NURS 196 - Walla Walla Community College
Walla Walla Community College
Nursing Education
Beginning Nursing Concepts I
NURS 101
Winter Quarter 2010
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Every effort is made to ensure accuracy in the syllabus at the time of printing. However, the Walla Walla Community College Nursing Education Program reserves the right to change any provision or requirement that is necessitated by circumstances arising during the course. All changes will be provided in writing.
COURSE OUTLINE
Course Identifier: NURS 101
Title: Beginning Nursing Concepts I
Credits: 6
Class Hrs Per Wk: 6
Catalog Description: A continuation of the principles of nursing care introduced in NURS 100. The focus is on providing care for clients of all ages who are experiencing normal life processes or common/chronic disease processes in selected systems.
Prerequisites: NURS 100 and 110
Corequisite: NURS 111
Teaching Format: Lecture/Discussion
Critical Thinking Activities
Small Group Activities
Audio-visual
Computer-based Learning Activities
Location: Walla Walla Campus – Room 1706
Clarkston Campus – Room 2107
Course Topics: Introduction to Care of the Child
Perioperative Nursing
Fluid, Electrolytes, Acid-Base Balance I
Cancer I
Men's Health
Integumentary
Musculoskeletal
Diabetes
Respiratory I
Evaluation Devices: Activities
Unit Tests
Comprehensive Final
ATI Tests
COURSE COMPETENCIES:
Critical Thinking
1. Demonstrate critical thinking in the use of the nursing process.
2. Demonstrate use of management/leadership principles in the delivery of client/patient care.
Caring
3. Perform interventions in a safe and effective manner.
4. Use therapeutic communication.
Professional Behaviors
5. Demonstrate professional behaviors.
FACULTY CONTACT LIST
NOTE: Students are encouraged to contact the faculty member responsible for the content area or clinical experience that they have a question about. Contact your faculty advisor for academic concerns and advising.
Walla Walla Campus: Nursing Office: 509-527-4240
Clarkston Campus: Nursing Office: 509-758-1702
Director of Nursing Education: Marilyn D. Galusha, RN, MSN
|Walla Walla-based Instructors |Office Number |Email addresses |
|Kathy Adamski, RN, MN |527-4244 |kathleen.adamski@wwcc.edu |
|(Level I Lead Instructor) | |Cell: 200-0904 |
|Brenda Anderson, RN, MSN |527-4327 |brenda.anderson@wwcc.edu |
| | |Cell: 240-4084 |
|Grace Hiner, RN, MN |527-4421 |grace.hiner@wwcc.edu |
|Clarkston-based Instructors | | |
|Carol McFadyen, RN, Ph.D. |758-1728 |carol.mcfadyen@wwcc.edu |
|(Clarkston Lead Instructor) | | |
|Todd Carpenter, RN, BSN |758-1787 |todd.carpenter@wwcc.edu |
Office Hours for instructors may be found on the Level I Bulletin Board
BEGINNING NURSING CONCEPTS I
NURS 101
Grading Criteria & Distribution of Points:
|CONTENT |POINTS |
|Perioperative Nursing |3 |
|Fluids, Electrolytes, Acid-Base Balance I (2 classes) |6 |
|Introduction to Care of the Child |3 |
|Diabetes (3 classes) |9 |
|Cancer I |3 |
|Respiratory I (4 classes) |12 |
|Integumentary |3 |
|Musculoskeletal (3 classes) |9 |
|Men's Health |3 |
|4 unit tests (9 questions per 3-hour lecture period) |153 |
|Final Test (5 questions per 3-hour lecture period) |85 |
|ATI PN Fundamentals of Nursing comprehensive test |30 |
|Total Points available |319 |
(All content will be taught via ITV. Faculty will travel part of the time weather permitting.)
**Students must attain 75% or greater cumulative score on tests to achieve a passing grade in NURS 101. Activity points will accumulate as achieved, however, they will not be added to the grade until the end of the quarter and will be added only if the test score is a minimum of 75%.
Group testing - following each of the four (4) unit tests, a small-group test will be given. If a 90% is achieved on this group test, the members of the group shall receive 2 additional points. If the group receives a score of 81-89% each member shall receive 1 additional point. Any group scoring 80% or below shall receive no points. All points achieved through group testing shall be documented as bonus activity points.
Course Expectations:
1. Follow all policies as outlined in Nursing Student Handbook
2. If absent from class, no points shall be awarded for missed in-class learning activities
3. All assignments must be accounted before progression regardless of score achieved.
4. Late papers will receive a one-point deduction per school day when turned in after the due date and /or time (i.e. beginning of class or as stated).
Testing: Failure to take a test at the scheduled time will result in an automatic reduction of 5% of the available score from the earned score. (See p. 18 of the WWCC Nursing Student Handbook).
