Syllabus 2010

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Pearl River Community College Department of Nursing Education

ASSOCIATE DEGREE NURSING

FALL 2010

COURSE TITLE: Nursing I - Fundamentals of Nursing

COURSE NUMBER: NUR 1110

CREDIT HOURS: 10

LEVEL I NURSING COORDINATOR: Strebeck, P. Admin. Suite: Ext. 1020

NURSING I INSTRUCTORS: Carney, H. Office 114; Ext. 1072

Entrekin, C. Office 413; Ext. 1078

Estes, A. Office 113; Ext. 1069

Kersh, E. Office 403; Ext. 1080

Laborde, J. Office 116; Ext. 1065

Ladner, P. Office 404; Ext. 1079

Shivers, M. Office 402; Ext. 1085

NURSING/WELLNESS COORDINATOR: Loustalot, L. Office 103; Ext. 1062

CAMPUS LAB COORDINATOR: Nightengale, S. Office 303A, Ext. 1088

OFFICE HOURS: Individual daily schedules will be posted on the bulletin board outside each faculty office.

COURSE DESCRIPTION: This fundamental course in nursing is based on the biological, psychosocial and

cultural aspects necessary to promote wellness of diverse patients, families, and communities. The content is designed

to introduce the practice of nursing as an integral component of total health care. The focus of this course is placed on

the process of learning; roles of the nurse as provider of care, manager of care, and member within the disciple of

nursing; critical thinking; dosage calculations; the nursing process; the wellness-illness continuum; the communication

process; development of beginning technology skills; six basic needs; and growth and development of the aged

individual. The course requires seven class hours and nine clinical hours per week.

PREREQUISITES: Admission to the Associate Degree Nursing Program.

COREQUISITES: BIO 2511, BIO 2513, MAT 1313, NUR 1101, PSY 1513

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

PROVIDER OF CARE

1. Begin utilizing therapeutic communication skills when interacting with patients and support persons.

2. Practice documenting assessments, interventions, and progress toward achieving expected outcomes.

3. Communicate relevant, accurate, and complete information in a concise and clear manner.

4. Assess the patient’s cultural and ethnic differences, developmental stage, six basic needs, and position on the

wellness-illness continuum.

5. Assess the patient’s response to actual or potential health problems and the response to interventions.

6. Begin to utilize assessment and reassessment data to plan care.

7. Evaluate the effectiveness of caring interventions provided in meeting patient outcomes and modify care as

indicated.

8. Protect and promote the patient’s dignity.

9. Demonstrate caring behavior toward the patient and support persons.

10. Begin to utilize critical thinking skills to provide evidence-based competent care to meet patient’s basic needs.

11. Perform nursing skills competently and provide a safe, physical and psychosocial environment for the patient.

12. Begin to support the patient and support persons to cope with and adapt to stressful events and changes in

health status.

13. Assist patient and support persons with information on health and fitness.

14. Demonstrate appropriate patient education in selected situations.

MANAGER OF CARE

15. Make clinical decisions to provide evidence-based competent care seeking assistance as needed.

16. Prioritize patient care.

17. Recognize nursing strategies to provide effective and cost efficient care.

18. Collaborate with other members of the health care team.

19. Demonstrate competence with current technologies.

MEMBER WITHIN THE DISCIPLINE OF NURSING

20. Utilize professional, ethical, legal behaviors while caring for individuals in health care settings.

21. Demonstrate accountability for nursing practice.

22. Recognize the standards of nursing practice.

23. Recognize patient rights and maintain confidentiality.

24. Identify the purposes of professional nursing organizations.

25. Recognize resources available to meet learning needs.

26. Use constructive criticism to improve nursing practice.

27. Recognize the importance of nursing research in nursing care.

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STUDENT LEARNING OUTCOMES: Upon completion of the program, the PRCC-ADN graduate will

demonstrate the following roles of nursing practice.

PROVIDER OF CARE

The graduate has current knowledge in nursing concepts, principles, and processes necessary to make decisions for

competent nursing practice in various health care settings by:

1 Utilizing critical thinking in the application of the nursing process.

2. Assessing the patient for relevant data.

3. Incorporating growth and development when implementing nursing interventions.

4. Meeting the patient’s basic needs to maximize their level of wellness or to support a peaceful and dignified

death.

5. Providing patient education for a diverse population in promoting wellness or restoring health.

6. Communicating verbally, non-verbally, in writing or through information technology.

7. Utilizing therapeutic communication skills when interacting with patients and support persons.

8. Demonstrating competency in the performance of essential nursing skills.

MANAGER OF CARE

The graduate possesses the knowledge and skills necessary for managing the delivery of safe effective nursing care.

9. Making appropriate decisions regarding priorities of nursing care.

10. Delegating some aspects of nursing care and supervising other personnel.

11. Managing time and resources efficiently and effectively.

12. Seeking assistance when needed.

13. Collaborating with health care team to provide evidence-based competent care.


The graduate has acquired the knowledge for professional growth, continuous learning and self-development by:

14. Practicing within the ethical and legal framework of nursing and promoting standards of nursing practice.

15. Utilizing resources for life-long learning and self-development.

16. Using constructive criticism for improving nursing practice.

17. Recognizing the importance of and using nursing research.

18. Recognizing the importance of and participating in professional nursing organizations.

19. Practicing within the parameters of individual knowledge and experience.

MS 5/10

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COURSE REQUIREMENTS:

1. Adhere to the policies and procedures in the PRCC Cat Country Guide, ADN Student Handbook, and clinical

agencies.

2. Complete all assignments, quizzes, tests, computer tests, and final exam.

3. Achieve a minimum grade of “80". This nursing course consists of a theory and clinical component, and a

student must pass both components to successfully complete the course. The theory component will be

assigned a numerical grade; the clinical component will be assigned a pass or fail. Failure in the clinical

component will constitute a failure in the course and will be recorded regardless of the theory numerical grade.

4. Prior to clinical experience, current CPR certification, TB skin results, and proof of Hepatitis B vaccination or

signed declination is required as stated in the ADN Student Handbook.

5. Spend a minimum of one (1) hour on the computer for each unit. A computer time sheet will be provided to

you for recording your time and the computer programs you completed. It must be shown to your advisor upon

request.

6. Spend a minimum of one (1) hour a week in the campus lab practicing nursing skills. This hour is not included

in your scheduled campus lab time with your instructor. A time sheet will be provided to you for recording

your time and attendance in the lab. Instructors will check your campus lab skills log sheet throughout the

semester.

GRADING PROCEDURES:

Minor Grades: Quizzes (scheduled and unscheduled)* 25%

Assignments*

Major Grades: Unit (Hour) Tests 45%

Final Exam 30%

Semester Total 100%

To pass the clinical component, the student must receive a ―Pass‖ on the Summative Evaluation Tool.

*Unit quizzes and/or assignments given during a unit will be averaged for one minor grade for the unit.

See Grade Conversion Chart in ADN Student Handbook for mid-term progress grade/report average.

FUNDAMENTAL FACULTY, 4/10

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PEARL RIVER COMMUNITY COLLEGE

Department of Nursing Education

Associate Degree Nursing

FUNDAMENTALS - NUR 1110

GRADE WORK SHEET

Student_________________________________________ ID# _____________________

Minor Grades 25%

Major Grades 45%

MID-TERM PROGRESS GRADE

Minor Grades =

Major Grades =

Progress Grade =

Instructor

Student _

Date ________________

Final Exam 30%

X 0.25 =

X 0.45 =

X 0.30 =

Minor Grades ______ + Major Grades ______ (prior to final exam) Date ________

Instructor Signature ___________________Student Signature _____________________

+ Final Exam _____________ =

Course Grade _________ Instructor ________ Date ____

Rev. 12/04; 11/09

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TEXTBOOKS:

REQUIRED:

Chabner, D. E. (2009). Medical Terminology A Short Course (5th ed.). St. Louis: Elsevier.

(ISBN #--978-1-4160-5518-1)

Morris, D. G. (2010). Calculate with Confidence (5th ed.). St. Louis: Elsevier.

(ISBN # --978-0-323-05629-8)

Nugent, P. M. & Vitale, B. A. (2008). Test Success: Test-Taking Techniques for Beginning Nursing

Students. (5th

ed.). St. Louis: Elsevier. (ISBN#--978-0-8036-1894-7)

Pagana, K. & Pagana, T. (2010). Manual of Diagnostic and Laboratory Tests (4th

ed.). St.

Louis: Elsevier. (ISBN #--978-0-323-05747-9.)

Potter, P. A. & Perry, A. G. (2011). Basic Nursing: Essentials for Practice (7th ed.). St. Louis:

Elsevier. (ISBN #--978-0-323-05891-9)

Riley, J.B. (2008). Communication in Nursing (6th ed.). St. Louis: Elsevier.

(ISBN #--978-0-323-04676-3)

Skidmore (2011). Mosby’s Drug Guide for Nurses (9th ed.). St. Louis: Elsevier.

(ISBN #--978-0-323-06703-4)

Taber's: Cyclopedic Medical Dictionary (21st ed.). (2009) Philadelphia: F. A. Davis Company.

(ISBN #--978-0-8036-1559-5)

REFERENCE:

Wissmann, J. editor. (2008). Assessment Technologies Institute: Fundamentals for Nursing

(6.1 version). Faculty will provide book at a later date.

Wissmann, J. editor. (2008). Assessment Technologies Institute: Pharmacology for

Nursing (4.2 version). Faculty will provide book at a later date.

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THEORY COMPONENT

FALL 2010

8

(THIS PAGE IS BLANK)

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GENERAL INFORMATION FOR THEORY:

1. Attendance: See ADN Student Handbook.

Note: Attendance in the classroom, clinical, and campus lab is considered important and is expected.

In the event of an absence or tardy (theory tests/quizzes, clinical, campus lab practice, check-off, class

lecture), the student must call the appropriate instructor prior to the absence or tardy. If the student

fails to notify of an absence or tardy, the student may be asked to meet with fundamental faculty.

On the 3rd absence, the student may be asked to meet with fundamental faculty.

For a clinical absence, see ADN Student Handbook: Student Attendance: Clinical

Requirements

2. Quizzes, Tests, and Assignments: See ADN Student Handbook.

Students must complete all assignments, quizzes, tests, and final exam.

3. Make-up work for assignments, quizzes, or tests: See ADN Student Handbook: Student Attendance

4. Talking, unless directed by instructor, any disruptive, irrespective behavior, or sleeping will not be

tolerated. Any student not complying will be asked to leave the classroom and be unable to return to

the classroom until conferencing by an advisor.

5. Cell phones and pagers are not allowed in the classrooms. See Cat Country Guide: Electronic Devices

6. Audio recording of lectures: See ADN Student Handbook: Recording Lectures

7. It is suggested that the student subscribe to one of the professional nursing journals and read each

current issue. Suggested journals include:

American Journal of Nursing

Nursing

RN

8. The use of instructor test banks is not allowed for studying/reference.

9. If you have a disability that qualifies under the American with Disabilities Act and you require special

assistance or accommodations, you should contact the designated coordinator for your campus for

information on appropriate guidelines and procedures: Poplarville Campus, Ms Tonia Moody at

601-403-1060 or [email protected]. Distant Learning Students who require special assistance,

accommodations, and/or need for alternate format should contact Tonia Moody.


mailto:[email protected]

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A P R O X I M A T E E Q U I V A L E N T S

W E I G H T Metric Apothecary

60 milligram = 1 grain

1 gram = 15-16 gr

1 Kilogram = 2.2 pounds V O L U M E

Metric Apothecary Household

1 minim = 1 gtt

1 milliliter = 16 minims = 16 gtts

5 ml = 1 dram = 1 teaspoon

15 ml = 1/2 ounce = 1 Tablespoon

30 ml = 1 ounce = 6 teaspoons

240 ml = 8 ounces = 1 Cup

500 ml = 16 ounces = 1 pint

1000 ml = 32 ounces = 1 quart O T H E R E Q U I V A L E N T S

1 Kg = 1000 g

1 g = 1000 mg

1 ml = 1 cubic centimeter

1 liter = 1000 ml

1 T = 3-4 tsp

1 mg = 1000 mcg A P R O X I M A T E E Q U I V A L E N T S

S Y M B O L S gtt = drop pt = pint

mg = milligram qt = quart

ml = milliliter gr = grain

mx = minim Gm, gm or g = gram

= dram lb = pound

= ounce kg = kilogram

T = tablespoon mcg or ug = microgram

tsp = teaspoon mEq = milliequivalent

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UNIT 1

FOCUS: Introduction to Nursing: Nursing Profession, Ethical and Legal Aspects of Nursing

OBJECTIVES:


1. Discuss PRCC ADN’s mission statement, program outcomes, philosophy, educational outcomes, and

conceptual framework.

