NUR 175 TRANSITION TO NURSING II - Mohave · PDF fileNUR 175 TRANSITION TO NURSING II...

INSTRUCTION Course Package

MCC Form EDU 0007 (rev. 10/07/11)

NUR 175

TRANSITION TO NURSING II

PRESENTED AND APPROVED: MAY 4, 2012

EFFECTIVE: FALL 2012-13


MCC Form EDU 0007 (rev. 10/07/11)

Prefix & Number NUR 175 Course Title: Transition to Nursing II

Purpose of this submission: New Change/Updated Retire

If this is a change, what is being changed?

(Check all that apply)

Update Prefix Course Description

Title Course Number

Format Change Credits

X Prerequisite Competencies

Textbook/Reviewed Competencies-no changes needed

Does this course require additional fees? No Yes If so, please explain. Summer or Nursing Program Fee for NUR 150 and NUR 175

Is there a similar course in the course bank? No Yes (Please identify)

Articulation: Is this course or an equivalent offered at other two and four-year universities in Arizona? No Yes (Identify the college, subject, prefix, number and title: College with Paramedic to RN

Track

Is this course identified as a Writing Across the Curriculum course? No Yes

Course Textbook, Materials and EquipmentCourse Textbook, Materials and EquipmentCourse Textbook, Materials and EquipmentCourse Textbook, Materials and Equipment

Textbook(s) Current edition

Title All books needed were listed on NUR 150.

Author(s)

Publisher

Title

Author(s)

Publisher

Software/ Equipment

All supplies/software needed were listed on NUR 150.

Course AssessmentsCourse AssessmentsCourse AssessmentsCourse Assessments

Description of Possible Course Assessments (Essays, multiple choice, etc.)

Multiple choice examinations, short thought papers, practice care plan based on case study.

Exams standardized for this course? Midterm Final Other (Please specify): Unit exams

Are exams required by the department? No Yes

If Yes, please specify: Unit and final exams.

Where can faculty members locate or access the required standardized exams for this course? (Contact Person and Location) Example: NCK – Academic Chair Office

Nursing faculty and Director of Nursing

Student Outcomes: Identify the general education goals for student Student Outcomes: Identify the general education goals for student Student Outcomes: Identify the general education goals for student Student Outcomes: Identify the general education goals for student learning that is a component of this course.learning that is a component of this course.learning that is a component of this course.learning that is a component of this course.

Check all that apply:Check all that apply:Check all that apply:Check all that apply:

Method of AsMethod of AsMethod of AsMethod of Assessmentsessmentsessmentsessment


MCC Form EDU 0007 (rev. 10/07/11)

1. Communicate effectively. a. Read and comprehend at a college level. b. Write effectively in a college setting.

Unit and final examinations, concept maps and care plans, process recording.

2. Demonstrate effective quantitative reasoning and problem solving skills.

Dosage exam and medication administration.

3. Demonstrate effective qualitative reasoning skills.

Care plans, concept maps demonstrating application of the nursing process.

4. Apply effective methods of inquiry. a. Generate research paper by gathering information

from varied sources, analyzing data and organizing information into a coherent structure.

b. Employ the scientific method.

Apply nursing process appropriately in clinical as demonstrated in care plans and concept maps; utilize evidence based practice.

5. Demonstrate sensitivity to diversity

a. Experience the creative products of humanity. b. Describe alternate historical, cultural, global

perspectives.

Include cultural aspects in care planning.

Office of Instruction Use only:

CIP Code:

ONET Code:

Minimum Qualifications:


MCC Form EDU 0007 (rev. 10/07/11)

COURSE INFORMATIONCOURSE INFORMATIONCOURSE INFORMATIONCOURSE INFORMATION

Initiator: Cynthia Huth, Linda Riesdorph

Date of proposal to Curriculum Sub-Committee: 4/17/12

Effective Semester/Year Fall Spring Summer 2013

Addendum: Please note the following changes with course description and prerequisite in the 2012-13 catalog.

Prefix & Number: NUR 175 Full Title: (100 character limit)

Transition to Nursing II

Short Title: (30 character limit)

Catalog Course Description: Within the framework of transition, the focus is on nursing care to promote healthy transitions for individuals and families with chronic health conditions in well-defined practice settings. Situational transitions transition of the individual to the nursing student role and the client’s admission to and movement within the healthcare system are included. Concepts of nutrition and pharmacology are integrated. Emphasis is on the student’s development as a caring, competent nurse within the legal/ethical framework of the profession, using critical thinking, evidence-based practice principles, communication and time management skills.

SUN Course Number:

Credit Hours: 9

Lecture Hours: 5 Lab Hours: 12

Prerequisite(s) NUR 150

Co-requisite(s) NUR 175 L

Intended Course GoalsIntended Course GoalsIntended Course GoalsIntended Course Goals By the end of the semester, students will be able to:By the end of the semester, students will be able to:By the end of the semester, students will be able to:By the end of the semester, students will be able to:

1. Accountability: Identify ethical, professional and legal principles within their current scope of practice and for nursing practice.

2. Caring: Demonstrate physical, emotional and spiritual components of caring behaviors for self and others.

3. Clinical competence: Demonstrate the use of evidence-based practice, knowledge and learned nursing skills to provide safe and effective nursing interventions for self, individuals and for families experiencing transitions in well-defined practice settings.

4. Communication: Demonstrate effective communication skills in interactions with clients, families, peers, faculty and others.

5. Critical Thinking: Begin to use theory and apply critical thinking and evidence-based practice in nursing clinical judgment and professional role development.

6. Culture: Recognize that biological cultural diversities impact self and others’ experience in healthcare.

7. Learning/Teaching: Recognize own learning needs and styles and apply learning principles for


MCC Form EDU 0007 (rev. 10/07/11)

health promotion, restoration, maintenance and prevention for individuals and families across the life span.

8. Leadership/Management: Implement basic management skills with individuals, families and other members of the healthcare team.


MCC Form EDU 0007 (rev. 10/07/11)

Course Competencies and ObjectivesCourse Competencies and ObjectivesCourse Competencies and ObjectivesCourse Competencies and Objectives

By the end of the semester, students will be By the end of the semester, students will be By the end of the semester, students will be By the end of the semester, students will be able to:able to:able to:able to: Competency 1 Review common principles of client care. (Clinical Competence) Objective1.1 Correctly implement infection control standards and specific infection control precautions (such as handling biohazard materials) and procedures. (Test Plan) Objective 1.2 Review the cycle of infection. Objective 1.3 Identify situations in which hand washing is indicated and comply with current WHO or CDC had hygiene guidelines. (National Patient Safety Goal) Objective 1.4 Identify biohazard and infectious materials. (Test Plan) Objective 1.5 Educate client regarding infection control measures. (Test Plan) Objective 1.6 Perform elements of a basic nursing assessment (cardiac, respiratory, gastrointestinal, neurological and musculoskeletal systems) correctly on a lab partner until it is completed smoothly, efficiently and accurately within a 10 minute time frame. (Test Plan) Objective 1.7 Utilize appropriate body mechanics when working with clients and apply principles of mobility to the care of the immobile client. (Clinical Competence) Objective 1.8 Assess ability of client to balance and transfer as well as use assistive devices. (Hartford Foundation: Institute for Geriatric Nsg and Test Plan) Objective 1.9 Assess client for mobility, gait, strength and motor skills. (Test Plan) Objective 1.10 Review necessary modifications with client to reduce stress on specific muscles or skeletal groups. (Test Plan) Objective 1.11 Select appropriate interventions for the immobile client and evaluate response. (Test Plan)

Competency 2 Safely and effectively assist clients with activities of daily living. (Clinical Competence) (Test Plan) Objective 2.1 Correctly complete a bed bath on a mannequin which includes using soap and water, changing of water, placing bedpan and urinal, back massage, and oral care. (Hartford: Institute for Geriatric Nsg) (Test Plan) Objective 2.2 Correctly make occupied bed following bed bath. Objective 2.3 Correctly identify three types of unoccupied beds: closed, open and surgical. Objective 2.4 Correctly provide perineal and perineal catheter care on male (including external condom catheter) and female mannequin. (Test Plan) Objective 2.5 Demonstrate safe shaving technique using a balloon. (Test Plan) Objective 2.6 Correctly demonstrate use of toileting devices. (Test Plan) Objective 2.7 Demonstrate positioning of bedridden immobile client to prevent skin breakdown and evaluate response. (Test Plan) Objective 2.8 Assess client for personal hygiene habits/routines. (Test Plan) Objective 2.9 Describe assessment of risk, prevention and treatment of pressure ulcers relative to each stage. (National Patient Safety Goal) (Test Plan)

Competency 3 Safely and correctly administer medications (oral, parenteral, topical IV fluids) according to agency policies and procedures and evidence-based nursing standards. (Clinical Competence, Critical Thinking) Objective 3.1 Utilize correct procedure in checking physician orders with Medication Administration Record (MAR) in the medication reconciliation process. (Medication Reconciliation is National Patient Safety Goal) (Test Plan) Objective 3.2 Document medication administration correctly including narcotics, refusal of medication and a wasted medication. (Test Plan) Objective 3.3 Verbalize the five rights of medication administration including at least two patient identifiers and demonstrate practice of them. (National Patient Safety Goal) (Test Plan) Objective 3.4 In evaluation, assess the client’s response for actual or potential side effects and adverse effects and document the same. (Test Plan) Objective 3.5 List the specific legal/ethical interventions that would be appropriate for clients receiving medications such as notifying the primary health care provider. (Test Plan) Objective 3.6 Determine client related variables such as age, vital signs, lab results, etc. which affect a client’s therapeutic drug regimen and related administration considerations. (Test Plan) Objective 3.7 Manage client experiencing side effects and adverse reactions of medications and document responses to actions taken. (Test Plan)


MCC Form EDU 0007 (rev. 10/07/11)

Objective 3.8 Educate client about medications including common side effects, adverse effects and when to call the physician. (Repeat in Teaching-Learning) (Test Plan)

Competency 4 Correctly complete sterile gloving procedure within a 5 minute time frame. (Test Plan) Objective 4.1 Correctly wash hands. Objective 4.2 Follow basic principles of surgical asepsis. Objective 4.3 Replace gloves if they become contaminated. Objective 4.4 Remove gloves using proper technique avoiding self-contamination. Objective 4.5 Dispose of gloves properly.

