NUR 105-Adult Nursing - Chattahoochee Valley …sacs.cv.edu/docs/Resource Documents/Numerical...

NUR 105-Adult Nursing Spring 2012

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Chattahoochee Valley Community College Spring 2012

NUR 105 – Adult Nursing Theory 5 credit hours Lab 1 credit hour Clinical 2 credit hours Total 8 credit hours Contact 14 hours CLASS MEETING DATES/TIMES/LOCATION Wednesday 09:00 am – 12:00 pm 12:00 pm – 1:00 pm (lunch) 1:00 pm – 3:00 pm IPAC Building: RM N320 CLINICAL DATES/TIMES/LOCATION Lab: Monday, 1:00 pm – 4:15 pm RM N300 Clinical: TBA INSTRUCTOR, CONTACT INFORMATION, OFFICE HOURS/LOCATION Judy Ennis, RNC MSN IPAC Building, RM 310 Office Hours posted on door Phone Number: 334-214-4808 E-mail: [email protected]

mailto:[email protected]


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COURSE DESCRIPTION: This course provides opportunities to develop competencies necessary to meet the needs of individuals throughout the lifespan in a safe, legal, and ethical manner using the nursing process. Emphasis is placed on providing care to individuals undergoing surgery, fluid and electrolyte imbalance and common alterations in respiratory, musculoskeletal, gastro-intestinal, cardiovascular, and endocrine systems. Nutrition, pharmacology, communication, cultural, and community concepts are integrated.

Teaching strategies: Learning activities incorporated into the course include classroom lecture, discussion, SIMS LAB, multi media learning support materials, guided practice of skills in the college lab, Learning Resource Center, written assignments, and suggested readings. Classroom lecture and discussion related to the theoretical basis of client care while the laboratory activities afford the opportunity for application of the theoretical basis.

PREREQUISITE(S)/COREQUISITE(S):

PREREQUISITE COURSES: NUR 102 – Fundamentals of Nursing

NUR 103 – Health Assessment

NUR 104 – Introduction to Pharmacology

BIO 201 – Human Anatomy and Physiology I

Math 100 or higher

CO-REQUISITE COURSES: NUR 106 – Maternal and Child Nursing

ENG 101 – English Comp I

BIO 202 – Anatomy and Physiology II

TEXTBOOK(S) AND OTHER LEARNING RESOURCES:

1. Davis's Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications, 4th Edition. F.A. Davis Company; Philadelphia

2. Davis’s Drug Guide for Nurses + Resource Kit CD-ROM 12th Edition. F.A. Davis Company; Philadelphia

3. Hopper, Williams. Understanding Medical Surgical Nursing, 4th Edition. (2011). F.A. Davis Company; Philadelphia

4. Hopper, Williams. Student Workbook for Understanding Medical Surgical Nursing, 4th Edition. (2011). F.A. Davis Company; Philadelphia

5. Lab Kit (required for completion of labs) 6. NCLEX/HESI Review Book for PN (Student Choice)


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7. Schuster, Pamela M. Concept Mapping; A Critical Thinking Approach to Care Planning, 3rd Edition. (2012). F.A. Davis Company; Philadelphia

8. Taber's Cyclopedia Medical Dictionary, 21st ed. F.A. Davis Company; Philadelphia

EVALUATION AND ASSESSMENT 5 unit exams @ 100 pts 500 points 1 Comprehensive Final 200 points Class Assignments/Quizzes 100 points Nursing Concept Map 30 points Community Teaching Project 50 points Computerized Fundamental Test at Level 2 or above 50 points Discharge Teaching Project 50 points Caring Moment Journal 20 points Total Points 1000 points

POINTS:

900-1000 = A 800-899 = B 750-799 = C

749.9 or below = D and failure of course

Only one (1) make-up exam maybe made per semester per course, please see Nursing

handbook, page 15. Thursday, 05/03/12 from 1:00 pm – 3:00 pm. Test results will not be reviewed except immediately after the test is given or as

scheduled by the Faculty member. Students will not be allowed to review tests at the end of the semester for the Purposes of challenging question answers to obtain points.

Students who wish to challenge a Test question must do so within 24 hours from the end of the test administration. Students who challenge test questions must do so in writing with documentation as to the reason for the Challenge. Students should follow the chain of command.

For any student requesting further review of question(s), requests must be submitted by the student in writing or by email within 3 days post-test review. Individual appointments must be scheduled to view tests. There will be no further exam reviews after 1 week of the exam date.

No student will be allowed to review all exams prior to the comprehensive final.


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The most frequently missed problems on unit exams will be reviewed in the next class period following the test. There will be NO copying of test questions or TAPING test review or unprofessional behavioral. Failure to comply will end test review privileges. Unprofessional behavior will be dealt with on an individual basis and may result in removal from the course.

The student MUST BE PRESENT for quizzes and assignments.

You will receive a 5% grade point reduction for each day an assignment is late.

Any assignment turned in via email or Blackboard message must have the students

name, NUR 105-PN and the date within the body of the paper for credit to be given, NO EXCEPTION!!!

Individual test grades are not rounded to the next higher score. For example, 76.2 and 77.8 would be recorded as test grades. Final course grades will be rounded if the final course grade is 0.5 or above without being rounded. For example, if the grade is 89.49, then a B will be recorded. This applies to grades that are 74.49. This will be recorded as a D.

It is REQUIRED that if you score below a 75 on any exam that you see Mrs. Ennis for additional help. The next exam will not be given until the student has met with the instructor to discuss the previous test

Tutoring is available with Mrs. Ennis. Schedule an appointment if you wish to be tutored.

BLACKBOARD Important information, course syllabus, course grades, and lecture notes can be accessed on Blackboard.

