Subject No.

2
CLINICAL SPECIALITY II
MEDICAL SURGICAL NURSING
SUBSPECIALITY-ONCOLOGY NURSING

Total: 1110 Hours Theory: 150 Hours Practical: 960 Hours

AIM:
• This course is designed to assist students in developing expertise and in depth understanding
in the field of oncology Nursing. It will help students to developadvanced skills for nursing
intervention in various oncological conditions. It will enable the student to function as
oncology nurse practitioner / specialist and provide quality care: It will further enable the
student to function as educator, manager, and researcher in the field of oncology nursing.

OBJECTIVES:
At the end of course students are able to:
• Explain the prevention, screening and early detection of cancer.
• Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of
oncological disorders of various body systems.
• Describe the psychosocial effects of cancer on patients and families.
• Demonstrate skill, in administering/assisting in various treatment modalities used for
patients with cancer.
• Apply nursing process in providing holistic, care to patients with cancer.
• Apply specific concepts of pain management.
• Appreciate the care of death and dying patients and value of bereavement support.
• Describe the philosophy, concept and various dimensions of palliative care.
• Appreciate the role of alternative systems of medicine in care of cancer patients.
• Appreciate the legal & ethical issues relevant to oncology nursing.
• Recognize and manage Oncological emergencies.
• Counsel the patients with cancer and their families.
• Incorporate evidence based nursing practice and identify the areas of research in the field
of oncology nursing.
• Recognize the role of oncology nurse practitioner as a member of oncology team.
• Collaborate with other agencies and utilize resources in caring for cancer patients.
• Teach and supervise nurses and allied health workers.
• Design a layout and develop standards for management of oncology units/hospitals and
nursing care.

CONTENTS:
Unit I -Introduction:
• Epidemiology-Incidence, Prevalence - Global, National, State and Local. Disease burden,
concept of cancer, risk factors. Historical perspectives. Trends and issues. Principles of
cancer management. Roles and responsibilities of oncology nurse.
Unit II -The nature of Cancer:
• Normal cell biology. The Immune system. Pathological and patho-physiological changes
in tissues. Biology of the cancer cell. Clone formation Transformation Tumors stem lines.
Structure of a solid tumor. Products produced by the tumor. Systemic effects of tumor
growth.

Unit III -Etiology of Cancer:

