UNIVERSITY OF ARKANSAS AT MONTICELLO

SCHOOL OF NURSING

NURS 332V - CONCEPTS IN NURSING CARE II

Spring 2014

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TABLE OF CONTENTS

Course Description ...........................................................................................................................1

Credit................................................................................................................................................1

Prerequisite ......................................................................................................................................1

Corequsite ........................................................................................................................................1

Required Textbooks .........................................................................................................................1

Faculty..............................................................................................................................................1

Office Hours.....................................................................................................................................1

Time .................................................................................................................................................1

Recommended Textbooks ................................................................................................................2

Special Policies ................................................................................................................................3

Disclaimer ........................................................................................................................................4

Special Dates of Concern To The Course ........................................................................................4

Clinical Objectives ...........................................................................................................................4

Tests and Evaluations ......................................................................................................................4

Grade Report Policy .........................................................................................................................4

Methods of Instruction .....................................................................................................................5

Content Outline ................................................................................................................................7

Class Objectives .............................................................................................................................12

Appendices .....................................................................................................................................44

Appendix A: Evidence Based Practice Summary (EBPS) Guidelines ..........................................45

Appendix B: Clinical Evaluation Tool and Nursing Care Plan Rubric ........................................................................................48

Appendix C: Community Clinical Evaluation Tool ......................................................................58

Appendix D: Clinical Objectives Perioperative .............................................................................61

Appendix E: Clinical Journal Guidelines Kids First ......................................................................64

Appendix F: Nursing Process and Care Plan Guidelines Pathophysiology ...................................68

Appendix G: Erickson’s Developmental Stages and Tasks ...........................................................77

Appendix H: Presentation Guidelines ............................................................................................82

Appendix I: Process Recording Guidelines ...................................................................................85

Appendix J: Specifics for Course Self Concept/Psychic Intergrity (Nursing Process) .................89

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Appendix K: Teaching Plan Guidelines ........................................................................................93

Appendix L: Course Calendar .......................................................................................................97

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UNIVERSITY OF ARKANSAS AT MONTICELLO School of Nursing

NURS 332V - Concepts in Nursing Care II

Instructor(s): Leia O’Fallon MSN, ANP and Belinda Wells MSN, ANP

Office Location: Sorrels Instructor Telephone Numbers: 1-870-460-1069 Instructor Email Address:ofallon@uamont.edu, wells@uamont.edu Office Hours: Ms. O’Fallon Ms. Wells Monday 1:00-3:00 Monday 1:00-3:30 P.M. Tuesday 1:00-3:00 Tuesday 1:00-3:30 P.M. Wednesday 9:00-12:00 1:00-3:00

Wednesday 9:00-12:00 P.M (by appointment) 1:00-3:30 P.M.

Friday 9:00-3:00 (by appt.) Friday (by appointment) Course Title and Credit Hours: NURS 332V Concepts in Nursing Care II Eleven (11) hours: 7 hours theory; 16 hours clinical Time: Class: Monday 9:00 A. M. - 12:30 P. M.

Tuesday 9:00 A. M. - 12:30 P. M. Clinical: Wednesday 12:00 P.M. - 4:00 P. M. Thursday 6:45 A.M. - 2:30 P. M. OR Wednesday & Thursday: Surgical Rotation TBA

Course Description: Application of the nursing process to individuals and families in communities. The focus is client adaptation within the physiological and self-concept modes. Prerequisites: NURS 311V and NURS 3103 Corequisite: NURS 3333 Required Textbooks: Abrams, A. (2014). Clinical drug therapy: Rationales for Nursing Practice. (10th ed.).

Philadelphia: Lippincott.

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Berman, A. & Snyder, S., Kozier, B., Erb, G., (2012). Fundamentals of Nursing: Concepts, Process and Practice. (9th ed.). St. Louis; Mosby. Upper Saddle River. Prentice Hall. Clark, M. (2008). Community health nursing: Advocacy for population health (5th ed.). New Jersey: Prentice Hall Davis, F.A., (2013). Taber’s Cyclopedic Medical Dictionary. (22th ed.). Philadelphia: Davis. Gayhart, Betty L. & Nazareno, A. (2014). Intravenous Medications (29th ed.). St. Louis;

Mosby. Hockenberry, M .& Wilson, D. (2011). Wong’s nursing care of infants and children (9th ed.). St. Louis: Mosby. Kee, J. (2014). Laboratory and diagnostic tests with nursing implications (9th ed.). Menlo Park, CA: Addison-Wesley. (ISBN 978-0-13-507405-3) Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical

surgical nursing: Assessment and management of clinical problems (6th ed.). St. Louis, MO.

UAM BSN Student Handbook (2013). Unpublished. Recommended Textbooks: American Psychological Association. (2010). Publication Manual of the American

Psychological Association (6th ed.). Washington, D.C.: American Psychological Association.

Ralph, S. S., & Taylor, c. M. (2014). Sparks and Taylor’s nursing diagnosis reference manual (9th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. Student Learning Outcomes: By the conclusion of this course, the student will be able to: 1. use the nursing process to provide prioritized, therapeutic nursing interventions to promote, maintain, and restore the health of culturally and ethnically diverse individuals and families in communities throughout the lifespan 2. formulate judgments using a problem solving process that is goal directed, ethical, and based on standards of professional nursing practice to provide care to individuals and families

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3. demonstrate effective communication with individuals, families, and members of the

health care team to provide health care in a variety of settings; 4. identify and apply nursing research findings related to protection, nutrition, fluid and

electrolytes, and psychic integrity needs; 5. utilize therapeutic nursing interventions in providing prioritized, quality health care to

individuals and families in a variety of settings; 6. implement strategies to promote cost effectiveness in providing quality health care; and 7. apply teaching learning principles in educating individuals and families to promote, maintain, and restore health. Special Policies: Regular and prompt attendance is a professional behavior and expected of all students. Students are responsible for notifying the instructor of each class of the intent to be absent or tardy. UAM policy provides that an instructor may involuntarily withdraw from class (without prior notice) any student who has consistently missed class. Students who are tardy or absent may be counseled by faculty and documentation will be placed in the student’s file. Refer to the BSN Student Handbook for policies on clinical attendance. Refer to UAM Student Handbook for specific policies. Course Requirements: 1. Class participation based on assigned preparation. 2. Achieve course and clinical objectives and requirements (including process recordings,

clinical journals, teaching plans, case study, presentations, and bib cards). 3. Submit written assignments on the date specified

4. Participate in all scheduled activities. 5. Adhere to all policies and procedures in the Nursing Student Handbook. 6. Attend and participate in weekly conferences with clinical instructor as needed. 7. Submit self-evaluation narrative identifying strengths and weaknesses and plans for important.

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Disclaimer: Care has been taken to ensure that the information contained within the syllabus is accurate and complete at the time of printing, however, due to constraining events and/or circumstances which may necessitate change, the School of Nursing faculty reserve the right to amend any information contained within this syllabus. Students will be informed in a timely manner of any changes made. Clinical Objectives: See Clinical Evaluation Tool and Weekly Clinical Objectives Tests and Evaluations: 1. Written examinations. Points possible may vary with each exam. 2. Four (4) Evidence Based Practice Summaries (EBPS), one each for content related to (1)

protection, (2) nutrition, (3) fluid and electrolytes and (4) physical self of the self-concept mode. Article must be approved by assigned instructors. Satisfactory nursing care plans and (1) teaching plan and two (2) satisfactory process recordings. (See Appendices for guidelines and evaluation criteria).

3. Clinical evaluation conferences. Self-evaluation to be submitted at final conference. 4. Assignments and quizzes as designated by faculty or syllabus. Grading Policy: Satisfactory completion of course requirements: To pass the course, a 74% must be achieved when all examination scores are averaged. Clinical component of the course is evaluated by the clinical instructor and course coordinator and must be satisfactorily completed prior to progression. Achievement of 74% of total possible points is required to pass the theory component of the course. The course grade will be calculated as follows:

Unit Exams (5) 75% Final Comprehensive Exam 20% Miscellaneous (quizzes, EBPS, formal papers, process recordings) 5% Total 100%

Additionally, students are required to score 85% on a drug dosage calculation examination prior to completion of this course. Grade Report Policy UAM will no longer mail grade reports to all students. You may access your grades through WeevilNet on the UAM homepage, http://www.uamont.edu/. To have your grades mailed to you, complete the grade request form available in the Registrar’s Office in Monticello or the Student Services offices in Crossett and McGehee.

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Special Dates of Concern To The Course: See Course Calendar Methods of Instruction: Lecture

Discussion Presentations

Small group projects Computer assisted instruction (CAI) Role playing Experiential learning (clinical experiences with client care and process recordings)

Students with Disabilities:

It is the policy of the University of AR at Monticello to accommodate individuals with disabilities pursuant to federal law and the University’s commitment to equal educational opportunities. It is the responsibility of the student to inform the instructor of any necessary accommodations at the beginning of the course. Any student requiring accommodations should contact the Office of Special Student Services located in Harris Hall room 120; phone 870-460-1026; TDD 870-460-1626; Fax 870-460-1926. Student Conduct Statement: Students at the University of Arkansas at Monticello are expected to conduct themselves appropriately, keeping in mind that they are subject to the laws of the community and standards of society. The student must not conduct him/herself in a manner that disrupts the academic community or breaches the freedom of other students to progress academically. Academic Dishonesty:

1. Cheating: Students shall not give, receive, offer, or solicit information on examinations, quizzes, etc. This includes but is not limited to the following classes of dishonesty:

a. Copying from another student’s paper b. Use during the examination of prepared materials, notes, or texts other than those specifically permitted by the instructor; c. Collaboration with another student during examination; d. Buying, selling, stealing, soliciting, or transmitting an examination or any material purported to be the unreleased contents of coming examinations or the use of any such material; e. Substituting for another person during an examination or allowing such substitutions for oneself.

2. Collusion: Collusion is defined as obtaining from another party, without specific approval in advance by the instructor, assistance in the production of work offered for

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credit to the extent that the work reflects the ideas of the party consulted rather than those of the person whose name in n the work submitted. 3. Duplicity: Duplicity is defined as offering for credit identical or substantially unchanged work in two or more coursed, without specific advanced approval of the instructors involved. 4. Plagerism: Plagerism is defined as adopting and reproducing as one’s own, to appropriate to one’s use, and to incorporate in one’s oen work without acknowledgement the ideas or passages from the writings or works of others. For any instance of academic dishonest that is discovered by the instructor, whether the dishonesty is found to be cheating, collusion, duplicity, or plagiarism, the result for the student(s) involved will be appearance before the School of Nursing Professional Standards and Review Committee as outlined in the UAM Nursing Student Handbook.

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NURSING 332V CONCEPTS IN NURSING CARE II CONTENT OUTLINE

I. Course Overview II. Mission, Philosophy and Organizing Framework

A. Mode B. Needs C. Nursing Process D. Standards of practice E. Ethical and legal considerations F. Research

III. Self-Concept Mode A. Physical self

IV. Lifespan A. Pediatric Standards of Care B. Developmentally appropriate communication and teaching techniques C. Health promotion

D. Health Fairs V. Interdependence Mode

A. Individuals and families in communities 1. Family theory 2. Assessment

a. Home visits VI. Self-Concept Mode

A. Family crisis B. Violence

VII. Physiological Mode A. Fluid and electrolytes

1. Fluid Balance/Imbalance 2. Electrolyte Balance/Imbalance 3. Acid-base balance 4. Compartmental fluid shifts

a. Shock b. Burns

5. Pharmacological agents a. Intravenous fluid and electrolytes b. Topical anti-infective

6. Lab and diagnostic tests a. Electrolytes

VIII. Physiological Mode A. Protection

1. Peri-Operative a. Preoperative b. Intraoperative 1. Surgical scrubbing, gowning, and gloving

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c. Postoperative d. Pharmacological agents

1. anesthetics 2. anesthesia 3. Drugs to control bronchial secretion

2. Healing process a. White blood cells (WBC) b. Inflammatory process c. Wounds and care d. Fever e. Pharmacological agents

1. Antipyretics 2. Anti-infective

3. Immunity a. Acquired b. Passive c. Natural d. Autoimmunity e. Hypersensitivity reactions

1. Allergy 2. Acute asthma

f. Immunodeficiency/HIV/AIDS 4. Communicable diseases and immunizations throughout the lifespan

a. Rubella, roseola and rubeola b. Mumps c. Varicella d. Hemophilus influenza type B e. Pertussis f. Diphtheria g. Tetanus h. Polio i. Hepatitis j. Influenza and pneumonia vaccines k. Tuberculosis skin testing

5. Poisonings a. Aspirin and acetaminophen b. Industrial and agricultural agents c. CNS stimulants d. CNS depressants e. Inhalants f. Cannabis and hallucinogens

6. Cancer a. Incidence throughout the lifespan b. Types

Leukemias Lymphomas

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c. Treatment modalities 1. Chemotherapy 2. Radiation 3. Surgery 4. Pharmacological agents

a. Neoplastic 7. Connective tissue disorders a. Adult rheumatoid arthritis

b. Juvenile rheumatoid arthritis c. Systemic lupus erythematosis d. Scleroderma e. Marfan’s Syndrome f. Other connective tissue disorders

8. Infectious Respiratory Disorders a. Influenza b. Acute bronchitis c. Pneumonia d. Respiratory Syncytical Virus (RSV) e. Croup f. Bronchiolitis g. Epiglottis h. Pharyngitis i. Tuberculosis j. Pharmacological agents

