SYLLABUS HANDOUTFOR

Spring 2009

Adult Nursing VNURS 2150 7A

INSTRUCTOR: Diana Blum RN, MSN

WELCOME TO METROPOLITAN COMMUNITY COLLEGE

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Metropolitan Community CollegeCourse Syllabus – SPRING 2009

COURSE IDENTIFICATION

Title: Adult Nursing VPrefix/Section: NURS 2150 7ACredit Hours: 5 credits (3 hr lecture/week, 7 hrs/wk clinical)Begins/Ends/No-Class Days: Tuesday, March 16, 2010 to Tuesday, May 25, 2010Meeting Day/Time: Tuesdays/Time: 9:00 a.m.-12:00 p.m.Last Day to Withdraw May 10, 2010Delivery Type: Classroom Class Location: SOC-Mahoney Bldg, RM 503Lab Location: SOC-Mahoney Bldg, RM 511Course Web Address: http://www.mccneb.edu/academics/alliedhealth/index.aspCourse Approval: October 16, 2008

CONTACT INFORMATION

Instructor Name: Diana Blum RN, MSNOffice Location: SOC-Mahoney Bldg, RM 513Office Telephone: 402-738-4561Facsimile: 402-738-4552Office Hours: Posted outside of SOC-Mahoney, RM 513Email Address: dblum3@mccneb.eduFaculty Web Site: http://www.mccneb.edu/academics/facultydisplay.aspAcademic Program Area: Health CareersDean’s Office Telephone: (402) 738-4789 in SOC-Mahoney RM 519Tutoring: Alice Ludwig, RN – SOC-Mahoney RM 513

COURSE INFORMATION

Course Description: Adult Nursing V is a continuation and advancement of previous content and includes the following content areas as well as treatment modalities, and nursing interventions; perioperative nursing, bariatrics, emergency, trauma, mass casualty, bioterrorism, neurological disorders, musculoskeletal and connective tissue diseases, endocrine disorders, infectious disease, immune dysfunctions, cancer, end of life and transplantation. The critical thinking process will be utilized with subsequent safe decision outcomes. A clinical component is included.

Course Prerequisites: Successful completion of NURS 2140, 2310, 2410, and NURS 2520.Co-requisite: NURS 2210

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Course Objectives: At the completion of this course the nursing student should be able to:1. Identify the nursing management of the perioperative patient including special needs of

the bariatric patient in relation to roles and responsibilities of the RN.2. Evaluate the emergency nurse’s role in triaging, critical thinking, and prioritizing patient

interventions.3. Implement assessment and prioritizing in the nursing management of the trauma patient.4. Identify assessment and nursing interventions in the management of neurological,

musculoskeletal and connective tissue disorders..5. Identify pathophysiological manifestations and nursing interventions for endocrine,

infectious, immune dysfunctions, and hepatic disorders.6. Explain the role of the RN in end of life care incorporating cultural and religious beliefs

as appropriate.7. Explain transplant criteria, potential complications, and prophylaxis treatment for heart,

kidney, bone marrow, corneal, and liver organs.8. Identify the role of the RN in treatment modalities utilizing the nursing process.9. Demonstrate critical thinking skills with subsequent safe decision outcomes.10. Demonstrate an understanding of pathophysiological knowledge through safe, competent

care, utilization of the nursing process and the evaluation of nursing interventions.11. Discuss the integration of knowledge from research as it influences current and/or future

practice.

Clinical Component:Clinical experience will take place in the hospital setting and will include medical-

surgical units, intensive care units, surgery, emergency room, and recovery room.

Clinical Objectives:Refer to NURS 2150 Clinical Evaluation Form attached to this syllabus.

Required & Supplemental Materials:Required:Osborne, K. et al (2010). Medical-Surgical Nursing Preparation for Practice. Pearson: Boston:Kaplan: Math for Nurses (2007)Supplements:

Pocket Reference for ECG’s Made Easy, 3rd Edition. Achlert, Barbara: Mosby 2006.Gahart, Betty: Intravenous Medications, (2009), Elsevier.Gulanick, Meg: Nursing Care Plans, (2007), 6th Edition. Mosby.Mosby’s Dictionary of Medical Nursing and Health Professionals, (2005), 7th Edition. Mosby.Bakerman, Seymour: Bakerman’s ABC’s of Interpretive Laboratory Data.Deglin, Judith: Davis’s Drug Guide for Nurses, (2009), 11th Edition. F.A. Davis.Silvestri, Linda: Saunders Comprehensive Review for the NCLEX-RN Examination, (2007), Elsevier.Stassi, Mary: Math for Nurses, by Kaplan, Kaplan Publishing.

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COURSE ASSESSMENT

Methods of Instruction:Classroom – A variety of teaching strategies may be used in presenting theory content, such as: case study, discussion, exams, guest speakers, lecture-discussion, concept mapping and questioning. Instructional strategies to be used may include: Handouts, video, powerpoints, and study guides.

Methods of Assessing Student Progress:Student progress is evaluated using a variety of methods including written examinations/quizzes, clinical observation of client care, written process recordings, nursing care plans, charting, and assessment of skills in clinical settings.