ELECTRONIC DEVICES

All cell phones, beepers and electronic devices are to be turned OFF during class and during clinical time. PDA’s and cellular phones are not to be used for test taking purposes. Basic calculators will be allowed on exams. Disruption of the class by such devices will result in the student being dismissed for the remainder of the class session.

SIMULATION CENTER CONFIDENTIALITY STATEMENT In order to preserve the realism of the scenarios used in the simulation center and to provide an equitable learning experience for each student, all persons using the simulation center will be required to sign a confidentiality agreement. Because every simulation will be recorded on a DVD, the statement also includes an agreement to be filmed and recorded. This confidentiality statement applies to the simulation itself, as well as all patient information made available to the students. Violation of this confidentiality statement will be considered a violation of the school’s code of conduct.


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Attendance: 1. Students are responsible for the knowledge, skills, and abilities not acquired due to absences

and for assignments made or due from the first day the class.

a. Students are expected to attend each class session, to arrive on time, and to remain for the entire class session.

b. Certain financial aid programs require instructors to verify students’ class attendance.

c. Faculty will record attendance from the first day of the term, and roll may be taken more than once during a class meeting.

d. Faculty members are given discretion to consider late arrival to class as an absence or some percentage counting toward an absence. For example, a faculty member may consider a late arrival as ½ of an absence. Partial absences added together may equal one or more full absences.

e. The instructor is not required to review with the student any material missed as a result of the student’s absence(s), nor is the instructor required to notify a student if the student is in danger of a lowered grade due to any graded work missed.

f. The instructor is not required to provide an opportunity for make-up work. The instructor’s

policies regarding make-up work shall be clearly defined in the syllabus.

2. Instructors are required to include the same attendance guidelines in syllabi for all classes, regardless of class format (traditional, on-line, or hybrid).

a. For on-line courses, each student must complete the required Class-Access Assignment by the deadline printed in CVCC’s official Class Schedule for the term.

b. Attendance in an online class (and for the on-line portion of a hybrid class) is defined as logging-in to the class site with the frequency required by the instructor and/or completing and submitting course work, including quizzes and exams, consistent with scheduled dates established by the instructor.

3. At the discretion of appropriate college personnel, an administrative class dismissal may occur due to an instructor’s unplanned absence, hazardous weather conditions, or other unforeseen circumstances. Administrative class dismissals will not be counted as student absences.

4. At the instructor’s discretion, an absence may be excused due to extenuating circumstances.


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a. Instructors must have sufficient information to determine whether an absence will be excused. Therefore, if a student desires an instructor to excuse an absence, he/she must submit written documentation that is acceptable to the instructor concerning the cause of the absence.

b. Upon submission of appropriate written documentation, excused absences include, but may not be limited to:

i. Active military duty

ii. Jury duty/court appearance

iii. Death in the immediate family—For purposes of this policy, this includes a student’s husband, wife, father, mother, son, daughter, brother, sister, or an individual with a close personal tie to the student.

For purposes of administration of this policy, an individual with a close personal tie to the

student is limited to the following: a person standing in loco parentis; where unusually strong

personal ties exist due to a student having been supported or educated by the person; father-

in-law; mother-in-law; son-in-law; daughter-in-law; brother-in-law; sister-in-law; nephew;

niece; granddaughter; grandson; grandfather; grandmother; aunt; or uncle.

iv.Illness—Students who give birth, experience an illness, injury, or other medical condition which requires more than one week’s absence from class may be required to provide a physician’s statement.

5. Excessive absences, regardless of the reason or circumstance, may interfere with the student’s ability to successfully complete the requirements of the course.

a. A student may be dropped administratively from any course for excessive absences, which is defined as failure to attend class(es) when, due to unexcused absences, the student has missed more than 12% of the total number of class hours for which the class is scheduled to meet during the term.

b. A student who is in danger of failing a class due to excessive absences, and who has not been administratively withdrawn from it, should withdraw from the class before the last day to drop with a grade of “W.” Withdrawal from class may affect eligibility for federal financial aid. Students should contact the Financial Aid Office for information.

6. A student who has been administratively withdrawn from a class because of unexcused absences related to extenuating circumstances may submit, in writing and with documentation, an appeal to the course instructor.


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a. If the instructor agrees, he/she will provide written notification to Admissions Office personnel for reinstatement of the student.

b. The student must verify his/her reinstatement in the Admissions Office, be cleared by the Business Office, and show the instructor documentation that the process was completed to finalize the reinstatement and be allowed to attend class.

Attendance requirements in programs that lead to board licensure or certification may differ from this policy. {For further information please see CVCC Catalog/Student Handbook}

Students are expected to attend all classes and labs for which they are registered

Each student should recognize at the beginning of his/her college career that a mature acceptance of his/her academic responsibilities is a prerequisite for accomplishment in college; this applies particularly to class attendance.

Any class sessions missed, regardless of cause, reduces the academic opportunities of the

student.

The ultimate responsibility for learning lies within the student. It is the student’s responsibility to make up any lab missed and they are responsible for missed content. Absence from labs is detrimental to success in this course and will result in failure. ALL lab time must be made up if in excess of 15 minutes. Lab make-up day will be Thursday, 05/03/12 from 9:00 pm – 12:00 pm

A tardy for class will be defined as five or more minutes past announced starting time of the class. Entrance to the classroom will be at the permission of the instructor.

Any student that is not in class when a test and/or quiz have begun will not be admitted in the classroom. Test can be made-up on make-up day (as stated on page 3) quizzes will not be allowed to be made up, no exception.

Any class time missed, regardless of cause, reduces the student’s opportunity for academic success. When a student is absent, the student is responsible for all announcements, content covered in class and for any assignments.

When reporting an absence or tardy for class, one student may not bear the message for the student who is absent or tardy.

