Bakersfield College Associate Degree Nursing …bcgentry.yolasite.com/resources/syllabus Spring 2010.doc · Web viewThe Bakersfield College Associate Degree Nursing Program is designed

BAKERSFIELD COLLEGE Associate Degree Nursing Program

Nursing B26: Medical-Surgical Nursing 3Instructional Syllabus

Spring/2010

Julie Gentry RN MSN FNP

COURSE DESCRIPTIONThis Level 3 course focuses on the application of previously learned knowledge as well as the development of more in depth knowledge for adult clients across the lifespan who have more diverse and complex disease states. The nursing process is the framework used in this course to present topics,such as leadership, critical thinking, pharmacology and safety. Correlated clinical experiences are provided with adult patients who have increasingly complex outcomes. The roles of Provider of Care, Manager of Care, and Member of the Profession are integrated and analyzed throughout the didacticand clinical experiences. Prerequisite: Appropriate standing in the Associate Degree Nursing Program or evaluation of skills and knowledge by the Program Director. Recommended: None. Hours: 45 lect, 162 lab. Offered: F, S. CCS: Occupational Education. Transferable: CSU and Private Colleges.

PROFESSOR :Julie Gentry RN MSN FNP

PROGRAM STUDENT LEARNING OUTCOMESThe Bakersfield College Associate Degree Nursing Program is designed to prepare graduates to competently transition from student to entry level Registered Nurse as defined by these roles: Provider of Care, Manager of Care, and Member of the Profession. Please refer to Associate Degree Nursing Student Handbook.

Upon completion of the program, the graduate shall be able to function as a:

A. Provider of Care --- The graduate will provide safe nursing care through therapeutic nursing interventions to clients with critical and complex disease states. The care is characterized by consistent critical thinking and problem-solving skills, clinical competence, accountability, effective communication skills, respect for diverse cultures, with an emphasis on health education and a commitment to the value of caring.

B. Manager of Care --- The graduate will provide safe nursing care consistently utilizing critical thinking skills for clients who have critical and complex disease states. The care is characterized by the ability to assess and establish priority of care for a group of client’s and delegation of appropriate aspects of nursing care to license and unlicensed personnel and directs their activities. The manager of care collaborates with other members of the health care team, including organizational and community resources, using effective oral and written communication sills. The manager of care recognizes roles and responsibilities within the

levels of the career ladder and is competent in using technology to provide evidence-based nursing care.

C. Member of the Profession --- The graduate will consistently demonstrate accountability, advocacy, legal/ethical and caring behavior, and responsibility for one’s own professional growth, behavior, and formal/informal education. The graduate nurse routinely participates in self-evaluation and makes changes to improve the practice of nursing, with the ultimate goal of making positive contributions to the nursing profession.

LEVEL 3 STUDENT LEARNING OUTCOMESLEVEL 3: The focus of level three is to analyze and utilize theoretical and technical knowledge to care for the more diverse and complex client.

Upon completion of the course, the student will be able to function as a:

A. Provider of Care --- The student will provide safe nursing care through therapeutic nursing interventions to clients that have increasingly complex outcomes. The care is characterized by the ability to cluster and prioritize increasingly complex nursing interventions, anticipate expected and unexpected outcomes, incorporate comprehensive assessment data into the plan of care, utilize effective communication skills, demonstrate respect for diverse cultures, educate clients regarding health needs, and promote client advocacy with increasing independence.

1. Developer/coordinator/evaluator of care to individuals, families, groups, communities, and populations: able to identify the rationale for care and competently deliver this care to an increasingly complex and diverse population in multiple environments, utilizing the nursing process.

a. Develop, implement, and modify a holistic plan of care for clients with increasingly complex outcomes

b. Function pro-actively and prioritize potential complications to mange client care for increasingly complex clients.

c. Anticipate and prioritize care of multiple clients/families during clinical rotations.d. Develop, implement, evaluate and modify interventions for clients with increasingly

complex outcomes to assist clients to reach goalse. Integrates pathophysiology into nursing interventions based on client assessment

and medical diagnosis.f. Demonstrates ongoing evaluation and implementation of modified interventionsg. Integrates supportive data (labs / diagnostics) when administering medications.

Consistently utilizes 6 rights of medication administration. Requires minimal prompting in the discussion of medications.

h. Role models professionalism, respect and kindness for the client’s uniqueness, developmental level, socio-cultural background, spiritual beliefs, perceptions and values.

i. Performs skills at the expected level with minimal supervision.j. Proficiently develops a process paper according to specified guidelines with a

passing grade of at least 75%k. Maintains asepsis at all times, role models appropriate behavior and assesses

members of healthcare team.

2. Demonstrate effective communication with clients, families, and other health care team members in all health care settings.

a. Assess and consistently utilize effective and therapeutic professional communication techniques and adapt them for individual situations of clients, families, and health care members.

b. Establish therapeutic relationships in all interactions.c. Communicate effectively with the expanded health care team members (nursing

staff and physicians) with increasing independence.

d. Demonstrates appropriate required documentation in an accurate and timely manner for clients with increasing complex outcomes.

3. Advocate for the client, profession and the interdisciplinary health care team in an effort to ensure that clients, families, and communities are well informed and included in care planning.

a. Utilize increasingly assertive techniques to promote client advocacy.b. Validate and clarify with instructor interventions for client advocacy before

initiating plan.

4. Educate clients, families, and health care professionals under their supervision using appropriate teaching principle, strategies and current information.

a. Individualize and adapt teaching strategies by utilizing the principles of teaching/learning.

b. Does appropriate teaching for clients/families with increasingly complex outcomes with instructor’s guidance.

5. Anticipates risks to the client and provides appropriate interventions to achieve optimal client outcomes.

a. Utilizes supportive data to identify potential complications and plans for and implement appropriate interventions.

B. Manager of Care --- The student will provide safe nursing care utilizing critical thinking skills for clients who have increasingly complex outcomes. The care is characterized by the ability to anticipate complications, analyze and utilize the data gained from specialized equipment, plan and evaluate utilization of appropriate resources for cost effective delivery of care and facilitation of communication among the health care team.

1. Demonstrate critical thinking to problem solve, organize, and prioritize care for individuals or a group of clients.

a. Demonstrate and verbalize the ability to anticipate complications based on the pathophysiology associated with complex disease processes and is able to modify care when this results.

b. Demonstrate pro-active thinking by being able to cluster and prioritize increasingly complex nursing interventions and complete the charting as appropriate for the clinical situation.

c. Consistently recognizes self-limitations and begin to utilize appropriate resources with increasing independence. (Textbook; instructor; nursing unit staff)

d. Design effective plan for resolving conflict.e. Incorporate comprehensive assessment, relevant data and begins to analyze this data

into the plan of the care.f. Demonstrate the ability to problem-solve in the delivery and management of care

for clients with increasingly complex disease processes.g. Is able to integrate the diagnostic data and assessment findings and plans care

accordingly.

