Spring 2018

NURS 3309-01 Pathophysiology

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

Welcome to Pathophysiology for the Traditional Track!

Please familiarize yourself with the course web site on Canvas before the first class, and make sure you have gone over the course materials (including the packet, calendar, and reading guide) by then. 

Also, see below (under "Calendar - 1st Day Only") for reading assignments to be completed before the first class day.

(Be assured that no homework is due the first day of class.)

I look forward to meeting you, and we will have a great semester!


Primary Faculty: Cheryl A. Lehman PhD RN CNS-BC RN-BC CRRN
Clinical Assistant Professor
Office # NSG 2.212
Office phone # (210) 567-5870
Office hours: By appointment

Secondary Faculty: James A. Cleveland MSN, RN
Director, Center for Simulation Innovation
Assistant Professor/Clinical
School of Nursing
University of Texas Health Science Center at San Antonio
7703 Floyd Curl Drive
San Antonio, Texas 78229-3900
Office Phone # 210-567-5862 FAX: (210) 567-1719
Office RM # SL 031, clevelandj@uthscsa.edu


Change the course description to read: This course focuses on concepts of pathophysiology essential to understanding the diseases and disabling conditions that can affect the body systems across the lifespan.


3 semester hours (3 hours theory)


Admission to the undergraduate program.


At the completion of the baccalaureate program the student will demonstrate the following:

  1. Incorporate knowledge, skills, and attitudes from the liberal arts and sciences in professional nursing education and practice.
  2. Apply knowledge and skills of organizational and systems leadership, quality improvement and patient safety in promoting safe, high-quality care for diverse patients across healthcare systems and environments.
  3. Analyze and apply evidence from research and other information sources as a basis for nursing practice.
  4. Incorporate knowledge and skills in using information systems and a range of patient-care technologies to facilitate delivery of quality patient care.
  5. Advocate for financial and regulatory healthcare policies, processes, and environments that improve the nature and functioning of the healthcare delivery system and nursing practice.
  6. Collaborate and communicate effectively with healthcare professionals to promote positive working relationships, improve patient health outcomes, and deliver quality, safe patient care.
  7. Promote individual and population health by assessing factors that influence individual and population health and apply principles and culturally appropriate health promotion and disease-prevention strategies. Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
  8. Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
  9. Integrate the knowledge, skills, and attitudes expected of baccalaureate prepared nurses by providing professional nursing care to diverse patients and populations across the lifespan, healthcare settings, and healthcare environments.


1. Describe the influence of genetics and genomics on disease and disability across the lifespan.  (Essentials I, III, VII, IX)

2. Describe the mechanisms the body uses to react to stressors and trauma.  (Essentials I, III, VII)

3. Identify the risk factors, causes, pathophysiology, clinical manifestations, and diagnostic tests related to concepts of disease across the lifespan.  (Essentials I, III, VII)

4. Identify the role of the nurse in recognition, assessment and interventions for pathophysiological processes.  (Essentials VII, IX)


A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)


Based on the readings expect a quiz weekly except the first week.

The grades are as follows:
Exam 1, Exam 2 - 15% each, total 30%
Final exam - 30%
Quizzes - 20%
System disorder homework - 10%
Class activities 10%



  1. Examination items are the proprietary intellectual property of the university and are not to be shared by students. Sharing of exam items by students is considered cheating and is subject to disciplinary action. There are no legal test item banks available to students in the SON other than those provided with the ATI NCLEX –RN exam preparation materials.
  2. Exams are required.
  3. Students are expected to take examinations at the scheduled time.
  4. The student must notify the course coordinator prior to the scheduled exam time if they are unable to take the exam as scheduled.  Failure to make this notification in advance will result in a "zero" for that examination.
  5. If the excuse is accepted as reasonable and necessary, arrangements will be made for a make-up examination.
  6. Exam content is based on course, class, and clinical objectives.  Included are all required readings, lecture and discussion, related material in the course packet, media presented in or required for class, material handed out, and material on Canvas.
  7. Students should follow the School of Nursing dress code during exams. 
  8. Students must leave all food and drink, books, purses, and backpacks in an area designated by exam proctors.  If available, students are encouraged to leave personal items in lockers.  No hats, caps or head coverings may be worn during exams, with the exception of those required for religious purposes.
  9. When entering the classroom for an exam, students will show their School of Nursing badge to the proctor.  Proctors will ensure only the students eligible to take the exam receive access to the test and take the exam in an approved testing location.  During the exam, students will wear their badge on the upper chest area.
  10. Calculators, scratch paper and pencils are provided by the School of Nursing for exams.  Proctors will distribute the scratch paper after students have initiated the exam.
  11. If students arrive late, no extra time to complete the exam will be given.
  12. Each student is responsible for making sure that he or she has completed the exam before the exam is turned in to a proctor.  Under no circumstances will a student be allowed to retrieve his or her exam materials after turning them in to the test proctor.
  13. Students will be given the opportunity to review exams.  


  1. To pass the course, a student must have a weighted average of 75% on all graded activities.
  2. Students must make a "C" (75) or higher in all nursing courses to progress in the program.


The final grade will be calculated to two decimal places and rounded mathematically as follows:


Attendance in class is an expectation of each student.