9. Drugs to treat tuberculosis a. Antiviral

B. Nutrition 1. Childhood nutritional disorders

a. Phyenylketonuria (PKU) b. Colic c. Celiac disease d. Short bowel syndrome e. Marasmus f. Kwashiorkor g. Failure to thrive h. Cystic fibrosis

C. Elimination 1. Gastrointestinal disorders

a. Inflammatory disorders 1. Appendicitis 2. Meckel diverticulum 3. Diverticulitis 4. Ulcerative colitis 5. Crohn=s disease 6. Irritable bowel syndrome

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b. Obstructive disorders 1. Mechanical

a. Intussusception b. Volvulus

2. Vascular 3. Neurogenic

a. Intestinal obstruction b. Hernias c. Hirschsprung=s Disease d. Pyloric stenosis e. Esophageal atresia

2. Tumors a. Benign b. Malignant

3. Pharmacological agents 1. Cholinomimetic 2. Anticholinergic

4. Ulcers 5. Other gastric disorders

a. Gastritis b Gastric trauma

6. Gastrointestinal Surgery 1. Gastrectomy 2. Colectomy 3. Weight loss

D. Oxygenation 1. Arterial Blood Gases ( ABGs) 2. Blood components 3. Blood types 4. Blood transfusion 5. Lab and diagnostic tests

a. Complete blood count (CBC) b. Prothrombin time, partial thrombin time (PT, PTT) c. Type and crossmatch d. Platelets e. Coombs f. Folate, iron and folic acid levels g. Bone marrow aspiration

6. Anemia a. Acute hemorrhagic b. Iron deficiency c. Pernicious d. Folate deficiency e. Hemolytic f. Sickle cell anemia g. Thalassemia

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h. Polycythemia i. Aplastic

7. Bleeding disorders a. Thrombocytopenic

8. Coagulation disorders a. Hemophilia b. Acquired c. Disseminated intravascular coagulation (DIC)

9. Pharmacological agents a. Anticoagulants b. Drugs to treat anemia

E. Childhood neurologic disorders a. Meningitis b. Encephalitis c. Neural tube defects d. Hydrocephalus e. Cerebral palsy

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Class 1: Overview of Course Mission, Philosophy and Organizing Framework Objectives: Upon completion of this class, the student will be able to: 1. identify and relate course and clinical requirements; 2. identify the UAM School of Nursing Mission, Goals, Philosophy and Organizing

Framework; 3. apply the American Nurses Association Standards of Clinical Nursing Practice and Code for Nurses; 4. apply the UAM Teaching/Learning Principles; 5. identify the six curriculum strands and apply to course objectives; 6. utilize Erickson=s developmental tasks to assess clients in given situations; 7. demonstrate use of critical thinking applying the nursing process in given situations; 8. use the nursing process to integrate the three roles of the professional nurse in the care individuals, families, and communities; 9. utilize the contents of the Nursing Student Handbook (UAM) to determine policy,

mission and goals; and 10. demonstrate Acaring@ of the client by promoting an atmosphere of mutual respect and

trust in a collaborative environment while providing hope, support and compassion to assist in the achievement of desired outcomes;

11. communicates effectively in verbal/nonverbal interactions between the student and the client, significant others and members of the health care team; 12. effectively validate activities associated with client care through written recordings that reflect quality and accountability in the provision of that care; 13. demonstrate a knowledge of and sensitivity to the beliefs and values of the client as well as the impact of diversity on the health care experience; 14. assist clients in varying locations on the wellnessBillness spectrum to meet their own health care needs, including maintenance of health and/or restoration of function; 15. facilitate the client=s acquisition of knowledge, skills and attitudes that lead to a positive change in health behavior; and 16. demonstrate critical thinking in the delegation and prioritization of care in given client care situations throughout the lifespan. Preparation: Review: NURS 332V Syllabus Lewis 8th : Chapter ,1, 2 Review: UAM BSN Student Handbook

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Class 2: Self-Concept Mode: Overview and Physical Self Objectives: Upon completion of this class, the student will be able to: 1. describe the components of the self-concept; 2. in given situations, identify factors affecting body image throughout the lifespan

including loss, low self-esteem, altered body image, sexual dysfunction and rape trauma syndrome;

3. describe the major types of body image disturbances that can occur with illness; 4. differentiate between communication techniques that are developmentally appropriate for

infants, children and adolescents; 5. identify developmental issues which necessitate the formulation of teaching/learning

plans for health promotion in children and adolescents; 6. apply the standards of practice for the pediatric client in given client situations; 7. formulate an assessment of self-concept using the nursing process in given client

situations; 8. utilize the nursing process to plan prioritized care for clients with body image disturbances; 9. develop play activities that may be effectively incorporated into nursing care for the

hospitalized child to facilitate learning, adjustment to a new situation, and expression of feelings; and

10. select opportunities for health promotion with the pediatric client as outlined by Healthy Children 2020. Preparation: Lewis 8th: pp. 5 & 6 Roy: Chapter 14 Hockenberry 9th: Chapters 1, 4, 6 p. 794-796 Review: Healthy People 2012 available in UAM Library

(call # RA427.8, H 557, 2000, Volumes I and II) Healthy People 2020 http://www.healthypeople.gov/2020/default.aspx Videos: NVT 54 Inpatient Play Assessment and Therapy

NVT 55 The Pediatric Nurse as Teacher NVT 56 Understanding the Pediatric Patient

78519 Young Children=s Reactions To Hospitalization Appendix J: Self-Concept/Psychic Integrity (Nursing Process)

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Class 3: Wellness Fairs – Student Presentations Objectives: Upon completion of these classes, the student will be able to: 1. describe various settings appropriate for Wellness Fairs to target vulnerable populations throughout the lifespan; 2. demonstrate a variety of effective educational display designs; 3. develop educational displays targeting identified population-based health care needs according to priority; 4. collaborate with a community agency chosen to meet identified health care needs of the chosen population; 5. identify additional community resources available to Wellness Fair participants; 6. develop or acquire educational materials appropriate for distribution at an educational display; 7. demonstrate physical assessment skills by providing health screenings including but not limited to heights and weights, blood pressures and pulse oximetry; 8. utilize ethical and legal principles when exhibiting health information to diverse populations in Wellness Fair Setting; 9. define health promotion and health education; 10. explain health as a value and determine common barriers to health; 11. define and identify vulnerable populations; 12. differentiate between illness, disease and health; 13. contrast primary, secondary and tertiary disease prevention; and 14. define screening and explain relevance of screening to preventive health care of prevalent health problems and appropriate screening methods for infants, toddlers, preschool children, school-age children, adolescents, young adults, middle-age adults, and the elderly adult; and 15. identify effective methods to promote health. Preparation: Clark: pp. 264-266, 267-270 Activities:

Six weeks prior to Wellness Fair, students will be divided into groups. Each group will choose a population based health care need, seek and secure a community agency partner, and begin development of their educational display.

Five weeks prior to Wellness Fair, each group will submit the name of their chosen community agency partner, a time line of meetings with this agency and a first draft of their educational display for preview by instructor.

Three weeks prior to Wellness Fair, each group will submit an update of their progress to the instructor.

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Group Presentation:

One week prior to Wellness Fair, each group will present their educational display in class, complete with screening equipment, educational handouts, and recruitment materials.

Appendix I: Presentation Guidelines & Evaluation Criteria

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Classes 4 & 5: Interdependence Mode: Family Theory and Assessment Objectives: Upon completion of these classes, the student will be able to: 1. describe the family as a social system; 2. utilize family and development theories to guide effective client use; 3. identify the characteristics of a healthy family and utilize during client assessments; 4. select family health risks and vulnerable families in given situations; 5. rotate the effect of family health to the health of the community; 6. identify common adaptive behaviors and coping mechanisms inherent in families; 7. describe the components of family health assessment; 8. analyze the structure, functions, and interactions of a family through a given case study; 9. utilize critical thinking to determine demographic, psychological,

social, and spiritual influences on the family; 10. utilize the nursing process in reference to the family as a unit of care including ECO

maps and Genograms; 11. utilize evaluation criteria during a family case study (see Appendix K); 12. apply therapeutic communication to enable and empower families in given situations; 13. employ principles of personal safety in making home visits; and 14. utilize information in assigned videos to plan quality nursing interventions in given client

situations. Preparation: Clark 5th : Chapter 14 Hockenberry 9th: Chapter 3

Assignment: Answer the following question briefly on 5 x 8 index card and bring to class. There are numerous advantages in home visits as a method of health care delivery. Explain what you see as one of the major advantages for the client and nurse.

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Class 6: Self-Concept Mode: Family Crisis and Violence Objectives: Upon completion of this class, the student will be able to: 1. define crisis and crisis intervention; 2. compare and contrast developmental and situational crisis; 3. identify how various theoretical approaches to crisis intervention can be incorporated into the nursing process; 4. identify family health issues that provoke family crisis including violence, abuse and homelessness; 5. describe various types of human abuse found in families and communities; 6. determine the effect of crisis on the social integrity needs of family members; 7. apply ethical and legal principles in caring for clients who are victims of violence and

other forms of maltreatment in given situations across the lifespan; 8. plan prioritized nursing strategies that ensure culturally sensitive care for clients experiencing violence or homelessness;

9. select measures to promote a safe, effective care environment for clients experiencing violence;

10. identify community resources for individuals, families and communities in given situations of crisis; and

11. utilize current research findings related to family crisis and violence to effectively care for clients in given situations. Preparation: Clark 5th: Chapter 32, Hockenberry 8th: pp. 631-641, 661, 766-767, 794 Lewis 8th: p. 1781 Videos: 78771 – W MEDcom: Victims of Abuse and Neglect: Meeting Identification

and Reporting Standards Domestic Violence: Faces of Fear (In Class) Assignment: Review and be prepared to discuss Arkansas Senate Bill 103: Act to implement the findings of the Arkansas Legislative Task force on Abused and Neglected Children. Review Appendix M.

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Class7: Physiologic Mode: Fluid and Electrolytes, Acid-Base Balance/Imbalance Objectives: Upon completion of this class, the student will be able to: 1. explain osmosis, diffusion, active transport and filtration; 2. describe the composition and distribution of body water throughout the lifespan; 3 describe the mechanisms of fluid movement and regulation; 4. explain the pathophysiology of fluid and electrolyte imbalances, including potassium,

sodium, phosphorus, magnesium, calcium, and chloride; 5. describe the assessment of a client with fluid and electrolyte balance/imbalance (excess

or deficit); 6. identify adaptive and ineffective behaviors associated with dehydration and

overhydration in given situations; 7. interpret laboratory and diagnostic tests for clients with fluid and electrolyte imbalances

in given situations; 8. identify good food or fluid sources for replacement of potassium, sodium, phosphorus,

magnesium, calcium and chloride; 9. identify medical management, nursing assessment and therapeutic nursing interventions

for clients with fluid and electrolyte imbalances to promote need integrity in given situations, throughout the lifespan;

10. explain the function of aldosterone and antidiuretic hormone (ADH) in fluid balance; 11. utilize the nursing process in the administration of medications used in the treatment of

electrolyte imbalances; 12. identify cost-effective nursing strategies for providing nursing care to individuals with

fluid and electrolyte imbalances; 13. identify research findings related to fluid and electrolyte imbalances and utilize those

findings when planning nursing care of clients; and 14. implement nursing measures to provide a safe, effective care environment for clients with

fluid and electrolyte imbalances; 15. explain the pathophysiology of acid-base imbalances including respiratory; 16. in given situations, identify appropriate medical diagnosis and management, nursing

assessment and prioritized, therapeutic nursing interventions for clients with acid-base imbalances to promote need integrity throughout the lifespan;

17. interpret laboratory and diagnostic tests for clients with acid-base imbalances; 18. utilize the nursing process in the administration of medications used in the treatment of

acid-base imbalances; 19. implement nursing measures to provide a safe, effective care environment for clients with

acid base imbalances; 20. identify research findings related to acid-base imbalances and utilize those findings when

planning client care as appropriate; and 21. utilize information from assigned video and CAI to plan quality client care in given

situations.

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Class 7 cont’d: Physiologic Mode: Fluid and Electrolytes, Acid-Base Balance/Imbalance Preparation: Abrams 9th: pp. 911 - 920 Lewis 8th: Chapters 17, pp. 501-502 Kee 8th: pp. 63-66, 84-90, 96-100, 123-125, 291-293, 325-327, 335-340, 385-388, 412-418, 630 Kozier 9th: Chapter 52 Hockenberry 9th: Chapter 28 (Review), Chapter 29 Videos: NVT 02 or NVT 57 Body Fluids: The Critical Balance - Part I NVT 03 or NVT 58 Body Fluids: The Critical Balance – Part II

NVT 81 Assessing Fluids and Electrolytes

Fluid and electrolyte tutorial for Lewis Text: Review this supplemental on-line resource.

