Lake-Sumter State College Course Syllabuslssc.edu/academics/Documents/nursing/12 gen-2nd yr-spring... · Lake-Sumter State College Course Syllabus ... Davis’ Drug Guide for Nurses

NU: NUR 2224L CN IV Spring 01.05.2018………………………………………………………………………..……………………………………… 1

Lake-Sumter State College Course Syllabus

Course Information:

Course Prefix/Number: NUR2224L

Course Title: Clinical Nursing IV

CRN: 20348/20354

Credit Hours: 4

Semester: Spring 2018

Class Days, Location, Time: See Calendars in Canvas

Course Description

This is the fourth course in a series of clinical courses and complements Alterations in Health IV. Emphasis will be on providing nursing care for clients with alterations in neurological, respiratory, and cardiovascular functioning as well as the critical care client with multi-system alterations. Clinical rotations will include experiences in acute care facilities and critical care.

Instructor Information: See –Current Students-Program Forms and Information Department Directory

Name: Varies by instructor

E-Mail: Varies by instructor

Office Location: Leesburg or Clermont location

Phone: See Faculty website

Office Hours: See office schedule on faculty door

Vital Communication Information: For e-mail, please note that all students are required to use Lakehawk Mail for official college e-mail

communications. See the college webpage for instructions on activating Lakehawk Mail.

Sending a private message using the MESSAGES tool in Canvas is always the most secure method of contacting your instructor. Please remember that any phone contact with your Instructor should be of a professional nature.

Please always leave a clear, concise, but detailed message with your contact and class information.

Always follow up a phone call with a written account via Canvas Message or e-mail.

http://lssc.edu/academics/Documents/nursing/04%20current%20students-prog%20forms%20and%20info/DeptDirectoryStudentPg.pdf

http://lssc.edu/academics/Documents/nursing/04%20current%20students-prog%20forms%20and%20info/DeptDirectoryStudentPg.pdf

http://www.lssc.edu/lakehawk/Pages/default.aspx


Prerequisites/Co-requisites: Prerequisites: NUR2220 Alterations in Health III

NUR2220L Clinical Nursing III NUR2463 Maternal Child Health NUR 2010C Microbiology

Co-requisites: NUR2224 Alterations in Health IV NUR 1823 Management of Care II NUR2801L Clinical Practicum Humanities (if not previously completed)

Textbook & Other Course Materials: (Program Duration) REQUIRED: PEARSON LeMone. (2015). Medical Surgical Nursing: Critical Thinking in Patient Care 6th ed. [Vol 1 & 2]

o Print- ISBN: 978-0-1331-3943-3 o eBook- ISBN: 978-0-1330-0439-7

F.A. DAVIS Townsend. (2014) Essentials of Psychiatric Mental Health Nursing. 6th ed. F.A. Davis


Doenges, Moorhouse and Murr. (2016) Nurse’s Pocket Guide 14th ed. o Print- ISBN: 978-0-8036-4475-5 o eBook- ISBN: 978-0-8036-4477-9

ELSEVIER PACKAGE: ISBN:

Yoost. (2016) Fundamentals of Nursing: Active Learning for Collaborative Practice Yoost. (2016) Fundamentals of Nursing: Active Learning for Collaborative Practice [eBook] Elsevier Adaptive Quizzing (2016) [Access for Yoost] Clinical Skills: Essentials Collection (2016) [Access Card] James, Nelson & Ashwill. (2013) Nursing Care of Children: Principles and Practice. 4th ed. James, Nelson & Ashwill. (2013) Nursing Care of Children: Principles and Practice. 4th ed.

