HEALTH PROFESSIONS NURSING EDUCATION PROGRAM NRS 230 ALTERATIONS IN HEALTH V … · 2019-08-19 · C. Revise your preliminary plan as needed using data obtained in report, from the

HEALTH PROFESSIONS

NURSING EDUCATION PROGRAM

NRS 230

ALTERATIONS IN HEALTH V

COURSE OUTLINE

FALL 2016

2

COURSE OUTLINE

Course Number NRS 230 Course Title: Alterations in Health V

Credits:

Weeks:

3 Hours: 3 Theory Hours

5 3 College Lab Hours

14 Clinical Lab Hours

Catalog description:

This 5-week course is a continuation of the alterations in health conception framework with an emphasis on

the concepts of elimination, oxygenation and perfusion. The concepts of shock and multisystem organ

failure are also examined. Includes selected clinical experiences in area health care agencies.

3 lecture/3 college laboratory/14 clinical hours

Prerequisites: NRS 110, NRS 120, NRS 121, NRS 122, NRS 220, NRS 221, and NRS 222 with a

minimum grade of 76

Corequisites: None

Required Textbooks and Materials:

Adams, M.L., Holland, L.N. & Urban, C.Q. (2014). Pharmacology for Nurses A

Pathophysiologic Approach. (4th ed.) Upper Saddle River: Pearson.

North Carolina Custom Edition, (2015). Nursing Skills for a Concept-Based Approach to

Learning. New York: Pearson Learning Solutions.

North Carolina Concept-Based Learning Editorial Board. (2015). Nursing A Concept-Based

Approach to Learning, Volumes One & Two. Upper Saddle River: Pearson.

Pickar, G.D., Abernethy, A.P. (2013) Dosage Calculations. (9th ed.) Clifton Park: Thompson

Delmar Learning.

NRS 230 Course Outline. Download from nursing website at www.mccc.edu/nursing

NRS 230 Lab manual. Download from the nursing website at www.mccc.edu/nursing

http://www.mccc.edu/index.shtml

http://www.mccc.edu/index.shtml

http://www.mccc.edu/nursing


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Recommended Textbooks:

American Psychological Association. (2010) Publication Manual of the American Psychological Association. (6th ed.). American Psychological Association: Washington D.C.

Revised: December 2012, July 2013, December 2013, July 2014, January 2015, July 2015,

January 2016, July 2016

Course Coordinator:

Lisa M. Dunn MSN/Ed, RN, CCRN, CNE, EdD (c)

Office: MS 149

Telephone: 609-570-3379

E-mail: [email protected]

Information Resources:

Nursing Program website – www.mccc.edu/nursing

Mercer Online (Blackboard) - https://mccc.blackboard.com/

Evolve-HESI – http://evolve.elsevier.com (for case studies & practice exams)

Pearson – http://www.pearsonhighered.com/nursingresources/products/index.html

The mynursingkit resources will now be accessed using the above cite. The course

coordinator will be providing you with directions to access this cite.

NCSBN NCLEX-RN Detailed Test Plan –

https://www.ncsbn.org/2016_RN_Test_Plan_Candidate.pdf

General Education Knowledge Goals:

Goal 1. Communication. Students will communicate effectively in both speech and writing.

Goal 2. Mathematics. Students will use appropriate mathematical and statistical concepts

and operations to interpret data and to solve problems.

Goal 3. Science. Students will use the scientific method of inquiry, through the acquisition

of scientific knowledge.

Goal 4. Technology. Students will use computer systems or other appropriate forms of

technology to achieve educational and personal goals.

Goal 5. Social Science. Students will use social science theories and concepts to analyze

human behavior and social and political institutions and to act as responsible citizens.

Goal 8. Diversity. Students will understand the importance of a global perspective and

culturally diverse peoples.

Goal 9. Ethical Reasoning and Action. Students will understand ethical issues and

mailto:[email protected]


http://evolve.elsevier.com/

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situations.

MCCC Core Skills:

Goal A. Written and Oral Communication in English. Students will communicate

effectively in speech and writing, and demonstrate proficiency in reading.

Goal B. Critical Thinking and Problem-solving. Students will use critical thinking and

problem solving skills in analyzing information.

Goal C. Ethical Decision-Making. Students will recognize, analyze and assess ethical

issues and situations.

Goal D. Information Literacy. Students will recognize when information is needed and

have the knowledge and skills to locate, evaluate, and effectively use information for college

level work.

Goal E. Computer Literacy. Students will use computers to access, analyze or present

information, solve problems, and communicate with others.

Goal F. Collaboration and Cooperation. Students will develop the interpersonal skills

required for effective performance in group situations.

Goal G. Intra-Cultural and Inter-Cultural Responsibility. Students will demonstrate an

awareness of the responsibilities of intelligent citizenship in a diverse and pluralistic society,

and will demonstrate cultural, global, and environmental awareness.

Program Student Learning Outcomes:

Guided by these principles and beliefs, Mercer County Community College provides a

program that prepares graduates who will function with technical competence within various

care settings. The graduate will:

P1. Function within the provisions of the Nurse Practice Act while maintaining the Code

of Ethics and accepting responsibility for self-growth and life-long learning.

P2. Assess the patient’s health status in a comprehensive and holistic manner.

P3. Analyze, synthesize and evaluate patient-related data to develop and implement

individualized patient care and teaching plans.

P4. Provide safe physical and psychological care to each patient incorporating

documented Best Practices to formulate clinical judgments and management

decisions.

P5. Evaluate the achievement of patient outcomes.

P6. Incorporate within nursing practice advocacy for patient’s rights, taking into

consideration cultural diversity, socioeconomic and political forces.

P7. Collaborate with others to respond to the needs of individuals, families, and groups

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across the health-illness continuum.

P8. Use effective verbal and written communication skills, incorporating lifespan

considerations.