2. Describe the historical development of nursing.

3. Discuss the role of caring in establishing a nurse-patient relationship.

4. Discuss the problems that might occur when nurses’ and patients’ perceptions of caring differ.

5. Discuss nurse caring interventions as perceived by families.

6. Discuss professional behaviors and nursing as a profession.

7. Differentiate educational programs available for registered nurse education.

8. Describe practice settings for nurses.

9. Describe the roles and career opportunities for nurses.

10. Identify factors influencing nursing practice.

11. Describe the trends in health care that are influencing nursing practice.

12. Discuss the ANA Standards of Clinical Nursing Practice.

13. Describe the influence of ethics on nursing practice.

14. Discuss how values can influence patient care.

15. Describe the Code of Ethics for Nurses.

16. Discuss Mississippi licensure requirements for registered nurses.

17. Summarize the legal responsibilities and obligations of nurses.

18. Explain why nursing students can be held responsible for actions while caring for patients.

19. Discuss the patient’s rights (Patient Bill of Rights).

20. Define the key terms listed at the beginning of each chapter in the Potter & Perry textbook.

PRESENTATION

Lecture

Discussion

STUDENT PREPARATION

REQUIRED

ADN Student Handbook, pp. 1-39.

ANA Standards of Clinical Nursing Practice (See ADN Student Handbook).

Nursing Practice Law from Mississippi Board of Nursing-

Can be accessed on website: htpp//www.msbn.state.ms.us

Basic Nursing, Chapters 2, 3, 4, & 5.

Test Success 5th

Edition (The World of the Patient and Nurse)

Website: www.HIPPA.com

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FOCUS: Introduction to Nursing: Nursing Profession, Ethical and Legal Aspects of Nursing (Cont’d.)

STUDENT PREPARATION (Cont’d.)

SUPPLEMENTAL

Brooks, P. (2008). Legal questions. Nursing 2008, 38 (12), pp. 20.

Haddad, A. (2002). Ethics in action. RN, 71 (6), p. 18.

Ladake, S. (2003). Protect your future with personal liability insurance. Nursing 2003, 33 (2), pp. 52-53.

Laduke, S. (2003). Your key to safe practice. Nursing 2003, 33 (3), p. 45.

Mee, C. (2003). What’s different about this nursing shortage. Nursing 2003, 33 (1), pp. 51-55.

Olsen, D. (2007) Ethical Issue Arranging Live Organ Donation over the Internet. AJN , 107 (3),

pp. 69-72.

Salladay, S. (2009). Ethical problems. Nursing 2009, 39 (2), pp. 18-19.

Simpson, P. (2009). Legal questions. Nursing 2009, 39 (2), p. 10.

Videos: VC 344.73 H83 How to reduce your risk of being sued.

VC 344.73 D361 Defending the nursing malpractice lawsuit.

Website Search Tools: yahoo.com

dogpile.com

ohsu.edu/cliniweb

askjeeves.com

Websites: www.allnurses.com

www.Nursezone.com

www.Nursingnet.org

www.Nursingcenter.com

www.Springnet.com

PL 3/10

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UNIT 1

FOCUS: Introduction to the Nursing Process

OBJECTIVES:

PROVIDER OF CARE

1. Define nursing process.

2. Identify the purpose of the nursing process.

3. Define the components of the nursing process.

4. Discuss the assessment phase of the nursing process.

5. Describe the analysis phase of the nursing process.

6. Identify NANDA - Approved Nursing Diagnoses.

7. Discuss the planning phase of the nursing process.

8. Describe the implementation phase of the nursing process.

9. Discuss the incorporation of the concept, nursing process, into PRCC’s philosophy and conceptual

framework.

PRESENTATION Lecture

Discussion

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 8.

Test Success 5th

Edition (The Nursing Process, Chapter 6)

SUPPLEMENTAL Websites: www.careplans.com

www.nursingnet

www.nanda.org

www.nurse.com

www.fadavis.com (for list of NANDA Approved Diagnoses)

PL 3/10

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UNIT 1

FOCUS: Documenting and Reporting

OBJECTIVES:

PROVIDER OF CARE

1. Discuss the relationship between documentation and health care financial reimbursement.

2. Identify multi-disciplinary communication within the health care team.

3. Discuss the purposes of a health care record.

4. List the guidelines for effective documentation and reporting.

5. Identify measures used to ensure that recording meets legal standards.

6. Discuss various methods of charting.

7. Describe different types of reports made by nurses.

8. Identify abbreviations and symbols commonly used for charting.

9. Describe different forms used in a chart.

10. Discuss the role of computerization in documentation.

11. Discuss JCAHO & HIPAA regulations in the delivery of health care.

12. Define the key terms at the beginning of Chapter 8.

13. Complete Appendix III abbreviations, acronyms, symbols, pp. 307-309 in the textbook: Medical

Terminology (5th ed.).


Discussion

STUDENT PREPARATION


Memorize abbreviations as directed by instructors.

Medical Terminology (5th ed.), pp. 308-309

SUPPLEMENTAL Manning, L. & Rayfield, S. (2007). Charting: An Incredibly Easy Pocket Guide. Philadelphia:

Lippincott, Williams, & Wilkins.

Author (available on request): (2006). Chart Smart: The A – Z Guide to Better Nursing

Documentation, (2nd

ed.). Philadelphia: Lippincott, Williams, & Wilkins.

Websites: hhs.gov/ocr/hipaa/findmaster.html

http://aspe.hhs.gov/admnsimp/find/pvcfact2.htm

nursing center.com

PL 3/10

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UNIT 1

FOCUS: Spirituality

OBJECTIVES:

PROVIDER OF CARE

1. Discuss essential facts about spiritual beliefs and religious practices and doctrines as they relate to health

care.

2. Compare spirituality and religion.

3. Identify methods of assessing patient’s spiritual needs.

4. Identify nursing diagnosis related to spiritual distress.

5. Discuss nursing interventions which support patient’s spiritual belief and religious practices.

6. Define the key terms at the beginning of the chapter in Potter and Perry.


Discussion

STUDENT PREPARATION


Riley, Chapter 16

SUPPLEMENTAL Websites: nursingnet

nursesareangels.com

nursingcenter.com

PL 3/10

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UNIT 1

FOCUS: Wellness/Illness and Basic Needs

OBJECTIVES:

PROVIDER OF CARE

1. Discuss the definition of health and related concepts.

2. List the two general Healthy People 2010 public health goals for Americans.

3. Discuss the health illness continuum, health promotion, basic human needs and holistic health models.

4. Describe variables influencing health beliefs and practices.

5. Discuss the three levels of preventive care and four types of risk factors.

6. Define the basic needs as described in Pearl River Community College Associate Degree Nursing’s

philosophy: oxygenation, food and fluids, psychosocial well-being, rest and activity, elimination and safe

environment.

7. Describe how the basic needs are utilized to maximize the patient’s level of wellness.

8. List all subcategories of needs included within the scope of psychosocial well-being, including cultural,

spiritual and sexual.

9. Explain how basic needs can be utilized in the assessment of individuals, families, groups and

communities.


Discussion

STUDENT PREPARATION


ADN Student Handbook - PRCC ADN Philosophy and Glossary of Terms

Test Success 5th

Edition (Common Theories Related to Meeting Patients’ Basic Human Needs)

PL 3/10

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UNIT 1

FOCUS: Critical Thinking and Nursing Judgment

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms and key concepts listed in Chapter 6.

2. Identify the components of a critical thinking model for nursing judgment.

3. Explain the difference between problem solving and decision making.

4. Rate the importance of clinical experience in critical thinking.

5. Contrast the relationship of the nursing process to a model for critical thinking.

6. Describe how attitudes influence the ability to make critical judgments.

7. Assess the standards to be applied in critical thinking in nursing.

8. Examine the five steps of the nursing process.

MEMBER WITHIN THE DISCIPLINE

9. Discuss the three levels of critical thinking.


Group Discussion

STUDENT PREPARATION


SUPPLEMENTAL

Website: www.critical thinking.org

PL 3/10

http://www.critical/

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UNIT 1

FOCUS: Rest and Sleep - Sleep Disorders

OBJECTIVES:

PROVIDER OF CARE

1. Define and analyze all key terms and review key concepts and critical thinking exercises at the

beginning of Chapter 29 in Potter & Perry.

2. Assess the physiologic basis of sleep.

3. Identify the characteristics of NREM and REM sleep.

4. State the four stages of NREM sleep.

5. Identify the developmental variations in sleep patterns.

6. Integrate interventions that promote sleep at various ages.

7. Identify factors that affect sleep.

8. Recognize common sleep disorders.

9. Identify the components of a sleep assessment.

10. State interventions that promote sleep.

11. Compare outcome criteria to interventions employed to promote sleep.

12. Review expected outcomes and nursing implications of major drug classifications of hypnotic agents

and barbiturates.

MANAGER OF CARE

13. Make proper referrals for patients with sleep disorders.


14. Using all media, stay abreast of legal, ethical, and drug issues on sleep disorders.

PRESENTATION Discussion

Lecture

STUDENT PREPARATION


Mosby's Drug Guide

Test Success 5th

Edition: (Meeting Patients’ Hygiene, Comfort, Rest, and Sleep Needs)

Search Web for most up-to-date information on sleep, sleep disorders, and medications affecting

sleep.

Website: nurses.medscape.com

PL 3/10

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UNIT 2

FOCUS: Communication Theory/Techniques of Communication

OBJECTIVES: PROVIDER OF CARE

1. Define key terms listed at the beginning of the chapter.

2. Describe the levels of communication and their use in nursing.

3. Describe the basic elements of the communication process.

4. Discuss the different forms of communication.

5. Describe the specific elements of professional communication.

6. Discuss the use of the nursing process in providing care of patients having problems with

communication.

7. Discuss communicating with patients who have special needs.

8. Discuss effective communication techniques for patients at various developmental levels.

9. Describe communication analysis or process recording analysis that might be used to improve

therapeutic communication.

10. Identify and describe techniques used to facilitate therapeutic communication.

11. Identify and describe techniques that are non-therapeutic in the nurse-patient relationship.

12. Analyze nurse-patient interaction (process recording).

13. Discuss special considerations for using electronic communications with patients and/or colleagues.

14. Complete Chapter 1 - Basic Word Structure in the textbook: Medical Terminology (4th ed.).

15. Review the anatomy and physiology of the nervous system.


Case Studies

Discussion

Handouts

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 10-Communication.

Medical Terminology, Chapter I - Basic Word Structure.

Riley, Chapters 1, 2, 6, 13 and 14 & Chapter 4, pp. 56-57.

Test Success 5th

Edition (Communication and Meeting Patients’ Emotional Needs)

SUPPLEMENTAL

Clayton, M. (2006). Communication: An important part of nursing care. AJN, 106 (11), pp. 70-72.

Hohenhaus, S., Et al. (2006). Enhancing Patient Safety during hands-offs. AJN, 106 (8),

pp. 72A-72C.

Miller, C.A. (2008). Communication Difficulties in Hospitalized Older Adults with Dementia.

AJN, 108,(3), pp. 58-67.

Mullens, M. (2006). Listening to the silence. Nursing 2006, 36 (4), p. 43.

Pullen, R. (2007). Tips for Communicating with a Patient from another Culture. Nursing 2007, 37

(10), pp. 48-49.

Williams, K. (2008). Communication Style Matters with Alzheimer's Patients. RN, 71 (9), p14.

RD 3/10

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UNIT 2

FOCUS: Group Dynamics

OBJECTIVES:

PROVIDER OF CARE

1. Define a group and list its functions.

2. Identify three essential conditions for group effectiveness.

3. Discuss the different types of groups.

4. Identify physical conditions that influence group dynamics.

5. Discuss phases of group development.

6. Discuss member roles in groups.

7. Discuss characteristics of an effective group.

8. Apply group concepts in classroom and clinical settings.

PRESENTATION Group Discussion

Lecture

Handouts

STUDENT PREPARATION

REQUIRED Riley, Chapter 5.

RD 3/10

21

UNIT 2

FOCUS: Professional Nursing Relationships

OBJECTIVES:

PROVIDER OF CARE

1. Discuss key concepts in the nurse-patient relationship.

2. Discuss the four phases of the therapeutic relationship.

3. Specify effective nursing interventions in each phase of the therapeutic relationship.

4. Discuss the benefits of warmth in communication with patients and colleagues.

5. Discuss the benefits of respect in the professional relationships in nursing care.

6. Discuss the importance of being genuine with patients and colleagues.

7. Describe the benefits of using empathy with patients and colleagues.

8. Discuss the use of humor in nursing care.

9. Discuss relationship and communication in the learning environment.

10. Discuss the following nursing relationships: nurse-family; nurse-health care worker; nurse-community.

11. Discuss strategies for effective communication with faculty, peers, patients, and hospital personnel.

12. Discuss caring as a part of the professional nurse-patient relationship.

13. Describe potential problems that may occur when nurses’ and patients’ perceptions of caring differ.

14. Discuss ways to demonstrate caring through providing presence, a caring touch, and listening.

15. Discuss the concept of knowing the patient.

16. Discuss six points to consider when asking questions in interviewing patients.

17. Discuss guidelines for appropriate self-disclosure by the nurse.

18. Identify strategies to express opinions in an assertive way.

19. Complete the Diagnostic Test Guide for Professional Nursing Relationships.


Case Studies

Discussion

Handouts

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 10 -Communication; Chapter 18 -Caring in Nursing Practice.