2. Manage human and fiscal resources in an efficient and cost effective manner.

a. Plan and evaluate utilization of appropriate resources for cost effective delivery of client care. (Refrain from unnecessary use of medical supplies)

3. Integrates current technology to provide competent client care.

a. Retrieve and record pertinent information utilizing multiple technological resources. (Chart; computer; physician/nursing rounds)

b. Analyze and utilize the data gained from specialized equipment in delivery of client care. Accurately work IV pumps, mini-infusers, cardiac monitors

4. Serve as a leader and partner in the interdisciplinary health care team.

a. Participate in nursing and physician rounds to facilitate communication among team members.

b. Make appropriate referrals based on client/family needs. (Soc Svc; APS; CPSc. Demonstrates team leading independently and is able to be an active participant in

interdisciplinary team meetings. (Collaborate with RT; PT; OT; ST)d. Consistently demonstrates and implements leadership with increasing independence.

C. Member of the Profession --- The student will assume responsibility and accountability, with minimal supervision, for the legal and ethical boundaries of nursing. The student consistently recognizes self-limitations and begins to independently utilize various resources to improve abilities, as well as analyze caring behaviors.

1. Demonstrates accountability for the provision and evaluation of nursing care that conforms to professional standards and incorporates legal and ethical responsibilities of the nurse especially the rights of the clients.

a. Provides care based on the California Nursing Practice Act and integrates components of the Nursing Practice Act in providing care

b. Implement policy regarding State and Federal regulations. (JCAHO – National Patient Safety Goals; DHS -Title 22 Ca Code of Regulations; CMS - HIPPA)

c. Initiates corrective action for variations from standard practice. (Occurrence reporting, Medication Event Report, Report of Injury)

d. Accept responsibility and accountability for individual actions in the clinical setting and the provision of patient care and implement a remediation plan.

e. Is consistently punctual for clinical experience – this is an expectation of all students at each level.

f. Adheres to Bakersfield College ADN Program dress code – this is an expectation of all students at each level.

g. Comes to the clinical setting prepared to care for assigned clients with daily care plan complete and appropriate equipment – this is an expectation of all students at each level.

2. Accountable for life long acquisition of knowledge and skills to effect change in health care practice and outcomes.

a. Differentiates and uses credible nursing and medical resources.b. Participates in at least one community project:c. Actively seeks out learning experiences, taking responsibility for their own

education – this is an expectation of all students at each level.d. Consistently participates in clinical post conferences – this is an expectation of all

students at each level.

COURSE ACTIVITIESVarious instructional methods may include, but are not limited to, lectures/discussions, demonstrations, audiovisual aids, required reading, computerized assisted instruction, simulated learning experiences, independent study, problem solving exercises, and quizzes/exams. Additional learning activities may also include nursing process assignments, calculation of age appropriate drug dosages, and leadership/ teaching assignments.

COURSE ASSIGNMENTSStudents are required to complete a variety of assignments which may include simulated learning experiences, computer assisted instruction, weekly reading, homework assignments, nursing process, presentations, and community projects in order to successfully meet the objectives for Nursing B26. Detailed instructions for each assignment are located in the Assignment section of the Theory syllabus and / or the Clinical Manual.

COURSE POLICIESGeneral: Students are expected to attend each class, be punctual, and assume

responsibility for assigned activities, be active participants in the learning process, and meet all established level objectives.

Cell phones and pagers must be turned off or placed in silent or vibrate mode.

Children are not allowed in classroom or clinical setting.

Supportive Students at Bakersfield College with disabilities who believe they may Services: need accommodations in this class are encouraged to contact Disabled

Student Programs & Services (661-395-4334), FACE 16, as soon as possible, or at your specific School site, to better ensure such accommodations are implemented in a timely fashion.

Live Captioning: Students with disabilities who are in need of live captioning in this Interactive Video Class are encouraged to contact Distance Learning (661)395-4694 as soon as possible to better ensure such accommodation is implemented in at timely fashion. Please contact Disable Student Programs & Services for all other accommodation requests at (661) 395- 4334 (FACE 16)

Please note: The Student Handbook also outlines a variety of services available to help meet your academic needs.

Attendance: The attendance policies as outlined in the Bakersfield College Catalog and Associate Degree Nursing Student Handbook will be strictly enforced. Students are expected to observe the attendance requirement of the College and instructor course policies. Instructors may require that absences be made up to meet course objectives even if the absences do not exceed College policy regarding attendance.

THEORY: For the lecture component the maximum number of allowable absences is two (2). If theory absences exceed the allowed amount, the student can either drop the course, or receive a letter grade. Lateness is not acceptable! Please note two tardies equal one absence—no exceptions.

Make-up Assignments

An Instructor has the right to require a student to make up a theory, laboratory/clinical absence even if the student has not exceeded the allowable maximum number of absences. If make-up assignments are required they may consist of: Theory – Case studies, independent study, written examinations,

attending seminars or workshops, computer-assisted instruction, or reports, or other assignments at the discretion of the instructor

Exams/Quizzes: Students are responsible for material presented during their absence.

The opportunity to make up one missed exam will only be allowed if the student informs the instructor prior to the scheduled exam. Pop quizzes may not be made up.

Students will not be allowed to retake any exam or quiz on which an unsatisfactory grade was earned.

Students may make arrangements with the instructor to review an individual exam up to two (2) weeks after the exam returned. The final exam will not be reviewed.

All cell phones, pagers, and / or any electronic device must be turned off during exams / quizzes unless prior arrangements are made with instructor. Ringing or vibrating phones and pagers will result in a five percent deduction from the student’s quiz or exam.

Electronic devices other than a calculator may not be used for in-class calculations work (ie. Cell phones, PDA’s, etc).

Academic There will be zero tolerance for academic dishonesty, including Honesty: plagiarism. Plagiarism is the intentional use of another person’s idea, data,

information, or work without giving credit.

If the student is caught cheating, the test will be collected, a zero (0) grade will be recorded, and the student will be directed to leave the classroom. The student is required to meet with the Director of Allied Health to discuss his / her standing in the program.

Please refer to statements on academic honesty located in your Bakersfield College Catalog, Associate Degree Nursing Student Handbook, and the Bakersfield College Class Schedule.

CourseEvaluations: Course evaluations for theory and clinic will be performed using an online survey

entitled “class climate” each student is responsible for completing evaluations in a timely manner.

STUDENT EVALUATION

Evaluation is an ongoing, essential process in education, by which the student is apprised of his/her progress in meeting the level outcomes and unit objectives. Theory and clinical grades are calculated separately. In order to pass the course, the student must achieve at least 75% in the theory AND clinical components. If the student achieves either less than 75% in the theory component, OR clinical

component, the student will not pass the course.

Grading scale Weighted grades in %A = 90 – 100 %B = 80 – 89 %C = 75 – 79%D = 70 – 74%F = 69 or less

Exams --------------------------------------------------------------------- 30%Mid-Term Exam --------------------------------------------------------- 32%Community Service Project --------------------------------------------- 1%ATI/CARP ----------------------------------------------------------------- 4%Final Cumulative Exam-------------------------------------------------- 33%

The student must achieve cumulative score of 75% or greater in order to successfully complete the course. Extra credit points cannot be used to attain a course grade of 75%.

REQUIRED TEXTS AND MATERIALS Huber, D. L., (2006) Leadership and Nursing Care Management (3rd ed). Philadelphia: Saunders.