P9. Manage health care for the individual using cost effective nursing strategies, quality

improvement processes and current technologies

Level Student Learning Outcomes

LII.1 Model nursing practice within the provision of the Nurse Practice Act, Nursing

Standards of Care, and the Nursing Code of Ethics.

LII.2 Generate an individualized patient plan of care from data collected in a

comprehensive and holistic assessment.

LII.3 Synthesize all patient related date to evaluate an individualized patient plan of care.

LII.4 Select clinical judgments and management decisions based on Nursing Standards of

Care.

LII.5 Evaluate the achievement of patient outcomes on the patient’s plan of care.

LII.6 Select interventions that address advocacy for patient’s rights.

LII.7 Examine how collaborative care effectively meets the needs of individuals, families

and groups.

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Course Student Learning Outcomes:

C1. Demonstrate professional nursing practice by functioning as part of the multidisciplinary

team within the provisions of the Nurse Practice Act, Nursing Standards of Care, and the

Code of Ethics in all healthcare settings when caring for groups of patients with

alterations in elimination, oxygenation, and perfusion. (Maps to Program Objective

1,2,3,4,5,6,7,8,9; Level Objective 1,2,3,4,5,6,7) (Core Skills A, B, C, D, E, F, G; Gen Ed

Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

C2. Examine his/her own knowledge accepting responsibility for self-growth and life-long

learning. (Maps to Program Objective 1, 8; Level Objective 2,3,4) (Core Skills A, B, C,

D, E, F, G; Gen Ed Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

C3. Analyze and evaluate all health-related data when assessing patients with alterations in

elimination, oxygenation, and perfusion. (Maps to Program Objective 2,3,4,5; Level

Objective 2,3,4,5) (Core skills A, B, D, E, F, G; Gen Ed Knowledge Goals 1, 2, 3, 4, 5, 8,

9)

C4. Incorporate critical thinking and evidence-based practice when using clinical judgment to

plan and implement individualized patient care and teaching plans based on priorities for

groups of patients with alterations in elimination, oxygenation, and perfusion. (Maps to

Program Objective 4,9; Level Objective 4,7) (Core Skills A, B, C, D, E, F, G; Gen Ed

Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

C5. Provide safe physical and psychological care to groups of patients across the life-span

integrating documented Standards of Care to formulate clinical judgments and

management decisions for patients with alterations in elimination, oxygenation, and

perfusion. (Maps to Program Objective 1,2,4,7; Level Objective 1,2,4,7) (Core Skills A,

B, C, D, E, F, G; Gen Ed Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

C6. Analyze data to evaluate the achievement of therapeutic outcomes based on the

individualized patient plan of care, revising as appropriate. (Maps to Program Objective

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3,4,5; Level Objective 3,4,5) (Core Skills A, B, C, D, E, F, G; Gen Ed Knowledge Goals

1, 2, 3, 4, 5, 8, 9)

C7. Act as a patient advocate when managing the care of patients. (Maps to Program

Objective 7; Level Objective 5,6) (Core Skills A, B, C, D, E, F, G; Gen Ed Knowledge

Goals 1, 2, 3, 4, 5, 8, 9)

C8. Relate the principles of collaboration as a member of the multidisciplinary team in

responding to the needs of individuals, families, and groups across the health-illness

continuum. (Maps to Program Objective 6,7; Level Objective 2,6,7) (Core Skills A, B,

C, D, E, F, G; Gen Ed, Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

C9. Demonstrate expertise in the use of verbal and written communication, incorporating life-

span considerations, when providing care to a diverse patient population. (Maps to

Program Objective 8; Level Objective 2,5) (Core Skills A, B, C, D, E, F, G; Gen Ed,

Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

C10. Correlate principles of cost-effectiveness, quality improvement processes, and current

technologies when managing health care for diverse patient populations. (Maps to

Program Objective 9; Level Objective 6) (Core Skills A, B, C, D, E, F, G; Gen Ed,

Knowledge Goals 1, 2, 3, 4, 5, 8, 9)

Nursing Program Concepts:

Accountability: The acceptance of responsibility for the outcomes of care as a result of the

actions or inactions of self or others within the context of delegation.

Cellular Regulation: The process that controls the series of events by which a cell goes through

a cell cycle.

Coping: The individual’s response tone or more stressors and their attempt to restore

homeostasis. (Pearson, pg. 1794)

Elimination: The process of and ability to rid the body of waste.

Immunity: The body’s natural reaction to infection.

Intracranial Regulation: the ability of the cranial contents (brain, blood, cerebral spinal fluid)

to maintain normal intracranial pressure.

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Metabolism: All physical and chemical processes that converts or uses energy.

Mobility: Making the most of the patient’s ability to use his/her musculoskeletal system.

Oxygenation: The means by which the body is able to supply oxygen to all cells of the body.

Perfusion: The process by which oxygen and nutrition are supplied to cells and tissues in the

body.

Pharmacotherapeutics: The use of medicine and its effects to treat and promote improved

health and wellness.

Self: One’s sense of being that distinguishes them from others.

Sensory Perception: The purposeful organization and translation of stimuli into meaningful

information.

Stress: The body’s reaction to any stimulus in the environment that demands change or disrupts

homeostasis.

Tissue Integrity: Includes integumentary, mucous membrane, corneal and subcutaneous tissues,

unbroken by wounds.

Integrated Concepts:

In addition, the MCCC Nursing Program has identified the following concepts as

integrated into all professional phase nursing courses:

Acid Base Balance: The method by which the acidity and alkalinity of body fluids are kept in a

state of balance.

Clinical Decision Making: The use of critical reasoning that involves interpretation, analysis,

inferences, explanation and evaluation.

Comfort: A state of physical ease and freedom from discomfort whether physiological, social, Psychospiritual, or environmental.

Communication: Communication is a process of exchanging ideas, information and feelings.

Diversity: Unique variations among and between individuals, as well as those defined by

genetics and cultural background, but are refined by experience and personal choice.

Evidence Based Practice: The practice of health care in which the health care provider uses the

most current and valid research findings as the basis for clinical decisions.