Riley, Chapters 2, 3, 7, 8, 9, 10, 11, 13, 14, 15; Chapter 4, pp. 56-57.

SUPPLEMENTAL Pagana, K. (2009). 7 Tips to Improve Your Professional Etiquette. Nursing 2009 39 (11), pp. 34-37.

Pope, B.; Rodzen, L.; Spross, G. (2008). Raising the SBAR: How Better Communication Improves

Patient Outcomes. Nursing 2008 58 (3), pp. 41-43.

RD 3/10

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DIAGNOSTIC TEST GUIDE: Professional Nursing Relationships

LAB TEST REQUIREMENTS

1. Magnetic Resonance Imaging of the A. Specimens or type of test

Brain (MRI)

2. Electroencephalogram (EEG) B. Purpose of the test

3. Computed Tomography of the

brain (CT Scan) C. Basics the Nurse needs to know

4. Positron Emission Tomography

(PET scan) D. Normal values

E. How is the test done

F. Significance of test results

G. Interfering factors

H. Nursing care (pretest, during, posttest)

*Use the following textbook:

Manual of Diagnostic and Laboratory Tests

by Pagana and Pagana.

RD 3/10

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UNIT 3

FOCUS: Assessing Vital Signs

OBJECTIVES:

PROVIDER OF CARE

1. Define selected terms associated with vital signs.

2. List ways in which the body's temperature is maintained.

3. Identify factors which cause variations in body temperature and how these variations are utilized in

clinical decision making.

4. Identify the effects of pyrexia and hypothermia on the body and the impact these may have in

determining a patient’s position on the health-illness continuum.

5. Describe principles in guiding nursing action in taking body temperature by oral, axillary, and rectal

methods.

6. Describe what happens in the circulatory system to cause a pulse.

7. List factors which may influence the pulse.

8. Identify common sites for obtaining a pulse in assessing the oxygenation need of patients.

9. Describe characteristics (rate, rhythm, and amplitude) of a pulse and variations.

10. Demonstrate ability to accurately measure and record pulse rate in the development of a nursing care

plan.

11. Describe the respiratory regulation mechanism of the body.

12. Describe the characteristics (nature, rate, and depth) of respirations and variations.

13. Demonstrate ability of measuring and recording respiration.

14. Identify factors that maintain normal arterial blood pressure in the body.

15. Differentiate systolic and diastolic blood pressure.

16. Demonstrate ability to accurately measure and record blood pressure.

17. Describe factors which may indicate a need for frequent measurement of vital signs in the

management of care.

18. Identify normal findings for well individuals.

19. Describe how to utilize information offered by the measurement of vital signs as a basis for

developing caring interventions.

20. Explain pulse oximetry measurement and necessary patient teaching.

21. Review the importance of diligent collaboration with hospital/community staff in reporting abnormal

vital signs findings.

22. Describe the classification, pharmacodynamics (mechanism of action), pharmacotherapeutics

(indications), predictable reactions (side effects), and nursing implications of specific drugs on the

pharmacology guide: ASA and Tylenol.


Demonstration

Practice Vital Signs Skill in Practice Lab. ( See Nursing Fundamentals Critical Behaviors)

Return Demonstration

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 14 -Vital Signs.

PRCC - Critical Behaviors "Temperature, Pulse, Respiration" and "Blood Pressure".

Practice in lab with partner.

24

FOCUS: Assessing Vital Signs (Cont’d.)

STUDENT PREPARATION

REQUIRED (Cont‘d.) Clinical Skills Return Demonstration: Vital Signs

Basic Nursing Essentials for Practice Companion CD: Vital Signs Video

Medical Terminology: Body Systems, Circulatory System pp. 208 – 215 & Lymphatic System

pp. 236 - 239

SUPPLEMENTAL Video: VC 610.73 B292ms Basic nursing skills:

Measuring Blood Pressure - Part 1; Measuring Body

Temperature - Part 2; Measuring pulse rate and respiratory rate - Part 3.

HC 3/10

25

UNIT 3

FOCUS: Mobility/Immobility: Skin Integrity, Body Mechanics, Moving, Turning, Transferring, Body

Alignment, Positioning, Ambulation, Range of Motion (ROM) Exercises

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms and review key concepts.

2. Recognize the importance of body alignment for patients and nurses.

3. State principles of body mechanics and use correctly and safely in lab and clinical. Review bones,

joints, and support structures and dynamics of movement.

4. List the major benefits of bedrest.

5. Identify groups of patients most prone to the development of the complications of bedrest and assess

activity tolerance.

6. Identify structural abnormalities that affect body alignment.

7. Relate nursing process to impaired mobility problems and their consequences according to

physiological & psychological effects. Describe nursing interventions for each immobility problem

identified.

8. Identify developmental changes throughout life which affects a patient's capabilities and limitations

for mobility/immobility.

9. Perform active and passive ROM for all joints.

10. Explain the assessment criteria for alignment of patients in a standing, sitting, or bed-lying position

according to developmental stage.

11. Demonstrate principles of positioning and needed supportive devices.

12. Choose nursing diagnoses and applying nursing process for patients with mobility problems.

13. Demonstrate ambulation with canes, crutches, and walkers. Perform all transfer techniques: bed to

chair, bed to stretcher, etc.

MANAGER OF CARE

14. Integrate factors that affect patient's mobility/immobility and criteria for maintenance.

15. Make proper referrals for rehabilitation and maintenance.


16. Using media, stay abreast of nursing research, and review new technologies, and advances for patients

and nurses to meet the needs for mobility and ways to prevent and treat pressure ulcers.

Website Example: www.medicaledu.com


Discussion

Demonstration

26

FOCUS: Mobility/Immobility: Skin Integrity, Body Mechanics, Moving, Turning, Transferring, Body

Alignment, Positioning, Ambulation, Range of Motion (ROM) Exercises (Cont’d.)

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapters 26 & 35

Taber’s Dictionary.

Practice all applicable skills.

Test Success 5th

Edition (Meeting Patients’ Physical Safety and Mobility Needs)

Critical Behaviors: Promoting Rest, Activity, and Safety.

Medical Terminology: Organization of body, pp. 43-75.

SUPPLEMENTAL Videos: VC 612.76 T687 Transferring Patients Safely

VC 610.73 P842 Positioning to prevent complications

VC 2026517-616.02 Immobility

VC 610.73Ac85 Activity and Exercise

AE 3/10

27

UNIT 3

FOCUS: Hygiene

OBJECTIVES:

PROVIDER OF CARE

1. Identify key terms; review key concepts and critical thinking at the end of Chapter.

2. Identify cultural factors in the assessment of patients which influences personal hygiene.

3. Describe kinds of hygienic care nurses provide for patients in the clinical decision making process.

4. List layers and functions of the skin.

5. List types of baths utilized in managing care.

6. Discuss the purposes and techniques involved in giving a bed bath and a back-rub.

7. Identify factors the nurse should consider when administering caring interventions to the following

areas: eye, ears, nose, teeth (including denture care and oral care), feet, and perineal areas.

8. Identify basic factors the nurse should consider in giving hygienic care to an individual with a Foley

catheter, intravenous infusion, and oxygen.

9. List and describe the types of beds made in the hospital.

10. List the characteristics of a comfortable and safe bed.

11. List ways in which the nurse can conserve time and energy while making a bed.

12. Explain how stage of development influences hygienic needs.

13. Demonstrate correct making of the following types of beds: closed, open, occupied and post-operative.

14. Show correct steps for giving a bed bath including back rub.

15. Discuss ways to provide patient’s cultural self care practices.

16. Begin to use critical thinking in determining type of hygienic care to provide for various patients.

17. Utilize principles of safety in providing hygiene care for individuals with acute and chronic illnesses

in the hospital as well as in the home.

18. Discuss how the professional behavior of the nurse is utilized to communicate caring interventions

while invading the patient’s personal space.

19. Identify most frequently used types of enemas and the rationale for each type.

20. Compare and contrast the type of enemas in regard to solution and volume.


Videos: Personal Hygiene: Giving a complete bath in bed (In Class)

Bedmaking (In Class)

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 28

Medical Terminology: Chapter 4 - Prefixes, pp 119-160.

Test Success 5th

Edition (Meeting Patients’ Hygiene Needs)

SUPPLEMENTAL

Stein, P.; Henry, R. (2009). Poor Oral Hygiene in Long-Term Care. AJN (2009),

109 (6), pp. 44-49.

Johnson, D.; Lineweaver, L.; Maze, L. (2009). Patients Bath Basins as Potential Sources of Infection:

A Multicenter Sampling Study. AJCC (2009), 18 (1): 31-38, 41.

AE 3/10

28

UNIT 4

FOCUS: Gastrointestinal Intubation, Feeding, Irrigation, Suction, N/G Removal


1. Define the key terms as listed:

a. Lavage

b. Gavage

c. Decompression

d. Enteral Nutrition

e. Compression

f. Gastrostomy

g. Jejunostomy

2. Compare reasons why gastric intubation is necessary.

3. Recognize types and characteristics of gastro-intestinal tubes.

4. Examine the steps and rationale in preparing a patient for intubation.

5. Explain how to ascertain correct distance to insert tube.

6. Recognize purposes of N/G tube irrigation.

7. Identify the types of suction equipment used.

8. Describe the nursing implications related to: feeding procedure, formula, I&O, gastric irrigations,

suction.

9. Explain rationale for each critical criterion on the following procedures: N/G tube insertion, N/G tube

removal, N/G tube feeding, and N/G tube irrigation.

10. Demonstrate the following procedures after selecting necessary equipment:

a. Insertion of nasogastric (N/G) tube

b. Feeding by N/G tube

c. Irrigation of the N/G tube; Connection to suction

d. Removal of N/G tube

e. Insertion of gastrostoscopy tube (PEG)

11. Chart/record above procedures, including I & O according to critical criteria.

12. Compare acute hospital setting vs. home care for the above procedures.

13. Describe possible complications of enteral nutrition and give nursing interventions to prevent/treat

such.

14. List different types of feeding formulas used for enteral tube feedings.

15. Review Appendix I – Body’s Digestive System, pp 204-211 in Medical Terminology textbook.


Demonstration

Return Demonstration (See Critical Behavior Requirements.)

STUDENT PREPARATION

REQUIRED Basic Nursing, pp 924-927,pp. 932-944,pp 1018-1023.

Medical Terminology (5th ed.), pp. 216-223.

Basic Nursing: Practice Companion CD: GI intubation

PL 3/10

29

UNIT 4

FOCUS: Medical-Surgical Asepsis

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms commonly used in the discussion of medical and surgical asepsis.

2. Differentiate between medical and surgical asepsis.

3. Explain the chain of infection.

4. List factors affecting risk of infection.

5. Identify casual factors of nosocomial infections.

6. Name essential facts about normal body defenses.

7. Describe the following nosocomial infections:

a.) MRSA - Methicillin-resistant Staphylococcus Aureas

b.) VRE - Vancomycin-resistant Enterococcus

c.) Clostridium difficile

8. Describe common practices of medical asepsis.

9. Explain technique for hand washing and using alcohol based hand rub.

10. Name situations in which surgical asepsis is used.

11. Discuss basic principles and practices of surgical asepsis.

12. Identify the steps necessary for the following techniques:

a.) Donning sterile gloves

b.) Opening sterile packages

c.) Pouring sterile solutions

d.) Handwashing

e.) Alcohol based hand rub

f.) Labeling sterile solutions after use

13. Complete diagnostic test guide in syllabus.

14. Complete Chapter 3 - Suffixes in Medical Terminology A Short Course (5th ed.).


Discussion

Role Play

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 13 -Infection Control

Basic Nursing Essentials for Practice Companion CD: Hand Hygiene

Medical Terminology A Short Course-Chapter 3 Suffixes


Taber’s 21st edition (Appendix 11)

Critical Behaviors: Sterile Gloving

Test Success 5th

Edition (Meeting Patients’ Microbiologic Safety Needs)

Flores, A. (2007). Appropriate Glove Use in the Prevention of Cross-Infection. Nursing Standard

21 (35).

Scalise, D. (2006). 30 Things You Can Do to Eliminate Infections. Hospitals and Health Networks

80 (9).

30

FOCUS: Medical-Surgical Asepsis (Cont’d.)

STUDENT PREPARATION

SUPPLEMENTAL

Holcomb, S. Susan. (2008). Patient Education Series: MRSA Infections. Nursing 2008, 38 (6), p. 33

Kjonegaard, R. & Myers, F. (2005). Arresting Drug-Resistant Organisms. Nursing 2005, 36 (6),

pp. 48-50.

Videos: VC 614.44 Part 3 Basic Infection Control

VC 614.44 Part 4 Basic Sterile Technique

VC 614.44 Part 1 Chain of Infection

VC 614.44 Part 2 Handwashing and Gloving

(Check out with Mrs. Shivers) Web Sites: cdc.gov (cdc.gov/handhygiene)

labtestsonline.org

MS 04/10

31

UNIT 4

FOCUS: Wound Care

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms commonly used to describe wounds.

