NUR 314-A Acute Care of the Adult Patient I

Concordia College

Division of Nursing

COURSE NO. AND TITLE: NUR 314 – Acute Care of the Adult Patient I

CREDITS: 4 Credits (4 hours lecture, 12 hours lab/7 weeks)

PREREQUISITES: NUR 311

COREQUISITES NUR 321 NUR 312

FACULTY: Ms. Lucia Alfano (Course Coordinator)

Dr. Christine Corcoran

Dr. Kathleen Flaherty

Ms. Sarit Orlofsky

Ms. Hyacinth Charles

Ms. Katherine Irizarry

Ms. Annmarie Kornobis

Ms. Allyne Kulk

Ms. Joan Parkes

Ms. Eileen Power

Ms. Charlene Scotton

Ms. Susan Tighe

Mr. Ken Tuttle

Ms. Barbara Ventura

PLACEMENT IN THE CURRICULUM: First Semester

COURSE DESCRIPTION: This course is the first in a two course series which focuses on

the development of theoretical knowledge and clinical skills involved in nursing care of the adult

patient. Concepts which address prevention, health promotion, disease management and

therapeutic interventions for adults with actual or potential alterations in fluid balance, and

neurologic, respiratory and cardiac systems will be addressed. Health issues and disease

processes commonly experienced by individuals and their families in the adult years will be

explored. Clinical practice experiences are provided in both out-patient and acute care settings

and will focus on knowledge and skills necessary for competent and compassionate care of adults

within the context of their families and community.

OBJECTIVES:

Upon successful completion of this course, the student will be able to:

1. Utilize evidence from physical and social sciences and nursing to the care of the adult patient

as measured by examinations, case study, nursing care plans, and clinical performance;

2. Apply the nursing process in the care of the adult patient and family as measured by

examinations, case study, nursing care plans, and clinical performance;

3. Select safe and effective therapeutic interventions based on the needs of the adult patient and

family and grounded in sound evidence and best-practices as measured by examinations,

case study, nursing care plans, performance in simulation laboratory, and clinical

performance ;

4. Utilize information systems and technology correctly in the delivery of patient care to adults

as measured by performance in the simulation laboratory and clinical performance;

NUR 314-A Acute Care of the Adult Patient I

5. Recognize the nurses role as part of the interdisciplinary health care team as measured by

clinical performance and participation in clinical conferences;

6. `Demonstrate precise written and therapeutic oral communication skills as measured by

participation in clinical conferences, case study, nursing care plans, and clinical

performance;

7. Identify processes and procedures that influence continuous efforts to maintain safety and

improve quality as measured by participation in clinical conferences, and case study.

8. Demonstrate responsibility for one's own learning and professional practice in the delivery of

client care as measured by performance in the simulation laboratory and clinical

performance.

TEACHING STRATEGIES: Lecture/discussion, case studies, concept mapping,

story-telling, role-play, collaborative group work,

demonstration/return demonstration, clinical experience

EVALUATION:

Lecture: Exam 1 30%

Exam 2 30%

Final Examination 35%

Clinical: Nursing Care Plans P/F

Clinical Performance P/F

Performance in the Simulation Laboratory P/F

ATI Practice Exams 5points possible

ATI:

1. All students are required to achieve at least 50% on the ATI Targeted Medical-

Surgical practice tests that correspond with the syllabus for NUR 314

(Perioperative, Fluid Electrolyte, and Acid-Base, Respiratory, and

Cardiovascular).

2. Students are to complete RN Fundamentals Online Practice 2013 A by week 6.

All students regardless of the score achieved on the online practice assessment,

are required to complete an ATI Focused Review and remediation assignment.

The remediation assignment is as follows: for each topic listed in the Focused

Review report, the student must complete an active learning template and/or

identify three critical points to remember. The remediation assignment must be

hand-written and handed to the course coordinator prior to the proctored exam

(Week 8). Each student must spend a minimum of one hour in the Focused

Review and hand in their remediation assignment to be awarded credit (2 points).

3. Students will then take the RN Fundamentals Proctored Assessment (Week 8).

The student’s score on the ATI proctored exam will result in the rewarding of

additional points (see chart below)

NUR 314-A Acute Care of the Adult Patient I

4. No student will be allowed to take the proctored exam without completing the

Targeted Medical-Surgical 2013 Practice tests, the RN Fundamentals Online

Practice 2013 A, and the Focused Review/remediation assignment.

ATI Credit

Targeted Medical-Surgical 2013:

Perioperative

Fluid, Electrolyte, and Acid-Base

Cardiovascular

Respiratory

Achieve at least 50% on all practice assessments

2 pts.

Complete Practice Assessment and

Remediation:

• Minimum one hour Focused Review

• Complete active learning templates and/or three critical points

to remember for each topic missed

Proctored Assessment

Level 3

3 pts.

Level 2

2 pts.

Level 1

1 pt.

Below Level 1

0 pts.

Program Procedures

Academic Integrity and Ethics

At Concordia College – New York, we are guided in all of our work by the values of

academic integrity and ethics: honesty, trust, fairness, responsibility, and respect. As a

student, you are required to demonstrate these values in all of the work you do.