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Family: Individuals who are joined together by bonds of emotional closeness, sharing and

support.

Fluid & Electrolytes: Maintenance of homeostasis (fluid balance) in the body in relation to

electrolyte values.

Grief: The total response to the emotional experience related to loss. (Pearson, pg. 601)

Leadership: A process whereby a person with clear vision and knowledge inspires others to

work together toward goal achievement.

Loss: An actual or potential situation in which something that is valued is altered or no longer

available.

Nursing Informatics: The processing of health and biomedical information through the

acquisition, storage, and retrieval of such data.

Pharmacotherapeutics: The use of medicine and their effects to treat and promote improved

health and wellness.

Professional Behaviors: Actions that define the practice of nursing whereby the nurse will

act professionally, gain knowledge, maintain competence, work well as a team member, show

compassion, reflect a positive attitude, and maintain integrity of self and the nursing profession.

Quality Improvement: Organized process of planning and implementing ongoing methods

aimed at providing safe, effective, patient-centered care that is timely, efficient and benefits all

equally.

Safety: Protection from harm or injury. The goal of the caregiver is to create an environment in

which one is able to provide safe patient care.

Self: One’s sense of being that distinguishes them from others.

Evaluation of Student Learning / Grading Information

Course Requirements:

Students are expected to take an active role in the learning process. Assigned readings need to

be completed prior to the scheduled lab or class.

Completion of all tests, written assignments, and visual evaluations as listed in the course outline by weeks indicated and in accordance with Nursing Program Policies.

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It is the responsibility of each student to be up to date on all content in order to progress from one clinical experience to another. The student must comply with all visual evaluation schedules. A comprehensive final examination will be given at the end of the course. Attendance: Students in nursing courses are required to attend all lecture, college

laboratory and clinical laboratory sessions. Attendance records will be maintained. Please

review Nursing Program Handbook, Attendance Policy. Clinical absences for a 12-hour

clinical experience are the equivalent to two (2) absences and will be recorded as such.

Attendance:

Students in nursing courses are required to attend all theory, college laboratory, clinical

laboratory and observation sessions. Attendance records will be maintained. Please review full

attendance policy in the Nursing Program Handbook.

Theory: Classroom sessions are based on learning objectives from the course outline.

Classroom sessions are 3 hours per week. Textbook readings are assigned based on weekly

learning objectives listed in the course outline and should be completed prior to the class session.

Interactive learning activities will be included with each large class sessions. Cell phones should

be shut off during class sessions. During testing cell phones, or any other electronic device must

be turned off and placed in the front of the room with personal belongings. Recording any class

session is at the discretion of the instructor. Permission to tape should be obtained prior to the

beginning of class.

HESI Exam: Medical/surgical exam will be given in this course. The exam must be completed

prior to progressing into NRS 240. This is a web exam which requires your evolve login and

password to access the exam. Students are expected to achieve a score of 850 on the exam. The

exam percentage score will be calculated into your final grade for the course (10%). Students

will be required to complete the medical/surgical practice test, which can be accessed on the

evolve website under “case studies”, before they will be able to sit for this HESI exam. If you

need additional assistance in accessing the case studies or practice tests, please see the NRS 230

course coordinator.

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Guidelines for Written Assignments:

Mercer County Community College

NRS 230 Simulation Journaling Activity

Grading Rubric and Guidelines

The purpose of journaling is to give the student the opportunity to reflect back on the

simulation event and consider what was learned, what was successful or done well and what

areas of content/skills are weak and could use more practice or study. Each student is required

to submit this journal, by email in a word document, within 24 hours of the completion of

the lab. Students will receive feedback from the instructor each week. This journaling activity

represents 5% of your course grade and is evidence of having met the day’s/week’s lab

simulation objectives. It is important that you take it seriously spending the appropriate amount

of time in this activity and truly reflect on the learning that has occurred.

GRADING RUBRICS FOR REFLECTION JOURNAL ENTRIES

REFLECTION JOURNAL RUBRIC Category Description Point Value Mechanics Well written, clear organization, uses standard English grammar, contains minor, if any, spelling errors, uses APA format.

Well-written and well-organized 2 Inadequate due to lack of organization, grammar, and/or major spelling errors, errors in APA format

1

MECHANICS – TOTAL POSSIBLE 2 Evidence of Critical Thinking Critical thinking includes application, analysis, synthesis and evaluation. Arguments are clear and show depth of insight into theoretical issues, originality of treatment, and relevance. May include unusual insights. Arguments are well supported.

Demonstrates critical thinking and the ability to apply concepts

3

Demonstrates some critical thinking and application of concepts

2

Shows minor or incorrect application of concepts

1

CRITICAL THINKING – TOTAL POSSIBLE 3 Development of Ideas Well-developed thoughts, ideas, and details, which shows evidence of reflection, new ideas, and grasp of

Well-developed; shows evidence of reflection and/or metacognition; new ideas introduced and reflects a good grasp of concepts presented.

3

Shows some evidence of reflection, but 2

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concepts. not well-developed; few new ideas introduced but reflects a grasp of concepts presented. Not much thought or detail; shows little evidence of reflection or grasp of concepts; no new ideas introduced.

1

DEVELOPMENT OF IDEAS – TOTAL POSSIBLE 3 Timeliness Submitting by stated due date

Submitted within 24 hours of deadline 2 Submitted no more than 24 hours after deadline

1

Submitted more than 24 hours after deadline or not submitted

0

TIMELINESS – TOTAL POSSIBLE 2

OVERALL TOTAL POSSIBLE FOR REFLECTION JOURNAL 10

Below are some suggestions on topics to be considered (but not limited to) in the journal

writing.

Was there anything during the lab experience that was confusing to you? What was it?

How did you handle that situation? Was there anything you could have done to better

prepare yourself?

Was there any time during the lab when you didn’t know what to do? How did you feel?

What would you do differently having had this experience?