Grading Scale – See Nursing Student Handbook
Assessment Technologies Institute (ATI) Testing
• One (1) proctored computerized mastery examination will be administered this quarter: PN Fundamentals for Nursing Practice.
• Prior to taking this content mastery examination, each student must complete a non-proctored, online practice test and achieve a score of 90%. This non-proctored, online practice test can be taken more than once however, a 90% must be achieved. You will not be allowed to take the proctored exam if you do not complete the online practice exam by the due date. Access and Test ID codes will be provided.
• In order to be admitted to the proctored exam, you will need to submit a copy of your non-proctored, online practice test individual score to Kathy/Carolyn/Carol (front page only).
• An ATI “Proficiency Level II” must be achieved. This is considered minimum competency.
• Failure to achieve a “Proficiency Level II” on the first proctored exam shall require remediation prior to retesting. A student has a maximum of five (5) attempts to meet the minimum proficiency on the proctored exam.
• Failure to achieve a “Proficiency Level II” prior to the end of winter quarter will result in an Incomplete “I” grade contract.
• Failure to clear the “I” grade contract by the end of the first two weeks of the next quarter will result in the conversion of the “I” grade to a C- and the student will not be allowed to progress.
• The points available on the ATI Content Mastery Test will be allocated on a curved scale basis. Points will be prorated with the highest percentage score earning 100% of the available points.
|Perioperative Nursing |
|Topic |Objectives |Assignments/Comments |
|Perioperative Nursing |1. Explain the concept of perioperative nursing |Lewis, et al (7th ed.) |
| | |Ch. 18, pp. 343-357 |
| |2. Describe essential components of preoperative nursing | |
|Preoperative Nursing C |(assessment, relevant diagnostic tests, teaching, informed consent, etc.) | |
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| |Develop a preoperative teaching plan for a client undergoing open abdominal surgery. | |
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| |Describe the action, therapeutic effect, and nursing implications of medications administered during the | |
| |perioperative period. | |
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|Intraoperative Nursing Care|Identify the surgical team and describe their role in client safety.* | |
| | |Lewis, et al (7th ed.) |
| |Compare and contrast types of anesthesia. |SCAN Ch. 19, pp. 359-373 |
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| |Describe the role of the nurse related to conscious sedation and explain potential risk factors. |[Objectives marked with (*) are also covered in the |
| | |Perioperative Experience Reaction Paper, NURS 111]. |
| |Discuss measures used to maintain client safety during the intraoperative phase.* | |
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| |Explain the role of the PACU nurse related to patient safety immediately after surgery (assessment/interventions).| |
|Postoperative Nursing Care | | |
| |Describe the role of the nurse caring for hospitalized surgical clients, including assessment, potential |Lewis, et al (7th ed.) |
| |complications, interventions, and evaluation. |Ch. 20, pp. 376-395 |
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|Acute Pain |Differentiate acute from chronic pain. | |
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| |Review methods of assessing acute pain and describe common responses to pain. | |
| | |Lewis, et al (7th ed.) |
| |Explain the mechanisms whereby non-narcotic and narcotic analgesics relieve pain. Discuss rationale and teaching |Ch. 10, pp. 125-148 |
|Pain, Acute |requirements for the use of a PCA. | |
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|Fluid and Electrolytes, Acid-Base Balance I (Class #1) |
|Topic |Objectives |Assignment/Comments |
|Fluid and Electrolyte |1. Describe the normal physiology of fluid balance |Potter. & Perry (7th ed.) |
|Imbalances |Fluid compartments |Ch. 41, pp. 966-970, 981-992, 1004-1021 (unexpected |
| |Functions of body fluids |outcomes)- stop at Blood Replacement |
| |Types of electrolytes | |
| |Role of proteins | |
|Laboratory & Diagnostic | |Silvestri (4th ed.), |
|Testing |2. Identify the significance of abnormal laboratory values related to fluid imbalances: |Ch. 11, pp. 100-104 and 107 |
| |Serum electrolytes |Albumin, |
| |Serum albumin |Protein, |
| |Hematocrit |Electrolytes, |
| |Blood Urea Nitrogen (BUN) |Renal function studies, |
| | |Hemoglobin and hematocrit |
| |Describe the etiology, clinical manifestations and nursing management of clients at risk for or with: | |
| |Fluid volume deficit/shock | |
| |Fluid volume excess | |
| |Fluid volume shifts | |
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| |Compare the actions of IV solutions in the body |Silvestri, (4th ed.) |
|IV Fluid Therapy |Hypotonic |Ch. 9, pp 74 - 89 |
| |Isotonic | |
| |Hypertonic | |
