Bakersfield College Associate Degree Nursing …bcgentry.yolasite.com/resources/New Syllabus FAll 2010... · Web viewAssociate Degree Nursing Program Nursing B26: Medical Surgical

BAKERSFIELD COLLEGE Associate Degree Nursing Program

Nursing B26: Medical Surgical Nursing 3Instructional Syllabus

Fall 2010

Julie Gentry MSN RN 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.

INSTRUCTOR Julie Gentry MSN FNP RN

Office hours: Monday 0930-1200 and 1500-1600 Tuesday 1330-1430 Wednesday by appointment only

Office location: MS 153 (I share an office with Ms. Folsom)Office phone: 395-4476Cell phone: 661-364-3656 (emergency only)Email: [email protected]: www.bcgentry.yolasite.com

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.

mailto:[email protected]

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 interventions.g. Integrates supportive data (labs / diagnostics) and age appropriateness when

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

h. Evaluates healthcare team’s professionalism, respect and kindness for the client’s uniqueness, developmental level, socio-cultural background, spiritual beliefs, perceptions and values. Implements corrective action.

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

passing grade of at least 80%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. Performs 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 associated with complex disease processes and is able to modify care.

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.

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

into the plan of care with minimal prompting from instructor. f. Demonstrate the ability to problem-solve in the delivery and management of care

for clients with increasingly complex disease processes.g. Integrates the diagnostic data and assessment findings and plans care for the

increasingly complex client

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, respiratory monitors, etc.

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; CPS)c. 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 basic responsibility and accountability in providing quality care within the legal and ethical boundaries of nursing. The student will develop a beginning recognition of self-limitations, as well as define 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. Conducts Nursing Services in Accordance with college, state, and federal practice standards as Safety outlined in:

b. California Nursing Practice Act (Sections 2725, 1443.5, and 70215)c. ANA Nurses Code of Ethics and Standards of Cared. Associate Degree Nursing Program Student Handbooke. HIPPA, The Joint Commission (TJC), National Patient Safety Goals, Core Measures,

Facilities policy and proceduresf. Consistently arrives punctually to clinical setting, wearing approved uniform, and

fully prepared for clinical experience, including completed care plan(s)/ assignment(s) and appropriate equipment.

g. Demonstrates clinical reasoning at the expected level. Demonstrates active participation and contribution in the clinical setting including, but not limited to, shift report, client care, multidisciplinary and/or physician rounds, and post conferences.

h. Follows appropriate chain of command.i. Demonstrates capacity to smoothly transition between the roles of followership and

leadership.j. Demonstrates ability to practice in the spirit of cooperation.

2. Demonstrates accountability and responsibility for clinical decisions and actions, and conducts practice with commitment and personal integrity.

a. Demonstrates a capacity for self reflection and independently develops strategies to master areas of deficiency.

b. Demonstrates ability to balance professional responsibilities and personal life. c. Receives constructive feedback, accepts responsibility for individual actions, develops

and implements a plan to change.

d. Follows directed learning activities as assigned and keeps scheduled appointments. When unable to keep scheduled appointments provides notification of cancellation in a timely manner.

e. Demonstrates responsibility for their own learning, and helps promote an atmosphere which facilitates maximum learning for classmates.

f. Consistently displays the nursing values of caring, integrity, altruism, social justice, and honesty.

g. Demonstrates respect for peers, staff, faculty, and acts in a manner which promotes dialogue, open communication, and positive interdisciplinary working relationships.

3. Establishes a foundation for the commitment to lifelong acquisition of knowledge and skills to effect change in health care practice and outcomes.

a. Independently and consistently seeks out instructor to cultivate and validate clinical judgment and reasoning and critical thinking skills, and demonstrates ability to accept responsibility for decisions.

b. Maintains professional requirements including, but not limited to, Portfolio, Basic Life Support Certification, PPD, TB Fit Test, Safety Packet, Skills Checklist.

c. Is a member of a professional nursing organization and / or participates in student governance committees, Student Advisory Committee, and / or faculty meetings.

d. Performs peer evaluation and communicate evaluative findings in professional manner.

e. Consistently utilizes reputable resources when transferring classroom knowledge to clinical setting for the provision of evidence based nursing practice.

f. Participates in community projects.

COURSE ACTIVITIESVarious instructional methods may include, but are not limited to, lectures/discussions, demonstrations, audiovisual aides, 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 Medical Surgical Nursing 3 (NURS 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 electronic devices 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.