Was there anything about the lab experience that troubled or disturbed you? What was

it? What will help make it easier for you to deal with this experience in the future?

Was there anything about the lab experience that made “the light bulb come on” -

something that made the content clearer to you? What was it and explain what happened

to illuminate your understanding?

Do you still have questions about the topic/content? What are they? How will you

resolve these questions?

How did today’s experience assist you in meeting the course/topic/program objectives?

Evolve Cases Studies:

None

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College Lab: This weekly lab is designed to help the student in application of prioritizing,

critical thinking, problem solving, planning, and application of patient care in a controlled setting

utilizing case study, simulation and critical thinking. Weekly readings, objectives, and activities

will be highlighted in the NRS 230 course outline. Assigned readings will be taken from your

formal text workbook, relevant journal articles, and skills text. The student is required to submit

a reflective journal after the simulated experience by email in a word document, within 24 hours

of completing the lab. The student will use the journal grading rubric to complete this

assignment. There are two reflective journals required for this course. These assignment are

worth 5% of the student’s total grade and will require a passing grade for learning to take place.

Clinical Lab: The clinical laboratory provides students with the opportunity to provide care to

patients in order to meet course goals. Preparation for clinical lab will focus on clinical

objectives listed in the course outline. The clinical lab is held at the assigned clinical facility. In

general, during the clinical lab, students are expected to:

Preconference:

None.

Clinical Experience: (on clinical unit)

A. Receive report on assigned patient, review medical record.

B. Assess your assigned patient.

C. Revise your preliminary plan as needed using data obtained in report, from the medical

record, and your assessment of the patient.

D. Implement the nursing plan by caring for your patient demonstrating proficiency in nursing

skills and seeking help from your instructor. (Refer to weekly clinical objectives in course

outline)

E. Administer medications as assigned by clinical instructor and coordinated with primary RN.

F. Report assessment findings to appropriate assigned nursing staff in a timely manner.

G. Document assessment and care as instructed and in accordance with facility policy.

H. Patient information received during clinical lab is to remain confidential at all times. Patient

records are not permitted to be photocopied.

Post Conference: One Hour:

A. Review and evaluate the care given and the patient's response to care plan.

B. Discuss revisions that should be made in your plan to improve care.

C. Discuss application of clinical objectives to your patient.

Testing Procedures

The course midterm theory exam will be given during the first hour of lecture. Final exams will

be given in the fifth week of class. The time and location will be determined by the course

coordinator. Students will have 1.5 minutes per question and 2 minutes per drug calculation

question to complete the midterm and final exams. All belongings, including but not limited to

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backpacks, books, purses, cell phones, and electronic devices are to be placed in the front of the

lecture hall. Seating during the exam is at the discretion of the instructor or exam proctor. All

cell phones are to be turned off during the exam period and stored at the front of the lecture hall

with the rest of your belongings. All coats and hats are to be removed during the exam period.

Please refer to nursing program testing policy in the Nursing Program Handbook for further

information.

Quiz Procedure: A quiz will be given at the beginning of class for weeks 1, 2, and 4 covering

the assigned readings for lecture that week. The quizzes will test factual knowledge. The

questions will come from the information in your assigned textbooks. Students will have 1

minute per question to complete the quiz. If a student is late for class, no additional time will be

given to take the quiz. If a student completely misses the quiz, a zero grade will be given for that

quiz. There will be no make-up quizzes. A quiz will not be given in week three or week five;

the midterm and final exam will be given these weeks. Review of the quiz will occur

immediately after its completion.

Dosage Calculation Math Requirement: All NRS 230 students will be required to pass a

dosage calculation exam which will be given during clinical the first week of the course. The

pass standard is 90 %. Dosage calculation problems will include all types learned in previous

nursing courses. The grade is pass/fail and will not be incorporated into the final grades of the

course.

Determination of NRS 230 Grade:

In order to receive a grade in NRS 230, these criteria must be satisfied:

(A) The simulation journal using the Journal Grading Rubric which is located in the NRS 230 Lab

Manual and in this course outline. The average of the two journals will be incorporated into the final

grades of the course and count as 5% of the final grade.

(B) Tests, quizzes, and the HESI must be taken as scheduled. A grade of 76% or better should be

maintained on all tests.

(C) Students must meet all the clinical objectives.

When all course criteria have been met, the student will be assigned a grade as outlined in

Evaluation of Student Learning - Grading.

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Grading:

HESI-10%

Mid-term- 30%

Final Exam- 45%

Quizzes – 10% (average of three quizzes)

Journal – 5% (average of two journals)

Grading Scale:

A = 93% - 100%

A- = 90% - 92.99%

B+ = 87% - 89.99%

B = 83% - 86.99%

B- = 80% - 82.99%

C+ = 77% - 79.99%

C = 76% - 76.99% (C= Pass)

C = 70% - 75.99% (C = Non-pass)

D = 60% - 69.99%

F = 0% - 59.99%

76% is the lowest acceptable passing grade for students in the 5 week curriculum

I = Incomplete

W = Withdrawal

WI = Withdrawal Instructor Initiated

WA = Withdrawal Administration Initiated

U = Unsatisfactory

Grades will not be rounded.

Grading Information:

Student learning will be evaluated by a midterm exam, 3 quizzes, a HESI exam, 2 journals, and a

cumulative final exam. In the case where a student misses a midterm or final exam, a make-up

test will be administered at the discretion of the instructor. The student must notify the

instructor in advance of the scheduled test of a student’s inability to take an exam as

scheduled. Failure to notify the instructor will result in a 0 grade for the exam.

Additionally, it is the student’s responsibility to inform the instructor if they are too ill to

take the exam prior to the exam.

All tests are scored on Scantron forms. The Scantron sheet stands as the formal grade.

Please have a #2 pencil available for testing.

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All cell phones must be turned off and stored with student belongings during testing.

The midterm exam will contain multiple choice format or multiple response format questions

and will include fill-in dosage calculation problems.

