & gall bladder
Inflammation obstruction,
stones, tumors
Demonstrations
- Preparing assessing &
witnessing
- Barium meal, enema,
- Abdominal paracentesis,
- Liver biopsy,
- Endoscopies, ERCP, OGD,
- Colonoscopy, Proctoscopy,
Sigmoidoscopy
- Liver function test Gastric
analysis, stomach wash
- Gastrostomy feeding
- Jejunestomy feeding
- Bowel wash
- Colostomy care
Liver inflammation cyst,
abscess, cirrhosis, portal
hypertension, hepatic failure,
tumours,
Gall Bladder, inflammation,
Obstruction, Stones, &
tumours
Special Therapies, alternative
therapies nursing procedures,
drug used in the treatment of
disorders & diseases of
digestive system

30

Nursing management of
Describe the etiology,
patient(adults including
pathophysiology, clinical
elderly) with blood and
manifestation, diagnostic
measures and management cardiovascular problems
Review of Anatomy &
of patients (adults
Physiology of blood and
including elderly) with
cardiovascular system
disorders of blood and
cardiovascular problems. Nursing Assessment history
& physical assessment.
Describe the vascular
conditions and its nursing Etiology, pathophysiology,
management
clinical manifestation,
diagnosis, treatment
modalities: medical, surgical,
Nutritional & nursing
management of:
Vascular systems
Hypertension, hypotension
Raynauds disease Aneurism
and Peripheral vascular
disorders
Heart- Coronary artery disease
- Ischemic heart disease
- Coronary atherosclerosis
- Angina pectoris
- Myocardial infarction
- Congestive cardiac failure
- Corpulmonale
- Pulmonary Oedema
- Cardiogenic shock
- Cardiac tamponade
- Endocarditis
- Myocarditis, Pericarditis
- Cardiomyopathies
Valvular heart disease- Congenital & acquired
- Rheumatic heart disease
Conduction system
- Cardiac dysarthmias & heart
blocks
Cardiac arrest- Cardio
pulmonary
resursitation(CPR)
Blood
- Anaemia
- Polycythemia
- Bleeding & cloatings
disorders, platelet defect
- Hemophilia
- Thalassemia
- Leukemia
- Leukopenia Agranulocytosis
- Lymphomas & Myelomas

Lectures & Discussion

Explain charts, graphs
models, films and slides
Demonstrations
Practice sessions
Case discussions/
Seminars
Clinical practice
Drug book
Exposure to procedure
visit to blood bank
participation in blood
bank counseling

Essay type
Short answers
Objective type
Skill assessment
with check list
Clinical work

VI

10

Special Therapies
Blood transfusion, safety
check, procedure, &
requirement, management of
adverse transfusion reaction,
records for blood transfusion
Management and counseling of
blood donors phlebotomy
procedures,& post donation
management. Blood bank
functioning and hospital
transfusion committee.
Management related to blood
transfusion
- Role of nurse in organ
donation, transplant, retrieval
& banking Drugs used in
cardiovascular system.
Alternative therapies
- Nursing procedures
Demonstration-ECG
Describe the etiology,
Nursing management of
Pathophysiology, clinical
patient (Adults including
manifestation, diagnostic
elderly) with genitourinary
measures and management problems
of patients (adults
Review of Anatomy &
including elderly) with
Physiology of genito-urinary
disorders of genitouinary
systems
system
Nursing Assessment history
& physical assessment.
Etiology, pathophysiology,
clinical manifestation,
diagnosis, treatment
modalities and medical,
surgical, dietetics & nursing
management of
- Nephritis
- Nephrotic syndrome
- Nephrosis
- Renal calculus
- Tumours
- Acute renal failure
- Chronic renal failure
- End stage renal disease
- Dialysis, renal transplant
- Congenital disorders, urinary
infections
- Benign prostate hypertrophy
Kidney
- Polycystic kidney
Disorders of ureter,
urinary bladder and
urethra- inflammation
infections, calculus stricture,
obstructions, tumors,

Lectures & Discussion

Explain using charts,
graphs models, films and
slides
Demonstrations
Practice sessions
Case discussions/
Seminars
Supervised Clinical
practice
Drug book/ presentation
Exposure to procedure
Health Education

Essay type
Short answers
Objective type
Skill assessment
with check list
Clinical work
Assessment of
patient
management
problem

prostrate
Special therapies,
alternative therapies,
nursing procedures.
Drug used in treatment of
Genito urinary disorders
Demonstrations Bladder
wash / Irrigation
Demonstration care of
Indwelling catheterization
male / female Condom
catheters (external)
VII