 • Carcinogenesis. Theories of cancer causation.Risk factors.Carcinogens - genetic factors,
chemical carcinogens, radiation, viruses, Immune system failure, rapid tissue proliferation.
• Hormone changes, diet, emotional factors .
Unit IV -Diagnostic Evaluation:
• Health assessment: History taking, physical examination; Staging and grading
of tumors, TNM Classification. Common diagnostic tests: Blood investigation:
Hematological, Bio-chemical, Tumor markers. Hormonal assay. Cyrology:
Fine needle aspiration cytology(FNAC).
• Histopathology: Biopsy.Radiological assessment: MRI, Ultrasound, Computed
tomography, Mammography, Positron emission tomography (PET), Radio nuclide
imaging, Functional metabolism imaging. Endoscopies.Nurses responsibilities in
diagnostic measures.
Unit V -Levels of prevention and care:
• Primary prevention - Guidelines for cancer detection, general measures, Warning signs of
caI1cer. Self examination-Oral, Breast, Testicular. Secondary prevention - early diagnosis.
Screening. Tertiary prevention - disability limitation. Rehabilitation: Mobility, Speech,
Bowel and bladder, Ostomies etc. Patient and family education. Discharge instruction,
follow-up care and use of community resources.
Unit VI -Cancer Treatment Modalities and Nurse’s Role
• Surgery:Principles of surgical oncology, Current surgical strategy,
Determining surgical risk, Special surgical techniques, Pre-intra-postoperative nursing
care, Acute and chronic surgical complications. Future directions and advances
• Chemotherapy:Principles and classification of chemotherapeutics, Pharmacology of
antineoplastic drugs- Mechanism of action, Absorption, protein binding, Bio-
transformation, excretion, common side effects, drug toxicity, Calculating drug
doses.Therapeutic response to chemotherapy-Tumor variables, drug resistance and Safety
precautions.
• Radiation Therapy: Physics of radiotherapy, Types of ionizing rays. Radiation
equipments: Linear accelerator, cobalt, Implants, Isotopes.Types of therapies: Oral,
Brachy therapy, tele-therapy, selectron therapy. Effects of radiation on the body tissue.
Radiation biology - cell damage hypoxic cells, alteration of tumor kinetics.Approaches to
radiation therapy – External radiotherapy. Internal radiotherapy - unsealed, scaled sources.
Effectiveness of radiotherapy- Radio sensitivity, treatment effects Complications of
radiotherapy. Radiation safety: Standards of Bhabha Atomic Research Centre(BARC)
• Bone Marrow 'Transplantation /Stem Cell Transplantation:
o Types, indications, transplantation procedure and complications, Types and donor sources,
Preparation and care of donor and recipient,Legal and ethical issues.
• Immunotherapy (Biotherapy): Concepts and principles, Classification of agents,
Treatment and applications
• Gene Therapy:Current Concepts and practices.
• Alternative and Complementary Therapies: Current practices
• Pain management : Theories, types, Nature of cancer pain, Pathophysiology of
pain, Pain threshold
• Assessment of pain: Principles of cancer pain control ,Pharmacological: Opioid and
non-opioid analgesic therapy , Patient controlled analgesia(pcA), Other invasive
techniques of pain control Recent developments in Cancer pain.
 • Non Pharmacological pain relief technique: Complementary therapies (Music,
massage, meditation, relaxation techniques, biofeed back etc) , Psychological
intervention in pain control.Alternative system of medicines. Role of nurse.
Unit VII -Pain management: Theories, types and Management modalities:
• Nature of cancer pain, Pathophysiology of pain, Assessment of pain
Principles of cancer pain control, Pharmacological: Opioid and non-opioid analgesic
therapy, Patient controlled analgesia (PCA)
Non Pharmacological pain relief technique: Psychological intervention in pain control,
Role of nurse, Pain threshold
Recent developments in Cancer pain relief, Alternative system of medicines, other
invasive techniques of pain control.
Non Pharmacological pain relief technique: Complementary therapies (Music,
massage, meditation, relaxation techniques, biofeedback, etc.)
Unit VIII -Palliative care:
• Definition and scope, philosophy, Concept and elements of palliative care, Global
and Indian perspective of palliative care,Quality of life issues, Communication skill
,Nursing perspective of palliative care and its elements, Home care , Hospice care.
• Role of nurse in palliative care.
Unit IX -Infection control: Process of infection, risk of hospitalization, nosocomial
infections- prevention and control of infection in acute, long term care facility and
community based care, Standard safety measures.
Unit X -Nursing Care of Patients With specific Malignant Disorders:
• Malignancies of G.I. system-oral, oesophagus, stomach, rectal, liver & pancreas,
care of ostomies / stoma.Respiratory malignancies.Genito-urinary system
malignancies- prostate Bladder, renal, testicular malignancies.Gynecological
malignancies-cervix, uterus, ovary.
Hematological malignancies-Lymphomas, Leukemia. Malignancies of
musculoskeletal system. Endocrine malignancies. Skin. Head and Neck-brain
tumors.Other malignancies - Breast cancer.
Unit XI -Pediatric malignancies:
• Leukemia, Lymphoma, Neuro-blastoma. Wilm's tumor, Soft tissue sarcoma,
Retinoblastoma.
• Nursing Management of children with Paediatric Malignancies.
Unit XII -Nursing Management of Physiological conditions and Symptoms of
Cancer Patient:
• Nutrition: - effects of cancer on nutritional Status and its consequences:-Anemia, Cachexia,
Xerostomia, mucositis, Dysphagia, nausea and vomiting, constipation, diarrhea, electrolyte
imbalance, taste alterations.
• Impaired mobility: Decubitus ulcer, pathologic fractul thrombophlebitis, pulmonary embolism,
contiactures, footdrop.
• Other symptoms: Dyspepsia & hiccup, dyspnoea.Intestinal obstruction,Fungating wounds.
Anxiety & depression, insomnia .Lymph edema.
• Impact of cancer on sexuality: Effects of radiotherapy / chemotherapy/surgery on sexuality of
the cancer patient. Nursing management of cancer patients experiencing sexual dysfunction.Sexual
counseling.
Unit XIII -Cancer Emergencies:
• Disseminated intravascular coagulation (DIC).Malignant pleural effusion. Neoplastic cardiac
tamponade and septic shock spinal cord Compression. Superior venacava syndrome. Metabolic
emergency: hyper and hypo calcemia. Surgical emergency, Urological emergency, Hemorrhage,
 Organ obstruction. Brain metastasis. Nurses role in managing oncologic emergencies.
Unit XIV -Psycho-Social Aspects of Nursing Care:
• Psychological responses of patients with cancer, psychosocial assessment.
• Crisis intervention, coping mechanisms, Stress management, spiritual/ cultural care and needs,
Counseling: individual and family. Maximizing quality of life of patient and family.
Ethical, moral and legal issues:Care of dying patient, Grief and grieving process,
Bereavement support.Care of Nurses who care for the dying.
Unit XV - Layout and Design of an oncology institution / ward, OPD,
chemotherapy unit, Bone marrow, transplantation unit, Pain clinic etc.
• Practice Standards of oncology nursing, Policies and Procedures. Establishing Standing orders and
Protocols.Quality Assurance Programme in oncology units . Nursing audit.

PRACTICALS:
• Clinical practice in the care of patients with various malignant disorders, Assessment of
client suffering with various malignant disorders, Applying nursing theories and process in
the management of patients suffering from various malignancies, Provide care to patients
with ostomies and other appliances, Assisting for implantation of radioisotopes, Clinical
case presentation, Projects, Clinical and classroom teaching, Health education on related
diseases conditions.
• Field visits – Regional cancer centers/cancer speciality hospital/units, Hospice, mobile
palliative care, community oncology centers, home care units, cancer registry, cancer
detection centers, etc.
• Procedures to be observed:CT Scan, MRI, Ultra sound, Mammography, Radio Nuclear
Imaging, Bone Scan, Thyroid function Test, Functional and metabolic Imaging,
Transportation of radioactive material, others.
• Procedures to be assisted: I. V cannulation – open method, Chemotherapy, Radiotherapy
– Brachytherapy – Low density radiation, High density radiation, interstitial implantation,
Tele therapy – treatment planning, bone marrow aspiration and biopsy, Tissue Biopsy,
FNAC and biopsy, Advance cardiac life support, Endotrachieal intubation, De fibrillation,
Ventilation, Trachesostomy,Thoracentesis, Lumbar Puncture, Arterial Blood Gasses,
Nerve Block,l Chest tube insertion, Inter costal drainage, CVP monitoring,
• Procedures to be performed: Screening for cancer, Assessment of pain, Assessment of
Nutritional status, Care of Tracheostomy, Endotracheal intibation, Gastric gavage, Pap
Smear, I. V cannulation, Care of surgical flaps, care of ostomies, Blood transfusion and
component therapy, counseling, Practice Standard Safety measures, Care of dead body and
mortuary formalities.
• Other procedures: As per the institutional protocol; Alternative therapies.
 CLINICAL SPECIALITY II
MEDICAL SURGICAL NURSING
SUB SPECIALITY – ONCOLOGY NURSING
Unit No. Contents with Distributed Hours
Objectives
& Hours

At the end of the unit the students are able to – Introduction:

• Epidemiology-Incidence, Prevalence - Global, National, State and Local
Knowledge: Understand and explain the concept of cancer, related
Disease burden, concept of cancer, risk factors. (1 hr)
I risk factors & principles of cancer management. • Historical perspectives
Trends and issues (1 hr)
(4 Hrs) Skill: Practice principles of cancer management.
• Principles of cancer management.
Role and responsibilities of oncology nurse (2 hrs)
Attitude: Adapt to the roles and take appropriate responsibilities
while caring.

