Bakersfield College Associate Degree Nursing Program
BAKERSFIELD COLLEGE
Associate Degree Nursing Program
Nursing B26: Medical-Surgical Nursing 3
Instructional Syllabus
Spring/2010
Julie Gentry RN MSN FNP
COURSE DESCRIPTION
This Level 3 course focuses on the application of previously learned knowledge as well as the development of more in depth knowledge for adult clients across the lifespan who have more diverse and complex disease states. The nursing process is the framework used in this course to present topics,
such as leadership, critical thinking, pharmacology and safety. Correlated clinical experiences are provided with adult patients who have increasingly complex outcomes. The roles of Provider of Care, Manager of Care, and Member of the Profession are integrated and analyzed throughout the didactic
and clinical experiences. Prerequisite: Appropriate standing in the Associate Degree Nursing Program or evaluation of skills and knowledge by the Program Director. Recommended: None. Hours: 45 lect, 162 lab. Offered: F, S. CCS: Occupational Education. Transferable: CSU and Private Colleges.
PROFESSOR :
Julie Gentry RN MSN FNP
Program Student LEARNING Outcomes
The Bakersfield College Associate Degree Nursing Program is designed to prepare graduates to competently transition from student to entry level Registered Nurse as defined by these roles: Provider of Care, Manager of Care, and Member of the Profession. Please refer to Associate Degree Nursing Student Handbook.
Upon completion of the program, the graduate shall be able to function as a:
A. Provider of Care --- The graduate will provide safe nursing care through therapeutic nursing interventions to clients with critical and complex disease states. The care is characterized by consistent critical thinking and problem-solving skills, clinical competence, accountability, effective communication skills, respect for diverse cultures, with an emphasis on health education and a commitment to the value of caring.
B. Manager of Care --- The graduate will provide safe nursing care consistently utilizing critical thinking skills for clients who have critical and complex disease states. The care is characterized by the ability to assess and establish priority of care for a group of client’s and delegation of appropriate aspects of nursing care to license and unlicensed personnel and directs their activities. The manager of care collaborates with other members of the health care team, including organizational and community resources, using effective oral and written communication sills. The manager of care recognizes roles and responsibilities within the
levels of the career ladder and is competent in using technology to provide evidence-based
nursing care.
C. Member of the Profession --- The graduate will consistently demonstrate accountability, advocacy, legal/ethical and caring behavior, and responsibility for one’s own professional growth, behavior, and formal/informal education. The graduate nurse routinely participates in self-evaluation and makes changes to improve the practice of nursing, with the ultimate goal of making positive contributions to the nursing profession.
Level 3 Student Learning outcomes
LEVEL 3: The focus of level three is to analyze and utilize theoretical and technical knowledge to care for the more diverse and complex client.
Upon completion of the course, the student will be able to function as a:
A. Provider of Care --- The student will provide safe nursing care through therapeutic nursing interventions to clients that have increasingly complex outcomes. The care is characterized by the ability to cluster and prioritize increasingly complex nursing interventions, anticipate expected and unexpected outcomes, incorporate comprehensive assessment data into the plan of care, utilize effective communication skills, demonstrate respect for diverse cultures, educate clients regarding health needs, and promote client advocacy with increasing independence.
1. Developer/coordinator/evaluator of care to individuals, families, groups, communities, and populations: able to identify the rationale for care and competently deliver this care to an increasingly complex and diverse population in multiple environments, utilizing the nursing process.
a. Develop, implement, and modify a holistic plan of care for clients with increasingly complex outcomes
b. Function pro-actively and prioritize potential complications to mange client care for increasingly complex clients.
c. Anticipate and prioritize care of multiple clients/families during clinical rotations.
d. Develop, implement, evaluate and modify interventions for clients with increasingly complex outcomes to assist clients to reach goals
e. Integrates pathophysiology into nursing interventions based on client assessment and medical diagnosis.
f. Demonstrates ongoing evaluation and implementation of modified interventions
g. Integrates supportive data (labs / diagnostics) when administering medications. Consistently utilizes 6 rights of medication administration. Requires minimal prompting in the discussion of medications.
h. Role models professionalism, respect and kindness for the client’s uniqueness, developmental level, socio-cultural background, spiritual beliefs, perceptions and values.
i. Performs skills at the expected level with minimal supervision.
j. Proficiently develops a process paper according to specified guidelines with a passing grade of at least 75%
k. Maintains asepsis at all times, role models appropriate behavior and assesses members of healthcare team.
2. Demonstrate effective communication with clients, families, and other health care team members in all health care settings.
a. Assess and consistently utilize effective and therapeutic professional communication techniques and adapt them for individual situations of clients, families, and health care members.
b. Establish therapeutic relationships in all interactions.
c. Communicate effectively with the expanded health care team members (nursing staff and physicians) with increasing independence.
d. Demonstrates appropriate required documentation in an accurate and timely manner for clients with increasing complex outcomes.
3. Advocate for the client, profession and the interdisciplinary health care team in an effort to ensure that clients, families, and communities are well informed and included in care planning.
a. Utilize increasingly assertive techniques to promote client advocacy.
b. Validate and clarify with instructor interventions for client advocacy before initiating plan.
4. Educate clients, families, and health care professionals under their supervision using appropriate teaching principle, strategies and current information.
a. Individualize and adapt teaching strategies by utilizing the principles of teaching/learning.
b. Does appropriate teaching for clients/families with increasingly complex outcomes with instructor’s guidance.
5. Anticipates risks to the client and provides appropriate interventions to achieve optimal client outcomes.
a. Utilizes supportive data to identify potential complications and plans for and implement appropriate interventions.
B. Manager of Care --- The student will provide safe nursing care utilizing critical thinking skills for clients who have increasingly complex outcomes. The care is characterized by the ability to anticipate complications, analyze and utilize the data gained from specialized equipment, plan and evaluate utilization of appropriate resources for cost effective delivery of care and facilitation of communication among the health care team.
1. Demonstrate critical thinking to problem solve, organize, and prioritize care for individuals or a group of clients.
a. Demonstrate and verbalize the ability to anticipate complications based on the pathophysiology associated with complex disease processes and is able to modify care when this results.
b. Demonstrate pro-active thinking by being able to cluster and prioritize increasingly complex nursing interventions and complete the charting as appropriate for the clinical situation.
c. Consistently recognizes self-limitations and begin to utilize appropriate resources with increasing independence. (Textbook; instructor; nursing unit staff)
d. Design effective plan for resolving conflict.
e. Incorporate comprehensive assessment, relevant data and begins to analyze this data into the plan of the care.
f. Demonstrate the ability to problem-solve in the delivery and management of care for clients with increasingly complex disease processes.
g. Is able to integrate the diagnostic data and assessment findings and plans care accordingly.