Selected Testing/Assessment Methods: Examinations/quizzes include multiple choice or essay. Written assignments include written nursing careplans or concept maps, and other written assignments appropriate to the clinical setting. Faculty observation of student completion of skills are primary methods of evaluating students in the clinical practicum setting. Evaluation: Final course grades are based on the following letter scale:

93-100 = A 84-92 = B 76-83 = C 70-75 = D Below 70 = F

A student’s course grade will be determined as follows:

Multiple Choice questions:

Exam # 1 25 questions, each question worth 4%Exam # 2 50 questions, each question worth 2%Exam # 3 50 questions, each question worth 2%Exam # 4 50 questions, each question worth 2%Exam # 5 50 questions, each question worth 2%Exam #6 25 questions, each question worth 4%Comprehensive Final 100 points

There will be no rounding of grades, i.e., a 75.7 = 75%. A final course grade of 76% is required to continue in the program.

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Clinical will be graded on a satisfactory/unsatisfactory basis. Refer to clinical evaluation attached to this syllabus. Students must obtain satisfactory on all assignments, and skills performances to obtain a satisfactory evaluation for the clinical component. Students must pass the math exam with a 100% before they can pass medications on the unit. Students are allowed three attempts to pass the math exam with a 100%. Failure to pass the exam after three attempts will result in failure of the course.

To satisfactorily complete a nursing course, the student must receive a “C” (76%) or above in the theory course and a pass in the corresponding clinical component. Failure by a student in either theory or clinical will necessitate repeating the entire course (both theory and clinical components).

Make-up Test Procedures:If it is necessary to be absent during an assigned test/quiz period, the student must make-up that exam/quiz prior to the next scheduled class date (i.e., if the missed test is on Wednesday, the test must be made up PRIOR to the next Wednesday). Failure to do so will result in a zero for the examination. The student may miss one exam/quiz without penalty, as long as the test is made up within the specific time period. If the student misses more than one exam/quiz, the exam/quiz may be made up, but the maximum score allowed is an 80%. The instructor may choose to administer an essay exam to those students who miss exams on the scheduled time. The final examination must be taken on the scheduled date and at the scheduled time.

Students may not enter the classroom after the testing has begun. If the student is not in the classroom when tests are being distributed the student must follow the provision for make up test procedures.

When necessary to make up an examination, it will be placed in the testing center. It is the student’s responsibility to make an appointment and take the test within the specified period of time.

Exceptions to these guidelines may be considered, but only if the student consults with the instructor in advance.

Late Assignments: Assignments are expected to be completed and turned in by the dates stipulated on the course calendar and the individual instructor due dates. It is the responsibility of the student to notify the clinical/course instructor of any delay in meeting the stated/written deadlines. Habitual lateness in handing in assigned work can contribute to course failure.

Maintenance of Student Records: Examination reviews will be held following all student completion and/or grading of scheduled exams. Courteous and respectful behavior is expected of every student present to facilitate the learning experience afforded by the review. Students may request to review the exams individually, by appointment. Appointments must be made individually with faculty of the course. Course faculty will keep all exams/quizzes.Every effort will be made to return all tests and written assignments in a timely manner for review.

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STUDENT EXPECTATIONS Methods of Learning:Students are expected to participate in all theory and clinical sessions. Assigned readings are to be completed prior to attending the class/clinical session scheduled for the specific topic. Written assignments, theory, and clinical assignments must be completed by specified dates. Due dates for written theory assignments and some clinical assignments will be on the class schedule. Due dates for written clinical assignments will be given with clinical information if not on class schedule. Assignments not handed in by the due date will receive a zero, and will not be accepted.

Pre-clinical lab preparation is a must. Students are expected to come to the clinical practicum setting prepared to give care to their clients. Being prepared includes such things as looking up medications, knowing the diagnosis of the clients, being prepared to do procedures/treatments, having data related to prior laboratory and previous assessments completed before clinical, and having a written plan of care. Faculty will provide students with clinical expectations the day of orientation to the clinical facility. Students not prepared for clinical assignment, will be sent home and will be subject to the clinical attendance policy per the Nursing Program Policy/Procedure Student Manual.Class Attendance:Each student is expected to recognize the importance of class attendance and promptness. If a student should miss a class for any reason he/she is expected to cover, on his/her own, the material he/she missed. All work must be made up to the satisfaction of the instructor involved. For absences on days when exams/quizzes are given, refer to section related to “makeup test procedure”. It is the student’s responsibility to notify the Instructor immediately if the student is unable to attend class. If a student demonstrates unprofessional behavior in the classroom, the student will be asked to leave. Frequent tardiness and early departures from class can contribute to course failure. Students who attend no class meetings up to and including the Section Census Date published in the Class Schedule at www.mccneb.edu/schedule/ may be disenrolled from the class. There is no appeal for this disenrollment.

Clinical Attendance:Refer to Attendance Policy in the Nursing Policy/Procedure Student Manual

Student Withdrawal: If you cannot participate in and complete this course, you should officially withdraw by calling Central Registration at 402-457-5231 or 1-800-228-9553. Failure to officially withdraw will result in either an attendance-related failure (FX) or failing (F) grade. The last date to withdraw is noted in the CLASS IDENTIFICATION section of this syllabus.