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Class 8: Physiologic Mode: Fluid & Electrolytes - Shock Objectives: Upon completion of this class, the student will be able to: 1. explain the pathophysiology of shock; 2. explain the hormonal and hemodynamics of shock; 3. differentiate between the major problems in shock relevant to the etiologies of

cardiogenic shock and hypovolemic shock; 4. identify the incidence, medical diagnostic measures and management, utilizing nursing

process and select prioritized, therapeutic interventions (including rationale) for clients experiencing shock to promote need integrity throughout the lifespan;

5. select common laboratory and diagnostic tests for clients experiencing shock and interpret them in given situations;

6. utilize the nursing process in the administration of medications for treatment of shock; 7. implement cost-effective strategies for providing care to individuals experiencing shock;

and 8. plan effective measures to provide a safe, effective care environment for the client

experiencing shock in given situations. Preparation: Abrams 9th: Chapter 51 Lewis 8th: pp. 1717-1739 Kee 8th: pp. 180, 316-318, 320 -332, 358 - 360 Hockenberry 9th: pp. 1100-1108 Assignment: Review drug information for Dopamine HCL (Intropin), Epinephrine HCL (Adrenalin), Amrinone (Inocor), Dobutamine (Dobutrex), Milrinone (Primacor), Norepinephrine (Levophed), Phenylephrine (Neo-synephrine), Drotrecogin Alpha (Xigris), Hydrocortisone (Solu-Cortef), Nitroglycerine (Tridil), Sodium Nitroprusside (Nipride), Vasopressin (Pressyn) for class. End of content for Exam 1

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Class 9: Exam I Class 10: Physiologic Mode: Fluid & Electrolytes, Burns Objectives: Upon completion of this class, the student will be able to: 1. explain the pathophysiology of burns related to fluid and electrolyte needs; 2. differentiate between superficial (1st degree), partial thickness (2nd degree), full thickness (3rd degree) and fourth degree burns (4th degree); 3. identify factors that determine the severity of burns; 4. describe the three classifications of burn injuries throughout the lifespan as defined by the American Burn Association and specify recommended treatment measures; 5. in given situations identify types of burn, incidence, medical diagnostic measures and management, nursing process and prioritized, therapeutic interventions (including rationale) for clients with burns to promote need integrity throughout the lifespan; 6. explain the four phases of burn care; 7. implement measures to provide a safe, effective care environment for clients with burns; 8. determine threats to self-concept related to burn injuries; 9. utilize the nursing process in the administration of medications for treatment of burns; 10. utilize ethical and legal principles in caring for clients with burns in given situations; 11. plan effective nursing strategies that ensure culturally sensitive care for client with burns; 12. identify community resources for potential referral of clients with burns; 13. implement cost-effective strategies for providing care to individuals with burns; and 14. identify current research related to utilize in planning care of clients with burns. Preparation: Abrams 9th: Chapter 6, Chapter 32 – Sulfonamide content Lewis 8th: Chapter 25 Kozier 9th: pp. 680-681 tetanus content Hockenberry 9th: pp. 1109-1132 Assignment: Review drug information for Silver Sulfadiazine (Silvadene Cream), Mafenide

Acetate (Sulfamylon), Acticoat Dresing, Aquacel Ag Dresing and Silver Nitrate for class.

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Class 11: Physiologic Mode: Protection – Preoperative Care Objectives: Upon completion of this class, the student will be able to: 1. utilize the components of the preoperative assessment during a given client assessment; 2. describe the medical management, nursing assessment and utilize prioritized, therapeutic

interventions (including rationale) for the preoperative client to promote need integrity throughout the lifespan;

3. utilize the nursing process in the administration of preoperative medications; 4. apply the Standards of Practice when caring for a surgical client; 5. implement nursing measures to provide a safe effective care environment for a given surgical client; 6. utilize cultural, ethical, and legal principles in caring for clients experiencing surgical

interventions; 7. select cost-effective strategies for providing care to the preoperative client; 8. demonstrate effective preoperative teaching for client needing surgical intervention; and 9. apply current research findings related to the care of a preoperative client when appropriate. Preparation: Review: surgical aseptic technique, care of clients with pain and surgical skin preparation Abrams 9th: Chapters 6 and 20 Lewis 8th: Chapter 18 Kozier 9th: pp. 960-973 Hockenberry 9th: pp.1005-1008 CAI: Preoperative skills-unit one In Class Demonstration: Surgical Handwashing, Gowning and Closed Gowning Assignment: 1) Review drug information for atropine sulfate, Robinual, Inapsine and Versed

and 2) develop a preoperative teaching plan for a client undergoing surgery to include turning, coughing, and deep-breathing, splinting, using incentive spirometry and bring to class.

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Class 12: Physiologic Mode: Protection - Intraoperative Care Objectives: Upon completion of this class, the student will be able to: 1. determine the classification of surgery in given situations; 2. explain the roles of members of the surgical team in assisting the client to adapt to threats to protection needs; 3. identify responsibilities of the nurse in regard to client advocacy, culture, legal and

ethical issues in giving situations during the intraoperative period; 4. identify common anesthetic agents used during surgery; 5. utilize the nursing process in the administration of anesthetics/anesthesia used during the intraoperative period; 6. determine potential intraoperative complications and select prioritized, measures to alleviate; 7. implement nursing measures to provide a safe effective care environment for the intraoperative client; and 8. utilize current research to plan the care of the surgical client when appropriate. Preparation: Abrams 9th: Chapters 6, Appendix D Lewis 8th: Chapter 19 Kozier 9th: pp. 973-976 CAI: A Surgical Patient Abdominal Surgery Assignment: Review the drug information Fentanyl, Pancuronium, Thiopental Sodium (Pentothal), Xylocaine, Succinylcholine, Etomidate (Amidate), Isoflurane Propofol (Diprivan), Ketamine (Ketalar), Nitrous Oxide for class.

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Class 13: Physiologic Mode: Protection –Postoperative Care Objectives: Upon completion of this class, the student will be able to: 1. explain immediate postoperative nursing care measures and care measures upon return to the clinical unit include rationale; 2. determine incidence, medical diagnostic measures and management, utilize nursing process and prioritized, therapeutic interventions (include rationale) for clients with postoperative complications throughout the lifespan; 3. interpret lab data for the postoperative client in given situations; 4. utilize the nursing process in the administration of postoperative medication; 5. determine nursing diagnoses, interventions, rationales, and goals, for the postoperative client in given situations; 6. utilize cultural, ethical, and legal principles when caring for a given postoperative client; 7. implement measures to provide a safe, effective care environment for postoperative

clients; 8. implement appropriate discharge teaching for the postoperative client; 9. identify community resources for referral of clients who have experienced surgical

intervention; 10. determine cost-effective strategies for providing care for the postoperative client; 11. identify current research findings and relate findings to the care of a postoperative client; and 12. apply information in assigned video and CAI to provide quality client care. Preparation: Abrams 9th: Chapter 6 Lewis 8th: Chapter 20 Kozier 9th: pp. 976-994 Video: 78533 Post Anesthesia Nursing: Guidelines for Care Assignment: 1) Review drug information for Promethazine (Phenergan), Ondansetron (Zofran), Meperidine (Demerol), Morphine Sulfate and Narcan for class. 2) Develop and bring to class a teaching plan for the postoperative client including the signs and symptoms of infection and care of an incision. End of Content for Exam II

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Class 14: Physiologic Mode: Protection - Healing Objectives: Upon completion of this class, the student will be able to: 1. determine the classification, function and characteristics of the white blood cells (WBC’s); 2. identify and describe the three stages of the inflammatory process; 3. explain the physiology of wound healing including types of repair; 4. identify the incidence, medical management, utilize nursing process and prioritized, therapeutic interventions (including rationale) for clients with wounds to promote need integrity throughout the lifespan; 5. list factors influencing healing; 6. differentiate between wounds according to classification; 7. explain the mechanism and manifestations of fever; 8. identify the three stages of fever; 9. select usual medical management, nursing assessment and utilize prioritized, therapeutic interventions (including rationale) for clients with fever to promote need integrity throughout the lifespan; 10. choose the mechanisms, types, clinical signs, and medical management of hypothermia; 11. identify disorders related to thermoregulation and select appropriate nursing assessment measures along with effective interventions (cite rationale) in given client situations; 12. implement measures to provide a safe, effective care environment for clients with altered protection in given client situations; 13. utilize cost-effective strategies for providing care to individuals with ineffective protection; 14. identify familial and folk remedies commonly used in healing; 15. utilize the nursing process in the administration of antipyretics; and 16. select current research related to the care of wounds and utilize research finding to plan nursing interventions when appropriate. Preparation: Abrams 9th: Chapter 7 (review) Lewis 8th: pp. 186-199 Kee 8th: pp. 180-181, 696 Kozier 9th: Chapter 34 (review) Hockenberry 9th: pp. 686-694 Video: 78531 - Nursing Management of Wounds (review) Assignment: 1) Formulate on an index card the components of the CBC, normal’s throughout the lifespan and clinical problems associated with abnormal levels and bring to class and 2) review drugs acetaminophen, aspirin, and ibuprofen.

26

Class 15: Physiologic Mode: Protection - Antiinfectives Objectives: Upon completion of this class, the student will be able to: 1. determine the appropriate classification of antibiotics (antiinfectives) cited below in assignments; 2. select factors that influence the outcome of antibiotic therapy; 3. identify and explain problems with antibiotic therapy; 4. utilize the nursing process in the administration of antiinfectives including penicillins and cephalosporins, quinolones, penicillin substitutes, tetracyclines and chloramphenicol, amino glycosides, sulfonamides, trimethoprim, and nitrofurantoin; 5. identify cost-effective strategies for providing care for individuals taking antiinfective agents in given client situations; and 6. determine priorities of the nurse when administering antibiotics in given situations. Preparation: Abrams 7th: Chapters 29-31, 33(Antinfectives) Kozier 9th: Chapter 31 Lewis 8th: pp. 238-239 Assignments: Review drug information for Amoxicillin (Amoxil), Cephradine (Velosef), Ciprofloxacin (Cipro), Erythromycin (E-Mycin), Tetracycline (Sumycin), Gentamicin (Garamycin), and Sulfamethoxazole (Bactrim), Levaquin, Rocephin, Vancomycin HCL and Ertapenem (Invanz) for class.

27

Class 16: Physiologic Mode: Protection - Immunity (Allergies and Asthma) Objectives: Upon completion of these classes, the student with be able to: 1. explain the pathophysiology of the immune system; 2. contrast cellular and humoral mediated immunity; 3. describe natural, passive, and acquired immunity in given situations; 4. identify and explain immunoglobins, types of allergens, and mediators involved in the

types of hypersensitivity reactions; 5. identify the incidence, medical diagnostic measures and management, and implement appropriate nursing and prioritized, therapeutic intervention measures (including rationale) for clients with allergies and asthma to promote need integrity throughout the lifespan; 6. utilize the nursing process in the administration of bronchodilators, antihistamines and

drugs controlling bronchial secretions; 7. interpret laboratory and/or diagnostic tests commonly used for clients with

hypersensitivity reactions; 8. utilize ethical and legal principles in caring for clients with allergies in given situations; 9. implement nursing strategies that ensure culturally sensitive nursing care for clients with

allergies and asthma; 10. implement measures to provide a safe, effective care environment for clients with allergies and asthma; 11. identify community resources for referral of clients with allergies and asthma; 12. select cost-effective strategies for providing care to individuals with allergies and asthma;

and 13. identify current research related to allergies and asthma and utilize findings to plan nursing interventions when appropriate. Preparation: Abrams 9th: Chapters 38, 43, 44 and 45 Lewis 8th: Asthma: pp. 588-604 Allergies: pp. 221-225, 363, 446 Kee 8th: pp. 258-260, 565-577, 587 -597 Hockenberry 9th: pp. 528-529, 1261-1280 Videos: Managing Childhood Asthma - for viewing by parents (useful for client teaching)

Winning Against Asthma - for viewing by pediatric client (optional) Environmental Control

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Assignment: Review drug information for Immune Globulin Intravenous (IGIV), Dipenhydramine (Benadryl), Albuterol (Proventil), Theophylline, or Cromolyn sodium (Intal), Singulair, Advair, Levalbuterol (Xopenex), Metaproternol (Alupent), Ipratropium (Atrovent), Terbutaline (Brethine), Tiotropium (Spiriva), Ipratropium/Albuterol (DuoNeb) for class.

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Classes 17: Physiologic Mode: Protection- Immunodeficiency (HIV/AIDS) Objectives: Upon completion of these classes, the student will be able to: 1. explain the pathophysiology of HIV/AIDS and indicate incidence; 2. choose incidence, common medical diagnostic measures and management, utilize nursing

process and prioritized, therapeutic interventions (including rationale) for clients with HIV/AIDS to promote need integrity throughout the lifespan;

3. interpret laboratory and diagnostic tests for clients with HIV/AIDS; 4. identify current research findings related to pharmacological treatment of HIV/AIDS and

apply findings in given situations when appropriate; 5. utilize the nursing process in the administration of medications used in the treatment of

HIV/AIDS; 6. identify community resources for referral clients with HIV/AIDS; 7. select cost-effective strategies for providing care for individuals with HIV/AIDS; 8. implement ethical and legal strategies in caring for clients with HIV/AIDS; plan nursing strategies that ensure culturally sensitive nursing care for clients with HIV/AIDS; and 9. implement measures to provide a safe effective care environment for clients with HIV/AIDS. Preparation: Abrams 9th: Chapter 35 and 36 Lewis 8th: pp. 241-255 Clark 5th: pp. 122-123,812,813T,820-823,831-832 Kee 8th: pp.239-251 Hockenberry 9th: pp.673, 765, 790-793, 800, 1452-1456

Videos: NVT 74 Living with AIDS

M132 Living with HIV 78523 Care of HIV Infected Children

Assignment: Review drug information for Ritonavir (Norvir), Lamivudine (Combivir), Zidovudine (Retrovir), Amphotericin B deoxycholate (Fungizone) for class.