2. Manage human and fiscal resources in an efficient and cost effective manner.
a. Plan and evaluate utilization of appropriate resources for cost effective delivery of client care. (Refrain from unnecessary use of medical supplies)
3. Integrates current technology to provide competent client care.
a. Retrieve and record pertinent information utilizing multiple technological resources. (Chart; computer; physician/nursing rounds)
b. Analyze and utilize the data gained from specialized equipment in delivery of client care. Accurately work IV pumps, mini-infusers, cardiac monitors
4. Serve as a leader and partner in the interdisciplinary health care team.
a. Participate in nursing and physician rounds to facilitate communication among team members.
b. Make appropriate referrals based on client/family needs. (Soc Svc; APS; CPS
c. Demonstrates team leading independently and is able to be an active participant in interdisciplinary team meetings. (Collaborate with RT; PT; OT; ST)
d. Consistently demonstrates and implements leadership with increasing independence.
C. Member of the Profession --- The student will assume responsibility and accountability, with minimal supervision, for the legal and ethical boundaries of nursing. The student consistently recognizes self-limitations and begins to independently utilize various resources to improve abilities, as well as analyze caring behaviors.
1. Demonstrates accountability for the provision and evaluation of nursing care that conforms to professional standards and incorporates legal and ethical responsibilities of the nurse especially the rights of the clients.
a. Provides care based on the California Nursing Practice Act and integrates components of the Nursing Practice Act in providing care
b. Implement policy regarding State and Federal regulations. (JCAHO – National Patient Safety Goals; DHS -Title 22 Ca Code of Regulations; CMS - HIPPA)
c. Initiates corrective action for variations from standard practice. (Occurrence reporting, Medication Event Report, Report of Injury)
d. Accept responsibility and accountability for individual actions in the clinical setting and the provision of patient care and implement a remediation plan.
e. Is consistently punctual for clinical experience – this is an expectation of all students at each level.
f. Adheres to Bakersfield College ADN Program dress code – this is an expectation of all students at each level.
g. Comes to the clinical setting prepared to care for assigned clients with daily care plan complete and appropriate equipment – this is an expectation of all students at each level.
2. Accountable for life long acquisition of knowledge and skills to effect change in health care practice and outcomes.
a. Differentiates and uses credible nursing and medical resources.
b. Participates in at least one community project:
c. Actively seeks out learning experiences, taking responsibility for their own education – this is an expectation of all students at each level.
d. Consistently participates in clinical post conferences – this is an expectation of all students at each level.
COURSE ACTIVITIES
Various instructional methods may include, but are not limited to, lectures/discussions, demonstrations, audiovisual aids, required reading, computerized assisted instruction, simulated learning experiences, independent study, problem solving exercises, and quizzes/exams. Additional learning activities may also include nursing process assignments, calculation of age appropriate drug dosages, and leadership/ teaching assignments.
Course Assignments
Students are required to complete a variety of assignments which may include simulated learning experiences, computer assisted instruction, weekly reading, homework assignments, nursing process, presentations, and community projects in order to successfully meet the objectives for Nursing B26. Detailed instructions for each assignment are located in the Assignment section of the Theory syllabus and / or the Clinical Manual.
COURSE POLICIES
General: Students are expected to attend each class, be punctual, and assume responsibility for assigned activities, be active participants in the learning
process, and meet all established level objectives.
Cell phones and pagers must be turned off or placed in silent or vibrate mode.
Children are not allowed in classroom or clinical setting.
Supportive Students at Bakersfield College with disabilities who believe they may Services: need accommodations in this class are encouraged to contact Disabled
Student Programs & Services (661-395-4334), FACE 16, as soon as possible, or at your specific School site, to better ensure such accommodations are implemented in a timely fashion.
Live Captioning: Students with disabilities who are in need of live captioning in this Interactive Video Class are encouraged to contact Distance Learning (661)395-4694 as soon as possible to better ensure such accommodation is implemented in at timely fashion. Please contact Disable Student Programs & Services for all other accommodation requests at (661) 395- 4334 (FACE 16)
Please note: The Student Handbook also outlines a variety of services available to help meet your academic needs.
Attendance: The attendance policies as outlined in the Bakersfield College Catalog and Associate Degree Nursing Student Handbook will be strictly enforced.
Students are expected to observe the attendance requirement of the College and instructor course policies. Instructors may require that absences be made up to meet course objectives even if the absences do not exceed College policy regarding attendance.
THEORY:
For the lecture component the maximum number of allowable absences is two (2). If theory absences exceed the allowed amount, the student can either drop the course, or receive a letter grade. Lateness is not acceptable! Please note two tardies equal one absence—no exceptions.
Make-up Assignments
An Instructor has the right to require a student to make up a theory, laboratory/clinical absence even if the student has not exceeded the allowable maximum number of absences. If make-up assignments are required they may consist of:
• Theory – Case studies, independent study, written examinations, attending seminars or workshops, computer-assisted instruction, or reports, or other assignments at the discretion of the instructor
Exams/Quizzes: Students are responsible for material presented during their absence.
The opportunity to make up one missed exam will only be allowed if the student informs the instructor prior to the scheduled exam. Pop quizzes may not be made up.
Students will not be allowed to retake any exam or quiz on which an unsatisfactory grade was earned.
Students may make arrangements with the instructor to review an individual exam up to two (2) weeks after the exam returned. The final exam will not be reviewed.
All cell phones, pagers, and / or any electronic device must be turned off during exams / quizzes unless prior arrangements are made with instructor. Ringing or vibrating phones and pagers will result in a five percent deduction from the student’s quiz or exam.
Electronic devices other than a calculator may not be used for in-class calculations work (ie. Cell phones, PDA’s, etc).
Academic There will be zero tolerance for academic dishonesty, including
Honesty: plagiarism. Plagiarism is the intentional use of another person’s idea, data, information, or work without giving credit.
If the student is caught cheating, the test will be collected, a zero (0) grade will be recorded, and the student will be directed to leave the classroom. The student is required to meet with the Director of Allied Health to discuss his / her standing in the program.
Please refer to statements on academic honesty located in your Bakersfield College Catalog, Associate Degree Nursing Student Handbook, and the Bakersfield College Class Schedule.
Course
Evaluations: Course evaluations for theory and clinic will be performed using an online survey entitled “class climate” each student is responsible for completing evaluations in a timely manner.
Student Evaluation
Evaluation is an ongoing, essential process in education, by which the student is apprised of his/her progress in meeting the level outcomes and unit objectives. Theory and clinical grades are calculated separately. In order to pass the course, the student must achieve at least 75% in the theory AND clinical components. If the student achieves either less than 75% in the theory component, OR clinical component, the student will not pass the course.
|Grading scale |Weighted grades in % |
|A = 90 – 100 % |Exams --------------------------------------------------------------------- 30% |
|B = 80 – 89 % |Mid-Term Exam --------------------------------------------------------- 32% |
|C = 75 – 79% |Community Service Project --------------------------------------------- 1% |
|D = 70 – 74% |ATI/CARP ----------------------------------------------------------------- 4% |
|F = 69 or less |Final Cumulative Exam-------------------------------------------------- 33% |
The student must achieve cumulative score of 75% or greater in order to successfully complete the course. Extra credit points cannot be used to attain a course grade of 75%.
REQUIRED TEXTS AND MATERIALS
Huber, D. L., (2006) Leadership and Nursing Care Management (3rd ed). Philadelphia: Saunders.
LeMone, P. & Burke K. (2008). Medical – Surgical Nursing Critical Thinking in Client Care (4th ed.) New Jersey: Pearson Prentice Hall. (ISBN: 978-0-13-171-309-3).