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| |5. Identify legal/ethical principles that guide the practice of IV therapy in providing care for children and | |
| |adults. | |
| |Assessments | |
| |Site | |
| |Rate | |
| |Solution | |
| |Documentation | |
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|Fluid and Electrolytes, Acid-Base Balance I (Class #2) |
|Topic |Objectives |Assignment/Comments |
|Assessment and Management |Describe the etiology, clinical manifestations, medical management and nursing interventions for the following |Potter & Perry (7th ed.) |
|of the Client with |imbalances: |Ch. 41, pp. 970-981 |
|Electrolyte Imbalances |Sodium (Na) | |
| |Chloride (Cl) | |
| |Potassium (K) | |
| |Calcium (Ca) | |
| |Phosphorus (P) |Silvestri, (4th ed.) |
| | |Ch. 10, pp 90-99 |
| |Describe the role of the chemical buffers in the lungs and kidneys in the maintenance of acid-base balance. | |
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| |Describe laboratory test results indicating acid base imbalance. | |
| |Arterial Blood Gases (ABGs) | |
| |Serum CO2 | |
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|Assessment and Management |Identify the four types of acid-base imbalances by ABG analysis. | |
|of the Client with |Metabolic acidosis and alkalosis | |
|Acid-Base Imbalances |Respiratory acidosis and alkalosis | |
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| |Describe the etiology, risk factors, clinical manifestations, medical management and nursing interventions for the| |
| |client with metabolic acidosis /alkalosis | |
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|Introduction to Care of the Child |
|Topic |Objectives |Assignment/Comments |
|Nurse’s Role |1. Discuss the nurse’s role in health maintenance and health promotion for children |Leifer (5th ed.) |
| | |SCAN Ch. 15, pp. 345-379 |
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|Health Maintenance & Health|2. Discuss the use of the nursing process in health maintenance and health promotion activities for children of |Leifer (5th ed.) |
|Promotion |each age group |Ch. 16 (Infants), “Key Points”, |
| |Assessment of normal growth & development |p. 397 |
| |Erikson and Piaget | |
| |Play, toys or activities |Ch. 17 (Toddlers), “Key Points”, |
| | |p. 412 |
|Learning Needs | | |
| |3. Discuss common learning needs for parents in regards to health promotion and maintenance for children of each|Ch. 18 (Pre-Schooler), “Key Points”, |
| |age group |pp. 426-427 |
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|Assessment | |Ch. 19 (School-Age), “Key Points”, |
| |4. Describe variations in techniques of physical assessment based on the child’s age and level of development |p. 442 |
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| | |Ch. 20 (Adolescent), “Key Points”, |
| | |pp. 461-462 |
|Care of Child in Hospital |5. Describe nursing interventions to provide age appropriate care to the ill child and family in the hospital | |
| | |Ch. 21 (Hospitalization), pp. 472-479 |
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| | |Appendix K, “Normal Vital Signs of Infants and |
| | |Children”, p. 773 |
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|Diabetes (Class #1) |
|Topic |Objectives |Assignment/Comments |
|Pathophysiology and |Differentiate between the etiology and pathophysiology of Type I and Type II Diabetes |Lewis, et al (7th ed.) |
|Etiology |Criteria for Diagnosis |Ch. 49 |
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| |Describe the significance of findings from laboratory and diagnostic testing in caring for the client with |Silvestri (4th ed.) |
|Laboratory & diagnostic |diabetes |Ch. 33, pp. 387-390 |
|testing |Blood glucose monitoring |Ch. 44, pp. 553-560 |
| |Urine testing for ketones | |
| |Glycosylated hemoglobin | |
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| |Discuss the medical/nursing management of the client with diabetes | |
|Management |Nutrition |Silvestri (4th ed.) |
| |Exercise |Ch. 44, pp. 558, Box 44-20 |
| |Medications | |
| |Care during illness and surgery | |
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|Diabetes (Class #2) |
|Topic |Objectives |Assignment/Comments |
|Medications |Identify the action, therapeutic effect, and nursing implications for the use of: |Lewis, et al (7th ed.) |
| |Insulin |Ch. 49 |
| |Oral hypoglycemic agents | |
| | |Silvestri (4th ed.) |
| |2. Identify steps/measures for safe administration of diabetic medications. |Ch. 45, pp. 553-555 |
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|Acute Complications |3. Identify the s/s of diabetic ketoacidosis (DKA). |Lewis, et al (7th ed.) |
| | |Ch. 17, pp. 334-337 (Alterations in Acid-Base |
| | |Balance and Clinical Manifestations) |
| |4. Interpret ABG results r/t DKA. | |
| | |Silvestri (4th ed.) |
|Collaborative Care Nursing | |Ch. 44, pp. 556-557 (Acute Complications of |
|Management |5. Discuss assessment and nursing interventions for a client with diabetes in an acute care facility |Diabetes Mellitus) |
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| | |Doenges (11th ed.) |
| | |“Fluid Volume, Deficient”, pp. 320-327 |