[eBook] Lilley. (2017) Pharmacology and Nursing Process 8th ed. Lilley. (2017) Pharmacology and Nursing Process 8th ed. [eBook]

CENGAGE Pickar. (2013) Dosage Calculations 9th ed. (MAY USE CURRENTLY OWNED OLDER EDITION)


LIPPINCOTT, WILLIAMS & WILKINS Ricci. (2013) Essentials of Maternity, Newborn, & Women’s Health Nursing. 3rd ed. [includes CD and

Access Code]. o Print- ISBN: 978-1-6083-1801-8 o eBook- ISBN: 978-1-4511-5162-6

NCLEX REVIEW GUIDE- SELECT ONE OF YOUR CHOICE w/COPYRIGHT NO OLDER THAN 2014

Suggested Titles-


Rhinehart, Sloan & Hurd. (2014) NCLEX-RN Exam Prep 3rd ed. Pearson o Print- ISBN: 978-0-7897-5106-5

Silvestri. (2014) Saunders Comprehensive Review for NCLEX-RN. 6th ed. Elsevier. o Print- ISBN: 978-1-4557-2755-1 o eBook- ISBN: 978-0-3232-2770-4

DRUG GUIDE- SELECT ONE OF YOUR CHOICE Suggested Title-

Vallerand & Sanoski. (2016) Davis’ Drug Guide for Nurses 15th ed. F.A. Davis o Print- ISBN: 978-0-8036-5705-2 o eBook- (not yet available)

MEDICAL DICTIONARY- SELECT ONE OF YOUR CHOICE Suggested Title-

Taber’s. (2013) Cyclopedic Medical Dictionary 22nd ed. F.A. Davis o Print- ISBN: 978-0-8036-2977-6 o eBook- ISBN: 978-0-8036-3909-9-6

LAB & DIAGNOSTICS HANDBOOK- SELECT ONE OF YOUR CHOICE Suggested Title-

Van Leeuwen (2015) Davis’ Comprehensive Handbook of Laboratory and Diagnostics Tests w/Nursing Implications 6th ed. F.A. Davis


OPTIONAL: Dunham. (2008) How to Survive, Maybe Even Love Nursing School 3rd ed. F.A. Davis


Nugent. (2015) Test Success: Beginning Nursing Students. 7th ed. F.A. Davis. o Print- ISBN: 978-0-8036-4418-2

Holloway. (2011) OB/GYN Peds Notes: Nurse’s Clinical Pocket Guide 2nd ed. F.A. Davis. o Print- ISBN: 978-0-8036-5863-9

NU: NUR 2224L CN IV Spring 01.05.2018………………………………………………………………………………………………....4

Technology Requirements: Canvas is a required component of this course. Students unfamiliar with Canvas are expected to complete the Student Orientation course located in Canvas within the first week of classes. Major writing assignments need to be created and saved in a file format that is compatible with Microsoft Word. If using a word processing program other than Word, it is the student’s responsibility to adhere to all formatting and submission requirements. Please ask for help if you are unsure how to save a file in a Word-compatible format. Please see the LSSC Lakehawk Page for information on how to obtain Microsoft Office 365 as an LSSC student. EVOLVE WEB TOOLS AND RESOURCES: Browsers: Internet Explorer 11; or Firefox latest version; or Chrome latest version; or Safari 9.0 - 10.0 Computer operating system: Windows and Mac Specific Elsevier products may work better in one environment than another. For specific product functioning, please see Elsevier’s Computer Requirements Page Elsevier Support Hub End of Program Student Learning Outcomes:

1. Interact appropriately through verbal, nonverbal, and written communication with patients, families, and members of the health care team.

2. Coordinate and collaborate with the interdisciplinary healthcare team to assess patients and provide and direct nursing care that promotes optimal wellness of clients throughout the lifespan.

3. Demonstrate competent and safe implementation of clinical nursing skills in meeting clients

psychosocial and physiological needs.

4. Provide compassionate and culturally sensitive care to a diverse population that personifies the core values and ethics of the nursing profession.

5. Demonstrate effective clinical judgment and decision making utilizing critical thinking supported

by scientific knowledge and evidence based practice.

6. Implement client/family centered teaching plans that promote selfcare and optimal health.

http://www.lssc.edu/lakehawk/Pages/default.aspx


Course Student Learning Outcomes: The following outcomes will be assessed in this course. An “outcome” is defined as something students take with them beyond this course.

1. Analyze comprehensive health assessment data to direct optimal, safe and effective client centered care.

2. Relate best practices to make appropriate decisions for 1-4 adult clients with complex and/or multisystem health problems in acute and critical care settings.