Participating in behavior that violates academic integrity and ethics (e.g., plagiarism,

unauthorized collaboration, multiple submissions, cheating on examinations, or

fabricating information) will result in your being sanctioned. Violations of Concordia

College’s academic integrity and ethics policies are very serious and documentation of

violations will be forwarded to the office of the Dean of Students where records are kept

for five years after the student graduates or withdraws from the college. Violations may

subject you to disciplinary action including the following: receiving a failing grade on an

assignment or examination; receiving a failing grade for the course; and/or suspension or

expulsion from the program and/or college. Refer to the Student Guide section on

Academic Integrity and Ethics for complete policies.

NUR 314-A Acute Care of the Adult Patient I

Academic Integrity All students are expected to comply with Concordia College’s and

the Division of Nursing’s Academic Integrity Policy. Plagiarism is the use of work by

another as one’s own. Cheating is the use of “aides” or the theft of information from

another. Both of these activities violate the premise of academic integrity and

professional nursing standards. Academic dishonesty in any form will result in

disciplinary action including but not limited to course failure. Students are responsible to

refer to the Undergraduate Nursing Handbook, 2015 and the College Student Handbook.

Accommodations for Students with Documented Disabilities

Concordia College complies with Section 504 of the Rehabilitation Act of 1973 and the

Americans with Disabilities Act of 1990 as amended by the ADA Amendments Act of

2008. Students with disabilities who need special accommodations must submit

documentation of the disability to the Concordia Connection Program in order for

reasonable accommodations to be granted. Students are encouraged to notify their

instructors and the Connection Program as soon as they determine accommodations are

necessary; however, documentation will be reviewed upon receipt at any point in the

semester. The Connection Program will partner with students to determine the

appropriate accommodations and, in cooperation with the instructor, will work to provide

all students with a fair opportunity to perform in the particular class. Specific details of

the disability will remain confidential between the student and the Connection Program,

unless the student chooses to disclose or there is legitimate academic need for disclosure

on a case-by-case basis.

Attendance

Attendance is expected for all class sessions including both lecture and

clinical/simulation laboratory sessions (as applicable to the course) for successful course

completion. All students are required to be punctual for all lecture and laboratory

sessions. Students are responsible for all missed work. Instructors are under no

obligation to provide make-up quizzes or examinations or to extend deadlines. 100%

attendance is required for all lab/clinical/simulation rotations (refer to the Nursing

Student Handbook).

College and Program Policies: Refer to Nursing Program and College Handbook

REQUIRED TEXTBOOKS:

Ackley, B., & Ladwig, G. (2014). Nursing Diagnosis Handbook, (10th Ed).

Philadelphia: Elsevier Mosby.

Deglin, J. & Vallerand, A. (2014). Davis’s Drug Guide for Nurses, (14th Ed).

Philadelphia: F. A. Davis Company.

Halter, M.J. (Ed.) (2014). Varcarolis’ Foundations of Psychiatric-Mental Health

Nursing (7th ed.). St. Louis: Elsevier-Saunders.

NUR 314-A Acute Care of the Adult Patient I

Lewis, S., Dirksen, S., Heitkemper, M. & Bucher, L. (2014). Medical-Surgical Nursing,

(9th Ed.). St. Louis: Elsevier Inc.

Pagana, K. & Pagana, T. (2015). Mosby’s Laboratory and Diagnostic Test Reference

(12th ed.). Philadelphia: Elsevier Mosby.

Gray-Morris, D.C. (2013). Calculate with Confidence (6th ed.). Philadelphia: Elsevier

Mosby.

RECOMMENDED:

Potter, P & Perry, A. (2012). Fundamentals of Nursing, (8th Ed.). Philadelphia: Elsevier Mosby

NUR 314-A Acute Care of the Adult Patient I

Week Content Preparation for Class

Week I

October 14

8:30 to 11 am

Ms. Alfano

I Management of Perioperative Patients

A. Categories and Purposes of Surgery

B. Surgical Settings

C. Preoperative Assessment and Teaching

D. Members of the Surgical Team

E. Preparation of the Surgical Suite and Team

and Team Safety

F. Anesthesia

G. Care of the patient in the Intraoperative Period

H. Post-operative care

Lewis, S., Dirksen, S.,

Heitkemper, M. & Bucher, L.

(2014). Medical-Surgical

Nursing, 9th Ed. St. Louis:

Elsevier Inc

Chapters 18, 19, 20

Week 2

October 19

8:30 to 11 am

Dr. Alfano

Oct. 21

8:30 to 11 am

Ms. Alfano

II. Care of patients with Problems with Oxygenation

A. Care of Patients with Infectious Resp. Problems

1. Pneumonia

2. Pulmonary tuberculosis

B. Care of Patients with Noninfectious

Lower Respiratory Problems

1. Chronic airflow limitation

a. Asthma

b. COPD

Lewis & Dirksen: Chapter 28, pp 551-553

Lewis & Dirksen: Chapter 29, pp. 560-601; 607-608.