| | |“Tissue Perfusion, Ineffective”, pp. 705-714 |
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|Diabetes (Class #3) |
|Topic |Objectives |Assignment/Comments |
|Long Term Complications |1. Discuss health promotion activities to prevent the long term complication of diabetes |Lewis, et al (7th ed.) |
|Health Promotion |Macrovascular |Ch. 49 |
| |Microvascular | |
| |Nephropathy | |
| |Neuropathy | |
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|Teaching Plan |Develop an age appropriate teaching plan for management of diabetes including learning needs, readiness to learn &|Doenges (11th ed.) |
| |documentation. |“Deficient Knowledge” regarding disease |
| | |process/treatment and individual care needs, pp. |
| | |433-437 |
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|Management |Describe the psychosocial needs of a client newly diagnosed with Diabetes Mellitus | |
| |Adjustment to life with a chronic disease |Potter & Perry (7th ed.) |
| |Developmental needs of children with diabetes |Ch. 11, pp. 138-140 |
| | |Review Erikson’s developmental stages and Piaget’s |
| | |Cognitive developmental stages |
| |Identify community resources available to meet the needs of clients with diabetes | |
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|Cancer I |
|Topic |Objectives |Assignment/Comments |
|Introduction to Cancer |1. Describe the biology of cancer. |Expect to use vocabulary in class activity |
|Concepts | |Silvestri (4th ed.) |
| |2. Compare and contrast benign and malignant neoplasms. |Ch. 42, p. 496 (vocabulary) |
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| |3. Explain how a diagnosis is made and the importance of the various classification systems related to diagnosis |Bring markers, colored pencils, crayons for drawing |
| |and outcome. |(crayons available in WW) |
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| |4. Describe prevalence, incidence, survival rates and mortality rates of common cancers in the US. |Silvestri (4th ed.) |
| | |Ch. 42, pp. 498-521 |
| |5. Describe the role of the nurse in prevention and/or early detection of cancer. | |
| | |Doenges (11th ed.) |
| |6. Discuss the psychological responses and coping mechanisms related to a diagnosis of cancer. |“Grieving” pp. 345-349 |
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| |7. Differentiate between treatment modalities and the ethical role of the nurse while clients are making care | |
| |choices. | |
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| |8. Describe nursing management for clients undergoing cancer treatment. | |
| |Patient and environmental safety | |
| |Potential side effects or complications | |
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|Respiratory I (Class #1) |
|Topics |Objectives |Assignment/Comments |
|Anatomy & Physiology |Discuss the anatomy and physiology (A & P) of the respiratory system in relation to care of the client with |Lewis, et al (7th ed.) |
| |respiratory disorders. |Ch. 26, pp. 509-532 |
| |ventilation | |
| |neural control of respiration |Pages 509-512 of assigned reading are a review of A |
| |differences between the child and adult respiratory systems |& P. You are responsible for the material. |
| |effects of aging on the respiratory system. |Concepts that will be discussed in class require |
| | |that you understand the A & P reviewed in these |
| |Describe the nursing assessment for a client with a respiratory problem. |pages before coming to class. Please call Grace |
| |history |Hiner to make an appointment if you are having |
| |examination of the respiratory system |difficulty understanding the A & P. |
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| |Describe the clinical manifestations of a client with respiratory dysfunction | |
|Assessment |normal versus abnormal breath sounds |Silvestri (4rd ed.) |
| |assessment abnormalities and chest examination findings in common pulmonary problems |pp. 364 (Tuberculosis & Mantoux Test) |
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| |Describe the nursing responsibilities for preparing and caring for the client receiving the following laboratory | |
|Laboratory & diagnostic |and diagnostic studies; also describe the significance of the results of the following laboratory and diagnostic|Graded Assignment: |
|studies |studies: |Video on reserve in library: |
| |CBC (Complete Blood Count: Focus on RBC, Hgb, Hct, & platelets) |“Performing Respiratory Assessment” by Springhouse |
| |ABGs (Arterial Blood Gases) |(2000) |
| |Pulse oximetry |Written assignment due at the beginning of |
| |Sputum studies |Respiratory Class #1 at 0900 (3 points): Briefly |
|Nursing Interventions |Skin test for tuberculosis |(one to two paragraphs) describe one main point that|
| |Radiographic studies |you learned from watching this video. Assignment |
| |Endoscopic examination |must be typed with the title, “Write-up for |
| |Pulmonary Function Tests |Respiratory Assessment Video”. Please be sure that |
| |Exercise Testing |student name and instructor name are at the top of |
| | |the page. |
|Respiratory I (Class #2) |
|Topics |Objectives |Assignment/Comments |