LeMone, P. & Burke K. (2008). Medical – Surgical Nursing Critical Thinking in Client Care (4th ed.) New Jersey: Pearson Prentice Hall. (ISBN: 978-0-13-171-309-3).

Fulcher, E. M. & Frazier, M. S., (2007). Introduction to Intravenous Therapy for Health Professionals. Philadelphia: Saunders.

Gentry, J., (2010). Nursing B26: Medical-Surgical Nursing 3 Instructional Syllabus Spring/2010.

Comprehensive Assessment and Review Program (CARP) by ATI. 4% will be awarded for completion of ALL assignments in ATI and grades will be docked to no more than 2% if not all assignments are completed.

Scantrons: Six 100 question (Form No.882-e).

RECOMMENDED TEXTS & WEBSITES

Nursing Practice Act with Regulations and Related Statutes. http://www.rn.ca.gov.

http://www.rn.ca.gov/

WEEK DATE Unit Topic Class meets Tuesdays from 1015-1245 Notes

Week 1 Jan 18 No class Holiday

Week 2 Jan 25IntroductionUnit 1

Medical Surgical B 26 Professional Issues & Nursing PracticeBio-psychosocial Concepts related to health care

Week 3 Feb 1 Unit 12 Problems of Protection

Week 4 Feb 8Unit 11 Fluid, Electrolytes, and Acid-Base Imbalances

Test Unit 1, 2 and 12Feb 12No clinic

Week 5 Feb 15 No Class Holiday

Week 6 Feb 22 Unit 3 Problem of Oxygenation

Week 7 March 6 Unit 4 Problems of Cardiac Output and Tissue PerfusionTest Unit 11 and 3

Week 8 March 8 Unit 5 Problems with Hematological System

Week 9 March 15 Mid TermMID TERM all material to date will be coveredYou will have the whole class time for exam

Week 10 March 22 Unit 6 Problems of Mobility, Sensation, and Cognition

***March 29-April 4 Easter Break***

Week 11 April 5 Unit 7 Problems of Digestion, Nutrition, and Elimination

Week 12 April 12 Unit 8 Problems of Regulation and MetabolismTest Unit 6-7

Week 13 April 19 Unit 9 Problems with Excretion

Week 14 April 26 Unit 10 Problems of Neurological FunctionTest Unit 8-9

May 3

Week 15 Review Final Review (ATI Testing)

Week 16 May 12 Final Exam Final 800-0950 Wednesday May 12, 2010

COURSE CONTENT

I. Review Program and Course Learning OutcomesII. Review SyllabusIII. Discuss Policies, Expectations and Requirements

PROFESSIONAL ISSUES AND NURSING PRACTICE

I. Role of The Medical Surgical NurseA. Review and Reinforce Roles of:

1. Provider of Care2. Manager of Care3. Member of The Profession

II. Role of The Perioperative NurseA. Review Roles and Concepts of Perioperative NursingB. Implement Roles of The Perioperative Nurse Under Direct Supervision of RN

III. Critical Thinking A. Utilize Critical Thinking SkillsB. Nursing ProcessC. Evidence Based-Practice

IV. Caring and ComfortA. Review and Reinforce:

1. Role of Caring2. Nursing Theory Related to Caring3. Implications When Nurses’ and Clients’ Perceptions of Caring Might Differ4. Ways to Convey Caring Through Presence and touch 5. Active Listening

V. Community Based CareA. Review

1. Ambulatory Care2. Home Care

a. Home Care Management With Altered Oxygen3. Long Term Care4. Transitional Care5. Rehabilitation

a. Pulmonary Rehabilitation6. Managed Care

B. Caring in the Hematologic/Oncologic environmentC. Collaborative Management

1. Age Appropriate Care 2. Diagnostic/Lab Data 3. Diversity4. Nutrition 5. Nursing Diagnosis/Interventions6. Pharmacology7. Safety8. Surgical/Nonsurgical9. Teaching/Learning

VI. Leadership A. Organizational Culture and Climate/Trends in NursingB. Professional/Employment IssuesC. Documentation /AssessmentD. Nurse Practice ActE. Legal /Ethical Issues

BIOPSYCHOSOCIAL CONCEPTS RELATED TO HEALTH CARE

I. Communication and Conflict ResolutionA. Interdisciplinary Communication

1. Formulate Guidelines For Making Effective Telephone Calls to PhysiciansB. Review and Implement and Reinforce Conflict Resolution Strategies As Presented in

Psychiatric NursingC. Consistently use SBAR for reporting, transporting, recommendations and follow-up.D. Communication styles

II. PainA. Differentiate Between Types of Pain and Therapies For Each:

1. Mild2. Moderate3. Severe4. Intractable

III. Recognize cultural factors related to pain managementIV. Define implantable pumps

NURSING PRACTICE FOR MEDICAL – SURGICAL DISORDERS

I. Problems of Oxygenation

A. Respiratory System1. Review Anatomy and Physiology 2. Health History3. Focused Physical Exam of Respiratory System4. Clinical Manifestations of Altered Respiratory Function5. Nursing Diagnoses6. Diagnostics

a. CXR (lateral /decubitus)b. CT scanc. Bronchoscopyd. Nasal Swab (MRSA)e. Sputum Culturef. CBCg. Oximetry

B. Alterations in function of Oxygenation1. Medical – Surgical Disorders

a. Hemo/Pneumo thorax1. Pulmonary Contusion2. Pneumothorax

i. Closedii. Open

3. Hemothoraxb. Empyema

1.Transudate2.Exudate

c. Pleuritisd. Pleural Effusione. Neoplasms (Lung Cancer)

1. Etiology2. Pathophysiology3. Clinical Manifestations4. Complications5. Collaborative Management

f. Age Appropriate Careg. Diagnostic/Laboratory Datah. Diversityi. Nutritionj. Nursing Diagnoses/Interventionsk. Pharmacologyl. Safetym. Surgical Management

1. Chest tubes and drainage systemsa. Water sealb. Dry Suctionc. Wet suctiond. Heimlich Valve

n. Teaching/LearningC. Interventions for Clients with Problems in Oxygenation

1. Artificial Airwaysa. Incorporate Use and Care of:b. Oralc. Nasopharyngeal Airwayd. Laryngeal Mask Airwaye. Tracheostomyf. Identify ETT

2. Oxygen Delivery Systemsa. Introduce and Appropriate Use and Care of:

1. Trach Shield2. Blowby (T-Tube)

3. Arterial Blood Gasesa. Review Normal/Abnormal Values b. Differentiate Between:

1. Respiratory Acid/Alkalosis2. Metabolic Acid/Alkalosis

c. Correlate ABG Results to Specific Client Condition4. Suctioning

a. Review Maintenance and Types Suctioning (Oral, Nasal, Pharyngeal, and Tracheal)b. Expanded Focus On Caring For Client With Tracheostomy

II. Problems of Cardiac Output and Tissue Perfusion

A. Cardiovascular System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Cardiovascular System4. Clinical Manifestations of Altered Cardiac Function5. Nursing Diagnoses6. Diagnostics – Identify Abnormal Values