CO-1- Interpret epidemiology: incidence, prevalence- global, national, state and local.
CO-2-Explain disease burden, concept of cancer.
CO-3- Explain risk factors.
CO-4- Explain historical perspectives
CO-5 Explain trends and issues in oncology
CO-6- Describe principles of cancer management.
CO7- Describe role and responsibilities of oncology nurse.
Course outcome Program outcome
Clinician/Nurse Professional Commu Leader and member of the health care team Lifelong Criti Researcher
educator nicator and system learner cal
thin
ker
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Interpret epidemiology: 3 3 2 3 2 3 3
incidence, prevalence- global, national,
state and local
CO-2-Explain disease burden, concept 3 3 2 3 2 3 3
of cancer

5
CO-3- Explain risk factors 3 3 2 3 2 3 3
CO-4- Explain historical perspectives 3 3 2 3 2 3 3
CO-5 Explain trends and issues in 3 3 2 3 2 3 3
oncology
CO-6- Describe principles of cancer 3 3 2 3 2 3 3
management.
CO7- Describe role and responsibilities 3 3 2 3 2 3 3
of oncology nurse.
At the end of the unit the students are able to – The nature of Cancer:
• Normal cell biology
Knowledge: Understand the pathological and pathophysiological • The Immune system.
II changes in tissues due to cancer. (1 hr)
Pathological and pathophysiological changes in tissues:
(5 Hrs) Skill: Recognize the structural and functional processes of • Biology of the cancer cell (1 hr)
tumours. • Clone formation Transformation
• Tumors stem lines. structure of a solid tumor
Attitude: Appreciate systemic effects of tumour growth. • Products produced by the tumor.
Systemic effects of tumor growth. (3 hrs)
CO-1- Explain pathological and pathophysiological changes in tissues in cancer.
CO-2-Explain biology of the cancer cell.
CO-3- Describe clone formation, transformation.
CO-4- Describe tumors stem lines, products produced by the tumor.
CO-5- Explain systemic effects of tumor growth
CO-6- Explain normal cell biology.
CO-7- Explain the immune system.
CO-8-Describe structure of a solid tumor
Program outcome
Clinician/Nurse Professional Communicator Leader and Lifelong learner Critical Researcher
educator member of the thinker
Course outcome
health care team
and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain pathological and 3 3 2 3 2 3 3
pathophysiological changes in tissues
in cancer.
CO-2-Explain biology of the cancer

6
cell.
CO-3- Describe clone formation, 3 3 2 3 2 3 3
transformation.
CO-4- Describe tumors stem lines, 3 3 2 3 2 3 3
products produced by the tumor.
CO-5- Explain systemic effects of 3 3 2 3 2 3 3
tumor growth
CO-6- Explain normal cell biology. 3 3 2 3 2 3 3
CO-7- Explain the immune system. 3 3 2 3 2 3 3
CO-8-Describe structure of a solid 3 3 2 3 2 3 3
tumor
At the end of the unit the students are able to – Etiology of Cancer:
• Carcinogenesis
Knowledge: Describe the etiology of cancers. • Theories of cancer causation.(1 hr)
III
• Risk factors.
(4 Hrs)
Skill: Identify the risk factors in patients with cancer. • Carcinogens - genetic factors, chemical carcinogens, radiation, viruses,
Immune system failure, rapid tissue proliferation.
Attitude: Determine hormonal, dietetic and emotional factors in Hormone changes, diet, emotional factors. (3 hrs)
the etiology of tumors.

CO-1- Explain risk factors of cancer.

CO-2-Explain carcinogens-genetics factors, chemical, radiation, virus, immune system failure.
CO-3- Describehormone changes, diet and emotional factors in cancer
CO-4- Describe tumors stem lines, products produced by the tumor.
CO-5- Explain theories of cancer causation.
Program outcome
Clinician/Nurse Professio Communicator Leader and Lifelong learner Critical Researcher
educator nal member of the thinker
Course outcome
health care team
and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain risk factors of cancer. 3 3 2 3 2 3 3
CO-2-Explain carcinogens-genetics 3 3 2 3 2 3 3
factors, chemical, radiation, virus,
immune system failure.
CO-3- Describe hormone changes,

7
diet and emotional factors in cancer
CO-4- Describe tumors stem lines, 3 3 2 3 2 3 3
products produced by the tumor.
CO-5- Explain theories of cancer 3 3 2 3 2 3 3
causation.
At the end of the unit the students are able to – Diagnostic Evaluation:
• Common diagnostic tests.
Knowledge: Understand and explain the diagnostic procedures for o Blood investigation: Hematological, Biochemical, Tumor markers, Hormonal
various cancer conditions. assay
o Cytology : Fine needle aspiration cytology (FNAC) (1hr)
Skill: Prepare the clients with cancer for different diagnostic • Histopathology: Biopsy
IV
procedures. Radiological assessment: MRI, Ultrasound, Computed tomography, Positron
(10 Hrs) emission tomography, Radio nuclide imaging, Functional metabolism
Read the results of diagnostic procedures. imaging.
• Mammography, Endoscopies.
Classify various stages of cancer. • Nurses responsibilities in diagnostic measures.(6 Hrs)
• Health assessment : History taking, physical examination; Staging and grading
Attitude: Adapt to the roles and take appropriate responsibilities of tumors,
while caring for patients with cancer. TNM Classification. (3 hrs)