Students at Porterville College: Contact the Disability Resource Center in AC115 or call (559)791-2215.

Students at Cerro Coso College: contact the Learning Assistance Center at (760) 384-6161.

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.

For the lecture component the maximum number of allowable absences is two (2). For the clinical component the maximum number of allowable absences is two (2).

Lateness is not acceptable! Please note two tardies equal one absence—no exceptions.

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.

Electronic devices other than a calculator may not be used for in-class calculations work (i.e. 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 failing grade (0) will be recorded, and the student will be directed to leave the classroom. The student is required to meet with the Director of Nursing to discuss his / her standing in the program.

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

CourseEvaluations: As mandated by the Board of Nursing, all student experiences in the program must

be evaluated. All students will evaluate the theory course and theory instructor at the completion of the course; the clinical instructor, and all clinical rotations/experiences are evaluated upon completion of the rotation. The student evaluation is done electronically using Class Climate. You can expect to receiveup to six (6) surveys for the clinical and theory portion of this course. In the event of technological difficulties, the instructor will provide the student with the Survey and the Scantron Form 20S. Failure to comply may result in delay of your grade.

STUDENT EVALUATIONEvaluation 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%(2% for ATI assignments and 2% for proctored exams)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 TEXTSNursing Practice Act with Regulations and Related Statutes. http://www.rn.ca.gov.

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

COURSE CONTENT

OUTLINE

PROFESSIONAL ISSUES AND NURSING PRACTICEI. Critical Thinking A. Demonstrate Level 3 Critical Thinking Skills 1. Nursing Process 2. Decision making 3. Problem solving 4. Evidenced based practiceII. Caring and Comfort A. Review previously learned principles of caring B. Caring in the Hematological / Oncological Environment. 1. Client. 2. Families. 3. Nurse.III. Diversity A. Reinforce diversity concepts, B. Diversity with each disease entity C Developmental level, cultural and spiritual assessment D. Nursing actions E. Outcomes of culturally congruent care.IV. Community Based Care A. Review 1. Ambulatory care 2. Home care 3. Long term care 4. Transitional care 5. Rehabilitation 6. Managed Care B. Introduce / focus 1. Home care a. Home care management with altered oxygen 2. Transitional care 3. Rehabilitation a. Pulmonary rehabilitation C. Collaborative managementV. Leadership A. Review and reinforce roles of the medical surgical nurse 1. Provider of Care 2. Manager of Care 3. Member of Profession B. Organizational Culture and Climate / Trends in Nursing

1. Definintion 2. Health care organizations by major classifications

Health care settings / types3. Quality control and quality assurance 4. Performance appraisal. 5. Risk management/ quality improvement.

C. Professional roles and responsibilities. D. Evidenced based practice E. Documentation / assessment. 1. Documentation strategies. 2. Legal ramification of documentation F. Legal / Ethical issues

1. Patient Safety and Quality Initiatives a. Standards of Competent Performance, Section 1443.5 b. NPA Business and Professions Code, Section 2725

BIOPSYCHOSOCIAL CONCEPTS RELATED TO HEALTH CARE

I. Communication / Conflict Resolution A. Conflict resolution process B. Alternatives for conflict resolutions / strategies C. Communication styles and basic leadership skills . D. Therapeutic communication techniques. E Guidelines for making effective telephone calls to physicians.II. Pain A. Types of pain 1. Mild 2. Moderate 3. Severe. 4. Intractable B. Cultural factors related to pain management. C Medical and nursing interventions related to pain. D. Implantable pumps. E. Addiction related hospitalized clients: 1. Pharmacological pain management 2. Non- pharmacological pain management. F. Safety considerations. G. Pharmacological prototypes

PROBLEMS OF OXYGENATION

I. Respiratory System A. Review Anatomy and Physiology B. Focused Health History C. Focused physical examination of the respiratory system. D. Physiological Changes with Aging E. Laboratory and diagnostics 1. CXR (lateral / decubitus) 2. CT Scan 3. Bronchoscopy 4. Nasal swab (MRSA) 5. Sputum culture 6. CBC 7. OximetryII. Alterations in function of Oxygenation A. Medical – Surgical Disorders 1. Spontaneous Pneumothorax 2. Traumatic Pneumothorax a. Open b. Closed 3. Hemothorax 4. Disorders of the Pleura a. Pleuritis b. Pleural Effusion 1. Differentiate between exudate and transudate fluid c. Empyema 5. Pulmonary Neoplasms