Describe the etiology,

Nursing management of
Pathophysiolgy, Clinical
disorders of male (adults
manifestations, diagnostic
including elderly)
measures and management reproductive system
of patients (adults
Review of anatomy and
including elderly) with
Physiology of male
disorders of male
reproductive system
reproductive system.
Nursing assessment- history
and physical assessment
Etiology, pathophysiology,
clinical manifestations,
diagnosis, treatment
modalities and medical,
surgical dietetics and nursing
management of disorders of
male reproductive system
Congenital malformations;
cryptorchidism
Infections
Hypospadiasis, Epispadiasis
Infection Testis and adjacent
structure
Penis
Prostate: inflammation,
infection hypertrophy, tumor
Sexual Dysfunction
Infertility
Contraception
Breast, gynecomastia, tumors
Climacteric changes special
therapies, alternative
therapies.
Nursing procedures
Drugs used in treatment of
disorders of male
reproductive system

Lecture discussion
Explain using Charts,
graphs
Models, films, slides
Demonstration
Practice session
Case discussion/ seminar
Health education
Supervised clinical
practice
Drug book/ presentation

VIII

10

Describe the etiology,

Pathophysiology, clinical
manifestation, diagnostic

Lecture discussion
Explain using Charts,
graphs

Essay type
Short answer
Objective type

Nursing management of
patient ( adults including
elderly) with disorders of

Essay type
Short answer
Objective type
Assessment of
skills with check
list
Assessment of
patients
management
problem

IX

10

measures and management endocrine system

of patients (adults
Review of anatomy and
including elderly) with
physiology of endocrine
disorders of endocrine
system
system
Nursing assessment-history
and physical assessment
Etiology, pathophysiology,
clinical manifestation,
diagnosis, treatment
modalities and medical,
surgical, dietetics and
nursing management of
Disorders of pituitary
Disorders of thyroid and
parathyroid
Adrenal tumour
Diabetes mellitus
Diabetes insipidus
special therapies, alternative
therapies
Nursing procedures
drugs used in treatment of
disorders of endocrine
system
Describe the etiology,
Nursing management of
Pathophysiology, clinical
patients (adults including
manifestations, diagnostic
elderly) with disorders of
measures and management Integumentary system
of patients (adults
Review of anatomy and
including elderly) with
physiology of skin and its
disorders of skin
appendages
Nursing assessment- history
and physical assessment
Etiology, Pathphysiology,
clinical manifestation,
diagnosis, treatment
modalities and medical,
surgical, dietetics and
nursing management of
disorders of skin and its
appendages
Lesions and abrasions
Infection and infestations:
Dermatitis
Dermatosis; infectious and
non infectious inflammatory
determatosis
Acne vulgaris
Allergies and Eczema
Psoriasis
Malignant melanoma
Alopecia
Care of patient with Skin
surgery Special therapies,

Models, films, slides

Assessment of
skills with check
Demonstration
list
Practice session
Case discussion/ seminar Assessment of
patients
Health education
management
Supervised clinical
problem
practice
Drug book/ presentation

Lecture discussion
Explain using Charts,
graphs
Models, films, slides
Demonstration
Practice session
Case discussion/ seminar
Health education
Supervised clinical
practice
Drug book / presentation

Essay type
Short answer
Objective type
Assessment of
skills with check
list
Assessment of
patients
management
problem

15

Describe the etiology,

Pathology, Physiology,
clinical manifestations,
diagnostic measures and
management of patients
(adults including elderly)
with disorders of
musculoskeletal system

alternative therapies
Nursing procedures,
Drugs used in treatment of
disorders of Integumentary
system
Nursing management of
patients (adults including
elderly) with musculoskeletal
problems
Review of anatomy and
physiology of
musculoskeletal system,
Nursing assessment-history
and physical assessment
Etiology, Pathophysiology,
clinical manifestation,
diagnosis, treatment
modalities and medical,
surgical, dietetics and
nursing management of
Disorders of:
Muscles, ligaments and
joints- inflammation,
infection , trauma

Bones-inflammation,
infection, dislocation,
sprain, fracture, tumour
& trauma
Osteomalacia and
osteoporosis
Arthritis
Congenital deformities

Spinal column
defects and
deformities, tumor,
Prolapsed inter
vertebral disc. Potts
spine

Pagets disease
Amputation
Prosthesis
Transplant and replacement
surgeries
Rehabilitation special
therapies, alternative therapies
Nursing procedures, drug
used in treatment of disorders
of musculoskeletal system

Lecture discussion
Explain using Chart,
graphs
Models, films, slides
Demonstration
Practice session
Case discussion / seminar
Health education
Supervised clinical
practice
Drug book /
presentation

Essay type
Short answers
Objective type
Assessment of
skill with check
list
check list
Assessment of
patients
management
problem

XI

10

Describe the etiology,

pathophysiology, clinical
manifestations diagnostic
Measures and
Management of Patients
(adults Including elderly)
with disorders of
Immunological systems