3. Coordinate an interdisciplinary plan of care to ensure continuity within the health delivery system.

4. Integrate therapeutic communication skills when interacting with and educating clients and their families.

5. Personify behaviors exemplifying the standards of professional nursing practice.

6. Illustrate competency in the delivery of safe and effective client centered care.

7. Support caring and cultural sensitivity in the delivery of individualized nursing care.

Institutional Policies & Procedures: Academic Integrity: The successful functioning of the academic community demands honesty, which is the basis of respect

for both ideas and persons. In the academic community, there is an ongoing assumption of academic

integrity at all levels. There is the expectation that work will be independently thoughtful and

responsible as to its sources of information and inspiration. Honesty is an appropriate consideration in

other ways as well, including but not limited to the responsible use of library resources, responsible

conduct in examinations, and the responsible use of the Internet. See college catalog for complete

statement.

Important Information for Students with Disabilities: Any student with a documented disability who requires assistance or academic accommodations should

contact the Office for Students with Disabilities immediately to discuss eligibility. The Office for Students

with Disabilities (OSD) is located on the Leesburg Campus, but arrangements can be made to meet with

a student on any campus. An appointment can be made by calling 352-365-3589 and specific

information about the OSD and potential services can be found at Disability Services.

Privacy Policy (FERPA): The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part99) is a Federal law that protects the privacy of a student’s education records. In order for your information to be released, a form must be signed and in your records located in the Admissions/Registrar’s Office.

http://www.lssc.edu/students/Pages/Current/CourseCatalog.aspx

http://lssc.edu/academics/Pages/Academic%20Resources/Disability%20Services/osd.aspx


Zero-Tolerance for Violence Statement: Lake-Sumter State College has a policy of zero tolerance for violence as stated in College Board Rule

2.17. Appropriate disciplinary action will be taken in accordance with Board Rule 2.17.

Attendance/Withdrawal Policies: Please refer to your ADN Student Policy Handbook for this information

Institutional Information: Once the Add/Drop period passes, students deciding to discontinue class attendance and/or online

participation have the responsibility for formal withdrawal by the withdrawal deadline.

Withdrawal Deadline: Monday, March 26, 2018

Nursing Program Policies: Please refer to your ADN Student Policy Handbook for this information.

Late Work/Extensions: Please refer to your ADN Student Policy Handbook for this information.

Conduct Please refer to your ADN Student Policy Handbook for this information.

Exam Policies Please refer to your ADN Student Policy Handbook for this information.

Grading Information: Please refer to your ADN Student Policy Handbook for method of course final grade determination.

Grading Scale:

S = Satisfactory U = Unsatisfactory

Skills Lab Testing: Please refer to your ADN Student Policy Handbook for this information.

Assigned clinical papers: Please refer to your ADN Student Policy Handbook for this information.


Focus Sheets There are three assigned clinical focus sheets that will be due following the clinical experiences. There are not specific due dates for these focus papers. The student will work with their individual clinical instructor for submission of these documents.

Instructor Clinical Evaluation Please refer to your ADN Student Policy Handbook for this information.

Math Component:

Please refer to your ADN Student Policy Handbook for this information.

Course Calendar: See Calendars in Canvas:


Schedule and Content Dosage Calculation Quizzes

Clinical Nursing IV Spring 2018

Quiz 1 Oral dosage calculations

Quiz 2 Parental dosage calculations

Quiz 3 IV dosage calculations

Quiz 4 Reconstitution of solutions

Quiz 5 Pediatric calculations (weight based)

Quiz 6 Review of all prior math problems



Quiz 9 Advanced IV calculations

Quiz 10 Advanced IV calculations



***Note this schedule allows for 12 quizzes. The syllabus and program policy calls for a 90% on ten (10) quizzes. This will allow you to throw out the lowest 2 grades.