B. Alterations in Cardiac Function1. Medical –Surgical Disorders

a. Cardiomyopathy

b. Permanent Pacemakersc. Chronic Congestive Heart Failured. Inflammatory Heart Disease

1. Infective Endocarditis2. Pericarditis3. Myocarditis4. Rheumatic Carditis

2. Etiology 3. Pathophysiology4. Clinical Manifestations5. Complications6. Collaborative Management

Age Appropriate Care Diagnostic/Lab Data DiversityNutrition Nursing Diagnoses/interventionsPharmacologySafetySurgical/NonsurgicalTeaching/Learning

C. Shock1. Review Types of Shock2. Differentiate Shock Types3. Discuss Management:

a. Distributive1. Anaphylactic

b. Hypovolemic ShockD. Interventions for Clients with Problems in Cardiac Function

1. Cardiac Emergencya. Review:

1. Crash Cart and BLS 2. Systematic Approach3. Code Team

2. Clinical Aima. Activate Code Blueb. Participate in Code Bluec. Record Code Blue

III. Problems of Hematological System

A. Hematological System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Hematological System4. Clinical Manifestations of Altered Hematological Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Hematological Function1. Medical –Surgical Disorders

a. Anemia1. Review Definition, Types and Causes, Associated Labs2. Aplastic – Define and Differentiate 3. Hemorrhagic

i. Acuteii. Chronic

b. Leukemiac. Lymphoma

1. Hodgkin’s2. Non Hodgkin’s

d. Lymphedema2. Etiology 3. Pathophysiology4. Clinical Manifestations5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnoses/interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

III. Problems of Mobility, Sensation, and Cognition

A. Musculoskeletal System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Musculoskeletal System4. Clinical Manifestations of Altered Musculoskeletal Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Musculskeletal Function1. Medical –Surgical Disorders

a. Neoplasms (Bone Cancer)2. Etiology (Types of Bone CA)3. Pathophysiology4. Clinical Manifestations 5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnoses/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

IV. Problems of Digestion, Nutrition, and Elimination

A. Gastrointestinal System (GI)1. Anatomy and Physiology2. Health History3. Focused Physical Exam of GI System

4. Clinical Manifestations of Altered GI Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Gastrointestinal Function1. Medical –Surgical Disorders

a. Cirrhosisb. Hepatitisc. Hepatic failure/PSEd. PSEe. Neoplasms (GI Cancer)

1. Esophageal 2. Gastric 3. Pancreatic4. Colorectal

f. Acute Pancreatitisg. Review Chronic Pancreatitis

2. Etiology 3. Pathophysiology4. Clinical Manifestations 5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnoses/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

C. Interventions for Clients with Gastrointestinal Problems1. Gastric Surgeries

a. Billroth I/Billroth IIb. Pyloroplastyc. Anthrectomyd. Vagotomye. Gastrectomy

2. Clinical Manifestations 3. Complications

D. Collaborative Management1. Age Appropriate Care 2. Diagnostic/Lab Data 3. Diversity4. Nutrition 5. Nursing Diagnosis/Interventions6. Pharmacology7. Safety8. Surgical/Nonsurgical9. Teaching/Learning

V. Problems of Regulation and Metabolism

A. Endocrine System1. Anatomy and Physiology

2. Health History3. Focused Physical Exam of Endocrine System4. Clinical Manifestations of Altered Endocrine Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Metabolic Function1. Medical –Surgical Disorders

a. Diabetic Ketoacidosis (DKA)b. HHNSc. Thyroid/Parathyroid

2. Etiology3. Pathophysiology4. Clinical Manifestations5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnosis/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

VI. Problems of Excretion

A. Renal System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Renal System4. Clinical Manifestations of Altered Renal Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Renal Function1. Medical –Surgical Disorders

a. Renal Insufficiencyb. Chronic Renal Failure/Uremiac. ESRDd. Dialysise. Tumors

1. Prostate2. Renal3. Testicular


a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnosis/Interventions

f. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

VII. Problems of Neurological Function

A. Neurological System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Neurological System4. Clinical Manifestations of Altered Neurological Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Neurological Function1. Medical –Surgical Disorders

a. Neoplasms1. Primary2. Secondary

b. Inflammatory Brain Conditions1. Bacterial Meningitis2. Viral Meningitis3. Encephalitis4. Brain Abscess

c. Myasthenia Gravisd. Multiple Sclerosise. ALS



VIII. Fluid, Electrolyte, and Acid-Base Imbalances

A. Intravascular Access Devices1. Differentiate Types of Accesses 2. Differentiate Care For Accesses 3. Describe Blood Component Therapy and Associated Nursing Care 4. Describe Care of Client Who Is Receiving TPN

a. Compositionb. Methods of Administrationc. Catheter Placementd. Potential Complicationse. Nursing Management

5. Describe Long Term Antimicrobial Therapy

IX. Problems of Protection

A. Immune System1. Review Anatomy and Physiology2. Obtain Health History3. Focused Physical Examination of Immune System4. Clinical Manifestations of Altered Immune Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Immunological Function1. Medical –Surgical Disorders

a. Neoplasmsb. SLE



C. Integumentary Disorders1. Anatomy and Physiology2. Health History3. Focused Physical Examination of Integumentary System4. Clinical Manifestations of Altered Integumentary Function5. Nursing Diagnoses6. Diagnostics

D. Alterations in Integumentary Function1. Medical –Surgical Disorders

a. Malignant skin disorders1. Melanoma2. Basal Cell3. Squamous cell4. Actinic keratosis

2. Etiology3. Pathophysiology4. Clinical Manifestations

a. Types of Burnb. Classificationc. Depth of Burnd. Percent of Body Surface

1. Adult 2. Children

5. Complications6. Collaborative Management

a. Age Appropriate Care

b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnoses/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

Unit 3 Problems of Oxygenation

Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Applicable information Ch 36-39

The goal of this unit is to provide the learner with the key information needed to care for a client with altered oxygenation related to specific respiratory disorders. Unit 3 provides an in depth review of assessment parameters for clients with respiratory problems. The module contains information on nursing care of the client with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.

OBJECTIVES:Upon completion of this unit, the student will be able to:

A. Theory1. Review the anatomy and physiology of the respiratory system and contrast normal

assessment from abnormals associated with Chest Trauma, pleuritis, empyema, pleural effusion and lung cancer.

2. Compare and contrast how factors such as: Chest Trauma, hemothorax, pneumothorax, pleuritis, empyema, pleural effusion and lung cancer affect ventilation and respiration (gas exchange).

3. Identify specific topics for consideration during a health history interview of clients with health problems involving the respiratory system.

4. Describe normal variations in assessment findings for the older adult.5. Describe surgical procedures used to treat: Chest Trauma, hemothorax, pneumothorax,

pleuritis, empyema, pleural effusion and lung cancer, and nursing responsibilities in caring for clients undergoing these procedures.

6. Discuss treatment options for oral and laryngeal cancers with their implications for the client’s body image and functional health.

7. Describe the nursing implications for oxygen therapy and medications used to treat respiratory disorders.

8. Describe the nursing implications for medications used to promote ventilation and gas exchange.

B. Clinical1. Identify assessment abnormalities in clients with moderate to high acuity with following

disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer2. Utilizing critical thinking skills develop and evaluate a care plan for a client with

moderate to high acuity and the following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.