Nursing management of
Patient (adults Including
elderly) with Immunological
problems
Review of Immune system.
Nursing Assessment-History
and physical assessment
Etiology, Pathophysiology,
clinical manifestations,
diagnosis treatment
modalities and medical,
surgical, dietetics and nursing
management of Immunodeficiency disorder
Primary immuno deficiency
Phagocytic dysfunction
B-cell and T-cell deficiencies
Secondary immunodeficiencies
Acquired Immuno Deficiency
Syndrome (AIDS)
Incidence of HIV & AIDS
Epidemiology
Transmission-prevention of
Transmission
Standard safety precautions
Role of nurse, counseling
Health education and home
care consideration,
National AIDS control
program NACO various
National and international
agencies.
Infection control program
Rehabilitation, Special
therapies, alternative therapies
Nursing procedures Drugs
used in treatment of disorders
of immunological systems

Lecture Discussion
Explain using Charts,
Graphs
Models, films slides
Demonstration
Practice session
Case discussion/ Seminar
Health education
Supervised clinical
practice
Drug book/ presentation
Orientation visit to
Hospital control system

Essay type
Short answer
Objective type
Assessment of
skills with check
list
Assessment of
patient
management
problem

XII

20

Describe the etiology,

Nursing management of
Pathophysiology, clinical
patient (adults including
manifestations, diagnostic
elderly) with Communicable
measures and management Diseases
of patients (adults
Overview of infectious
including elderly) with
disease, the infectious
Communicable Diseases
process
Nursing Assessment-History
and physical assessment
Epidemiology, infectious
process, clinical
manifestations, diagnosis,
treatment, prevention and
dietetics. Control and
eradication of common
communicable diseases
Tuberculosis
Diarrhoeal diseases
Hepatitis A-E
Herpes
Chickenpox
Smallpox
Typhoid
Meningitis
Gas gangrene
Leprosy
Dengue
Plague
Malaria
Diphtheria
Pertusis
Poliomyelitis
Measles
Mumps
Influenza
Tetanus
Yellow fever
Filariasis
HIV, AIDS
Reproductive Tract
Infections
Special infection control
measures; Notification,
Isolation, Quarantine,
Immunization, Infectious
Disease, Hospitals, Special
therapies, Alternative
therapies
Nursing procedures
Drugs used in treatment of
communicable diseases

Lecture discussion
Explain using Charts,
graphs
Models, films, slides
Demonstration
Practice session
Case discussion / seminar
Health education
Supervised clinical
practice
Drug book / presentation

Essay type
Short answer
Objective type
Assessment of
skills with
check list
Assessment of
patients
management
problem

XIII

20

Describe the
organization and
physical set up of
Operation theatre
Identify the various
instruments and
equipments used for
common surgical
procedures
Describe the infection
control measures in the
operation theatre
Describe the role of the
nurse in the Peri
operative nursing care

Peri Operative nursing:

Organization and physical set
up of the operation theatre
(OT):
Classification
O.T.DESIGN
Staffing
Members of the OT
team.
Duties and
responsibility of nurse
in OT
Principles of health and
operating room attire.
Instruments
Sutures and suture
materials
Equipments
O.T. tables and sets for
common surgical
procedure
Scrubbing procedures
Gowning and gloving
Preparation of O.T.
sets
Monitoring the patients
during surgical
procedures
Maintenance of therapeutics
environment in O.T.
Standard safely measures
Infection control:
fumigation,
disinfections and
sterilization
Biomedical waste
management
Prevention of
accidents and hazards
in O.T.
Anesthesia
Types
Methods of
administration
Effects and stages
Equipment
Drugs
Cardio pulmonary
Resuscitation (CPR)
Pain management techniques
Legal Aspects

Lecture discussion
Explain using Charts,
graphs
Models, films, slides
Demonstration
Practice session
Supervised clinical
practice Drug book /
presentation

Essay type
Short answer
Objective type
Assessment of
skills with check
list

MEDICAL SURGICAL NURSING

(Adult including Geriatrics)-I
Practical
Placement: Second Year
Time: 720 Hours
Areas
General Medical
Ward
(Respiratory,
GI, Endocrine,
Renal, Hematology)

Hrs
06

Objective

Skills

Provide nursing care

to adult patients with
medical disorders
Counsel and educate
patients and families

Assessment of the patient

Taking history
Perform general and
specific physical
examination
Respiratory
GI
Endocrine
Renal
Hematology
Identify alterations
and deviations.
Practice medical surgical
asepsis, Standard safety
measures.
Administer medications
Oral, IV, IM, ID,
Subcutaneous,
Airlock and Z-Track
method
Blood and Component
Therapy
IV therapy
IV canulation
Maintenance and
monitoring
IV additives
IV Bottle change
Oxygen therapy by
different methods
Ambu bag
Ventury mask
Nebulization
Chest physiotherapy
Postural drainage Naso
gastric feeding
Gastric lavage
Perform/Assist in
therapeutic procedures
Thoracentesis
Abdominal
Paracentesis
Barium meal
USG
Endoscopy
ERCP

Assignment
Plan and give care to
3-4 assigned patients
Nursing care plan- 02
Nursing case
presentaion-1
Drug presentation-1
Maintain drug book
Maintain Practical
record book

Assessment
Methods
Assess
performance with
rating scale
Assess each skill
with checklist
Evaluation of case
study/
presentation
Completion of
practical record.