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Class 18: Exam II Class 19: Physiologic Mode: Protection - Communicable Diseases and Immunizations Objectives: Upon completion of this class, the student will be able to: 1. explain the pathophysiology, etiology and identify the incidence of childhood rubella,

roseola, rubeola, mumps, varicella (chickenpox), pertussis (whooping cough), diphtheria, polio, tetanus, hepatitis, and hemophilus influenza type B;

2. determine the incidence, medical diagnostic measures and management, and utilize nursing process and utilize prioritized, therapeutic interventions (include rationale) for clients with communicable diseases cited in objective # 1 to promote need integrity throughout the lifespan;

3. identify the sequence and scheduling of childhood immunization therapy; 4. utilize the nursing process in the administration of immunomodulars used in the treatment of communicable diseases; 5. determine nursing responsibilities associated with administering influenza and pneumonia adult vaccines; 6. describe the procedure of tuberculosis skin testing; 7. apply ethical and legal principles when administering immunizations in given client situations; 8. utilize ethical and legal principles when caring for clients with a communicable disease; 9. implement nursing strategies that ensure culturally sensitive nursing care for clients with communicable diseases; 10. identify cost-effective strategies for providing care to individuals with communicable disease; 11. identify community resources for prevention of communicable disease; and 12. identify current research findings for potential use in the care of clients with a

communicable disease or who is receiving immunizations. Preparation: Abrams 9th: Chapter 39 Clark 5th: pp. 48, 120-124, 822-823, 826-834, 841-844 Kozier 9th: pp. 680-681t (adults). 678-679t (children and adolescents) Lewis 8th: pp. 211-212 Hockenberry 9th: pp.129, 495-509, 607-616, 695, 767-768, 937-938, 1232, 1288, 1376, 1451-1452, 1455-1458, 1479, 1535, 1540 Assignment: Review drug information for Hepatitis B Vaccine, MMR (measles, mumps, rubella), Influenza Vacccine, hemophilus b conjugate vaccine, and Inactivated Polio Virus Vaccine (IPV), Varicella Virus Vaccine (Varivax), Toxoid, Tetnus and Diptheria toxoid (adult Td) for class

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Class 20: Physiologic Mode: Protection –Protection-Poisonings-Student Presentations Objectives: Upon completion of these classes, the student will be able to: 1. determine the toxicodynamics, toxicokinetics, pharmacokinetics of the drugs cited in group 1 to 6 below; 2. identify populations at risk for abuse of drugs in group 1 to 6 below; 3. implement the nursing process in given situations of clients receiving or abusing the

medications cited in groups 1 to 6 below; and 4. indicate common medical treatment for clients using or abusing the drugs cited below (including priority of care). Group 1: Aspirin and Acetaminophen

Group 2: Industrial and Agricultural Agents: Arsenic, Cyanide, Pesticides, Defoliants, and Lead

Group 3: CNS Stimulants: Caffeine, Nicotine, Amphetamines (Crystal/Meth), Cocaine/Crack

Group 4: CNS Depressants: Narcotic Analegesics, Sedative-Hypnotics, Barbiturates, Benzodiazpines and alcohol. Group 5: Inhalants: Glue, Gasoline, Aerosols, Paint, and Solvents Group 6: Cannabis and Hallucinogens

Preparation: Abrams 9th: Chapters 8, 14, 15, Review Chapter 19, p. 308 Lewis 8th: pp. 1779-1781 Clark 4th: Chapter 26, p. 154-155 Kozier 9th: pp. 843-846 Hockenberry 9th: pp. 5, 510-511, 514, 516, 580-581

Appendix H: Presentation Guidelines and Evaluation Criteria Activity: Group presentation: 45 minutes minimum to 60 minutes maximum End of content for Exam III

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Class 21: Health Fair Presentations Classes 22 & 23: Physiologic Mode: Elimination- Gastrointestinal Disorders Objectives: Upon completion of these classes, the student will be able to: 1. explain the pathophysiology of gastrointestinal disorders including inflammatory and

obstructive disorders (appendicitis, Meckel diverticulum, diverticulitis, ulcerative colitis, values, Crohn=s, intussusception, obstruction, hernias, Hirschsprung, pyloric stenosis, benign and malignant tumors, gastritis, ulcers, trauma, Mallory-Weiss syndrome, irritable bowel syndrome, Zollinger-Ellison Syndrome) and identify the incidence of each;

2. identify the common medical diagnostic measures and management, utilize nursing process and implement prioritized, therapeutic nursing interventions (including rationale) for clients with gastrointestinal disorders in given situations to promote need integrity throughout the lifespan;

3. interpret laboratory and diagnostic tests for clients with gastrointestinal disorders including endoscopic studies, radiographic studies, computed tomography (CT),magnetic resonance imaging (MRI) and gastric analysis and implement nursing process with clients receiving these tests or studies;

4. explain the procedure for obtaining stool for guaiac and ova and parasites; 5. utilize the nursing process in the administration of cholinomimetics and anticholinergics used in the treatment of gastrointestinal disorders including medical treatment for ulcers; 6. utilize ethical and legal principles when caring for clients with gastrointestinal disorders; 7. implement nursing strategies that ensure culturally sensitive nursing care for clients with gastrointestinal disorders; 8. identify community resources for referral of clients with gastrointestinal disorders; 9. select cost effective strategies for providing care to individuals with gastrointestinal disorders; 10. identify current research findings related to gastrointestinal disorders; and 11. implement nursing measures to provide a safe, effective care environment for clients with gastrointestinal disorders. Preparation: Abrams 9th Review Chapter 56, 59, 60, 61, 62 Lewis 8th: Chapter 39, 41, pp.986-1001, 1015-1051 Kee 8th: pp.197, 311-312, 320-321, 470-472, 494-496, 498-502 Hockenberry 9th: pp.1089-1100 (Review), 1305-1326 Assignment: Review drug information for Metoclopramide (Reglan), Cimetidine HCL (Tagmet), Misoprostol (Cyotec), Omeprazole (Prilosec), and Famotidine (Pepcid), Esomeprazole Magnesium(Nexium).

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Class 24: Math Exam Class 25: Physiological Mode: Protection – Connective Tissue Disease Objectives: Upon completion of this class, the student will be able to: 1. explain the pathophysiology of Juvenile Rheumatoid Arthritis (JRA), Fibromyalgia,

Systemic Lupus Erythematosus (SLE), Marfan’s syndrome, polymyositis, dermatomyositis and scleroderma and identify the incidence of each;

2. select usual medical diagnostic measures and management, and utilize nursing process and prioritized, therapeutic interventions (including rationale) for clients with Juvenile Rheumatoid Arthritis (JRA), Systemic Lupus Erythematosus (SLE), Marfan’s syndrome, Polymyositis, fibromyalgia, dermatomyositis, and scleroderma to promote need integrity

throughout the lifespan; 3. interpret laboratory and diagnostic tests for clients with disorders cited in objective # 1; 4. utilize the nursing process in the administration of drugs to treat Juvenile Rheumatoid

Arthritis (JRA), Systemic Lupus Erythematosus (SLE), Marfan’s syndrome, and scleroderma;

5. utilize ethical and legal principles for caring for clients with connective tissue disorders; 6. implement nursing strategies that ensure culturally sensitive nursing care for clients with connective tissue diseases 7. identify community resources for referral of clients with Juvenile Rheumatoid Arthritis

(JRA), Fibromyalgia, Systemic Lupus Erythematosus (SLE), Marfan’s Syndrome, scleroderma and other connective tissue disorders cited in objective # 1;

8. identify current research findings related to the treatment of connective tissue disorders and utilize the finding when caring for clients when appropriate;

9. implement nursing measures to provide a safe, effective care environment for clients with connective tissue disorders; and

10. identify cost-effective strategies for providing care to individuals with connective tissue disorders. Preparation: Abrams 9th: Chapters 7, 41 and review Chapter 13 Lewis 8th: pp. 1649-1654, 1664-1673, 1674-1677 Kee 8th: pp. 383-384 Hockenberry 9th: pp. 1676-1682, 91t-94t, 419t Assignment: 1) Review information for Myochrysine, Methotrexate, Diclofenac, and Piroxicam for class. 2) Search the internet for information on Marfan’s Syndrome and bring an article to class. Be prepared to discuss findings.

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Class 26: Physiologic Mode: Protection – Infectious Respiratory Disorders Objectives: Upon completion of these classes, the student will be able to: 1. explain the pathophysiology of influenza, acute bronchitis, pneumonia, respiratory syncytial virus (RSV), croup and tuberculosis and identify the incidence of each; 2. select common medical diagnostic measures and management; utilize nursing process

and implement prioritized, therapeutic interventions (including rationale) for clients with influenza, acute bronchitis, pneumonia, respiratory syncytial virus (RSV), croup and tuberculosis to promote need integrity in given situations throughout the lifespan;

3. determine predisposing factors for acquiring infectious respiratory diseases; 4. interpret laboratory and diagnostic tests for clients with infectious respiratory diseases; 5. utilize the nursing process in the administration of pharmacological agents used in the

treatment of infectious respiratory diseases (include priorities); 6. utilize ethical and legal principles in caring for clients with tuberculosis; 7. implement nursing strategies that ensure culturally sensitive nursing care for clients with infectious respiratory disease; 8. identify community resources for referral of clients with infectious respiratory diseases; 9 identify cost-effective strategies for providing care to individuals with infectious respiratory diseases; 10. implement nursing measures to provide a safe effective care environment for clients with

infectious respiratory diseases; 11. identify current research findings related to infectious respiratory diseases and utilize

finding in care of clients when appropriate; and 12. apply information in assigned videos to provide quality client care. Preparation: Kozier 9th: Smoking p. 403, 1434 Abrams 9th: Chapters 38, 39 Lewis 8th: pp. 524-525, 546-557 Clark 4th: Review Appendix B for Specific Diseases Kee 8th: pp. 451-455 Hockenberry 9th: pp. 29-30, 1231-1232, 1241-1248, 1118-1119, 1284, 1255-1257 Videos: M124 TB: Prevention and Practices for Health Care Workers

M 137 The patient guide to TB Assignments: Review drug information for Isoniazid, Amantadine, Ribavirin, and Relenza.

Review the online CDC guidelines for Tuberculosis at www.cdc.gov/tb prior to class.

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Classes 27 & 28: Physiologic Mode: Protection Cancer Objectives: Upon completion of these classes, the student will be able to: 1. explain the pathophysiology of cancer (including leukemias and lymphomas) and identify the incidence; 2. describe the characteristics of malignancies; 3. describe the process of metastasis; 4. identify the medical diagnostic measures and management; utilize nursing process and

prioritized, therapeutic interventions (including rationale) for clients with cancer to promote need integrity throughout the lifespan;

5. interpret laboratory and diagnostic tests for clients with cancer; 6. utilize the nursing process in the administration of neoplastic drugs used in the treatment

of cancer; 7. identify various treatment modalities for cancer including chemotherapy, radiation, and surgery and indicate the advantages/disadvantages of each; 8. identify complications of cancer and cancer treatment, and implement therapeutic nursing interventions (including rationale) when caring for oncology clients; 9. explain the purpose for immunosuppression and select related nursing assessment and nursing interventions (including rationale) for clients receiving immunosuppressant in given situations. 10. implement measures to provide a safe, effective care environment for oncology clients; 11. utilize ethical and legal principles in caring for clients with cancer; 12. implement nursing strategies that ensure culturally sensitive nursing care for clients with cancer; and 13. identify cost-effective strategies for providing care to individuals with cancer; 14. identify community resources for referral of clients and family members of clients with cancer; and 15. identify current research findings related to cancer and utilize findings when caring for clients with cancer when appropriate. Preparation: Abrams: 9th: Chapter 42, (review) Chapters 6, 62 Lewis 8th: Chapter 16 Kee 8th: pp. 99-101, 698-709 Kozier 9th: pp. 1205, 1208t, 576t, 403-407, 1047t Hockenberry 9th: Chapter 36

36

CAI: Hematology Series - Lymphoma (non-Hodgkins), Anemia & Immunosuppression, Principles & Practice of Oncology Assignment: Review drug information for Cytoxan, Flurouracil, Methotrexate, Adriamycin Hydroxyurea, Vincristine, Taxol, Megace, Tamoxifen Citrate, for class. End of Content for Exam IV

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Classes 29 & 30: Physiologic Mode: Oxygenation – Hematologic Disorders Objectives: Upon completion of these classes, the student will be able to: 1. explain the anatomy and physiology of blood and blood forming organs; 2. interpret lab and diagnostic tests findings (CBC, platelets, ESR, reticulocytes,

prothrombin (PT), partial prothrombin time (PTT), bilirubin, coombs, B-12, folic acid (FA), Total Iron Binding capacity (TIBC), schilling, plasma proteins, electrophoresis, bone marrow aspiration) for clients with hematologic disorders and indicate nursing responsibilities associated with each test;

3. identify common blood types and the critical elements used to determine compatibility; 4. identify indications, advantages, precautions, and nursing interventions when caring for clients receiving common components of blood; 5. explain the procedure for administration of common blood products; 6. determine potential complications of blood and blood product transfusions; 7. identify the incidence, medical diagnostic measures and management, and utilize the nursing process to implement prioritized, therapeutic nursing interventions (including rationale) for clients with common hematologic disorders including anemias, bleeding and coagulation disorders throughout the lifespan; 8. identify ethical, legal, and religious beliefs that commonly affect the administration of blood and blood products in given situations; 9. implement nursing strategies that ensure culturally sensitive nursing care for clients with hematogic disorders in given situations; 10. utilize the nursing process in the administration of anticoagulants, antiplatelets, thrombolytics, and hemostatics and drugs used in the treatment of anemias (include priorities); 11. identify current research findings related to hematologic disorders and utilize findings

when planning client care when appropriate; 12. select cost-effective strategies for providing care to individuals with hematologic disorders; 13. identify community resources for referral of clients with hematologic disorders; and 14. implement nursing measures to provide a safe, effective care environment for clients with hematologic disorders; Preparation: Abrams 9th: Chapter 54 Lewis 8th: Chapters 31 Kee 8th: pp. 323-325, 340-341, 369-372, 376-379, 451-455 Hockenberry 9th: Chapter 35, pp. 295-299

38

Assignment: Review Drug information for Heparin, Lovenox, Warfarin(Coumadin) FeSo4, Vitamin B12, Vitamin K for class. Review index card of the components of the CBC developed in Class 11. Review typing and cross matching and administration of blood and blood products.