Fulcher, E. M. & Frazier, M. S., (2007). Introduction to Intravenous Therapy for Health Professionals. Philadelphia: Saunders.
Gentry, J., (2010). Nursing B26: Medical-Surgical Nursing 3 Instructional Syllabus Spring/2010.
Comprehensive Assessment and Review Program (CARP) by ATI. 4% will be awarded for completion of ALL assignments in ATI and grades will be docked to no more than 2% if not all assignments are completed.
Scantrons: Six 100 question (Form No.882-e).
RECOMMENDED TEXTS & WEBSITES
Nursing Practice Act with Regulations and Related Statutes. .
|WEEK |DATE |Unit |Topic Class meets Tuesdays from 1015-1245 |Notes |
| |Jan 18 | | | |
|Week 1 | |No class |Holiday | |
| |Jan 25 | |Medical Surgical B 26 | |
|Week 2 | |Introduction |Professional Issues & Nursing Practice | |
| | |Unit 1 |Bio-psychosocial Concepts related to health care | |
| |Feb 1 | | | |
|Week 3 | |Unit 12 |Problems of Protection | |
| | Feb 8 | | | |
|Week 4 | |Unit 11 |Fluid, Electrolytes, and Acid-Base Imbalances |Feb 12 |
| | | |Test Unit 1, 2 and 12 |No clinic |
| |Feb 15 | | | |
|Week 5 | |No Class |Holiday | |
| |Feb 22 | | | |
|Week 6 | |Unit 3 |Problem of Oxygenation | |
| |March 6 | | | |
|Week 7 | |Unit 4 |Problems of Cardiac Output and Tissue Perfusion | |
| | | |Test Unit 11 and 3 | |
| |March 8 |Unit 5 |Problems with Hematological System | |
|Week 8 | | | | |
| |March 15 | |MID TERM all material to date will be covered | |
|Week 9 | |Mid Term |You will have the whole class time for exam | |
| |March 22 | | | |
|Week 10 | |Unit 6 |Problems of Mobility, Sensation, and Cognition | |
|***March 29-April 4 Easter Break*** | |
| |April 5 | | | |
|Week 11 | |Unit 7 |Problems of Digestion, Nutrition, and Elimination | |
| |April 12 | | | |
|Week 12 | |Unit 8 |Problems of Regulation and Metabolism | |
| | | |Test Unit 6-7 | |
| |April 19 | | | |
|Week 13 | |Unit 9 |Problems with Excretion | |
| |April 26 | | | |
|Week 14 | |Unit 10 |Problems of Neurological Function | |
| | | |Test Unit 8-9 | |
| |May 3 | | | |
|Week 15 | |Review |Final Review (ATI Testing) | |
| |May 12 | | | |
|Week 16 | |Final Exam |Final 800-0950 | |
| | | |Wednesday May 12, 2010 | |
COURSE CONTENT
I. Review Program and Course Learning Outcomes
II. Review Syllabus
III. Discuss Policies, Expectations and Requirements
PROFESSIONAL ISSUES AND NURSING PRACTICE
I. Role of The Medical Surgical Nurse
A. Review and Reinforce Roles of:
1. Provider of Care
2. Manager of Care
3. Member of The Profession
II. Role of The Perioperative Nurse
A. Review Roles and Concepts of Perioperative Nursing
B. Implement Roles of The Perioperative Nurse Under Direct Supervision of RN
III. Critical Thinking
A. Utilize Critical Thinking Skills
B. Nursing Process
C. Evidence Based-Practice
IV. Caring and Comfort
A. Review and Reinforce:
1. Role of Caring
2. Nursing Theory Related to Caring
3. Implications When Nurses’ and Clients’ Perceptions of Caring Might Differ
4. Ways to Convey Caring Through Presence and touch
5. Active Listening
V. Community Based Care
A. Review
1. Ambulatory Care
2. Home Care
a. Home Care Management With Altered Oxygen
3. Long Term Care
4. Transitional Care
5. Rehabilitation
a. Pulmonary Rehabilitation
6. Managed Care
B. Caring in the Hematologic/Oncologic environment
C. Collaborative Management
1. Age Appropriate Care
2. Diagnostic/Lab Data
3. Diversity
4. Nutrition
5. Nursing Diagnosis/Interventions
6. Pharmacology
7. Safety
8. Surgical/Nonsurgical
9. Teaching/Learning
VI. Leadership
A. Organizational Culture and Climate/Trends in Nursing
B. Professional/Employment Issues
C. Documentation /Assessment
D. Nurse Practice Act
E. Legal /Ethical Issues
BIOPSYCHOSOCIAL CONCEPTS RELATED TO HEALTH CARE
I. Communication and Conflict Resolution
A. Interdisciplinary Communication
1. Formulate Guidelines For Making Effective Telephone Calls to Physicians
B. Review and Implement and Reinforce Conflict Resolution Strategies As Presented in Psychiatric Nursing
C. Consistently use SBAR for reporting, transporting, recommendations and follow-up.
D. Communication styles
II. Pain
A. Differentiate Between Types of Pain and Therapies For Each:
1. Mild
2. Moderate
3. Severe
4. Intractable
III. Recognize cultural factors related to pain management
IV. Define implantable pumps
NURSING PRACTICE FOR MEDICAL – SURGICAL DISORDERS
Problems of Oxygenation
A. Respiratory System
1. Review Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Respiratory System
4. Clinical Manifestations of Altered Respiratory Function
5. Nursing Diagnoses
6. Diagnostics
a. CXR (lateral /decubitus)
b. CT scan
c. Bronchoscopy
d. Nasal Swab (MRSA)
e. Sputum Culture
f. CBC
g. Oximetry
B. Alterations in function of Oxygenation
1. Medical – Surgical Disorders
a. Hemo/Pneumo thorax
1. Pulmonary Contusion
2. Pneumothorax
i. Closed
ii. Open
3. Hemothorax
a. Empyema
1. Transudate
2. Exudate
b. Pleuritis
c. Pleural Effusion
d. Neoplasms (Lung Cancer)
1. Etiology
2. Pathophysiology
3. Clinical Manifestations
4. Complications
5. Collaborative Management
e. Age Appropriate Care
f. Diagnostic/Laboratory Data
g. Diversity
h. Nutrition
i. Nursing Diagnoses/Interventions
j. Pharmacology
k. Safety
l. Surgical Management
1. Chest tubes and drainage systems
a. Water seal
b. Dry Suction
c. Wet suction
d. Heimlich Valve
m. Teaching/Learning
C. Interventions for Clients with Problems in Oxygenation
1. Artificial Airways
a. Incorporate Use and Care of:
b. Oral
c. Nasopharyngeal Airway
d. Laryngeal Mask Airway
e. Tracheostomy
f. Identify ETT
2. Oxygen Delivery Systems
a. Introduce and Appropriate Use and Care of:
1. Trach Shield
2. Blowby (T-Tube)
3. Arterial Blood Gases
a. Review Normal/Abnormal Values
b. Differentiate Between:
1. Respiratory Acid/Alkalosis
2. Metabolic Acid/Alkalosis
c. Correlate ABG Results to Specific Client Condition
4. Suctioning
a. Review Maintenance and Types Suctioning (Oral, Nasal, Pharyngeal, and Tracheal)
b. Expanded Focus On Caring For Client With Tracheostomy
I. Problems of Cardiac Output and Tissue Perfusion
A. Cardiovascular System
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Cardiovascular System
4. Clinical Manifestations of Altered Cardiac Function
5. Nursing Diagnoses
6. Diagnostics – Identify Abnormal Values
B. Alterations in Cardiac Function
1. Medical –Surgical Disorders
a. Cardiomyopathy
b. Permanent Pacemakers
c. Chronic Congestive Heart Failure
d. Inflammatory Heart Disease
1. Infective Endocarditis
2. Pericarditis
3. Myocarditis
4. Rheumatic Carditis
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
Age Appropriate Care