General Surgical
Ward (GI,
urinary, CTVS)

06

Provide pre and post

operative nursing
care to adult patients
with surgical
disorders
Counsel and educate
patients and families

OGD scopy
Colonoscopy
Proctoscopy
Sigmoidoscopy
Blood and component
Transfusion
Plasma
RBC
Whole blood
Platelet
Cryoprecipitate
Throat suctioning
Collect specimens
for common
investigations
Blood
Urine
Stool
Sputum
Maintain elimination
Catheterization
Catheter care
Bowel wash
Enema
Urinary drainage
Bladder wash
Maintain Intake, output and
documentation
Counsel and teach related
to specific disease
conditions.
Similar to skills of General
medical Ward +
Practice medical surgical
asepsis, standard safety
measures
Pre operative preparation
of patients.
Preparation of skin
Informed Consent
Assist in various
investigations in
various surgeries
Post operative care
Receiving patient,
assessment, monitoring,
care
Care of wounds and
drainage
Suture removal
Ambulation and exercise
Naso gastric aspiration
Care of chest drainage
Ostomy care
Gastrostomy

Plan and give care to

3-4 assigned patients
Nursing care plan- 02
Nursing case study 01
Maintain drug book
Maintain practical
record book

Assess
performance with
rating scale
Assess each skill
with checklist
Evaluation of case
study/
presentation
Completion of
practical record.
Evaluation of care
& case plan

Colostomy
Enterostomy
Practice universal
precaution
Rehabilitation
Physical examination of
the cardio vascular system
Recording and interpreting
ECG
Monitoring of patients
Preparation and assisting in
noninvasive and invasive
diagnostic procedures.
2D Echo
Colour Doppler
Holter
12 Lead ECG
Stress test
Care of patients
undergoing Angiography
Administer cardiac drugs
Cardio pulmonary
Resuscitation
Pre operative and
postoperative care of
patients undergoing cardiac
surgeries.
Scrubbing, gowning,
gloving
Identify instruments,
suturing materials for
common operations.
Disinfection, carbolization,
fumigation
Preparation of instrument
sets for common operations
Sterilization of sharps and
other instruments
Prepare the OT table
depending upon the
operation
Positioning and monitoring
of patients
Endotracheal intubation
Assisting in minor and
major operations.
Handling specimens
Disposal of waste as per
the guidelines.
Care of instruments after
surgery
Packing of trays

Cardiology ward /
CCU/ ICU

02

Provide nursing care

to patients with
cardiac disorders
Counsel and educate
patients and families

Operation Theatre

06

Identify instruments
used in common
operations
Participate in
Infection control
practices in the
Operation Theatre
Set up the table /
trolleys for common
operative procedures
Assist in giving
anesthesia
Assist in the
operative procedures
Provide preoperative
nursing care

Plan and give care to

3-4 assigned patients
Nursing care plan - 01
Nursing case
presentation- 01
Maintain drug book
Maintain practical
record book

Assess
performance with
rating scale
Assess each skill
with checklist
Evaluation of case
study
Evaluation of
Nursing care plan
Compilation of
activity record

Assist as a circulatory Assess

nurse in
performance with
- Major cases- 10
rating scale
- Minor cases-5
Completion of
Assist as a scrub nurse
practical record
in
- Major cases- 10
- Minor cases-05
Maintain drug book

Orthopedic
Ward

02

Skin &
Communicable
diseases Ward

02

Provide nursing care Assessment of the

orthopedic patient
to adult patients with
Taking history
orthopedic problem
Physical examination
Counsel and educate
of musculo skeletal
patient and families
system.
Apply skin traction
bucks extension
traction splints &
patient care
Practice medical surgical
asepsis Standard safety
measures
Pre and postoperative care
of patients with orthopedic
surgery.
Preparing, assisting and
witnessing in non invasive
and invasive diagnostic
procedure
Physiotherapy-Range of
Motion exercises (ROM),
muscle strengthening
exercises
Crutch maneuvering
technique
Activity of daily living
Ambulation
Teach & counsel patient &
family
Assist in application &
removal of prosthesis
POP application and
removal
Rehabilitation.
Identify skin
Assessment of patients
problems
with skin disorders
Provide nursing care Assist in diagnostic and
to patients with Skin
therapeutic procedures
disorders and
Administer topical
Communicable
medication
diseases
Practice medical surgical
Counsel and educate
asepsis Standard safety
patients and families
measures
Use of personal protective
equipment (PPE)
Give Medicated baths
Teach prevention of
infectious diseases.
Counseling HIV Positive
patient