Clinical Skills Fair Outcomes

Students will:

1. Demonstrate proficiency with previously experienced clinical nursing skills.

2. Demonstrate accurate patient identification.*

3. Measure, assess and be able to discuss timely, effective communication regarding

patient status.*

4. Use appropriate abbreviations, acronyms, symbols and dose designations as prescribed

by the Joint Commission.*

5. Demonstrate the ability to give medications safely.*

6. Explain interventions for the professional nurse to reduce the likelihood of patient harm

with the use of anticoagulants.*

7. Demonstrate infection control methods.* List what leads to catheter associated urinary

tract infections and list what infection control methods the RN can use for prevention.*

8. Demonstrate hand hygiene as prescribed by the Centers for Disease Control.*

9. List ways to identify patients with safety risks, especially to find out which patients are

most likely to try to commit suicide.*

10. List how to prevent mistakes in surgery.

Implementation: The above mentioned skills will be evaluated by the Applied Nursing Instructors (Skills Lab

instructors) and other assigned nursing instructors. In the event the instructor is not satisfied

with the student’s performance, there will be a referral to the skills lab for remediation.

* These outcomes are adapted from the 2016 National Patient Safety Goals Hospital Program.

The Joint Commission. (2015). 2016 Hospital National Patient Safety Goals for Hospitals

retrieved 11/20/15 from http://www.jointcommission.org/standards_information/npsgs.aspx.


Advanced Clinical Skills

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

Advanced Respiratory Support 1. Tracheostomy Care and Suctioning

Describe the proper placement of an artificial airway.

Explain the rationale for care of an artificial airway.

Use proper techniques when suctioning and performing tracheostomy care

2. Ventilator Support

Discuss indications for mechanical ventilation.

Discuss different modes of mechanical ventilation and types of ventilators.

Explain the physiological impact of mechanical ventilation.

Discuss nursing interventions necessary for care of a patient on a ventilator.

Describe potential complications of mechanical ventilators.

Discuss criteria and nursing interventions for weaning a patient from a

ventilator.

3. Chest Tubes

Describe the process by which intrapleural negative pressure is generated.

List indications for chest tube placement.

Discuss the nursing interventions necessary to prevent complications in a

patient. with a chest tube drainage system.

Describe the nursing actions required to maintain chest tube patency.

Hemodynamic Monitoring

1. Describe the characteristics of a normal systemic arterial, right atrial, right ventricular,

pulmonary artery, and pulmonary capillary wedge waveform.

2. Discuss the basic components necessary to monitor pressure invasively.

3. State nursing interventions that ensure accuracy of pressure readings.


4. Discuss the major complications that can occur with an indwelling arterial line and

pulmonary artery catheter.

5. Identify nursing interventions taken to prevent the above complications.

EKG Interpretation 1. Define the principle components of cardiac conduction system.

2. Describe sequence of normal electrical conduction through the heart.

3. Discuss normal (ECG) waveforms and intervals.

4. Apply a systematic approach to ECG rhythm interpretation.

5. Analyze rhythm strips to identify presence of arrhythmias using specific interpretation

criteria

Code Management Outcomes 1. Compare roles of the interdisciplinary team in managing cardiopulmonary arrest

situations.

2. Identify equipment used during a code.

3. Differentiate basic and advanced life support measures used during a code.

4. Identify medications used in code management, including use, action, side effects and

nursing implications.

5. Discuss treatment of special considerations (i.e. resuscitation techniques, medication

choices, roles of the code team etc.) that can occur during a code.

6. Describe adaptations related to the geriatric and pediatric population during a code.

7. Identify information documented during a code.

8. Identify psychosocial, legal, and ethical issues related to code management.


Utilizing the Nursing Process to Meet Client Needs

Medical/Surgical Clinical Competencies 1. Assess the needs of medical and surgical clients with a variety of pathophysiology.

2. Identify the appropriate nursing diagnosis for specific nursing problems.

3. Accurately document assessment findings, interventions and evaluations of care.

4. Administer medications safely with understanding of implications, considerations, and

contraindications.

5. Demonstrate the ability to relate pathophysiological principles to nursing care.

6. Demonstrate effective communication skills with clients of all ages, including family

members.

7. Complete an admission, discharge, and community referral on a medical or surgical

client coordinating inter disciplinary plan of care.

8. Demonstrate the ability to perform comprehensive nursing care on assigned clients,

including evaluation of your nursing care.

9. Identify the psychosocial needs of medical and surgical clients and incorporate these

needs into the client's care.

10. Complete a concept map on client of choice.

ICU Clinical Competencies 1. Demonstrate the ability to relate pathophysiological principles to the acutely ill client.