CO-1- Explain blood investigation: hematological, biochemical, tumor markers, hormonal assay in cancer.
CO-2-Explain cytology: fine needle aspiration cytology (FNAC), histopathology: biopsy in cancer.
CO-3- Describe different radiological investigations: MRI, Ultrasound, Computed tomography, Mammography, Endoscopies in cancer.
CO-4- Describe nurses responsibilities in diagnostic measures in cancer.
CO-5- Explain health assessment includes history taking and physical examination.
CO-6- Differentiate between staging and grading in cancer.
CO-7- ExplainTNM classification.
CO-8-Describe diagnostic evaluation: positron emission tomography, radio nuclide imaging, functional metabolism imaging
Program outcome
Clinician/Nur Professional Communicator Leader and member of the Lifelong learner Critical thinker Researcher
Course outcome
se educator health care team and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain blood 3 3 2 3 2 3 3
investigation: hematological,
biochemical, tumor markers,
hormonal assay in cancer.
CO-2-Explain cytology: fine 3 3 2 3 2 3 3
8
needle aspiration cytology
(FNAC), histopathology:
biopsy in cancer.
CO-3- Describe different 3 3 2 3 2 3 3
radiological investigations:
MRI, Ultrasound, Computed
tomography, Mammography,
Endoscopies in cancer.
CO-4- Describe nurses 3 3 2 3 2 3 3
responsibilities in diagnostic
measures in cancer.
CO-5- Explain health 3 3 2 3 2 3 3
assessment includes history
taking and physical
examination.
CO-6- Differentiate between 3 3 2 3 2 3 3
staging and grading in cancer.
CO-7- Explain TNM 3 3 2 3 2 3 3
classification
CO-8-Describe diagnostic 3 3 2 3 2 3 3
evaluation: positron emission
tomography, radio nuclide
imaging, functional metabolism
imaging
At the end of the unit the students are able to – Levels of prevention and care :
• Primary prevention - Guidelines for cancer detection, general measures,
Knowledge: Explain the preventive aspects of cancer. Warning signs of cancer,
• Self examination-Oral, Breast, Testicular
V Skill: Aid in early diagnosis and treatment of the cancer patients. • Secondary prevention - early diagnosis.
• Screening.
(10 Hrs) Attitude: Participate in the rehabilitation of the patients with
• Tertiary prevention - disability limitation (6 Hrs)
cancer. • Rehabilitation: Mobility , Speech, Bowel and bladder, Ostomies, etc
• Patient and family education.(1 Hr)
Discharge instruction, follow-up care and use of community resources. (3
Hrs)

9
CO-1- Explain Primary prevention, Guidelines for cancer detection, and general measures
CO-2-Interprete warning signs of cancer.
CO-3- Describe Self-examination: Oral, Breast, Testicular for detection of cancer.
CO-4- Describe Secondary prevention and early diagnosis in cancer.
CO-5- Explain Rehabilitation in cancer.
CO-6-Explain patient and family education in cancer.
CO-7-Discuss discharge instruction, follow-up care and use of community resources.
CO-8-Describe Tertiary prevention - disability limitation in cancer.

Course outcome Program outcome

Clinician/Nurse Profes Communicator Leader and member of the Lifelong learner Critical Researcher
educator sional health care team and system thinker
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain Primary 3 3 2 3 2 3 3
preventionGuidelines for
cancer detection, and general
measures
CO-2-Interprete warning signs 3 3 2 3 2 3 3
of cancer.
CO-3- Describe Self- 3 3 2 3 2 3 3
examination: Oral, Breast,
Testicular for detection of
cancer.
CO-4- DescribeSecondary 3 3 2 3 2 3 3
prevention and early diagnosis
in cancer.
CO-5- Explain Rehabilitation in 3 3 2 3 2 3 3
cancer.
CO-6-Explain patient and 3 3 2 3 2 3 3
family education in cancer.
CO-7-Discuss discharge 3 3 2 3 2 3 3
instruction, follow-up care and
use of community resources.
CO-8-Describe Tertiary 3 3 2 3 2 3 3
prevention - disability
limitation in cancer.

10
 At the end of the unit the students are able to – Cancer Treatment Modalities and Nurse’s Role:
Surgery-
Knowledge: Understand and explain various modalities of • Principles of surgical oncology.
treatment for cancer clients. • Current surgical strategy.
• Determining surgical risk
Skill: Prepare clients with cancer for various therapies. • Special surgical techniques
• Pre-intra-postoperative nursing.
Participate in the therapeutic procedures. • Acute & chronic surgical complications. Future directions and advances
(5 hrs)
Observe the response of different therapies in cancer clients. • Chemotherapy:
• Principles and classification of chemotherapeutics.
Discuss the ethical and legal issues in various therapies for cancer • Pharmacology of anti neoplastic drugs- Mechanism of action, Absorption,
clients. protein binding, Bio-transformation, excretion, common side effects, drug
toxicity.
Attitude: Develop mind set to use different alternative and • Calculating drug doses,
complimentary therapies. • Therapeutic response to chemotherapy – tumor variables, drug resistance
• Safety precautions (5 hrs)
• Radiation Therapy:
VI
• Physics of radiotherapy.
• Types of ionizing rays.
(25 Hrs)
• Radiation equipments: Linear accelerator, cobalt, Implants, Isotopes.
• Types of therapies: Oral, Brachytherapy, teletherapy, selectron therapy.
• Effects of radiation on the body tissue,
• Radiation biology- cell damage hypoxic cells, alteration of tumor kinetics.
Approaches to radiation –
• External radiotherapy
• Internal radiotherapy- unsealed,
• Sealed sources.
• Effectiveness of radiotherapy- Radio-sensitivity, treatment effects.
Complications of radiotherapy.
• Radiation safety : Standards of Bhabha Atomic Research Centre (BARC)
(5 hr)
• Bone Marrow Transplantation /Stem Cell Transplantation
• Types, indications, transplantation procedure and complications and nursing
management,
• Types and donor sources.
• Preparation and care of donor and recipient.