Nursing care plan-01 Assess

performance with
Nursing case study 01
rating scale
Nursing case

Evaluation of
presentation 01
Nursing care plan
Maintain drug book
& Nursing case
Maintain practical
study/
record book
presentation
Maintain practical
record book

Plan and give care to 3 Assess

assigned patients
performance with
rating scale
Health talk to patients
and families- 01
Evaluation health
talk
Maintain drug book
Completion of
Maintain practical
practical record
record book

EDUCATIONAL VISITS:
Medical Surgical Nursing:
1. Artificial Kidney Unit
2. C.S.S.D.
3. Waste Disposal Unit
4. Hospital Kitchen
5. Blood Bank
6. Radiology Department
7. Artificial Limb Center
8. Rehabilitation Center
- Physical
- Vocational
BIBLIOGRAPHY
1. Black J.M. Hawk, J.H. (2005) Medical Surgical Nursing Clinical Management for
Positive Outcomes. (7th ed) Elsevier.
2. Brunner S. B., Suddarth D.S. The Lippincott Manual of Nursing practice
J.B.Lippincott. Philadelphia.
3. Medical Surgical Nursing: An Integrated approach 2nd ed , White, L, Delmar
Thomson learning (2002) United States
4. Lewis, Heitkemper&Dirksen (2000) Medical Surgical Nursing Assessment and
Management of Clinical Problem (6 thed) Mosby.
5. Colmer R.M. (1995) Moroneys Surgery for Nurses (16th thed) ELBS.
6. Shah N.S. (2003) A P I textbook of Medicine, The Association of Physicians of India
Mumbai.
7. Satoskar R.S., Bhandarkar S.D. & Rege N.N. (2003) Pharmacology and
Pharmacotherapeutics (19 thed) Popular Prakashan, Mumbai.
8. Phipps W.J., Long C.B. & Wood N.F. (2001) Shaffers Medical Surgical Nursing
B.T.Publication Pvt. Ltd. New Delhi.
9. Datta T.K. (2003) Fundamentals of Operation Theatre Services, Jaypee, New Delhi.
10. Maheswari J Essentials of Orthopedics (3rd ed) Mehta Publication, NewDelhi.
11. Pasricha J.S., Gupta R. (2001) Illustrated Text book of Dermatology (2nded) Jaypee
brothers New Delhi.
12. Haslett C., Chilvers E.R., Hunder J.A.A. &Boon, N.A. (1999) Davidsons Principles
and Practice of Medicine (18 thed) Churchill living stone. Edinburgh.
13. Walsh M. (2002) Watsons Clinical Nursing and Related Sciences (6thed) Bailliere
Tindall Edinburgh.
14. Medical Surgical Nursing: A Nursing process approach Vol. I & II, , Ignatacicius,
Donna & Workman, Linda, W. B. Saunders Company, Philadelphia (1995)
15. The Lippincott Manual of Nursing practice, 7th ed, Nettina, Sandra, Lippincott
Williams & Wilkins, Philadelphia (2001).
Evaluation Scheme

Internal Assessment:

Theory:
Mid-Term:

Marks
50

Prelim:

75

Marks
Marks
Total:
125
Marks
(125 Marks to be converted in to 25 Marks for Internal Assessment (Theory)
Practical
a) Nursing Care Plan 03 X 25 Marks
(Medical ward 01, Surgical ward 01, Ortho / any other 01)
b) Case Presentation 01
c) Case study 02 X 50 Marks
(Medical Ward 01, Surgical Ward 01)
d) Health Education 01
e) e) Therapeutic Diet 01
f) f) Clinical Evaluation 03 X 100 Marks
(Medical Ward 01, Surgical Ward 01, Operation Theatre 01)
g) g) Practical Examinations
Mid-term Examination 50 Marks
Pre-final Examination 100 Marks

Total marks 100

75 Marks
50 Marks
100 Marks
25 Marks
25 Marks
300 Marks
150 Marks
Total 725

(725 Marks to be converted in to 100 Marks for Internal Assessment (Practical)

External Assessment
University Examination
Theory:
75 Marks
Practical:
100 Marks

a) Guideline for Nursing Care Plan: (3 X 25 Marks)