The final exam will consist of multiple choice formats or multiple response format questions

and will include fill-in dosage calculation problems.

After testing, all Scantron forms are secured in the nursing office.

Please refer to the nursing program testing policy in your program handbook for more

information on testing.

Testing Schedule:

HESI given in week 5

Quizzes given in weeks 1, 2, and 4

Midterm given Tuesday of week 3

Final Exam given week 5

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THE STUDENT IS RESPONSIBLE FOR MAINTAINING A RECORD OF HIS/HER

OWN GRADES AS THEY ARE ACHIEVED. BELOW IS A FORM FOR KEEPING A

RECORD OF THE GRADES EARNED AND FOR CALCULATING THE FINAL

COURSE GRADE. PLEASE MAKE USE OF THIS TOOL.

MIDTERM EXAM

________ x 0.30 =

FINAL EXAM

________ x 0.45 =

HESI EXAM

________ x 0.10 =

QUIZZES (average of three)

________ x 0.10=

JOURNALS (average of two)

_______ x 0.05=

Total score ______________

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Academic Honesty:

Academic honesty is important to the learning organization's purpose of helping learners to

develop critical, independent thinking skills and habits. Cheating and other forms of academic

dishonesty run counter to this purpose and violate ethical and intellectual principles; they are

therefore subject to penalties. For purposes of this course we will define academic dishonesty as:

Plagiarism: Presentation of work that originates from another unacknowledged source as one's

own. Presenting someone else's ideas, argument, or information verbatim (or close to verbatim)

without acknowledgement of the source in assessments, papers, or discussions, constitutes

plagiarism.

Cheating:

a) Giving, receiving, or using, or attempting to give, obtain, or use, unauthorized information or

assistance during an assessment or an examination

b) Obtaining or conveying, or attempting to obtain or convey, unauthorized information about an

assessment or examination questions

c) Giving or receiving assistance on an essay or assignment that goes beyond that specifically

allowed by the instructor (this includes buying and selling, or attempt to buy or sell essays and/or

research assistance relating to course assignments)

d) Impersonating someone else or causing or allowing oneself to be impersonated in an

examination, or knowingly availing oneself of the results of impersonation

e) Presenting a single piece of work in more than one course without the permission of the

instructors involved

Academic Integrity Statement:

Mercer County Community College is committed to Academic Integrity – the honest, fair and continuing pursuit of knowledge, free from fraud or deception. This implies that students are expected to be responsible for their own work, and that faculty and academic support services staff members will take reasonable precautions to prevent the opportunity for academic dishonesty.

The college recognizes the following general categories of violations of Academic Integrity, with representative examples of each. Academic Integrity is violated whenever a student:

A. Uses or obtains unauthorized assistance in any academic work.

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Copying from another student’s exam. Using notes, books, electronic devices or other aids of any kind during an exam when

prohibited. Stealing an exam or possessing a stolen copy of an exam.

B. Gives fraudulent assistance to another student. Completing a graded academic activity or taking an exam for someone else Giving answers to or sharing answers with another student before, during or after an

exam or other graded academic activity. Sharing answers during an exam by using a system of signals.

C. Knowingly represents the work of others as his/her own, or represents previously completed academic work as current.

Submitting a paper or other academic work for credit which includes words, ideas, data or creative work of others without acknowledging the source.

Using another author’s words without enclosing them in quotation marks, without paraphrasing them or without citing the source appropriately

Presenting another individual’s work as one’s own. Submitting the same paper or academic assignment to another class without the

permission of the instructor. D. Fabricates data in support of an academic assignment.

Falsifying bibliographic entries. Submitting any academic assignment which contains falsified or fabricated data or

results. E. Inappropriately or unethically uses technological means to gain academic advantage.

Inappropriate or unethical acquisition of material via the Internet or by any other means. Using any electronic or hidden devices for communication during an exam.

Each instructor and academic support service area is authorized to established specific guidelines consistent with this policy.

Consequences for Violations of Academic Integrity

For a single violation, the faculty member will determine the course of action to be followed. This may include assigning a lower grade on the assignment, assigning a lower final grade, failing the student in the course, or other penalty appropriate to the violation. In all cases, the instructor shall notify the Chair of the Academic Integrity Committee of the violation and the penalty imposed.

When two (or more) violations of academic integrity are reported on a student, the Academic Integrity Committee may impose disciplinary penalties beyond those imposed by the course instructor/s. The student shall have the right to a hearing before the Academic Integrity Committee or a designated subcommittee thereof.

Appeals. The student has a right to appeal the decision of the instructor, or the Academic Integrity Committee. Judicial procedures governing violations of Academic Integrity are contained in the Student Handbook. Approved by Board of Trustees May 18, 2000 Amendments by AIC 1/26/2004

ADA Statement:

Mercer County Community College is committed to ensuring the full participation of all students

in all activities, programs and services. If you have a documented differing ability or think that

you may have a differing ability that is protected under the ADA and Section 504 of the

Rehabilitation Act, please contact Arlene Stinson in LB 216 [email protected] for information

regarding support services.

mailto:[email protected]

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If you do not have a documented differing ability, remember that other resources are available to

all students on campus including academic support through our Academic Learning Center

located in LB 214.

The Nursing Program Handbook Information Packet:

Each nursing student receives a copy of this handbook, is responsible for the information

contained in the handbook, and is expected to comply with requirements and policies.

21

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

WK-

1

1. Differentiate the

application of the

nursing process across

the lifespan as it

applies to the care of

the patient with

alterations in urinary

elimination.