Academic Honesty Statement:Students are reminded that materials they may use as sources for this course may be subject to copyright protection. Additional information about copyright is provided on the library webpage at http://www.mccneb.edu/library, by your instructor, or by the college’s Copyright Officer. In response to incidents of student dishonesty (cheating, plagiarism, etc.) the College imposes specific actions, that may include receiving a failing grade on a test, failure in a course, suspension from the College, or dismissal from the College. The disciplinary procedures are available in Student Services

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Use of Student Work:The ownership of student works submitted in fulfillment of classroom requirements shall remain with the student(s): By enrolling in classes offered by Metropolitan Community College, the student gives the College license to mark on, modify, and retain the work as may be required by the process of instruction, as described in the course syllabus. The institution shall not have the right to use the work in any other manner without the written consent of the student(s).

Accommodations for Students with Disabilities:If you have a disability that may substantially limit your ability to participate in this class, please contact a Disability Support Services Counselor, located in the Student Services Office on each campus. Metropolitan Community College will provide reasonable accommodations for persons with documented qualifying disabilities. However, it is the student’s responsibility to request accommodation. For further information, please contact the Student Services Office at your campus.

Assessment of Student Learning Program:Metropolitan Community College is committed to continuous improvement of teaching and learning. You may be asked to help us to accomplish this objective. For example, you may be asked to respond to surveys or questionnaires. In other cases, tests or assignments you are required to do for this course may be shared with faculty and used for assessment purposes. This will be done in accordance with FERPA guidelines.

Technology Resources and Use of College Computers:By using the information technology systems at MCC (including the computer systems and phones) you acknowledge and consent to the conditions of use as set forth in the Metropolitan Community College Procedures Memorandum on Acceptable Use of Information Technology and Resources. It is your responsibility as a student to be familiar with these procedures. The full text of the Procedures Memorandum may be found at the following website: http://www.mccneb.edu/itprocedures.htm

When using College computers at the computer labs, Learning Centers, Libraries and classrooms, you need to login with your username and password*. Your username and password are the same whenever you log into the network (campus computers), SharePoint Services, student e-mail, WebAdvisor and WebCT (if enrolled in an online or blended course). For other systems (not listed above), your instructor will provide you with the necessary username and password information.

The Password Center (http://www.mccneb.edu/password) is a new web resource available to all students and staff. This web site allows you to change (reset) your password even if you don’t know your username and password, provided the personal information you enter to verify your identity, matches the information the College has in it’s database. Verification information consists of student ID number (or the last 5 digits of your Social Security number), last name, birth date, street address and ZIP Code.

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*Note: If you have not logged in before, your initial password is the first initial of your first name (in UPPERCASE), the first initial of your last name (in lowercase), followed by your student ID number with leading zeros to make the password 9 characters long. For example, if your name is Chris Doe and your student ID number is 1234, your initial password will be Cd0001234.

Notice: This syllabus is written as an expectation of class topics, learning activities, and expected learning outcomes. However, the instructor reserves the right to make changes in this schedule that may result in enhanced or more effective learning for students. These modifications will not substantially change the intent or objectives of this course and will be done within the policies and guidelines of Metropolitan Community College.

LEARNING SUPPORT Metro's Learning, Math, and Writing Centers can help you achieve educational success. The staff in these centers provide drop-in assistance with basic math, reading, writing and computer skills. We offer a friendly, supportive learning environment. Self-paced computer-assisted instructional support in reading, vocabulary, typing, English as a Second Language, and online course orientation is also available.

Detailed information about these services are in the Student Handbook, College Catalog, and online. Links to these resources are located at http://www.mccneb.edu/learningcenter/.

COLLEGE POLICIESCollege policies, such as student rights and responsibilities, academic standards, plagiarism, and etc. are outlined in the College Catalog and Student Handbook. This information can be accessed via the online catalog at http://www.mccneb.edu/academics/catalog.asp.

STUDENT WITHDRAWAL: If you cannot attend and complete this course, you should officially withdraw by calling Central Registration, 457-5231. Failure to officially withdraw will result in either an instructor withdraw (IW) or failing (F) grade. The last date to withdraw is identified on the second page of this syllabus handout.

STUDENT CODE OF CONDUCT: The college has a standard code of conduct that involves consequences for specific academic and non-academic behavior that may result in a failing grade, probation, or suspension from the college. More complete information about the code of conduct is located in the Student Services portion of the online catalog (http://www.mccneb.edu/catalog/studentinformation.asp).

ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES: If you have a disability that may substantially limit your ability to participate in this class, please contact a Vocational Special Needs Counselor, located in the Student Services Office on each campus. Metropolitan Community College will provide reasonable accommodations for persons with documented qualifying disabilities. However, it is the student’s responsibility to request accommodations. For further information, please contact the Student Services Office at your campus.

[Other pertinent college policies are posted on the CDS website www.mccneb.edu/cds; it is suggested, but not required, that they be attached to your syllabus.]

