NURS 196 - Walla Walla Community College



Walla Walla Community College

Nursing Education

Beginning Nursing Concepts II

NURS 102

Spring Quarter 2010

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To request accommodations related to a disability, contact Claudia Angus, Ph.D., Coordinator of Disability Support Services, at 527-4262 or email claudia.angus@wwcc.edu on the Walla Walla Campus. Clarkston students may contact Carol Bennett, at 758-1718 or email carol.bennett@wwcc.edu .

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 102

Title: Beginning Nursing Concepts II

Credits: 6

Class Hrs Per Wk: 6

Catalog Description: A continuation of NURS 101. The focus is on providing care to clients of all ages experiencing normal life processes or common/chronic disease processes in selected body systems.

Prerequisites: NURS 101 and 111

Corequisites: NURS 112 and 197

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: Normal Maternal-Newborn

Cardiac I

Peripheral Vascular

Gastrointestinal

Special Senses

Women's Health

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 102

Grading Criteria & Distribution of Points:

|CONTENT |POINTS |

|Normal Maternal-Newborn (4 classes) |12 |

|Women’s Health |3 |

|Special Senses (2 classes, Ear, Eye) |6 |

|Gastrointestinal (4 classes) |12 |

|Cardiac I (4 classes) |12 |

|Peripheral Vascular |3 |

|Sub-Total: Class Activities |48 |

|ATI PN Maternal-Newborn (60 questions) |20 |

|ATI PN Nutrition (60 questions) |20 |

|ATI PN Pharmacology (60 questions) |20 |

|4 unit tests (9 questions per 3-hour lecture period) |144 |

|Final Test (5 questions per 3-hour lecture period) |80 |

|Sub-Total: Tests Only |284 |

|Total Points available |332 |

(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 102. 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%.

Course Expectations:

1. Follow all policies as outlined in Nursing Student Handbook

2. If absent from class, no points shall be awarded for any learning activities for that lecture.

3. All assignments must be accounted for before progression (regardless of score achieved).

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 Nursing Student Handbook).

Grading Scale – See Nursing Student Handbook

Assessment Technologies Institute (ATI) Testing

• Three (3) proctored computerized Content Mastery Examinations will be administered this quarter: PN Maternal-Newborn, PN Nutrition, PN Pharmacology

• Prior to taking a 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. The student will not be allowed to take the proctored exam if the online practice exam is not completed by the due date. Test ID and Password codes will be provided.

• The student’s score on the non-proctored, online practice test will be verified on the ATI website by the designated instructor on the due date.

• An ATI “Proficiency Level II” cut score 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 attempts on a Content Mastery Exam to reach the minimum proficiency Level 2 cut score. The first retake of a Content Mastery Exam is free of charge. Subsequent retakes will result in a cost to the student.

• Failure to achieve a “Proficiency Level II” prior to the end of Spring 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 Tests will be included in the “Tests Only” points for NURS 102 and will be allocated on a curved scale basis. Points will be prorated with the highest percentage score earning 100% of the available points. The score earned on the first attempt of a Content Mastery Exam will be the score on which a student’s earned points are calculated.

|Women’s Health |

|Topic |Objectives |Assignments/Comments |

|Review of A&P |1. Review the anatomy and physiology of the female reproductive tract, including the physiology of menstruation |Lewis, et al. (7th ed.) |

| | |Ch. 51, pp. 1325-1342 (Esp figs 51-3, 51-4, 51-5) |

| |2. Describe the teaching needed for correct use of contraceptive Methods | |

|Contraception |Mechanical Barrier methods |Leifer, (5th ed.) |

| |Hormonal Contraceptives |Ch. 11, pp. 260-266 |

| |Vaginal Spermicides | |

| | |Leifer, (5th ed.) |

| |3. Define infertility and describe the nurse’s role in working with infertile couples |Ch. 11, pp. 268-272 |

|Infertility | |Lewis, et al. (7th ed.) |

| |4. Discuss the nursing care of the women undergoing diagnostic testing for reproductive disorders |Ch. 54, pp. 1382-1383 |

|Diagnostic Testing |Pelvic exam/ Pap smear | |

| |Schiller’s Test |Lewis, et al. (7th ed.) |

| |Colposcopy |Ch. 51,pp. 1338-1341, Table 51-12 |

| |Cervical/Endometrial Biopsy | |

| |Cervical Conization | |

| |Ultrasound | |

| | | |

| |5. Describe health promotion activities for the women experiencing menopause | |