Diagnostic/Lab Data
Diversity
Nutrition
Nursing Diagnoses/interventions
Pharmacology
Safety
Surgical/Nonsurgical
Teaching/Learning
C. Shock
1. Review Types of Shock
2. Differentiate Shock Types
3. Discuss Management:
a. Distributive
1. Anaphylactic
b. Hypovolemic Shock
D. Interventions for Clients with Problems in Cardiac Function
1. Cardiac Emergency
a. Review:
1. Crash Cart and BLS
2. Systematic Approach
3. Code Team
2. Clinical Aim
a. Activate Code Blue
b. Participate in Code Blue
c. Record Code Blue
II. Problems of Hematological System
A. Hematological System
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Hematological System
4. Clinical Manifestations of Altered Hematological Function
5. Nursing Diagnoses
6. Diagnostics
B. Alterations in Hematological Function
1. Medical –Surgical Disorders
a. Anemia
1. Review Definition, Types and Causes, Associated Labs
2. Aplastic – Define and Differentiate
3. Hemorrhagic
i. Acute
ii. Chronic
b. Leukemia
c. Lymphoma
1. Hodgkin’s
2. Non Hodgkin’s
d. Lymphedema
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnoses/interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
Problems of Mobility, Sensation, and Cognition
A. Musculoskeletal System
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Musculoskeletal System
4. Clinical Manifestations of Altered Musculoskeletal Function
5. Nursing Diagnoses
6. Diagnostics
B. Alterations in Musculskeletal Function
1. Medical –Surgical Disorders
a. Neoplasms (Bone Cancer)
2. Etiology (Types of Bone CA)
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnoses/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
Problems of Digestion, Nutrition, and Elimination
C. Gastrointestinal System (GI)
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of GI System
4. Clinical Manifestations of Altered GI Function
5. Nursing Diagnoses
6. Diagnostics
D. Alterations in Gastrointestinal Function
1. Medical –Surgical Disorders
a. Cirrhosis
b. Hepatitis
c. Hepatic failure/PSE
d. PSE
e. Neoplasms (GI Cancer)
1. Esophageal
2. Gastric
3. Pancreatic
4. Colorectal
f. Acute Pancreatitis
g. Review Chronic Pancreatitis
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnoses/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
E. Interventions for Clients with Gastrointestinal Problems
1. Gastric Surgeries
a. Billroth I/Billroth II
b. Pyloroplasty
c. Anthrectomy
d. Vagotomy
e. Gastrectomy
2. Clinical Manifestations
3. Complications
F. Collaborative Management
1. Age Appropriate Care
2. Diagnostic/Lab Data
3. Diversity
4. Nutrition
5. Nursing Diagnosis/Interventions
6. Pharmacology
7. Safety
8. Surgical/Nonsurgical
9. Teaching/Learning
II. Problems of Regulation and Metabolism
A. Endocrine System
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Endocrine System
4. Clinical Manifestations of Altered Endocrine Function
5. Nursing Diagnoses
6. Diagnostics
B. Alterations in Metabolic Function
1. Medical –Surgical Disorders
a. Diabetic Ketoacidosis (DKA)
b. HHNS
c. Thyroid/Parathyroid
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnosis/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
III. Problems of Excretion
A. Renal System
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Renal System
4. Clinical Manifestations of Altered Renal Function
5. Nursing Diagnoses
6. Diagnostics
B. Alterations in Renal Function
1. Medical –Surgical Disorders
a. Renal Insufficiency
b. Chronic Renal Failure/Uremia
c. ESRD
d. Dialysis
e. Tumors
1. Prostate
2. Renal
3. Testicular
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnosis/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
IV. Problems of Neurological Function
A. Neurological System
1. Anatomy and Physiology
2. Health History
3. Focused Physical Exam of Neurological System
4. Clinical Manifestations of Altered Neurological Function
5. Nursing Diagnoses
6. Diagnostics
B. Alterations in Neurological Function
1. Medical –Surgical Disorders
a. Neoplasms
1. Primary
2. Secondary
b. Inflammatory Brain Conditions
1. Bacterial Meningitis
2. Viral Meningitis
3. Encephalitis
4. Brain Abscess
c. Myasthenia Gravis
d. Multiple Sclerosis
e. ALS
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnosis/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
Fluid, Electrolyte, and Acid-Base Imbalances
C. Intravascular Access Devices
1. Differentiate Types of Accesses
2. Differentiate Care For Accesses
3. Describe Blood Component Therapy and Associated Nursing Care
4. Describe Care of Client Who Is Receiving TPN
a. Composition
b. Methods of Administration
c. Catheter Placement
d. Potential Complications
e. Nursing Management
5. Describe Long Term Antimicrobial Therapy
V. Problems of Protection
A. Immune System
1. Review Anatomy and Physiology
2. Obtain Health History
3. Focused Physical Examination of Immune System
4. Clinical Manifestations of Altered Immune Function
5. Nursing Diagnoses
6. Diagnostics
B. Alterations in Immunological Function
1. Medical –Surgical Disorders
a. Neoplasms
b. SLE
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnosis/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
C. Integumentary Disorders
1. Anatomy and Physiology
2. Health History
3. Focused Physical Examination of Integumentary System
4. Clinical Manifestations of Altered Integumentary Function
5. Nursing Diagnoses
6. Diagnostics
D. Alterations in Integumentary Function
1. Medical –Surgical Disorders
a. Malignant skin disorders
1. Melanoma
2. Basal Cell
3. Squamous cell
4. Actinic keratosis
2. Etiology
3. Pathophysiology
4. Clinical Manifestations
a. Types of Burn
b. Classification
c. Depth of Burn
d. Percent of Body Surface
1. Adult
2. Children
5. Complications
6. Collaborative Management
a. Age Appropriate Care
b. Diagnostic/Lab Data
c. Diversity
d. Nutrition
e. Nursing Diagnoses/Interventions
f. Pharmacology
g. Safety
h. Surgical/Nonsurgical
i. Teaching/Learning
Unit 3 Problems of Oxygenation
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition
Applicable information Ch 36-39
The goal of this unit is to provide the learner with the key information needed to care for a client with altered oxygenation related to specific respiratory disorders. Unit 3 provides an in depth review of assessment parameters for clients with respiratory problems. The module contains information on nursing care of the client with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the respiratory system and contrast normal assessment from abnormals associated with Chest Trauma, pleuritis, empyema, pleural effusion and lung cancer.