|Disorders of the Upper |Review the structures of the upper respiratory system |Lewis, et al (7th ed.) |
|Respiratory system |differences between child and adult |Ch. 27, pp. 533-551 |
| |effects of aging on the upper respiratory tract | |
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|Assessment and Management |Discuss considerations in the care of the pediatric client with disorders of the upper respiratory system | |
|of the client with | | |
|disorders of the Upper |Describe the pathophysiology (etiology, pathogenesis, and clinical manifestations) nursing interventions, and |Silvestri, (4rd ed.) |
|Respiratory System |client learning needs of upper airway disorders. |pp. 357-360 |
| |Nasal Fracture | |
| |Expistaxis |Review fall lecture (NURS 100) PowerPoint slides |
| |Sinusitis |covering Sympathetic Nervous System and |
| |Otitis Media |Parasympathetic Nervous System from Intro to |
| |Tonsillitis |Pharmacology & Medication Administration Class #1. |
| |Allergic Rhinitis, Acute Viral Rhinitis |Review the terms: sympathomimetic, adrenergic, |
| |Influenza; H1N1 |anticholinergic, parasympathomimetic, muscurinic, |
| |SARS; West Nile Virus |and cholinergic. |
| |Acute Pharyngitis | |
| |Peritonsillar Abscess | |
| |Obstructive Sleep Apnea (OSA) | |
| |Epiglotitis | |
| |LTB (laryngotracheo-bronchitis)—Croup |Doenges (11th ed.) |
| |Laryngeal cancer |Review the following nursing diagnoses |
| | |1. Ineffective Airway Clearance |
|Pharmacology |Identify the action, therapeutic effects, drug interactions and nursing implications of medications used to treat |2. Ineffective Breathing Pattern |
| |upper respiratory problems. | |
| |nose drops/nasal steroids |Bring Doenges (11th ed) Nursing Pocket Guide : |
| |antihistamines |Diagnoses, Interventions & Rationales to class. |
| |decongestants | |
| |expectorants & mucolytic agents | |
| |antitussives | |
| |alternative therapies: Echinacea, zinc, ascorbic acid (vitamin C) | |
|Respiratory I (Class #3) |
|Topics |Objectives |Assignment/Comments |
|Care of the Client with a |1. Describe nursing interventions to maintain or restore health for the client with a tracheostomy |Lewis, et al (7th ed.) |
|Tracheostomy: |Assessment |pp. 543-550 (Tracheostomy) |
|Nursing Interventions |Suctioning: Complications (Hypoxia, Trauma, Infection, Vagal Stimulation) | |
| |Swallowing; Nutrition | |
| |Communication; Psychosocial considerations | |
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| |2. Describe the etiology, pathogenesis, clinical manifestations, and nursing management of the client with: | |
|Disorders of the Lower |Acute Bronchitis; Bronchiolitis (Respiratory Syncytial Virus- RSV) |Lewis, et al (7th ed.) |
|Respiratory System |Pneumonia |pp. 561-569 (Acute Bronchitis & Pneumonia) |
| |Atelectasis |pp. 578-585 (Lung cancer) |
| |Lung cancer | |
| | |Silvestri (4rd ed.) |
| |3. Describe nursing precautions and interventions in caring for the client with a respiratory infection |pp. 360-362 (Bronchitis, RSV, Pneumonia) |
| |Transmission based guidelines and best practices for drug resistant infections (Isolation Precautions) | |
| |Laboratory assessment: CBC—focus on WBC & differential; Culture, Gram stain, &|Potter & Perry (7th ed.) |
| |Sensitivity |pp. 661-667 (Isolation Precautions) |
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|Nursing Interventions |4. Describe the action, therapeutic effects, side effects and nursing implications of medications used for the | |
| |treatment of infections. | |
| |Antipyretics | |
| |Antimicrobial therapy | |
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| |Develop a plan for providing information about continuing with antibiotic therapy after discharge | |
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| |Describe the nursing responsibilities in relation to the use of oxygen therapy, including the assessment for | |
| |complications. |Lewis, et al (7th ed.) |
| |Goals of oxygen therapy |pp. 640-643 (O2 therapy) |
| |Hazards and complications of oxygen therapy | |
| |Types of oxygen delivery systems |Bring Davis Drug Guide(11th ed.) to class |
|Respiratory I (Class #4) |
|Topic |Objectives |Assignment/Comments |
|Obstructive Pulmonary |Discuss the etiology, pathophysiology, clinical manifestations, and nursing management of the client with asthma.|Supplemental Reading Assignment on Peak Flow |
|Diseases: |Triggers |Meter—in NURS 101 syllabus |
|Asthma |Peak flow monitoring | |
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| | |Lewis, et al (7th ed.) |
|Pharmacology |Describe the actions, therapeutic effects, and nursing implications of pharmacological therapies used to treat |Ch. 29: pp. 607-634; 646-659 |
| |and prevent asthma attacks. | |
| |Bronchodilators (short and long acting) |Silvestri (4rd ed.) |
| |Corticosteroids |pp. 362-367 (Asthma and Cystic Fibrosis) |
| |Methylxanthines | |
| |Mast Cell Stabilizers (Cromolyn Sodium) |Review the following lung volume terms (See |
| |Leukotrienne Modifiers |Respiratory Class #1 lecture notes and Lewis, 7th |
| | |ed, p. 531) |
| | |Peak Expiratory Flow Rate (PEFR) |