2. Describe the three phases of wound healing.

3. Differentiate primary, secondary and tertiary wound healing.

4. Identify types of wound drainage.

5. Describe factors that affect wound healing.

6. Identify the main complications of wound healing.

7. Identify assessment data pertinent to wounds.

8. Name the 5 cardinal classic signs and symptoms of inflammation.

9. Describe nursing strategies to promote wound healing and prevent complications of wound healing.

10. Discuss types of drains utilized in wound care.

11. Identify purposes of commonly used dressing material and binders.

12. Describe principles of sterile technique in wound care necessary to promote the patients basic need for

safe environment.

13. Review expected outcomes and nursing implications for major antibiotic classifications: penicillin,

cephalosporins, tetracyclines, amino glycosides, macrolides, and fluoroquinolones.

14. Identify steps necessary for the following techniques:

a. Wound cleansing

b. Application of sterile dressing

c. Application of bandages

d. Removal of staples/sutures

15. Identify local and systematic physiological effects of heat and cold.

16. List the therapeutic uses of heat and cold applications.

17. Identify the recommended special precautions for using heat and cold applications.

18. Describe methods for applying dry and moist heat and cold.

19. Demonstrate how to measure wounds.

20. Discuss how to document wounds, wound care, use of hot and cold therapy, and use of binders and

bandages.

21. Discuss various laboratory tests (WBC’s, C&S, etc.) associated with wounds.

22. Complete diagnostic test guide in syllabus.

23. Discuss the etiology, pathogenesis, and treatment of pressure ulcers.

24. List nursing interventions for prevention and care of pressure ulcers.

25. Identify the different types of dressings by ulcer stage and their mechanism of action for each stage.

26. Complete Appendix I - Body Systems (Skin & Sense Organs), pp. 270-277 in Medical Terminology A

Short Course (5th ed.).


Demonstration

Discussion

32

FOCUS: Wound Care (Cont’d.)

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 36 -Skin Integrity and Wound Care

Mosby’s Drug Guide for Nurses (9th

edition)

Medical Terminology A Short Course (5th

edition)

Manual of Diagnostic and Laboratory Tests (4th

edition)

Taber’s: Cyclopedic Medical Dictionary (21st edition)

Basic Nursing Essentials for Practice Companion CD:

Applying Wet-to-Dry Moist Dressings

Assessment for Risk of Pressure Ulcer Development

Treating Pressure Ulcers

Critical Behaviors: 1. Sterile gloving, 2. sterile dressing change, and 3. Hot and cold application

Baldwin, K. (2006). Damage Control: Preventing and Treating Pressure Ulcers. Nursing Made

Incredibly Easy ! , 4, (1), pp. 12-39.

Kayser-Jones, J., Beard, R., and Sharpp, T. (2009). Dying with a Stage IV Pressure Ulcer.

American Journal of Nursing ,109, (1), pp. 40-49.

SUPPLEMENTAL Black, J., M. Baharestani, J. Cuddigan, B. Dorner, et al. (2007). National Pressure Ulcer Advisory

Panel’s Updated Pressure Ulcer Staging System. Dermatology Nursing, 19, (4), p. 343.

Bluesteine, D. & Javaher, A. (2008). Pressure Ulcers: Prevention, Evaluation, and Management.

American Family Physician. 78, (10), p. 1186.

Videos: VC 617.14 W915 Wound Care & Applying Dressings

VC 617.1 W915 Wound Care - The surgical dressing

(Check out with Mrs. Shivers)

Websites: woundcarenet.com

cdc.gov

www.dressings.org

www.worldwidewounds.com

MS 04/10

33

DIAGNOSTIC TEST GUIDE: WOUND CARE

Look up in Manual of Diagnostic and Laboratory Test by Pagana and Pagana and Basic Nursing by Potter &

Perry


1. Wound culture A. Specimen or type of test

2. Serum albumin B. Purpose of the test

3. Total protein C. Basics the Nurse needs to know

D. Normal values

E. How the test is done



H. Nursing care (pretest, during, and posttest)

MS 04/10

34

UNIT 4

FOCUS: Protective Asepsis (Isolation)

OBJECTIVES:

PROVIDER OF CARE

1. Discuss CDC isolation guidelines including standard precautions, airborne precautions, droplet

precautions, and contact precautions.

2. Identify precautions taken in each type of protective asepsis.

3. Discuss psychological problems associated with protective asepsis.

4. Describe nursing interventions that prevent these psychological problems.

5. List facts to teach patient and family concerning protective asepsis.

6. Discuss blood borne pathogens and their effect on isolation/standard precautions.

7. Identify the steps necessary for the following techniques:

a. Donning and removing a face mask

b. Gowning for protective asepsis

c. Donning and removing disposable gloves

d. Double bagging

e. Assessing the vital signs.

f. Reverse protective asepsis (Reverse Isolation)

g. Collecting specimens

8. Discuss standard precautions and infection control practices of health care providers with infectious

diseases according to CDC guidelines.

9. Discuss ways to prevent and treat needle sticks.


Role play

Discussion

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 13 -Infection Control.

Taber’s: Cyclopedic Medical Dictionary Appendix 11.

Critical Behaviors: Isolation Technique

Test Success 5th

Edition (Meeting Patients’ Microbiologic Safety Needs)


SUPPLEMENTAL

Flores, A. (2007). Appropriate Glove Use in the Prevention of Cross-Infection. Nursing Standard. 21,

(35), p. 45.

Scalise, D. (2006). 30 Things You Can Do To Eliminate Infections. Hospitals and Health Networks,

80, (9), p. 32.

Websites: cdc.gov (standard precautions)

MS 04/10

35

DIAGNOSTIC TEST GUIDE: ASEPSIS Look up in Manual of Diagnostic and Laboratory Tests by Pagana and Pagana.


1. Culture and sensitivity (C&S) A. Specimen or type of test of wound

B. Purpose of the test

2. WBC count C. Basics the Nurse needs to know

3. Erythrocyte sedimentation rate D. Normal values

4. Iron level E. How the test is done



H. Nursing care (pretest, during and Post-test)

MS 04/10

36

UNIT 4

FOCUS: Fecal Elimination

OBJECTIVES:

PROVIDER OF CARE

1. Review key terms; key concepts; & critical thinking exercises, Chapter 33.

2. Examine and review anatomical structures and assessment techniques of the abdomen. Demonstrate

safe (1) auscultation of bowel sounds, (2) percussion, (3) palpation, and (4) measuring of abdomen.

3. Describe the process of formation and excretion of feces.

4. Compare and contrast psychological and physiological factors that influence the amount and patterns

of bowel elimination.

5. Choose interventions to promote bowel elimination, ie. enemas, care for an ostomy, and put a patient

on and off all types of bedpans.

6. Perform collection of stool specimens, digital removal of fecal impaction, insertion of a rectal tube,

and bowel retraining.

7. Recognize indications for the use of laxatives, suppositories, and enemas.

8. Identify most frequently used types of enemas and internalize rationale for each type.

9. Compare and contrast the types of enemas in regard to solution and volume.

10. Describe the classification, predictable reactions, and nursing implications of antidiarrheals and

laxatives.

11. Complete the Diagnostic Test Guide for fecal elimination.

MANAGER OF CARE

12. Given a patient with a bowel elimination problem related to diet or anatomical structure, utilize the

nursing process to provide quality care via direct care, collaboration and or referrals.

13. Describe all gastrointestinal tests and patient preparations for each.


14. Using all media, stay abreast of ethical, legal, health promotion, and drug issues in nursing pertaining

to fecal elimination.

PRESENTATION Lecture/Discussion/Demonstration/Return Demonstration/

Student Presentations

STUDENT PREPARATION


PRCC Critical Behaviors: Enemas & Ostomy Care

Mosby’s Manuel of Diagnostic and Laboratory tests” (4’th ed.)

Test Success 5th

Edition (Meeting Patients’ Elimination Needs)

PL 3/10

37

DIAGNOSTIC TEST GUIDE: FECAL ELIMINATION Look up in Pagana & Pagana and Potter & Perry


1. Guaiac test A. Specimen or type of test

2. Stool culture B. Purpose of the test

3. Stool for occult blood C. Basics the Nurse needs to know

4. Upper GI/Barium Swallow D. Normal values

5. Barium Enema E. How the test is done

6. Colonoscopy F. Significance of test results


H. Nursing care (pretest, during, Posttest)

Use the following textbook:

Manual of Diagnostic and Laboratory Test

By Pagana & Pagana (4th

edition)

PL 03/10

38

UNIT 4

FOCUS: Introduction (Unit 4)/Basic Pharmacology (Unit 9)

OBJECTIVES:

PROVIDER OF CARE

1. Discuss the nurse’s legal and ethical responsibilities concerning drug administration.

2. Discuss the impact of drug legislation and standards on drug therapy and nursing.

3. Describe the physiological mechanisms of drug action, including: absorption, distribution, metabolism,

and excretion.

4. Discuss toxic, idiosyncratic, allergic, and side effects of drugs.

5. Identify factors that influence drug actions.

6. Discuss factors concerning routes of medication administration.

7. Review systems of drug measurement and conversion, including: equivalents, conversions, ratio, and

proportion and calculations.

8. Describe the roles of the pharmacist, physician, and nurse in drug administration.

9. List the six rights of medication administration.

10. Discuss the five phases of the nursing process as it relates to drug therapy.

11. Identify growth and development considerations specific to drug administration.

12. Define key terms used in pharmacology.


Discussion

Class Handouts

STUDENT PREPARATION


Study approximate equivalents and symbols in syllabus/ADN Student Handbook.

Review conversions, ratio and proportion, and calculations in Dosage and Solution book.

Test Success 5th

Edition (Administration of Medications)

ATI Review Module: Pharmacology for Nursing, Basic Pharmacologic Principles and Safe

Administration of Medications, pgs 1-62.

SUPPLEMENTAL Websites: medscape.com

rxlist.com

nursingcenter.com

fadavis.com

JL 03/10

39

UNIT 5

FOCUS: Urinary Elimination

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms; review key concepts & critical thinking exercises.

2. Review anatomical structures of the male and female urinary system.

3. Describe the physiological process of micturition.

4. Assess patterns of urinary elimination.

5. List diagnostic tests relating to renal system and patient preparation for each.

6. Identify nursing diagnoses related to urinary elimination problems.

7. Describe the methods used to monitor a patient's I&O and rationale.

8. Identify the definition, types, and causes of urinary incontinence.

9. List the types of external and internal urinary devices and describe the appropriate nursing care of

each.

10. Identify the signs and symptoms of urinary retention.

11. Differentiate between catheter irrigation and bladder irrigation.

12. Describe nursing interventions to maintain normal urinary elimination and to assist patients with

urinary incontinence and/or retention.

13. Identify normal/abnormal characteristics and constituents of urine and common urine tests and

common symptoms of urinary alterations.

14. Demonstrate male and female urinary catheterization using principles of asepsis.

15. Describe and demonstrate intermittent catheter irrigation, care of continuous bladder irrigation,

collection of urine specimens and discontinuation of an indwelling catheter with rationale for each.

16. Complete the Diagnostic Test Guide in syllabus.

MANAGER OF CARE 17. Given a patient with a urinary elimination problem, utilize nursing process to provide quality care via

direct, collaborative and or referral care.


18. Using all media, stay abreast of ethical, legal, health promotion, and drug issues in nursing pertaining

to urinary elimination.

PRESENTATION Lecture/Discussion/Demonstration/Return Demonstrations/

Student Presentations

Video: Indwelling and Intermittent Catheters (In Class)

STUDENT PREPARATION


Test Success 5th

Edition (Meeting Patients’ Elimination Needs)

Medical Terminology: Appendix I - Urinary, pp. 278-283.

Basic Nursing Essentials for Practice Companion CD: Catheter Insertion/Removal

Critical Behaviors: Insertion/Removal of an Indwelling Catheter

40

FOCUS: Urinary Elimination (Cont’d.)

STUDENT PREPARATION (Cont‘d.)

SUPPLEMENTAL

Stokowski, L. (2009). Preventing Catheter-Associated Urinary Tract Infections. Medscape Nurses:

Nursing Perspectives; www.medscape.com, Article# 587464.

AE 5/10

http://www.medscape.com/

41

DIAGNOSTIC TEST GUIDE: URINARY ELIMINATION Look up in Manual of Diagnostic and Laboratory Tests by Pagana and Pagana.