2. Compare and contrast how factors such as: Chest Trauma, hemothorax, pneumothorax, pleuritis, empyema, pleural effusion and lung cancer affect ventilation and respiration (gas exchange).
3. Identify specific topics for consideration during a health history interview of clients with health problems involving the respiratory system.
4. Describe normal variations in assessment findings for the older adult.
5. Describe surgical procedures used to treat: Chest Trauma, hemothorax, pneumothorax, pleuritis, empyema, pleural effusion and lung cancer, and nursing responsibilities in caring for clients undergoing these procedures.
6. Discuss treatment options for oral and laryngeal cancers with their implications for the client’s body image and functional health.
7. Describe the nursing implications for oxygen therapy and medications used to treat respiratory disorders.
8. Describe the nursing implications for medications used to promote ventilation and gas exchange.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.
4. Develop a pulmonary rehabilitation plan of care for a client returning home on oxygen.
5. Assess the need and perform tracheostomy care and suctioning for an assigned client.
6. Identify and implement health teachings for the client with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.
7. Present an ethical or legal issue associated with clients with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.
8. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer
9. Practice and/or use the computerized charting in the clinical setting.
UNIT 4-PROBLEMS OF CARDIAC OUTPUT AND TISSUE PERFUSION
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition
Chapter 30-32
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with altered oxygenation related to specific cardiovascular disorders. Unit 4 provides an in depth review of clients with cardiac problems. The unit contains information on nursing care of the client with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the cardiovascular system.
2. Identify normal heart sounds and relate them to the corresponding events in the cardiac cycle.
3. Explain cardiac output and explain the influence of various factors in its regulation.
4. Describe normal variations in assessment findings for the older adult.
5. Identify manifestations of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
6. Compare and contrast the pathophysiology and manifestations of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
7. Relate the outcomes of diagnostic tests and procedures to the pathophysiology of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock and implications of client responses to the disorder and associated nursing care for each.
8. Discuss nursing implications for medications and treatments used in the prevention, treatment and management of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
9. Explain risk factors and preventive measures for Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
4. Identify and implement health teachings for the client with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
5. Present an ethical or legal issue associated with clients with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.
7. Practice and/or use the computerized charting in the clinical setting.
UNIT 5-PROBLEMS OF HEMATOLOGICAL SYSTEM
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 33 – 35
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with problems of the hematological system. Unit 5 contains information on nursing care of clients with Anemia, Leukemia, Lymphoma, and Lymphedema. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the hematologic, peripheral vascular and lymphatic systems and relate it to Anemia, Leukemia, Lymphoma, and Lymphedema.
2. Outline a focused physical assessment of the hematologic system.
3. Describe normal variations in assessment findings for the older adult.
4. Identify manifestations of impairment in the function of the hematologic, peripheral vascular and lymphatic systems.
5. Describe, compare and contrast the pathophysiology, manifestations and management of Anemia, Leukemia, Lymphoma, and Lymphedema.
6. Differentiate Hodgkins disease from non-hodgkins lymphomas and describe nursing interventions for each.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema
4. Identify and implement health teachings for the client with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema
5. Present a ethical or legal issue associated with clients with Anemia, Leukemia, Lymphoma, and Lymphedema
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Anemia, Leukemia, Lymphoma, and Lymphedema
7. Practice and/or use the computerized charting in the clinical setting.
UNIT 6 – PROBLEMS OF MOBILITY, SENSATION, AND COGNITION
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapter 40 – 42 Adding SLE from Unit 12
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with bone cancer as well as review the musculoskeletal system. Unit 6 contains information on nursing care of clients with the different types of bone cancer. Bone cancer will be discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the musculoskeletal system.
2. Identify specific topics for consideration during a health history interview of the client with health problems involving the musculoskeletal system.
3. Describe normal variations of the musculoskeletal system in the older adult.
4. Discuss the purposes and related nursing interventions for stump care.
5. Explain the causes, levels, types and potential complications (infection, delayed healing, chronic stump pain, phantom pain, and contractures) of an amputation.
6. Explain the pathophysiology, manifestations, complications, interdisciplinary care, and nursing care of neoplastic disorders, bone tumors, and systemic lupus erythematosus.
7. Describe surgical procedures used to treat clients with bone tumors.
8. identify common laboratory and diagnostic tests associated with diagnosis, management and evaluation of clients with disorders of the musculoskeletal system.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with bone cancer and SLE.
2. Utilizing critical thinking skills develop and evaluate a care plan for a client diagnosed with bone cancer and SLE with moderate to high acuity.
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with bone cancer and SLE.
4. Identify and implement health teachings for the client with bone cancer and SLE.
5. Present an ethical or legal issue associated with clients with bone cancer and SLE.
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with cancer and SLE.
7. Practice and/or use the computerized charting in the clinical setting.
UNIT 7-PROBLEMS OF DIGESTION, NUTRITION, AND ELIMINATION
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 23-26
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with problems of digestion, nutrition and elimination. Unit 7 contains information on nursing care of clients with Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the gastrointestinal system.
2. Describe the pathophysiology of Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.
3. Relate manifestations, diagnostic tests, and surgeries associated with Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.
4. Utilize knowledge of normal anatomy and physiology to understand the manifestations and affects of Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.
5. Describe normal variations of digestion, nutrition and elimination for the older adult.
6. Discuss the purposes, nursing implications, and health education for the client and family of medications used to treat gastrointestinal disorders.
7. Describe surgical procedures of the bowel including Billroth I, Billroth II, colectomy, colostomy, ileostomy, and perianal surgery.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.
4. Identify and implement health teachings for the client with any of the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.
5. Present an ethical or legal issue associated with clients with Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis
7. Practice and/or use the computerized charting in the clinical setting.
UNIT 8 – PROBLEMS OF REGULATION AND METABOLISM
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition. Chapters 18 – 20
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with problems of regulation and metabolism. Unit 8 contains information on the nursing care of clients with Diabetic Ketoacidosis (DKA), Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the endocrine system.
2. Explain the function of the hormones secreted by the endocrine glands.
3. Identify specific topics to consider during a health history interview of the client with health problems involving endocrine function.
4. Describe normal variations in assessment findings for the older adult.
5. Identify abnormal findings that may indicate malfunction fo the gladns of the endocrine system.
6. Compare and contrast the manifestations of disorders that result from hyperfunction and hypofunction of the thyroid, parathyroid and pancreas.
7. Provide appropriate nursing care for the client before and after a total and subtotal thyroidectomy.
8. Compare and contrast the manifestations and interdisciplinary care of hypoglycemia, diabetic ketoacidosis, and hyperosmolar hyperglycemic state.
9. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
4. Identify and implement health teachings for the client with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
5. Present an ethical or legal issue associated with clients with Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathryoid disorders.
7. Practice and/or use the computerized charting in the clinical setting.
UNIT 9-PROBLEMS OF EXCRETION
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 27 – 29
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with problems of excretion. Unit 9 contains information on nursing care of clients with Prostate, Testicular and Renal Cancer. This unit will also include Chronic Renal failure and dialysis. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy, physiology and function of the genital urinary system.
2. Describe normal variations in assessment findings for the older adult.
3. Explain the role of the urinary system in maintaining homeostasis.
4. Identify specific topics for consideration during a health history assessment interview of the client with problems involving the urinary system.