| |Discuss risk factors, etiology, pathophysiology, clinical manifestations and nursing management for the client |Forced Vital Capacity (FVC) |
|COPD |with Chronic Obstructive Pulmonary Diseases (COPD). |Forced Expiratory Volume (FEV) |
| |Chronic Bronchitis |Residual Volume (RV) |
|Health Maintenance |Emphysema | |
|& Restoration | | |
| |4. Describe the actions, therapeutic effects, and nursing implications of |Doenges (11th ed.) |
| |pharmacological therapies used to manage COPD |Review the nursing diagnosis |
| | |“Impaired Gas Exchange” |
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| |5. Discuss risk factors , etiology, pathogenesis, clinical manifestations and nursing management for the client | |
| |with Cystic Fibrosis | |
|Cystic Fibrosis | | |
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RESPIRATORY SUPPLEMENTAL REFERENCE
Original Article:
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Asthma: Use a peak flow meter to gain control
A peak flow meter is a simple, hand-held device that measures how efficiently you can move air out of your lungs. Peak flow readings can warn you of an impending asthma attack hours — or even days — before you experience any signs or symptoms. With time on your side, you can adjust your asthma medication and take other steps to help prevent an attack.
One day at a time
A peak flow meter allows you to objectively measure day-to-day variations in your breathing. When your asthma is under control, your airways are open and you can force more air into the peak flow meter. But when your airways are inflamed and constricted, you can't blow as hard into the meter — making your peak flow rate lower.
Your doctor may recommend using a peak flow meter at least once a day — typically before taking your asthma medication in the morning. Use the peak flow meter at the same time every day, and record your readings in an asthma diary. These readings will help you and your doctor:
• Determine the severity of your asthma
• Evaluate the effectiveness of your current treatment
• Determine when to add or stop certain medications
• Recognize an asthma attack before signs or symptoms appear
• Decide when to seek emergency care
Using your peak flow meter
Peak flow meters are available over-the-counter. Better yet, they're easy to use.
• Move the marker to the bottom of the numbered scale, and connect the mouthpiece to the peak flow meter.
• Stand up.
• Take a deep breath, filling your lungs completely.
• Place your lips tightly around the mouthpiece. Blow as hard and as fast as you can with a single breath.
• Note the final position of the marker. This is your peak flow rate.
• Blow into the peak flow meter two more times. Record the highest reading of the three in your asthma diary.
For the most accurate readings, it's important to keep your peak flow meter clean. Follow the manufacturer's instructions.
Determining your personal best
Your "personal best" peak flow rate is the highest peak flow rate you can reach over a two- to three-week period when you feel good and have no asthma symptoms. This flow rate serves as a benchmark in your daily self-management plan. Because everyone's asthma is different, your personal best will be unique to you.
Your doctor will help you determine your personal best. Typically, you'll take readings twice a day for two weeks when you're not having symptoms. Ignoring any outliers, the highest consistent reading during the trial period is your personal best.
Organizing your peak flow zones
Your doctor will use your personal best peak flow rate to organize peak flow zones: green (stable), yellow (caution) and red (alert). If your peak flow readings fall too far below your personal best, you'll need to take action to prevent or minimize an asthma attack.
• Green zone. Your peak flow rates are 80 percent to 100 percent of your personal best, an indication that your asthma is under good control. You probably have no asthma signs or symptoms. Take your preventive medications as usual. If you consistently stay within the green zone, your doctor may recommend reducing your asthma medication.
• Yellow zone. Your peak flow rates are 50 percent to 80 percent of your personal best, an indication that your asthma is getting worse. You may have signs and symptoms such as coughing, wheezing or chest tightness. You may need to increase or change your asthma medications.
• Red zone. Your peak flow rates are less than 50 percent of your personal best, an indication of a medical emergency. You may have severe coughing, wheezing and shortness of breath. Stop whatever you're doing and use a bronchodilator or other medication to open your airways. Your asthma action plan will help you decide whether to call your doctor, take an oral corticosteroid or seek emergency care.
Taking control
Take charge of your treatment — and your life. Identify the things that trigger your asthma symptoms or make them worse. Meet with your doctor periodically to review your asthma action plan and revise it as needed. Show your doctor how you're using your peak flow meter, just to make sure you're doing it correctly.