2. Demonstrate the effective use of communication skills with critically ill clients and their

families.

3. Utilize the nursing process in caring for a critically ill client.

4. Recognize and differentiate between normal and abnormal cardiac rhythms utilizing

appropriate nursing interventions in response.

5. Demonstrate an understanding of hemodynamic monitoring and nursing considerations

in the maintenance and prevention of complications for the clients involved.

6. Discuss how a ventilator functions and identify the special nursing needs of patients on

ventilators.


7. Identify the most common drugs utilized in the Special Care Units, and the appropriate

dosages and routes of administration.

8. Identify the proper functioning of chest tube drainage systems and discuss management

of clients with chest tube systems.

9. Participate in care of the client with a tracheotomy demonstrating proper interventions

for cleaning and suctioning.

10. Identify the psychosocial problems associated with hospitalization in an acute care unit.

11. Recognize the special dietary needs/problems of those who are critically ill.

12. Complete ICU Clinical Form and reflective journal.

Emergency Department Competencies 1. Explain initial nursing assessment and levels of triage in the emergency department.

2. Describe priority nursing interventions you observed in emergency situations.

3. Discuss laws/guidelines governing client admission and transfer.

4. Identify situations that hospitals, nurses, and physicians are required to report to

appropriate enforcement agencies.

5. Describe the methods of communication and patient documentation in the emergency

department.

6. Identify and describe signs and symptoms associated with the medical emergencies you

observed.

7. Discuss discharge teaching of clients from the emergency department.

8. Collaborate with Respiratory Therapy to participate in pulmonary hygiene measures

9. Complete the Emergency Department Focus Sheet and post to Canvas.


Cardiac Cath/Diagnostics/ Rehab Competencies 1. Describe procedures you observed

2. For each observed procedure describe:

Indication for the procedure

Patient preparation prior to procedure

Nurse’s role prior to, during, and after the procedure

Risks/contraindications associated with procedure

Potential patient complications post procedure

Interventions related to patient safety, comfort, and infection control

Conditions that could influence testing process or outcomes

3. Complete the Cardiac Catheterization Focus Sheet and post to Canvas.

Patient Care Coordinator 1. Prioritize the components of care for multiple clients.

2. Utilize effective strategies for communication with colleagues and clients in the clinical

setting.

3. Collaborate with members of the health care team to ensure safe and appropriate care.

4. Implement effective strategies in conflict resolution within the unit.

5. Utilize evidence-based practice to insure the optimal quality of client centered care.

6. Complete the Patient Care Coordinator Focus Sheet and post to Canvas.


Clinical Focus Sheet: Intensive Care Unit Objectives

1. Name three (3) communication skills that may be useful with critically ill clients and

their families. Give rationale.

1. ...

2. …

3. …

2. What is the alteration in utilizing the nursing process in caring for a critically ill client?

Describe.

3. What two (2) leads were used on your patient for cardiac rhythm monitoring and why?

4. Provide a brief explanation of EKG monitoring as if you were telling your patient.


5. Obtain a NSR strip and label:

a. P, QRS, T waves (label on the strip)

b. Measure PR interval

c. Measure QRS complex

d. Is ST normal, elevated, or depressed?

e. Is T wave normal, elevated, or depressed?

f. What is the heart rate?

g. What is the patient’s rhythm?

h. Are there any ectopic beats?

Tape Strip Here (6 seconds)

6. Obtain a rhythm strip with a dysrhythmia. Can you identify it?

Tape Strip Here (6 seconds)


7. What does a central venous line measure? Where does the tip of the central line lie?

8. Describe the measurements obtained from a pulmonary artery catheter. What the significance of these measurements? (If your patient does not have a pulmonary artery catheter in place, refer to Resources in order to answer these questions.)

a. …

b. …

c. …

d. …

9. Define the purpose of a ventilator.

10. List two (2) priority nursing diagnoses of patients on ventilators:

1. .

2.


List five (5) common drugs utilized only in the special care units. Include the appropriate dosages, and route of administration. Discuss why each of these drugs would not be safe to administer on a medical/surgical unit.

1. …

2. …

3. …

4. …

5. …

Discussion:

11. List two (2) purposes of chest tubes:

1.

2.