2. Compare and

contrast the use of

medical and surgical

interventions as it

affects the care of the

patient with alterations

in urinary elimination

3. Discriminate the

different

pharmacological

management

4. Discriminate

between modifiable

and non-modifiable

risk factors as it

3 hours

QUIZ #1

UNIT I –

ALTERATIONS IN

ELIMINATION

Pre-Renal, Intra-renal,

post-renal

Acute/chronic renal

failure

ESRD

Dialysis

Hemodialysis/peritoneal

Nephritis

Glomerulonephritis

Interactive

lecture and

discussion

NCLEX

Questions

with

rationales

Assessment:

Focused Renal

Assessment in a

simulation

Diagnostic

Studies: In a

SIMULATION

Assessment of

renal function

in

simulation/case

study

Case study

analysis

Plan/Nsg Dx:

Simulation

Drug

Calculations

Students to Review:

- Alterations in Elimination

Urination and Renal

Failure

Assessment:

- normal anatomy and

physiology

- diagnostic studies

- pharmacology

- nutrition

- cultural considerations

- pediatric and gerontology

considerations

Student CD-ROM NCLEX

test questions

22

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

relates to the care of

the patient with


elimination

5. Compare and

contrast the clinical

manifestations of

selected disorders that


elimination may cause

6. Analyze how


elimination and/or

renal failure affect all

other basic human

needs

Reading Assignment:

North Carolina Concept-

Based Learning Editorial

Board. (2015). Nursing A

Concept-Based Approach to

Learning-

Review pages 619-629

Read pages 374-404

Read pages 669-676

Review all prior course

information related to

elimination.

Pharmacology for Nurses

A Pathophysiologic

Approach.

Chapter 23 and 24

Drug Calculations Review

23

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

WK-

2

1. Apply the nursing

process across the

lifespan to the care of

the patient with

alterations in

perfusion

2. Compare and

contrast the special

needs of patients with

alterations in

perfusion

3. Discriminate the

different

pharmacological

management of

patients with selected

forms of alterations in

perfusion

4. Compare and

contrast the nursing

process to the patient

with alterations in

3 hours

Quiz #2

UNIT II –

ALTERATIONS IN

PERFUSION

Dysrhythmias

Myocardial infarction/

cardiogenic shock

CABG

Cardiomyopathy

Interactive

lecture and

discussion

NCLEX

Questions

with

rationales

Simulation Lab:

Assessment:

Focused

Assessment in

simulation of a

patient

experiencing

alterations in

perfusion

Diagnostic

Studies: As they

relate to the

SIMULATION

Assessment of

all bodily

functions as

they relate to

simulation/case

study

Case study

Students to Review:

- Alterations in perfusion

Assessment:

-Normal anatomy and

physiology/perfusion

- Collaboration

- Diagnostic studies

- Pharmacology

- Oxygen

- Nutrition/Fluid Therapy

-Clinical Therapies

- Cultural considerations

- Pediatric and

Gerontology

considerations


test questions

24

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

perfusion

5. Discriminate

between different

pharmacological

management used in

the treatment of

patients with

alterations in

perfusion

6. Analyze how

alterations in

perfusion affect a

selected group of

patients.

analysis

Plan/Nsg Dx:

Simulation

Drug

calculations

Student website

Nursing A Concept-Based

Approach to Learning-

Review all of chapter 16.

Pay special attention to the

following pages in chapter

16:

Read 1070-1083

Read 1105-1129

Read 1144-1157

Read 1178-1198



perfusion.


A Pathophysiologic

Approach.

Chapter 29. Review

chapters 25, 26, and 27.


25

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

WK-

3


process across the


the patient with

alterations in

oxygenation.

2. Compare and



selected alterations in

oxygenation

3. Discriminate the

different

pharmacological

management of



oxygenation

4. Compare and



3 Hours

Theory

Midterm

Exam at

the

beginning

of class

UNIT II –

ALTERATIONS IN

OXYGENATION

Acute respiratory

failure

Acute Respiratory

distress syndrome

Chest trauma

Interactive

lecture and

discussion

NCLEX

Questions

with

rationales

Simulation Lab:

Assessment:

Focused

Assessment in

simulation of a

patient

experiencing

alterations in

oxygenation

Diagnostic

Studies: As they

relate to the

SIMULATION

Assessment of

all bodily

functions as

they relate to

simulation/case

study

Case study

Students to Review:

- Alterations in

oxygenation

Assessment:

-Normal anatomy and

physiology/oxygenation

- Collaboration


- Pharmacology

- Oxygen


-Clinical Therapies


- Pediatric and

Gerontology

considerations


26

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

with alterations in

oxygenation

5. Discriminate

between different

pharmacological

management used in

the treatment of

patients with

alterations in

oxygenation

6. Analyze how

alterations in

oxygenation affect all

other concepts

analysis

Plan/Nsg Dx:

Simulation

Drug

calculations

test questions

Student website





Learning-

Read 953-990

Read 1210-1217

Review notes from NRS

110 on acid-base balance

and all prior course


oxygenation.


A Pathophysiologic

Approach.

Review chapter 39


27

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

WK

4


process across the


the patient with

alterations in

perfusion

2. Compare and



selected forms

alterations in

perfusion

3. Discriminate the

different

pharmacological

management of



perfusion

4. Compare and


3 hours

Quiz #3

UNIT II –

ALTERATIONS IN

PERFUSION

Shock

Obstructive Shock

Distributive Shock

Hypovolemic Shock

Cardiogenic Shock

DIC

Multiple organ

Dysfunction Syndrome

Death and dying

Organ

donation/transplantation

Grief and loss

Interactive

lecture and

discussion

NCLEX

Questions

with

rationales

Simulation Lab:

Assessment:

Focused

Assessment in

simulation of a

patient

experiencing

various types of

shock.

Diagnostic

Studies: As they

relate to the

SIMULATION

Assessment of

all bodily

functions as

they relate to

simulation/case

study

Case study

Students to Review:

- Alterations in perfusion

Assessment:

-Normal anatomy and

physiology/perfusion

- Collaboration


- Pharmacology

- Oxygen


-Clinical Therapies


- Pediatric and

Gerontology

considerations


28

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT


with alterations in

perfusion

5. Discriminate

between different

pharmacological

management used in

the treatment of

patients with

alterations in

perfusion

6. Analyze how

alterations in

perfusion affect all

other concepts

analysis

Plan/Nsg Dx:

Simulation

Drug

Calculations

test questions





Learning-

Read 599-605

Review 397-399

Read 1138-1144

Read 1157-1162

Read 1218-1234

Read 174-184



perfusion.