| |Gerontological Considerations |Lewis, et al. (7th ed.) |

| | |Ch. 51, pp. 1330-1331 |

|Health Promotion |6. Use the nursing process to provide care to a client undergoing GYN surgery |Ch. 51, p. 1340, Table 51-12 |

| |Laporoscopy | |

| |Dilatation & Curettage (D&C) | |

|GYN Surgery |Hysterectomy, Vaginal, Abdominal |Lewis, et al. (7th ed.) |

| |Anterior & Posterior Repair (A&P Repair) |Ch. 54, pp. 1404-1409 |

| | | |

| |7. Compare and contrast the signs and symptoms, medical management and nursing care of the client with | |

| |Endometriosis vs. Pelvic Inflammatory Disease (PID) | |

| | |Lewis, et al. (7th ed.) |

|Endometriosis | |Ch. 54, pp. 1395-1398 |

| | | |

| |8. Identify the cause, treatment and prevention of the following sexually transmitted diseases (STD) | |

| |Syphilis | |

| |Gonorrhea |Lewis, et al. (7th ed.) |

|Sexually Transmitted |Herpes |Ch. 11, pp. 254-258 |

|Disease |Chlamydia | |

| |Human Papilloma Virus | |

| |Trichimonas | |

| |Candidiasis | |

| |HIV/AIDS | |

| | | |

| |9. Identify warning signs of cervical, ovarian, endometrial cancer | |

| | | |

| | | |

| |10. Describe the method for teaching breast self examination (BSE) to a client |Lewis, et al. (7th ed.) |

| | |Ch. 54, pp. 1400-1404 |

|Warning signs of cancer | | |

| |11. Describe the nursing care of clients undergoing diagnostic procedures of the breast |Lewis, et al. (7th ed.) |

|Breast Self Examination |Mammography |Ch. 11 pp. 250-251 and Skill 11-1 |

| |Ultrasonography | |

|Diagnostic Procedures |Breast Biopsy | |

| | |Lewis, et al. (7th ed.) |

| |12. Describe the nursing care of clients with benign breast disorders |Ch. 52, pp. 1344-1348 |

| | | |

|Benign Breast Disorders | | |

| |13. Use the nursing process to develop a nursing care plan for a client with a malignant lesion in the breast | |

|NCP for breast malignancy | | |

| | | |

| | | |

| | |Lewis, et al. (7th ed.) |

| | |Ch. 52, pp. 1356-1360 |

|Normal Maternal-Newborn (Class #1) |

|Topic |Objectives |Assignments/Comments |

|Introduction |Identify the goals of maternal newborn care and the roles of the providers of care |Leifer (5th ed.) |

| | |Ch. 1, pp. 6-7 |

| |Calculate estimated date of delivery (EDD) using: |Ch. 4, pp. 44 – 77 |

|Antepartum |Nagele’s Rule | |

|EDD |McDonald’s Rule | |

| | | |

|Signs of Pregnancy |3. Differentiate between presumptive, probable, and positive signs of pregnancy | |

| | |Leifer (5th ed.) |

|Assessment |4. Relate the physiologic and psychosocial changes during pregnancy to variations in assessment of the |Box 4-3, p. 48 |

| |pregnant client | |

| |Reproductive system |Leifer (5th ed.) |

| |Breasts |Table 4-6, pp. 73 - 76 |

| |Systemic changes | |

| |Management of common discomforts of pregnancy | |

|Fetal | | |

|Development |5. Describe the development of the fetus during each month of pregnancy and factors that effect fetal | |

| |development |Leifer (5th ed.) |

| |Organogenesis |Ch. 3, pp. 31 – 40 |

| |Critical Period | |

| |Teratogens | |

| | | |

| |6. Identify the assessment measures completed during prenatal care | |

| |Health assessment | |

| |Laboratory and diagnostic testing |Leifer (5th ed.) |

| |Physical examination |Table 4-2, p. 53 |

| |Risk assessment | |

| | | |

| |7. Describe the nutritional needs of the pregnant mother and assessment measures indicating adequate | |

|Nutritional Needs |nutrition | |

| |Weight gain pattern and Assessment of nutrient intake | |

|NORMAL Maternal-Newborn (Class #2) |

|Topic |Objectives |Assignments/Comments |

|Postpartum |Describe the physiologic changes that occur during the postpartum period |Leifer (5th ed.) |