Competency 5 Correctly prepare sterile field within a 10 minute time frame. (Test Plan) Objective 5.1 Correctly wash hands. Objective 5.2 Follows basic principles of surgical asepsis. Objective 5.3 Ensure that supplies are intact and not opened. Objective 5.4 Note expiration date. Objective 5.5 Open/prepare field using proper technique. Objective 5.6 Correctly add sterile solution into sterile container. Objective 5.7 Label all medications/solutions on and off of the sterile field (National Patient Safety Goal)

Competency 6 Correctly complete wound irrigation and sterile dressing change within a 15 minute time frame. Objective 6.1 Confirm physician order. Objective 6.2 Determine level of pain and administer analgesics. Objective 6.3 Follow basic principles of surgical asepsis. Objective 6.4 Remove old dressing and apply new dressing using correct technique. Objective 6.5 Correctly assess wound and old dressing (presence, amount, type, color and odor of any drainage, size of wound, signs and symptoms of infection) Objective 6.6 Position client so that solution flows away from the wound. Objective 6.7 Irrigate and clean wound using proper technique. Objective 6.8 Document appropriate information. Objective 6.9 Evaluate whether aseptic/sterile techniques is performed correctly. (Test Plan)

Competency 7 Correctly remove sutures and staples within a 5 minute time frame. (Test Plan) Objective 7.1 Confirm physician orders. Objective 7.2 Assess wound appearance (approximation, color of the wound and surrounding area, presence of drainage). Objective 7.3 Follow basic principles of surgical asepsis. Objective 7.4 Assess for the need for analgesic medication. Objective 7.5 Clean incision before suture/staple removal. Objective 7.6 Remove sutures/staples using proper technique. Objective 7.7 Document appropriate information.

Competency 8 Correctly perform urinary catheter insertion within a 20 minute timeframe and discontinuation. (Test Plan) Objective 8.1Confirm physician order. Objective 8.2 Assesses activity limitations (hip surgery or spinal injury). Objective 8.3 Assess allergy to iodine or latex and history of prostate problem (male). Objective 8.4 Provide for privacy. Objective 8.5 Correctly cleanse urinary meatus and maintain separation of the labia until catheter inserted. (female) Objective 8.6 Insert catheter using correct technique. Objective 8.7 Correctly secure catheter. Objective 8.8 Document appropriate information regarding insertion. Objective 8.9 Deflate balloon prior to removal. Objective 8.10 Note characteristics and amount of urine in collection bag. Objective 8.11Provide appropriate teaching for client following catheter removal (burning, irritation, difficulty voiding).

Competency 9 Correctly perform a manual bladder irrigation within a 10 minute time frame. (Test Plan) Objective 9.1 Confirm physician order. Objective 9.2 Follow basic principles of surgical asepsis. Objective 9.3 Assess for bladder fullness, pain. Objective 9.4 Empty catheter bag prior to starting procedure noting amount, color and characteristics of urine. Objective 9.5 Clamp catheter below injection port. Objective 9.6 Irrigate bladder using correct technique.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 9.7 Document appropriate information.

Competency 10 Correctly administer insulin within a 5 minute time limit.. Objective 10.1 Confirm physician’s order. Objective 10.2 Determine compatibility of insulins if mixing. Objective 10.3 Note blood glucose level prior to administration of insulin. Objective 10.4 Follow the 5 Rights of Medication Administration. Objective 10.5 Gently agitate insulin that is in suspension. Objective 10.6 Draw up insulin using proper technique Objective 10.7 Titrate dose of insulin based on ordered parameters. Objective 10.8 Document appropriately.

Competency 11 Correctly performs a neurological assessment within a 5 minute time limit. (Test Plan) Objective 11.1 Assess mental status (impaired cognition) and speech. (Test Plan) Objective 11.2 Assess cranial nerve function. Objective 11.3 Assess sensory and motor functions. Objective 11.4 Assess reflexes.

Competency 12 Correctly demonstrates phlebotomy procedure within a 10 minute time limit. (Test Plan) Objective 12.1 Observe standard precautions. Objective 12.2 Confirm physician order. Objective 12.3 Assess for conditions that would prevent use of extremity. Objective 12.4 Maintain asepsis of supplies and chosen site and cleanse appropriately. Objective 12.5 Stabilize needle while in vein and remove tourniquet during draw of last tube. Objective 12.6 Release last blood tube before withdrawing needle and apply pressure. Objective 12.7 Properly prepare tube for lab and label.

Competency 13 Demonstrate clinical competency in IV therapy. Objective 13.1 Correctly demonstrate intravenous insertion within a 15 minute time limit. (Test Plan) Objective 13.2 Correctly change intravenous solution within a 5 minute time limit. (Test Plan) Objective 13.3 Correctly convert intravenous line to saline lock and appropriately flush it within a 5 minute time limit. (Test Plan) Objective 13.4 Correctly change IV site dressing within a 5 minute time limit. (Test Plan) Objective 13.5 Correctly discontinue an intravenous infusion within a 5 minute time limit. (Test Plan) Objective 13.6 Correctly change a central line dressing within a 10 minute time limit. (Test Plan) Objective 13.7 Change a central line cap and flush a central line correctly within a 10 minute time limit. (Test Plan)

Competency 14 Apply the Healing Community Nursing Model and the concept of Transitions to the clinical nursing care of adults with chronic health problems in the present health care system. Objective 14.1 Review the definition of nursing and transitions as related to the Healing Community Nursing Model. Objective 14.2 Review critical points within chronic health-illness transitions and identify possible cultural and spiritual implications. Objective 14.3 Review healthy versus unhealthy outcomes in health-illness transitions. Objective 14.4 Describe concepts of health and wellness taking cultural differences and multidimensional aspects of health promotion into consideration. Objective 14.5 Describe factors causing significant changes in today’s health care delivery system and the impact on health care in general and the nursing profession. Objective 14.6 Describe several nursing care delivery models. Objective 14.7 Discuss changes in the health care system that have increased the need for medical-surgical nurses to practice in community-based settings. Objective 14.8 Compare community-based and acute care settings. Objective 14.9 Ascertain why cultural competence is necessary especially in community-based settings. Objective 14.10 Describe the acute care discharge process in relation to home care preparation. Objective 14.10a Assess need for supplies and equipment.(Test Plan) Objective 14.10b Explore resources including community and support systems available to assist client in achieving or maintaining independence. (Test Plan) Objective 14.10c Provide client with information on discharge procedures to home and community setting. (Test Plan) Objective 14.10d Identify specific documents to include when referring or transferring a client. (Complete and reconciled medication list) (Test Plan and National Patient safety Goal)


MCC Form EDU 0007 (rev. 10/07/11)

Objective 14.10e Assure patient receives a complete and reconciled medication list and that list is explained when leaving the hospital. (National Patient Safety Goal) Objective 14.10f Assess need for home modifications. (Test Plan) Objective 14.10h Apply knowledge of client pathophysiology to home safety interventions. (Test Plan) Objective 14.10i Assess client understanding of and ability to manage self-care in the home environment. (Test Plan) Objective 14.11 Discuss how to prepare for and conduct a home health care visit. Objective 14.12 Define and recognize stages of chronic illness. Objective 14.13 Identify factors related to increasing incidence of chronic illness. Objective 14.14 Describe characteristics and implication of chronic conditions for individuals and their families.

Competency 15 Competency 22 Apply critical thinking, ethical decision making, nursing standards, evidence-based practice and the nursing process to the clinical nursing care of adults with chronic health problems in the present health care system. (Test Plan) Objective 15.1 Describe the relationship between critical thinking characteristics and the nursing process. Objective 15.2 Review the nursing process. Objective 15.2a Implement expectations of a Transition to Nursing II student in regard to comprehensive health and risk assessments. (Test Plan) Objective 15.2a1 Effectively utilize the pain rating scale appropriate to age and elicit expectations of client family for relief of pain, discomfort or suffering. (QSEN Patient Centered Care)

Objective 15.2a2 Utilize effective communication and procedure in client interview to determine key components of history and to complete a comprehensive health assessment. (Elicit client values, preferences and expressed needs). (QSEN-Patient Centered Care, Test Plan) Objective 15.2a3 Compare diagnostic testing results and current client data with previous test results and baseline data, evaluate results and if deviation from normal, intervene as needed. (Recognize trends and notify physician) (Test Plan)

Objective 15.2a4 Recognize deviations from normal and report critical results of tests (lab) and diagnostic procedures on a timely basis. (National Patient Safety Goal) Objective 15.2a5 Assess fluid and electrolyte imbalances, monitor hydration status and manage care. (Test Plan) Objective 15.2a6 Assess emotional status via observation of general demeanor. Objective 15.2a7 Assess how the client views their problem to determine impact and significance on individual/family lifestyle. (Test Plan). Objective 15.2a8 Assess coping skills and ability to adapt to temporary/permanent role changes. (Test Plan) Objective 15.2a9 Correlate clinical assessment parameters and manifestations with pathophysiology. (Test Plan) Objective 15.2a10 Assess adaptation of client to health alteration, illness or disease. (Test Plan) Objective 15.2a11 Assess tube drainage during the time the client has an alteration in body system. (Test Plan) Objective 15.2a12 Perform a focused assessment and re-assessment of body system in alteration. (Test Plan) Objective 15.2a13 Monitor client output for changes from baseline. (Test Plan) Objective 15.2a14 Assess client area for sources of infection. (Test Plan) Objective 15.2a15 Assess client perception of health status. (Test Plan) Objective 15.2a16 Identify client and environmental deficits that may impede client safety and communicate observations or concerns to the appropriate person. (QSEN Safety) Objective 15.2a17 Identify the degree of sensory involvement and deficits that may impede client safety.(Test Plan) Objective 15.2a18Identify factors that influence accident/injury prevention. (Test Plan) Objective 15.2a19 Identify factors including prescriptions for treatments that influence accident/injury prevention. ((Test Plan) Objective 15.2a20 Ascertain client/staff knowledge of safety needs and injury prevention. (Test Plan) Objective 15.2a21 Identify lifestyle practices and assist client to identify same that impact health and memory. (Test Plan) Objective 15.2a22 Assess stressors, including environmental, that affect client care. Objective 15.2a23 Identify client health oriented behaviors. (Test Plan) Objective 15.2a24 Assess food interactions and ability to eat. Test Plan)


MCC Form EDU 0007 (rev. 10/07/11)

Objective 15.2a25 Assess client for medication interactions. (Test Plan) Objective 15.2a26 Assess need for consultation with other health care providers and initiate as needed. (Test Plan)