4. Develop a pulmonary rehabilitation plan of care for a client returning home on oxygen.5. Assess the need and perform tracheostomy care and suctioning for an assigned client.6. Identify and implement health teachings for the client with following disorders: Chest

trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.7. Present an ethical or legal issue associated with clients with Chest trauma, Pleuritis,

Empyema, Pleural Effusion and Lung cancer.8. Select nursing interventions that demonstrate patient advocacy when caring for a patient

with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer

9. Practice and/or use the computerized charting in the clinical setting.

UNIT 4-PROBLEMS OF CARDIAC OUTPUT AND TISSUE PERFUSIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Chapter 30-32

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with altered oxygenation related to specific cardiovascular disorders. Unit 4 provides an in depth review of clients with cardiac problems. The unit contains information on nursing care of the client with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory

1. Review the anatomy and physiology of the cardiovascular system.2. Identify normal heart sounds and relate them to the corresponding events in the cardiac

cycle.3. Explain cardiac output and explain the influence of various factors in its regulation.4. Describe normal variations in assessment findings for the older adult.5. Identify manifestations of Cardiac Emergency, Permanent Pacemakers, Chronic CHF,

Inflammatory Heart Diseases and Shock.6. Compare and contrast the pathophysiology and manifestations of Cardiac Emergency,

Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.7. Relate the outcomes of diagnostic tests and procedures to the pathophysiology of

Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock and implications of client responses to the disorder and associated nursing care for each.

8. Discuss nursing implications for medications and treatments used in the prevention, treatment and management of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

9. Explain risk factors and preventive measures for Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

B. Clinical

1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

4. Identify and implement health teachings for the client with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

5. Present an ethical or legal issue associated with clients with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.


UNIT 5-PROBLEMS OF HEMATOLOGICAL SYSTEMMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 33 – 35

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of the hematological system. Unit 5 contains information on nursing care of clients with Anemia, Leukemia, Lymphoma, and Lymphedema. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the hematologic, peripheral vascular and

lymphatic systems and relate it to Anemia, Leukemia, Lymphoma, and Lymphedema.2. Outline a focused physical assessment of the hematologic system.3. Describe normal variations in assessment findings for the older adult.4. Identify manifestations of impairment in the function of the hematologic, peripheral

vascular and lymphatic systems.5. Describe, compare and contrast the pathophysiology, manifestations and management

of Anemia, Leukemia, Lymphoma, and Lymphedema.6. Differentiate Hodgkins disease from non-hodgkins lymphomas and describe nursing

interventions for each.


disorders: Anemia, Leukemia, Lymphoma, and Lymphedema2. Utilizing critical thinking skills develop and evaluate a care plan for a client with

moderate to high acuity and the following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

4. Identify and implement health teachings for the client with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

5. Present a ethical or legal issue associated with clients with Anemia, Leukemia, Lymphoma, and Lymphedema

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Anemia, Leukemia, Lymphoma, and Lymphedema


UNIT 6 – PROBLEMS OF MOBILITY, SENSATION, AND COGNITIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapter 40 – 42 Adding SLE from Unit 12

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with bone cancer as well as review the musculoskeletal system. Unit 6 contains information on nursing care of clients with the different types of bone cancer. Bone cancer will be discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the musculoskeletal system.2. Identify specific topics for consideration during a health history interview of the client

with health problems involving the musculoskeletal system.3. Describe normal variations of the musculoskeletal system in the older adult.4. Discuss the purposes and related nursing interventions for stump care.5. Explain the causes, levels, types and potential complications (infection, delayed healing,

chronic stump pain, phantom pain, and contractures) of an amputation.6. Explain the pathophysiology, manifestations, complications, interdisciplinary care, and

nursing care of neoplastic disorders, bone tumors, and systemic lupus erythematosus.7. Describe surgical procedures used to treat clients with bone tumors.8. identify common laboratory and diagnostic tests associated with diagnosis, management

and evaluation of clients with disorders of the musculoskeletal system.

B. Clinical1. Identify assessment abnormalities in clients with moderate to high acuity with bone

cancer and SLE.2. Utilizing critical thinking skills develop and evaluate a care plan for a client diagnosed

with bone cancer and SLE with moderate to high acuity. 3. Discuss lab findings and their relationship to appropriate nursing interventions for

clients with bone cancer and SLE.4. Identify and implement health teachings for the client with bone cancer and SLE.5. Present an ethical or legal issue associated with clients with bone cancer and SLE.6. Select nursing interventions that demonstrate patient advocacy when caring for a patient

with cancer and SLE.7. Practice and/or use the computerized charting in the clinical setting.

UNIT 7-PROBLEMS OF DIGESTION, NUTRITION, AND ELIMINATIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 23-26

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of digestion, nutrition and elimination. Unit 7 contains information on nursing care of clients with Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the gastrointestinal system.2. Describe the pathophysiology of Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries

and Acute and Chronic Pancreatitis.3. Relate manifestations, diagnostic tests, and surgeries associated with Cirrhosis,

Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.4. Utilize knowledge of normal anatomy and physiology to understand the manifestations

and affects of Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.

5. Describe normal variations of digestion, nutrition and elimination for the older adult.6. Discuss the purposes, nursing implications, and health education for the client and

family of medications used to treat gastrointestinal disorders.7. Describe surgical procedures of the bowel including Billroth I, Billroth II, colectomy,

colostomy, ileostomy, and perianal surgery.

B. Clinical1. Identify assessment abnormalities in clients with moderate to high acuity with the

following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

4. Identify and implement health teachings for the client with any of the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

5. Present an ethical or legal issue associated with clients with Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis


UNIT 8 – PROBLEMS OF REGULATION AND METABOLISMMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition. Chapters 18 – 20

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of regulation and metabolism. Unit 8 contains information on the nursing care of clients with Diabetic Ketoacidosis (DKA), Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the endocrine system.2. Explain the function of the hormones secreted by the endocrine glands.3. Identify specific topics to consider during a health history interview of the client with

health problems involving endocrine function.4. Describe normal variations in assessment findings for the older adult.5. Identify abnormal findings that may indicate malfunction fo the gladns of the endocrine

system.6. Compare and contrast the manifestations of disorders that result from hyperfunction and

hypofunction of the thyroid, parathyroid and pancreas.7. Provide appropriate nursing care for the client before and after a total and subtotal

thyroidectomy.8. Compare and contrast the manifestations and interdisciplinary care of hypoglycemia,

diabetic ketoacidosis, and hyperosmolar hyperglycemic state.9. Discuss lab findings and their relationship to appropriate nursing interventions for

clients with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.


disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.