|Physiologic |Involution |Ch. 9, pp. 148, 199-214 |

|needs |Lochia | |

| |Perineum/episiotomy | |

| |Systemic changes | |

| |Changes in vital signs | |

| |Breasts/lactation | |

| | | |

| |Complete an assessment of a postpartum client and document assessment findings using correct terminology |Leifer (5th ed.) |

|Assessment/ |Health History |Box 9 – 1, p. 201 |

|Documentation |Laboratory data |Box 9 – 2, p. 211 |

| |Physical assessment | |

| |Psychosocial assessment | |

| | | |

| |Develop a nursing care plan to meet the needs of the postpartum client | |

| |Pain |Leifer (5th ed.) |

|Nursing care |Risk for Infection |Nursing Care Plan 9 -1, pp. 209 - 212 |

|plan |Sleep Pattern Disturbance | |

| |Alteration in Nutrition | |

| |Alteration in Elimination | |

| |Altered Tissue Perfusion (peripheral), Risk for | |

| |Altered Sexuality Patterns, Risk for | |

| |Altered Parenting, Risk for | |

| | | |

| |Identify the actions, therapeutic effect, and nursing implications for medications given in the postpartum | |

| |period | |

|Medications |Oxytoxics | |

| |Pain medications | |

| |Stool softeners/Laxatives | |

| |Rubella vaccine | |

| |RhoGam | |

|NORMAL Maternal-Newborn (Class #3) |

|Topic |Objectives |Assignments/Comments |

|Newborn |1 Relate the changes in physiologic function that occur at birth to assessment and care of the newborn |Leifer (5th ed.) |

|Physiologic function |Respiratory system |Ch. 9, pp. 215–234 |

| |Circulatory system |Ch. 12, pp. 279–303 |

| |Thermoregulation | |

| |GI system | |

| |Renal function | |

| |Hepatic function | |

| |Immunologic function | |

| |Neurologic function | |

| | | |

| |2 Complete an assessment of the newborn and document findings using correct terminology | |

|Assessment/ Documentation |Physical Assessment | |

| |Gestational Age assessment | |

| |Behavioral Assessment | |

| | | |

| |3. Identify the actions, therapeutic effects, and nursing implications of medications given to the newborn | |

|Medications |Vitamin K | |

| |Erythromycin ointment | |

| | |Leifer (5th ed.) p. 151 |

| |4. Develop a teaching plan to meet the needs of parents of a newborn | |

| |Daily care | |

|Teaching Plan |Sleeping | |

| |Crying | |

| |Circumcision care | |

| |Continued Health Maintenance | |

| |Car safety | |

| |Meeting the nutritional needs of the newborn | |

| |Breast feeding | |

| |Bottle feeding | |

| | | |

|Normal Maternal-Newborn (Class #4) |

|Topic |Objectives |Assignments/Comments |

|Preparation for Childbirth |1. Identify the components of childbirth education classes |Leifer (5th ed.) |

| |Expectations during labor & delivery |Ch. 7, pp. 154-156 |

| |Managing discomfort during labor | |

| |Conscious relaxation | |

| |Controlled breathing | |

| |Cutaneous stimulation | |

| |Focusing | |

| |Medications | |

|Intrapartum Care | | |

| |2. Identify the signs of labor | |

|Signs of Labor |Preliminary |Leifer (5th ed.) |

| |True vs.: False Labor |Ch. 6, pp. 115-148 |

| | | |

|Labor Progress |3. Discuss the effect on labor progress for the following components of labor: | |

| |Passage | |

| |Passenger | |

| |Powers | |

| |Psyche | |

| | | |

|Maternal / Fetal Response |4. Describe the maternal and fetal response during each stage of labor | |

| |First Stage | |

| |Latent Phase |Leifer (5th ed.) |

| |Active Phase |Table 6 – 3, p. 140-141 |

| |Transition | |

| |Second Stage | |

| |Third Stage | |

| |Fourth Stage | |

| | | |

| |5. Describe nursing interventions related to pain control measures during labor | |

| |Epidural | |

|Danger Signs | | |

| |6. Identify the fetal and maternal danger signs during labor and delivery | |

|Peripheral Vascular |

|Topic |Objectives |Assignments/Comments |

|Review of A & P |Apply knowledge of the anatomy and physiology of the Peripheral Vascular System in providing care to clients with|Lewis, et al. (7th ed.) |