Objective 15.2b Implement expectations of a Transition to Nursing II student in regard to planning safe cost effective care. (Test Plan) Objective 15.2b1 Assess importance of culture and ethnicity when planning approaches to care. (Test Plan) Objective 15.2b2 Develop plan of care with client/significant other to meet client and significant other’s needs and value the active partnership; examine how effectiveness of health care can improve with active partnerships. (QSEN Patient Centered Care) Objective 15.2b3 Apply knowledge of related pathophysiology, nursing procedures and psychomotor skills when client is undergoing diagnostic testing and nursing assessment. (Test Plan) Objective 15.2b4 Identify interventions and safety devices to promote a safe physical environment. Objective 15.2b5 At beginning level, review plan of care to assure continuity across disciplines. (Test Plan) Objective 15.2b6 Consider client self-care needs before developing or revising care plan. (Test Plan) Objective 15.2c Implement expectations of a Transition to Nursing II student in regard to nursing therapeutics (Interventions). Objective 15.2c1 Report critical diagnostic values to physician and identify client data that needs to be reported immediately. (Test Plan)

Objective 15.2c2 Recognize need for referrals, make appropriate referrals and document action taken. (Test Plan) Objective 15.2c3 Identify specific documents to include when referring a client. (Test Plan) Objective 15.2c4 Initiate and evaluate outcomes of consultations. (Test Plan) Objective 15.2c5 Provide for interdisciplinary team conferences. Objective 15.2c6 Collaborate with other health care team members in other disciplines when providing care (physician, respiratory therapist). (Test Plan) Objective 15.2c7 Initiate, evaluate, update plan of care, care map, clinical pathway used to guide and evaluate care. (Test Plan) Objective 15.2c8 Use appropriate strategies to reduce reliance on memory. (QSEN Safety)

Objective 15.2c9 Apply knowledge of client pathophysiology to illness management and health screening. (Test Plan) Objective 15.2c10 Promote client progress from an alteration in body systems. (Test Plan) Objective 15.2c11 Act as a client advocate. (Test Plan) Objective 15.2c12 Maintain continuity of care between/among health care agencies. (Test Plan) Objective 15.2c13 Follow up on unresolved issues regarding client care. (Test Plan) Objective 15.2c14 Provide follow-up to the client following participation in health promotion. (Test Plan) Objective 15.2c15 Assist primary caregivers working with client to meet self-care goals. (Test Plan) Objective 15.2c16 Promote client progress from an alteration in body systems. (Test Plan). Objective 15.2c17 Provide support to client in coping with life changes. (Test Plan) Objective 15.2c18 Incorporate client cultural practices and beliefs when planning and providing care. (Test Plan)

Objective 15.2c19 Provide care in culture of safety to prevent errors. (Test Plan) Objective 15.2c20 Facilitate safe and appropriate use of equipment. Inspect equipment and if unsafe, participate in removal. (Test Plan) Objective 15.2c21 Place assistive devices within reach. Objective 15.2c22 Follow communication practices that minimize risks associated with handoffs among providers and across transitions in care. (QSEN Safety)

Objective 15.2c23 Use precautions to prevent injury and or complications associated with a procedure or diagnosis. (Test Plan)

Objective 15.2c24 Assure implementation of diet modifications. Objective 15.2c25 Monitor clients before, during and after procedure/surgery. (Test Plan)

Objective 15.2c26 Recognize trends and changes in client condition and intervene appropriately. (Test Plan) Objective 15.2c27 Verify appropriateness and accuracy of medication orders, including reconciling orders. (Test Plan) Objective 15.2c28 Research action of medications and assess for actual/potential side effects. (Test Plan) Objective 15.2c29 Consider actual/potential incompatibilities/interaction and notify primary health care


MCC Form EDU 0007 (rev. 10/07/11)

provider of same. (Test Plan) Objective 15.2c30 Assess for and notify primary health care provider of side effects, adverse effects and contraindications, manage care and document same. (Test Plan)

Objective 15.2c31 Review pertinent data prior to medication administration. (Test Plan) Objective 15.2c32 Promote recovery of client from unexpected response to therapy. (Test Plan) Objective 15.2d Implement expectations of a Transition to Nursing II student in regard to evaluation and revision of care plan as needed. (Test Plan)

Objective 15.2d1 Evaluate use of stress management techniques Objective 15.2d2 Assess changes, note complications and appropriateness of therapy/treatment orders. (Test Plan) Objective 15.2d3 Evaluate results of consultations. (Test Plan) Objective 15.2d4 Apply knowledge of pathophysiology to monitoring for complications. (Test Plan) Objective 15.2d5 Evaluate responses to procedures and treatments. (Test Plan) Objective 15.2d6 Evaluate use of medications over time. (Test Plan) Objective 15.2d7 Evaluate therapeutic effects of medications. (Test Plan) Objective 15.2d8 Use clinical decision making/critical thinking when addressing expected effects/outcomes of medications. (Test Plan) Objective 15.2d9 Evaluate client understanding of health promotion behaviors/activities. (Test Plan) Objective 15.2d10 Evaluate client alternative or homeopathic health care practices outcomes. (Test Plan)

Objective 15.2d11 Evaluate client response to interventions to correct fluid and electrolyte balance. (Test Plan) Objective 15.3 Explain the importance of nursing codes and standards as guidelines for medical-surgical nursing care. (Test Plan) Objective 15.4 Seek examples of how technology and information management are related to quality and safety of nursing care. (QSEN Competency and Test Plan) Objective 15.5 Describe reliable sources for locating evidence reports and clinical practice guidelines. (Test Plan} Objective 15.6 Discuss the National Patient Safety Goals. Objective 15.7 Describe how facility standards and guidelines are used as aids in decision making.

Competency 16 Apply principles of health education and health promotion to the clinical nursing care of adults with chronic health problems in the present health care system. Objective 16.1 Describe health education and the importance of the client’s adherence to the therapeutic regimen.

Objective 16.1a Educate client on home safety issues. (Test Plan) Objective 16.1b Access data for client via online data bases, journals. (Information Technology) (Test Plan) Objective 16.1c Assess readiness to learn, learning preferences and barriers to learning. (Test Plan) Objective 16.1d Select appropriate teaching method. (Test Plan)

Objective 16.1e Educate client regarding purpose and procedure of diagnostic testing. Objective 16.1f Provide client with information on discharge procedures to home/community setting. Objective 16.1g Teach client principles of infection control and safe use of health care equipment. (Test Plan) Objective 16.1h Teach frequency of recommended diagnostic testing. Objective 16.1i Educate client on methods to prevent complications associated with activity, diagnosed illness or disease. (Test Plan) Objective 16.1j Educate client about medications, treatments and procedures. (Test Plan) Objective 16.1k Provide information to client on common side effects, adverse effects and potential interactions of medications and when to notify primary health provider. (Test Plan) Objective 16.1l Provide information about healthy behaviors and heal promotion/maintenance recommendations. (Test Plan) Objective 16.1m Provide information for prevention of high risk behaviors. (Test Plan) Objective 16.1n Assess and teach client about health risks based on known population or community characteristics. (Test Plan) Objective 16.1o Educate client on actions to promote/maintain health and prevent disease. (Test Plan) Objective 16.1p Provide information about healthy behaviors, prevention of high risk behaviors and health promotion/maintenance recommendations. (Test Plan) Objective 16.1q Evaluate client understanding of information given. (Test Plan)

Objective 16.1r Educate client about home management of care and articulate long range plans. (Test Plan) Objective 16.1s Educate client about purpose and procedures of laboratory tests, treatments and nursing care procedures. (Test Plan)


MCC Form EDU 0007 (rev. 10/07/11)

Objective 16.2 Review characteristics and components of effective therapeutic communication in client care. Objective 16.3 Identify the impact of personal and client commonalities and diversities on the caring relationship. Objective 16.4 Demonstrate therapeutic communication skills in client interactions.

Objective 16.4a. Use therapeutic communication to provide support to client. (Test Plan) Objective 16.4b Allow time to communicate with client. (Test Plan)

Objective 16.5 Identify the phases of a therapeutic relationship. Objective 16.6 Review defense mechanisms and their impact as you relate them to clinical exemplars. Objective 16.6a Evaluate constructive use of defense mechanisms by client. (Test Plan)

Competency 17 Provide clinically competent nursing care to clients with altered patterns of bowel elimination and gastrointestinal (GI) function. (esophageal reflux disease (GERD), acute and chronic gastritis, hiatal hernia, appendicitis, diverticulitis, Crohn’s, ulcerative colitis, anal fissure, anal abcess, gastroenteritis, conditions due to parasitic organisms, colon obstruction, cirrhosis, hepatitis, cholelithiasis, cholecystitis) Objective 17.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of altered bowel elimination and GI function. (Test Plan) Objective 17.1a.Describe the relationship of dental hygiene and dental problems to nutrition. Objective 17.1b.List and explain the types of impaired esophageal motility. Objective 17.1c.Differentiate the types of hiatal hernia. Objective 17.1d Correlate risk factors of chronic gastritis with cancer of the stomach. Objective 17.1e Explain the pathophysiology of appendicitis and how it could lead to peritonitis. Objective 17.1f Compare and contrast pathophysiology, clinical manifestations, diagnostic evaluation and medical/surgical and nursing management of clients with ulcerative colitis and Crohn’s disorders. Objective 17.1g Define hemorrhoids, anal fissure and anal abcess. Objective 17.1h Compare and contrast mechanical versus function colon obstructions. Objective 17.1i Discuss causative organisms of gastroenteritis and modes of infection. Objective 17.1j Compare and contrast the normal metabolic functions of the liver and alterations that occur in these functions with liver disease. Objective 17.1k Differentiate the three types of hepatic cirrhosis. Objective 17.1l Compare and contrast the normal metabolic functions of the gallbladder and alterations that occur with gallbladder dysfunction. Objective 17.2 Identify key physical assessment parameters and diagnostic test results for clients with altered bowel elimination and GI function. Objective 17.2a Differentiate the key assessment parameters of the different types of hiatal hernia. Objective 17.2b Correlate liver function test results with liver pathophysiologic alterations. Objective 17.2c Relate jaundice, portal hypertension, ascites, varices, nutritional deficiencies and hepatic encephalopathy/coma to specific pathophysiological alterations of the liver. Objective 17.2d Identify variables that influence bowel function (diarrhea and constipation). Objective 17.2e Identify client potential for aspiration. (Test Plan) Objective 17.2f Identify client potential for skin breakdown due to nutritional status. (Test Plan) Objective 17.3 Formulate priority nursing diagnoses and plan expected outcomes for clients with altered bowel elimination and GI function by engaging client/significant other in active partnership in planning. Objective 17.3a. Formulate nursing diagnosis and appropriate outcomes for the client with altered bowel elimination including potential complications. Objective 17.3b Formulate priority nursing diagnosis and outcomes for clients with malabsorptive syndrome, inflammatory bowel disdorder, intestinal obstruction, ostomy, cirrhosis and hepatitis. Objective 17.3c Formulate nursing diagnosis and appropriate outcomes for client undergoing laparoscopic cholecystectomy or lithotripsy. Objective 17.4 Identify support interventions for clients during diagnostic testing and nursing care in order to meet psychosocial needs. Objective 17.4a Describe the appropriate preparation, teaching and follow-up care for clients undergoing diagnostic testing of the GI tract. Objective 17.4b Include frequency of recommended diagnostic testing and dietary considerations in preventative care. Objective 17.5 Identify priority nursing therapeutics (interventions) Including evidence-based practice principles in the plan of care for clients with altered bowel elimination and GI function. (Test Plan) Objective 17.5a Differentiate between the different types of nasogastric/gastric feeding tubes and their