Week 3

October 26

8:30 to 11 am

Ms. Orlofsky

October 28

8:30 to 11 am

Ms. Orlofsky

Exam 1 – Oct. 28 Wednesday 2:20 to 3:30 Content from

Weeks 1 & 2

C. Care of Patients with Critical Acute

Respiratory Problems

1. Pulmonary embolism

2. Acute Respiratory Failure & Acute Respiratory

Distress Syndrome

1. Care of the Patient on a Ventilator

D. Hematologic System

1. Red blood cell disorders

2. Platelet disorders

3. Transfusion therapy

Lewis & Dirksen: Chapter 28 - pp. 551-553

Chapter 68

Chapter 66, pp. 1613-1629

Lewis & Dirksen

Chapters 30 & 31

Week 4

Nov 2

8:30 to 11 am

Ms. Kulk

Nov 4

8:30 to 11 am

Ms. Kulk

III. Psychosocial Needs of Medical Surgical Patients

A. Care of the Patient with Anxiety and Fear

1. Generalized Anxiety Disorder

2. Phobias

3. Panic Disorder

4. Post-traumatic Stress Disorder

5. Obsessive-Compulsive Disorder

B. Loss, Grief, and Depression

1. Normal grief reactions & coping process

2. Depressive Disorders

3. Suicide

Halter, M. (2014) Varcarolis’s

Foundations of Psychiatric Mental

Health Nursing, A Clinical

Approach.

Chapter 15

Chapter 14

Chapter 25

NUR 314-A Acute Care of the Adult Patient I

Week Content Preparation for Class

Week 5

November 9

8:30 to 11 am

Ms. Alfano

November 11

8:30 to 11 am

Ms. Orlofsky

Exam II – November 10th Tuesday 2:20 to 3:20

Content from Weeks 3 & 4

IV. Care of patients with Problems in Cardiac Output and

Tissue Perfusion

A. Care of the Patients with Shock

1. Oxygenation and Tissue Perfusion

2. Types of shock

3. Care of the Patient Experiencing

Hypovolemic Shock

4. Care of the Patient with Sepsis and Septic

Shock

C. Care of Patients with Vascular Problems

1. Arteriosclerosis and atherosclerosis

2. Hypertension

Lewis & Dirksen:

Review Chapter 17

Chapter 67

.

Lewis & Dirksen:

Chapter 34

Chapter 33

Week 6

November 16

8:30 to 11 am

Ms. Orlofsky

November 18

8:30 to 11 am

Ms. Orlofsky

D. Care of Patients with Acute Coronary Syndromes

1. Coronary artery disease

2. Angina

3. Myocardial infarction

E. Care of Patients with Dysrhythmias

1 Normal rhythms

2. Atrial dysrhythmias

3. Ventricular dysrhythmias

Lewis & Dirksen:

Chapter 34

Lewis & Dirksen:

Chapter 36

NUR 314-A Acute Care of the Adult Patient I

Week Content Preparation for Class

Week 7

November 23

8:30 to 11 am

Dr. Flaherty

V. Care of patients with Central Nervous and

Peripheral Nervous System Disorders

1. Guillain-Barre

2. Myasthenia Gravis

3. Multiple Sclerosis

Lewis & Dirksen:

Chapter 61, pp. 1467-1468

Chapter 59, pp. 1437-1439

Chapter 59, pp. 1428-1432

Week 8

November 30

8:30 to 11 am

Dr. Flaherty

VI. Care of patients with Traumatic Brain Injuries and

Central Nervous System Injuries/Problems

A. Traumatic Brain Injury 1. Incidence/risk factors

2. Pathophysiology

a. Types of traumatic brain injury

b. Intracranial Pressure

c. Cerebral Perfusion

3. Nursing care

a. Acute care

b. Rehabilitation: promoting maximum

functional, cognitive, memory,

judgment, and emotional stability

levels.

4. Care of client experiencing coma

5. Community Support Systems & Research

B. Care of the patient with seizures

1. Types of Seizures

2. Treatments & Nursing Care

3. Safety precautions

Lewis & Dirksen:

Review Chapter 56

Lewis & Dirksen:

Chapter 57, pp. 1368-1375

Lewis & Dirksen:

Chapter 59, pp. 1419-1427

December 2

8:30 to 11 am

Dr. Flaherty

C. Spinal Cord Injury

1. Incidence/risk factors

2. Pathology

a. Levels of injury and related functional

levels

b. Neurological impairment

3. Nursing care

a. Acute care

b. Rehabilitation: promotion of

maximum functional levels &

prevention/management of

complications

4. Community support systems & research

Lewis & Dirksen::

Chapter 61, pp. 1469-1485.

December 2nd

Wednesday

ATI Proctored Exam: 3:00 to 4:30 Room TBA

December 7th

Monday

Final Exam: 2:30 – 4:00 pm, Room 201

Content from Weeks 5, 6, 7, & 8 will be on the final exam.

TBA Med Math Calculation Exam for NUR 315