B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management

1. Age Appropriate Care2. Diagnostic / Laboratory Data3. Diversity4. Nutrition5. Nursing Diagnoses / Interventions6. Pharmacology7. Safety8. Surgical Management9. Teaching / Learning

III. Interventions for Clients with Problems in Oxygenation A. Chest Tubes and Drainage Systems 1. Types of chest drainage systems. a. Water seal b. Dry suction c. Wet suction d. Heimlich valve 2. Indications 3. Nursing Management 4. Complications 5. Troubleshooting 5. Collaborative Management. B. Pleurodesis 1. Indications 2. Pharmacological agents 3. Nursing Management 4. Complications 5. Collaborative Management. C. Artificial Airways 1. Airways in clinical setting, a. Oral b. Nasopharyngeal Airway c. Laryngeal Mask Airway / Combitube d. Tracheostomy D. Oxygenation Delivery Systems 1 Types of oxygen delivery systems in clinical setting. a. Bi-Level Positive Airway Pressure

b. Continuous Positive Airway Pressure E. Arterial Blood Gases 1. Normal/Abnormal Values a. Respiratory Acid / Alkalosis b. Metabolic Acid / Alkalosis 2. ABG Results manifested in Specific Client ConditionF. Suctioning 1. Maintenance and Types of Suctioning (Oral, Nasal, Pharyngeal, and Tracheal) 2. Client with Tracheostomy

PROBLEMS OF CARDIAC OUTPUT AND TISSUE PERFUSION

I. Cardiovascular System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of Cardiovascular System D. Physiological Changes with Aging E. Laboratory and diagnostics 1. BNP 2. Ultrasound 3. EKG 3. CXR 4. Chemistry panelII. Alterations in Cardiovascular Function A. Medical – Surgical Disorders 1. Cardiomyopathy a. Dilated b. Hypertrophied c. Restrictive 2. Congestive Heart Failure a. Systolic versus Diastolic b. Left versus Right c. High Output versus Low Output d. Acute versus Chronic 3. Inflammatory Heart Disease a. Infective Endocarditis b. Pericarditis c. Myocarditis d. Rheumatic Carditis 4. Shock a. Introduce and define types of shock, including: 1. Cardiogenic 2. Hypovolemic 3. Obstructive 4. Distributive B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / LearningIII. Interventions for Clients with Problems in Cardiac Function A. Cardiac Emergency 1. Crash Cart and Basic Life Support 2. Systematic Approach 3. Code Team

B. Introduction to Rapid Response Team PROBLEMS OF HEMATOLOGICAL SYSTEMI. Hematological System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of Hematological System D. Clinical Manifestations of Altered Hematological Function E. Physiological Changes with Aging F. Laboratory and diagnostics 1. CBC Differential 2. WBC Differential 3. Bone Marrow AspirateII. Alterations in Hematological Function A. Medical –Surgical Disorders

1. Leukemia 2. Lymphoma a. Hodgkin’s

b. Non Hodgkin’s 3. Lymphedema (Types)

B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

PROBLEMS OF MOBILITY, SENSATION, AND COGNITIONI. Musculoskeletal System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of Musculoskeletal System D. Clinical Manifestations of Altered Musculoskeletal Function E. Physiological Changes with Aging F. Laboratory and diagnostics II. Alterations in Musculoskeletal Function A. Medical –Surgical Disorders

1. Neoplasms (Bone Cancer) B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care

2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

PROBLEMS OF DIGESTION, NUTRITION, AND ELIMINATIONI. Gastrointestinal System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of GI System D. Clinical Manifestations of Altered GI Function E. Physiological Changes with Aging F. Laboratory and diagnostics 1. Liver Function Tests 2. Hepatitis Panel 3. Serum ammonia levels 4. Albumin 5. Amylase and LipaseII. Alterations in Gastrointestinal Function A. Medical – Surgical Disorders 1. Cirrhosis 2. Hepatitis 3. Hepatic Failure 4. Portal Systemic Encephalopathy 5. Neoplasms a. Esophageal b. Gastric c. Pancreatic d. Colorectal 6. Pancreatitis a. Acute b. Chronic B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