MCC Form EDU 0007 (rev. 10/07/11)

placement prior to feeding. Objective 17.5b Explain the pre- and postoperative care of the client with gastrostomy. Objective 17.5c Utilize the nursing process as a framework for care and management of the client receiving an enteral feeding. Objective 17.5d Formulate nursing interventions which support dietary alterations and changes in life style. Objective 17.5e Describe surgical approaches utilized to treat chronic gastritis, peptic ulcer disease and cancer of stomach and resulting nursing care needed. Objective 17.5f Formulate interventions for client with malabsorptive syndrome. Objective 17.5g Describe the nursing management of clients who undergo surgical procedures to treat obesity. Objective 17.5h Compare and contrast nursing care needed for cholelaparotomy versus laparoscopic approaches to surgery including lithotripsy. Objective 17.5i Identify critical nursing interventions when client undergoes liver biopsy. Objective 17.5j Identify critical elements of nursing role in assisting with paracentesis procedure. Objective 17.5k Formulate priority interventions and goals for client with diverticulits. Objective 17.5l Rapidly prepare client for surgery. Objective 17.5m Describe the responsibilities of the nurse in meeting needs of a client with an iliostomy, Objective 17.5n Formulate plan of care for client experiencing gastroenteritis and conditions caused by parasitic organisms. Objective 17.5o Incorporate appropriate cultural and psychosocial interventions for clients with bowel disorders and ostomies. Objective 17.5p Formulate nursing interventions to facilitate client acceptance of ostomy. Objective 17.5q Develop a plan of care to meet the physiological and psychosocial integrity needs of clients with anorectal disorders. Objective 17.5r Identify supportive measures in meeting psychosocial integrity needs for clients with cirrhosis/hepatitis. Objective 17.5s Utilize principles of wound care in caring for post-surgical incision. (Test Plan) Objective 17.5t. Develop post-operative plan of care for client experiencing intestinal obstruction. Objective 17.5u Compare nursing care differences in conservative treatment versus surgery for anorectal disorders. Objective 17.5v Monitor and maintain devices and equipment used for surgical wound drainage. (Test Plan) Objective 17.6 Formulate teaching plans addressing activity and medications utilized for clients with altered bowel elimination and altered GI function. (Test Plan) Objective 17.6a. Identify the health care learning needs of clients with constipation or diarrhea. Objective 17.6b. Prepare dietary teaching plan and use of medications for client with diverticulitis. Objective 17.6c Formulate teaching plan for medications that stop acute attacks of inflammatory bowel disorder quickly and address dietary management strategies that will assist in lowering inflammation of the bowel. Objective 17.6d Prepare client teaching plan for ostomy care. (Test Plan) Objective 17.6e Teach client hand washing as well as other methods to manage symptoms, prevent complications and spread of infection. Objective 17.6f Formulate teaching plan regarding dietary and fluid management of cirrhosis/hepatitis. Objective 17.6g Prepare teaching plan regarding hepatotoxic drugs to be able to administer safely and teach avoidance of alcohol when client experiences liver dysfunction. Objective 17.6h Formulate teaching plan regarding nutritional management of gallbladder disorders. Objective 17.6i Teach client purpose of T-Tube and nasogastric tube. Objective 17.7 Apply pharmacological management principles for clients with altered bowel elimination and GI function. Objective 17.7a Research usual dosage, side effects and nursing implications of medications commonly prescribed to treat GERD, hiatal hernia, etc. Objective 17.7b. Identify correct dose and nursing implications of combination therapies used to eradicate H. Pylori infection. Objective 17.7c. Identify potential complications of medications utilized to treat alterations in bowel elimination. Objective 17.7d Appropriately utilize pain reduction measures postoperatively. Objective 17.7e Review side effects and nursing implications of broad spectrum antibiotics. Objective 17.8 Identify priority nursing assessments in recognizing complications of altered patterns of bowel elimination and GI function while evaluating achievement of desired outcomes. (Test Plan)


MCC Form EDU 0007 (rev. 10/07/11)

Objective 17.8a Identify complications of gastric surgery and their prevention and management. Objective 17,8b Recognize manifestations of dumping syndrome and utilize nursing therapeutics to prevent. Objective 17.8c Recognize signs and symptoms of shock. Objective 17.8d Recognize abnormal diagnostic values and complications of clients with inflammatory bowel disorder. Objective 17.8e Explain the reasons for development of varied complications of liver cirrhosis. Objective 17.8f Recognize complication of esophageal varices and seek emergency assistance.

Competency 18 Provide clinically competent nursing care to clients with altered patterns of oxygenation. Objective 18.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology for altered patterns of oxygenation. (atalectasis, upper respiratory infections and epistaxis: UTI, sinusitis, pharyngitis, tonsillitis, adenoiditis, peritonsillar abscess and laryngitis; influenza(s), lower respiratory tract problems: pneumonia, chronic bronchitis, COPD, bronchiectasis, asthma, tuberculosis, anthrax, fungal infections, occupational lung disease and sarcoidosis, pneumonia, COPD, tuberculosis. (Test Plan) Objective 18.1a Discuss causes of altered patterns of oxygenation while identifying pathophysiology related to a chronic condition. Objective 18.1b Identify pathophysiology related to impaired gas exchange and ineffective breathing pattern. Objective 18.1c Review the anatomy and physiology of the respiratory system prior to lecture. Objective 18.1d Review the functions of the upper and lower respiratory tracts prior to lecture. Objective 18.1e Explain the mechanics of ventilation and describe factors affecting respiration. Objective 18.1f Define and describe the assessment of inspiratory force. Objective 18.1g Explain the concept of lung compliance. Objective 18.1h Define the ventilation/perfusion ratio. Objective 18.1i Differentiate the varied types of pneumonia, COPD, tuberculosis. Objective 18.2 Identify physical assessment parameters and diagnostic test results for clients with altered patterns of oxygenation. (atalectasis, upper respiratory infections and epistaxis, influenza(s), pneumonia, chronic bronchitis, COPD, bronchiectasis, asthma, tuberculosis, anthrax, fungal infections, occupational lung disease and sarcoidosis. Objective 18.2a Identify clinical assessment parameters of the respiratory system and identify those which would reflect ineffective airway clearance (to determine characteristics and severity of major symptoms of respiratory dysfunction). Objective 18.2b Choose physical assessment equipment and techniques appropriate for the client. (Test Plan) Objective 18.2c Identify clinical assessment parameters of the respiratory system which would reflect impaired gas exchange and ineffective breathing pattern. Objective 18.2d Utilize effective communication techniques in client interview to determine key components of respiratory history and to complete a comprehensive health assessment. Objective 18.2e Discriminate between normal and abnormal breath sounds. Objective 18.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients with altered patterns of oxygenation. Objective 18.3a Identify outcomes/evaluation criteria for clients with dyspnea, impaired gas exchange and ineffective breathing pattern. Objective 18.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 18.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients with altered patterns of oxygenation. (Test Plan) Objective 18.5a Identify appropriate nursing therapeutics for ineffective airway clearance. Objective 18.5b Identify the nurse’s role in treatments (nursing therapeutics) used to improve elimination of secretions. Objective 18.5c Formulate specific nursing interventions to prevent atalectasis. Objective 18.5d Identify the nurse’s role in treatments used to improve ventilation and remove secretions (pulmonary hygiene). Objective 18.5e Identify laboratory values for arterial blood gases and recognize deviations from normal. Monitor serial results and notify primary health care provider as needed. Objective 18.5f Monitor oxygenation via pulse oximetry to verify maintenance/improvement in O2 saturation. Objective 18.5g Perform suction as needed to clear secretions: oral, nasopharngeal and nasotracheal (pulmonary hygiene). (Test Plan) Objective 18.5 h Encourage slower deeper respirations to assist client in taking control.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 18.5i Identify nurse’s role in treatments and complementary therapies in management of upper respiratory infections, influenza(s), epistaxis and lower respiratory chronic conditions. Objective 18.5j Manage care of client with impaired oxygenation and appropriately administer oxygen. (Test Plan) Objective 18.5k Encourage client participation and provide information in appropriate behavior modification programs related to health and wellness such as stress management and smoking cessation. (Test Plan) Objective 18.6 Formulate teaching plans addressing activity and education utilized for clients with altered patterns of oxygenation. (Test Plan) Objective 18.6a Demonstrate/assist client in performing specific airway clearance techniques (pulmonary hygiene). (Test Plan) Objective 18.6b Educate client regarding rationale and importance of oxygen order and no smoking (safety). Objective 18.6c Provide information for prevention of high risk health behaviors such as smoking cessation. Objective 18.6d Outline preventative health care teaching for clients with upper respiratory infections; educate client/staff regarding infection control measures. Objective 18.6e Assess and teach client health risks of respiratory conditions based on known population or community characteristics. Objective 18.6f Teach clients the medications regimes of asthma and tuberculosis. Objective 18.6g Teach client purpose of HEPA filtered respirator and appropriate masking for visitors and staff and when client is outside of room. Objective 18.6h Identify and teach appropriate clients the significance of the public health threat of tuberculosis as related to importance of screening and disease transmission. Objective 18.7 Apply pharmacological management principles for clients with altered patterns of oxygenation. Objective 18.7a Administer bronchodilators as ordered after evaluating appropriateness/accuracy of medication order for client. Educate client on self-administration. (Test Plan) Objective 18.7b Evaluate effectiveness of aerosol/nebulizer treatments. Objective 18.7c Identify medication common to respiratory system and nursing implications: allergic symptoms, actual/potential incompatibilities and managing side effects. Objective 18.7d Identify medications used in treatment of upper and lower respiratory infections and chronic conditions. Objective 18.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing altered patterns of oxygenation. (Test Plan) Objective 18.8a Assess changes, note complication and appropriateness of therapy. Objective 18.8b Observe for respiratory distress and other notable complications and identify client data that needs to be reported immediately. (Test Plan) Objective 18.8c Educate client regarding bronchodilator medications and assess client technique for self-administration. Objective 18.8d Evaluate client use of stress management techniques.