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Class 31: Exam IV Class 32: Physiologic Mode: Nutrition-Childhood Disorders Objectives: Upon completion of this class, the student will be able to: 1. describe the food pyramid and explain the use of the food pyramid to determine and

nutritional requirements of the pediatric client in given situations; 2. explain the pathophysiology of childhood nutritional disorders to include

Phyenylketonuria (PKU), colic, celiac disease, short bowel syndrome, marasmus, failure to thrive, kwashiorkor and cystic fibrosis and identify the incidence of each;

3. identify the medical diagnostic measures and management, utilize nursing process and implement prioritized, therapeutic interventions (including rationale) for childhood nutritional disorders to promote need integrity in given situations;

4. interpret laboratory and diagnostic tests for childhood nutritional disorders; 5. utilize ethical and legal principles when caring for children with nutritional disorders; 6. implement nursing strategies that ensure culturally sensitive nursing care for clients with childhood nutritional disorders; 7. dentify community resources for referral of clients and families experiencing childhood nutritional disorders; 8. select cost-effective strategies for providing care to individuals with childhood nutritional disorders; 9. identify current research findings related to childhood nutritional disorders and utilize findings when caring for clients when appropriate; and 10. implement nursing measures to provide a safe effective care environment for clients experiencing childhood nutritional disorders. Preparation: Abrams 9th: Chapter 57, pp. 435 Lewis 8th: Review pp. 923-940 Kee 8th: pp. 329-331 Hockenberry 9th: pp. 101-104, 304-308, 525-528, 532-538, 845, 1280-1289, 1325-1328

40

In Class Activity: 1) Work in small groups and develop teaching strategies a nurse may use to achieve compliance with special diet instructions for a child with PKU, celiac disease, short bowel syndrome, failure to thrive and cystic fibrosis.; and 2) Plan a weekly menu for a(n): a) Hispanic-American child with PKU b) Orthodox Jewish child with celiac disease; c) Nigerian child with Kwashiorkor

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Class 33: Physiological Mode: Childhood Neurologic Disorders Objectives: Upon completion of this class, the student will be able to: 1. explain the pathophysiology of neural tube defects, hydrocephalus, encephalitis, Reye’s

Syndrome, meningitis, and cerebral palsy (CP) and cite the incidence of each; 2. identify common medical diagnostic measures and management, and utilize nursing

process and implement prioritized, therapeutic interventions (including rationale) for a child with a neurologic disorder to promote need integrity;

3. explain the impact chronic illness or disability may have on the child and family with common neurologic disorders;

4. utilize ethical and legal principles when caring for children with a neurologic disorder; 5. implement nursing strategies that ensure culturally sensitive care for clients with common childhood neurologic disorders; 6. identify community resources for referral of children with a neurologic disorder; 7. select cost-effective strategies for providing care to individuals with childhood neurologic disorderrs; 8. identify recent research findings related to the treatment of childhood neurologic disorders and utilize when planning client care when appropriate; 9. determine the scope of practice role of the nurse, and utilize the standards of care outlined

by the ANA in the Standards of Nursing Practice for Early Intervention Services in the Care of Children and Adolescents with Special Health and Developmental Needs; and

10. implement nursing measures to provide a safe effective care environment for children with neurologic disorders. Preparation: Lewis 8th: pp. 1418-1419, 1422t, 1429, 1452-1453 Hockenberry 9th: pp. 101-103, 399-408, 522, 409-415, 1535-1542, 1543-1544, 1691-1701 End of Content for Exam V Class 34: Exam V

44

Appendices

45

Appendix A

Evidence Based Practice Summary (EBPS) Guidelines

46

University of Arkansas at Monticello School of Nursing

Evidence Based Practice Summary Guidelines (EBPS) NURS 332V Concepts in Nursing Care II

Purpose: EBPS are designed to assist the student in formulating judgments needed to use clinical data as a basis for professional practice.

Objectives:

Upon completion of the assigned number of EBPS, the student will be able to:

1. select articles related to specific needs; 2. summarize articles related to specific needs; and 3. demonstrate effective written communication.

Directions:

1. Submit EBPS related to specific needs.

2. Select an article based on current nursing research (less than or equal to 5 years). 3. Include bibliographic information, typed in APA format, at the top of 8 1/2" x 11" paper with a summary of the article. The summary should contain the purpose, design (type of study), sample, and conclusion. The summary should include an example of application of the research implication to the students practice. The summary should not be taken directly from the abstract of the article. 4. Submit a copy of the article with the EBPS. 5. Submit all EBPS on date specified (see course calendar). 6. Submit a copy of the Evaluation Criteria with each EBPS.

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University of Arkansas at Monticello School of Nursing

Evidence Based Practice Summary (EBPS) NURS 332V Concepts in Nursing Care II

Student:_____________________________

Evaluation Criteria:

Points Possible

(2) ____ 1. Submitted EBPS in APA format on 8 1/2" x 11" paper with a copy of the article.

(6) ____ 2. Summarized article, including purpose, design (type of study), population, (sample size) findings (statistical significance) and conclusions. (2) ____ 3. Identified one example of how research implications from the article could be applied in your practice.

10 (total points)

Comments: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Faculty:____________________________ Date:____________ Score: ____________

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Appendix B

Clinical Evaluation Tool &

Nursing Care Plan Rubric

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University of Arkansas at Monticello School of Nursing

Nursing Care Plan Grading Rubric Clinical Week:____________________ Student: __________________________ Location:_________________________

STANDARDS MET (M) (41-50 POINTS)

PP PROGRESSING (P) (30-40 POINTS)

PP UNMET(U) (< 30 POINTS)

MY SCORE

Assessment: Demographics Complete. 2 Partially Complete. 1 Incomplete/Not addressed

Pathophysiology Complete 5 Partially Complete 1-3 Incomplete/Not addressed Subjective &

Objective Data Data collected are consistent, pertinent, and accurate. No omissions.

9-12

Data collected are reasonably accurate. Minimal omissions.

8

Data collected are inaccurate or incomplete

Lab Data Data collected are consistent, pertinent, and accurate. No omissions.

4-5

Data collected are reasonably accurate. Minimal omissions.

3

Data collected are inaccurate or incomplete

Developmental Level

Assessment appropriate to chronological age/psychosocial development

2

Assessment appropriate to chronological age/psychosocial development

1

Assessment inappropriate for developmental level

Analysis of Data Consistently differentiates normal from abnormal findings

3

Fairly Consistent differentiation of normal from abnormal findings (<5 errors)

2

Inconsistently differentiation of normal from abnormal findings (>5 errors)

Nursing Diagnoses:

Identify all ineffective problems. Identifies the three components of diagnoses (PES). Appropriate NANDA classification supported by documented assessment data. Ranks all diagnoses in priority order.

2

Identify major ineffective problems. Identifies two components of diagnoses (PES). Appropriate NANDA classification supported by documented assessment data. Ranks all diagnoses in priority order.

1

Diagnoses are not written in PES format. No NANDA classification. Diagnoses not supported by data. Lacking prioritization.

Outcome Criteria: Short Term(ST) Discharge Goal(LT)

One ST and LT goal for each diagnosis. Related to diagnosis. Realistic & measurable. Client focused.

2

One goal identified for each diagnosis. Related to diagnosis. Fairly realistic & measurable. Client focused.

1

No goals identified. Unrelated to diagnosis. Unrealistic & nonmeasurable. Not client focused.

Nursing Interventions

Related to diagnosis. Appropriate rationales given. Client specific. Correctly identifies all critical interventions for each diagnosis. Medications and referrals are included as interventions. Correctly labels type of nursing order and if order promotes, maintains or restores health. (PMR)

9-12

Related to diagnosis. Appropriate rationales given. Fairly client specific. Identifies at least 5 interventions correctly stated for each diagnosis. Correctly labels at least five types of nursing orders and PMR.

8

Not related to diagnosis. Poor or nonexistent rationale. Non-specific. Less than 5 interventions or incorrectly stated interventions. Does not label type of order or PMR.

Evaluation of Outcome:

Correctly identifies achievement of all LT and ST goals based on assessment data.

2

Correctly identifies achievement of majority LT and ST goals based on assessment data.

1

Incorrectly identifies/omits achievement of ST/LT goals.

Presentation of NCP

No errors in spelling, grammar punctuation. Consistent, accurate use of terminology. Precise language. Legible print.

2-3

Minimal errors (<5) in spelling, grammar, punctuation. Fairly consistent use of appropriate terminology. Clear language. Legible print.

1

Multiple errors (>5) in spelling, grammar, punctuation. Inconsistent use of terminology. Unclear language. Illegible.

MET = >41 points Progressing= 30-40 points UNMET= <30 points

Total points possible = 50 Score:_________

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University of Arkansas at Monticello School of Nursing

Clinical Evaluation Tool The student is evaluated weekly on clinical performance, the Nursing Care Plan, and attendance. Students are expected to show consistent improvement in meeting the criteria throughout the semester, demonstrating progression of learning. The criterion for clinical performance is: Met = 2 points Able to initiate or perform independently or with minimal prompting, consistently, and/or safely. Progressing = 1 point Needs improvement. Unmet = 0 point Unable to perform independently, required repeated prompting, omitted and/or performed

Non-therapeutic care is observed. Not Applicable (NA) No opportunity for student to demonstrate behavior or instructor to observe student performance. Attendance: All clinical experiences are important and cannot be made up. Students are expected to notify the clinical

instructor if absent or tardy per the UAM Student Nurse Handbook. The criterion for attendance is: Present (P) Absent (A) Nursing Care Plan: See Nursing Care Plan Grading Rubric. Total Score possible for all components = 100 points. Criteria indicated with an asterisk (*) are considered critical performance requirements for passing. A “U” on a critical requirement may result in clinical failure. The student is to submit a copy of this evaluation with required paperwork at the end of each clinical experience. The clinical instructor will review the completed evaluation with the student when returning paperwork. The student is responsible for keeping all evaluations in the required clinical folder for all twelve weeks. They will be placed in your permanent file at the end of the semester.

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Clinical Site

Critical Component

PERFORMANCE BEHAVIOR 1 2 3 4 5 6 7 8 9 10 11 12

Provider Role Demonstrates application of nursing care plan to clinical

practice

Uses basic problem solving skills to identify problems and seeks assistance with problem solving.

Demonstrates caring behaviors towards the client, significant others, and health care team members.

Provides safe, cost-effective, and quality client care environment by performing nursing care competently in diverse settings.

Reports and documents client information accurately.

Demonstrates understanding of and correctly administers, documents, and evaluates effects of assigned client’s medications and treatments.

Understands and accurately verbalizes rationales of client care guidelines and procedures.

Performs accurate and complete physical assessment on Day 1 and focused assessment on Clinical Day 2.

Coordinator Role Assists the OHTM in the teaching of information to

clients and significant others as needed and information is consistent with the nurse’s knowledge.

Gives and receives nursing change of shift report in an effective manner.

Communicates effectively with the client family, instructor, peers and OHTMs.

Able to manage personal time/actions to work effectively in diverse client care settings.

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Critical Component

PERFORMANCE BEHAVIOR 1 2 3 4 5 6 7 8 9 10 11 12

Professional Role Demonstrates professional behavior and attitude with client

and family, OHTMs, instructors and peers.

Demonstrates preparation for clinical by verbalizing pathophysiology, (5 pts.) medications (5 pts.) and written plan of care during the clinical experience. (10 pts.) (20 pts. possible)

Receives feedback/criticism from evaluation in an assertive, positive manner.

Follows UAM Student Handbook related to clinical attire and equipment.