KNOW FOR EACH TEST:

1. Creatine Clearance 1. Normal ranges

2. Rationales of abnormal findings

2. Prostate Specific Antigen (PSA) 3. Procedure (Care of patient before, during

and after)

3. Blood Urea Nitrogen (BUN) 4. Explanation of test

4. Urine Culture and Sensitivity

AE 5/10

42

UNIT 5

FOCUS: Nursing Health History and Basic Physical Assessment

OBJECTIVES:

PROVIDER OF CARE

1. Describe interview techniques which enhance communication during history taking.

2. Identify information to collect from the nursing history.

3. Discuss the purposes of physical assessment.

4. Describe the techniques used with each physical assessment skill.

5. Discuss preparations for performing basic physical assessment.

6. Identify the importance of cultural diversity as it influences the physical assessment process.

7. Describe the proper position for the patient during each phase of the examination.

8. Discuss developmental considerations during physical assessment.

9. Describe physical measurements made in assessing each body system.

10. Define key terms, key concepts, and complete the Critical Thinking and Review Questions at the end

of chapter.


11. Discuss the role of the registered nurse in obtaining the health history and performing physical

assessment.


Discussion

Video

Campus Lab: Practice Skill of a Basic Physical Assessment (See Critical Behaviors Requirements)

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapters 15 -Health Assessment and Physical Examination

Medical Terminology, Appendix I - VII Musculoskeletal System

Test Success 5th

Edition (Physical Assessment of Patients)

ATI Review Module: Fundamentals of Nursing, Unit 2 Health Assessments pgs 233-346

Video: Delmar’s Basic Nursing Care Skills Video Series:

Basic Physical Assessment

Websites: nursezone.com

springnet.com

nursingcenter.com

cp-tel.net

JL 03/10

43

UNIT 6

FOCUS: Care Plans: Assessing, Analyzing, Planning, Implementing, and Evaluating

OBJECTIVES:

PROVIDER OF CARE

1. Identify the purpose of assessing.

2. Review types, sources and methods of data or data collection.

3. Discuss the NANDA - Approved Nursing Diagnoses.

4. Discuss the characteristics of a nursing diagnostic statement.

5. Describe the essential guidelines for writing diagnostic statements.

6. Identify the purposes of establishing patient expected outcomes.

7. Contrast the relationship of expected outcomes to the nursing diagnoses.

8. Explain the relationship of outcome criteria to patient expected outcomes.

9. Discuss planning and implementation of nursing care.

10. Identify essential characteristics of an evaluation statement.

11. Discuss the revision of the nursing care plan.

12. Utilizing growth and development, basic needs, and the nursing process, write nursing care plan for a

hypothetical patient.


Discussion

Case studies

Group Work

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 8 -Nursing Process.

ADN Student Handbook: Review Basic Needs.

Review lecture notes and required readings from “Introduction to the Nursing Process” in Unit 1.

Taber’s Dictionary - Appendix N4

Test Success 5th

edition (The Nursing Process)

MS 04/10

44

UNIT 6

FOCUS: Late Adulthood

OBJECTIVES:

PROVIDER OF CARE 1. Review key Terms - geriatrics, gerontology, gerontological nursing.

2. Discuss the role of culture and its effects on attitudes toward aging in our society.

3. Examine your own feelings and perceptions of the aging process.

4. State Erickson's developmental stage of the elderly - egointegrity vs. despair.

5. List activities which characterize Havinghurst's developmental task for patients 65 years of age and

older (given in class).

6. List most commonly reported chronic conditions of the elderly and their implications for nursing.

7. Discuss common physical changes of aging.

8. Describe the nursing management of the patient with impaired cognition.

9. Discuss proper application of restraints.

10. Describe cognitive changes of dementia and delirium found in some older adults.

11. Discuss the spiritual needs of the elderly patient.

12. Discuss special concerns regarding medications with elderly patients.

13. Give examples of health education for the geriatric patient which would assist movement toward

wellness on the wellness-illness continuum.

14. Discuss community services which are available for the elderly.


Handouts

Videos: VC 362.16 C72 Gerontology: The confused Resident: Strategies for Quality

Care (In class)

VC 362.16 R313 Gerontology: Restraints: The Last Resort (In Class)

CD - Your Time to Care: Alzheimer’s Disease and Dementia

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 21 -Late Adulthood, pp. 588-597 and chapter 27.pp.730-745

Videos: VC 362.16 R313 Gerontology: Restraints: The Last Resort (In class)

SUPPLEMENTAL Covell, C.A. (2007). New Outlook for age-related macular degeneration. Nursing 2007, 27 (3),

pp. 22-24.

Horgas, A. (2008). Pain assessment in people with dementia. AJN, 108, (7), pp. 62-71.

Lyons, D; Grimley, S. ; and Sydnor, L. (2008). Double Trouble when Delirium Complicates

Dementia. Nursing 2008, 38 (9), 48-55.

Robbins, E.H. (2007). End of life decisions: Influence of advanced directives on patient care.

Journal of Gerontological Nursing, 33 (10), pp. 30-35.

EK 3/10

45

UNIT 6

FOCUS: Concepts of Growth and Development

OBJECTIVES:

PROVIDER OF CARE

1. Define the key terms and key concepts at beginning of Chapter.

2. Differentiate growth from development. List the basic principles of growth and development and how

this knowledge assists in the management of care.

3. List major factors that influence growth and development.

4. Contrast the developmental theories of Erickson and Havinghurst as they relate to middle and older

adulthood.

5. Examine biological and psychosocial theories as they relate to the aging adult.

6. Identify the major health concerns of the young, middle, and older adult age group as well as their

impact on clinical decision making.

7. Compare physiological, cognitive, and psychosocial development for the young, middle, and older

adult.

8. Analyze the major life-span transitions that occur throughout life and how these transitions effect the

planning of caring nursing interventions.


Discussion

Case Studies/Group Presentations

STUDENT PREPARATION


AE 3/10

46

UNIT 6

FOCUS: Oxygenation

OBJECTIVES:

PROVIDER OF CARE

1. Define the key terms and review key concepts at beginning of the chapter.

2. Review anatomy and physiology regarding ventilation and respiration.

3. Identify physiologic processes involved in ventilation, perfusion, and exchange of respiratory gases.

4. Examine the ways a patient’s level of health, age, lifestyle, and environment can affect tissue

oxygenation.

5. Discuss causes and effects of hyperventilation, Hypoventilation, and hypoxia.

6. Describe diagnostic tests used for the measurement of ventilation and oxygenation.

7. Review the nursing process related to oxygenation including physical assessment.

8. Explain oropharyngeal and nasopharyngeal suctioning.

9. Describe the various methods to administer O2 insertion of therapy including home oxygen systems.

10. Discuss various breathing exercises used to improve ventilation and oxygenation that can be taught in

the acute hospital setting or at the community/home level.

11. Complete the Diagnostic Test Guide in syllabus.


Discussion

Practice skill of Oropharyngeal & Nasopharyngeal Suctioning in

Campus Lab (See Critical Behavior Requirements.)

Practice skill of Applying Nasal Cannula or Oxygen Mask in Campus Lab

(See Critical Behavior Requirements.)

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 29 -Oxygenation.

ADN Computer Lab:

Auscultating Breath Sounds

Medical Terminology - Respiratory System (p.262 - 269)

Test Success 5th

Edition (Meeting Patients’ Oxygen Needs)

Basic Nursing Essentials for Practice Companion CD: Suctioning Video

SUPPLEMENTAL Video: VC 616.2 Ai78s Airway Management: Suctioning:

Nasotracheal, oropharyngeal and endotracheal techniques

Valdez-Lowe, C., Ghareeb, S., & Artinian, N. (2009). Pulse Oximetry in Adults. AJN 2009, 109 (6),

pp. 52-65.

HC 3/10

47

DIAGNOSTIC TEST GUIDE: OXYGENATION Look up in Manual of Diagnostic and Laboratory Test by Pagana and Pagana

LAB TESTS REQUIREMENTS

1. Bronchoscopy A. Specimen or type of test

2. Thoracentesis B. Purpose of test

3. Arterial Blood Gases C. Basics the nurse needs to know

4. Pulmonary Function Tests D. Normal values

5. Pulse Oximetry E. How the test is done

6. Hemoglobin F. Significance of test results

7. Peak Expiratory Flow Rate G. Interfering factors

8. Throat Culture H. Nursing care (Pretest, during,

Posttest)

9. Sputum Specimen

HC 3/10

48

UNIT 7

FOCUS: Communicating with Patients and Staff Experiencing Stress/PTSD/Crisis

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms at the beginning of the chapter 24 in Basic Nursing.

2. Describe the three stages of the General Adaptation Syndrome (GAS).

3. Discuss the effects of prolonged stress on each system.

4. Discuss the Local Adaptation Syndrome (LAS).

5. Describe the stressors across the lifespan.

6. Discuss the assessment process in collecting data from patients experiencing stress.

7. Describe ego defense mechanisms that may be used by patients to cope with stress.

8. Discuss diagnoses for patients experiencing stress.

9. Discuss the planning phase of the nursing process used in caring for patients experiencing stress.

10. Discuss the nursing interventions for patients experiencing stress.

11. Describe health promotion activities/stress management techniques useful in preventing stress or coping

with stress.

12. Discuss stress management in the workplace for nurses.

13. Discuss common coping responses for stress

14. Describe negative coping responses to stress

15. Discuss the psychological and physical manifestations associated with posttraumatic stress disorder

(PTSD). (See article under Required Readings)

16. Using the nursing process, discuss the nursing care for a patient with PTSD.

17. List resources for patients with PTSD.

18. Discuss the phases in the development of a crisis.

19. Define situational and developmental crises.

20. Using the nursing process, describe the crisis intervention for patients.

21. Complete the exercises presented at the end of each chapter in the assigned readings for

Communication in Nursing by Riley.

22. Complete the Diagnostic Test Guide for Communication.

23. Complete the following pages in Appendix I – Nervous System in the Medical Terminology textbook.

24. Review the anatomy and physiology of the nervous system.

25. Review readings, notes, handouts in Unit 2.

PRESENTATION

Case Studies

Lecture

Handouts

Video

49

FOCUS: Communicating with Patients and Staff Experiencing Stress/PTSD/Crisis (Cont’d.)

STUDENT PREPARATION

REQUIRED

Basic Nursing, Chapter 24 – Stress and Coping.

Medical Terminology – Nervous System-Appendix I

Communication in Nursing, Chapters 20, 21

CD Rom that goes with Basic Nursing, Chapter 24.

Test Success 5th

Edition (Communication and Meeting Patients’ Emotional Needs)

Neason, K. (2006). PTSD: Help Patients Break Free. RN, 69 (10), pp. 30-36

SUPPLEMENTAL

Kane, T. (2008). Getting a Grip on Stress. Nursing 2008, 38 (3), p. 33.

Kayyali, A. (2006). Music therapy for decreasing stress. AJN, 106 (4), pp. 72A-72B.

Welker-Hood, K. (2006). Does workplace stress lead to accident or error? AJN, 106, (9),p.

104

RD 3/10

50

UNIT 7

FOCUS: Communicating with Patients Experiencing Anxiety

OBJECTIVES

PROVIDER OF CARE

1. Discuss the major causes of anxiety.

2. Differentiate the four levels of anxiety.

3. Discuss the assessment process in collecting data from patients experiencing anxiety.

4. List nursing diagnoses for patients experiencing anxiety.

5. Discuss the planning phase of the nursing process used in caring for patients with anxiety.

6. Discuss the nursing interventions for patients experiencing anxiety.

7. Discuss overcoming evaluation anxiety in nursing school.

8. Describe professional approaches to gain self-confidence when faced with nursing situations that

evoke anxiety.

9. Review notes, handouts, readings in Unit 2.

PRESENTATION

Case Studies

Lecture

Skits

Handouts

STUDENT PREPARATION

REQUIRED

Basic Nursing, Chapter 24 – Stress and Coping

Communication in Nursing, Chapter 18, 22.

SUPPLEMENTAL Schenk, P. (2008). Just Breathe Normally: Word Choices that Trigger Nocebo Responses in

Patients. AJN, 108 (3), pp. 52-57.

RD 3/10

51

UNIT 7

FOCUS: Communicating with Patients and Staff Experiencing Conflict/Anger/Aggression

OBJECTIVES:

PROVIDER OF CARE

1. Discuss causes of conflict.

2. Discuss 3 different approaches to conflict resolution.

3. Describe collaboration and the win-win strategy.

4. Discuss confrontation skill and when it should be used.

5. Discuss the steps of the CARE (clarify, articulate, request, encourage) model of confrontation.

6. Describe the effect that conflict has on the nurse-patient relationship.

7. Discuss aggression and anger.

8. Discuss the causes of workplace anxiety and anger

9. Describe effective communication with aggressive patients and colleagues.

10. Discuss professional strategies to deal with aggression in the health care setting.

11. Using the nursing process, discuss the nursing care of the angry patient.

12. Review notes, handouts, and readings in Unit 2.

PRESENTATION

Case Studies

Lecture

Handouts

Video clips

STUDENT PREPARATION

REQUIRED

Communication in Nursing, Chapters 23, 25, 26, 27, 28

SUPPLEMENTAL Nicole, F. (2008). Dealing with an Angry Patient. Nursing 2008, 38 (5), pp. 30-31.

RD 3/10

52

DIAGNOSTIC TEST GUIDE: COMMUNICATION: STRESS/CRISIS/ANXIETY (ETC.)