11
 • Bone marrow bank
• Legal and ethical issues.(4 hrs)
Immunotherapy (Biotherapy): Concepts and principles. Classification of
agents. Treatment and applications (2 hrs)
• Gene Therapy: Current Concepts and practices.( 2hrs)
Alternative & Complementary Therapies: Current practices (2 hrs)
CO-1- Explain principles of surgical oncology and current surgical strategy.
CO-2- Describe pre-intra-postoperative nursing.
CO-3- Evaluate acute & chronic surgical complications in cancer surgery.
CO-4- Discuss future directions and advances in cancer surgery
CO-5- Describe Principles and classification of chemotherapeutics.
CO-6-Explain pharmacology of anti-neoplastic drugs its mechanism of action, Absorption, protein binding, Bio-transformation, excretion, common
side effects, drug toxicity.
CO-7- Describe calculating drug doses and safety precautions.
CO-8 - Describe physics of radiotherapy and types of ionizing rays,radiation equipments
CO- 9-Explain types of radiation therapies: Oral, Brachytherapy, teletherapy, selectron therapy.
CO-10- Describe effects of radiation on the body tissue, Scaled sources. Effectiveness of radiotherapy- Radio-sensitivity, treatment effects.
CO-11- Discuss complications of radiotherapy
CO-12- Explain gene therapy in cancer.
CO-13-Explain alternative and complementary therapies in cancer.
CO-14-Discuss immunotherapy in cancer.
CO-15- Explain Radiation safety : Standards of Bhabha Atomic Research Centre (BARC)
• CO-16- Describe bone marrow transplantation /stem cell transplantation, its type, indications, transplantation procedure, and types and donor
sources,preparation and care of donor and recipient, nursing management and legal and ethical issues.
CO-17-Explain therapeutic response to chemotherapy-Tumor variables, drug resistance.
Course outcome Program outcome
Clinician/Nurse Professional Communicator Leader and member of Lifelong learner Critical thinker Researcher
educator the health care team and
system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain principles of 3 3 2 3 2 3 3
surgical oncology and current
surgical strategy
CO-2- Describe pre-intra- 3 3 2 3 2 3 3
postoperative nursing.
CO-3- Evaluate acute & 3 3 2 3 2 3 3

12
chronic surgical complications
in cancer surgery.
CO-4- Discuss future 3 3 2 3 2 3 3
directions and advances in
cancer surgery
CO-5- Describe Principles and 3 3 2 3 2 3 3
classification of
chemotherapeutics.
CO-6-Explain pharmacology 3 3 2 3 2 3 3
of anti-neoplastic drugs its
mechanism of action,
Absorption, protein binding,
Bio-transformation, excretion,
common side effects, drug
toxicity.
CO-7- Describe calculating 3 3 2 3 2 3 3
drug doses and safety
precautions.
CO-8 - Describe physics of 3 3 2 3 2 3 3
radiotherapy and types of
ionizing rays and radiation
equipments
CO- 9-Explain types of 3 3 2 3 2 3 3
radiation therapies: Oral,
Brachytherapy, teletherapy,
selectron therapy.
CO-10- Describe effects of 3 3 2 3 2 3 3
radiation on the body tissue,
Scaled sources. Effectiveness
of radiotherapy- Radio-
sensitivity, treatment effects.
CO-11- Discuss complications 3 3 2 3 2 3 3
of radiotherapy
CO-12- Explain gene therapy 3 3 2 3 2 3 3
in cancer.
CO-13Explain alternative and 3 3 2 3 2 3 3
complementary therapies in
cancer.

13
 CO-14-Discuss immunotherapy 3 3 2 3 2 3 3
in cancer.
CO-15- Explain Radiation 3 3 2 3 2 3 3
safety : Standards of Bhabha
Atomic Research Centre
(BARC)
• CO-16 Describe bone marrow 3 3 2 3 2 3 3
transplantation /stem cell
transplantation, its type,
indications, transplantation
procedure, and types and donor
sources, preparation and care of
donor and recipient and legal
and ethical issues.
CO-17-Explain therapeutic 3 3 2 3 2 3 3
response to chemotherapy-
Tumor variables, drug
resistance.
At the end of the unit the students are able to – Pain management: Theories, types and Management modalities:

Knowledge: Describe theories of pain, types of cancer pain and o Nature of cancer pain.
management modalities for cancer patients. o Pathophysiology of pain.
• Pain threshold (3 hrs)
Skill: Practice principles of cancer pain control. Assessment of pain.

Administer pain medications as prescribed. • Principles of cancer pain control.

VII • Pharmacological: Opioid and non-opioid analgesic therapy.
Provide psychological support to the clients with cancer pain • Patient controlled analgesia (PCA) (3 hrs)
(10 Hrs) • Other invasive techniques of pain control
Attitude: Demonstrate competence in management of pain by • Recent developments in Cancer pain relief
using various complementary therapies. Non Pharmacological pain relief technique:

o Complementary therapies (Music, massage, meditation, relaxation

techniques, biofeedback, etc.)
o Psychological intervention in pain control.
• Alternative system of medicines.
Role of nurse. (4 Hr)

14
CO-1- Explain nature of cancer pain, Pathophysiology of pain.
CO-2-Interprete assessment of pain.
CO-3- Describe Principles of cancer pain control. Pharmacological: Opioid and non-opioid analgesic therapy, patient controlled analgesia.
CO-4- Explain Non Pharmacological pain relief technique: Psychological intervention in pain control
CO-5-Explain role of nurse in cancer pain management.
CO-6-Discuss Alternative system of medicines in cancer pain management. .
CO-7-Describe Other invasive techniques of pain control
CO-8- Explain non pharmacological pain relief technique in cancer.