CLINICAL PERFORMANCE (50 points possible)

ATTENDANCE: P or A

NURSING CARE PLAN GRADE

TOTAL GRADE (NCP + Clinical Performance)

TOTAL POINTS (up to 100 points possible)

Four Week AVERAGE: %

___ ___ ___ ___ ___ ___ ___ ___ ___

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FACULTY AND STUDENT COMMENTS

Objective #, Clinical #, Comments, and Faculty Initials

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________

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FACULTY AND STUDENT COMMENTS

Objective #, Clinical #, Comments, and Faculty Initials

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Student Signature Faculty Signature Clinical Week

1. ___________________________________________

1. _____________________________________________

2. ___________________________________________

2. _____________________________________________

3. ___________________________________________

3. _____________________________________________

4. ___________________________________________

4. _____________________________________________

Status: Clinical Grade Average _______ Progressing satisfactorily toward meeting objectives ___________ Is not progressing satisfactorily toward meeting objectives __________ (See counseling record)

5. ___________________________________________

5. _____________________________________________

6. ___________________________________________

6. _____________________________________________

7. ___________________________________________

7. _____________________________________________

8. ___________________________________________

8. _____________________________________________

Status: Clinical Grade Average _______ Progressing satisfactorily toward meeting objectives ___________ Is not progressing satisfactorily toward meeting objectives __________ (See counseling record)

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Student Signature Faculty Signature

9. ___________________________________________

9. _____________________________________________

10. ___________________________________________

10. _____________________________________________

11. ___________________________________________

11. _____________________________________________

12. ___________________________________________

12. _____________________________________________

Final Evaluation Final Score ____________ Pass ___ Fail ____ _________________________________________ _____________________________________ Student Signature Faculty Signature _________________________________________ _____________________________________ Date Date

57 University of Arkansas at Monticello

School of Nursing Final Self-Evaluation

Instructions: For each of the behaviors listed below, circle the appropriate number using the following key: 5 = Excellent, 4 = Above Average, 3= Average, 2= Below Average, 1= Poor

Complete and return it to your clinical instructor during your final clinical evaluation conference. At the completion of this course: A. I would rate my assessment skills as ________. B. I would rate my ability to prioritize client problems as ________. C. I would rate my ability to formulate appropriate nursing diagnoses for client as________. D. I believe that may ability to write nursing interventions is ________. E. I would rate my ability to give safe and effective care to clients as ________. F. I believe that my ability to document and report findings about my client is _______. G. I would rate my ability to teach clients as________. H. I would rate my ability to evaluate outcomes of therapeutic nursing intervention as________. I. I would rate my ability to coordinate effective organized care in the clinical area as________. J. I would rate my ability to communicate with staff, students and instructors as________. K. I would rate my ability to provide cost effective care as ________. L. I would rate my use of critical thinking as ________. M. I would rate my professionalism as ________.

Overall Rating: __________ (an average of all ratings) Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Faculty: __________________ Student: _______________________

58

Appendix C

Community Clinical Evaluation Tool

59 University of Arkansas at Monticello

School of Nursing Community Clinical Evaluation Tool

Agency: The student involved in a community clinical experience will: 1. Discuss with the supervising nurse the objectives for the community experience; 2. Communicate with interdisciplinary health team members in regard to their roles related

to services offered by the agency; and 3. Demonstrate professional behaviors while involved in the assigned clinical experience. Evaluation:

The evaluation is to be completed by the community clinical nurse supervising the UAM nursing student. Please indicate your evaluation of the student’s performance on a 0-4 scale. The student must return the completed form to their clinical instructor at the completion of the community experience Rating scale: 4 = exceptional/outstanding 3 = consistently very good/above average 2 = satisfactory/average 1 = unsatisfactory/needs improvement 0 = not applicable 1. Correlated the community objectives to the community experience. 0 1 2 3 4 2. Scheduled and maintained attendance as agreed. 0 1 2 3 4 3. Accepted supervision, teaching and evaluation. 0 1 2 3 4 4. Dress (including make-up, jewelry, hair, etc) was appropriate for the experience. 0 1 2 3 4

60 5. Used professional communication skills and behaviors with other health care team

members. 0 1 2 3 4 6. Demonstrated responsibility for own learning by spending time wisely. 0 1 2 3 4 PERFORMANCE STRENGTHS: AREAS NEEDING DEVELOPMENT: OVERALL RATING: Has met objectives Has not met objectives COMMENTS: In addition to your evaluation of the student, we would be interested in any comments you wish to make regarding the community experience in order to make the experience more valuable. Agency Supervisor Signature: _______________________________________ Student Signature: _________________________________________________ UAM Clinical Instructor Signature: ___________________________________

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Appendix D

Clinical Objectives Perioperative

62 University of Arkansas at Monticello

School of Nursing NURS 332V - Concepts in Nursing Care II

Clinical Objectives (Perioperative)

For the perioperative clinical experience, the student will: 1. provide a brief description of the surgical procedures observed. 2. describe members of the surgical team and their roles; 3. prepare a NCP that addresses the following area for the perioperative client: a) oxygenation,

b) fluid and electrolytes, c) sensation, d) protection, e) elimination, and f) self-concept. 4. explain surgical asepsis, surgical hazards and anesthesia used in the surgical area; (Clinical) in the surgical area; (NCP & Clinical performance) 5. demonstrate administration of perioperative medications and explain associated nursing responsibilities; (Clinical performance) 6. interpret lab values and diagnostic test ordered preoperiatively and intraoperatively ; ( NCP) 7. demonstrate use of health assessment techniques and clinical skills performed in caring for surgical clients; (Clinical performance) 8. assess client behaviors related to coping, developmental stage and tasks, role function, interdependence, and self-concepts; (NCP ) 9. apply Standards of Performance and Code for Nurses in caring for surgical clients; and (Clinical performance) 10. demonstrate each of the three roles of the professional nurse while implementing caring for surgical clients.(Clinical performance)

63 University of Arkansas at Monticello

School of Nursing NURS 332V- Concepts in Nursing Care II

Clinical Journal Guidelines Criteria (Perioperative)

Student ______________________ Clinical Week #_______ Site___________________ Evaluation Criteria Points Possible (75) _____ 1. Described how clinical objectives were met and documented all activities: (10)__ A. Provided a brief description of the surgical procedures observed. (10)__ B. Identified members of the surgical team and their roles. (45)__ C. Described care of the perioperative client form admission to discharge. (10)__ D. Described diagnostic tests and interpret lab values for the client undergoing surgery. (10) _____ 2. Indicated h9ow each of the three roles of the baccalaureate prepared nurse were implemented in caring for clients in the perioperative areas. (10) _____ 3. Analyzed feelings or thoughts, values and/or attitudes about the clinical experience, including a self evaluation by analyzing personal strengths and weaknesses. (05) _____ 4. Submitted legible journal as directed and on time with appropriate spelling, grammar, and APA format as indicated. 100 (total points) Comments:___________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Faculty: ____________________________ Date: ________________ Score: ______________

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Appendix E

Clinical Journal Guidelines Kids First

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University of Arkansas at Monticello

School of Nursing NURS 332V Concepts in Nursing Care II

Community Clinical Journal Guideline Criteria (Kid=s First)

Student _________________________ Clinical Week #_______ Site_______________ Evaluation Criteria Points Possible 1._____ 1. Described how clinical objectives were met and documented all activities:

(10)_____ A. Provided a brief medical history for infant and toddler.

(10)_____ B. Identified client’s developmental stage and tasks using Erickson’s Stage of Development.

(45)_____ C. Described observations made of infant and toddler’s physical, cognitive, social and language development.

(10)_____ D. Summarized conclusions of child’s development based on observation and knowledge of normal infant toddler development.

(10) _____ 2. Described in detail therapies utilized in the care selected child with

developmental delays. (10) _____ 3. Analyzed feelings or thoughts, values and/or attitudes about the clinical

experience, including as self evaluation by analyzing personal strengths and weaknesses.

(5) ______ 4. Submitted legible journal as directed an on time with appropriate spelling,

grammar, and APA format as indicated. 100 (total points) Comments:____________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Faculty: ___________________________ Date_______________ Score:__________________ December 20, 2002

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UNIVERSITY OF ARKANSAS at MONTICELLO

School of Nursing NURS 332V Concepts in Nursing Care II

KIDS FIRST EXPERIENCE LOG GUIDELINES

Purpose: The Kid’s First Experience will provide an opportunity to learn about behavioral and developmental patterns in certain age groups and identify appropriate measures to help the child meet age-appropriate developmental milestones. Objectives: Upon completion of the Kid’s First Experience, the student will be able to: 1. demonstrate assessment of physiological and psychosocial growth of infants and toddlers and compare normals; and 2. identify behavioral and developmental milestones in infants and toddlers diagnosed as developmentally-delayed. Directions: 6. Select an infant and toddler to observe. Write a brief medical history for each client.

7. Perform appropriate screening tests as direted by age and conditionof client.

8. Identify and record the following observations (Do not copy the assessments from the client record)

a. Erickson’s Stage of Development- What stage is the child in according to development?

How well is child accomplishing developmental tasks?

b. Physical - (Infant) Observe the infant’s motor activity, such as head control, posture, use of the hands, and locomotion. What use does the infant make of his/her motor skills? Does the infant demonstrate age-appropriate behaviors. (Toddler) How does the toddler use his/her body? Are the child’s motions graceful or clumsy? Describe the standing stance and gait. Observe gross motor development versus fine motor development. How does he/she hold his or her hands?

c. Cognitive/Social - (Infant) What aspects of cognitive development were observable?

How does the infant explore the immediate environment? Is the infant, visually, attentive to people and objects? What is the infant’s reactions to objects or toys? Note how the infant examines and plays with toys. What kind of social stimuli is provided for the infant? How does the infant respond to the stimuli? What social behaviors does the infant demonstrate (i.e., smile, vocal, reaching out, following, cooing, attentiveness, etc.)

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(Toddler) Describe the toddler’s play. Note his/her choice of toys and activities. Look for examples of sex-typed behaviors. Is the play solitary, parallel, or cooperative? Where is the parent or staff while the child is playing? How does the child use the parent’s or staff’s presence? How far away from the parent or staff does the child move? How does the child respond when frustrated in play?

d. Language - (Infant) Listen to the sounds the infant makes and describe them? Are they appropriate for the age of the infant? (Toddler) Note the toddler’s use of grammar. How does the child express needs to the staff or parent? To other children? Does the toddler expect a response to his/her conversations? How much does the child use direct questioning? Monologue? How does the child respond to conversation? How does the parent or staff communicate with the child?

2. Write your conclusions drawn about the infant and toddler’s development in your journal.

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Appendix F

Nursing Process and Care Plan Guidelines Pathophysiology

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University of Arkansas at Monticello School of Monticello

Concepts in Nursing Care II Nursing Process and Care Plan Guidelines

Collect subjective and objective assessment data. See Clinical Data Collection Guidelines. Cluster the data: Group like data together using the systems approach. Identify grouped data as: Self Concept, Interdependence, Role Function, or Physiologic Mode (Activity & Rest, Sensation, Fluid & Electrolytes, Nutrition, Elimination, Endocrine, Oxygenation, or Neurological).

Interpret data: Assign meaning or determine what is significant. Recognize diagnostic cues and the direct or concealed meaning of cues. Analyze the data collected and determine the appropriate Nursing Diagnoses. Read the definition in Carpenito-Moyet to make sure you have chosen the appropriate Nursing Diagnosis. If the definition of the nursing diagnosis does not match the client’s condition, reconsider the nursing diagnosis Review the “Assessment” data in Carpenito-Moyet to make sure data is complete. Then enter the data on the Subjective and Objective data columns on the NCP form to support each Nursing Diagnosis. The data collected are the defining characteristics of each nursing diagnosis. If the data does not support the nursing diagnosis, you cannot use the diagnosis. The nursing diagnostic statement includes the health problem along with the related factor or factors and the signs and symptoms. The health problem can be selected from the list of NANDA Nursing Diagnoses if the cluster of signs and symptoms collected during assessment corresponds, at least in part, to the defining characteristics for a specific nursing diagnosis. Not all of the defining characteristics need to be observed or reported by the client to use the diagnosis. Diagnosis 3 Components: Problem – related to (r/t) etiology – as evidenced by Problem: NANDA approved nursing diagnosis are used must be clearly modifiable and specific. Etiology: Contribute to the existence or maintenance of the person’s health problem. Only one per diagnosis Signs/Symptoms: Must support problem and /or etiology. Example: Ineffective airway clearance R/T increased secretions AEB rhonchi, dsypnea, and expectorating thick secretions

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If more than one nursing diagnosis is identified, they must be prioritized to identify those requiring immediate intervention. They are prioritized according to Maslow’s Hierarchy of Needs. Assessment may reveal the client does not have an actual or evident health problem, but may suggest the presence of risk factors, thus indicating a high-risk diagnosis. Planning 1. Goals Generated from the problem component of the nursing diagnosis A positive statement of the desired health status or outcome Must be measureable: What action you expect to take place, under what conditions, how well, and time specific. Example: IV site will be free of edema and redness by 1500 on 10/15/08 Short term (within 24 hours) Discharge (directed toward prevention) 2. Nursing Interventions (NI) Generated from the etiology component of the nursing diagnosis Who, what, when, where and how (specific) Individualized Must indicate whether the NI is dependent, independent, or collaborative action (D,I, or C) Identify whether the NI will Promote, maintain, or restore health (PMR) Number and list sequentially (in order of priority) Must prevent, modify, remove, or control the etiology Rationales: Explain why the NI was implemented. The rationale does not have to be verbatim from the text. It can be paraphrased based on something you read and understood. Cite the page and text used to find this information. Example: NI: Check vital signs every 4 hours Rationale: VS are an important indicator of patient status (Kozier p.555) Example: NI: Administer Verapamil 240mg po q day Rationale: A calcium channel blocker used to dilate peripheral blood vessels (Not “LOWERS BP”) Abrams p.242 Implementation Executing the planned interventions (Includes documentation/ charting). Evaluation A statement related to goal achievement Conclusion: (1) Goal met – No further need for NI

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OR (2) Goal partially met – Some revision of nursing interventions needed or additional time for goal attainment OR (3) Goal not met - Modify goal, NI, and /or nursing diagnosis In NURS 332V Concepts II, you will select your own client assignment for clinical. If student managers are assigned to your area, they will assist you in selecting a client from the available prototypes. It is important that you select a client that you will learn the most from and who has a condition that you are or will be studying this semester. Due to client acuity level, you may be assigned one or two clients for the clinical rotation. Your clinical instructor will notify you and the student manager if it is your turn to take two client assignments. A Pathophysiology and Client Analysis Form must be submitted with the Nursing Care Plan for each client assigned. A full NCP addressing all ineffective problems will be submitted on the most acute care client when you care for two clients. The Pathophysiology and client analysis form and NCP addressing three priority problems will be submitted on the non-acute client.

