Full Course Description

Advanced Pathophysiology & The Direct Impact on Patient Care

As an experienced healthcare professional, you see disease and injury all the time. The underlying cause of the presenting symptoms or complications can shed valuable insight in the delivery of patient care. And that is why the backbone of pathophysiology understanding is so essential. However, we know that these concepts are not always easy to master.

Angelica F. Dizon, MD, MSN, MBA-HCM, BSN, RN, NP-C, will share from her extensive years in practice, working as a physician and advance practice nurse. She has collected pearls of insight that will help you, too, to finally grasp pathophysiology at an advanced level.

Often patient care becomes very complex with multiple conditions and diagnoses overlapping. At the end of this comprehensive training, you will take away new skills to critically analyze patients entrusted to your care. You will be able to target your clinical assessments and have confidence in the interventions that you initiate — on your very next shift!

Program Information

Objectives

1. Evaluate clinical examples to explain the statement: "Virtually all human disease is 'autoimmune' in nature."
2. Analyze an effective method to review options in pharmacologic therapy for any condition.
3. Plan for the self-destructive spiral of progressive chronic heart failure.
4. Determine how the statin drugs significantly reduce a person's risk of cardiovascular disease (MI and stroke), regardless of the serum cholesterol level.
5. Differentiate the mechanism underlying death in asthma and a way to prevent it.
6. Apply the "Three Question Approach" to interpretation of arterial blood gases.
7. Distinguish the "common mechanism" for shock, regardless of the initial cause.

Outline

Endocrine and Metabolic Problems

• Pituitary disorders
• Hypoglycemia
• Free radicals – Essential in health, deadly in disease
• Diabetic ketoacidosis
• Apoptosis
• Adrenal gland dysfunction
• Addison’s disease
• Jaundice
• Implications of hormones
• Thyroid disorders – Mechanism of onset affects treatment

Cardiovascular and Renal Problems

• Starling’s Law – Normal capillary flow
• Heart failure
• Relationship between cardiac diseases and hypertension
• Unraveling hypertension
• Current concept on cardiogenic shock
• Atherosclerosis – The role of inflammation
• Anaphylaxis
• Acid-base disorders

Respiratory Problems

• Chronic obstructive pulmonary disease exacerbations
• Obstructive lung diseases affecting the mechanics of lung ventilation
• Sudden death in asthma
• Acute lung failure/ARDS
• Arterial blood gases - Made simple

Shock

• Common mechanisms of all types of shock
• The cardinal role of mediators in shock
• Newer therapies based on current pathophysiological understanding
• End points of resuscitation
• What type of shock is this?

The Immune System

• Inflammation – Acute phase response
• Systemic inflammatory response
• Infection – Part of a bigger picture
• Multiple organ dysfunction syndrome
• Stress reaction
• Autoimmune diseases

Target Audience

• Nurses
• Nurse Practitioners
• Physician Assistants
• Counselors
• Occupational Therapists
• Occupational Therapy Assistants
• Physical Therapists
• Physical Therapist Assistants

Mastering Physical Assessment Skills: Identify Cardiac, Respiratory and Neurological Disorders

You will learn:

• Strategies to detect and identify abnormal heart and lung sounds
• Case Studies and audio playback to enhance learning
• Crackles, wheezes, rubs, gallops, clicks and snaps
• Full discussion and how this leads to proper differential diagnoses
• Characteristics and causes of heart murmurs
• Complete 6-part neuro exam made simple - exam will be demonstrated
• Discussion and work-up for mental status changes

Attend this seminar and learn to identify the different variants in the cardiac, respiratory and neurological assessments. National speaker and expert, Diane Wrigley, BS, PA-C, has developed a CD that accurately plays both abnormal and normal heart and lung sounds. Diane will teach you the origin and significance of these sounds utilizing the auditory portion of the CD. Differential diagnoses are considered and a systematic six-part neurological assessment is reviewed and demonstrated for you.

Case studies will be presented for discussion to help reinforce the physical assessment skills and listening techniques. Diane will also illustrate the proper methods to document your assessments and findings. You will feel confident leaving this seminar with information you can utilize for your future patient assessments.

Past attendees applaud Diane Wrigley and this seminar:

“The incorporation of real-life heart and lung sounds make this presentation come alive.”