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Student Services Important Dates2010 SPRING

March 11, 2010 – May 26, 2010

Tuition Payment Deadline..................................................................................................February 15 (M)Spring Quarter Begins...........................................................................................................March 11 (TH)First Day for Faculty to Initiate WX grade.......................................................................First class sessionSpring Recess (College Closed).....................................................................................April 3-4 (Sa – Su)Spring Term Graduation Application Deadline......................................................................April 01 (TH)Fall Priority Registration begins................................................................................................May 05 (W)Annual Graduation Ceremony.....................................................................................................May 14 (F)Fall General Registration begins................................................................................................May 19 (W)Winter Term “I” Grades Due ....................................................................................................May 19 (W)Last Day of Spring Classes........................................................................................................May 26 (W)Grades Due and Posted to WebAdvisor...........................................................................May 28 (F) 5 p.m.Memorial Day Recess (College Closed).......................................................................May 29-31 (Sa – M)Summer Term Graduation Application Deadline.....................................................................July 01 (TH)

The Last Day to Drop for a student-initiated “W” grade is also the last day for students to change from “Credit” to “Audit” or “Audit” to “Credit” with instructor approval. Students must drop by this date to avoid being assigned a grade of “F”. NOTE: “Last day to drop” refers to grades only.

To view the Last Day to Drop specific to your course section, go to the online class schedule at http://www.mccneb.edu/schedule/classschedule.asp and click on the “Important Dates” tab next to the course.

The Refund drop dates for each course section are automatically calculated based on the start and end dates and the number of sessions for the course. NOTE: Refer to refund policy below to determine the last day to receive a refund for your course.

REFUND POLICYEligibility for a refund is automatically calculated by the date of the withdrawal. The amount of refund is based on the number of class meetings held prior to the withdrawal compared to the total number of scheduled sessions for the course.

For refund or account questions call: (402) 457-2405 or 1-800-228-9553, extension 2405.

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Schedule of Assignments

* Please Note For Exams: Expect incorporation of delegating, prioritizing and pharmacology questions throughout all exams. Exam questions may be obtained from all sources (textbook, study guides, lecture, powerpoints, videos, concept maps, and handouts) and are objective based.

* Please Note For Lectures: Concept mapping may be utilized in the classroom. The class schedules is used as a guide and may need to be adjusted per Instructor discretion.

NURS 2150Class Schedule

WEEK

1 03/16/10 Unit 1 Management of the Perioperative Patient, Bariatrics

2 03/23/10 Unit 2 Emergency and Trauma Nursing. Exam over Unit I.

3 03/30/10 Unit 3 Bioterrorism and Mass Casualty Nursing With Triage.

4 & 5 4/6 & 4/13 Unit 4 Neurological, Musculoskeletal Disorders, and Connective Tissue Disease. Exam 2 over Units 2 and 3.

6/7 4/20 & 4/27 Unit 5 Endocrine and Hepatic Disorders. Exam 3 over Unit 4.

8 05/04/10 Unit 6 Infectious Diseases and Immune Dysfunctions. Exam 4 over Unit 5.

9 05/11/10 Unit 7 Cancer, End of Life, and Transplantation. Exam 5 over Unit 6.

10 05/18/10 Unit 8 Mega Code. Exam 6 over Unit 7 Review for Comprehensive Final

11 05/25/10 Comprehensive Final Exam

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NURS 2150 Clinical Component

Location:Assignments to clinical facility in the acute care setting.

Clinical focus:Hierarchy of needs, the nursing process, communication, safety, advancement of clinical skills, advancement of assessment skills, along with advancement of the understanding of pathophysiology to include medications, labs, diagnostic tests, and other significant data.

Preceptor Experience: Students may be assigned clinical experience with an RN preceptor. Refer to following page for specifics.

Clinical Methods of Instruction:A variety of teaching strategies applicable to the clinical experience will be utilized such as patient care, case study, demonstration, return demonstration, discussions group and/or individual, individual supervision, pre/post conferences, and journaling.

Emphasis in Clinical Experience: Safety is the emphasis in all areas of patient care to include but not limited to; medication administration and physiological cares.

Assessment of Clinical Student Progress:The instructor will observe and assess knowledge base through discussion and questioning during patient care. Pre and post conferences will be utilized to assess knowledge base through discussion. The written patient care plan, pre-lab data and ongoing patient care data will be assessed. Medication administration safety will also be an important area of patient care that will include verbal questioning and direct observation as to action, therapeutic response, side effects, and proper administration.

Assessment Methods:The student will be evaluated daily/weekly and will receive a satisfactory (S), or not observed (NO) or not applicable (NA) on the clinical assessment sheet based on quality of clinical performance by your clinical instructor. The student must achieve a satisfactory for each objective by the end of the clinical components. If the student does not achieve a satisfactory for each objective by the end of the clinical experience this indicates that the objectives was not met and therefore constitutes a clinical failure. Pre-lab requirements must be completed before the clinical experience. Pre-lab forms and clinical forms must be completed and submitted weekly. Students are responsible for completion of all assignments. The student must successfully complete clinical to pass the course. The student will participate in self-evaluation during the quarter.