PROBLEMS OF REGULATION AND METABOLISM

I. Endocrine System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of Endocrine System D. Clinical Manifestations of Altered Endocrine Function E. Physiological Changes with Aging F. Laboratory and diagnostics 1. Thyroid Studies 2. ElectrolytesII. Alterations in Endocrine Function A. Medical – Surgical Disorders 1. Diabetic Ketoacidosis 2. Hyperglycemic, Hyperosmolar, Non Ketotic Coma 3. Thyroid Disease 4. Parathyroid Disease B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

PROBLEMS OF EXCRETION I. Renal System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of Renal System D. Clinical Manifestations of Altered Renal Function E. Physiological Changes with Aging F. Laboratory and diagnostics 1. BUN, Creatinine 2. Bun /Creatinine Ratio 3. Creatinine Clearance II. Alterations in Endocrine Function A. Medical – Surgical Disorders 1. Uremia 2. Renal Insufficiency 3. Chronic Renal Failure 4. End Stage Renal Failure 5. Neoplasms a. Prostate b. Renal c. Testicular B. Etiology

C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / LearningIII. Interventions for Clients with Problems in the Renal System. A. Dialysis 1. Indications. 2. General Principles of Dialysis, including concepts of: a. Concepts of diffusion b. Osmosis c. Ultra Filtration d. Permeable versus Semi – permeable membranes. 3. Types a. Peritoneal Dialysis b. Hemodialysis 4. Benefits 5. Complications 6. Nursing Interventions 7. Collaborative Management. a. Age Appropriate Care b. Diagnostic / Laboratory Data c. Diversity d. Nutrition e. Nursing Diagnoses / Interventions f. Pharmacology g. Safety h. Teaching / Learning Principles

PROBLEMS OF NEUROLOGICAL FUNCTION

I. Neurological System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Exam of Neurological System D. Clinical Manifestations of Altered Neurological Function E. Physiological Changes with Aging F. Laboratory and diagnosticsII. Alterations in Neurological Function A. Medical – Surgical Disorders 1. Inflammatory Brain Conditions a. Meningitis b. Encephalitis c. Brain Abscess 2. Myasthenia Gravis

3. Multiple Sclerosis 4. Amyotrophic Lateral Sclerosis 5. Neoplasms a. Primary b. Secondary B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

FLUID, ELCECTROLYTE, AND ACID-BASE IMBALANCESI. Intravenous Access Devices A. Differentiate Various Vascular access Devices 1. Porta-cath

2. Broviac 3. Hickman 4. Quinton Catheter

5. Central Line B. Care and Usage of access devices C. Describe care of client who is receiving TPN 1. Composition 2. Methods of Administration 3. Catheter placement 4. Potential Complications 5. Nursing Management D. Long term antimicrobial therapy. E. Chemotherapy treatments (described within each neoplasm system) F. Define and introduce: 1. TPN 2. PPN 3. Lipids G. Methods of Parenteral Replacement and Related Care.II. Fluid and Electrolytes A. Signs and symptoms of: a. Hypo / Hypercalcemia b. Hypo / Hyperphospatemia

PROBLEMS OF IMMUNE SYSTEM I. Immune System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Examination of Integumentary System

D. Clinical Manifestations of Altered Integumentary Function E. Physiological Changes with Aging F. Laboratory and diagnostics

1. Rheumatoid factor 2. Antinuclear antibody 3. Erythrocyte Sedimentation Rate 4. Serum protein electrophoresis 5. Serum complement 6. Immunological tests

II. Alterations in Immune Function A. Medical – Surgical Disorders 1. SLE 2. Neoplasms B. Etiology C. Pathophysiology D. Clinical Manifestations E. Complications F. Collaborative Management 1. Age Appropriate Care 2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

PROBLEMS OF INTEGUMENTARY SYSTEM I. Integumentary System A. Review Anatomy and Physiology B. Focused Health History C. Focused Physical Examination of Integumentary System D. Clinical Manifestations of Altered Integumentary Function E. Physiological Changes with Aging F. Laboratory and diagnostics II. Alterations in Integumentary Function A. Medical – Surgical Disorders 1. Malignant Skin Disorders a. Melanoma b. Basal Cell c. Squamous Cell d. Actinic Keratosis B. Etiology (Adult and Child) C. Pathophysiology D. Clinical Manifestations 1. Classifications 2. Causative agents. 3. Phases E. Complications F. Collaborative Management 1. Age Appropriate Care

2. Diagnostic / Laboratory Data 3. Diversity 4. Nutrition 5. Nursing Diagnoses / Interventions 6. Pharmacology 7. Safety 8. Surgical Management 9. Teaching / Learning