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NURSING CARE PLAN

*Indicate dates and times when vital signs, labs and diagnostic studies were resulted. **Additional Comments: If the goal is PARTIALLY OR UNMET identify changes that need to be made to the NCP (i.e. Revise plan or modify interventions, more time is needed to observe outcomes etc.).

Revised 2/20/12

MODE________________

NEED________________

SUBJECTIVE DATA

Defining

OBJECTIVE DATA

Characteristics NURSING DIAGNOSIS INTERVENTIONS RATIONALES

Past Medical HX

AGE ADMITTING DIAG: SECONDARY DIAG: *VS OBSERVATIONS & BEHAVIORS MEDICATIONS (INCLUDING RELATED PRN’S)

*LABS

*DIAGNOSTIC FINDINGS

________________________ R/T_____________________ AEB: ________________________ _________________________ STG: The client will ________ _________________________ by (Date & Time)____________________ Priority Problem # _______ EVALUATION

__MET __**PARTIALLY MET __**UNMET

* provide comments below. DISCHARGE GOAL By discharge the client will: ______________________________ ______________________________ ______________________________ (If discharged evaluate this goal)

ONGOING ASSESSMENTS (Label each intervention type: dependent, independent or collaborative and if it will promote, maintain, or restore health) PRIORITY INTERVENTIONS

(Interventions should be critical to resolving the problem)

Cite page and text.

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Nursing Care Plan

SUBJECTIVE DATA

OBJECTIVE DATA

MODE________________ NEED_________________

NURSING INTERVENTIONS RATIONALES

NURSING DIAGNOSIS______________________ ______________________ ______________________ AEB__________________ ______________________ ______________________ Priority #_______________ STG______________________________________________________________ EVALUATION Met__________________ Partially Met* _________ Not Met*_____________ Discharge Goal ______________________________________________________________ EVALUATION Met _________________ Partially Met*_________ Not Met*_____________

*Additional comments regarding evaluation

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*Comments:

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UNIVERSITY OF ARKANSAS at MONTICELLO School of Nursing

NURS 311V – Concepts in Nursing Care II

PATHOPHYSIOLOGY AND CLIENT ANALYSIS FORM

Student:_________________________ Clinical Area: ________________________ Client Initials: ______________ Age: ______ Gender: __________ Primary Medical Diagnosis:_______________________________________________________ Pathophysiology (Include definition, cause, incidence.):________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Assessment Findings (What signs and/or symptoms would the typical client present with this diagnosis?):____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Diagnostic Tests/Procedures (What tests would be ordered for a client with this diagnosis?) ______________________________________________________________________________ ______________________________________________________________________________

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______________________________________________________________________________ ______________________________________________________________________________ Treatment (Include medications, supportive therapy, and type of surgical intervention, if applicable.):___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Teaching/Learning Needs: List priority learning needs for a client with this diagnosis?

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Appendix G

Erickson’s Developmental Stages and Tasks Erickson’s Developmental Learning Needs

78

DEVELOPMENTAL STAGES AND TASKS (Erickson)

INFANCY (BIRTH TO 18 MONTHS) TRUST VS. MISTRUST Establishing oneself as a very dependent being Beginning the establishment of self-awareness Developing a feeling for affection Becoming aware of the alive as against the inanimate, and the familiar as against the unfamiliar Developing rudimentary social interaction Beginning to adjust to the expectations of others Adjusting to adult feeding demands Adjusting to adult cleanliness demands Adjusting to adult cleanliness demands Adjusting to adult attitudes toward genital manipulation Developing physiologic equilibrium Developing eye-hand coordination Establishing satisfactory rhythms of rest and activity Exploring the physical world Developing preverbal communication Developing verbal communication Forming rudimentary concepts EARLY CHILDHOOD (18 MONTHS TO 3 YEARS-TODDLER) AUTONOMY VS SHAME AND DOUBT Achieving physiologic stability Learning to become physically independent while remaining emotionally dependent Expanding verbal communication Learning to control the elimination of body wastes Learning to coordinate large muscles and small muscles LATE CHILDHOOD (3 TO 5 YEARS - PRESCHOOL) INITIATIVE VS. GUILT Learning sex differences and developing sex modesty Learning to give affection and to share affection Beginning to interact with age-mates Relating emotionally to parents, siblings, and others Learning to identify with male and female adult roles Learning simple concepts about the social and physical world Learning to distinguish right and wrong, being obedient, and developing a conscience

SCHOOL AGE (6 TO 12 YEARS) INDUSTRY VS. INFERIORITY

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Building a wholesome attitude toward oneself Developing and refining skills in the use of small muscles Learning to form friendships with peers Learning to give as much love as one receives Learning appropriate behaviors for the masculine and feminine role and identifying with contemporaries of the same sex Learning to use language to exchange ideas or to influence listeners Learning more rules and developing a beginning sense of values, inner moral control, and respect for moral rules ADOLESCENCE (12 TO 20 YEARS) IDENTITY VS. ROLE CONFUSION Accepting changing body size, shape, and function in relation to others and understanding the meaning of sexual and physical maturity Achieving a socially accepted and satisfying masculine or feminine role and recognizing the distinctions and similarities in each Achieving new and more adult relationships with peers of both sexes Selecting and preparing for an occupation and economic independence Developing a workable set of values, ideals, and standards as a guide for behavior YOUNG ADULTHOOD (20 - 40 YEARS) INTIMACY VS. ISOLATION Select a life partner Choose an occupation or career Establish independence from parents and financial self-sufficiency Establish intimate relationships Establish a social network Form a personal philosophy and ethical structure MIDDLE ADULTHOOD (40 - 65 YEARS) GENERATIVITY VS. STAGNATION Accepting the changes of middle age Investing in a new generation Adjusting to the needs of aging parents Reevaluating life’s goals and accomplishments MATURITY OR LATE ADULTHOOD (65 YEARS TO DEATH) INTEGRITY VS. DESPAIR Accepting diminishing abilities and limitations Adjusting to retirement Adjusting to reorganized life patterns Accepting loss and death with serenity

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University of Arkansas at Monticello School of Nursing

ERICKSONS’ DEVELOPMENTAL LEARNING NEEDS

People learn from the day of birth to the day of death. Nurses should be aware of the normal learning needs of their clients and families during the lifespan and support these needs when appropriate. Consider the developmental learning needs in identifying what you should teach. Stage Infancy: Trust vs Mistrust, learns to love & be loved. Needs: 1. Learns by exploring the environment with his senses. 2. Learns best from primary care giver. 3. Learns best in structured, familiar routine. Stage Early Childhood: Autonomy vs Shame, learns to be independent & make decisions for self. Needs: 1. Learns best if activity leads to independent functioning. 2. Learns if activity is presented as a game. 3. Praise reinforces learning. Stage Late childhood: Initiative vs Guilt, learns how to do things (basic problem solving) & that doing things is desirable. Needs: 1. Instructions should be geared to child’s vocabulary. 2. Learns by observing & is able to return demonstrate a skill. 3. Learning centers on one characteristic at a time. 4. Learning is limited by short attention spans (5 minutes). Stage School age: Industry vs Inferiority, learns how to do things well. Needs: 1. Learning in short separate stages is most effective. 2. Immediate rewards & reinforcement increases learning. 3. Teaching plan must be modified to school & social schedule. 4. Teaching must be consistent to meet child’s sense of “right & wrong.”

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Stage Adolescence: Identify vs Role Confusion, learns who he is. Needs: 1. Learning should take place separately from parents. 2. Resist learning activities that make them different or conspicuous.

3. Adolescents are oriented to the present; they learn procedures & new information best if they can see how it will benefit them immediately.

Stage Young adulthood: Intimacy vs Isolation, learns to establish meaningful relationships. Needs: 1. Learning is related to change in relationships & environment. 2. Learning is best accomplished if cause & effect is presented. 3. Expectation of changes in roles & life-style are a great concern. Stage Middle adulthood: Generativity vs Stagnation, learns to be productive & creative in work & leisure. Needs: 1. Learning relates to adjustments necessitated by health problems, physiologic changes & anticipated requirements. Stage Maturity: Integrity vs Despair, learns to accept the worth & uniqueness of one’s own life. Needs: 1. Learning is most concerned with diminishing physical capacities. 2. Learning may be limited by diminished mental capacities. 3. Learning is often difficulty for an elderly person, repetition enforces learning.

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Appendix H

Presentation Guidelines

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University of Arkansas at Monticello School of Nursing

PRESENTATION GUIDELINES Purpose: Presentations allow the student to use critical thinking skills in the preparation

and presentation of content and to demonstrate effective communication skills.

Objectives: Upon completion of the oral presentation, the student will be able to: 1. organize, prepare, and present assigned content professionally; 2. use audiovisuals effectively; 3. submit a written report, which demonstrates scholarly preparation; and 4. effectively function as a member of a group. Directions: 1. Select group members and a topic from the designated list. 2. Each group is to submit a typed content outline no later than one week before the presentation. 3. Present the content in a professional manner adhering to time requirements. All members of the group are to participate in the presentation. 4. A minimum of three audiovisual aids are to be used in the presentation. 5. Submit a report of the content presented that is scholarly prepared and based on a

minimum of three resources other than the required textbooks. Required textbooks may also be used.

6. Participate in group process as a means for achieving mutual goals. Evaluation: A group grade will be given. Submit the paper and Presentation Evaluation Criteria when the topic is presented.

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University of Arkansas at Monticello School of Nursing

Presentation Grading Criteria Students:______________________________ Topic: __________________________ ________________________________ Date: ___________________________ Evaluation Criteria Points Possible (10) ______ 1. Outline typed and submitted a minimum of one week before and presentation followed the outline. (20) ______ 2. Presentation creative, organized, used a variety of teaching methods (lecture, discussion, role play, etc.) and was effectively presented. (20) ______ 3. Content demonstrated thorough knowledge of subject and adhered to objectives. (20) ______ 4. Audiovisuals - A minimum of three were used. Were clear,and legible and strengthened the presentation. (10) ______ 5. Written report - scholarly prepared and included a minimum of three references other than required textbooks. Report followed the presentation. APA format with at least one reference being from a nursing research journal. Peer Evaluation (10) _______ 6. Worked collaboratively and cooperatively with group members to complete the presentation. (10) _______ 7. Participated in the preparation and presentation of the topic. 100 (total points) Comments: _____________________________________________________________________________ _____________________________________________________________________________ Faculty: ________________________ Date: _____________ Score: _________________

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Appendix I

Process Recording Guidelines

86

University of Arkansas at Monticello School of Nursing

PROCESS RECORDING GUIDELINES

Purpose: The process recording provides the student the opportunity to demonstrate the use of therapeutic communication. It is a formal method of evaluating nurse/client interactions by developing insight into these behaviors. Objectives: Upon completion of the process recording, the student will be able to:

1.) Recognize an appropriate setting and environment for a therapeutic interaction; 2.) Identify client and student behaviors which reflect effective and ineffective behaviors; 3.) Analyze own responses and determine if therapeutic or nontherapeutic; 4.) Identify an alternative response if the response was nontherapeutic; 5.) Interact therapeutically to enable clients to more effectively achieve their goals; and 6.) Document closure of interaction. Directions: 1.) Describe and analyze an interaction with a client, including a verbatim account of your own and the client's communications. 2.) Review the Communication Techniques and Process Recording Guidelines from NURS 311V Concepts in Nursing Care I. 3.) Use the approved format for documentation of the process recording. 4.) Submit legible Process Recording with appropriate spelling and grammar. 5.) Submit a copy of the Evaluation Criteria with the process recording. 6.) Process Recordings are due as specified on course calendar and no later than the Monday following the interaction. 7.) No Process Recordings will be accepted for grading after week 8.