| |disorders of this system. |Ch. 38, pp. 892-924 |

| |Arteries, capillaries, and veins | |

| |Factors affecting blood flow |Silvestri (3rd ed.) |

| |Diameter of the vessel |(Saunders NCLEX-PN) |

| |Elastic recoil |pp. 711-728. |

| |Viscosity of blood | |

| |Age related considerations | |

| | | |

|Assessment |Describe variations in assessment data for the client with disorders of the Peripheral Vascular System, and | |

| |Arterial Disorders | |

| |Clinical manifestations of vascular dysfunction | |

| |Pain | |

| |Intermittent claudication | |

| |Rest pain | |

| |Venous insufficiency | |

| |Ischemic neuropathy | |

| |Ulceration or gangrene | |

| |Changes in skin color, temperature, and integrity | |

| |Bruits | |

| |Abdominal pulsations | |

| |History | |

| |Risk factors | |

| |Physical examination | |

| | | |

|Pathophysiology |Review the pathophysiology and factors related to arteriosclerosis and atherosclerosis |Lewis et al (7th ed.) |

| | |Ch. 38 |

| | |Review anatomy and physiology of peripheral |

| |Describe the nursing care of clients undergoing diagnostic testing and relate findings to the care of clients |vascular system. |

|Diagnostic Testing |with peripheral vascular disorders. | |

| |Common arterial diagnostic studies |Lewis et al (7th ed.) |

| |Common venous diagnostic studies |Ch. 38 |

| | | |

| |Identify the actions, therapeutic effects and nursing implications of medications used to treat peripheral | |

|Medications |vascular diseases. |Silvestri (3rd ed.) |

| |Hypolipedemics |(Saunders NCLEX-PN) |

| |Anticoagulants |pp. 729-747 |

| |Vasodilators | |

| |Antiplatelet aggregation agents | |

| | | |

| |Differentiate pathophysiology, assessment and medical management of arterial vascular disease from venous | |

|Arterial vs.: venous disease |vascular disease. Include: | |

| |Aneurysms |Doenges et al (11ed.) |

| |Buerger's Disease |(Nurse’s Pocket Guide) |

| |Raynaud's Phenomenon |Nursing Diagnosis: |

| |Venous Thrombosis |“ Ineffective Tissue Perfusion, Peripheral” |

| |Varicose Veins | |

| | | |

|Health Maintenance |Describe the goals of medical management of peripheral arterial and venous vascular disease and health | |

| |maintenance activities to meet the goals. |Information located throughout chapters assigned |

| |Diet | |

| |Lifestyle |Doenges et al (11ed.) |

| |Medications |(Nurse’s Pocket Guide) |

| |Safety |Nursing Diagnosis: |

| |Prevention of complications |“ Knowledge Deficit”, |

| | | |

| |Develop a teaching plan for a client with peripheral vascular disease |Nursing Diagnosis: |

| |Readiness model for Smoking Cessation |“Ineffective Health Maintenance” |

| |Nursing Diagnosis of patients with Peripheral Arterial Disease of the Lower Extremities | |

|Cardiac I Class # 1 |

|Topic |Objective |Assignments/Comments |

|Function of the Heart |Apply knowledge of the anatomy & physiology of the cardiac system to care of the client with cardiac disorders |Lewis Med-Surg Text, Chapter 32 (p. 739-760) |

| |Blood flow | |

| |Regulation of impulses | |

| |Normal sinus rhythm | |

| |Age related changes | |

| | | |

|Assessment |Identify significance of variations from normal assessment findings for both the adult and child with cardiac | |

| |disease | |

| |S1 and S2 |Bring the following books with you to class: |

| |S3 and S4 |Davis’s Drug Guide |

| |Murmurs |Nurse’s Pocket Guide: Diagnoses, prioritized |

| | |interventions, & rationales |

|Laboratory/ Diagnostic |Describe nursing interventions to prepare a client for and/or in response to findings from common laboratory and| |

|Studies |diagnostic studies: | |

| |EKG/ Holter Monitoring | |

| |Echocardiogram | |

| |Cardiac catheterization |Utilize your NCLEX-PN review book to review all the |

| | |cardiovascular medications that we will be covering in the|

| |Identify the actions, side effects, and nursing implications for the following classes of medications: |4 cardiac lectures. |

|Medication |Beta-Adrenergic Receptor Blockers (Beta Blockers) | |

| |atenolol (Tenormin) |Chapter 51 begins on page 729, and the practice questions |