5. Discuss the nursing implications of medications and treatments prescribed for clients with urinary tract disorders.
6. Describe the pathophysiology of clients with Prostate, Testicular and Renal Cancer including Chronic Renal failure and dialysis.
7. Explain diagnostic studies used to identify disorders of the kidneys and their effects.
8. Compare and contrast dialysis procedures (ie hemodialysis and peritoneal) used to manage chronic renal failure.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer
4. Identify and implement health teachings for the client with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer
5. Present a ethical or legal issue associated with clients with Chronic Renal Failure and Prostate, Testicular and Renal Cancer
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Prostate, Testicular and Renal Cancer as well as Chronic Renal Failure
7. Practice and/or use the computerized charting in the clinical setting.
UNIT 10- PROBLEMS OF NEUROLOGICAL FUNCTION
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 43 – 46
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with problems of neurological function. Unit 10 contains information on nursing care of clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS). Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the anatomy and physiology of the neurological system.
2. Outline a focused physical assessment of the neurological system.
3. Identify specific topics for consideration during a health history assessment interview of the client with neurologic disorders.
4. Identify manifestations of impairment of neurologic function.
5. Identify prevalence, incidence, and risk factors for clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
6. Compare and contrast the pathophysiology, manifestations, interdisciplinary care, and nursing care of clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
7. Discuss the purposes, nursing implications, and health education for the client and family for medications used to treat Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
8. Discuss surgical options for the treatment of Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
9. Describe the procedures (plasmapheresis etc.) used to treat selected neurologic disorders.
B. Clinical
1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
4. Identify and implement health teachings for the client with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
5. Present an ethical or legal issue associated with clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotropic Lateral Sclerosis (ALS).
7. Practice and/or use the computerized charting in the clinical setting.
Unit 11-Fluid, Electrolyte, and Acid-Base Imbalances
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition
Unit 3 Chapter 10
INTRODUCTION
The goal of this unit is to provide the learner with the key information needed to care for a client with intravenous (IV) access devices. Unit 11 contains an in depth review of intravenous therapy. Primarily intravenous devices will be discussed including the types and nursing care associated with each device. Blood Component therapy will also be included in this unit. A nursing process approach is used for nursing management with focus on health promotion and self care. Nursing diagnoses and client outcomes are identified. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Review the purpose and types of intravenous (IV) therapy.
2. Recall the nursing care related to IV therapy appropriate for patients across the lifespan.
3. Outline the steps to an IV assessment for various types of patients and IV therapy.
4. Differentiate the use and care of short and long term catheters for immunosuppressed clients: Central venous access devices
i. PICC Lines
ii. Port-a-cath
iii. Hickman
5. Differentiate and start to evaluate diagnostic exams used to assess appropriateness of IV therapy.
6. Distinguish between the nursing care of the patient with TPN and peripheral IV therapy.
7. Compare and contrast rationales behind long term antimicrobial therapy.
8. Relate nursing care to long-term antimicrobial therapy.
9. Identify Principles and practice of blood transfusion
B. Clinical
1. Care for patients with intravenous access’s
2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and an intravenous access device.
3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with intravenous access devices.
4. Identify and implement health teachings for the client with intravenous access devices.
5. Present an ethical or legal issue associated with clients with intravenous access devices.
6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with intravenous access devices.
7. Identify and implement the steps necessary for blood and blood component transfusion
8. Practice and/or use the computerized charting in the clinical setting.
Unit 12 REGULATION/PROTECTION NEEDS: CANCER
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition
Chapter 14
INTRODUCTION
This unit at first reviews the general aspects of cancer that can be applied regardless of the sites. Cancer of the specific body systems is described in more detail in each unit. A nursing process approach is used for nursing management, with emphasis on health promotion and self care.
OBJECTIVES:
Upon completion of this unit, the student will be able to:
A. Theory
1. Recall selected terms associated with cancer.
2. Define cancer and differentiate benign from malignant neoplasms.
3. Describe the theories of carcinogenesis.
4. Explain and discuss known carcinogens and identify risk factors for cancer.
5. Compare the mechanisms and characteristics of normal cells with those of malignant cells.
6. Describe and compare laboratory and diagnostic tests for cancer.
7. Discuss the role of chemotherapy in cancer treatment and classify chemotherapeutic agents
8. Discuss the role of surgery, radiation therapy, and biotherapy in the treatment of cancer.
9. Identify causes and discuss the nursing interventions for common oncologic emergencies.
10. Design an appropriate care plan for clients with cancer and their families regarding cancer diagnosis, treatment, and coping strategies.
B. Clinical
1. Assess functional health status of clients with cancer, and monitor, document, and report abnormal manifestations.
2. Incorporate evidence-based research into the plan of nursing care for clients with cancer.
3. Prioritize nursing diagnosis based on assessment data and implement appropriate nursing interventions for clients with cancer during cancer diagnosis, treatment and rehabilitation.
4. Evaluate the client who has been administered chemotherapeutic medications and assess the need for other medications for pain, nausea, and vomiting, mucosistis, or anemia knowledgeably and safely.
5. Use the nursing process as a framework for planning and providing individualized care and integrating interdisciplinary care for clients with cancer to meet their healthcare needs.
6. Include cultural variations and diverse values in designing and implementing individualized plans of care for clients with cancer.
7. Design and provide individualized client and family teaching to restore, promote, and maintain clients’ functional status.
8. Revise plan of care as needed provide effective interventions for clients with cancer and their families.
BAKERSFIELD COLLEGE
Associate Degree Nursing Program
Nursing B26: Medical-Surgical Nursing 3
Clinical Manual
Julie Gentry RN MSN FNP
COURSE DESCRIPTION
Laboratory experiences are correlated with theory with emphasis on providing nursing care to the client with increasing complex needs. Concepts presented in Nursing B 26 are applied in a variety of healthcare settings.
Prerequisites: Completion of the first and second semesters of Associate Degree Nursing Program and/or evaluation by program director for skills and knowledge.
LEAD INSTRUCTORS
Main Campus Distance Education
Asst. Professor: Lisa Harding, RN MSN CEN Asst. Professor: Julie Gentry RN MSN FNP
Email: Lharding@bakersfieldcollege.edu Email : jgentry@bakersfieldcollege.edu
Website : bcmedsurg3. Website: bcgentry.
Phone:(661) 395-4728:cell (661)246-6587 (661) 395-4476; Cell (661) 364-3656
Location: M S Building Room 178 Location: M S Building Room 153
Office Hours: Tuesday 1300-1430 Office Hours: Monday 11:00a - 4:00p
(may be extended if no staff meeting) Tuesday 1:30p – 2:30p
Wednesday 1300-1530 (by appointment only)
Address: 1801 Panorama Drive Address: 1801 Panorama Drive
Bakersfield, CA 93305 Bakersfield, CA 93305
****Open door policy – Students may contact/meet with instructor during scheduled office hours at any time. If the student has special needs, individual time can always be scheduled.