CLASS SCHEDULECALENDAR

WEEK DATE Unit Topic Class meets Tuesdays from 0800-1030 Notes

Week 1Aug 23

IntroductionUnit 1&2

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

Week 2 Aug 30 Unit 12 Problems of Protection

Week 3 Sept 6 No class….Holiday

Week 4 Sept 13 Unit 11 Fluid, Electrolytes, and Acid-Base ImbalancesTest Unit 1, 2 and 12

Week 5 Sept 20 Unit 3 Problem of Oxygenation (1)

Week 6 Sept 27 Unit 3 Problem of Oxygenation (2)Test Unit 11 and 3

Week 7 Oct 4 Unit 4 Problems of Cardiac Output and Tissue Perfusion

Week 8 Oct 11 MID TERM MID TERM all material to date will be coveredYou will have the whole class time for exam

Week 9 Oct 18 Unit 5 Problems with Hematological System

Week 10 Oct 25 Unit 6 Problems of Mobility, Sensation, and Cognition

Week 11 Nov 1 Unit 7 Problems of Digestion, Nutrition, and EliminationTest Unit 5 & 6

Week 12 Nov 8 Unit 8 Problems of Regulation and Metabolism

Week 13 Nov 15 Unit 9 Problems with ExcretionTest Unit 7, & 8

Week 14 Nov 22 Unit 10 Problems of Neurological Function

Week 15 Nov 29 ATI Testing Specific times and dates to be announced

Week 16 Dec 6 Final ExamFinal exam date is subject to change Final Exam on MONDAY Dec 6 1200-1350

ASSIGNMENTS

WEEK Due DATEAll due by midnight on

assigned date

Unit Topic Class meets Mondays from 1200-1450

FMS- Focused Med-surg from ATI/CARP

Notes

Week 1

Wed Aug 25

IntroductionUnit 1& 2

Read ATI Leadership bookFMS- Leadership and PharmacologySelect Reading in Huber text

Level objectives project due Tu. Aug 31Medication exam 100% completion due

Week 2 Wed Sept 1 Unit 12 Read Ch. 14 L & BFMS- Immune

Week 3 Wed Sept 8 HOLIDAY Week

Week 4 Sept 15 Unit 11Read Ch 10 L & BFMS- Fluid and ElectroytesTest Unit 1, 2 and 12

Week 5 Sept 29 Unit 3Read ch 36-39 L & BFMS-Respiratory

Week 6 Sept 29 Unit 3Test Unit 11 and 3

FMS-Respiratory

Week 7 Oct 6 Unit 4Read ch 30-32 L & BFMS-Cardiovascular

Week 8 Oct 12

MID TERM MID TERM all material to date will be coveredYou will have the whole class time for exam

Week 9 Oct 20 Unit 5Read ch 33-35 L & BFMS-Nutrition

Week 10

Oct 27 Unit 6Read ch 40-42 L & BFMS-Perioperative

Week 11

Nov 3 Unit 7 Read ch 23-26 L & BTest Unit 5 & 6FMS-Gastrointestinal

Week 12

Nov 10 Unit 8Read ch 18-20 L & BFMS-Endocrine

Week 13

Nov 16 Unit 9Read ch 27-29 L & BTest Unit 7, & 8FMS- Renal and Urinary

Week 14

Nov 24 Unit 10Read Ch 43-46 L & BFMS-Neuro Musculo

Week 15 Nov 30 ATI Testing Community service project due

4 hr simulation dueWeek 16 FINALS WEEK FINAL

ExamFinal Exam Thursday Dec 9 0800-0950

ASSIGNMENTS

Weekly ATI/CARP assignements as noted in the topical outline.

Week 1 (Aug 23-25)The student must pass with 100% a medication administration exam by the third attempt. Studetns will not be allowed in the clinical setting without successful completion of the exam.

Aug 31, 2010Level objectives project

The purpose of this assignment is to allow the student to identify and differentiate level 2 and level 3 nursing. Review each section in the ADN student handbook and identify in practical terms the difference of each. This should be approx one page in length and cover provider of care, manager of care and member of the profession. The student may also look at the level 3 clinical evaluation form and compare it to the level 2 evaluation to lead the thought process.