FORMAT FOR NURSING CARE PLAN
(Medical / Surgical / Ortho or ..)
Marks 25
1. Patients Biodata:
Name, address, age, sex, religion, marital status, occupation , source of health care,
date of admission, provisional diagnosis, date of surgery if any
2. Presenting complaints:
Describe the complaints with which the patient has come to hospital
3. History of illness
History of present illness onset, symptoms, duration, precipitating/ alleviating
factors
History of past illness- illnesses, surgeries, allergies, immunizations, medications
Family history family tree, history if illness in family members, risk factors,
Congenital
Problems, Psychological Problems.
4. Economic status:
Monthly income & expenditure on health, marital assets (own pacca house car, two
wheeler, phone, TV etc. ..)
5. Psychological status:
Ethnic background, (geographical information, cultural information) support system
available.
6. Personal habits:
consumption of alcohol, smoking, tobacco chewing, sleep, exercise, work
elimination, nutrition.
7. History to Physical examination with date and time
8. Disease condition:
Definition, Anatomy Physiology, incidence,
Etiology & risk factor, Pathophysiology, clinical manifestation
9. Investigation
Date
Investigation done
Normal value
Patient value
Inference

10. Medical Surgical management complications & prognosis

11. Drug Study
S.N. Drug: trade Pharmacolo Route Dose &
Action Side effect &
name
gical name
frequency
Drug
interaction

12. Guide line for writing Nursing care plan (including health education)
Marks 20
Date
Assessment Nursing
Objective Plan of care
Rationale
Subjective
diagnosis
Implementation
&

Nursing
responsibility

Evaluation Remarks

Marks

Objective
Data
4

13. Guide line for writing Nurses Note

Date
Diet
Medication

7
Observation & Nursing
Intervention

Remark

Note: Same format to be used for 1) Medical, 2) Surgical & 3) Ortho or any other, having
25 Marks each)
Evaluation Criteria for Nursing Care Plan
S.N.
Contents
Marks
1
History to Physical examination with date time
05
2
Disease condition:
08
(Definition Anatomy Physiology, incidence,
Etiology & risk factor, Pathophysiology, clinical
manifestation
3
Investigations
02
4
Medical Surgical management complications & prognosis
06
5
Drug study
04
6
Nursing care plan
20
7
Nurses note
05
Total
50

b) FORMAT FOR CASE PRESENTATION

1.
2.
3.

4.
5.
6.
7.
8.
Date

Marks 50
Patients Biodata:
Name, Address, Age, sex, religion, martial status, occupation, source of health care,
date of admission, provisional diagnosis, date of surgery if any
Presenting complaints:
Describe the complaint with which the patient has come to hospital
History of illness:
History of present illness- onset, symptoms, duration, precipitating / alleviating
factors
History of past illness- illnesses, surgeries, allergies, immunizations, medications
congenital problems, psychological problems.
Economic status:
Monthly income & expenditure on health, marital assets (own pacca house, car, two
wheeler, phone, TV etc...)
Psychological status:
ethnic background, (geographical information, cultural information) support system
available.
Habits:
Consumption of alcohol, smoking, tobacco chewing, sleep, exercise, work
elimination, nutrition.
Physical examination with date and time
Investigation
Investigation done
Normal value
Patient value
Inference

9. Treatment
S.N. Drug: trade Pharmacolo
name
gical name

Route

Dose &
frequency

Action Side effect &

Drug
interaction

Nursing
responsibility

10. Description of disease

11. Definition, related anatomy physiology, etiology, risk factors, clinical features,
management and nursing care
12. Clinical features of the disease condition
Clinical features present in the book
Description of clinical features of patient
Pathophysiology
13. Nursing care plan
Marks-15
Patient name:
Ward:

Date:

Date

Assessment Nursing
Objective Plan of care
Rationale Evaluation Remarks
Subjective
diagnosis
Implementation
&
Objective
4
3
2
7
2
2
14. Discharge planning: It should include health education and discharge planning
given to patient. Marks-15
15. Evaluation of care: Overall evaluation, problem faced while providing care
prognosis of the patient and conclusion.
Evaluation Criteria for Nursing Care Plan
S.N.
Contents
1
Assessment / Introduction
2
Knowledge and understanding of disease
3
Nursing care plan
4
Presentation skill
5
A.V. aids
6
Time
7
Summary & conclusion
8
Bibliography

Marks

Total

05
10
15
10
04
02
02
02
50

c) Guide line for Nursing Case Study (2 X 50 Marks)