1. Antidiuretic Hormone (ADH) Vasopressin A. Specimen or type of test

2. Exercise stress testing (cardiac stress testing) B. Basics the Nurse needs to know

3. Cortisol, (blood and urine) C. Purpose of the test

4. Catecholamines and VMA ( 24 hr. urine) D. Normal values

5. Glucose, Fasting (blood) E. How the test is done



H. Nursing care (pretest, during, and post-

test)

RD 3/10

53

UNIT 8

FOCUS: Normal Nutrition

OBJECTIVES:

PROVIDER OF CARE

1. Discuss the balance between energy intake and energy requirements.

2. Explain the importance of each nutrient in the daily diet. Give examples.

3. Recall Anatomy & Physiology of the digestive tract and the processes of digestion, absorption, and

metabolism.

4. Describe the USDA’s Food Guide Pyramid.

5. Define the goals of the World Health Organization’s Healthy People 2010 regarding nutrition.

6. Distinguish nutritional variances throughout growth and development.

7. Explain alternative food patterns.

8. Discuss the relationship between culture, food preferences, and religious dietary restrictions.

9. Review the concepts, key terms and Critical Thinking Exercises at the end of chapter.


Handouts

STUDENT PREPARATION


Review the anatomy and physiology of the digestive organs.

Medical Terminology: Appendix I - Body Systems- Endocrine, pp. 224-229.

Test Success 5th

Edition (Meeting Patients’ Fluid and Nutritional Needs)

AE 3/10

54

UNIT 8

FOCUS: Therapeutic Nutrition

OBJECTIVES:

PROVIDER OF CARE

1. Define therapeutic nutrition and describe the purposes.

2. Give examples of various lab tests used to detect subclinical malnutrition.

3. Review nursing diagnoses related to actual or potential nutrition problems.

4. Identify nursing interventions used to achieve optimal nutrition.

5. Identify the different types of hospital diets and when their use would be most effective.

6. List essential nursing responsibilities associated with monitoring and administering enteral tube

feedings and parenteral nutrition.

7. Describe interventions necessary to prevent complications of enteral tube feeding and parenteral

nutrition.


STUDENT PREPARATION


Test Success 5th

Edition (Meeting Patients’ Fluid and Nutritional Needs)

SUPPLEMENTAL Tilton, D. (2006). How to fine-tune your PICC care. RN 2006, 69 (9), 30-36.

AE 3/10

55

UNIT 8

FOCUS: Sensory Perception and Cognition/Safety

OBJECTIVES:

PROVIDER OF CARE

1. Define:

sensory deprivation, sensory overload, sensory deficit and sensory alteration.

2. Identify patients predisposed to/or who suffers from sensory alteration.

3. Identify how sensory alteration affects or influences the 6 basic needs.

4. Discuss common emotional responses to sensory alteration as imposed by such conditions as:

a. Impaired or lost vision

b. Impaired or lost hearing ability

c. Isolation precautions

d. Bombardment of senses

5. Develop a plan of care for patients with visual, auditory, tactile, speech, and olfactory deficits.

6. List interventions for preventing sensory deprivation and controlling sensory overload.

7. Describe conditions in the health care agency or the patient’s home setting that can be adjusted to

promote meaningful sensory stimulation.

8. Discuss the specific risks to safety as they pertain to the patient’s developmental age.

9. Describe safety risks in a health care agency.

10. Develop a nursing care plan for a patient whose safety is threatened.

11. Describe nursing interventions specific to the patient’s age for reducing the risk of falls, fires,

poisoning, and electrical hazards.

12. Describe methods to evaluate interventions designed to maintain or promote patient safety.

MANAGER OF CARE

13. Identify principles of nursing management of sensory alteration in relation to the nursing process in

differing cultural, ethnic and age groups.

14. Make proper referrals for health care in patients with sensory alteration.


15. Stay abreast of legal, ethical, and technological issues of those who suffer from alterations in sensory

perception.


Role Play/Poster Presentations

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapters 27 & 37.

Test Success 5th

Edition (Meeting Patients’ Physical Safety and Mobility Needs)

AE 3/10

56

UNIT 8

FOCUS: Perioperative Nursing : Interventions for the Preoperative Patient

OBJECTIVES:

PROVIDER OF CARE

1. Examine and define key terms and review key concepts at the beginning of chapter.

2. Identify perioperative phrases.

3. Describe nursing activities during the perioperative phases.

4. Classify surgery according to intent or purpose and degree of urgency.

5. Apply preoperative assessment technique and the rationale for collecting required data to specific case

studies.

MANAGER OF CARE

6. Identify groups at high risk for perioperative complications.

7. Apply the common nursing diagnoses and patient goals for the patient scheduled for surgery.

8. Describe the preparation of the patient for surgery including appropriate teaching documentation.

9. List nursing interventions to reduce patient and family perioperative anxiety.

10. Review expected outcomes and nursing implications for major drug classifications associated with

perioperative preparation: Anticholinergics, Sedatives, Narcotics, Benzodiazepines, and Histamine

Receptor Antagonists.

11. Discuss common pre-operative tests and routine pre-operative orders observed before surgery on

Diagnostic Test Guide for Preoperative Nursing in syllabus.


12. Appraise and discuss current trends of perioperative nursing care.

13. Complete Chapter 5 (Medical Specialists and Case Reports) in Medical Terminology (5th ed.), pp.

167-205.


Case Studies

Discussion/Demonstration

Video: Life of a Perioperative Nurse (If time allows)

VC 610.73 B292pr Basic Clinical Skills: Pre and Post Op Care, Surgical Preparation

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 38 -Surgical Patient.

Mosby's Drug Guide for Nurses

Complete Pharmacology Guide for Pre-Op.

Review wounds, bandaging and medical-surgical asepsis.

Test Success 5th

Edition: (Meeting the Needs of Perioperative Patients)


Taber’s:Cyclopedic Medical Dictionary

Basic Nursing: Essentials for Practice Companion CD

Demonstrating Post-Op Exercises: Incentive Spirometer; Leg Exercises

57

FOCUS: Perioperative Nursing : Interventions for the Preoperative Patient (Cont’d.)

STUDENT PREPARATION

SUPPLEMENTAL Tabor, W. (2007). Robotic Surgery. Nursing 2007, 37 (2), pp. 48-50

MS 04/10

58

UNIT 8

FOCUS: Perioperative Nursing: Interventions for the Intraoperative Patient

OBJECTIVES:

PROVIDER OF CARE

1. Describe role of the members of the surgical team.

2. Identify methods to ensure patient safety during surgery (include skin integrity, wound infection,

positioning, and documentation).

3. Describe the assessment and nursing diagnoses of the patient upon entering the operating room.

4. Name the different classifications of anesthetic agents; identify the benefits, hazards of each, and

nursing responsibilities for each.

5. Discuss the types of regional anesthesia administration: Topical, infiltration, nerve block, and

intravenous.

6. List and define the stages of anesthesia.

7. Discuss the complications that can occur during surgery.

8. View and discuss video on malignant hyperthermia.

9. Describe endoscopes, lasers and other materials and equipment used during surgical procedures.

MANAGER OF CARE

10. Review, identify, and analyze nursing responsibilities with anesthesia process.

11. Identify the information given to the recovery room nurse as the patient is transferred from the

operating room.


12. Read current intraoperative nursing trends and research and relate to practice.


Discussion

Videos: Prevention of Malignant Hyperthermia

STUDENT PREPARATION


Mosby’s Drug Guide for Nurses.

Test Success 5th


SUPPLEMENTAL

DeJohn, P. (2008). Be Prepared: Malignant Hyperthermia. OR Manager, 24, (6), pg. 26.

Websites: www.AORN.ORG (This is a professional organization for the intraoperative nurse)

Video: Malignant Hyperthermia Diagnosis Treatment and Patient Counseling (must check out with

Mrs. Shivers)

MS 04/10

http://www.aorn.org/

59

UNIT 8

FOCUS: Perioperative Nursing: Interventions for the Postoperative Patient

OBJECTIVES:

PROVIDER OF CARE

1. Review key concepts in chapter.

2. Describe the ongoing head-to-toe nursing assessments and interventions completed in the

postanesthesia care unit (PACU).

3. Analyze the PAR score and release from the PACU.

4. Examine common postoperative complications.

5. Choose and incorporate nursing diagnoses in the postoperative .

6. Discuss common nursing interventions for the postoperative patient in the immediate and recuperating

phases.

MANAGER OF CARE

7. Make proper referrals for needed diagnostic procedures needed by PACU patients.

8. Rate types of postoperative pain.

9. Design ways of management of postoperative pain.

10. Review post-operative orders before discharging from the PACU.

MEMBER WITHIN THE DISCIPLE OF NURSING

11. Read current postoperative nursing trends and research related to postoperative nursing care.


Discussion

Video: VC 610.73 B292pr Basic Clinical Skills: Pre and Post Operative Care Surgical Preparation

STUDENT PREPARATION


Mosby’s Drug Guide for Nurses.

Test Success 5th



SUPPLEMENTAL

Brendle, T. (2007). Surgical Care Improvement Project and Perioperative Nurse’s Role. AORN

Journal. 86, (1), pp. 94.

Winslow, E. and Brosz, D. (2008). Graduated Compression Stockings in Hospitalized Post-

Operative Patients: Correctness of Usage and Size. AJN, 108 (9), pp. 40-51.

MS 4/10

60

DIAGNOSTIC TEST GUIDE: PERIOPERATIVE NURSING Look up in Manual of Diagnostic and Laboratory Tests by Pagana and Pagana.

LAB TESTS REQUIREMENTS

1. Coagulation studies: A. Specimen or type of test

PT, INR, PTT, Platelets

B. Purpose of the test

2. BUN, Creatinine

C. Basics the Nurse needs to know

3. Electrolytes

Na D. Normal values

K

Cl E. How the test is done

HCO3


4. Glucose


5. CBC:

RBC H. Nursing care (pretest, during, Posttest)

WBC

Hgb

Hct

6. Chest X-Ray

7. ECG

MS 04/10

61

UNIT 9

FOCUS: Patient/Community Education

OBJECTIVES:

PROVIDER OF CARE

1. Determine the purposes and significance of patient education.

2. Explain the essential facts about health promotion.

3. Discuss the nurse’s role in patient education/health promotion.

4. Describe the similarities and difference between teaching and learning.

5. Describe Bloom’s three domains of learning.

6. Describe factors that facilitate and inhibit learning.

7. Describe characteristics of a good learning environment.

8. Identify the principles of effective teaching.

9. Describe how to incorporate communication principles into patient education.

10. Consider the influences of culture, ethnicity, and developmental factors in patient teaching.

11. Compare and contrast the nursing process and the teaching-learning process.

12. Describe ways to incorporate teaching with routine nursing care.

13. Identify methods for evaluating learning.

14. Identify nursing interventions to improve compliance.


Discussion

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 1 -Health and Wellness; Chapter 11 -Patient Education

Test Success 5th

Edition (Meeting the Needs of Patients in the Community Setting)

SUPPLEMENTAL Bloom, B.S. (1956). Editor: Taxonomy of educational objectives. Cognitive Domain, Vol. I.

New York: Longman.

Healthy People 2000 Review, D.H.H.S., Public Health Service. Publication No. PHS 93-1232.

Hyattsville, Maryland. (Located in the Wellness Center.)

Healthy People 2010. (2000). U.S. Department of Health and Human Services. Washington, DC.

Hohler, S. (2004). Tips for better patient teaching. Nursing 2004, 34 (7), 32.

Mason, D. (2001). Promoting health literacy. AJN, 101 (2), 7. Roberts, D. (2004). Advocacy

through patient teaching. MedSurg Nursing, 13 (6), 363.

Windslow, E. (2001). Patient education materials: can patients read them, or are they ending up in

the trash? AJN, 101 (10), 33-39.

Websites: infonet.welch.jhu.edu/advocacy.html (Johns Hopkins)

healthanswers.com (Orbis Broadcast Group)

healthfinder.gov (U.S. Government Site)

intelihealth.com (John Hopkins)

nlm.nih.gov (National Library)

wellweb.com (WellnessWeb)

LL 4/10

62

UNIT 9

FOCUS: Cultural Diversity

OBJECTIVES:

PROVIDER OF CARE

1. Define culture and other related terms, review key concepts, and analyze critical thinking exercises at

the beginning of chapter.

2. Discuss the influence of culture on the health beliefs and practices of individuals.

3. Recognize and discuss the existence of ethnic and cultural diversity in the general society and the

health care arena.

4. Identify and internalize feelings and behaviors that influence your ability to interact with individuals

of another culture or ethnic group.

5. Compare and contrast groups according to ethnicity, origin, religious beliefs, and gender roles.

MANAGER OF CARE

6. Make necessary referrals for differing cultures and ethnic groups.

7. Examine how the nursing process can be applied when caring for patients of different cultural and

ethnic backgrounds.

8. Assess and discuss food preferences among ethnic groups in the United States.

MEMBER WITH THE DISCIPLINE OF NURSING

9. Using all media, stay abreast of ethical, legal, and health promotion issues in nursing pertaining to

ethnic and cultural changes within the context of global or world society.