Your lifestyle matters, too. Eat a healthy diet. Exercise regularly, with your doctor's OK. Don't smoke. Get enough sleep. Taking good care of yourself can help you handle life with asthma.
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|Integumentary |
|Topic |Objectives |Assignment/Comments |
|Anatomy & Physiology |Discuss the anatomy and physiology of the skin in relation to care of the client with integumentary disorders. |Lewis et al (7th ed.) |
| | |Ch. 23 and 24, pp 449-489 |
| |Describe assessments to identify integumentary dysfunction and documentation of assessment findings: | |
|Assessment/ |History & physical examination | |
|Documentation |Clinical manifestations & types of lesions | |
| |Diagnostic procedures | |
| | | |
| |Describe the risk factors, etiology, and clinical manifestations of the major skin disorders: | |
| |Infections (Bacterial, fungal, viral) | |
| |Inflammations (Dermatitis) | |
| |Eruptions/Allergic reactions | |
| |Structural Disorders | |
| |Infestations, bites, stings | |
| | | |
| |Describe the actions, therapeutic effect and nursing implications for medications used to treat integumentary | |
| |problems | |
| |Oral and parental medications | |
|Pharmacology |Topical medications | |
| |Baths | |
| | | |
| |Discuss the nursing responsibility in care of the client undergoing: | |
| |Ultraviolet radiation | |
| |Dermatologic surgical procedures | |
| | | |
| |Discuss nursing interventions and common learning needs for the client and family with skin disorders. | |
| | | |
| |Discuss health promotion measures to prevent integumentary system disorders in children, adults, and older adults.| |
|Learning Needs |CENTER OBJECTIVES | |
| | |Doenges (11th ed.) |
| | |Review the nursing diagnoses |
|Health Promotion | |“Body Image Disturbance” |
| | |“Impaired Skin Integrity” |
|Musculoskeletal (Class #1) |
|Topic |Objectives |Assignment/Comments |
|Anatomy & Physiology |1. Review the anatomy and physiology of the musculoskeletal system in relation to care of the client with |Lewis, et al (7th ed.) |
| |disorders in the musculoskeletal system. |Ch. 62, pp. 1614-1621, 1623-1628 |
| | | |
|Assessment |2. Describe nursing assessment related to musculoskeletal function: |Lewis, et al (7th ed.) |
| |Health interview/client history |Chap. 62, Table 62-5, p. 1623 |
| |Physical assessment/examination | |
| |Significant diagnostic procedures |Leifer (5th ed.) |
| |Changes in function across the life span |pp. 549-551; 563-564 |
|Sports Injuries | | |
| |3. Discuss cause of soft tissue injuries and usual management |Lewis, et al (7th ed.) |
| |Strains/sprains |Ch. 62, p. 1628 (Arthroscopy) |
| |Dislocations/subluxations |Ch. 63, pp. 1629-1651 |
| |Injuries to ligaments and tendons | |
| | | |
| |4. Describe “R.I.C.E.” therapy for soft tissue injury | |
|Management of Clients with | |Leifer (5th ed.) |
|Fractures |5. Describe clinical manifestations of fractures and identify the stages of healing |Nursing Tip, p. 552 |
| | | |
| |6. Discuss the nursing management of a client with a fracture |Lewis, et al (7th ed.) |
| |Reduction |Chap. 63, pp. 1635-1651 |
| |Immobilization | |
| |Casts/ Cast Care | |
| |Traction | |
| |External/Internal Fixation | |
| | |Leifer (5th ed.) |
| |7. Describe assessments and nursing interventions for common complications of fractures |Nursing Tip, pp. 553, 555, NCP 24-1, p. 558-559 |
| |Compartment Syndrome | |
| |Avascular necrosis |Lewis, et al (7th ed.) |
| |Osteomyelitis |Ch. 64, pp. 1668-1672 |
| |Venous Thrombosis | |
| |Fat Embolism | |
|Musculoskeletal (Class #2) |
|Topic |Objectives |Assignment/Comments |
|Pathophysiology: |Compare and contrast the etiology, pathophysiology, clinical manifestations, diagnostic studies and medical |Lewis, et al (7th ed.) |
|Arthritis |management for clients with Arthritis |Ch. 65, pp. 1693-1711, 1715-1716 |
| |Osteoarthritis |Table 65-6, p. 1704 |
| |Rheumatoid Arthritis | |
| |Gout |Liefer, (5th ed.) |
| | |Chap 24, pp. 561-562 |
|Medications |Describe the actions and nursing implications of common medications used in the treatment of connective tissue | |
| |diseases | |
| |Salicylates | |
| |Non-steroidal anti-inflammatory drugs (NSAIDS) | |
| |Non opioid/opioid analgesics | |
| |Corticosteroids | |