Course outcome Program outcome

Clinician/Nurse Professional Communicator Leader and member of the Lifelong learner Critical thinker Researcher
educator health care team and
system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain nature of 3 3 2 3 2 3 3
cancer pain,
Pathophysiology of pain.
CO-2-Interprete assessment 3 3 2 3 2 3 3
of pain.
CO-3- Describe Principles of 3 3 2 3 2 3 3
cancer pain control.
Pharmacological: Opioid
and non-opioid analgesic
therapy, patient controlled
analgesia.
CO-4- Explain Non 3 3 2 3 2 3 3
Pharmacological pain relief
technique: Psychological
intervention in pain control
CO-5-Explain role of nurse in 3 3 2 3 2 3 3
cancer pain management.
CO-6-Discuss Alternative 3 3 2 3 2 3 3
system of medicines in
cancer pain management. .
CO7-Describe Other invasive 3 3 2 3 2 3 3
techniques of pain control
CO-8- Explain non 3 3 2 3 2 3 3

15
pharmacological pain relief
technique in cancer.
At the end of the unit the students are able to – Palliative care:
• Definition and scope, philosophy
Knowledge: Explain concepts and elements of palliative care and • Concept and elements of palliative care.
nurses’ role in it. • Global and Indian perspective of palliative care
VIII
• Quality of life issues.
(5 Hrs)
Skill: Identify quality of life issues. • Communication skill.
• Nursing perspective of palliative care and its elements. Role of nurse in
Attitude: Render palliative care in home and hospice setting. palliative care. (4 hrs)
• Home care
Hospice care.(1 hr)

CO-1- Explain definition and scope, philosophy, concept and elements of palliative care.
CO2- Describequality of life issues,communication skill,nursing perspective of palliative care and its elements.
CO3- Describe role of nurse in palliative care.
CO-4- Explain global and Indian perspective of palliative care
CO-5-Explain role of nurse in cancer pain management.
CO-6-Discuss home care and hospice care.
Course outcome Program outcome
Clinician/Nurse Professional Communicator Leader and member of Lifelong Critical Researcher
educator the health care team and learner thinker
system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain definition and 3 3 2 3 2 3 3
scope, philosophy, concept and
elements of palliative care
CO-2- Describequality of life 3 3 2 3 2 3 3
issues,communication
skill,nursing perspective of
palliative care and its elements.
CO-3- Describe role of nurse in 3 3 2 3 2 3 3
palliative care.
CO-4- Explain global and Indian 3 3 2 3 2 3 3
perspective of palliative care
CO5-Explain role of nurse in cancer 3 3 2 3 2 3 3
pain management.

16
CO6-Discuss home care and 3 3 2 3 2 3 3
hospice care.
At the end of the unit the students are able to – Infection control :
• Process of infection, risk of hospitalization, Nosocomial infections-
Knowledge: Explain the importance of infection control in cancer prevention and control of infection in acute, long term care facility and
IX care. community based care (1 hr)
• Standard safety measures (1 hr)
(2 Hrs) Skill: Practice standard safety measures while caring for cancer
patients.

Attitude: Illustrate the risk of infections in hospitalized clients.

CO-1- Explain nosocomial infections- prevention and control of infection in acute, long term care facility and community based care in cancer.
CO-2-Explain Standard safety measures
CO-3- Describe process of infection.
CO-4- Describe risk of hospitalization.
Course outcome Program outcome
Clinician/Nurse Professional Communicator Leader and member of Lifelong Critical thinker Researcher
educator the health care team learner
and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain nosocomial 3 3 2 3 2 3 3
infections- prevention and
control of infection in acute,
long term care facility and
community based care in
cancer
CO-2-Explain Standard safety 3 3 2 3 2 3 3
measures
CO-3- Describe process of 3 3 2 3 2 3 3
infection.
CO-4- Describe risk of 3 3 2 3 2 3 3
hospitalization
X At the end of the unit the students are able to – Nursing Care of Patients With specific Malignant Disorders:
• Malignancies of G.I. system-oral, oesophagus, stomach, rectal, liver &
(30Hrs) Knowledge: Explain the nursing care of clients with specific pancreas, care of ostomies / stoma (3 hrs)
• Respiratory malignancies (3 hrs)
17
 malignant disorders. • Genitourinary system malignancies- prostate Bladder, renal, testicular
malignancies, (4 hrs)
Skill: Render culturally congruent and competent comprehensive • Gynecological malignancies-cervix, uterus, ovary (3 hrs)
care to the cancer patients • Hematological malignancies Lymphomas, Leukemias (2 hrs)
• Malignancies of musculoskeletal system (3 hrs)
Attitude: Educate clients and families about nutrition, exercises • Endocrine malignancies (3 hrs)
and other health promotion activities in cancer. • Skin (2 hrs)
• Head and Neck-brain tumors. (4 hr)
Other malignancies, Breast cancer, AIDS related malignancies ( Kaposi’s)(3 hr)

CO-1- Explain nursing care of patients withmalignancies of G.I. system-oral, oesophagus, stomach, rectal, liver & pancreas and care of ostomies /
stoma

CO-2-Explain nursing care of patients withrespiratory malignancies.

CO-3- Describenursing care of patients withGenitourinary system malignancies- prostate Bladder, renal, testicular malignancies.