A Pathophysiologic

Approach. Chapter 28 and

review chapter 18.

Drug Calculations review

29

LEARNING

OBJECTIVES

Lecture

Hours

CONTENT –

Alterations V

LEARNING

ACTIVITY

LAB

ACTIVITY

STUDENT LEARNING

ACTIVITY/READING

ASSIGNMENT

WK

5

Final

exam and

HESI

exam

No lab in the

fifth week.

30


Division of Math, Science & Health Professions

Nursing Program

Clinical Laboratory Performance Evaluation

NRS 230 – Alterations in Health V

Course: (Medical-Surgical Nursing - 5 week Clinical Experience)

Student: _________________________________________ MCCC ID #_________________

Semester: _____________________________ Clinical Facility: ________________________

1. Program objective: Functions within the provisions of the Nurse practice Act while

maintaining professional standards, the Code of Ethics and accepting responsibility for self-

growth and life-long learning

Evaluation Period Week 3 Week 5

Clinical Competency: Demonstrate professional and

ethical behaviors

Clinical Performance Criteria for assignments of 2 or more patients with complex medical-

surgical problems (includes, but not limited to):

1. Complies with agency and MCCC nursing program policies and standards.

2. Treats all individuals with dignity and respect.

3. Is prepared for clinical experiences and observations.

4. Utilizes objectives for clinical/observation experience preparation and actively evaluates

the experience in post conference.

5. Protects patient rights (privacy, autonomy, confidentiality)

6. Practices within the legal and ethical framework of nursing.

7. Demonstrates appropriate professional behaviors (attendance, punctuality, honesty,

appearance, attitude, acceptance of criticism)

8. Reports errors promptly

9. Assumes responsibility for learning.

10. Maintains professional boundaries.

11. Accepts responsibility for assigned patients.

12. Demonstrates accountability for actions.

31

2. Program Objective: Assess the patient’s health status in a comprehensive and holistic

manner.


Clinical Competency: Collects and analyzes

comprehensive patient assessment data



1. Uses correct techniques for physical assessment.

2. Uses effective interview and data collection techniques.

3. Identifies support systems and appropriately assesses patient hemodynamics.

4. Collects and analyzes relevant diagnostic testing results, interventional radiological and

cardiovascular procedures, as well as surgical procedures.

5. Validates data collected for accuracy.

6. Adapts assessment techniques based on individual patient needs and characteristics

(culture, spiritual, age, developmental level, illness, mental state).

7. Reports abnormal data and changes in patient’s condition to the instructor and appropriate

health care professionals within appropriate timeframe.

8. Assesses patients in a timely and efficient manner.

9. Assesses patients and families based on basic human needs.

10. Anticipates changes in health status based on assessments.

11. Utilizes an efficient method of data collection when organizing collected information for

assigned patients (student created form, hospital form, course form)

12. Utilizes available technology to collect data necessary to provide appropriate care.

3. Program Objective: Provide individual patient care in a safe physical and psychological

environment.


Clinical Competency: Adheres to principles of patient

safety and infection control.



1. Comes to clinical mentally and physically prepared to provide safe and effective care to

assigned patients.

2. Protects assigned patients from injury, infection, and harm.

3. Protects self and others from injury, infection, and harm.

4. Maintains a safe, effective care environment.

5. Uses available technology in accordance with agency policies and procedures.

6. Requests assistance when needed.

32


environment. (Medication Administration)


Clinical Competency: Administers medications safely



1. Recalls patient medication information including classification, indication, action, dosage,

side effects, interactions, and nursing implications.

2. Calculates medication dosages and IV rates correctly.

3. Checks “seven” rights prior to medication administration (right drug, right patient-using

two identifiers, right dose, right time, right route, right reason, and right documentation).

4. Performs appropriate assessments prior to, during, and after medication administration.

5. Follows correct procedures in preparing and administering medications.

6. Utilizes critical thinking and clinical judgment when administering medications to

assigned patients.

7. Administers medications within the agency-allotted timeframe.

8. Evaluates the effects of medications administered while identifying if appropriate clinical

outcomes have been achieved.

9. Incorporates assessment data in decision-making related to medication administration.

10. Relates patients’ medications to their health status.

11. Documents medication administration correctly according to agency policy.

5. Program Objective: Analyze, synthesize and evaluate patient-related data to develop and

implement individualized patient care and teaching plans.


Clinical Competency: Provide individualized care based

on relevant patient data



1. Determines and supports assigned patients’ preferences.

2. Prepares assigned patients for interventions

3. Performs nursing skills competently to assigned patients.

4. Demonstrates caring behaviors towards patients and families.

5. Responds to patients in distress in order of priority.

6. Ensures patients’ ADLs are completed for the respective time of day.

7. Considers patients’ family and community when developing and implementing the plan of

care.

8. Independently implements nursing care plan in an organized fashion.

9. Utilizes priority patient needs to determine order of care provided to assigned patients.

10. Modifies interventions in a flexible manner to assigned patients based on changing health

33

needs.

11. Independently manages time constructively when providing care to assigned patients.

12. Assesses assigned patients’ learning needs.

13. Provides patient teaching as a part of plan of care.

14. Applies knowledge about development and pathophysiology of complex health problems

in a variety of patient settings.

6. Program objective: Evaluate the achievement of patient outcomes.


Clinical Competency: Evaluation of patient outcomes

using clinical reasoning.



1. Gathers adequate, relevant information for decision-making.

2. Reports abnormal data and changes in patient condition to the instructor and appropriate

health care professionals within appropriate timeframe.

3. Responds appropriately to information from team members and/or other sources.

4. Uses clinical data and evidence-based practice to support decisions in providing care to

assigned patients.