4. Identify and implement health teachings for the client with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.

5. Present an ethical or legal issue associated with clients with Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.


UNIT 9-PROBLEMS OF EXCRETIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 27 – 29

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of excretion. Unit 9 contains information on nursing care of clients with Prostate, Testicular and Renal Cancer. This unit will also include Chronic Renal failure and dialysis. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy, physiology and function of the genital urinary system.2. Describe normal variations in assessment findings for the older adult.3. Explain the role of the urinary system in maintaining homeostasis.4. Identify specific topics for consideration during a health history assessment interview of

the client with problems involving the urinary system.5. Discuss the nursing implications of medications and treatments prescribed for clients

with urinary tract disorders.6. Describe the pathophysiology of clients with Prostate, Testicular and Renal Cancer

including Chronic Renal failure and dialysis.7. Explain diagnostic studies used to identify disorders of the kidneys and their effects.8. Compare and contrast dialysis procedures (ie hemodialysis and peritoneal) used to

manage chronic renal failure.B. Clinical

1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

4. Identify and implement health teachings for the client with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

5. Present a ethical or legal issue associated with clients with Chronic Renal Failure and Prostate, Testicular and Renal Cancer

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Prostate, Testicular and Renal Cancer as well as Chronic Renal Failure


UNIT 10- PROBLEMS OF NEUROLOGICAL FUNCTIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 43 – 46

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of neurological function. Unit 10 contains information on nursing care of clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS). Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the neurological system.2. Outline a focused physical assessment of the neurological system.3. Identify specific topics for consideration during a health history assessment interview of

the client with neurologic disorders.4. Identify manifestations of impairment of neurologic function.5. Identify prevalence, incidence, and risk factors for clients with Neoplasms,

Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

6. Compare and contrast the pathophysiology, manifestations, interdisciplinary care, and nursing care of clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

7. Discuss the purposes, nursing implications, and health education for the client and family for medications used to treat Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

8. Discuss surgical options for the treatment of Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

9. Describe the procedures (plasmapheresis etc.) used to treat selected neurologic disorders.


disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

4. Identify and implement health teachings for the client with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

5. Present an ethical or legal issue associated with clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotropic Lateral Sclerosis (ALS).


Unit 11-Fluid, Electrolyte, and Acid-Base ImbalancesMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Unit 3 Chapter 10

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with intravenous (IV) access devices. Unit 11 contains an in depth review of intravenous therapy. Primarily intravenous devices will be discussed including the types and nursing care associated with each device. Blood Component therapy will also be included in this unit. A nursing process approach is used for nursing management with focus on health promotion and self care. Nursing diagnoses and client outcomes are identified. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the purpose and types of intravenous (IV) therapy.2. Recall the nursing care related to IV therapy appropriate for patients across the lifespan.3. Outline the steps to an IV assessment for various types of patients and IV therapy.4. Differentiate the use and care of short and long term catheters for immunosuppressed

clients: Central venous access devicesi. PICC Lines

ii. Port-a-cathiii. Hickman

5. Differentiate and start to evaluate diagnostic exams used to assess appropriateness of IV therapy.

6. Distinguish between the nursing care of the patient with TPN and peripheral IV therapy.7. Compare and contrast rationales behind long term antimicrobial therapy.8. Relate nursing care to long-term antimicrobial therapy.9. Identify Principles and practice of blood transfusion

B. Clinical1. Care for patients with intravenous access’s2. Utilizing critical thinking skills develop and evaluate a care plan for a client with

moderate to high acuity and an intravenous access device.3. Discuss lab findings and their relationship to appropriate nursing interventions for

clients with intravenous access devices.4. Identify and implement health teachings for the client with intravenous access devices.5. Present an ethical or legal issue associated with clients with intravenous access devices.6. Select nursing interventions that demonstrate patient advocacy when caring for a patient

with intravenous access devices.7. Identify and implement the steps necessary for blood and blood component transfusion8. Practice and/or use the computerized charting in the clinical setting.

Unit 12 REGULATION/PROTECTION NEEDS: CANCERMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Chapter 14

INTRODUCTIONThis unit at first reviews the general aspects of cancer that can be applied regardless of the sites. Cancer of the specific body systems is described in more detail in each unit. A nursing process approach is used for nursing management, with emphasis on health promotion and self care.


A. Theory1. Recall selected terms associated with cancer.2. Define cancer and differentiate benign from malignant neoplasms.3. Describe the theories of carcinogenesis.4. Explain and discuss known carcinogens and identify risk factors for cancer.5. Compare the mechanisms and characteristics of normal cells with those of malignant

cells.6. Describe and compare laboratory and diagnostic tests for cancer.7. Discuss the role of chemotherapy in cancer treatment and classify chemotherapeutic

agents8. Discuss the role of surgery, radiation therapy, and biotherapy in the treatment of cancer.9. Identify causes and discuss the nursing interventions for common oncologic

emergencies.10. Design an appropriate care plan for clients with cancer and their families regarding

cancer diagnosis, treatment, and coping strategies.

B. Clinical1. Assess functional health status of clients with cancer, and monitor, document, and

report abnormal manifestations.2. Incorporate evidence-based research into the plan of nursing care for clients with

cancer.3. Prioritize nursing diagnosis based on assessment data and implement appropriate

nursing interventions for clients with cancer during cancer diagnosis, treatment and rehabilitation.

4. Evaluate the client who has been administered chemotherapeutic medications and assess the need for other medications for pain, nausea, and vomiting, mucosistis, or anemia knowledgeably and safely.

5. Use the nursing process as a framework for planning and providing individualized care and integrating interdisciplinary care for clients with cancer to meet their healthcare needs.

6. Include cultural variations and diverse values in designing and implementing individualized plans of care for clients with cancer.

7. Design and provide individualized client and family teaching to restore, promote, and maintain clients’ functional status.

8. Revise plan of care as needed provide effective interventions for clients with cancer and their families.

BAKERSFIELD COLLEGE Associate Degree Nursing Program

Nursing B26: Medical-Surgical Nursing 3Clinical Manual

Julie Gentry RN MSN FNP

COURSE DESCRIPTIONLaboratory experiences are correlated with theory with emphasis on providing nursing care to the client with increasing complex needs. Concepts presented in Nursing B 26 are applied in a variety of healthcare settings.

Prerequisites: Completion of the first and second semesters of Associate Degree Nursing Program and/or evaluation by program director for skills and knowledge.

LEAD INSTRUCTORS

Main Campus Distance EducationAsst. Professor: Lisa Harding, RN MSN CEN Asst. Professor: Julie Gentry RN MSN FNPEmail: [email protected] Email : [email protected] : www.bcmedsurg3.yolasite.com Website: www.bcgentry.yolasite.comPhone:(661) 395-4728:cell (661)246-6587 (661) 395-4476; Cell (661) 364-3656Location: M S Building Room 178 Location: M S Building Room 153Office Hours: Tuesday 1300-1430 Office Hours: Monday 11:00a - 4:00p

(may be extended if no staff meeting) Tuesday 1:30p – 2:30pWednesday 1300-1530 (by appointment only)

Address: 1801 Panorama Drive Address: 1801 Panorama Drive Bakersfield, CA 93305 Bakersfield, CA 93305

****Open door policy – Students may contact/meet with instructor during scheduled office hours at any time. If the student has special needs, individual time can always be scheduled.