Competency 19 Provide clinically competent nursing care to clients with nutritional and endocrine disorders. Objective 19.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered endocrine function: hypothyroidism, hyperthyroidism, hyperparathyroidism, hypoparathyroidism, Addison’s Disease, Cushing’s Syndrome and diabetes. (Test Plan) Objective 19.1a Review the functions of the endocrine glands and the negative feedback system regarding their hormones as preparation for class. Objective 19.1b Review the anatomy and physiology of the endocrine system independently in preparation for class. Objective 19.1c Define common terminology associated with chronic endocrine disorders and nutritional deficits which are associated with hypothyroidism, hyperthyroidism, goiters, thyroid crisis, parathyroid disorders, adrenal disorders, pituitary disorders and diabetes mellitus. Objective 19.1d Differentiate pathophysiology and risk factors of Type I and Type II Diabetes. Objective 19.1e Distinguish between Type I and Type II Diabetes Classifications. Objective 19.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered endocrine function: hypothyroidism, hyperthyroidism, hyperparathyroidism, hypoparathyroidism, Addison’s Disease, Cushing’s Syndrome and diabetes. Objective 19.2a Identify clinical assessment parameters of the endocrine system which would indicate risk for imbalanced nutrition less than body requirements. Objective 19.2a1 Apply knowledge of nutrition to assessing client weight. (Test Plan)


MCC Form EDU 0007 (rev. 10/07/11)

Objective 19.2b Identify clinical assessment parameters of the endocrine system which would indicate risk for imbalanced nutrition more than body requirements, risk for unstable glucose levels. Objective 19.2c Identify clinical assessment parameters of the endocrine system which would indicate risk for falls. Objective 19.2c1 Assess and evaluate correct use of assistive devices. (Test Plan) Objective 19.2d Identify clinical assessment parameters of the endocrine system which would indicate risk for ineffective health maintenance, knowledge deficit. Objective 19.2e Identify the diagnostic tests used to determine alterations in function of each of the endocrine glands. Objective 19.2e1 Compare and contrast manifestations and diagnostic test results of hypothyroidism and hyperthyroidism. Objective 19.2e2 Perform glucose monitoring. (Test Plan) Objective 19.2f Identify signs and symptoms of client fluid and/or electrolyte imbalance. Objective 19.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered endocrine function. Objective 19.3a Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing risk for imbalanced nutrition, less than body requirements; more than body requirements, risk for unstable blood glucose; risk for falls; risk for ineffective health maintenance and knowledge deficit. Objective 19.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 19.4a Note influence of cultural/religious factors impacting dietary practices, taking responsibility for own care and expressions of outcomes and incorporate cultural religious factors into care. Objective 19.4b Evaluate client’s social situation for factors that influence diabetic treatment and education plan. Objective 19.4c Provide support to client in coping with life changes such as newly diagnosed diabetes. Objective 19.4d Assist client with planning and implementing problem-solving strategies for areas of client’s concern regarding their health condition. Objective 19.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experience chronic altered endocrine function. (Test Plan) Objective 19.5a Consult dietitian to implement interdisciplinary team management in risk for altered nutrition, less than body requirements. Objective 19.5b Formulate specific nursing interventions for the client requiring total or subtotal thyroidectomy. Objective 19.5c Apply knowledge of pathophysiology when caring for client experiencing a medical emergency as Addisonian Crisis or complication of diabetes. Objective 19.5d Recognize complications of diabetes and make appropriate decisions regarding treating of hypoglycemia and diabetic ketoacidosis. Identify data that needs to be reported immediately. Objective 19.5e Develop and implement a plan of care based on the physiological and psychosocial integrity needs of client with diabetes undergoing surgery. Objective 19.5f Recognize long term complications of diabetes and make appropriate decisions regarding treatment. Objective 19.5g Manage client who has alteration in nutritional intake. (Test Plan) Objective 19.6 Formulate teaching plans addressing activity and educations utilized for clients experiencing chronic altered endocrine function. (Test Plan) Objective 19.6a Formulate a teaching plan for client on corticosteroid therapy. Objective 19.6b Formulate teaching plan for client on insulin and include blood glucose testing and use of protective equipment when using devices such as syringes which can cause injury. (Test Plan) Objective 19.6c Promote compliance in the client with diabetes. Objective 19.6d Explain emergency interventions to the client. Objective 19.6e Teach sick day rules to the diabetic client. Objective 19.6f Prepare a diabetic teaching plan including lifestyle modifications, nutritional planning, exercise plan and anti-diabetic medication or insulin self management as well as self care activities to prevent long term complications. Take culture into consideration. Objective 19.7 Apply pharmacological management principles for clients experiencing chronic altered endocrine function. Objective 19.7a Identify and teach pertinent information regarding medications used in treatment of hypothyroidism and hyperthyroidism. Include common side effects, adverse effects, potential interactions and when to call the primary health provider.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 19.7b State the definition of insulin and explain its action. Objective 19.7c Identify the functions of insulin for the client with diabetes. Objective 19.7d Identify the correct procedure for administering insulin. Objective 19.7e Identify the functions of oral hypoglycemic for the client with diabetes. Objective 19.7f Identify oral hypoglycemic used in treatment of diabetes. Objective 19.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered endocrine function including hypothyroidism, hyperthyroidism, hypo-hyperparathyroidism, etc. (Test Plan) Objective 19.8a Consider client choices regarding meeting nutritional requirements when diagnosis of risk for impaired nutrition, less than body requirements. Objective 19.8b Evaluate the impact of disease/illness on nutritional requirements. (Test Plan)

Competency 20 Provide clinically competent nursing care to clients with altered cardiac and circulatory function. Objective 20.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered chronic cardiac and circulatory function: (congestive heart failure, cardiomyopathy, coronary artery disease, angina pectoris, atherosclerosis and cardiovascular disease). (Test Plan) Objective 20.1a Define selected cardiac terms. Objective 20.1b Review the conduction system of the heart. Objective 20.1c Relate the concepts of cardiac cycle and cardiac output. Objective 20.1d Define cardiac output and identify what factors influence it. Objective 20.1e Outline the determinants of cardiac output. Objective 20.1f Apply the concepts of preload, afterload and Starling’s Law to the care of client with chronic alteration in cardiac function and circulation. Objective 20.1g Discuss the concept of cardiac index. Objective 20.1h Differentiate between modifiable and non-modifiable risk factors. Objective 20.1i Differentiate right and left heart failure. Objective 20.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered chronic cardiac and circulatory function. (angina pectoris, myocardial infarction, cardiomyopathy, congestive heart failure; impaired tissue and cardiac tissue perfusion; pain related to decreased tissue perfusion; knowledge deficit of cardiac issues; ineffective health maintenance; activity intolerance related to imbalanced oxygen supply and demand; and coping issues. (Test Plan-peripheral edema) Objective 20.2a Identify clinical assessment parameters of cardiac system which would reflect decreased cardiac output. (Test Plan) Objective 20.2b Incorporate assessment of functional health patterns and cardiac risk factors into the health history and physical assessment of client with chronic cardiovascular disease utilizing effective interview techniques. Objective 20.2c Differentiate the different types of angina, cardiomyopathy.. Objective 20.2d Recognize abnormal results of blood studies and follow reporting system. Objective 20.2e Compare baseline results with progressive testing in congestive heart failure including serum electrolytes, urinalysis, BUN, Creatinine, blood gasses, ANF, ANH, BNP, etc. Objective 20.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered cardiac and circulatory function. (angina pectoris, myocardial infarction cardiomyopathy, congestive heart failure, Objective 20.3a Identify outcome evaluation criteria for clients with decreased cardiac output, impaired tissue perfusion, pain related to decreased tissue perfusion; knowledge deficit of cardiac issues; ineffective health maintenance; activity intolerance related to imbalanced oxygen supply and demand; and coping issues. Objective 20.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 20.4a Discuss end of life care for client with chronic heart failure. Objective 20.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experiencing chronic altered cardiac and circulatory function. (angina pectoris, myocardial infarction, cardiomyopathy, congestive heart failure) (Test Plan) Objective 20.5a Identify the nurse’s role in treatment used to improve and maintain circulation for clients with decreased cardiac output. (Provide client with strategies.) (Test Plan) Objective 20.5b Determine VS, etc. to provide baseline for comparison to follow trends and evaluate response to interventions. Objective 20.5c Monitor intake and output and calculate 24 hour fluid balance. (Test Plan) Objective 20.5d Identify key nursing interventions in care of client undergoing cardiac catheterization both pre-and


MCC Form EDU 0007 (rev. 10/07/11)

post-operatively (Assessing peripheral pulses, positioning client to prevent complications, monitoring for bleeding, assessing for dysrhythmia). (Test Plan) Objective 20.6 Formulate teaching plans addressing activity and education utilized for clients experiencing chronic altered cardiac and circulatory function. (Test Plan) Objective 20.6a Prepare teaching plan which outlines approaches to changing life style and dealing with modifiable risk factors. Objective 20.6b Discuss significant signs and symptoms and danger signs that require prompt reporting to healthcare provider. Objective 20.6c Instruct BP monitoring at home. Objective 20.6d Formulate teaching plan which address medication regimen usually ordered for client with myocardial infarction, cardiomyopathy and congestive heart failure. Objective 20.7e Prepare teaching plan relative to cardiac rehabilitation program, risk factor modification, smoking cessation, exercise, hypertension control and principles of dietary management. Objective 20.7f Develop discharge plan including teaching for patient with cardiomyopathy. Objective 20.7 Apply pharmacological management principles for clients experiencing chronic altered cardiac and circulatory function. Objective 20.7a Identify common medications and pharmacological measures used in treating chronic alterations of cardiac function. Objective 20.7b Outline purpose, action, route, side effects and nursing implications of administering digitalis, nitrates, beta blockers, calcium channel blockers, anti-platelet and other related drugs to clients with angina pectoris and myocardial infarction. Objective 20.7c Evaluate therapeutic effects of pain medications. Objective 20.7d Recognize signs of digitalis toxicity. Objective 20.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered cardiac and circulatory function. (angina pectoris, myocardial infarction, cardiomyopathy and congestive heart failure) (Test Plan) Objective 20.8a Recognize long term complications of myocardial infarction. (Test Plan)