| |propranolol (Inderal) |begin on page 739. |

| |Calcium Channel Blockers |Davis’s Drug Guide is also a good resource. |

| |diltiazem (Cardizem) | |

| |verapamil (Calan) | |

| |digoxin (Lanoxin) | |

| |Anticoagulants | |

| |heparin & lovenox | |

| |warfarin (Coumadin) | |

| |5. Identify the most common nursing diagnoses utilized in patients with | |

| |cardiac disorders | |

|Nursing Diagnoses | | |

|Cardiac I Class # 2 |

|Topic |Objective |Assignments/Comments |

|Coronary Artery Disease |1. Describe the pathophysiology and clinical manifestations of coronary artery disease and lipoprotein disorders |Lewis Med-Surg Text, Chapter 34 (p. 784-819) |

|(CAD) | | |

| |2. Discuss health promotion measures for the client at risk for coronary artery disease: | |

|Health promotion | |Assignment: |

| |3. Develop a teaching plan for a client with coronary artery disease or lipoprotein disorder(s) |RISKO Paper: Due at beginning of cardiac |

|Teaching | |class # 2, before start of lecture. |

| |4. Differentiate between angina pectoris and myocardial infarction. | |

| | |See attached handout for the RISKO Paper |

| |5. Describe the nursing management of the patient following a myocardial infarction. Include psychosocial needs of the |criteria and for the RISKO form. |

| |client. | |

| | | |

| |6. Identify the actions, side effects, and nursing implications for the following medications: | |

| |Platelet Aggregation Inhibitors | |

|Medications |aspirin | |

| |plavix | |

| |Lipid Lowering Agents | |

| |atorvastatin (Lipitor) | |

| |lovastatin (Mevacor) | |

| |simvastatin (Zocor) | |

| |Nitrates--Nitroglycerin | |

| |Angiotensin-Converting Enzyme Inhibitors | |

| |captopril (Capoten) | |

| |enalapril (Vasotec) | |

| |Morphine | |

| |Fibrinolytics | |

| |Activase | |

| |Retavase | |

| | | |

| |7. Develop a nursing care plan for a client with coronary artery disease | |

| | | |

| | | |

|Nursing Process | | |

Pre-Class Assignment For Cardiac Lecture # 3: RISKO Paper

(Total Points Possible = 3 points)

1. Complete an American Heart Association “RISKO” form using your own data as much as possible. The RISKO form is attached.

• If you do not know your cholesterol and HDL numbers and are unable to have it done, your instructor will provide you with some numbers.

• For this paper, you will be your own “client”.

2. (Lifestyle) Describe your “clients” current lifestyle with regard to:

• Stressors

• Typical daily diet

• Typical exercise (or lack of it) program

3. (RISKO Interpretation) Interpret the RISKO profile, using the guidelines of “What Your Score Means” for your

“client.”

4. (Recommendations) Develop a lifestyle plan for your “client”. Include specific recommendations you would make for this “client” with regard to identified risk factors. Include areas of:

• Stress Management

• Diet

• Exercise

**On your paper, please use the following headings:

• Lifestyle

• RISKO Interpretation

• Recommendations/ Lifestyle Plan

**Grading will be based on how well the above three aspects are discussed. Length of paper is 2-4 pages, single spaced. Hint: If paper is less than 2 pages, it probably does not reflect good critical thinking. If paper is more than 4 pages, it

probably needs to be more concise.

**This paper is due on the day of cardiac lecture # 3, before start of lecture. Late papers will be deducted one point per day late.

RISKO Form--Retrieved & Slightly Modified 3/17/08



|Calculating Heart Disease Risk |

|[pic][pic]Nurses can help their clients develop increased awareness of potentially modifiable factors that increase the risk of developing heart disease by having them |

|calculate their own level of risk. The American Heart Association's RISKO scale, which is based on data collected in the long-term Framingham Heart Study, is a popular tool |

|for this purpose. It has been most useful for education of healthy individuals who are currently free of heart disease but may be at risk of developing heart disease in the |

|next few years. |

|[pic|Systolic Blood Pressure |[pic|Systolic Blood Pressure |[pic|

|] |If you ARE NOT taking antihypertensives |] |If you ARE taking antihypertensives |] |

| |

| |

|TOTAL |

|Height |A |B |C |D |

|4'8" | ................
................

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