FORMAT FOR NURSING CASE STUDY
(Medical Ward / Surgical Ward)
Marks 25
1. Patients Biodata:
Name, address, age, sex, religion, marital status, occupation , source of health care,
date of admission, provisional diagnosis, date of surgery if any
2. Presenting complaints:
Describe the complaints with which the patient has come to hospital
3. History of illness:
History of present illness onset, symptoms, duration, precipitating / alleviating
factors
History of past illness- illnesses, surgeries, allergies, immunizations, medications
Family history family tree, history if illness in family members, risk factors,
Congenital problems, psychological Problems.
4. Economic status:
Monthly income & expenditure on health, marital assets (own pacca house car, two
wheeler, phone, TV etc. ..)
5. Psychological status:
Ethnic background, (geographical information, cultural information) support system
available.
6. Habits:
Consumption of alcohol, smoking, tobacco chewing, sleep, exercise, work
elimination, nutrition.
7. History to Physical examination with date and time
8. Disease condition:
Definition, Anatomy Physiology, incidence, Etiology & risk factor,
Pathophysiology, clinical manifestation
9. Investigation
Date
Investigation done
Normal value
Patient value
Inference

10. Medical Surgical management complications & prognosis

11. Drug Study
S.N. Drug: trade Pharmacolo Route Dose &
Action Side effect &
name
gical name
frequency
Drug
interaction

12. Nursing Care Plan

Marks 20
Patient name:
Ward:
Date
Assessment Nursing

Nursing
responsibility

Date:
Objective

Plan of care

Rationale

Evaluation Remarks

Subjective
&
Objective
3

diagnosis
2

Implementation
2

13. Nurses Notes:

14. Self Evaluation:
15. Bibliography:
Note: Note: Same format to be used for Medical Ward / Surgical Ward having 50 Marks
each.
Evaluation Criteria for Nursing Care Plan
S.N. Contents
1
Patient history, Physical examination
2
Anatomy, Physiology, Pathophysiology & Clinical
manifestations
3
Investigations
4
Medical surgical management, complication & prognosis
5
Drugs study
6
Nursing care plan
7
Nursing note
8
Self evaluation / conclusion
9
Bibliography

Marks
5
8

Total
d) Evaluation format for Health Education
1. Name of the student teacher:
2. Name of the supervisor:
3. Venue:
4. Date:
5. Time:
6. Group:
7. Previous knowledge of the group
8. AV aids used
9. General objectives
10. Specific objectives
Lesson plan for health talk
S.N. Time
Specific Objectives
Content

S.N.
1
2
3

Contents
Lesson Plan
Presentation
Communication skill

2
8
4
15
4
2
2
50

Teaching, Learning A V Aids

Activities
(Maximum Marks: 25)
Marks
Marks
Allotted
Obtained
08
05
05

Evaluation

4
5

Preparation and effective use of A V. Aids

Group participation
Total

04
03
50

Remarks:
Evaluation discussed
& Students Signature
Date :

Sing. Of Supervisor
Date :

e) Guideline for Therapeutic Diet

Introduction: Name of the patient, age, sex, religion of the patient, education, language,
socioeconomic status, regular meal pattern, food like and dislikes, disease condition of
the patient, reason for prescribed diet
Menu planning: Recommended diet plan with details of CHO, protein, fat and calories
with nutrients and restrictions with due consideration to commonly available seasonal
foods
Patients education: Ability of student to explain to the patient the need for adherence to
recommended diet.
Evaluation: Ensuring whether patient follows the prescribed diet.
References:
Evaluation criteria for Therapeutic Diet
S.N. Contents
Marks
1
Introduction
05
2
Menu planning
10
3
Patient education
05
4
Evaluation
02
5
References
03
Total
25

GUIDELINE FOR CLINICAL ASSESSMENT OF STUDENT

f - i & ii) Format for Clinical Assessment
(MEDICAL WARD / SURGICAL WARD)
CLINICAL ASSESSMENT FORM
Students Name:- ______________________________
Hospital:- _______________
Year
:- _______________________________
Unit/Ward:- _____________
Students Number:- ______________ _
From _____________ to ____________
S.N. PERFORMANCE
CRITERIA
I
1.1
1.2
1.3
II
2.1
2.2
2.3
III
3.1
3.2
3.3
3.4
IV
4.1
4.2
V
5.1
5.2
5.3

Nursing Process (75)

Assessment and Nursing
Diagnosis (15)
Collects data accurately
Identifies & Categorizes
basic Needs of Patients
Formulates Nursing
Diagnosis
Planning (15)
Prioritizes patients needs
Plans nursing action for each
of need
States rationale for nursing
action
Implementation (20)
Implements nursing care
Accurately and safely with in
given time
Applies scientific Principles
Maintains safe and
comfortable environment
Gives health teaching as per
plan to the patients / family
Evaluation (10)
Evaluate patients response
to nursing care
Reexamines & Modifies care
plan
Documentation (15)
Records patient information
accurately
Report patient information
accurately
Maintains self up to date

(5)
Excellent

(4)
Very
Good

Maximum 100 Marks

(3)
(2)
(1)
Good Satisfactory Poor

Remarks

VI
6.1
6.2
6.3
VII
7.1

7.2

Professional Conduct (25)