Please arrive on time and do not leave early, it is disruptive to others in the class that wishes to learn.

For complete attendance policies see the Student Nursing Handbook.

Appeal Process:

A student who has been administratively withdrawn from a class because of unexcused absences related to extenuating circumstances may submit, in writing and with documentation, an appeal to the course instructor.


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The course instructor will evaluate the appeal for extenuating circumstances and will notify the student of the appeal’s outcome within three working days.

If a student is to be allowed to return to class, the instructor must submit to the Admissions Office a written request for the student’s reinstatement, and the student must verify his/her reinstatement in the Admissions Office, be cleared by the Business Office, and show the instructor documentation that the process was completed to finalize the reinstatement and be allowed to attend class.

If a student is not allowed to return to class, the student may file a written appeal, with documentation, to the appropriate division chair who will notify the student of that appeal’s outcome within three working days.

If the matter cannot be resolved at the division chair level, the student may make a final documented written appeal to the chief academic officer. The decision of the chief academic officer is final and will be communicated to the student within three working days from the date the written appeal is received.

Clinical Evaluation:

A clinical grade of “Satisfactory” is required to pass NUR 105 successfully. The following ratings can be given for the student’s performance: “Satisfactory,” “Needs Improvement,” “Unsatisfactory,” and “Not Observed.” Behaviors are designated as Critical Behaviors or Professional Behaviors. In order to successfully complete the clinical portion of this course, the student must have earned a minimum of 75% “Satisfactory” on the overall clinical evaluation.

Any combination of 3 “U’s” on the clinical evaluation will constitute failure of the course, due to inability to meet clinical/course objectives regardless of the theory grade. This result in a grade of an ‘F’ and the student CANNOT progress. The faculty will share the evaluation(s) with the student at the various points during the clinical experience. The faculty and student will sign and date the evaluation(s) and make any pertinent comments. S = Satisfactory: Student demonstrated knowledge and preparation in performing all aspects of the behavior. NI = Needs Improvement: Clinical behavior and/or work are safe but do not meet all aspects of the performance described in the behavior or performance is inconsistent. When a NI is awarded, the student is given specific criteria required to convert the NI to a S. U = Unsatisfactory: Clinical behavior and/or work are unsafe, inconsistent, or inadequate in meeting all aspects of the performance described in the behavior. When a U is given for the first time, the student is given specific criteria required to convert the U to a S.

Consequences of Unsatisfactory Behaviors: 1. If a student receives a “U” during a clinical experience, he/she may be dismissed from that clinical session.


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2. Three (3) “U’s” during one semester are grounds for immediate termination from the currently enrolled nursing course, regardless of theory grade, due to failure to meet required clinical/course objectives and will result in inability to progress within the nursing program.

3. The faculty has the right to withdraw a student from the clinical setting due to unsatisfactory behavior that jeopardizes the health and/or safety of the client, staff, faculty, and/or other students.

4. Dismissal and permanent removal from the program may occur in cases of extreme circumstances that result in potential or actual harm to any individual, pending due process procedures.

NO = Not Observed: May be given for a behavior that is not observed. Critical Behaviors: Behaviors required to demonstrate that the student’s nursing practice

meets legal, ethical, and safety standards expected of a PN and/or ADN student in the Alabama College System.

If the student is unable to successfully demonstrate a critical behavior, the instructor will evaluate the behavior as “Needs Improvement” or “Unsatisfactory” and will provide the student with an outline of specific criteria required to convert the NI or U to a S.

Labs and Lab Manuals:

All labs are mandatory.

Dress must be appropriate for lab. Suggested attire is a top like a T-shirt (no halter tops, or low V-neck shirt). All tops must cover the waist. Clothing should be comfortable and modest. No flip-flops will be worn!

Lab kit must be brought each week to class to be utilized by the student during lab, no exception! {A list of can be supplied upon request of the student}

It is the responsibility of the student to review what will be covered in lab each week.

Each student will bring their own skills validation sheet with name and date prior to entering lab or they will not be able to check-off that day.

Academic Integrity: 1. Academic dishonesty is one form of academic misconduct. Students are expected

to practice academic honesty. Academic dishonesty includes the following:

Cheating on an exercise, test, or examination to meet course requirements; Cheating includes the use of unauthorized aids in any form.

Plagiarism on an assignment, paper, or report or other material; Plagiarism is

incorporating into one’s work the work of another without indicating the source

from which the work was obtained

2. If a student is found cheating on an exam or committing plagiarism, a student may:

Be required to retake an examination or resubmit an assignment


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Receive an “F” on the given exam or assignment

Receive an “F” for the course

3. Further disciplinary action will be taken at the discretion of the Dean of Students.

4. For further information about academic misconduct please refer to the CVCC

Catalog and Student Handbook.

DRUG TESTING

Students may be asked to do a random or scheduled drug screening at any time while in the health sciences program. One positive drug screen will result in immediate dismissal from the program.

CLASSROOM CONDUCT

As per the CVCC Catalog and Student Handbook, students will not be permitted to

consume food or beverages inside classrooms or labs.

Unsanctioned talking, eating, sleeping and unrelated material during class may be

considered rude and disruptive and is subject to dismissal from the classroom at the

discretion of the instructor.

STATEMENT ON DISCRIMINATION/HARASSMENT The College and the Alabama Board of Education are committed to providing both employment and educational environments free of harassment or discrimination related to an individual’s race, color, gender, religion, national origin, age, or disability. Such harassment is a violation of State Board of Education policy. Any practice or behavior that constitutes harassment is a violation of State Board of Education policy. Any practice or behavior that constitutes harassment or discrimination will not be tolerated.