PROFESSIONAL EXPERTS - - - BAKERSFIELD COLLEGE
Asst. Professor Lisa Harding, RN Mercy Hospital Truxtun Avenue
Phone: (661) 395-4728; Cell (661) 246-6587 (4 West)
Asst. Professor Julie Gentry RN, MSN San Joaquin Community Hospital
Phone: (661) 395-4679; Cell (661) 619-8248 (3 South)
Alisha Loken BSN, RN Kern Medical Center
Phone: (661) 821-0105; Cell (310) 948-3707 (3 Center)
Heather Ryall RN BSN San Joaquin Community Hospital
Cell (661) 204-5615 (4 South)
COURSE ASSIGNMENTS
Students are required to complete a variety of assignments which may include simulated learning experiences, computer assisted programs and weekly reading and homework assignments in order to successfully meet the objectives for Nursing B26 Clinical. Detailed instructions for each assignment are located in the ASSIGNMENTS section of the syllabus.
CLINICAL LABORATORY GUIDELINES
Attendance
Clinical experience is essential for the student to meet all course objectives. For that reason, it is crucial students attend all scheduled clinical experiences. According to the handbook, two (2) days of clinical may be missed for compelling reasons. Failure to meet course objectives will result in failure of the course. Make up days are not allowed. If the clinical instructor determines additional time is required in order to evaluate ability to progress to the next level, you will be notified and a learning contract will be initiated in order to aid in your successful completion of B 26. Lateness is not acceptable! Each tardy will be considered one absence. All absences and tardies must be reported to the clinical instructor by 0600. Do not call and leave a message with the nursing staff on the unit.
• Please refer to the Bakersfield College Catalog and the ADN Student Handbook for Guidelines related to: Personal Appearance; Grooming; Uniforms; Jewelry; Alternative lab experience dress code; Dress Code While Obtaining Assignments; Campus Skills Laboratory Dress Code; Photo ID.
Student Orientation to Healthcare Facility
All students must be oriented to the facility where laboratory experience is provided. It is the responsibility of the instructor to provide this orientation either personally or by arrangement with staff members. Orientation shall include but is not limited to the following:
• Parking Regulations (include both daytime and evening rules)
• Cafeteria Procedure:
• Restroom Facilities
• Locker Facilities and/or proper location for books, outer clothing, purses, and valuables storage.
• Safety and Emergency Procedures:
• Absences or Tardiness in the Laboratory Areas:
• Paging System:
• Location in Facility of:
• Location of Student Assignment and Daily Laboratory Objectives:
• Learning Resource Material:
• Charting:
• Medication Administration:
• Supplies:
• Orientation to Client Unit:
• Introduction to Key Personnel:
• Pre and Post Conference Facilities:
• Communications During Laboratory Rotation:
• Information About Facility:
• Telephone Protocol
Limitation of Student Activity - Laboratory Area
Students are not to leave the nursing unit or department to which they are assigned without the permission of the instructor. Students may not undertake care of clients, which have not been assigned by instructor.
Phone Calls/Student Visitors
No personal phone calls should be made or received while in the laboratory areas. Emergency calls are directed to the instructor. Cell phones and pagers should be turned off. Cellular phones are not allowed in the laboratory areas. Also, students may not have visitors while in the laboratory area.
Laptop Computers/PDA’s
• No laptop computers are to be used/present in the health care facilities.
• PDA’s are to be used only as a resource, not as a word processing device while in the health care facility.
Transportation
• Students are responsible for transportation to and from healthcare facilities.
• Students assume all liability for traveling to and from healthcare facilities.
• Students must park only in designated parking areas.
ACADEMIC HONESTY
There will be zero tolerance for academic dishonesty, including plagiarism. Plagiarism is the intentional use of another person’s ideas, data, information, or work without giving credit. If the student is caught cheating, the clinical paperwork will be collected, a zero (0) grade will be recorded, and the student will be directed to leave the clinical area. The student is required to meet with the Director of Allied Health to discuss his/her standing in the program. Please refer to the statements on academic honesty in your Bakersfield College Catalog, Associate Degree Nursing Student Handbook, and the Bakersfield College Class Schedule
COURSE EVALUATIONS
Clinical site and instructor evaluations are a requirement for this course. Evaluations will be conducted the last day of each clinical rotation. Students are expected to complete and online survey using class climate, for each clinical instructor and site. Also, students are required to turn in 3rd Semester Critical Elements Forms and the Student Self Evaluation Form.
STUDENT EVALUATION
Evaluation is an ongoing, essential process in education, by which the student is, appraised of his/her progress in meeting the level outcomes and unit objectives. Student performance evaluations are based on course level outcomes, written and or oral assignments, and program critical elements. Clinical is graded on the care plan and the Nursing Process score. Student must also demonstrate the ability to consistently transfer classroom knowledge i.e. apply the information/skills at the bedside.
If the student earns a no credit for clinical he/she is unable to progress in the program and will receive a failing grade for B26.
|Grading Scale | | |
|For assignments |Course Grade | |
|A = 90 – 100 |≥ 75% = Credit | |
| |≤ 75% = No Credit |Medical Surgical Rotation _ _ _ _ _ _ _ _ _ _ |
|B = 80 – 89 | |Process paper ( 1 ), Daily abbreviated care plans, Verbal |
| | |presentation |
|C = 75 – 79 | |Clinical assignments _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| | |Simulation learning, skills completion lists, presentation |
|D = 70 – 74 | |Float out rotations _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| | |Professionalism and participation |
|F = 69 or less | | |
REQUIRED TEXTS AND MATERIALS
Leadership and Nursing Care Management, Huber, D. 3rd Edition
Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition
Harding, L. (2010). Bakersfield College Associate Degree Nursing Program. Instructional syllabus Theory and Clinical, B26
Nursing Practice Act with Regulations and Related Statutes. .
Information from bcmedsurg3.
Comprehensive Assessment and Review Program (CARP) by ATI.
▪ The CARP textbook/resource package includes books, DVDs, practice tests with thousands of NCLEX-style questions as well as proctored exams.
*Each student will need one book of their choice from each of the following categories. Due to limited clinical space, each clinical group needs to determine who will bring which reference to share with the group.
1. Laboratory and diagnostic reference book
2. Intravenous medication book
3. General medication book
4. Pathophysiology book
5. Nursing Care plan book
PORTFOLIOS
Each student must have their portfolio immediately accessible upon request. Students can expect to present the portfolio at the beginning of each clinical rotation, and during the clinical evaluation process. The portfolio should include:
1. Copies of:
a. Physical Exam
b. TB skin test or Chest X-ray
c. Immunizations
d. Current American Heart Association CPR card
2. ADN Student Handbook
3. Safety Manual
4. Conference/Anecdotal/Probation forms
5. Evaluation Forms (Clinical site/Instructor/Theory)
6. Completed clinical evaluation forms
7. Skills checklist
8. TEAS results
CLINICAL GUIDELINES
1. The student will become acclimated to the environment, including:
• Physical layout of the facility
• Location of fire alarms and extinguishers
• Location of supplies and equipment
• Charting/Documentation
• Nurse care plans
2. All accidents and incidents are to be reported to the clinical instructor immediately. It is the student’s responsibility to complete the proper forms and notify the Bakersfield College Health Services Office
3. BREAKS-----Instructor and team leader MUST be notified of any breaks to be taken. When you take a break, another student must watch and be responsible for your client---not the hospital staff.