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Metropolitan Community CollegeClinical Experience

Preceptor SupervisionAssociate Degree RN Program

Spring 2010

Goal: -Enhance learning on the clinical site, increase collegiality with staff nurses, smooth transition to RN role. -Build self-confidence -Develop problem-solving, critical thinking, and application of theory to practice -Develop time management and organizational skills

Student nurse role:- formulate individualized learning objectives and share such with staff RN- self-directed learner along with self-assessment development- develop effective communication skills - develop critical thinking, problem solving skills- develop clinical skills and prioritizing skills

Assigned staff RN role:- develop learning experiences congruent to student’s objectives- communicate with faculty as to student’s progress- be available at all times for the student- maintain high level clinical skills, critical thinking, and nursing interventions- discuss each step of process or skill for student to understand- share potential problems and how to solve or prevent- provide prompts or cues to assist student to retain information- supervise all medication administration- supervise all invasive procedures- emphasize safe practice

Faculty role:- facilitate relationship between staff RN and student- monitor learning experiences- evaluate student performance with staff RN

Staff RN characteristics:- at least 24 months clinical experience with current active license, BSN preferred- comprehensive knowledge, specialty certification or demonstrated expertise in

area of practice- interest in professional growth & mastery of clinical skills- patience and enthusiasm- nonthreatening and nonjudgmental- willingness to share knowledge and skills- knowledge of application of nursing theory to practice

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Unit I Management of the Perioperative PatientBariatrics

Goal: To increase knowledge base in perioperative nursing and achieve a greater understanding and empathy to patients who have undergone surgical interventions.

Objective: At completion of this unit you should be able to:1. Describe a comprehensive preoperative assessment including the identification of

surgical risk factors which are significant in perioperative management of the patient.2. Evaluate AORN standards of perioperative nursing practice. 3. Evaluate the roles and responsibilities of the RN in perioperative nursing including

legal/ethical considerations.4. Compare various types of anesthesia and related nursing responsibilities/interventions.5. Describe additional knowledge base required by the RN in the operating room (OR).6. Describe surgical asepsis. 7. Identify surgical prepped zones specific for various procedures.8. Evaluate roles of surgical team members.9. Identify required safety measures specific to OR in all phases of perioperative care to

decrease risk of infections/complications for all age specific populations.10. Identify common positions of the patient for specific procedures including prevention of

positioning complications.11. Discuss steps followed to prepare for surgical procedure.12. Evaluate bariatric concerns in OR.13. Critique physiological management intraoperatively and postoperatively for the surgical

patient to prevent postop complications.14. Critique documentation requirements for perioperative nursing.

Clinical Objectives:1. Experience perioperative nursing in the hospital setting.2. Complete perioperative experience form to identify management of the perioperative

patient.

Required Reading:Osborne: Chapter 25, 26, 27 & p. 279-284, & p. 319-320

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METROPOLITAN COMMUNITY COLLEGENURS 2150

Management of the Perioperative Patient

* You may use a separate sheet to complete this form.

Student Nurse____________________________________________________

Medical Diagnosis________________________________________________

Age__________Weight_____________Circle One: Male Female

Medication Allergies___________________Latex Allergy: Yes No

Scheduled Procedure:_____________________________________________

Include the following information:

1. Rationale for procedure:

2. Preoperative diagnostic labs, procedures, and rationale:

3. Identify significant assessment data that places the patient at a surgical risk with rationales.

4. Preoperative care; include teaching:(follow healthcare facilities policy and procedures, e.g. checklist, documentation)

5. Identify common medications that need to be discontinued prior to surgery, include rationale.

6. Describe surgical scrub.

7. Identify surgical attire and rationale.

8. Describe members of the surgical team and roles of each.

9. Describe preparation of the surgical suite.

10. Describe the position of the patient on surgical bed.

11. Identify safety measures taken during positioning.

12. Identify areas of body prepped and rationale.

13. Identify agent used for prep and rationale.

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14. Identify type of anesthesia used and rationales (e.g. general, MAC, block, local).

15. Describe anesthesia role throughout perioperative time frame.

16. Identify the following safety measures:

RN’s role in pre-op checks prior procedure:_________________________________

Time out:_____________________________________________________________

Counts:_______________________________________________________________

Grounding device and purpose of:___________________________________________

______________________________________________________________________

Other measures (ex. warming devices):______________________________________

17. Briefly explain how procedure was performed.

18. Identify specimens sent to lab.______________________________________________

_______________________________________________________________________

19. Identify immediate postoperative care: dressings, warmth, etc.

20. Identify pain management.

21. Identify documentation procedure by the RN.

22. Identify post surgical care in Medical Surgical Unit, ICU, or short term care

_______________________________________________________________________

23. Identify at least 3 nursing diagnosis appropriate for the specific procedure (may include 1 immediately post op period and 2 other for 1st 24-48 hours postop).

24. Identify unexpected outcomes that may have occurred during the patient’s surgical experience:

25. Summarize your perioperative experience including thought, feelings, and/or concerns.

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Unit II Emergency and Trauma Nursing

Objectives: At completion of this unit you will be able to:

1. Describe care of the emergency room patient using a holistic approach that includes the patient, family, and significant others.