| |Disease modifying antirheumatic drugs | |
| |Methotrexate | |
| |Gold salts | |
| |Anti-malarial drugs (Plaquinel ®) | |
| |Biologic Therapy | |
| |Specific anti-gout medications | |
| |Colchicine | |
| |Benemid ® | |
| |Zyloprim ® | |
| | | |
| |Compare and contrast the etiology, pathophysiology, clinical manifestations, diagnostic studies and medical |Lewis, et al (7th ed.) |
|Pathophysiology: |management for clients with connective tissue disorders |Ch. 65, pp. 1716 |
|Connective Tissue Disorders |Systemic Lupus Erythematosus | |
| |Soft tissue rheumatic syndrome | |
| |Fibromyalgia | |
|Musculoskeletal (Class #3) |
|Topic |Objectives |Assignment/Comments |
|Amputation |Discuss the physiologic, psychosocial and health restoration needs of a client with an amputation |Lewis, et al (7th ed.) |
| | |Ch. 63, pp. 1658-1662 |
| | | |
| | |Doenges (11th ed.) |
| | |“Disturbed Body Image” |
| |Discuss nursing interventions for the client experiencing orthopedic surgery on the joints | |
|Orthopedic surgery |Hip pinning (ORIF) |Lewis, et al (7th ed.) |
| |Total hip arthroplasty (replacement) |Ch. 63, p. 1662-1666 |
| |Total knee arthroplasty (replacement) | |
| | | |
| |Discuss the manifestations of Ewing’s and osteogenic sarcoma | |
| | |Lewis, et al (7th ed.) |
| | |Ch. 64, pp. 1668-1672 |
| |Discuss nursing care for clients with disorders of the foot: |Leifer, Chap. 24, p.561 |
| |Bunion | |
| |Hammertoe |Lewis, et al (7th ed.) |
| |Morton’s neuroma |Ch. 64, p. 1684-1686 |
| | | |
| |Describe the clinical manifestations, nursing assessment for and treatment of common congenital anomalies | |
| |Dysplasia of the hip | |
|Congenital Anomalies |Talipes equinovarus (clubfoot) |Liefer, (5th ed.) |
| | |Ch. 14, pp. 328-332 |
| |Compare and contrast the etiology, pathophysiology and medical management of metabolic bone diseases | |
| |Osteomalacia | |
| |Paget’s Disease | |
|Metabolic bone disease |Osteoporosis |Lewis, et al (7th ed.) |
| | |Ch. 64, p. 1686-1691 |
| | | |
| | | |
| |Describe health promotion measures to reduce the incidence and progression of osteoporosis | |
| |Nutrition | |
|Health promotion |Exercise | |
| |Medications | |
| | | |
| |Describe the actions, therapeutic effects and nursing implications for the medications used in the treatment of | |
| |osteoporosis | |
| |Calcium Supplementation | |
|Medications |Estrogen Replacement | |
| |Calcitonin | |
| |Bisphosphonates (Fosamax ®) | |
| |Estrogen receptor Modulators (Evista ®) | |
| |Human parathyroid hormone (Forteo ®) | |
|Men’s Health |
|Topic |Objectives |Assignment/Comments |
|Anatomy and Physiology: Male |Describe anatomy and physiology of the male reproductive system |Lewis, et al (7th ed.) |
|Reproductive System | |pp. 1154-1187 (review elimination, tests) |
| |Identify psychological and emotional implications related to disorders/dysfunction of the male reproductive | |
| |system |Lewis, et al (7th ed.) |
|Male Reproductive Problems | |pp. 1339-1340; pp. 347-1348 (male reproductive |
| |Describe historical data, physical examination procedures used to diagnose dysfunction of the male reproductive |system) and other content related to male |
| |system. |reproductive system |
| | | |
| |Describe health promotion/maintenance measures for males across the life span. | |
| | |Lewis, et al (7th ed.) |
| |Discuss the laboratory and diagnostic test findings used in diagnosing dysfunction of the male reproductive |pp. 1414-1438 (Male reproductive problems) |
| |system | |
| | | |
| |Discuss pathophysiology, clinical manifestations, and collaborative care of benign prostatatic hypertrophy (BPH) | |
| | | |
| |7. Discuss nursing management of clients with infection/inflammation of the male reproductive system. | |
| | | |
| |8. Briefly discuss cancers of the male reproductive system | |
| | | |
| |9. Discuss nursing management of problems related to male sexual function/dysfunction | |
| |10. Discuss nursing care for clients with common problems affecting the penis, scrotum, and testes | |
| |Hydrocele | |
| |Scrotal trauma | |
| |Priapism | |
| |Cryptorchism | |
| |Phimosis | |
| |11. Formulate a nursing plan for the post-surgical client following male reproductive surgery. | |
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