Competency 21 Provide clinically competent nursing care to clients with alterations in peripheral circulation. (chronic peripheral vascular, hematologic and lymphatic disorders) (Buerger’s and Raynaud’s Disease, disorders of venous circulation, thrombophlebitis, primary and secondary hypertension, anemia) Objective 21.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered peripheral circulation. (Test Plan) Objective 21.1a Review the anatomy and physiology of the peripheral vascular circulatory system prior to lecture. Objective 21.1b Review factors affecting circulation. Objective 21.1c Review regulators of and factors affecting blood pressure. Objective 21.1d Discuss Virshow’s Triad associated with thrombophlebitis. Objective 21.1e Differentiate primary and secondary hypertension. Objective 21.1f Describe the process of hematopoiesis. Objective 21.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered peripheral circulation. Objective 21.2a Differentiate clinical manifestations of arterial insufficiency versus venous insufficiency. Objective 21.2b Recognize manifestations of thrombophlebitis. Objective 21.2c Appropriately classify blood pressure of adults. Objective 21.2d Identify clinical assessment parameters commonly ordered in secondary hypertension. Objective 21.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered peripheral circulation. Objective 21.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 21.4a Prepare client for diagnostic studies utilized with thrombophlebitis. Objective 21.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experience chronic altered peripheral circulation.(hypertension, thrombophlebitis, chronic venous insufficiency, varicose veins, hypertension, anemia.) (Test Plan) Objective 21.5a Identify prophylactic measures utilized for hospitalized clients at risk for thrombophlebitis and identify clients at risk. Objective 21.6 Formulate teaching plans addressing activity and education utilized for clients experiencing chronic


MCC Form EDU 0007 (rev. 10/07/11)

altered peripheral circulation. (Test Plan) Objective 21.6a Formulate a teaching plan addressing smoking, diet, exercise and periodic screening for complications. Objective 21.6b Formulate teaching plan for client experiencing varicosities. Objective 21.6c Formulate teaching plan stressing lifestyle modifications for client experiencing hypertension. Objective 21.7 Apply pharmacological management principles for clients experiencing chronic altered peripheral circulation. Objective 21.7a Discuss action, purpose, side effects and nursing implications of administering anti-coagulant therapy; reduce the likelihood of harm associated with use of anticoagulant therapy. (National Patient Safety Goal) Objective 21.7b Correctly follow medication administration orders for antihypertensive medications. Objective 21.7c Discuss pharmacological guidelines followed in pharmacologic control of hypertension. Objective 21.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered peripheral circulation. (Test Plan) Objective 21.8a Recognize complications of thrombophlebitis and evaluate achievement of desired outcomes. (Test Plan

Competency 22 Provide clinically competent nursing care to clients with altered sensory function. Objective 22.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered sensory function. (integumentary disorders, ocular disorders, ear disorders) (Test Plan) Objective 22.1a Identify and describe primary and secondary skin lesions and their pattern and distribution. Objective 22.1b Discuss the consequences of diabetes and HIV on the sensory organs. Objective 22.1c Review anatomy, physiology and functions of the external, middle and inner ear. Objective 22.1d Explore the role of the inner ear in balance and equilibrium. Objective 22.1eDifferentiate problems of the external ear from those of middle and inner ear. Objective 22.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered sensory function. (risk for or actual impaired skin integrity, risk for infection, pain due to impaired skin integrity, impaired sensory perception, risk for injury, ocular disorders, hearing disorders) (Test Plan) Objective 22.2a Recognize common skin eruptions and manifestations associated with systemic disease. Objective 22.2b Describe the components of physical assessment that are most useful when examining the skin, hair and nails. Objective 22.2c Discuss common skin tests and procedures used in diagnosing skin and related disorders. Objective 22.2d Identify deficits in hearing that may impede client safety. Objective 22.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered sensory function. Focus is on risk for or altered skin integrity, risk for infection, risk for increased pain, risk for impaired sensory perception and risk for injury, Objective 22.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 22.4a Identify ways to communicate effectively with client with hearing disorder. Objective 22.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experiencing chronic altered sensory function. (Test Plan) Objective 22.5a Identify nurse’s role in treatment used to improve or maintain skin integrity (needed assessments and interventions.) Objective 22.5b Apply principles of infection control. Objective 22.5c Describe the general management of client with abnormal skin condition. Objective 22.5d Use the nursing process as a framework for care of the client with psoriasis, pruritis, noninfectious, inflammatory dermatoses, secretory disorders, skin infections and blistering disorders. Objective 22.5e Describe the management and nursing care of client with skin cancer and benign tumors. Objective 22.5f Compare the nursing care needs of various types of dermatologic and plastic reconstructive surgeries. Objective 22.5g Use the nursing process as a framework for care of client undergoing facial reconstructive surgery. Objective 22.5h Compare the various types of surgical procedures used for managing middle ear disorders and appropriate nursing care. Objective 22.6 Formulate teaching plans addressing activity and education utilized for clients experiencing chronic altered sensory function. (Test Plan) Objective 22.6a Identify health education needs of the client with infections of the skin and parasitic skin diseases. Objective 22.6b Describe the teaching topics that need to be addressed for clients undergoing middle-ear and


MCC Form EDU 0007 (rev. 10/07/11)

mastoid surgery. Objective 22.7 Apply pharmacological management principles for clients experiencing chronic altered sensory function. Objective 22.7a Administer analgesics as needed and comply with requirements governing controlled substances. Objective 22.7b Demonstrate installation of eye drops and ointments. Objective 22.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered sensory function. Focus is on risk for or altered skin integrity, risk for infection, risk for increased pain, risk for impaired sensory perception and risk for injury, (Test Plan)

Competency 23 Provide clinically competent nursing care to clients with alterations in sensory, cognition and perception. Objective 23.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered in cognition and perception. (headache, infectious disease (Creutzfeldt-Jakob), cranial nerve disorders (Trigeminal Neuralgia, Bell’s Palsy), degenerative neurological syndromes (Muscular Dystrophy, Post-Polio Syndrome, Amyotrophic Lateral Sclerosis, Huntington’s Disease, Parkinson’s), peripheral neuropathy, disorders of immune, origin, seizure, degenerative disk disease, trans-ischemic attack, stroke, ) (Test Plan) Objective 23.1a Review the anatomy and physiology of the nervous system defining overall function and including cranial nerves. Objective 23.1b Identify the antecedent events including risk factors leading to health/illness transitions due to alteration in neurological system related to changes in level of consciousness. Objective 23.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered cognition and perception function. (Test Plan) Objective 23.2a Identify clinical assessment parameters of neurological system which would reflect risk for injury, impaired memory, ineffective health maintenance, knowledge deficit, body image disturbance. Objective 23.2b Identify deficits that may impede client safety. (Test Plan) Objective 23.2c Assess client’s degree of sensory impairment. Objective 23.2d Assess lifestyle practice that may impact memory, health. (Test Plan) Objective 23.2e Review health history data that is essential for assessment of the neurological system and varied levels of consciousness so assessment of client for abnormal neurological status can be completed. Objective 23.2f Correctly utilize and interpret the Glasgow Coma Rating Scale in client assessment. Objective 23.2g Correlate lab and diagnostic test results with assessment date related to nervous system disorders and compare diagnostic testing findings with pre-test results. Objective 23.2h Recognize and cluster significant assessment data for clients experiencing health illness transition due to headache, infectious disease (Creutzfeldt-Jakob), cranial nerve disorders (Trigeminal Neuralgia, Bell’s Palsy), degenerative neurological syndromes (Muscular Dystrophy, Post-Polio Syndrome, Amyotrophic Lateral Sclerosis, Huntington’s Disease), peripheral neuropathy, disorders of immune origin (Multiple Sclerosis, Myasthenia Gravis), alterations in vertebral structure, TIA and stroke) (Test Plan-Parkinson’s) Objective 23.2i Differentiate the different types of seizure activity by assessment and identify time, place and stimuli surrounding the appearance of symptoms. (Test Plan) Objective 23.2j Differentiate the different types of stroke and correlate with planned outcomes. Objective 23.2k List four symptomatic characteristics of Parkinson’s Disease. (Test Plan) Objective 23.2l Describe the progression of Parkinson’s as a chronic disease with consideration of pathophysiology, diagnostic tests, and assessment of the client’s ability to adapt and resulting role change. (Test Plan) Objective 23.3m Differentiate Parkinsonian Syndrome from Parkinson’s Disease. Objective 23.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered cognition and perception. (unconscious client, headache, infectious disease (Creutzfeldt-Jakob), cranial nerve disorders (Trigeminal Neuralgia, Bell’s Palsy), degenerative neurological syndromes (Muscular Dystrophy, Post-Polio Syndrome, Amyotrophic Lateral Sclerosis, Huntington’s Disease), peripheral neuropathy, disorders of immune origin, altered vertebral structure, TIA and stroke) Objective 23.3a Perform thorough assessment regarding safety issues when planning for client care and or preparing for discharge from care. Objective 23.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 23.4a Implement nursing interventions which facilitate the improvement of coping measures and lessoning of fears for clients with seizure. Objective 23.4b Develop a plan of care based on psychosocial integrity needs of clients experiencing TIA/stroke. Objective 23.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experiencing chronic altered cognition and perception function. (headache, infectious disease (Creutzfeldt-Jakob),