2. Identify patient populations seen in ER to include variance in culture and religion.3. Describe priority emergency measures for any patient with an emergency condition.4. Critique the scope of emergency nursing practice.5. Identify certification requirements of the Certified Emergency Nurse.6. Identify the importance of assessing triaging and intervening patients in emergency or

trauma status.7. Identify priorities of care for the patient with multiple injuries.8. Differentiate heat related and cold injuries to include pathophysiology, assessment, and

interventions.9. Critique triage classification and priorities.10. Prioritize interventions for care of a patient with snake bite and insect bites.11. Prioritize care to patients who have experienced lightning injuries.12. Critique altitude-related illnesses to include assessment and interventions.13. Identify near-drowning interventions.14. Compare types of spinal cord injuries to include prioritization assessment, nursing

diagnosis, and interventions for best patient outcomes.15. Explore traumatic brain injury to include assessment, nursing interventions,

medical and surgical interventions.16. Identify nursing assessment, interventions and management of the patient with increased

Intracranial Pressure (ICP)17. Identify nursing assessment and emergency interventions for the patient with fractures. 18. Identify traumatic amputation in the emergency setting.19. Evaluate crush syndrome to include nursing assessment and interventions.20. Critique complex regional pain syndrome including assessment and interventions.21. Critique nursing care in the management of common sports related injuries.22. Critique care of stab and gun shot wounds.23. Identify interventions for the rape victim.24. Identify conditions that a nurse is mandated to report at state level.

Required Reading:

Reading: Osborne: Chapter 43Required: pg. 53-54, p. 75, p. 714-729, p. 1558-1559, p. 2167-2168, Chart 60-2, Chapters 32, 56, 68, 73, 74Supplements: Powerpoint

Video on emergency room nursingVideo on bioterrorismStudy guide

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Unit III Bioterrorism and Mass Casualty Nursing Including Triage

Objectives: At completion of this unit you should be able to:1. Critique triage classification in the mass casualty scenario.2. Identify mass casualty principles.3. Describe the mass casualty response plan.4. Compare and contrast the many types of bioterrorist agents including signs and

symptoms, and treatment options.5. Identify purpose of debriefing.6. Participate in case scenarios’ situations related to mass casualty, bioterrorism, and

emergencies.7. Discuss prioritization of patient movement in a mass casualty situation.

Assignments

Reading: Osborne: Chapter 72.

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Unit IV Neurological, Musculoskeletal DisordersConnective Tissue Disease

Objectives: At completion of this unit you should be able to:1. Identify seizure disorders.2. Explain types of seizure disorders, including diagnostic tests and nursing interventions.3. Describe movement disorders (MS, ALS).4. Explain dementia disorders of Alzheimer’s disease.5. Describe disorders of vertigo.6. Describe the presentation of headaches to include migraine, cluster, and tension.7. Explain movement disorders.8. Describe nursing management of the coma condition.9. Correlate nutritional deficiencies that cause neurologic syndrome.10. Differentiate visual field defects to include closed-angle, open angle glaucoma, macular

degeneration, and retinal occlusion.11. Describe assessment and interventions for patients with musculoskeletal problems.12. Describe the common levels of lower extremity amputation.13. Describe the role of the nurse in regards to caring for the patient with an amputation.

AssignmentsOsborne: p. 697, p. 1816-1818, p. 2291-2295, Chapter 29, 31, 55, 71

ReviewChapter 60.

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Unit V Endocrine DisordersHepatic Disorders

Objectives: At completion of this unit you should be able to:1. Recall physiology of the endocrine system.2. Compare clinical manifestations associated with hypofunction and hyperfunction of the

pituitary glands.3. Explain interventions for treatment of disorders of the pituitary glands.4. Identify teaching priorities for the patient taking hormone replacement therapy for

pituitary glands.5. Prioritize nursing care for the patient immediately post-transphenoidal hypophsectory.6. Describe disorders of the posterior pituitary glands including assessment interventions.7. Describe disorders of the adrenal glands to include clinical manifestations and treatment

modalities.8. Identify clinical manifestations for thyroid and parathyroid disorders.9. Explore assessment findings and treatment modalities for thyroid and parathyroid

disorders.10. Identify metabolic functions of the liver and liver disease including cirrhosis, surgical

management, non-surgical management, and postop care.11. Explain liver function tests and clinical manifestations of liver dysfunction.12. Identify jaundice, portal hypertension, ascites, varices, nutritional deficiencies, and

hepatic coma to pathophysiological alterations in the liver to include nursing and medical management.

13. Discuss the management of esophageal varices.14. Compare the various types of hepatitis, their cause, prevention, manifestation,

management, prognosis, and home health needs.

Assignments

Reading: Osborne: Chapter 46, 51, 52.

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Unit VI Infectious Disease and Immune Dysfunction

Objectives: At completion of this unit you should be able to:1. Identify patients that are immunocompromised.2. Describe the autoimmunity processes.3. Identify anphylaxis to include assessment, interventions, treatment.4. Identify Latex allergy, pathophysiology and management.5. Identify respiratory infections to include pneumonia, tuberculosis (TB), acute

pharyngitis and sinusitis.6. Distinguish between human immunodeficiency virus (HIV) and AIDS for clinical

manifestations and complications.7. Identify transmission of HIV/AIDS.8. Prioritize nursing diagnosis for a patient with HIV.9. Describe technique to reduce risk of infection in immunocompromised patients.10. Identify CNS infections to include, meningitis, encephalitis, and brain absess. 11. Identify opportunistic infections to include candidal thrush, cryptoccocal meningitis,

histoplasmosis, pneumocystis carinii pneumonia, cytomegalovirus, mycobacterium avium complex and toxoplasmosis.