“I would love to attend another seminar by this presenter! I liked the clinical assessment situations and the step by step helpful hints provided!”

Program Information

Objectives

1. Determine where and why vesicular, bronchovesicular and bronchial sounds can be normal or abnormal and the significance of the abnormalities.
2. Determine pathophysiology and differential diagnoses for crackles, wheezes, rhonchi and rubs.
3. Evaluate management of obstructive vs. restrictive lung disease.
4. Demonstrate a thorough 6-part neurological exam and document findings.
5. Assess primary causes of mental status changes and identify which patients are at risk for delirium and how to respond.
6. Distinguish whether abnormal S1 and S2 heart sounds are pathological or benign.
7. Measure whether systolic and diastolic murmurs are benign or indicate cardiac disease.

Outline

Respiratory Exam

Abnormal Lung Sounds

• • Pneumonia
  • Atelectasis
  • URI
  • Bronchial Breathing
  • Bronchophony
  • Egophony
  • Whispered Petroliloquy
  • Death Rattle
  • Absent Breath Sounds
  • Pneumothorax
  • Hemothorax
• Crackles
• Rhonchi
• Stridor
• Wheezes
  • Asthma
  • COPD
  • Emphysema
• Pleural Friction Rub

Strategies for Detection

• Chronic Bronchitis
• Pneumonia
• Emphysema
• Acute Asthma
• Croup

NEUROLOGICAL EXAM

Mental Status

• Mnemonic to Cover All Bases
  • Stroke
  • Overdose
  • Infection
  • Toxic states
  • Mental illness

Cranial Nerves

• Techniques to Cover I-XII Quickly and Completely
• Motor
• Evaluate Strength and Symmetry

Sensory

• Quick Field/Bedside Assessment

Coordination

• Simple Test to Assess

Reflexes

• Systematic Approach/Technique

Head Injury Evaluation

• Glasgow Coma Scale

Abnormalities of Consciousness

Clinical Clues

• Delirium
• Stupor
• Coma

Altered Mental Status

• Confusion Assessment Method (CAM)

CARDIAC EXAM

Auscultation Sites, Sequencing and Skills

• S2 split
• S3
• S4
• Gallop
• Opening Snap
  • Mitral and Tricuspid Valves
• Clicks
  • Mitral Valve Prolapse
• Systolic Ejection Sounds
  • Hyperdynamic State

Murmurs

• Intensity (Grade I - VI)
• Location
• Radiation
• Pitch
• Quality
• Timing
• Pattern or Configuration
• Functional vs. Pathologic Murmur

Strategies for Detection of Abnormal Cardiac Sounds

• Innocent Systolic Ejection Murmur
• Mitral Valve Prolapse
• Aortic Stenosis
• Systolic Regurgitation
• Mitral Regurgitation
• Tricuspid Regurgitation

Diastolic Murmurs

• Aortic Regurgitation
• Aortic Stenosis
• Mitral Stenosis
• Patient Ductus Arteriosis

Prosthetic Heart Sounds

• Pericardial Rubs
• Mediastinal Crunch

Target Audience

Nurses, Nurse Practitioners, Clinical Nurse Specialists Respiratory Care Practitioners, Paramedics, Physician Assistants

Heart and Lung Sounds, 2nd Edition

Program Information

Target Audience

Nurses/Nurse Practitioners/Clinical Nurse Specialists, Other Professions

Objectives

1. Analyze 6 extra heart sounds and distinguish what they mean when you hear them.
2. Assess the difference between systolic and diastolic murmurs, as well as clues to expected assessment finding with each.
3. Analyze 5 adventitious breath sounds and understand the clue and common causes for their occurrence.
4. Evaluate voice sounds to confirm pulmonary pathology.

Outline

Cardiac Assessment Skills

• Extra Heart Sounds
  • S2 Splits
  • S3
  • S4
  • Summation Gallops
  • Mechanical Clicks
  • Pericardial friction Rubs

• Heart Murmurs
  • 4 Systolic Murmurs
  • 3 Diastolic Murmurs

Pulmonary assessment

• Adventitious Breath Sounds
  • Wheezes
  • Rales
  • Rhonchi
  • Stridor
  • Pleural Friction Rubs
• Using Vocal Fremitus to Confirm Pathology
  • Bronchophony
  • Whispered Pectoriloquy
  • Egophony