PROFESSIONAL EXPERTS - - - BAKERSFIELD COLLEGEAsst. Professor Lisa Harding, RN Mercy Hospital Truxtun AvenuePhone: (661) 395-4728; Cell (661) 246-6587 (4 West)

Asst. Professor Julie Gentry RN, MSN San Joaquin Community HospitalPhone: (661) 395-4679; Cell (661) 619-8248 (3 South)

Alisha Loken BSN, RN Kern Medical CenterPhone: (661) 821-0105; Cell (310) 948-3707 (3 Center)

Heather Ryall RN BSN San Joaquin Community HospitalCell (661) 204-5615 (4 South)

http://www.bcmedsurg3.yolasite.com/

mailto:[email protected]

mailto:[email protected]

COURSE ASSIGNMENTS

Students are required to complete a variety of assignments which may include simulated learning experiences, computer assisted programs and weekly reading and homework assignments in order to successfully meet the objectives for Nursing B26 Clinical. Detailed instructions for each assignment are located in the ASSIGNMENTS section of the syllabus.

CLINICAL LABORATORY GUIDELINES

AttendanceClinical experience is essential for the student to meet all course objectives. For that reason, it is crucial students attend all scheduled clinical experiences. According to the handbook, two (2) days of clinical may be missed for compelling reasons. Failure to meet course objectives will result in failure of the course. Make up days are not allowed. If the clinical instructor determines additional time is required in order to evaluate ability to progress to the next level, you will be notified and a learning contract will be initiated in order to aid in your successful completion of B 26. Lateness is not acceptable! Each tardy will be considered one absence. All absences and tardies must be reported to the clinical instructor by 0600. Do not call and leave a message with the nursing staff on the unit.

Please refer to the Bakersfield College Catalog and the ADN Student Handbook for Guidelines related to: Personal Appearance; Grooming; Uniforms; Jewelry; Alternative lab experience dress code; Dress Code While Obtaining Assignments; Campus Skills Laboratory Dress Code; Photo ID.

Student Orientation to Healthcare Facility

All students must be oriented to the facility where laboratory experience is provided. It is the responsibility of the instructor to provide this orientation either personally or by arrangement with staff members. Orientation shall include but is not limited to the following:

Parking Regulations (include both daytime and evening rules)

Cafeteria Procedure:

Restroom Facilities

Locker Facilities and/or proper location for books, outer clothing, purses, and valuables storage.

Safety and Emergency Procedures:

Absences or Tardiness in the Laboratory Areas:

Paging System:

Location in Facility of:

Location of Student Assignment and Daily Laboratory Objectives:

Learning Resource Material:

Charting:

Medication Administration:

Supplies:

Orientation to Client Unit:

Introduction to Key Personnel:

Pre and Post Conference Facilities:

Communications During Laboratory Rotation:

Information About Facility:

Telephone Protocol

Limitation of Student Activity - Laboratory Area

Students are not to leave the nursing unit or department to which they are assigned without the permission of the instructor. Students may not undertake care of clients, which have not been assigned by instructor.

Phone Calls/Student Visitors

No personal phone calls should be made or received while in the laboratory areas. Emergency calls are directed to the instructor. Cell phones and pagers should be turned off. Cellular phones are not allowed in the laboratory areas. Also, students may not have visitors while in the laboratory area.

Laptop Computers/PDA’s

No laptop computers are to be used/present in the health care facilities.

PDA’s are to be used only as a resource, not as a word processing device while in the health care facility.

Transportation

Students are responsible for transportation to and from healthcare facilities. Students assume all liability for traveling to and from healthcare facilities. Students must park only in designated parking areas.

ACADEMIC HONESTY

There will be zero tolerance for academic dishonesty, including plagiarism. Plagiarism is the intentional use of another person’s ideas, data, information, or work without giving credit. If the student is caught cheating, the clinical paperwork will be collected, a zero (0) grade will be recorded, and the student will be directed to leave the clinical area. The student is required to meet with the Director of Allied Health to discuss his/her standing in the program. Please refer to the statements on academic honesty in your Bakersfield College Catalog, Associate Degree Nursing Student Handbook, and the Bakersfield College Class Schedule

COURSE EVALUATIONSClinical site and instructor evaluations are a requirement for this course. Evaluations will be conducted the last day of each clinical rotation. Students are expected to complete and online survey using class climate, for each clinical instructor and site. Also, students are required to turn in 3rd Semester Critical Elements Forms and the Student Self Evaluation Form.

STUDENT EVALUATION

Evaluation is an ongoing, essential process in education, by which the student is, appraised of his/her progress in meeting the level outcomes and unit objectives. Student performance evaluations are based on course level outcomes, written and or oral assignments, and program critical elements. Clinical is graded on the care plan and the Nursing Process score. Student must also demonstrate the ability to consistently transfer classroom knowledge i.e. apply the information/skills at the bedside. If the student earns a no credit for clinical he/she is unable to progress in the program and will receive a failing grade for B26.

Grading Scale For assignments Course Grade

A = 90 – 100

B = 80 – 89

C = 75 – 79

D = 70 – 74

F = 69 or less

≥ 75% = Credit≤ 75% = No Credit Medical Surgical Rotation _ _ _ _ _ _ _ _ _ _

Process paper ( 1 ), Daily abbreviated care plans, Verbal presentation Clinical assignments _ _ _ _ _ _ _ _ _ _ _ _ _ _ Simulation learning, skills completion lists, presentationFloat out rotations _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Professionalism and participation

REQUIRED TEXTS AND MATERIALS

Leadership and Nursing Care Management, Huber, D. 3rd Edition

Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Harding, L. (2010). Bakersfield College Associate Degree Nursing Program. Instructional syllabus Theory and Clinical, B26

Nursing Practice Act with Regulations and Related Statutes. http://www.rn.ca.gov.

Information from www.bcmedsurg3.yolasite.com

Comprehensive Assessment and Review Program (CARP) by ATI.

The CARP textbook/resource package includes books, DVDs, practice tests with thousands of NCLEX-style questions as well as proctored exams.

*Each student will need one book of their choice from each of the following categories. Due to limited clinical space, each clinical group needs to determine who will bring which reference to share with the group.

1. Laboratory and diagnostic reference book

2. Intravenous medication book

3. General medication book

4. Pathophysiology book

5. Nursing Care plan book

PORTFOLIOS

Each student must have their portfolio immediately accessible upon request. Students can expect to present the portfolio at the beginning of each clinical rotation, and during the clinical evaluation process. The portfolio should include:

1. Copies of:

a. Physical Exam

b. TB skin test or Chest X-ray

c. Immunizations

http://www.bcmedsurg3.yolasite.com/

http://www.rn.ca.gov/

d. Current American Heart Association CPR card

2. ADN Student Handbook

3. Safety Manual

4. Conference/Anecdotal/Probation forms

5. Evaluation Forms (Clinical site/Instructor/Theory)

6. Completed clinical evaluation forms

7. Skills checklist

8. TEAS results

CLINICAL GUIDELINES

1. The student will become acclimated to the environment, including: Physical layout of the facility Location of fire alarms and extinguishers Location of supplies and equipment Charting/Documentation Nurse care plans

2. All accidents and incidents are to be reported to the clinical instructor immediately. It is the student’s responsibility to complete the proper forms and notify the Bakersfield College Health Services Office

3. BREAKS-----Instructor and team leader MUST be notified of any breaks to be taken. When you take a break, another student must watch and be responsible for your client---not the hospital staff. Students are allowed (2)15 min breaks and a 30 min lunch. break. NO OTHER OPTIONS ARE AVAILABLE. In taking a break your work MUST be done on time and be on time to post-conference.