5. Validate nursing decisions with instructor or health care professional prior to

implementing plan of care or changes in the plan.

6. Anticipates patient/family care needs for assigned patients.

7. Cluster data to identify patient/nursing problems for assigned patients.

8. Identify priority problems for assigned patients.

9. Plan individualized nursing care with appropriate outcomes for assigned patients.

10. Use critical thinking strategies in decision-making and care planning for assigned patients.

11. Modify patient care based on evaluation for assigned patients.

7. Program objective: Incorporate within nursing practice advocacy for patient’s rights taking

into consideration cultural diversity, socioeconomic and political forces.


Clinical Competency: Act as a patient advocate



1. Promotes access to health care for assigned patients.

2. Protects patients’ right to make independent choices.

3. Prevents harm.

4. Protects self and others from injury, infection, and harm.

5. Eliminates potential sources of injury from assigned patients.

6. Monitors the quality of patient care provided to assigned patients.

7. Identifies and provides names and numbers of supportive organizations appropriate to

34

medical diagnosis to assigned patients.

8. Program objective: Collaborate with others to respond to the needs of individuals, families,

and groups across the health-illness continuum.


Clinical Competency: Ensure collaborative care.



1. Uses appropriate channels of communication.

2. Reports complete, accurate, pertinent information to instructor and staff.

3. Maintains effective communication with peers, staff, and instructor.

4. Conveys mutual respect, trust, support, and appreciation to student peers and other health

care members.

5. Contributes to projects, discussions, and pre and post-conferences.

6. Confers with other health care and student team members regarding patient care needs.

7. Reviews collaborative behaviors when working with colleague student and health team

members leading to achievement of patient outcomes.

8. Applies conflict resolution and problem solving skills as appropriate.

9. Facilitates continuity of care within and across health care settings (e.g. transfer reports,

referrals).

10. Volunteers to assist student colleagues and health care members.

9A. Program objective: Use effective verbal and written communication skills, incorporating

lifespan considerations.


Clinical Competency: Communicate effectively with

patients, families, healthcare staff and groups



1. Provides accurate information to patient and families.

2. Uses appropriate and respectful words and tone in verbal communications.

3. Demonstrates appropriate non-verbal communication strategies.

4. Uses communication techniques to assist patients/families in coping with stressful events

and changes in health status.

5. Adapts communication strategies based on patients’ age, developmental level, disability,

and/or culture.

6. Evaluates the effectiveness of therapeutic interactions.

7. Able to receive report and prioritize care for multiple patient assignment.

35

8. Is able to give report in an organize manor using SBAR assessment tool.

9. Effectively communicates with health care team, care that is provide and what care with

be delegated to ancillary staff.

9B. Program objective: Use effective verbal and written communication skills, incorporating



Clinical Competency: Document effectively.



1. Documents, completes, accurate, pertinent information in a timely manner.

2. Completes documentation according to agency guidelines (format, timing, abbreviations,

etc.)

3. Uses appropriate terminology, spelling and grammar in written communications.

Week 3- Faculty Comments – Areas of strength and areas requiring improvement:

____________________________________

Faculty Signature Date

Student Comments regarding Clinical Goals

__________________________________

36

Student Signature Date

Remediation Plan Instituted (date) ______________________________________ (attach

copy)

Clinical Evaluation Grading Criteria:

Met Performance criteria met, performing as expected for this level

None Met Performance criteria not met, areas needing improvement require remediation

plan.

Unsafe Demonstrates unsafe practice

Scoring:

An evaluation criterion is assigned for each program objective and competency twice

during the clinical evaluation period.

A designation of “Not Met” requires a written remediation plan.

A designation of “Unsafe” in any of the competencies will result in a clinical failure for the

course.

Faculty reserve the right to document an evaluation at any time during the clinical

rotation.

Week 5 - Faculty Comments – Areas of strength and areas requiring improvement:

____________________________________



37

__________________________________



copy)



Not Met Performance criteria not met, areas needing improvement require remediation

plan.


Scoring:





course.


rotation.

38


Division of Math, Science & Health Professions

Nursing Program

Clinical Laboratory Performance Evaluation

NRS 230 – Alterations in Health V

Course: Medical-Surgical Nursing - 5 week Clinical Experience

Student: _________________________________________ MCCC ID #________________

Semester: _____________________________ Clinical Facility: _______________________

3. Program objective: Functions within the provisions of the Nurse practice Act while

maintaining professional standards, the Code of Ethics and accepting responsibility for self

growth and life-long learning


Clinical Competency: Demonstrate professional and

ethical behaviors

4. Program Objective: Assess the patient’s health status in a comprehensive and holistic

manner.


Clinical Competency: Collects and analyzes

comprehensive patient assessment data


environment.


Clinical Competency: Adheres to principles of patient

safety and infection control.


environment. (Medication Administration)

39


Clinical Competency: Administers medications safely

5. Program Objective: Analyze, synthesize and evaluate patient-related data to develop and

implement individualized patient care and teaching plans.


Clinical Competency: Provide individualized care based

on relevant patient data

6. Program objective: Evaluate the achievement of patient outcomes.


Clinical Competency: Evaluation of patient outcomes

using clinical reasoning.

7. Program objective: Incorporate within nursing practice advocacy for patient’s rights taking

into consideration cultural diversity, socioeconomic and political forces.


Clinical Competency: Act as a patient advocate

8. Program objective: Collaborate with others to respond to the needs of individuals, families,

and groups across the health-illness continuum.


Clinical Competency: Ensure collaborative care.

9A. Program objective: Use effective verbal and written communication skills, incorporating



Clinical Competency: Communicate effectively with

patients, families, healthcare staff and groups

9B. Program objective: Use effective verbal and written communication skills, incorporating


40


Clinical Competency: Document effectively.


____________________________________



__________________________________



copy)



41


plan.


Scoring:





course.


rotation.


____________________________________



__________________________________

42



copy)




plan.


Scoring:





course.


rotation.