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University of Arkansas at Monticello School of Nursing

Process Recordings

Student: ____________________ Clinical Week ________ Site ____________________ Evaluation Criteria: Process recordings are evaluated as satisfactory (Scores 40 and above) or unsatisfactory (Scores below 40) based on meeting the following criteria: (15)_____1. Select a therapeutic interaction with a client. (05)_____2. The clinical setting was evaluated for appropriateness. The physical positioning of client & nurse during the interaction was documented. Enviromental factors which may have affected the process were identified. (10)_____3. Documented a brief history, an actual verbal interchange, the client’s non-verbal behaviors, and closure of the interaction. (10)_____4. Identified own non-verbal behaviors, thoughts and feelings related to the interaction. (10)_____5. Demonstrated knowledge of therapeutic communication process and identified responses as therapeutic or non-therapeutic, and a more effective therapeutic was identified when appropriate. Comments: __________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Faculty:________________________ Date:_________ Evaluation: _______________________ 10/4/11

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University of Arkansas at Monticello School of Nursing Process Recording

Process Recording Number:________________Student:____________________________Client initials: ________________ Date of interaction:_______________________Length of interaction:_________________ Clinical setting: ______________ Setting:_______________________________________________________________________________________________

Client Behavior

Nurse Behavior Analysis

89

Appendix J

Sample of Self Concept/Psychic Integrity Nursing Process

90

SUBJECTIVE DATA

OBJECTIVE DATA MODE Self Concept

NEED Psychic Integrity NURSING INTERVENTIONS RATIONALES

GROWTH AND

AI never see my son or grandchildren any more. He=s divorced and can=t get the kids very much.@ AWe had to put my mother in a home when my husband was so sick. He just died six months ago.@ PRECEPTION: AThis surgery was terrible and that thing is gross. I=ll never be myself again.@ AI stink.@ GENERATIVITY VS AI give up. I=m old and alone. COPING STRATEGIES: AI don=t want to talk to anyone.@ Close the door and turn out the lights.@ Please close the drapes.@

DEVELOPMENT 2 days post-op, colostomy. 52 year old widow. Has not worked since husband=s recent illness and death. One son with 2 children under 6 years of age lives out of state. 82 y/o mother lives in residential care facility. Belongs to a bridge club and health club. OHTM states that Ms. S. has refused to look at the stoma or participate in care STAGNATION Friends from the bridge club attempted to visit but she requested a no visitor sign be placed on the door.

NURSING DIAGNOSIS Impaired social interaction R/T body image disturbance Priority # _______________ STG Client will resume contacts with friends during visiting hours by 1400 on 12-6-96_________________ EVALUATION* Met Partially Met ____________ Not Met ________________ Discharge Goal

EVALUATION* Met Partially Met Not Met

1. Show acceptance for the expression of grief and the need for denial. 2. Show personal acceptance through attentive care and brief visits not associated with stoma care. 3. Encourage expression of feelings about the change in appearance and elimination. 4. Explain grief reactions. 5. Plan mutually suitable times for stoma care and pouch emptying. 6. Plan for a time to inspect the stoma. 7. Use proper name Astoma care@ and describe what is seen and done.

1. Grieving is the natural response to loss Kozier p. 1082 2. To reduce feelings of aloneness and instill hope. Kozier p. 1089 3. Nursing care of the grieving client begins with establishing the significance of the loss Kozier p.1088 4. Knowing the feelings associated with grieving helps to acknowledge them as normal and acceptable and helps to understand anger and guilt, if present. Kozier p. 1092 5. Active participation and advances learning. 6. UAM T/L Principles # 4 7. If learners know what they are expected to learn they will learn more efficiently. UAM T/L Principles # 1

91

SUBJECTIVE DATA

OBJECTIVE DATA MODE Self Concept

NEED Psychic Integrity NURSING INTERVENTIONS RATIONALES

NURSING DIAGNOSIS

____________________________ ____________________________ ____________________________ Priority #____________________ STG________________________ ____________________________ ____________________________ EVALUATION ____________________________ Met_________________________ Partially Met__________________ Not Met_____________________ Discharge Goal________________ ____________________________ ____________________________ ____________________________ EVALUATION Met_________________________ Partially Met__________________ Not Met_________________________

8. Acknowledge the need to look away and that it takes time to gather courage for looking. 9. Show Ms. S. the equipment that is used without expecting participation. 10. Introduce enterostomal therapist as available resource and support. 11. Discuss possible social contacts and encourage plans for visitors. 12. Assist Ms. S. in developing a daily schedule that allows for social contact and activities.

8. Grieving has a therapeutic value, enabling people to think through their thoughts and resume life with new insights and directions. Kozier p. 1088 9. If learners know what they are expected to learn, they will learn more efficiently. UAM T/L Principle # 1 10. Contact with others who have experienced a similar loss decreases feelings of isolation. Kozier p. 1089 11. To reduce feelings of aloneness and instill hope. Kozier p. 1089 12. Helps to structure day and provides opportunity for social contacts. Kozier p. 1089

92

UNIVERSITY OF ARKANSAS at MONTICELLO School of Nursing

Jefferson Regional Medical Center 1515 W. 42nd Avenue Pine Bluff, AR 71603 Phone (870) 541-7100

GUIDELINES

1. Students are to park in Parking Deck. Do not park in Patient parking, AHEC or Wellness Center parking lots. 2. Cafeteria Hours: 0600-1000 Closed: 1000-1100

1100-1400 1600-1700 1700-1900

3. Lunch: arrange lunch breaks with your instructor or primary nurse. Students may leave the unit

for approximately 30 minutes. There is to be no discussion of client interactions in the dining area.

4. Clients are discharged through the main entrance ONLY. 5. Any unit may be contacted by telephone through the main number or by dialing the unit directly. 6. JRMC is a smoke-free facility. 7. Locate instructors by pager, telephone, or in person. Do not page on the public address system. When contacting the clinical instructor via their pager/cell phone, do not use cell phone in patient

rooms or open areas where conversations may be overheard by visitors. 8. Computer charting will be used on all units. Follow the unit’s instructions for using the charting and medication scanning system. 9. Use black ball point ink. Carry two pens and small pad with you at all times. 10. Clipboards are helpful. Make sure your name is visible on the clipboard so it will not be

confused with those that are JRMC property. 11. All supplies and Accuchecks must be charged for using the designated changing system. 12. Students and all employees must adhere to universal precautions at all times. You may contact Employee Health if you need special gloves due to allergy. 13. Avoid areas used by physicians for charting. 14. Students are to use stairways instead of elevators unless given permission by clinical instructor.

93

Appendix K

Teaching Plan Guidelines

94

University of Arkansas at Monticello School of Nursing

TEACHING PLAN GUIDELINES

Purpose: The teaching plan provides an opportunity for the student to develop clinical judgments and related skills to educate individuals concerning the promotion,

Objectives: Upon completion of the teaching plan, the student will be able to: 1. Identify appropriate learning needs of a client; 2. Recognize teaching/learning principles and developmental learning needs in developing a

teaching plan; 3. Implement the teaching plan using various teaching and learning strategies; and 4. Evaluate learning outcomes. Directions: 1. Identify a learning need based on assessment data of a hospitalized client. Validate with

instructor. 2. Use the UAM School of Nursing Teaching/Learning Principles and the Developmental

Learning Needs to develop a teaching plan. 3. Implement and evaluate the outcomes of the teaching process. Instructor must review

teaching plan before it is implemented. 4. Submit in a folder, legibly, in ink on one side of paper only. Appropriate spelling and

grammar are expected. 5. Submit a copy of the Evaluation Criteria with the teaching plan in the clinical area. 6. Teaching plans are due with Nursing Care Plans.

95

University of Arkansas at Monticello School of Nursing

Teaching Plan Student __________________________Clinical Week_________#Site___________________ Evaluation Criteria: Points possible (10) ___ 1. Identified appropriate learning needs of hospitalized client. (20) ___ 2. Teaching plan was correct, complete, organized, and used a variety of teaching/learning strategies and audio visuals. (10) ___ 3. Used teaching/learning principles and developmental learning needs to guide the teaching session. (05) ___ 4. Evaluation of the teaching session was measurable, realistic and related to the goal.

(05) ___ 5. Submitted legible teaching plan as directed with appropriate spelling and grammar. 50 (total points) Comments: ___________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Faculty:_______________________________Date:__________________Score: ____________

96

UNIVERSITY OF ARKANSAS at MONTICELLO School of Nursing

TEACHING PLAN

SUBJECTIVE DATA

OBJECTIVE DATA MODE NEED

NURSING INTERVENTIONS RATIONALES

Physical Age and Motiva Anx Communication Sen Educa Previous Knowledge Developmental

Environment Physical Status tion iety Skills ses tion Experience of Condition Learning Needs

NURSING DIAGNOSIS Problem should relate to Deficient knowledge of Rt AEB: STG EVALUATION Met Partially Met* Not Met* Discharge Goal EVALUATION Met Partially Met* Not Met*

1. Physical Environment 2. Timing 3. Teaching A. Tell client teaching topic B. Teaching in detail as presented to client. C. Include method of presentation. D. Summarize. Include Audio-visual aids used. E. Validate learning F. Praise

See Koizer See Kozier UAM Teaching/Learning Principle See source of teaching content for rationale UAM Teaching/Learning Principle UAM Teaching/Learning Principle UAM Teaching/Learning Principle UAM Teaching/Learning Principle

97

Appendix L

Course Calendar

98

University of Arkansas at Monticello School of Nursing

NURS 332V - Concepts in Nursing Care II JANUARY 2014

Monday Tuesday Wednesday Thursday Friday

31 1 2 3

6 7 9

10

13

14

15 FIRST DAY OF CLASS (Class Time: 9:00 am - 12:00 pm

1:00 pm - 3:00 pm)

Class 1: Overview

Class 2: Self-Concept

Class 3: Wellness Fair

16

(Class Time: 9:00 am – 12:00 pm, 1:00 pm – 3:00 pm)

Class 4 & 5: Family Theory & Assessment

Class 6: Family Crisis & Violence

17

20 MARTIN LUTHER KING HOLIDAY

21 Class Time: 9:10 am – 12:30 pm)

Class 7: Physiologic Mode Fluid & Electrolyte Acid-Base Balance/Imbalance LAST DAY TO REGISTER OR ADD A CLASS

22 Class Time: 9:10 am – 12:30 pm) Class 7: cont. Physiologic Mode Fluid & Electrolyte Acid-Base Balance/Imbalance

23 Class 8: Fluid & Electrolytes: Shock

24

27 Fluid and Electrolyte Review for Exam I END OF CONTENT FOR EXAM 1

28 Class 9: EXAM I

29 Class 10: Burns Guest speaker ACH

30 Clinical Orientation TBA

31

Clinical Orientation TBA

99

University of Arkansas at Monticello School of Nursing

NURS 332V - Concepts in Nursing Care II February 2014

Monday Tuesday Wednesday Thursday Friday

3 (9:10 am – 12:30 pm) Class 11:Preopertive Care Class 12: Intraoperative Care

4 (9:10 am – 12:30 pm) Class 13: Post-operative Care

5 Clinical 1

6 Clinical 1

7

10 Class 14: Healing END OF CONTENT FOR EXAM II

11 Class 15: Anti-infectives

12 Clinical 2

13 Clinical 2

14

17 Class 16: Immunity: Allergies and Asthma

18 Class 17: Immunodeficiency

(HIV/AIDS)

EBPS Due

19 Clinical 3

20 Clinical 3

21

24 Class18: EXAM II

25 Class 19: Communicable Diseases & Immunizations

26 Clinical 4

27 Clinical 4

28

100University of Arkansas at Monticello

School of Nursing NURS 332V - Concepts in Nursing Care II

March 2014

Monday Tuesday Wednesday Thursday Friday

28

3 Class 20: Poisoning END OF CONTENT FOR EXAM III

4 Class 21: Student Health Fair Presentations

5 Clinical 5 #2 Process Recordning Due

6 Clinical 5 #2 Process Recordning Due

7

10 Class 22: EXAM III

11 Class 23: GI disorders

12 Clinical 6

13 Clinical 6

14

17 Class 23: GI disorders

cont. or Prep for health fair

18 Class 24: MATH EXAM

19 Clinical 7 UAM Health Fair

20 Math exam retakes

21

24

25

SPRING

26

BREAK

27

SPRING

28

BREAK

31 Class 25: Connective Tissue Disorders

101University of Arkansas at Monticello

School of Nursing NURS 332V - Concepts in Nursing

April 2014

Monday Tuesday Wednesday Thursday Friday

1 Class 26: Infectious Respiratory Disorders

2 Clinical 8 LAST DAY TO DROP WITH A “W”

3 Clinical 8

4

7 Class 27: Cancer PREREGISTRATION BEGINS

8 Class 28 : Cancer cont.

END OF CONTENT FOR EXAM IV

9 Clinical 9

10 Clinical 9

11 REGISTRATION ENDS

14 Class 29: Hematologic Disorders

15

Class 30: Hematologic Disorders (continued)

16 Clinical 10

17 Clinical 10

18

21 Class 31 EXAM IV

22 Class 32: Childhood Nutritional Disorders

23 Clinical 11

24 Clincal 11

25

28 Class 33: Childhood Neurologic Disorders

29

Clinical and Course Evaluations

30 Clinical 12

University of Arkansas at Monticello School of Nursing

NURS 332V - Concepts in Nursing Care II May 2014

Monday Tuesday Wednesday Thursday Friday

1 Clinical 12

2

5 EXAM V

6 LAST DAY OF CLASSES

7

FINAL EXAM PERIOD

8

9

12 CONCEPTS II FINAL EXAM 10:00

13

FINAL EXAM PERIOD

14 GRADUATE RECOGNITION CEREMONY PRACTICE

15 GRADUATE RECOGNITION CEREMONY

16 COMMENCEMENT

19 20 21 22 23

26 27 28 29 30