MCC Form EDU 0007 (rev. 10/07/11)

cranial nerve disorders (Trigeminal Neuralgia, Bell’s Palsy), degenerative neurological syndromes (Muscular Dystrophy, Post-Polio Syndrome, Amyotrophic Lateral Sclerosis, Huntington’s Disease, Parkinson’s), peripheral neuropathy, disorders of immune origin, altered vertebral structure, TIA and stroke) (Test Plan) Objective 23.5a Identify the nurse’s role in treatment of clients at risk for injury and maintain the client safe from injury. Objective 23.5b To evaluate source/degree of risk inherent in the individual situation, Identify factors that influence accident and injury prevention. (Test Plan) Objective 23.5c Identify interventions and safety devices to promote safe physical environment and facilitate safe and appropriate use of equipment. (Test Plan) Objective 23.5c Examine ethical issues that may arise in health care of client with dysfunction in cognition/perception. (Test Plan) Objective 23.5e Identify areas in care of clients with dysfunction of cognition perception that would benefit from increased nursing research or evidence based practice principles. Objective 23.5f Recognize complications of neurological disorders. Objective 23.5g Identify the priority nursing interventions for the unconscious client. Objective 23.5 h Identify key assessment parameters and nursing interventions during seizure activity. (Test Plan) Objective 23.5i Outline the nurse’s role in emergency treatment of TIA and stroke. Objective 23.5j Discuss the societal impact of Parkinson’s Disease in our culture and how this disease may necessitate a role change. (Test Plan) Objective 23.6 Formulate teaching plans addressing activity and educations utilized for clients experiencing chronic altered cognition and perception function. (Test Plan) Objective 23.6a Identify individual needs and resources for safety education. (Test Plan) Objective 23.6b Design teaching plan regarding medications ordered for seizure disorder. Objective 23.6c Educate client regarding management of Parkinson’s Disease. (Test Plan) Objective 23.7 Apply pharmacological management principles for clients experiencing chronic altered cognition and perception function Objective 23.7a Determine client’s response to and effect of medications. Objective 23.7b Recognize the accepted pharmacological treatment parameters for clients with seizure disorders. Objective 23.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered cognition and perception function. (headache, infectious disease (Creutzfeldt-Jakob), cranial nerve disorders. (Test Plan) Objective 23.9 Discuss evidence-based practice literature relative to nursing care for client with Parkinson’s Disease. (QSEN skill competency is to locate evidence reports related to clinical practice topics and guidelines.)

Competency 24 Competency 31 Provide clinically competent perioperative nursing care. Objective 24.1 Discuss general perioperative principles. Objective 24.1a Outline the classifications of surgical procedures. Objective 24.1b Compare and contrast differences and similarities between inpatient and outpatient surgery. Objective 24.1c Review the three phases of perioperative nursing. Objective 24.1d Relate the principles of surgical asepsis. Objective 24.1e Describe the interdisciplinary approach to the client during surgery and explain the roles of surgical team members during the intra-operative phase of care. (Test Plan) Objective 24.1f Describe the variables that influence wound healing. Objective 24.1fg Compare various types of anesthesia with regard to uses as to advantages, disadvantages. Objective 24.2 Conduct a comprehensive preoperative assessment to identify surgical risk factors. (risk for infection, anxiety, pain). Objective 24.2a Identify health factors that affect the client preoperatively. Objective 24.2b Identify the surgical risk factors related to age-specific and condition-specific populations. Objective 24.2c Identify clinical assessment parameters of pain which would reflect pain related to decreased tissue perfusion. Objective 24.2d Recognize both verbal and nonverbal clues of anxiety. Objective 24.2e Recognize abnormal values in the usual diagnostics completed prior to surgery. Objective 24.2f Identify assessment parameters for the early detection of post-operative complications. Objective 24.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing surgery. Objective 24.4 Identify support interventions for clients during the perioperative experience in order to meet psychosocial needs.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 24.4a Identify the nurse’s role in interventions used to decrease anxiety episodes and improve client’s coping skills in stressful situations. Objective 24.4b Recognize the importance of individual cultural practices and tradition and their effect on the post-operative experience. Objective 24.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experiencing surgery. Objective 24.5a Identify the nurse’s role in treatment used to improve and prevent pain issues related to decreased tissue perfusion. Objective 24.5b Identify preoperative nursing measures that decrease the risk for skin infection and other postoperative complications. Objective 24.5c Identify the immediate preoperative preparation measures of the client. (Test Plan) Objective 24.5d Outline nursing responsibilities as related to anesthesia and assess client response to recovery from local, regional or general anesthesia. (Test Plan) Objective 24.5e Identify adverse effects of surgery and anesthesia. Objective 24.5f Use the nursing process for optimizing client outcomes during the intra-operative period. Objective 24.5g Describe the responsibilities of the post-anesthesia unit nurse in the prevention of immediate post-operative complications. (Test Plan) Objective 24.5h Compare postoperative care of the ambulatory surgery client with that of the hospitalized surgery client. Objective 24.5i Utilize principles of pain management specific to the acute post-operative pain control and consider cultural differences. (Test Plan) Objective 24.5j Describe the gerontological considerations related to post-operative management. Objective 24.5k Identify common post-operative problems and their management. Objective 24.5l Demonstrate post-operative dressing techniques. Objective 24.5m Monitor client for signs of bleeding. (Test Plan) Objective 24.6 Develop a perioperative teaching plan designed to promote the client’s recovery from anesthesia and surgery, to prevent postoperative complications. (Test Plan) Objective 24.6a Incorporate effective communication skills while discharge teaching. Objective 24.7 Apply pharmacological management principles for clients experiencing surgery. Objective 24.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing surgery. (Test Plan) Objective 24.9 Consider legal/ethical factors in perioperative nursing. (Test Plan) Objective 24.9a Consider legal/ethical factors as related to informed consent. (Test Plan) Objective 24.9b Describe the role of the nurse in ensuring client safety outcomes such as pre-procedure verification process, marking of procedure site and time-out during the perioperative experience. (National Patient Safety Goal) Objective 24.9c Verify that client comprehends and consents to care/procedures especially those requiring informed consent. (Test Plan)

Competency 25 Provide clinically competent nursing care to clients with altered urinary elimination. Objective 25.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered urinary elimination. (acute and chronic glomerulonephritis, nephrotic syndrome, renal failure, acute and chronic pyelonephritis, urolithiasis, nephrolithiasis) (Test Plan) Objective 25.1a Review the anatomy and physiology of the renal and urinary systems prior to class. Objective 25.1b Review the concepts of filtration, absorption and reabsorption; Renin-Angiotensin System. Objective 25.1c Review causative factors of urinary tract infection. Objective 25.1d Define ureterolithotomy, pyelolithotomy, nephrolithotomy and cystoscopy. Objective 25.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered urinary elimination. Objective 25.2a Identify questions to elicit subjective data from client concerning urinary elimination history. (Test Plan) Objective 25.2b Recognize abnormal diagnostics relative to urinary tract infections and chronic disorders. (Test Plan) Objective 25.2c Correctly obtain urine specimens. Objective 25.2d Identify clinical manifestations of acute and chronic glomerulonephritis; acute and chronic pyelonephritis, uterolithiasis, nephrolithiasis, nephritic syndrome, renal failure. Objective 25.2e Assess for signs and symptoms of fluid volume excess.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 25.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered urinary elimination. Objective 25.3a Formulate nursing diagnoses and nursing outcomes for client undergoing urinary tract surgery. Objective 25.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 25.4a Prepare client for cystoscopy. Objective 25.4b Consider psychosocial and cultural aspects when caring for client with urinary elimination disorder. Objective 25.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experience chronic altered urinary elimination. (Test Plan) Objective 25.5a Formulate a nursing care plan for client with chronic renal disease. (glomerulonephritis, pyelonephritis) Objective 25.5b Keep accurate intake and output and daily weight records. Objective 25.5c Formulate a nursing care plan for client with urinary incontinence and urinary retention. Objective 25.5d Provide clinically correct catheter care. Objective 25.5e Plan appropriate treatments for incontinent client. Objective 25.5f Formulate nursing interventions for client with urinary calculi. Objective 25.5g Develop a postoperative plan of nursing care for client undergoing kidney and urinary tract surgery. Objective 25.6 Formulate teaching plans addressing activity and educations utilized for clients experiencing chronic altered urinary elimination. (Test Plan) Objective 25.6a Formulate teaching plan for client with urinary calculi based on prevention of same. Objective 25.6b Develop a teaching plan for client undergoing kidney and urinary tract surgery. Objective 25.7 Apply pharmacological management principles for clients experiencing chronic altered urinary elimination. Objective 25.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered urinary elimination. (Test Plan) Objective 25.8a Identify assessment parameters appropriate for early detection of postoperative complications. (Test Plan)

Competency 26 Provide clinically competent nursing care to clients with altered immune function and cancer disorder. Objective 26.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered immune function and cancer disorder. (Hodgkin’s, Non-Hodgkin’s, Leukemia, bone tumors, brain tumor, oral cancer, laryngeal, thyroid, breast, lung, colorectal, malignant melanoma). (Test plan) Objective 26.1a Relate the principles of internal consistency, homeostasis, stress, and adaptation to the concept of the steady state. Objective 26.1b Identify the significance of the body’s compensatory mechanisms in promoting adaptation and maintaining the steady state. Objective 26.1c Identify physiologic and psychosocial stressors including environmental that affect client care. (Test Plan) Objective 26.1d Review the inflammatory and reparative processes. Objective 26.1e Describe the body’s general immune responses, stages of the immune response and differentiate between cellular and humoral immune responses. (Test Plan) Objective 26.1f Describe the effects of selected variables on function of the immune system. Objective 26.1g Compare the different types of primary immunodeficiency disorders as to their causes, clinical manifestations, management, potential complications and common treatment modalities. Objective 26.1h Describe the modes of transmission, pathophysiology and physiology underlying the clinical manifestations of HIV infection. Objective 26.1i Compare the structure and function of the normal cell with the cancer cell. (Test Plan) Objective 26.1j Differentiate between benign and malignant tumors. Objective 26.1k Identify agents that have found to be carcinogenic. Objective 26.2 Identify physical assessment parameters and diagnostic test results in clients experiencing chronic altered immune function and cancer disorder to determine client’s status of immune function. Objective 26.2a Identify clinical assessment parameters for clients for risk for imbalanced nutrition less than body requirements. Objective 26.2b Determine all factors that can affect ingestion such as client’s ability to eat and/or digestion of nutrients. Objective 26.2c Assess for actual/specific drug/food interactions and disease effects that may be affecting


