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Concept: Metabolism
Definition: Metabolism is defined as the physical and chemical processes the body uses to maintain itself through anabolism and catabolism.

Exemplars: The Concept of Metabolism

• Metabolism Metabolic: acidosis/alkalosis
• Diabetes mellitus
• Thyroid/Parathyroid function issues (Calcium balance, Hypothyroidism , Hyperthyroidism)
• Adrenal function issues (Adrenal insufficiency, Adrenal hyperfunction)

Course Objectives

Upon completion of this course the student will be able to:

• apply the nursing process to meet the homeostasis, perfusion, oxygenation, and metabolism needs of patients in acute care settings; [I, II] (7)
• recognize abnormalities when performing focused patient assessments then effectively communicate and document this information appropriately; [I] (7, 11)
• use informatics to assist patients in improving health outcomes; [II, IV] (4)
•  design patient-centered teaching plans for patients with alterations in homeostasis, perfusion, oxygenation, and metabolism; [I] (12)
•  demonstrate safe administration of intravenous fluids and medications; [I, II] (8,11)
• recognize the physiologic consequences of hypo and hypersecretion of hormones from various endocrine glands; [I] (5, 7)
• plan care accordingly for the knowledge deficits recognized in a patient newly diagnosed with diabetes; and [I] (5, 12)
• apply basic principles of effective teaching to patients with metabolic disorders through their lifespan. [I] (5, 7, 12)

Overview
This unit introduces the student to the concept of Metabolism from assessment through evaluation. Patients with disruptions in metabolic functioning are seen at every stage of the life span. Alterations in metabolism can affect every system in the body and result in far reaching physical changes that can significantly impact growth and development, life style, and overall health and well being. In order to understand metabolic processes in the body, the nurse must understand the physical and chemicals processes by which the body builds and maintains itself. The nurses caring for patients with metabolic disorders must develop expert assessment skills to evaluate patients with acute and chronic alterations in the metabolic systems. The focus of nursing care for these patients is to assess, maintain and restore the body’s metabolism. Medication knowledge and administration plays an important part in this concept. Exemplars for metabolism are related to dysfunction in the endocrine system and include diabetes mellitus, thyroid alterations and adrenal alterations.

Unit Objectives
At the conclusion of this unit the student will be able to:

Assessment

1. compare normal and abnormal assessments in patients with metabolic disorders.
2. discuss major risk factors for metabolic disorders;
3. identify changes across the life span that could affect metabolism;
4. identify cultural and spiritual considerations related to abnormalities in the body’s metabolism;
5. discuss the pre- and post care of patients experiencing selected laboratory and diagnostic procedures for metabolic disorders;
6. differentiate between the pathophysiology of selected examples of metabolic dysfunction;

Plan

1. utilize the nursing process to develop a plan of care for patients with selected disorders of the body’s metabolism;
2. utilize health promotion activities to improve the status of patients with metabolic disorders;
3. discuss a collaborative plan of care for patients with metabolic disorders;
4. describe Complementary and Alternative Medicine (CAM) agents that influence metabolism;
5. develop a teaching plan that promotes improvement in metabolism;

Implementation

1. describe the nursing interventions and the related evidence based practices that can be used to promote metabolic functions;
2. apply essential pharmacological principals to the management of patients with metabolic dysfunction;
3. assist the patient with a metabolic disorder to identify specific learning needs related to promoting improvements in metabolism;
4.  demonstrate the skills necessary to manage patients with metabolic disorders (injections and IV therapy).; identify community-based health care resources to assist a patient to achieve optimal management of metabolic disorders;

Evaluate

1.  discuss related bio-physical concepts and how they are used to evaluate the care of  patient with metabolic dysfunction;
2. evaluate the effectiveness of nursing care in patients with dysfunctions in metabolism;
3. evaluate the patient for potential complications that can occur in patients with metabolic disorders.