AMERICANS WITH DISABILITIES

The Rehabilitation Act of 1973 (Section 504) and the American with Disabilities Act of 1990 state that qualified students with disabilities who meet the essential functions and academic requirements are entitled to reasonable accommodations. It is the student’s responsibility to provide appropriate disability documentation to the College. Please contact the ADA representative Vickie Williams at (334) 214-4803.

** REFER TO NUSING HANDBOOK FOR DETAILS NOT LISTED IN THE COURSE SYLLABUS.


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COMPETENCIES AND OBJECTIVES: MODULE A – FLUID, ELECTROLYTE, AND ACID BASE BALANCE Required reading: Chapter 6 pages 69 – 87 Learning Objectives:

Define terms associated with fluid and electrolyte homeostasis.

Explain the physiology of fluids and electrolytes.

Explain how the body’s regulators systematically maintain homeostasis.

Identify causes of fluid and electrolytes imbalance.

Interpret clinical manifestations to determine types of fluid and electrolyte imbalance.

Identify treatment modalities for maintaining fluid and electrolyte homeostasis.

Evaluate outcomes of treatment modalities for maintaining fluid and electrolyte homeostasis.

Define terms associated with acid-base homeostasis.

Explain the physiology of acid and bases.

Explain how the body’s regulators systematically maintain homeostasis for acid-base.

Identify causes of acid-base imbalance.

Interpret clinical manifestations to determine types of acid-base imbalance.

Identify treatment modalities for maintaining acid-base homeostasis.

Evaluate outcomes of treatment modalities for maintaining acid-base homeostasis. Module A Outline:

Fluid and Electrolyte Homeostasis

o Functions of fluids and electrolytes

o Transports

Active

Passive

Disturbances in Fluid and Electrolyte Balance

o Causes of imbalance

o Alterations

Dehydration

Fluid Volume Excess

Hyper/Hypo electrolyte disturbances

o Nursing Process

Acid-Base Homeostasis

o Blood gases


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o Regulators

Acid-Base Alterations

o Causes of imbalance

o Respiratory acidosis/alkalosis

o Metabolic acidosis/alkalosis

o Nursing Process

MODULE B – Venipuncture and Intravenous (IV) Therapy

Required reading: Chapter 7 pages 88 – 105; pages 557 – 559; Chapter 27 pages 557 – 559; additional handouts

Learning Objectives:

Define terms associated with IV Therapy.

Describe key points of the Nurse Practice Act concerning intravenous therapy.

Explain CDC guidelines and agency policies for intravenous therapy.

Explain selected concepts of ethics and patient’s rights related to intravenous therapy.

Differentiate between the registered and practical nurse’s responsibilities for intravenous therapy.

Explain the registered and practical nurse’s responsibilities in administration of blood, blood products, and volume expanders.

Interpret doctor’s orders for intravenous therapy

Explain the anatomical and physiological considerations associated with intravenous therapy.

Explain rationale for the selection of intravenous solutions

Describe the purpose of equipment and supplies for intravenous therapy.

Select appropriate equipment and supplies for specified intravenous therapy.

Describe the process of preparing a patient for intravenous therapy.

Describe the process of preparing the equipment for performing intravenous therapy.

Calculate IV flow rates.

Describe the process of starting the intravenous therapy.

Describe the process of managing intravenous therapy including IV piggyback and saline flush.

Identify expected outcomes of treatment modalities for IV Therapy.

Use critical thinking to prioritize management of care for clients receiving selected IV Therapy.

Obtain blood specimens.


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Identify equipment and techniques for collecting blood specimens.

Select the appropriate color collection tube for an ordered diagnostic test based on organizational protocol.

Describe the process of preparing a patient for collecting blood specimens.

Explain the process for obtaining blood specimens.

Explain CDC guidelines and/or agency policies for handling blood specimens.

Explain the procedures for handling and disposing of specimen gathering materials.

Explain CDC guidelines and/or agency policies for handling blood specimens.

Explain the procedures for handling and disposing of specimen gathering materials.

Module B Outline:

Roles and Responsibilities

Legal and Ethical Guidelines

o Nurse Practice Act

o CDC Guidelines

o Handling medical waste

o Agency policies

o Ethics and patient’s rights

Interpreting doctor’s orders

Terminology and A & P Review

Types and use of intravenous solutions

Equipment and Supplies

Pumps and controllers

Tubing and filters

IV needles and catheters

Criteria for choosing appropriate equipment

Calculating Flow Rates

Patient physical and psychological preparation for IV therapy

Venipuncture Process

Techniques

Securing the IV site

Dressings and labeling

Flow rate problems

IV Complications

Local


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Systemic

Monitoring and Maintenance of the IV

Documentation

Site care

Patient education

IV Medications

Continuous

Intermittent

Blood, Blood Products, and Volume Expanders

Practical nurses responsibilities

Transfusion reactions

Nursing Process

MODULE C – PERIOPERATIVE CARE Required reading: Chapter 12 pages 196-229 Learning Objectives:

Define terms associated with perioperative care.

Explain the nurse’s role within perioperative settings.

Explain the elements of informed consent.

Explain nursing process for perioperative care.

Explain preoperative care.

Explain intraoperative care.

Explain postoperative care.

Describe techniques for acute pain management.

Use critical thinking to prioritize management of care. Module C Outline:

A. Nurses Role Within Perioperative Settings

B. Informed Consent

C. Pre-Operative

Legal considerations

Types of surgery

Risk factors

Diagnostic tests and exams


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Complete preoperative checklist

Prep for surgery

Nursing process

D. Intraoperative

Surgical gowning

Surgical scrub

Holding area

Operative area

o Maintaining a sterile field

o Safety

o Types of anesthesia

o Malignant hyperthermia

E. Post-Operative

Complications

Wound classification and healing

Recovery area

o Post anesthesia recovery

Nursing Process

Pain management

o Epidurals

o Patient Controlled Analgesia (PCA’s)

Shock

Pharmacology

MODULE D – RESPIRATORY SYSTEM ALTERATIONS Required reading: Chapter 29 pages 591 – 621; Chapter 30 pages 622 – 636; Chapter 31

pages 637 – 680; additional handouts Learning Objectives:

Explain the anatomy and physiology of respiratory system.