12. List two (2) priority nursing diagnoses of a patient with a chest tube:

1.

2.

13. List two (2) nursing interventions for a patient with a tracheostomy that does not

include suctioning or tracheostomy care:

1.

2.

14. List two (2) psychosocial nursing diagnoses utilized for patients admitted to a critical

care unit.

1.

2.


Clinical Focus Sheet: Emergency Department Experience

1. Explain initial nursing assessment and levels of triage in the emergency department.

2. Describe priority nursing interventions you observed in emergency situations.

3. Discuss laws/guidelines governing client admission and transfer.

4. Identify situations that hospitals, nurses, and physicians are required to report to appropriate enforcement agencies.


5. Describe the methods of documentation in the emergency department.

6. Identify and describe signs and symptoms associated with the medical emergencies you observed.

7. Discuss discharge teaching of clients from the emergency department.

8. Collaborate with Respiratory Therapy to participate in pulmonary hygiene measures.


Clinical Focus Sheet: Cardiac Cath Lab Experience

1. Describe procedures you observed

2. For each observed procedure describe:

a. Indication for procedure

b. Patient preparation prior to procedure

c. Nurse’s role prior to, during, and after the procedure

d. Risks/contraindications associated with procedure

e. Potential patient complications post procedure

f. Interventions related to patient safety, comfort, and infection control

g. Conditions that could influence testing process or outcomes


Clinical Focus Sheet: Patient Care Coordinator Experience

1. Prioritize the components of care for multiple clients.

2. Utilize effective strategies for communication with colleagues and clients in the clinical setting.

3. Collaborate with members of the health care team to ensure safe and appropriate care.

4. Implement effective strategies in conflict resolution within the unit.

5. Utilize evidence-based practice to insure the optimal quality of client centered care.


Medication Variance Policy

Variance in medication delivery in a facility is a serious matter. Medication administration must be done with an instructor/preceptor and facility policy adhered to

The incidence of medication errors is the leading cause of patient injury in the health profession. Medication variances that cause these errors can range from incorrect documentation to incorrect administration to the patient. The LSSC Nursing Program places serious importance on this issue. The following policy specifies the types of variations that can occur, lists a score valuing each type variation, and designates a progressive disciplinary plan.


Lake-Sumter State College Nursing Program Medication Variance Concern Form

Student name: ________________________________________________________________________

Date/Time: _______________________________ Initiated by: _________________________________

Schedule appointment with lab instructor for plan of action: _________________Date/Time: _________

Date of incident: ____________________________________Location: ___________________________

Variance: Check one that represents the end result

___Wrong drug/solution ___Wrong patient ___Did not verify orders with MAR

___Wrong dose ___Wrong documentation ___Knowledge of med insufficient

___Wrong time/date ___Wrong administration rate ___Wrong route

___Omission of medication

Name/dosage/route/time of medication: ___________________________________________________

Was the variance discovered before it reached the client? yes ____no____

Additional client interventions related to variance (monitoring, vs, labs, procedures)

_____________________________________________________________________________________

Describe patient outcome resulting from medication variance: __________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Was there direct supervision of student by an Instructor/RN? yes____no____

What factors contributed to the variance? __________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

How could the variance have been prevented? _______________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Hospital policy followed as appropriate: yes ___no ____

Plan of Action/addendum attached: yes ____no ____


Syllabus Disclaimer: Information contained in this syllabus is, to the best knowledge of this instructor, considered correct and complete when distributed to the student. The instructor reserves the right, acting within policies and procedures of Lake-Sumter State College, to make necessary changes in course content or instructional techniques without prior notice or obligation to the student


SYLLABUS RECEIPT ACKNOWLEDGEMENT

COURSE NUMBER: NUR2224L TERM - YEAR: Spring 2018

COURSE NAME: Clinical Nursing IV

STUDENT: Complete and return to instructor on day of syllabus review.

My instructor reviewed the content of this syllabus. I understand course requirements. I understand Nursing Student Handbook and Syllabi guide progression through the nursing program. I understand declining signature indicates my decision to withdraw from course and program.

PRINT NAME: _______________________________________________ XID#:_______________

SIGNATURE:_________________________________________________ DATE:______________