10. Make proper referrals for rehabilitation and maintenance.


Student Presentations/Discussion/Audiovisuals

Handouts

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 19 -Cultural Diversity.

Communication in Nursing, Chapter 4.

ATI Review Module: Fundamentals of Nursing, Unit 4 – Cultural Health pgs 573-581

SUPPLEMENTAL

McDonald BSN, Skip (2008). Caring Across Cultures. Minority Nurse, Fall 2008, 34-38.

JL 03/10

63

UNIT 9

FOCUS: Pain

OBJECTIVES:

PROVIDER OF CARE

1. Define all key terms and review key concepts and critical thinking exercises at the beginning of

chapter.

2. Define and describe the characteristics of pain.

3. Identify the theories of pain and comfort phenomenon.

4. Describe pain perception, pain threshold, and pain tolerance.

5. Identify the psychosocial influences on pain: include culture, ethnic and age related factors.

6. Distinguish between and identify assessment findings of acute, chronic pain.

7. Identify subjective and objective data assessed during pain episodes.

8. Relate nursing diagnoses directly and indirectly to patients in pain.

9. Define specific goals for patients experiencing acute, and chronic pain.

10. Describe and discuss pharmacologic and non-pharmacologic measures to relieve and or reduce acute

and chronic pain.

11. Discuss nursing implications for administering analgesics.

12. Differentiate nursing implications associated with managing cancer pain versus non-cancer pain.

13. Describe the sequence of treatments recommended in pain management for cancer patients.

14. Know expected outcomes and nursing implications for the following classifications of drugs and

specific drugs under each classification: opioid agonists, mixed opioid agonist-antagonists, opioid

antagonists, non-opioids, nonsteroidal anti-inflammatory drugs, adjuvant medications for pain such as

sedative/hypnotics, antiemetics, antianxiety, muscle relaxants, anticonvulsants, steroids, and

antidepressants.

MANAGER OF CARE

15. Determine proper referrals for pain management.

16. Analyze ways to collaborate with other health care providers for continuity of pain relief

methodology.

17. Evaluate a patient’s response to pain therapies.


18. Review ongoing nursing research of pain phenomenon and relate to practice.

PRESENTATION Discussion

Lecture

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 31 -Promoting Comfort.

Mosby's Drug Guide

Test Success 5th

Edition (Meeting Patients’ Hygiene, Comfort, Rest and Sleep Needs)

ATI Review Module: Fundamentals of Nursing, Unit 3 – Comfort and Basic Needs, Pain

Management pgs 500-513.

64

FOCUS: Pain (Contd.)


REQUIRED (Cont‘d.) ATI Review Module: Pharmacology for Nursing, Unit 4 – Medications for Pain and Inflammation,

pgs 127-144.

Search Web for most up-to-date information on pain, comfort, and medications affecting each.

Note cultural aspects.

Website: nurses.medscape.com

SUPPLEMENTAL D’Arcy, Yvonne (2008). Meeting the Challenges of Acute Pain Management. Medscape

Neurology and Neurosurgery, Pharmacologic Management of Pain Expert Column.

http://cme.medscape.com

D’Arcy, Yvonne (2008). Pain Management Survey Report. Nursing 2008, June, 42-49.

JL 03/10

http://cme.medscape.com/

65

UNIT 9

FOCUS: Communicating with Patients Families and Staff Experiencing Grief, and Death.

OBJECTIVES:

PROVIDER OF CARE

1. Define key terms, concepts, and Critical Thinking Exercises and Review Questions at beginning of

chapter.

2. Discuss the stages of grief and the nurse’s role in helping the grieving including identification of

clinical symptoms of grief.

3. Identify the significance of developing self-awareness about death and dying.

4. Identify measures that facilitate the grieving process.

5. Identify psychosocial and cultural variables which affect a patient’s belief about death.

6. State the physiologic and emotional needs of the patient and their families in various stages of dying.

7. Identify the clinical signs of impending clinical death.

8. Identify changes that occur in the body after death and essential nursing measures for care of the body

after death.

MANAGER OF CARE

9. Identify rights of terminally ill persons, including dying at home and a living will.

10. Identify how death is viewed across the life span within cultural context.

11. Make proper referrals for individuals, families and spouses who are experiencing loss, grief, dying and

death.


12. Stay abreast of ethical, legal, social issues pertaining to nursing and loss, grief, and death.


Handouts

Group Participation

Discussion/Articles

Videos on Death and Dying

STUDENT PREPARATION

REQUIRED Basic Nursing, Chapter 25 - Loss and Grief.

Communication in Nursing, Chapter 29, pp. 352-359.

ATI Module: Fundamentals of Nursing, Unit 4 – Grief, Loss, and End of Life, 590-597.

SUPPLEMENTAL

Emanuel, L., Ferris, F., Gunten, C., Roenn, J. (2010). The Last Hours of Living: Practical Advice for

Clinicians. http://medscape.com

JL 03/10

http://medscape.com/

66


67

CLINICAL COMPONENTS

FALL 2010

68

THIS PAGE BLANK

69

INFORMATION FOR CAMPUS LAB AND CLINICAL: 1. Attendance: See ADN Student Handbook.

In the event of an absence or tardy (clinical, campus lab practice, check-off), the student

must call the appropriate instructor prior to the absence or tardy. If the student fails to notify

of an absence or tardy, the student may be asked to meet with fundamental faculty.

2. Critical Incidents: See ADN Student Handbook.

3. Dress Code: See ADN Student Handbook

4. Guidelines for Campus Skills Lab and Clinical Practice:

A. Nursing Skills Performance: Prior to clinical, each student is required to satisfactorily

demonstrate all the critical behaviors for the designated nursing skills, (i.e. those skills that are

required in the campus lab).

B. It is the student’s responsibility to:

1. Practice all skills.

2. Attend all lab practice sessions.

3. Utilize the campus skills lab, if additional practice is needed.

4. Attend designated check-off time.

5. View required audio-visuals prior to campus lab practice.

C. The procedure for demonstrating satisfactory performance on the skills includes:

Step 1: Come into the lab and begin the procedure.

Step 2: Complete the procedure satisfactorily.

Step 3: If less than satisfactory, leave the lab and prepare for recheck on another

SCHEDULED DAY.

The student will be given a lab referral sheet. It is the student’s responsibility to

complete this lab referral sheet prior to recheck or the student will not be able to

recheck.

Step 4: Unless otherwise specified with the instructor, each skill must be satisfactorily

checked off prior to the day of the next check off. All skills must be performed

satisfactorily prior to clinical orientation. On the 3rd attempt the student will

check off with two (2) instructors. No more than 3 attempts will be allowed for

satisfactory completion of the assigned skill. If the student is not satisfactory on

the 3rd attempt, the student will be dismissed from NURSING I at that time.

D. Preparation for clinical: Review the clinical information provided by the clinical instructor.

Information in the packet will be specific to the clinical agency and the clinical instructor’s

requirements. The student is expected to be prepared to give safe and quality patient care. If a

student is not prepared at the start of the clinical day, he/she will be sent home.

Before attempting to provide patient care, the student needs to familiarize herself/himself with all

aspects of care the patient will require. The following guidelines will assist the student in this

preparation. Preparation is completed prior to pre-conference and includes the following:

1. Obtain the clinical assignment in sufficient time to prepare for safe practice.

2. Review the patient’s chart and obtain all pertinent data. This encompasses the following

items: history and physical, physician’s progress notes, graphic sheet, medication record,

laboratory findings, nurses’ notes and/or flowsheets, admissions data base, patient care

plan, Kardex card, and physician’s orders. When reviewing doctor’s orders begin at the

admission and check all orders to make sure they are current.

3. Review all procedures that are included in the care of assigned patient. Use critical

behaviors and Nursing I books for review.

4. Research the medical diagnosis including pathophysiology, etiology, and signs and

symptoms. Identify alterations from normal, such as altered lab values, vital signs, etc.

5. Research all medications administered to the patient as to actions, side effects and

nursing implications.

6. Plan the day’s experience by developing a time plan to help keep organized and to enable

completion of patient care in a timely manner.

70

7. Practice charting procedures. Charting should include:

a. Initial assessment (including V/S and basic needs. See Daily Initial Assessment

Guide).

b. Pertinent data.

c. Assessment when you leave (including V/S and basic needs).

8. Complete the care plan as directed by the clinical instructor.

9. Assess the patient at the beginning of each clinical day.

F. Procedures:

1. Before doing a procedure, review procedure in the health care facility’s procedure

manual.

2. Do procedures only under instructor’s supervision unless otherwise instructed.

G. Specialty Areas: During the clinical rotation, the student may participate in various clinical

settings that may include physical therapy or wound care for example. Clinical instructors

reserve the right to cancel specialty area experiences.

H. Conduct: Students exhibiting loud, disruptive, or inappropriate laughter/conversation/behaviors

may be asked to leave the clinical area. A conference with the clinical instructor is required.

I. Confidentiality: The student will maintain patient confidentiality at all times.

J. The student should be responsible for introducing herself/himself to the nurse in charge of the

patient on entering the hospital unit. The student will always report off to the nurse in charge of

the patient before leaving the unit.

K. The student should be prepared to deliver adequate patient care. If a student comes to the

clinical area and he/she is not prepared, he/she will be sent home.

L. Notify instructor and primary care nurse of abnormalities.

M. Never give any drug without instructor‘s supervision.

N. Never leave unit without permission from instructor and/or primary care nurse.

5. Students in each campus lab group will be required to satisfactorily participate in communication group

lab experience. Specific assignments for this experience will be given by the instructor.

6. Once clinical at the agencies has begun, each student will be required to attend two (2) communication

clinical days. The students must satisfactorily participate in these communication clinical days.

Specific assignments for this experience will be given by the instructor.

7. Clinical Evaluation Progress & Criteria: If any behaviors are evaluated as unsatisfactory, there must be

documentation that the behavior has become satisfactory by the end of the semester. If any behavior is

evaluated as unsatisfactory on the Summative Clinical Evaluation, the student receives an unsatisfactory

for the clinical component of the course and fails the course.

8. If you have a disability that qualifies under the American with Disabilities Act and you require special

assistance or accommodations, you should contact the designated coordinator for your campus for

information on appropriate guidelines and procedures: Poplarville Campus, Ms Tonia Moody at

601-403-1060 or [email protected]. Distant Learning Students who require special assistance,

accommodations, and/or need for alternate format should contact Tonia Moody.


mailto:[email protected]

71



NUR 1110

NORMAL ASSESSMENT STANDARDS

A head-to-toe assessment must be done. This assessment should be done after report from the patient's primary

nurse.

I. PSYCHOSOCIAL WELL-BEING

1. Appearance, behavior, and speech appropriate to situation.

2. Affect appropriate with no mood swings.

3. Alert and oriented to person, place, time.

4. Verbalization clear and understandable

II. OXYGENATION

A. Cardiovascular

1. Regular apical/radial pulse; strong.

2. Capillary refill returned in less than 3 seconds.

3. Peripheral pulses palpable.

4. No edema. No calf tenderness.

B. Respiratory

1. Respirations 10-20/min. at rest.

2. Respirations quiet and regular.

3. Breath sounds vesicular through both lung fields, bronchial over major airways, with no

adventitious sounds - posterior and anterior chest.

4. Sputum clear, if present.

5. Lips, nailbed, and mucous membranes pink.

C. Integumentary

1. Skin color within patient's norm.

2. Skin warm and intact.

D. Surgical Dressing/Incisional

1. Dressing dry and intact.

2. Wound edges well approximated.

3. No drainage present.

III. FOOD AND FLUIDS

A. Appetite Appropriate

1. Percentage eaten and (mL) ingested.

2. Internal tube feeding - patient - no irritation at entry site - Placement verified, rate as

ordered. Pump.

3. Mucous membranes moist, pink and intact.

4. Skin turgor - springs back quickly after fold of skin is grasped.

B. Intravenous Therapy and/or Heplock Location

1. Site - no redness, swelling, or drainage.

2. IV Patent with good blood return.

3. Rate as ordered. Pump.

72

NORMAL ASSESSMENT STANDARDS (Cont'd.-2)

IV. ELIMINATION

A. Gastrointestinal

1. Abdomen soft and flat.

2. Bowel sounds active in all four quadrants.

3. Date of last BM continent. No pain with palpation.

4. Continent.

B. Bladder

1. Catheter Size.

2. Urine Color and Characteristics.

3. Palpable. No bladder distention.

4. Continent.

C. Drains

1. Location.

2. Amount and Characteristics of Drainage.

V. REST AND ACTIVITY

A. Musculoskeletal

1. Absence of joint swelling and tenderness.

2. Normal ROM of all joints with equal strength.

3. No muscle weakness.

B. Neurovascular

1. Affected extremity is pink, warm, and moveable within patient's average ROM.

2. Sensation intact without numbness or paresthesia.

C. Sleep - normal pattern, feels rested - quality and quantity.

VI. SAFE ENVIRONMENT

A. Equipment check including: O2 rate, signs in place, Heplock, side-rails, bed height, brakes, aqua

pad, suction, telemetry leads intact, etc.