Define terms associated with the respiratory system.

Describe diagnostic tests for respiratory system alterations.

Describe upper respiratory system alterations.

Describe lower respiratory system alterations.

Describe respiratory failure for adult clients.


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Interpret clinical manifestations to determine necessary care for respiratory system alterations.

Describe the process of tracheotomy care, suctioning, and chest physiotherapy.

Describe the pharmacological agents for respiratory system alterations.

Describe nutritional considerations for treating respiratory system alterations.

Describe the process for implementing a nursing care plan to treat respiratory system alterations.

Identify expected outcomes of treatment modalities for respiratory system alterations.

Use critical thinking to prioritize management of care. Module D Outline:


Diagnostic tests

Alterations

o Upper

o Disorders of the nose and sinuses

Sinusitis

Deviated Septum

Epistaxis

Nasal obstruction

Nasal Polyps

Fracture of the nose

Infectious Disorders:

Rhinitis

Pharyngitis

Tonsillitis/Adenoiditis

Laryngitis

Peritonsillar abscess

Laryngeal obstruction

Influenza

Other Viral Infections (Avian influenza, SARS, H1N1 Flu, West Nile Virus)

o Malignant Disorders:

Cancer of the Larynx

Head and Neck Cancer

Lower

o Infectious Disorders


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Acute Bronchitis

Bronchiectasis

Pneumonia

Legionnaires

Tuberculosis

Acute respiratory failure

Restrictive Disorders:

Pleurisy (Pleuritis)

Pleural Effusion

Empyema

Pulmonary Fibrosis

Atelectasis

Obstructive Disorders:

Chronic Obstructive Pulmonary Disease (COPD)

Chronic bronchitis

Emphysema

Asthma

Cystic Fibrosis

Pulmonary Vascular Disorder:

Pulmonary embolism

Lung abscess

Pulmonary edema

Pulmonary Arterial Hypertension

Chest Trauma:

Pneumothorax/Hemothorax

Rib fracture

Flail Chest

Respiratory Failure

Acute Respiratory Failure

Adult Respiratory Disorder Syndrome (ARDS)

Lung Cancer

Tracheotomy care and suctioning

Chest Physiotherapy

Nursing Process

Pharmacological agents

Nutritional Considerations


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MODULE E – CARDIOVASCULAR SYSTEM ALTERATIONS Required reading: Chapter 21 pages 385 – 411; Chapter 22 pages 413 – 428; Chapter 23

pages 451 -456; Chapter 24 pages 459 – 497; Chapter 26 pages 521 – 545; Chapter 27 pages 549 – 557; Chapter 28 561 - 574

Explain the anatomy and physiology of cardiovascular system.

Define terms associated with the cardiovascular system

Describe diagnostic tests for selected cardiovascular system alterations and complications.

Describe selected cardiovascular system alterations and complications.

Interpret clinical manifestations to determine selected cardiovascular system alterations and complications.

Describe the pharmacological agents for selected cardiovascular system alterations and complications.

Describe nutritional considerations for treating selected cardiovascular system alterations and complications.

Describe the nursing process for providing care for selected cardiovascular system alterations and complications.

Describe the process for implementing a nursing care plan to treat selected cardiovascular system alterations.

Identify expected outcomes of treatment modalities of selected cardiovascular system alterations and complications.

Use critical thinking to prioritize management of care.

Module E Outline:


Diagnostic tests

Alterations and Complications

o Hypertension

Hypertensive Emergency

Hypertensive Urgency

Peripheral Vascular Alterations (PVD)

o Arterial

Arterial Thrombosis and Embolism

Buerger’s disease (Thromboangiitis Obliterans)

Raynaud’s disease

Aneurysms

Arterial ulcers

Arterial thrombosis


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Arterial occlusion

Venous

Varicose veins

Thrombophlebitis

Chronic venous insufficiency

Venous stasis ulcers

Heart Failure

Hematological

o Normal hematologic and Lymphatic System Anatomy and Physiology

o Diagnostic Testing for the Hematologic and Lymphatic Systems

Anemia

o Hypovolemic

o Iron deficiency

o Aplastic

o Pernicious

o Sickle cell

o Polycythemia-vera

o Thalassemia

Hemorrhagic Disorders:

Hemophilia

Disseminated Intravascular Coagulation

Idiopathic Thrombocytopenic Purpura

Von Willebrand’s Disease

Nursing Process


Nutritional considerations

MODULE F – ENDROCRINE SYSTEM ALTERATIONS Required reading: Chapter 40 pages 913 – 939 Learning Objectives:

Care for clients with selected endocrine system alterations.

Explain the anatomy and physiology of endocrine system.

Define terms associated with the endocrine system

Describe diagnostic tests for selected endocrine system alterations and complications.

Describe selected endocrine system alterations and complications.


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Interpret clinical manifestations to determine selected endocrine system alterations and complications.

Describe the pharmacological agents for selected endocrine system alterations and complications.

Describe nutritional considerations for treating selected endocrine system alterations and complications.

Describe the nursing process for providing care for selected endocrine system alterations and complications.

Describe the process for implementing a nursing care plan to treat selected endocrine system alterations.

Identify expected outcomes of treatment modalities of selected endocrine system alterations and complications.