Ex. “As provider of care the level 3 student will proactively prioritize potential complications of a client with increasingly complex problems instead of simply providing care as described in level 2. An example of this would be to prepare to act quickly if a pt admitted with a headache related to a brain tumor, were to have a seizure. Critical thinking leads the level 3 student to anticipate that a complication of a brain tumor would be possible seizure.”

In addition to the level objectives, the student must submit an electronic picture of themselves. It can be emailed together to [email protected] or turned in during the regular class time on Aug. 31, 2010.

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 November 30, 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. This option MUST be approved by your instructor prior to completion to achieve credit.

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 November 30, 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.

UNIT 1 Professional Issues and Nursing Practice

Column I Column II Column III Column IVTheory Objectives Learning Activities Clinical Objectives Clinical Activities

(Expected competencies/skills)1. Analyze and expand on what

the term advocacy means and also demonstrate its concept.

2. Outline the roles and concepts of the perioperative nurse.

3. Define evidence based practice, and understand the benefits of using evidence based practice vs. non-evidence based practice.

4. Develop and Practice ways to convey caring thru presence, touch and active listening.

5. Review and reinforce ways to use appropriate communication skills.

6. Distinguish the differences between ambulatory care, home care, long term care, rehabilitation and managed care

7. Formulate guidelines that will help the nurse meet legal responsibilities related to ethical dilemmas.

8. Reinforce diversity and cultural concepts related to clients.

9. Define and identify the nurses’ role in quality control, quality assurance and quality improvement.

10. Diagram guidelines for conducting an effective appraisal interview.

Read the following:1. Huber, pg. 231-2322. Lemone and Burke, pg 12-153. Huber, pg 461,473-474 5. Huber, pg 412-4136. Lemone and Burke Chp 37. Huber, pg 744-7458. Huber, pg 610-6149. Huber, pg. 843-84611. Huber, pg . 860-86112. Huber, pg. 546-55015. Huber, pg. 100-10117. Huber, pg 220

1. Provide and manage total nursing care for adult and geriatric clients and families with moderate to high acuity using effective communication skills in assessment and implementation.

2. Demonstrate professionalism by being accountable in the total nursing care provided to all client’s cared for during the rotation.

3. Implement the role of the perioperative nurse under direct supervision of an RN.

4. Identify and implement health teaching for all clients with moderate to high acuity with disease processes presented in Level III Medical-Surgical Nursing course.

5. Identify vital sign and physical assessment parameters for all clients during the Level III Medical-Surgical Nursing course rotation.

6. Demonstrate level 3 nursing interventions for all clients with moderate to high acuity during the

1. Actively participate in all assigned clinical activities as described in the Clinical Manual of the syllabus.

2. Students must successfully achieve 100% on the level 3 medication exam in order to participate in the clinical setting.

3. The student must submit at least one page narrative comparing and contrasting the level 2 vs level 3 roles of the nursing student as: Provider of care, Manager of Care and Member of the profession.

Take the practice leadership exam on ATI in preparation for your first exam.

FMS- leadership and pharmacology

Due by Midnight Wed Sept 1

11. Define risk management and how it relates to quality improvement

12. Formulate guidelines for effective delegation and discuss why nurse managers fail to delegate and the implications for nursing practice.

13. Apply techniques that will assist in making effective assignments.

14. Differentiate between learning and understanding and discuss the implications of each.

15. Design a personal plan to deal effectively with personal and professional stress, and also formulate a plan for keeping organized when in the role of a nurse .

16. Develop techniques that will assist the nurse leader in encouraging positive team participation.

17. Differentiate between a policy and a procedure .

18. Apply the nursing process to assessing the needs of the health care team members.

Level III Medical-Surgical Nursing course rotation.

7. Under supervision, proficiently deliver PO, SQ, IM, topical, and IV medications.

8. Proficiently care for 2 clients after receiving clinical assignment the night before.

9. Present an ethical dilemma encountered in student’s own experience.

10. Demonstrate ways to convey caring thru presence, touch and active listening.

UNIT 2 Bio-psychosocial Concepts related to Health Care


(Expected competencies/skills)1. Differentiate between

aggressive, assertive, passive and responsive behavior and determine the effects of each.

2. Analyze how effective communication principles relate to leadership and management.

3. Formulate guidelines for making effective telephone calls to physicians.

4. Differentiate between types of pain and therapies for mild, moderate and severe pain.

5. Describe pain management for the oncological client

6. Reinforce cultural factors related to pain management.

1. Huber, Chp. 244. Lemone and Burke, pg. 173-1775. Lemone and Burke, pg 381

Lemone and Burke CH 9

1. Develop a plan of care for a patient utilizing a PCA pump for pain management.

2. Review and implement the facility protocol for PCA pumps and the required nursing assessment and interventions.

3. Develop and implement a plan of care incorporating pharmacological and non-pharmacological pain control interventions for a client in pain.