Uniform and Punctuality
Always well groomed, neat
& conscious about
professional appearance
Is always punctual in
Clinical & completing
assignments
Readily accepts
responsibility for own
behavior & has initiative
Communication skills
Establishes & Maintains
effective working /
communication relationship
with patients and family
Establishes good inter
personal relationship with
members of health team /
supervisors / Teachers
Total Marks

Comment / Remarks by Teacher / Supervisor:

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Total marks 100
Total marks obtained
Signature of Teacher
Date:
Evaluation is seen and discussed by the student
Signature of student
Date of Sign
Note: Same format to be used for 1) Medical Ward & 2) Surgical Ward having 100
Marks each.

f - iii) Format for OPERATION THEATRE experience EVALUATION

Maximum 100 Marks
Students Name :_____________________________________________________________________
Year
:- ________________________ Duration
of
position
:________________________
Area of posting :- ________________________
Grades
:- [5-Excellent, 4-V. Good, 3-Good, 2-Fair, 1-Poor]
S.N. Content
5
4
3
I
Personal &professional behavior:
1 Wears theatre dress correctly
2 Arrives and leaves punctually
3 Notably poised & effective even in stressful situation
4 Works with interest & willingness
5 Shows respect to co-workers, works well as a team
member.
II
Knowledge of:
6 Anatomy & surgical procedure
7 Equipment & articles
8 Anaesthesia, Microbiology, Legal responsibilities
III
Skills
9 Collects & receives all preoperative information about
patients.
10 Follows principles f scrubbing, gowning& gloving
11 Arranges trolley according to procedure
12 Assists efficiently knowing the steps
13 Works efficiently as a circulating nurse
14 Assists the anesthetist for induction, intubation &
extubation
15 Follows strict infection control measures
16 Maintains therapeutic operation theatre environment
17 Checks adequacy of equipment & supplies
18 Records & reports immediately
19 Provides appropriate postoperative care
20 Follows cleaning, packing & sterilization of equipment
Signature of Class Coordinator
Date:
Signature of Students
Signature of Supervisor
Date:
Date:
f iii - 1) Guide line for Operation Theatre Report Writing
i.
Introduction
ii. Objective
iii. Physical layout of OT
iv. Role and functions of Nurse in OT

Head Nurse
Scrub Nurse
Circulating Nurse
v.
Preparations for Surgery
Sterilization of articles
Preparation and packing
Instruments, Sutures and needless
Anesthetic trolley
Anesthetic drugs
Operating tables and necessary equipment
vi. Assisting in surgery
Scrubbing, Gowning and gloving
Position and draping of patient
Trolley setting for various operations/ conditions
vii. Care of Patient in OT
Pre operative
Intra operative
Post operative
Transportation of patient in and out of OT
viii. Hazards of OT
Accidents
ix. Cleaning of OT
Carbolization
Fumigation
x.
Problems faced and suggestions
xi. References
[Note: Assignments are requirement of operation theatre posting, however they are
not for evaluation.]
f iii 2) Guide line for WITNESSED CASES Operation Theater
I.
Demographic Profiles
Name of Patient:
WD/ Bed No.
Age/ Sex:
Diagnosis:
Proposed Surgery:
Actual surgery:
Date of witnessed:
II. Type of Anesthesia
A) Drug used in anesthesia
Name of Drug Dose Given
Dose Available
Route
Action

B) Intubation:
Type of ETT -

Size

C) Boyles apparatus
Ventilators
Circuit

Connection

Mechanism

Electric
Gadget

D) Extubation: (Steps)
E) Type of I/V Fluids and suture Material available in that area:
I/ V Fluids
Suture Material

Signature of Supervisor
Date :

Signature Student
Date :

Note: Assignments are requirement of operation theatre posting, however they are
not for evaluation.

f - iii - 3) Guideline for ASSISTED CASES in Operation Theatre

I.
I) DEMOGRAPHIC PROFILE:
Name of Patient :
WD/ Bed No. :
Age/ Sex
:
Diagnosis
:
Proposed Surgery :
Actual surgery :
Date of witnessed :
II. II) TYPE OF ANAESTHESIA:
Drug used in anesthesia:
Name of Drug Dose Given
Dose Available
Route
Action

III. TROLLEY PREPRATION:

Dressing & draping
Instruments

Suture

IV. STEPS IN SURGERY:

1. Position
2. Painting
3. Draping
4. Incision
5. Method of Homeostasis
6. Dissection
7. Retraction
8. Anastomosis
9. Drainage
10. Haemostatic
11. Closure
12. Dressing
13. Adhesive
Signature of Supervisor
Date :

Signature Student
Date :

Note: Assignments are requirement of operation theatre posting, however they are
not for evaluation.