SMOKING AREAS---None.

There is to be no drinking, eating ect.. while on unit. (against infection control guidelines)

4. You may perform procedures that an RN may legally perform once you have demonstrated competency in the skills lab and/or the clinical setting.

5. Listen to report and practice taking notes. Clarify anything that is unclear with your instructor. A verbal report to the instructor is expected on each client you are assigned, inform of significant changes also. Keep the RN informed about everything relating to your clients condition.

6. Read the hospital policy and procedure before performing any procedure. We are guest in this facility and must follow written procedures

7. Perform a physical assessment each day for each client, and chart according to the hospital policy.

8. Medications:

The six rights of medication administration will be followed at all times All medications mus tbe checked by the instructor before you give them. If the

instructor is unavailable, WITH THE INSTRUCTORS PERMISSION you may ask the staff RN to check medications.

The instructor or staff nurse must observe administration of all IV medications. Students are not to handle narcotic keys, or possess computer access numbers to the

automated medication delivery system (Pyxis, Omnicell)

9. Students are responsible for the care of the client/team. If you are unable to complete any part fo the patient care you must notify the instructor immmediately.

10. Students are expected to follow directives in code situations – code blue, red, etc.

11. Post Conference--------1430pm -1530 pm ALL STUDENTS MUST BE ON TIME TO POST-CONFERENCE UNLESS NOTIFIED OTHERWISE

12. Please turn in careplans in a manila envelope, keep all graded assignments together. All assignments will be returned to the student.

POST CONFERENCE

Post conference is an opportunity to apply the information learned in the clinical setting and fosters and enviornment for discussion and learning. Each clinical instructor is responsible for the flow and structure of post conference and may consist of:

Each student must present a verbal process paper based on a patient in clinic Verbal report of disease process Verbal presentation of Journal or news item pertinent to healthcare Field trip/site visit as prearranged by the instructor Role-play among students based on disease process preseented

”Knowing is not enough, we must apply. Willing is not enough, we must do”.Johann von Goethe

ASSIGNMENTS

SKILLS CHECKLIST

PURPOSE OF THE ASSIGNMENTThe primary objective for this assignment is to provide record keeping for all clinical skills acquired, and to facilitate new learning experiences.

LEARNING OBJECTIVE1. Demonstrate accountability and responsibility for individual leaning needs.2. Practice a series of skill sets to assist in role transition from student to entry level RN

DUE DATESkills checklist are due at the completion of each clinical rotation. (Please submit to your clinical instructor). It is the student’s responsibility to keep up to date on clinical skills checklist.

FORMATEach student is required to maintain their skills checklist throughout the entire rotation in order to fulfill course objectives. It is the student’s responsibility to keep their skills checklist with them during their clinical rotation and keep it up to date. Students are encouraged to have clinical instructors sign off the newly acquired as soon as possible

GRADING CRITERIAStudents will earn either “credit” or “no credit” for this assignment. Successful completion will be based on completion of the assignment, adhering to the format and due dates.

COMMUNITY PROJECTSStudents are required to be in full uniform during community service projects. NO EXCEPTIONS.

PURPOSE OF THE ASSIGNMENTAs a member of the profession it is part of our professional responsibility to participate in community health related events. All community projects must be approved by the instructor prior to attendance in order to receive credit for the participation.

LEARNING OBJECTIVE1. Integration of standards into aspects of patient care of the client in the community setting.2. Independently collaborate with the interdisciplinary team to uphold State and Federal

regulations

DUE DATEA 250 to 500 word typed paper highlighting the experience. The paper should include your role in the experience, and how the peer group performed as positive or negative role models in the experience. Please include if this is a function you would continue to participate in if it were not an assignment for the course completion. All students are required to participate in one (1) community project (2-4 hours) throughout the course of the semester. The written report is due no later than May 4, 2010.

FORMATThroughout the semester opportunities will arise for student participation in the community setting. Opportunities will be announced as they become available

OPTION 1Contact Beth-Anne Mulder regarding the RN explorer program and set up a time to assist in the orientation process as directed by the leader of the program.

OPTION 2Contact www.1-800-volunteer.org and identify a community service project to participate in. There are also several opportunities within the BC arena that may benefit from nursing students.

OPTION 3Contact the community service department at any local area hospital and volunteer to participate in the community activities involved.

OPTION 4Find a community project of interest to you; health care related is preferred but not totally necessary. Civil responsibility many times goes far beyond health care – clothing drives, toys drives, canned food drives, healthcare education opportunities for younger scout groups, and day care settings or possibly church activities. The program leader information for your project must be included on your written assignment of the experience.

OPTION 5Contact the volunteer services at any local hospice, home health or hospital organization to assist in preplanned health fairs or volunteer opportunities.

GRADING CRITERIAStudents will earn either “credit” or “no credit” for this assignment. Successful completion will be based on completion of the assignment, adhering to the format and due dates. Please do not take this assignment lightly; failure to earn “credit” may result in failure of NURS B26.

SIMULATED LEARNING REQUIREMENT

PURPOSE OF THE ASSIGNMENTSimulated learning provides a mechanism to practice, develop, and apply nursing care in safe interactive, and non threatening healthcare environments. This realistic experience supports critical thinking every step of the way while maintaining realistic experiences in controlled environments to produce standardized experiences.

LEARNING OBJECTIVE1. Enhance clinical skills and application at a third semester level.2. Build self confidence in application of knowledge and skills.3. Promote success as a Provider and Manager of care and a Member of the Profession.

DUE DATEEach student must turn in completed Simulation Learning Requirements no later than Tuesday May 4, 2010. FORMATAll students are required to complete a minimum of 4 hours of simulated learning experiences throughout the course of the semester. These hours are mandatory as they count towards the clinical hour’s allotment. The simulated learning experiences will be broken down into 4 hour units. Each unit will contain sections developed to enhance skill acquisition, confidence and clinical competence. Students will have 14 weeks to complete the units and simulation hours.

Please keep track of your hours and use the Positive Attendance Tracking system (PAT). A minimum of (1) one hour of high fidelity simulation in addition to one of the learning modules created for B26 must be completed in order to obtain a passing grade for this assignment.

GRADING CRITERIAStudents will be awarded 4 hours of clinical time upon completion of each unit. Partial hours will not be awarded. Remember simulation hours counts toward clinical hours, noncompliance will result in missed clinical experience and the student will receive no credit for the clinical portion of B26 and failure of the course. Successful completion will be based on completion of learning module completion, documentation of simulation completion forms and documented hours on the PAT system. Your personal log or hours is your proof should the PAT system fail to record your time successfully.

ATI/CARPComprehensive Assessment and Review Program (CARP) by ATI.

The CARP textbook/resource package includes books, DVDs, practice tests with thousands of NCLEX-style questions as well as proctored exams.

Assignments will be announced in class as they pertain to each lecture or unit as determined by lead faculty.

Documents

Bakersfield College Associate Degree Nursing …bcgentry.yolasite.com/resources/syllabus Spring 2010.doc · Web viewThe Bakersfield College Associate Degree Nursing Program is designed