4. Utilize pain assessment tool for client in pain and devise nursing interventions.

5. Demonstrate appropriate pain assessment/ treatment documentation

2.3. 6. Apply effective

communication techniques when speaking with physicians and other healthcare providers.

1. Student will perform role as team leader to include: making assignments, relieving breaks, and other duties to ensure team success in the clinical setting.

FMS- leadership and pharmacology

Due by Midnight Wed Sept 1

UNIT 3 –Problems of Oxygenation


(Expected competencies/skills)1. 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.

Read chapter 36-39 1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer

2. 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.

1. Practice set up and evaluation of chest tube in skills lab.

2. Complete the learning module on ABG interpretation.

FMS Respiratory Due September 29 at Midnight

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.

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 Perfusion



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.


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

Read Chapter 30-32 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

Complete ATI FMS: Cardiovascular

Due MN Oct 6

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.

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 with Hematologic System



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.


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-Hodgkin’s lymphomas and describe nursing interventions for each.

Read Ch 33-35 1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

2. 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

FMS Nutrition Due 10/20 MN

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 Cognition



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.

Read ch 40-42 1. 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.


FMS Perioperative Due 10/27 MN

UNIT 7 –Problems of Digestion, Nutrition and Elimination



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.

Read ch 23-26 1. 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

FMS Gastrointestinal Due 11/3 @ MN

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 Metabolism



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.


5. Identify abnormal findings that may indicate malfunction of the glands 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

Read ch 18-20 1. Identify assessment abnormalities in clients with moderate to high acuity with following 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

FMS: Endocrine Due 11/10@MN

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

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 with Excretion


(Expected competencies/skills)1. Review the anatomy,

physiology and function of the genital urinary system.


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.

Read CH 27-29 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

FMS: Renal and UrinaryDue 11/17@MN

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 Neurologic Function



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

Read Ch 43-46 1. Identify assessment abnormalities in clients with moderate to high acuity with following 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

FMS Neuro/musc Due 11/24@MN

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.

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, Electrolytes and Acid-Base Imblances


(Expected competencies/skills)1. 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 devices

i. PICC Linesii. Port-a-cath

iii. Hickman5. 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

Read Ch 10 1. Care for patients with intravenous access’s

2. 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 transfusion

8. Practice and/or use the

FMS Fluid and electrolytes Due 9/15@MN

computerized charting in the clinical setting.

UNIT 12 –Problems of Protection/Regulation- Cancer


(Expected competencies/skills)1. 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 agents

8. 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.

Read Ch 14 1. 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

FMS: Immune Due 9/8 @MN

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.

CLINICAL MANUAL

BAKERSFIELD COLLEGE Associate Degree Nursing Program

Nursing B26: Medical-Surgical Nursing 3Clinical Manual

Julie Gentry MSN FNP RN

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 protected] : www.bcmedsurg3.yolasite.com www.bcgentry.yolasite.comPhone:(661) 395-4728:cell (661)246-6587 (661) 395-4476; Cell (661) 364-3656Location: M S Building Room 175 M S Building Room 153Office Hours: Tuesday 1030-1430&1630-1730 Monday 1100-1600

(may be extended if no staff meeting) Wed by appt only

Address: 1801 Panorama Drive 1801 Panorama DriveBakersfield, 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 COLLEGEAssoc. Professor Lisa Harding, MSN RN CEN Mercy Hospital Truxtun AvenuePhone: (661) 395-4728; Cell (661) 246-6587 (4 West)

Assoc. 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)

Kristy Doty RN San Joaquin Community HospitalCell: (661) 623-6975 (4 South)

Kristina Hunt RN Kern Medical Center (3 South) and SJCH (4S)Cell:

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



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 (1)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

Gentry, J. (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.bcgentry.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

d. Current American Heart Association CPR card

2. ADN Student Handbook

http://www.bcgentry.yolasite.com/

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

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

Documents

Bakersfield College Associate Degree Nursing …bcgentry.yolasite.com/resources/New Syllabus FAll 2010... · Web viewAssociate Degree Nursing Program Nursing B26: Medical Surgical