12. Identify tick-borne infections to include Lyme Disease, Rocky Mountain Spotted Fever.13. Explain infections of the eye and ears to include infectious conjunctivitis, otitis media,

mastoiditis, labrinthitis, Meniere’s Disease.14. Describe the management and care of patients with skin infections including: contact,

parasite, viral, fungal, and bacterial.

AssignmentsOsborne: p. 729-734, p. 892-894, p. 937-946, p. 1855-1857, Chapter 20, 59, 60, 61 (p. 1968-1976), 66, & p. 2305-2311, p. 2353-2355

ReviewChapter 50.

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Unit VII Cancer, End of Life and Transplantation

Objectives: At completion of this unit you should be able to:

1. Describe the pathophysiology of death.2. Describe the purpose of advanced directives.3. Discuss philosophies of palliative and Hospice Care.4. Describe the role of the nurse and the interdisciplinary team in postmortem care.5. Interpret the physical and emotional signs of impending death.6. Prioritize interventions for symptoms of the client near death.7. Compare how variations in cultures and religious beliefs can impact the experience of

dying and death.8. Describe post-mortem care.9. Discuss the ethical and legal obligations of the nurse in regard to end of life care.10. Discuss perioperative interventions of heart transplantation.11. Discuss selection criteria for kidney donation.12. Prioritize nursing care during the first 24 hours post kidney transplantation.13. Describe complications of liver transplantation.14. Differentiate between sources of stem cell transplants.15. Identify interventions for patient who has undergone a bone marrow/stem cell transplant.16. Identify pre and post operative care of the corneal transplant patient.17. Identify how immune system responds to transplanted tissue or organs.18. Explain short and long term side effects of immunosuppression drugs.19. Identify rejection prophylaxis.20. Identify potential complications of transplantation.21. Identify available resources to allow dying patient to receive care in hospice or at home.22. Differentiate between benign/malignant tumors.23. Identify carcinogenic agents.24. Describe the nursing process in caring for a patient undergoing surgery, radiation,

chemotherapy, and other treatments for cancer.25. Discuss the role of RN in assessment and management of common oncological

emergencies.26. Identify components of grief and mourning and the nursing measures to support patient

and families.27. Provide cultural and spiritual care to terminally ill patient and their families.28. Discuss communication between the terminally ill patient, their family, and the RN.

Required Reading: Osborne: Chapter 17, 27, 64

p. 1300, p. 1441, p. 2370-2374p. 320-321, p. 206, p. 1489p. 1917-1920, p. 1865-1866p. 1914, p. 1447

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Unit VIII Mega Code

Objectives: At completion of this unit you should be able to:1. Analyze rhythm strips to identify cardiac dysrythmias.2. Discuss pharmacological measure to help treat cardiac dysrhymias.3. Explain and discuss pacing, defibrillation, cardioversion, and code blue.4. Participate in mega code scenarios.

Assignments

Osborne: Chapter 38, 39

Supplements: HandoutsPowerpointsStudy Guide

Participate in mega code scenarios.

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METROPOLITAN COMMUNITY COLLEGENURSING PROGRAM

NURS 2150 CLINICAL EVALUATIONCharting By Exception: If objective criteria is satisfactory, the area will be blank. Scale for rating clinical performance: U=Unsatisfactory NI=Needs Improvement NO=No OpportunityNA = Not Applicable

Name:

OBJECTIVE I: Maintain standards of ethical, professional and legal behavior while functioning as a safe and competent member of the interdisciplinary team.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Functions within the Scope of Practice and in accordance with educational level. 1. Protects confidential information.b. Independently records data on graphic sheet/client’s care record/flow sheet, I & O sheets. c. Maintains safe environment at all times. 1. Uses side-rails appropriately.

2. Call light is within reach. 3. Practices appropriate body mechanics consistently.

d. Adheres to institutional policies regarding standard precautions and security.

1. Hand-washing.2. Utilizing barrier protectors.3. Cleaning client area.4. Handling linen correctly.

e. Administers medications utilizing safe practices.

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OBJECTIVE II: Demonstrate responsibility and accountability for nursing practice with an awareness of the need for continued personal learning and self-development.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Demonstrate accountability for own actions.

1. Self learner and takes initiative.b. Identifies own strengths and limitations with guidance from instructor.c. Reports promptly and participates in conferences.d. Successfully completes all written assignments on time and with appropriate minimum score when applicable.

1. Completes thorough and accurate documentation per agency policy. 2. Completes daily pre-lab documents as assigned.

3. Completes math exam with 100% (only three attempts per policy).e. Demonstrates reliable clinical attendance.

1. Notifies clinical instructor in timely manner when unable to attend clinical.f. Maintains good personal hygiene.g. Adheres to acceptable clinical dress.