Use critical thinking to prioritize management of care. Module F Outline:


Diagnostic tests

Diabetes Mellitus

o Types

Type I

Type II

Acute and chronic complications

Management

Blood and urine glucose monitoring

Insulin and insulin pumps

Oral hypoglycemic agents

Diet and exercise

Emergency management

Self-care and monitoring

Nursing Process



MODULE G – GASTROINTESTINAL SYSTEM ALTERATIONS Required reading: Chapter 32 pages 683 – 685; Chapter 33 pages 716 - 742


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Explain the anatomy and physiology of gastrointestinal system.

Define terms associated with the gastrointestinal system

Describe diagnostic tests for selected gastrointestinal system alterations and complications.

Describe selected gastrointestinal system alterations and complications.

Interpret clinical manifestations to determine selected gastrointestinal system alterations and complications

Describe the pharmacological agents for selected gastrointestinal system alterations and complications.

Describe nutritional considerations for treating selected gastrointestinal system alterations and complications.

Describe the nursing process for providing care for selected gastrointestinal system alterations, complications, and surgical procedures.

Describe the process for implementing a nursing care plan to treat selected gastrointestinal system alterations.

Identify expected outcomes of treatment modalities of selected gastrointestinal system alterations and complications.


Explain the process of managing gastric decompression.

Describe the process of reinserting a selected Gastrostomy tube. Module G Outline:


Diagnostic tests

Upper GI

o Nausea and Vomiting

Eating Disorders:

o Anorexia Nervosa

o Bulimia Nervosa

o Obesity

Oral Health and Dental Care

o Xerostomia (Dry Mouth)

o Dentures

o Gingivitis

o Candida Albicans Infection (Yeast Infection)

o Angular Cheilosis

Oral Inflammatory Disease

o Stomatitis

o Ulcers (oral and gastric)


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o Herpes Simplex Virus Type I Infection

Gastritis

Gastroesophageal Reflux Disease (GERD)

Hiatal hernias

Oral cancer

Esophageal Cancer

Mallory-Weiss Tear

Esophageal Varices

Peptic Ulcer Disease

Stress Ulcers

Gastric Bleeding

E. Coli, Salmonella, Clostridium

Fractured Mandible

Nasogastric intubation

Gastrostomy tube reinsertion, medications via NG tube, and management

Gastric Surgery

o Complications of Gastric Surgery

Gastric decompression

Nursing Process



MODULE H – MUSCULOSKELETAL SYSTEM ALTERATIONS Required reading: Chapter 45 pages 1047 – 1062; Chapter 46 pages 1063 - 1108

Explain the anatomy and physiology of musculoskeletal system.

Define terms associated with the musculoskeletal system

Describe diagnostic tests for musculoskeletal system trauma and alterations.

Describe selected musculoskeletal system trauma and alterations.

Interpret clinical manifestations to determine musculoskeletal system trauma and alterations.

Describe the pharmacological agents for musculoskeletal system trauma and

alterations.

Describe nutritional considerations for treating musculoskeletal system trauma and

alterations.

Describe the nursing process for providing care for musculoskeletal system alterations,

complications, and surgical procedures.


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Describe the process for implementing a nursing care plan to treat musculoskeletal

system trauma and alterations.

Explain the nursing process for assisting clients with cast care and complications.

Identify techniques for various crutch-walking methods

Identify techniques for various traction methods

Identify expected outcomes of treatment modalities of musculoskeletal system trauma

and alterations.

Describe techniques for management of chronic pain


Module H Outline:


Diagnostic tests

Bone and Soft Tissue Disorders

o Strains

o Sprains

o Dislocations

o Bursitis

o Carpal Tunnel Syndrome

Fractures

o Cast care

o Traction

o Crutches and other devices

Complications of Fractures

o Hemorrhage

o Infection

o Thromboembolitic Complications

o Acute Compartment syndrome

o Fat Embolism

Inflammatory alterations

o Rheumatoid arthritis

o Osteomyelitis

Degenerative alterations

o Osteoporosis

o Osteoarthritis

Paget’s Disease


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Bone Cancer:

o Osteosarcoma

Connective Tissue Disorders

o Gout

Systemic Lupus Erythematosus

Osteogenesis Imperfecta

Polymyositis

Muscular Dystrophy

Lyme disease

Osteomylacia disease

Surgical procedures

o Total Joint Replacement

o Total Hip Replacement

o Total Knee Replacement

Amputation

Spinal fusion

Laminectomy

Disc repair

Nursing Process



The following skills will be reviewed and checked off with instructor during lab. Please review skills sheet prior to coming to lab:

1. Tracheostomy care and suctioning 2. Chest tube care/monitoring 3. Chest Physiotherapy 4. Perform Venipuncture 5. Applying Tourniquet 6. Initiate IV Therapy 7. Maintaining an IV site 8. Change IV tubing 9. Change Fluid Container 10. Discontinue IV access 11. Discontinue IV medications 12. Collecting blood specimens 13. Incentive spirometer 14. Use of crutches


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15. Cast care 16. Surgical scrub 17. Surgical field 18. Staple removal 19. Removal of stitches 20. Surgical Prep 21. Medications via NG tube 22. Traction

Math Objectives for NUR 105:

1. Solve problems using ratio and proportion

2. Perform calculations using various formulas:

a. Ratio and proportion

b. Dimensional analysis

c. D/H x Q = X

3. Convert between English units of weights and measures and Standard International units:

a. Apothecary, metric, and household

b. International units

c. Conversion between systems

4. Calculation of Drug Dosages:

a. Oral

b. Parental

c. Insulin

5. Define terms associated with calculating IV infusion rates

6. Calculate primary and secondary IV infusion:

a. Drip rate by gravity (gtts/min)

b. Drip rate by dial-a-flow (ml/hr)

c. Drip rate on IV pump (ml/hr)

d. Solution sets: standard, micro- drip, and secondary infusion

Student will have medication dosage calculations included in each unit exam throughout the

semester. It is the students responsibility to know the above and seek guidance from the

instructor as needed for assistance.