MCC Form EDU 0007 (rev. 10/07/11)

appetite. Objective 26.2d Assess weight to establish baseline. Objective 26.2e Assist in nutritional assessment and apply knowledge of mathematics to client nutrition. Objective 26.2f Identify clinical assessment parameters which would reflect fluid volume deficit, pain, fatigue, impaired oral mucosa. Objective 26.2g Identify clinical assess parameter of integumentary system which would reflect risk for infection. Objective 26.2h Assess the health patterns of a client and determine their effects on maintenance of the steady state, maladaptive responses and use of measures that reduce stress. Objective 26.2iIdentify clinical assessment parameters of laryngeal, lung cancers. Objective 26.2j Assess client need for alternative and/or complementary therapy or for palliative care. (Test Plan) Objective 26.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing chronic altered immune function and cancer disorder. Objective 26.3a Identify outcome/evaluation criteria for client with immune system diseases with nutrition, less than body requirements. Objective 26.3b Identify client at risk for malnutrition. Objective 26.3c Prioritize nursing diagnoses and collaborative problems for client with AIDS, cancer, oral cancer. Objective 26.3d Outline key evaluation factors in achieving planned outcomes for client with bone tumor. Objective 26.4 Identify support interventions for clients during the diagnostic and nursing care stages in order to meet psychosocial needs. Objective 26.4a Ascertain client understanding of individual nutritional needs and consider client choices regarding meeting nutritional requirements. Objective 26.4b Assist in diagnostic procedures. Objective 26.4c Differentiate among the purposes of surgical procedures used on cancer treatment, diagnosis, prophylaxis, palliation and reconstruction. Objective 26.4d Describe the concept of Hospice in providing care for clients with advanced cancer. Objective 26.4e Formulate nursing interventions when client has disturbance in self image. Objective 26.4f Respect client palliative care choices. (Test Plan) Objective 26.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experiencing chronic altered immune function and cancer disorder. (laryngeal, lung) (Test Plan) Objective 26.5a Consult dietitian and implement interdisciplinary team management. Objective 26.5b Provide for diet modifications as needed. Objective 26.5c Review laboratory data relative to fluid deficit and recognize deviations from normal. Objective 26.5d Discuss the nurse’s role in treatment plans and nursing management for clients with immunodeficiency disorders. Use appropriate precautions. (Test Plan) Objective 26.5e Describe the nursing and treatment management of clients with HIV infection and AIDS. (Test Plan) Objective 26.5f Describe the roles of surgery, radiation therapy, chemotherapy, bone marrow transplantation and other therapies in treating cancer and evaluate client response. Objective 26.5f1 Implement interventions to address side/adverse effects of radiation therapy. (Test Plan) Objective 26.5f2 Ensure safe implementation of internal radiation therapy. (Test Plan) Objective 26.5g Use the nursing process as a framework for care of clients with cancer. Objective 26.5h Discuss the role of the nurse in assessment and management of common oncologic emergencies. Objective 26.5i Explore the role of the nurse as provider of care and counselor in health promotion, maintenance and adaptation. Objective 26.5j Incorporate alternative/complementary therapies into client plan of care and apply knowledge of pathophysiology to nonpharmacological comfort/palliative care interventions. (Test Plan) Objective 26.6 Formulate teaching plans addressing activity and educations utilized for clients experiencing chronic altered immune function and cancer disorder. (Test Plan) Objective 26.6a Identify essential teaching needs for client with immunodeficiency. Objective 26.6b Describe the significance of health education and preventive care in decreasing the incidence of cancer. Objective 26.6c Outline health teaching opportunities for clients with laryngeal tumors. Objective 26.7 Apply pharmacological management principles for clients experiencing chronic altered immune function and cancer disorder.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 26.7a Provide for pain relief and evaluate and document client’s response to pain and comply with requirements governing controlled substances. (Test Plan) Objective 26.7b Identify the nursing implications of administering the different types of chemotherapy. Objective 26.7c Describe the special nursing needs of clients receiving chemotherapy Objective 26.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered immune function and cancer disorder. (Test Plan) Objective 26.8a Assess client for signs and symptoms of adverse effects of radiation therapy. (Test Plan) Objective 26.8b Evaluate outcomes of palliative care interventions. (Test Plan)

Competency 27 Provide clinically competent nursing care to clients with altered mobility due musculoskeletal dysfunction. Objective 27.1 Discuss the incidence, etiology, antecedent events including risk factors and pathophysiology of conditions that result from altered musculoskeletal dysfunction. (soft tissue injuries, fractures, osteoporosis, degenerative joint disease, osteomalacia, Paget’s Disease, osteomyelitis, rheumatoid arthritis, ankylosing spondylitis, connective tissue disorders-lupus, scleroderma, polymysitis, rheumatic disorders.-gout, fibromyalgia, Reiter’s Syndrome, psoriatic, amputation) Objective 27.1a Review anatomy and physiology of the muscle-skeletal system as well as bone formation/maintenance/healing independently in preparation for class. Objective 27.1b Distinguish between dislocation and subluxation as related to complication of avascular necrosis. Objective 27.1c Explore emergency treatment of fractures including methods of fracture reduction. Objective 27.1d Explain the cardiovascular pathophysiology as related to amputation. Objective 27.1e List levels and approaches to amputation that may occur. Objective 27.2 Identify physical assessment parameters and diagnostic test results in clients experiencing altered musculoskeletal function and altered mobility (musculoskeletal trauma, bone mass loss, hip fracture post surgery, degenerative joint disease pre- and post-operatively, osteomyelitis, inflammatory disease processes, connective tissue disease rheumatic disease, amputation.) Objective 27.2a Identify clinical assessment parameters which would reflect risk for increased acute or chronic pain or risk for injury due to musculoskeletal injury or dysfunction. Objective 27.2b Identify clinical assessment parameters which reflect impaired physical mobility and insufficient vascular perfusion. (Assess client’s ability to balance, transfer and use assistive devices.)(Test Plan) Objective 27.2c Identify clinical assessment parameters which reflect self-care deficit. Objective 27.2d Identify key elements of health history pertinent to the assessment of muscle-skeletal health. Objective 27.2e Recognize and demonstrate skill in significant physical assessment parameters of the muscle skeletal system. Objective 27.3 Formulate priority nursing diagnoses and plan for expected outcomes for clients experiencing altered musculoskeletal function. (musculoskeletal trauma, bone mass loss, hip fracture post surgery, degenerative joint disease pre- and post-operatively, osteomyelitis, inflammatory disease processes, connective tissue disease rheumatic disease, amputation.) Objective 27.4 Identify support interventions for clients during the diagnostic and nursing care stages (Casts, splints, tractions, braces) in order to meet psychosocial needs. (Support to client with unexpected altered body image) (Test Plan) Objective 27.5 Identify priority nursing interventions including evidence-based practice principles in the plan of care for clients experience altered musculoskeletal function in order to prevent potential neurological complications. (Test Plan) Objective 27.5a Consult with physical/occupational therapist as indicated. Objective 27.5b Identify priority nursing interventions utilized in post-operative arthroscopy client to promote positive outcomes. Objective 27.5c Research evidence-based practice principles applicable to fall prevention and prevention of osteoporosis with outcome of minimizing aging changes and maximizing musculoskeletal health. Objective 27.5d Clinically recognize the varied classifications of traction used to treat hip fracture. Objective 27.5e Formulate nursing interventions which address post-operative wound care, assessment parameters and interventions for complications and prevention of complications for client with amputation. Objective 27.5f Use precautions to prevent further injury when moving client with musculoskeletal condition. (Test Plan) Objective 27.5g Maintain correct adjustment of client traction device. (Test Plan) Objective 27.6 Formulate teaching plans addressing activity and educations utilized for clients experiencing chronic altered musculoskeletal function. (Test Plan) Objective 27.6a Formulate teaching strategies to prepare client to undergo both noninvasive and invasive medical diagnostic tests utilized in assessment of musculoskeletal system.


MCC Form EDU 0007 (rev. 10/07/11)

Objective 27.6b Formulate a discharge teaching plan for client with cast, splint or braces. Objective 27.6c Formulate nutritional and physical activity teaching plans to address physiological and psychosocial integrity needs of client with significant loss of bone mass. Objective 27.6d Design an appropriate pre-operative teaching plan for client undergoing hip surgery. Objective 27.6e Formulate discharge teaching plan for post-operative hip repair client. Objective 27.6f Formulate a health promotion teaching plan addressing body mechanics, exercise, body weight, adequate support and medication regime. Objective 27.6g Formulate teaching plan addressing activity and medications utilized for clients with inflammatory, rheumatic and connective tissue disease processes. Objective 27.6h Formulate teaching plan addressing nutrition, medication and hydration regime in gout and fibromyalgia. Objective 27.7 Apply pharmacological management principles for clients experiencing chronic altered musculoskeletal function. Objective 27.7a Administer analgesics as needed. Notify physician if regimen inadequate. Objective 27.7b Address non-pharmacological pain management for client with inflammatory disease process. Objective 27.7c Address varied methods of pain relief for phantom and chronic stump pain and consider cultural implications regarding pain. Objective 27.8 Evaluate the effectiveness of nursing therapeutics and achievement of desired outcomes in clients experiencing chronic altered musculoskeletal function. (prevent complications from immobility) (Test Plan) Objective 27.8a Identify priority nursing assessments necessary to recognize early, late and systemic complications of fracture and other musculoskeletal traumas as well as complications of immobility when evaluating achievement of desired outcomes. (Test Plan) Objective 27.8b Identify priority nursing assessments necessary to recognize complications of connective tissue disease processes when evaluating achievement of desired outcomes. (Test Plan)

Competency 28 Effective provide nursing care for client with impaired cognition. Objective 28.1 Define Alzheimer’s Disease and its related pathophysiology. Objective 28.2 Describe the antecedent events prior to Alzheimer Disease diagnosis. Objective 28.3 Differentiate the different stages of Alzheimer’s Disease through client assessment findings. Objective 28.4 Describe diagnostic test findings in Alzheimer’s Disease. Objective 28.5 Describe the medical management of Alzheimer’s Disease. Objective 28.6 Formulate a client problem list (nursing diagnosis) at a beginning level and nursing therapeutics (interventions you can do for client) at each stage of Alzheimer’s Disease by incorporating behavioral management techniques. Objective 28.7 Make an appropriate room assignment for a cognitively impaired client. (Test Plan) Objective 28.8 Assess client for potential/actual abuse. (Hartford Foundation: Institute for Geriatric Nsg) (Test Plan) Objective 28.9 Assist family to plan care for client with impaired cognition. (Test Plan) Objective 28.10 Provide support and assist client to cope with life transitions as retirement. (Test Plan)

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