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OBJECTIVE III: Display caring behaviors in the delivery of nursing care to clients

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Accommodates differences of race, culture.

b. Demonstrates a respectful attitude towards others.

c. Uses appropriate title and tone of voice.

d. Spends time with client beyond the time spent providing physical care.

e. Provides privacy for the client when appropriate.

f. Able to recognize measures to support psycho-social integrity.

g. Accepts client’s communications without judging.

h. Demonstrates an awareness of client’s religious needs.

i. Demonstrates a positive attitude through one’s behavior.

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OBJECTIVE IV: Utilize knowledge from nursing and related disciplines when applying the nursing process in the provision of nursing care to clients.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Assesses the basic human needs 1. Collects data from appropriate

sources, i.e, chart, Kardex, client, significant others, nursing staff. 2. Demonstrates critical thinking skills through data collection and subsequent problem solving. 3. Performs basic physical assessment, progressing to mastery of advanced assessment skills. a. Submits assessment data weekly and as part of each care plan. b. Defines diagnostic tests and relates to client’s condition. c. Successfully completes wkly head to toe assessments on assigned client(s) in clinical area. d. Identifies priority nursing diagnosis.

1. Reviews assessment data.

2. Identifies the problem (s) for the client.

3. Expresses the problems in the form of a nursing diagnosis.

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OBJECTIVE IV continued Utilize knowledge from nursing and related disciplines when applying the nursing process in the provision of nursing care to clients.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

e. Develops a plan of care based on the nursing diagnosis.

1. Establishes goals.2. Evaluate goals.3. Identifies nursinginterventions related toestablished goals.4. Documents

appropriaterationale and source for eachnursing intervention.

f. Implements the plan of care in a thorough manner under the supervision of the clinical instructor.1. Initiates basic care

without direct supervision of the clinical instructor.

g. Participates in the evaluation of care.1. Observes and

describes changes in client’s status.

2. Establish new goals as needed.

h. Successfully completes two concept maps with five nursing diagnoses and five nursing interventions for each N.D.

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OBJECTIVE V: Manage the nursing care of clients with selected health needs in structured settings in collaboration with the interdisciplinary team.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Discusses plan of care with appropriate nursing staff.

b. Informs appropriate staff member if client assignment requires nursing action above level of responsibility.

c. Utilizes an organized plan of care.

d. Follows instructions provided by instructors or appropriate health team member.

e. Directs questions or problems regarding nursing care to the instructor.

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OBJECTIVE VI: Employ effective communication to establish relationships with clients and the interdisciplinary team.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Introduces self and initiates conversation with client.

b. Notes client’s verbal and nonverbal communication.

c. Explains procedures before beginning.

d. Reports client concerns and pertinent observations to appropriate health team member and instructor in a timely manner.

e. Gives a concise and comprehensive report to appropriate health team member at the end of clinical hours.

f. Completes wkly reflective journaling.

g. Communicates effectively with all clients, families and health care team members at all times.

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OBJECTIVE VII: Utilize the teaching-learning process to assist clients to reach a higher level of health.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Instructs client on health promotion measures.

b. Identifies learning readiness.c. Identifies assessing for

appropriate learning style for patient.

d. Instructs patient on identified needs.

e. Assesses learning and technique used to achieve goal.

f. Completes documentation of teaching and evaluation of learning by the patient.

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OBJECTIVE VIII: Follow the hierarchy of needs when providing nursing care to clients in collaboration with the interdisciplinary team.

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Instructor Comments

a. Meets the physiologic needs of the client.1. Feeds client when indicated.2. Positions client to enhance

pulmonary functions.3. Maintains recommended level of

oral intake.4. Provides range of motion exercises.

b. Meets the safety needs of the client.1. Demonstrate safe and competent

nursing practice.2. Identifies factors related to client’s

current condition which may put them at risk for complications.

Charting By Exception: If objective criteria is satisfactory, the area will be blank. Scale for rating clinical performance: U=Unsatisfactory NI=Needs Improvement NO=No OpportunityNA = Not Applicable

EVALUATION: The student will receive a satisfactory, unsatisfactory, needs improvement, no opportunity or not applicable based on the quality of clinical performance as outlined in the course syllabus. The instructor will rate the student’s performance weekly. The student must achieve a satisfactory for each objective by the end of the clinical course. If the student does not achieve a satisfactory for each objective by the end of the quarter the grade will be an unsatisfactory for that objective. An unsatisfactory in any one objective at the end of the quarter indicates that the objective has not been met and therefore constitutes a clinical failure. (Any unsatisfactory must all be followed by a satisfactory.) The student must successfully pass clinical to pass the course. The student will participate in self-evaluation during the quarter.

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SUMMARY OF ABSENCES/TARDIESWeek 1 2 3 4 5 6 7

Hours of absence.

Number of tardies.

Total of absences and tardies

ACKNOWLEDGEMENT OF INSTRUCTOR’S NOTATIONS

Week 1 2 3 4 5 6 7

Instructor’s initials

Student’s initials

NOTE: Student’s initials indicate that she/he has reviewed instructor’s notations for the previous week of clinical practice.

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Instructor’s signature: Date:

Student’s signature:

Student’s Comments:

Date:

FINAL QUARTER EVALUATION

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