CO-4- Describe nursing care of patients withGynecological malignancies-cervix, uterus, ovary

CO-5- Explain nursing care of patients withHematological malignancies Lymphomas, Leukemias

CO-6-Explain nursing care of patients withMalignancies of musculoskeletal system

CO-7-Discussnursing care of patients withEndocrine malignancies,Head and Neck-brain tumors,Breast cancer

Course outcome Program outcome

Clinician/Nurse Profess Communicator Leader and member Lifelong learner Critical Researcher
educator ional of the health care thinker
team and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain nursing care of 3 3 2 3 2 3 3
patients withmalignancies of G.I.
system-oral, oesophagus, stomach,
rectal, liver & pancreas and care of
ostomies / stoma
18
CO-2-Explain nursing care of 3 3 2 3 2 3 3
patients withrespiratory
malignancies.
CO-3- Describenursing care of 3 3 2 3 2 3 3
patients withGenitourinary system
malignancies- prostate Bladder,
renal, testicular malignancies.
CO-4- Describe nursing care of 3 3 2 3 2 3 3
patients withGynecological
malignancies-cervix, uterus, ovary
CO-5- Explain nursing care of 3 3 2 3 2 3 3
patients withHematological
malignancies Lymphomas,
Leukemias
CO-6-Explain nursing care of 3 3 2 3 2 3 3
patients withMalignancies of
musculoskeletal system
CO-7-Discussnursing care of 3 3 2 3 2 3 3
patients withEndocrine
malignancies.Head and Neck-brain
tumors, Breast cancer.
At the end of the unit the students are able to – Pediatric malignancies:
• Leukemia, Lymphoma, Neuro-blastoma. (4 hrs)
Knowledge: Describe common malignancies in pediatric clients. • Wilm's tumor, Soft tissue sarcoma, Retinoblastoma. (3 hrs)
XI
• Nursing Management of children with Pediatric Malignancies.
Skill: Identify need of children with various malignancies and (3 hrs)
(10 Hrs)
render them effective care.

Attitude: Provide relevant health education to the parents.

CO-1- Explain Pediatric malignancies: Leukemia, Lymphoma, Neuro-blastoma

CO-2-Explain Nursing Management of children with Pediatric Malignancies.
CO-3- DescribePediatric malignancies: Wilm's tumor, Soft tissue sarcoma, Retinoblastoma.
Course outcome Program outcome
Clinician/Nurse Professional Communicator Leader and member of the Lifelong Critical Researcher
educator health care team and system learner thinker
PO1 PO2 PO3 PO4 PO5 PO6 PO7
19
CP-1-Explain Pediatric 3 3 2 3 2 3 3
malignancies: Leukemia,
Lymphoma, Neuro-
blastoma
CO-2-Explain Nursing 3 3 2 3 2 3 3
Management of children
with Pediatric Malignancies
CO-3- DescribePediatric 3 3 2 3 2 3 3
malignancies: Wilm's tumor,
Soft tissue sarcoma,
Retinoblastoma
At the end of the unit the students are able to – Nursing Management of Physiological conditions and Symptoms of
Cancer Patient:
Knowledge: Understand the symptomatic treatment modalities for • Nutrition: - effects of cancer on nutritional Status and its consequences:-Anemia,
the cancer clients. Cachexia, Xerostomia, mucositis, Dysphagia, nausea and vomiting, constipation,
diarrhea, electrolyte imbalance, taste alterations.
Skill: Plan and arrange for appropriate diet for cancer clients. • Impaired mobility: Decubitus ulcer, pathologic fractures, thrombophlebitis,
XII pulmonary embolism, contractures, foot drop. (5 Hrs)
Render effective an efficient care for bed ridden cancer clients. Other symptoms: Dyspepsia & hiccup, dyspnoea, Intestinal obstruction, Fungating
(13 Hrs) wounds. Anxiety, depression, insomnia, Lymph edema (5 hr)
Manage physiological symptoms in cancer clients. Impact of cancer on sexuality:
• Nursing management of cancer patients experiencing sexual dysfunction. (2
Attitude: Understand the impact of cancer on sexuality and hrs)
provide sexual counseling to the cancer clients. • Effects of radiotherapy / chemotherapy/surgery on sexuality of the cancer patient. (2
hrs)
Sexual counseling (1 hrs)

CO-1- Explain Nursing Management of Physiological conditions and Symptoms of Cancer Patient: Anemia, Cachexia, Xerostomia, mucositis,
Dysphagia, nausea and vomiting, constipation, diarrhea, electrolyte imbalance, taste alterations.

CO-2-Explain Nursing Management of Physiological conditions and Symptoms of Cancer Patient. Impaired mobility: Decubitus ulcer, pathologic
fractures, thrombophlebitis, pulmonary embolism, contractures, foot drop

CO-3- Describenursing care of patients withDyspepsia & hiccup, dyspnoea, Intestinal obstruction, Fumigating wounds. Anxiety, depression, insomnia.

CO-4- Describe Nursing management of cancer patients experiencing sexual dysfunction

CO-5- Explain Effects of radiotherapy / chemotherapy/surgery on sexuality of the cancer patient sand counselling.

20
CO-6-Explain nursing care of patients withLymph edema

Course outcome Program outcome

Clinician/Nurse Profession Communicator Leader and Lifelong Critical Researcher

educator al member of the learner thinker
health care team
and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain Nursing Management of 3 3 2 3 2 3 3
Physiological conditions and Symptoms
of Cancer Patient: Anemia, Cachexia,
Xerostomia, mucositis, Dysphagia, nausea and
vomiting, constipation, diarrhea, electrolyte
imbalance, taste alterations.
CO-2-Explain Nursing Management of 3 3 2 3 2 3 3
Physiological conditions and Symptoms
of Cancer Patient. Impaired mobility:
Decubitus ulcer, pathologic fractures,
thrombophlebitis, pulmonary embolism,
contractures, foot drop

CO-3- Describenursing care of patients 3 3 2 3 2 3 3

withDyspepsia & hiccup, dyspnoea, Intestinal
obstruction, Fumigating wounds. Anxiety,
depression, insomnia.
CO-4- Describe Nursing management of 3 3 2 3 2 3 3
cancer patients experiencing sexual
dysfunction

CO-5- Explain Effects of radiotherapy / 3 3 2 3 2 3 3

chemotherapy/surgery on sexuality of the
cancer patient sand counselling.