Students are allowed (2)15 min breaks and a 30 min lunch. break.
NO OTHER OPTIONS ARE AVAILABLE. In taking a break your work MUST be done on time and be on time to post-conference.
SMOKING AREAS---None.
There is to be no drinking, eating ect.. while on unit. (against infection control guidelines)
4. You may perform procedures that an RN may legally perform once you have demonstrated competency in the skills lab and/or the clinical setting.
5. Listen to report and practice taking notes. Clarify anything that is unclear with your instructor. A verbal report to the instructor is expected on each client you are assigned, inform of significant changes also. Keep the RN informed about everything relating to your clients condition.
6. Read the hospital policy and procedure before performing any procedure. We are guest in this facility and must follow written procedures
7. Perform a physical assessment each day for each client, and chart according to the hospital policy.
8. Medications:
• The six rights of medication administration will be followed at all times
• All medications mus tbe checked by the instructor before you give them. If the instructor is unavailable, WITH THE INSTRUCTORS PERMISSION you may ask the staff RN to check medications.
• The instructor or staff nurse must observe administration of all IV medications.
• Students are not to handle narcotic keys, or possess computer access numbers to the automated medication delivery system (Pyxis, Omnicell)
9. Students are responsible for the care of the client/team. If you are unable to complete any part fo the patient care you must notify the instructor immmediately.
10. Students are expected to follow directives in code situations – code blue, red, etc.
11. Post Conference--------1430pm -1530 pm ALL STUDENTS MUST BE ON TIME TO POST-CONFERENCE UNLESS NOTIFIED OTHERWISE
12. Please turn in careplans in a manila envelope, keep all graded assignments together. All assignments will be returned to the student.
POST CONFERENCE
Post conference is an opportunity to apply the information learned in the clinical setting and fosters and enviornment for discussion and learning. Each clinical instructor is responsible for the flow and structure of post conference and may consist of:
• Each student must present a verbal process paper based on a patient in clinic
• Verbal report of disease process
• Verbal presentation of Journal or news item pertinent to healthcare
• Field trip/site visit as prearranged by the instructor
• Role-play among students based on disease process preseented
”Knowing is not enough, we must apply. Willing is not enough, we must do”.
Johann von Goethe
ASSIGNMENTS
SKILLS CHECKLIST
PURPOSE OF THE ASSIGNMENT
The primary objective for this assignment is to provide record keeping for all clinical skills acquired, and to facilitate new learning experiences.
LEARNING OBJECTIVE
1. Demonstrate accountability and responsibility for individual leaning needs.
2. Practice a series of skill sets to assist in role transition from student to entry level RN
DUE DATE
Skills checklist are due at the completion of each clinical rotation. (Please submit to your clinical instructor). It is the student’s responsibility to keep up to date on clinical skills checklist.
FORMAT
Each student is required to maintain their skills checklist throughout the entire rotation in order to fulfill course objectives. It is the student’s responsibility to keep their skills checklist with them during their clinical rotation and keep it up to date. Students are encouraged to have clinical instructors sign off the newly acquired as soon as possible
GRADING CRITERIA
Students will earn either “credit” or “no credit” for this assignment. Successful completion will be based on completion of the assignment, adhering to the format and due dates.
COMMUNITY PROJECTS
Students are required to be in full uniform during community service projects. NO EXCEPTIONS.
PURPOSE OF THE ASSIGNMENT
As a member of the profession it is part of our professional responsibility to participate in community health related events. All community projects must be approved by the instructor prior to attendance in order to receive credit for the participation.
LEARNING OBJECTIVE
1. Integration of standards into aspects of patient care of the client in the community setting.
2. Independently collaborate with the interdisciplinary team to uphold State and Federal regulations
DUE DATE
A 250 to 500 word typed paper highlighting the experience. The paper should include your role in the experience, and how the peer group performed as positive or negative role models in the experience. Please include if this is a function you would continue to participate in if it were not an assignment for the course completion. All students are required to participate in one (1) community project (2-4 hours) throughout the course of the semester. The written report is due no later than May 4, 2010.
FORMAT
Throughout the semester opportunities will arise for student participation in the community setting. Opportunities will be announced as they become available
OPTION 1
Contact Beth-Anne Mulder regarding the RN explorer program and set up a time to assist in the orientation process as directed by the leader of the program.
OPTION 2
Contact 1-800- and identify a community service project to participate in. There are also several opportunities within the BC arena that may benefit from nursing students.
OPTION 3
Contact the community service department at any local area hospital and volunteer to participate in the community activities involved.
OPTION 4
Find a community project of interest to you; health care related is preferred but not totally necessary. Civil responsibility many times goes far beyond health care – clothing drives, toys drives, canned food drives, healthcare education opportunities for younger scout groups, and day care settings or possibly church activities. The program leader information for your project must be included on your written assignment of the experience.
OPTION 5
Contact the volunteer services at any local hospice, home health or hospital organization to assist in preplanned health fairs or volunteer opportunities.
GRADING CRITERIA
Students will earn either “credit” or “no credit” for this assignment. Successful completion will be based on completion of the assignment, adhering to the format and due dates. Please do not take this assignment lightly; failure to earn “credit” may result in failure of NURS B26.
SIMULATED LEARNING REQUIREMENT
PURPOSE OF THE ASSIGNMENT
Simulated learning provides a mechanism to practice, develop, and apply nursing care in safe interactive, and non threatening healthcare environments. This realistic experience supports critical thinking every step of the way while maintaining realistic experiences in controlled environments to produce standardized experiences.
LEARNING OBJECTIVE
1. Enhance clinical skills and application at a third semester level.
2. Build self confidence in application of knowledge and skills.
3. Promote success as a Provider and Manager of care and a Member of the Profession.
DUE DATE
Each student must turn in completed Simulation Learning Requirements no later than Tuesday May 4, 2010.
FORMAT
All students are required to complete a minimum of 4 hours of simulated learning experiences throughout the course of the semester. These hours are mandatory as they count towards the
clinical hour’s allotment. The simulated learning experiences will be broken down into 4 hour units. Each unit will contain sections developed to enhance skill acquisition, confidence and clinical competence. Students will have 14 weeks to complete the units and simulation hours.
Please keep track of your hours and use the Positive Attendance Tracking system (PAT). A minimum of (1) one hour of high fidelity simulation in addition to one of the learning modules created for B26 must be completed in order to obtain a passing grade for this assignment.
GRADING CRITERIA
Students will be awarded 4 hours of clinical time upon completion of each unit. Partial hours will not be awarded. Remember simulation hours counts toward clinical hours, noncompliance will result in missed clinical experience and the student will receive no credit for the clinical portion of B26 and failure of the course. Successful completion will be based on completion of learning module completion, documentation of simulation completion forms and documented hours on the PAT system. Your personal log or hours is your proof should the PAT system fail to record your time successfully.
ATI/CARP
Comprehensive Assessment and Review Program (CARP) by ATI.
▪ The CARP textbook/resource package includes books, DVDs, practice tests with thousands of NCLEX-style questions as well as proctored exams.
▪ Assignments will be announced in class as they pertain to each lecture or unit as determined by lead faculty.
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