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NUR 105- PN Patient Discharge Teaching Plan Role Play

Group Presentation

1. Patient Assessment

Determine the patient's level of understanding about their disease, injury or condition

Use the information gathered about the patient to judge how well they will be able to understand and apply what is being taught.

Be sure to factor in cultural considerations that are specific to that patient such as ethnicity and religion. It will be necessary to factor in any information you have about the patient's level of development as well. It may be necessary for the nurse to motivate the patient in order for the patient to learn. Ability to learn is affected if the patient is too tired, in pain, upset or distracted.

2. Planning

Formulate patient goals. Take the patient and the family’s point of view into consideration, as their input will have an effect on their outcomes. Patient outcomes and motivation are directly associated with the amount of input they have in determining their goals. The goals must be realistic and able to be achieved by the patient.

Identify how the teaching plan will be carried out. Implement the plan according the patient's learning style (audio, visual, or kinetic) as opposed to the nurse's teaching style.

Develop nursing goals based on desired health outcomes. They should be patient-centered and based on health outcomes for the patient's health status and quality of life.

3. Determine Method of Implementation

The method of implementation of the nursing patient teaching plan should be specific to the patient's learning style and desired outcomes that were identified.

Prepare to document patient responses and level of understanding as the nurse perceives them while the teaching plan is implemented.

Prepare to document any other relevant information that will assist with the evaluation of learning.

4. Formulate Evaluation Process

http://www.ehow.com/culture-and-society/

http://www.ehow.com/how_4587946_nursing-patient-teaching-plan.html

http://www.ehow.com/how_4587946_nursing-patient-teaching-plan.html


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An evaluation process will need to be formed in order to assess patient outcomes. The following specific elements of patient learning will need to be evaluated: patient knowledge, behavior, attitude, and skills. The evaluation should include a review of the documentation that details patient responses and level of understanding that were recorded during the implementation steps.

The evaluation plan should include observations of the family's understanding of what will be required of them for the patient to achieve desired outcomes.

The last key element of the evaluation plan is the nurse's recommendation for follow-up procedures to be used in the event that the patient's learning was not sufficient to produce desired outcomes.

Things to Be Included in the Discharge Teaching Plan

1. Students should be able to explain the pathophysiology of the disease process to the patient so that they understand what exactly is happening inside their body. Example: What is Congestive Heart Failure?

2. Include the medications they will be sent home on and any side effects that may occur with the medications, teaching associated with the medications, etc. Example: Digoxin: the patient needs to be taught how to check their pulse prior to taking their medications.

3. When should the patient call the physician? What type diet if any should they follow? 4. The group will present in post-conference and may use any props that you need to

teach your patient. 5. Length of teaching project: 10 – 15 minutes

Each student will turn in a one page paper to include:

assessment of learner

nursing diagnosis

long-term goal

intermediate goal

short-term goal

learning outcome

content outline

teaching method


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NUR 105-PN

Grading Rubric for Clinical Teaching Plan Role Play Group Project

Student Name:_______________________________ Instructor:_________________________________ Points Earned: _____________________

Criteria

Point Value Student Points/Comments

Explains disease pathophysiology so that patient understands the disease process

10

Include medications to be sent home. Explain side effects, and other teaching associated with medications

10

When patient should call the physician. Diet to follow after discharge

10

Uses props or handouts for patient teaching

10

Length of teaching project is 10-15 minutes

5

Complete one page paper

5


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Patient Teaching Project Worth: 50 points

1. This is a group project, date due to be announced. Class will report to the designated

facility and teach an appropriate teaching activity.

2. Nursing students will assess the learning needs and interests of the participants as a

group.

3. Nursing students will plan an educational/learning activity with the following guidelines:

a) Establish 2-3 specific learning objectives (goals)…

Example: After participating in _________ the participant will be able to

_______.

b) Establish a method to evaluate if learning has occurred. Evaluate your teaching

to include the participants’ views.

c) Keep it simple!

d) Plan and create an outline of the activity.

e) Each student participates in each planning phase and provides the actual activity.

f) The teaching plan requires research in the area that is being covered.

Each student will provide {not on same article, each needs to be on a

different article}:

i. A TYPED one (1) page summary of the research

ii. A bibliography to include a textbook and at least one PROFESSIONAL

nursing/health field journal article.

iii. An evaluation to include: Were goals met? Describe. What feedback did

the participants give? What would you do differently? What did you

learn from this activity?

g) Will need to be in APA format. Each student should attach the objectives,

outline, summary, evaluation, bibliography, and journal article.

Grading Rubric for Teaching Project

Student Name: _________________________________________

Points Earned: _____________

Criteria Point Value Student Points


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Clinical Caring Moments Journal: 20 points

What is a “Caring Moment?”: It is a practical customer service action that complements the professional practices of the Relationship Based Care Model. It integrates caring behaviors and organizational learning into our existing strategic and operational plans. It provides guidelines for caring behaviors that apply to every member of the care team. Guidelines for the Caring Moments Journal:

Objectives (clear, specific, student-oriented)

10 points

Outline 5 points

Summary 10 points

Bibliography 5 points

Evaluation 10 points

APA format 10 points

Total Points 50


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1. Each student nurse assigned to the care of a patient will be required to sit in a chair at the bedside of the patient, or at the foot of the bed when appropriate. 2. Introduce yourself to the patient and family and explain your role in their care for that day. 3. Call the patient by his/her preferred name 4. Use touch appropriately: a handshake, a touch on the arm, holding a hand as prescribed by

the patient 5. Student nurses are required to sit at the bedside for at least 5 minutes during the clinical day

to plan and review care and desired outcomes 6. This special time of patient/family engagement is for their voice to be heard and to allow

them the opportunity to share concerns. This should not be a time for the student to do all the talking. Allow the patient/family unit a time for questions about care, plans, and goals and anticipated and expected outcomes.