CO-6-Explain nursing care of patients 3 3 2 3 2 3 3

21
withLymph edema

At the end of the unit the students are able to – Cancer Emergencies:
• Disseminated intravascular coagulation (DIC)
Knowledge: Describe the emergency conditions in cancer clients. • Malignant pleural effusion.
• Neoplastic cardiac tamponade, septic shock, spinal cord Compression.
Skill: Demonstrate competence in identifying emergency • Superior venacava syndrome.
XIII situations in cancer clients. • Metabolic emergency: hyper and hypo calcemia.
• Surgical emergency.
(10Hrs) Report and intervene promptly an effectively to manage the cancer • Urological emergency
emergencies.
• Hemorrhage, Organ obstruction.
• Brain metastasis. (8 hrs)
Attitude: Recognizes the signs of brain metastasis and vital organ
Nurses role in managing oncologic emergencies. (2 hrs)
involvement in cancer and render efficient care to relieve
discomfort.

CO-1- Explain Nursing Management of Cancer Emergencies: Disseminated intravascular coagulation (DIC), Malignant pleural
effusion.,Neoplastic cardiac tamponade, septic shock, spinal cord Compression. Superior venacava syndrome.
CO-2-Explain Nursing Management of Metabolic emergency: hyper and hypo calcemia. Surgical emergency and Hemorrhage, Organ obstruction.
CO-3- DescribeNurses role in managing oncologic emergencies

CO-4- Describe Nursing management of Urological emergency and Brain metastasis

Course outcome Program outcome

Clinician/Nurse Professional Communicat Leader and member Lifelong learner Critical thinker Researcher
educator or of the health care
team and system
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain Nursing 3 3 2 3 2 3 3
Management of Cancer
Emergencies: Disseminated
intravascular coagulation (DIC),
Malignant pleural
effusion.,Neoplastic cardiac
tamponade, septic shock, spinal
cord Compression. Superior
venacava syndrome

22
CO-2-Explain Nursing 3 3 2 3 2 3 3
Management of Metabolic
emergency: hyper and hypo calcemia.
Surgical emergency and Hemorrhage,
Organ obstruction
CO-3- DescribeNurses role in 3 3 2 3 2 3 3
managing oncologic emergencies

CO-4- Describe Nursing management 3 3 2 3 2 3 3

of Urological emergency and Brain
metastasis
At the end of the unit the students are able to – Psycho-Social Aspects of Nursing Care:
• Psychological responses of patients with cancer.
Knowledge: Understand the need for and explain the techniques • Psychosocial assessment. Crisis intervention, coping. Stress management,
involved in crisis intervention and stress management for the spiritual/cultural care and needs.
clients with cancer. • Counseling: individual and family.
XIV
• Maximizing quality of life of patient and family. (3 hrs)
Skill: Practices various spiritual and alternative treatment Ethical, moral and legal issues: (3 Hrs)
(08Hrs)
modalities for management of stress in cancer case. Participates in • End of life care
crisis interventions for cancer clients. • Grief and grieving process
• Bereavement support.
Attitude: Provide culturally congruent care to the dying cancer Care of Nurses who care for the dying. (2 hrs)
client.

CO-1- Explain Psychosocial assessment. Crisis intervention, coping. Stress management, spiritual/cultural care and needs.
CO-2-ExplainMaximizing quality of life of patient and family in cancer
CO-3- Describenursing care of dying patient and Bereavement support.
CO-4- Describe Care of Nurses who care for the dying
CO-5- Explain Grief and grieving process, Counseling: individual and family and psychological responses of patients with cancer
Course outcome Program outcome

Clinician/Nurse Professional Communicator Leader and Lifelong Critical Researcher

educator member of the learner thinker
health care
team and
system
PO1 PO2 PO3 PO4 PO5 PO6 PO7

23
CO-1- Explain Psychosocial 3 3 2 3 2 3 3
assessment. Crisis intervention,
coping. Stress management,
spiritual/cultural care and needs.
CO-2-ExplainMaximizing quality of 3 3 2 3 2 3 3
life of patient and family in cancer
CO-3- Describenursing care of 3 3 2 3 2 3 3
dying patient and Bereavement
support.
CO-4- Describe Care of Nurses who 3 3 2 3 2 3 3
care for the dying
CO-5- Explain Grief and grieving 3 3 2 3 2 3 3
process, Counseling: individual and
family and psychological responses of
patients with cancer
At the end of the unit the students are able to – Layout & Design of an oncology institution / ward, OPD, chemotherapy
unit, Bone marrow, transplantation unit, Pain clinic etc. (1Hr)
Knowledge: Understand the significance of practice standards, • Practice Standards of oncology nursing.
XV
policies and protocols. Skill: Frame policies and protocols for the Policies and Procedures
oncology nursing unit. • Establishing Standing orders and Protocols.
(2Hrs)
• Quality Assurance Programme in oncology units
Attitude: Provide suggestions for the improvement of functioning Nursing audit (1 hr)
of oncology unit. •

CO-1- Explain Practice Standards of oncology nursing, Policies and Procedures and Quality Assurance Programme in oncology
CO-2-ExplainLayout & Design of an oncology institution / ward, OPD, chemotherapy unit, Bone marrow, transplantation unit, Pain clinic
CO-3- DescribeEstablishing Standing orders and Protocolsin oncology
Course outcome Program outcome

Clinician/Nurs Professional Communicator Leader and member of the Lifelong Critical Researcher
e educator health care team and system learner thinker
PO1 PO2 PO3 PO4 PO5 PO6 PO7
CO-1- Explain Practice Standards of 3 3 3 3 2 3 3
oncology nursing, Policies and Procedures
and Quality Assurance Programme in
oncology
CO-2-Explain Layout & Design of 3 3 2 2 2 3 3

24
an oncology institution / ward,
OPD, chemotherapy unit, Bone
marrow, transplantation unit, Pain
clinic
CO-3- DescribeEstablishing Standing 3 3 2 3 2 3 3
orders and Protocolsin oncology

25
26