  1. If written assignments are made in a course they are required.
  2. Students are expected to submit written work on the scheduled date and time.
  3. The student must notify the course coordinator prior to the scheduled due date and time if they are unable to submit the written work as scheduled. Failure to make this notification in advance will result in a "zero" for that written work.
  4. If the excuse is accepted as reasonable and necessary, arrangements will be made for an alternative due date and time.
  5. Each student is responsible for making sure that he or she has completed the written work prior to submission.
  6. Late work will be accepted with consequences as outlined per course syllabi.


The APA Publication Manual 6th edition is required for use in all nursing school programs. 

Assessment Technologies Institute®, LLC (ATI) RN CONTENT MASTERY SERIES®

UTHSCSA School of Nursing utilizes the ATI RN Content Mastery Series®, RN Comprehensive Predictor® practice and proctored exams, and the ATI Virtual "greenlight" program to assist students in preparing for the NCLEX-RN® exam. Through practice and proctored examinations, students are able to assess their own knowledge and receive feedback and direction for content review throughout the program of study.

The proctored exams are administered in specific courses in both undergraduate tracks.

In order for a student to take the course related proctored exam, students will take the non-proctored (Practice A and B) tests individually, as often as they wish with a minimum of a 24 hour wait period between attempts. The student should engage in a minimum of one hour focused review on missed topics and/or identify three critical points to remember. Achievement of a 90% or higher individual score is required prior to taking the proctored test. Students may be required to show documentation by submitting a printed copy of the individual student transcript to the faculty prior to testing. Non-proctored tests are pass/fail.

To strengthen the review method, if students did not achieve a 90% or greater on the practice exam, students should understand the rationales for each distracter. It is recommended that students review 5-15 questions at a time with ample time given to review each of the rationales. When the student logs in again, the exam will continue from where the student had stopped previously.

Content Mastery Exams will comprise 15% of the total course grade. The following provides guidelines for inclusion of the CME in the course grade.

                   Content Mastery Examinations Requirements


 1st ATI Exam  (15% of Course Points)

2nd ATI Exam      (15% of Course Points)


100% of points  

85% of points


90% of points

80% of points    


*0% of points, develop focused review** and must retake exam

0% of points

Less than Level 1

*0% of points, develop focused review** and must retake exam

0% of points

*Level 1 and below: An individualized student success plan will be developed and implemented in conjunction with faculty to help student attain content mastery.

* Focused review consists of printing out the specific proctored “report” and using either the available ATI templates or a plain piece of paper to handwrite all of the missed items under “Topics to Review” and label each missed item with the topic descriptors. This handwritten remediation will be stapled with the student’s proctored “report”. 

The RN Comprehensive Predictor will be given in Nurs 4420 (traditional BSN program) or Nurs 4423 accelerated BSN program).


Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.


Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.



Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.


Huether, S & McCance, K. (2017). Understanding Pathophysiology (6th Ed.). Mosby, St. Louis ISBN:  9780323354097

This book is also available in an ebook format.

Neafsey, P.J. (2013). Case Mysteries in Pathophysiology (2nd ed). Englewood; Morton Publishing. ISBN 161731152-9.


Huether, S & McCance, K. (2017). Study guide for Understanding Pathophysiology (6th Ed.) Mosby, St. Louis. ISBN:  9780323370455


  1. Introduction to Pathophysiology
  2. Altered cells and tissues
  3. Inflammation and tissue repair
  4. Altered cellular proliferation and differentiation:  Cancer
  5. Immunology in health and disease
  6. Infection
  7. Altered fluid, electrolyte and acid-base balance
  8. Genetic and developmental disorders
  9. The Neurologic System:  Altered neuronal transmission
  10. The Hematologic System:  Hematology and clotting disorders
  11. The Endocrine System:  Altered hormonal metabolic regulation
  12. The Cardiovascular and Lymphatic Systems:  Altered perfusion
  13. The Pulmonary System:  Altered ventilation and diffusion
  14. Digestive and Urinary Functions:  Altered elimination
  15. Combining complex pathophysiologic concepts:  Diabetes

CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.

Topic / Assignment Due
Thursday January 11th Review the Canvas site materials for the class.  As shown on the Calendar, we will cover "Introduction to Pathophysiology" and "Altered Cells and Tissues" at our first class meeting.

These topics include the specific learning objectives listed in Week 1 of the "Reading Guide and Learning Objectives" document and the diseases and disorders shown in Week 1 of the Calendar.

Use the Reading Guide to, well, guide your reading of the chapters because you are NOT responsible for the entirety of the material in the chapters.  Rather, you are responsible for the material described by the learning objectives, which can be answered from the material in the chapters.

Note that NO homework is due for Week 1.  We will go over how to do the homework for subsequent weeks during the first class meeting, and the rest of the class mechanics will make sense as we progress through the first two weeks of the course (so don't worry if things seem rather confusing or complicated right now).  Thank you!

  • Chapters 1 and 4 in Huether & McCance (6th ed.), as well as:
  • Cervical dysplasia p 225 (Fig 9-2), p 77
    Acromegaly p 464-465
    Hypertrophic cardiomyopathy p 624-625

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