7. Record caring moments in a journal each week and turn in at the end of the clinical rotation

to your lead instructor. Relationship Based Care is a caring and healing model. Our goal in the “Caring Moments Journal” is to ensure a positive experience for all patients trusted to our care. The therapeutic relationship between the nurse and the patient is vital to this process!

STUDENT ACKNOWLEDGEMENT FORM PLEASE READ AND SIGN THEN RETURN TO THE INSTRUCTOR

I have a copy of the syllabus for NUR 105. I understand the content in the syllabus. The content is accurate at the time of printing. Change of the content may be necessary as deemed appropriately by the College/Nursing Department to fulfill the role and mission or to accommodate circumstances beyond control of the Nursing Department. A final course grade of 75% (750 points) or better is considered passing for this course. The student must pass both theory, lab, and clinical to be successful in the course. I understand all missed lab/clinical time


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must be made up prior to satisfactory course completion. Failure to complete the hours is failure of the course. Disclaimer for Nursing Program All nursing equipment or devices provided for students use during the nursing education program at CVCC are for practice purposes only. Clinical demonstrations utilizing procedures or equipment are for practice simulations only. Actual medical procedures are not to be performed on persons without approval and/or supervision by CVCC clinical instructors. Students are responsible for reading the Nursing Handbook 2011- 2012. Students are responsible for purchasing a nursing lab kit and bringing to each lab for completion of lab and skills validation. This is a requirement for NUR 102 lab component, a list of lab kit components can be supplied to students upon request. Students are instructed in the importance of confidentiality of clients. They are never to bring any part of the medical record out of the hospital or clinical area or discuss the client by name. Students are only allowed to be a clinical site under the supervision of faculty. The client’s chart is only available for review during clinical. I have read and understand the above statements with opportunity to ask questions and clarify information. I understand my grades are my responsibility. Name: ________________________________ (print) Name: ________________________________ (signature) Date: ________________________________ Instructors: Judy Ennis, RN, MSN

Simulation Lab Confidentiality Form Confidentiality Agreement and Consent to Video

Chattahoochee Valley Community College

During your participation in a simulated clinical experience at Chattahoochee Valley Community College, you will be both an active participant in simulated scenarios and an observer.


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The objectives of the simulated experience are to educate nursing students to better assess and improve their performance involving health care situations. The simulated experience is designed to challenge nursing student’s response and judgment in a controlled environment, and develop clinical reasoning. By signing this agreement, you agree to maintain strict confidentiality regarding both yours and other’s performance, whether seen in real time, on video or otherwise communicated to you. Failure to maintain confidentiality may result in unwarranted and unfair defamation of character of the participant. You will be discussing the scenarios during debriefing, but we believe that “all that takes place in the simulation environment stays in the simulation environment”. Due to copyrights, and to maintain optimal simulation experiences for the other learners who will be following you in the center, you are to maintain optimal simulation experiences for other learners who will be following you in the simulation lab, you are to maintain strict confidentiality regarding the specific scenarios, as well as what happened during the simulation experience. A breach in confidentiality will result in disciplinary actions (see Student Code of Conduct in the CVCC student and college handbook and 2011-2012 Nursing Handbook). ______ I agree to maintain strict confidentiality about the details of scenarios, participants, and performance of any participant(s). ______ I authorize Chattahoochee Valley Community College Simulation Lab staff to video record my performance during clinical simulation experiences. ______ I authorize Chattahoochee Valley Community College Simulation Lab staff to use the video recording(s) for purposes including, but not limited to: debriefing, faculty review, educational research, public relations, advertisement, promotional, and/or fund raising activities. Signature: ______________________________________________________ Date: _________


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January 2012

Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 2

3 4 5

6 7

8 9 Ms. Chen – Library Presentation

Syllabus Review IV Therapy

10

11 Module A Fluid and Electrolytes

12 13

14

15 16 No School

17 18 Module A Fluid and Electrolytes

19 20 Graduation Application

Due

21


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22 23 Lab

24

25 Module B Venipuncture and IV Therapy

26

27 28

29 30 Lab

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February 2012

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

1 Exam 1: Module A and B Module D Respiratory

2 3 4

5 6 Lab

7 8 Module D Respiratory

9

10 11


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12 13 Lab

14

15 Exam 2: Module D Module E: Cardiovascular System

16 17 18

19 20 Lab

21 22 Module E: Cardiovascular System

23

24 25

26 27 Lab

28 29 Exam 3: Module E Module F Endocrine System

March 2012

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

1 2 3


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4 5 Lab

6 7 Module F Endocrine System

8 9 10

11 Spring

Break Daylight Savings Begins

12

13

14

15

16

17

18 19

20 21 Module C Perioperative Care

22 23

Last Day to Drop with a

“W”

24

25 26 Lab

27 28 Exam 4: Module F and C Module H Musculoskeletal System

29

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April 2012

Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 2

Lab 3

4 Module H: Musculoskeletal System

Module G Gastrointestinal

5 6 7


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8 9 Lab

10 11 Module G Gastrointestinal

12

13 14

15 16 Lab

17

18 Exam 5: Module G and H

19 20

21

22 23 Lab

24 25 Computerized Exam

26 27 28

29 30 Lab

May 2012

Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1

2

Comprehensive Final Exam

3 Lab Make-up Day: 9-1200

Exam Make-Up Day: 1:00 –

4

Clinical Make-up Day: Location to be announced

5


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3:00

6 7

8

9 10 11 12

13 14

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