B. Environment for neatness, safety hazards.

THROUGHOUT THE SHIFT

**Include more data depending on patient's medical diagnosis and nursing actions.

END OF THE SHIFT

When completing care for patient a final "safety" assessment must be done which should include:

1. Equipment checks.

2. State of alertness

3. Orientation level (X 4)

4. Verbal complaints

5. Vital signs

6. Color of skin, m.m., lips, nailbeds.


73



CLINICAL PROGRESS REPORT

The purpose of the clinical progress report is to provide feedback for student learning.

The instructor will complete the clinical progress report at the end of each rotation and periodically, i.e.

whenever an instructor feels the need to provide feedback to the student regarding clinical performance. Care

plans (written or verbalized), and actual clinical performance will be considered as evidence of the student’s

performance.

Clinical Evaluation Progress & Criteria

If any behaviors are evaluated as unsatisfactory, there must be documentation that the behavior has become

satisfactory by the end of the semester. If any behavior is evaluated as unsatisfactory on the Summative Clinical

Evaluation, the student receives an unsatisfactory for the clinical component of the course and fails the course.

The following definitions will be used to provide feedback of clinical performance:

Satisfactory (S) = The student consistently performs the expected outcome.

Needs Improvement (NI) = Performance is minimal; however, does not

warrant unsatisfactory at this time. The student needs to demonstrate more knowledge and skill

through practice, study, and self-discipline. Failure to show progress will result in unsatisfactory

on subsequent progress reports.

Unsatisfactory (U) = The student consistently fails to perform the expected outcome.

Not Applicable (NA).

CLINICAL ASSIGNMENTS

Written work will be evaluated as either satisfactory, needs improvement, or unsatisfactory. Work that needs

improvement or is unsatisfactory must revised and returned to the instructor on the designated date.

Clinical Progress Reports

Students are required to review and sign as directed by the clinical instructor.

FUNDAMENTAL FACULTY,4/10

74

Pearl River Community College

Department of Nursing Education Associate Degree Nursing

Clinical Progress Report

Guidelines

1. The clinical instructor will complete the evaluation tool daily on each student. Anecdotal notes will be

written on the form related to any incidents, positive or negative in nature. Students and faculty should

review the form together at regular intervals during the clinical rotation. Students should initial that they

have reviewed the evaluation.

2. An evaluation of “needs improvement” does not necessarily precede an evaluation of “unsatisfactory”.

3. When a student earns a “needs improvement”, the student is then expected to improve performance in

the area of deficiency.

4. An “unsatisfactory” clinical day will result from two “needs improvements” scores on any one item, an

inappropriately handled clinical absence or any behavior that may violate patient safety.

5. Any student who receives an “unsatisfactory” evaluation will be counseled by the instructor prior to the

next clinical experience. At this time, the student may address the evaluation in written form and attach

the response to the form.

6. If a student receives two “unsatisfactory” scores on any one item, the student will meet with level

instructors to address the student’s inappropriate handling of clinical absences or performances.

Course instructors will determine if the student’s behavior warrants continuation of clinical with

stipulations or a clinical failure.

Level coordinator will be notified of student’s unsatisfactory performance.

7. Any one “unsatisfactory” score can result in a clinical failure.

8. Upon completion of the clinical rotation, the instructor and student will review the evaluation and both

will sign the form to verify review.


75



NURSING 1110-Nursing I

CLINICAL PROGRSS REPORT

LEGEND: S = SATISFACTORY; NI = NEEDS IMPROVEMENT; U = UNSATISFACTORY; NA = NOT APPLICABLE

Student:____________________________________ Instructor:_________________________________ Semester Term:________________

STUDENT LEARNING OUTCOMES

CLINICAL DATE:

[PROVIDER OF CARE]

ASSESSMENT

Clinical

Identifies the medical diagnosis and verbalizes the pathology of the disease.

Demonstrates knowledge of ADL’s, diet, plan of care, labs, diagnostic procedures and

is able to find results and relate results to plan of care.

Checks the MD orders and compares them to the current MAR

Completes a physical assessment in a timely manner.

Assesses critical data and communicates this data to instructor and/or primary nurse in

a timely manner.

Identifies the patient throughout care.

Using therapeutic communication, introduces self and asks appropriate questions to

obtain assessment data.

Written Work

Completes the student assignment worksheet.

Completes the assessment of body systems, basic needs, growth and development,

and position on wellness-illness continuum on the careplan.

Accurately documents critical data.

DIAGNOSIS

Clinical

Analyzes objective and subjective data to formulate pertinent nursing diagnosis.

Prioritizes care based on assessment findings.

Written Work

Writes appropriate nursing diagnoses that is supported by defining

characteristics.

PLAN

Clinical

Plan and organizes actions to resolve the problem in the nursing diagnosis that will

ultimately meet the patient’s needs.

Demonstrates critical thinking skills in prioritizing patient care; is adaptable to

changes as patient’s needs change.

Prioritizes nursing care within time frame.

Written Work

Identifies pertinent and measureable goals and outcome criteria to meet patient‘s

needs.

IMPLEMENTATION

Clinical

Safely implements appropriate interventions and/or skills to meet patient needs.

Explains procedures and provides privacy during nursing care.

Maintains standard precautions during nursing care.

Accurately documents nursing care using correct terminology, spelling and grammar.

Demonstrates correct rationale for medications and important side effects to monitor

Demonstrates satisfactory skill performance.

Provides for patient education, including family/significant others.

76

CLINICAL DATE:

[PROVIDER OF CARE CONTINUED]

IMPLEMENTATION CONTINUED

Written Work

Identifies appropriate nursing interventions to meet the patient‘s needs.

Completes 1 Nurse Patient Interaction (NCI)

EVALUATION

Clinical

Discusses effects of nursing care and re-adjusts based on patient needs.

Recognizes own strengths and weaknesses.

Written Work

Evaluates nursing care and redesigns as needed.

Evaluates achievement of goal/outcome criteria.

Evaluates own strengths and weaknesses.

[MANAGER OF CARE]

Clinical

Manages care of assigned patient using good time management.

Completes documentation in assigned time.

Demonstrates fundamental critical thinking skills in managing patient care.

Communicates with the instructor, primary nurse, patient, and healthcare personnel as

it relates to ’s care.

[MEMBER WITHIN THE DISCIPLINE]

Adheres to expectations of the discipline of nursing.

Demonstrates a positive attitude toward learning and seeks learning experiences.

Accepts constructive criticism in a positive manner.

Demonstrates professional behavior before, during, and after clinical.

Arrives on time for clinical assignment.

Notifies instructor of tardiness or absence prior to clinical.

Turns in written assignments on time.

Receives report and gives report to appropriate health care members.

Adheres to the PRCC ADN Student uniform dress code.

Maintains confidentiality.

Reports to instructor and/or staff when leaving assigned clinical area.

Functions within limits of student nurse and seeks assistance as required.

Follows the policies and procedures of the school of nursing and the assigned agency.

STUDENT INITIAL

DATE OF REVIEWING PERFORMANCE

COMMENTS:

12/09- PRCC ADN FACULTY

77



Department of Nursing Education

CLINICAL SUMMATIVE EVALUATION

The purpose of the summative clinical evaluation is to determine satisfactory clinical performance.

At the end of each semester, the student’s achievement of the expected clinical outcomes will be evaluated.

The student must receive satisfactory in every area to pass the clinical component of the course.

The following definitions will be used to evaluate each outcome:

Satisfactory (S) = The student consistently performs the expected outcome.

Unsatisfactory(U) = The student consistently fails to perform the expected outcome.

The student is accountable for the knowledge and skills learned in all previous nursing course(s).

The following summative evaluation form is based on the philosophy of the ADN program and course

objectives.

CLINICAL ASSIGNMENTS

Written work will be evaluated as either satisfactory, needs improvement, or unsatisfactory. Work that needs

improvement or is unsatisfactory must revised and returned to the instructor on the designated date.

Clinical Summative Evaluation

Students are required to review and sign as directed by the clinical instructor.


78


79



CLINICAL SUMMATIVE EVALUATION FORM

Name: Course: Date:

EXPECTED OUTCOMES *S

*U

COMMENTS

PROVIDER OF CARE Assessment

Demonstrates knowledge of patient’s medical

diagnosis, pathology, treatments, orders, and

drugs.

Accurately and completely assesses the

patient?s basic needs, growth and

development, and position on the wellness-

illness continuum.

Diagnosis

Demonstrates critical thinking skills in

prioritizing patient care.

Identifies appropriate nursing diagnoses for

assigned patients.

Plan

Plans and organizes nursing actions to meet

patient’s needs.

Implementation

Safely implements appropriate and caring

interventions and/or skills to meet

patient needs.

Communicates effectively

Provides for patient education

Acute Care Wellness/Community

Accurately documents

Evaluates

Evaluates nursing care and redesigns as

needed.

MANAGER OF CARE Demonstrates critical thinking skill in man-

aging patient care.

Safely manages care of assigned patients in a

timely manner and collaborates with members

of the health care team.


Maintains professional behavior and adheres

to expectation of the discipline of nursing.

*S=Satisfactory *U=Unsatisfactory

Clinical Component: Passed Failed

Student’s Comments:

Instructor’s Comments:

Student’s Signature/Date Instructor?s Signature/Date

DR 4/96; Rev. 11/02, RD Reviewed 11/08 –PRCC ADN FACULTY

80


81

TOPIC: Clinical: Nursing Home and Hospital

FOCUS: Professional, Ethical, and Legal Behaviors; Interpersonal Relationships; Nursing Process;

nursing Care of the Adult Patient; Organization of Patient Care

OBJECTIVES:

PROVIDER OF CARE

1. Adhere to policies and procedures of the school of nursing and assigned institution.

2. Safely perform skills that have been successfully completed in campus lab and/or discussed in class.

3. Incorporate principles of gerontological nursing in performing skills.

4. Incorporate scientific principles of gerontological nursing in communicating with assigned geriatric

patient.

5. Initiate a helping relationship and discuss goals of interviews with assigned patient.

6. Begin to implement the actions necessary to accomplish goals established during the orientation phase

of the helping relationship.

7. Evaluate goal attainment or progress with patient in relation to termination phase of the helping

relationship.

8. Select patient for Nurse-Patient Interaction (NCI) and complete as assigned.

9. Utilize the nursing process, basic needs, and growth and development when providing care to assigned

patient(s).

10. Correctly record assessment data and plan of care on the form provided.

11. Incorporate nursing measures for pressure ulcer care related to prevention, detection, and improvement

of existing ulcers.

12. Identify standards of pressure ulcer care within the student’s clinical-institution of practice.

13. Verbalize beginning knowledge of medications prescribed for assigned patient(s).

14. Discuss the relationship between culture and food preference of assigned patient(s).

15. Discuss the role of various nutrients from the food guide pyramid in the daily diet of assigned

patient(s).

16. Observe for and record signs of nutritional deficiencies in assigned patient(s).

17. Identify purpose of and foods allowed on various therapeutic diets.

18. Appropriately record intake and output of assigned patient(s).

19. Begin to relate abnormal lab values to the patient’s illness.

20. Using general rules for charting and hospital policies, document care of assigned patient.

21. Compute dosage problems as assigned.

22. Discuss in post-conference care given to patient(s) in a nursing home or hospital.

MANAGER OF CARE

23. Utilize the Guidelines for clinical practice when attending clinical.

24. Organize care and materials to provide effective and efficient patient care.


25. Review the "Guidelines for Clinical Practice" that will assist in conveying nursing competence to

assigned patient including professionalism, ethics, and values.

26. Explore cultural and sociological factors and their impact on the aging process.

27. Discuss in post-conference feelings and attitudes toward nursing homes and the aged patient.


82

TOPIC: Clinical: Wellness Center

FOCUS: Wellness Center Experience


In combining the disciplines of Health, Physical Education and Recreation, the ADN students will participate

in the post-assessment and orientation process of HPR 1021, HPR 1051, HPR 1591, HPR 1752, and

HPR 1213 by compiling the following information for planning a lifestyle exercise program for participants in

the PRCC Wellness Center:

1. Recording post-assessment data at each of the fitness assessment stations, i.e., blood pressure and

resting heart rate (pulse); three-minute step test; push-up test; and modified sit-and-reach test.

2. Noting information obtained from pre-participation health history checklist and making

recommendations for medical follow-up regarding students’ participation in Wellness Center

activities.

3. Providing an explanation of each assessment score to aid in the development of specific goals for the

participants.

4. Providing encouragement to follow problem-solving techniques to integrate physical activity in the

participant’s schedule.

STUDENT PREPARATION

REQUIRED Promptness in attendance

Professionalism and encouragement in approach to participants

SUPPLEMENTAL Pate, R.; Pratt, M.; et al. Physical activity and public health: a recommendation from the Centers for

Disease Control and Prevention and the American College of Sports Medicine. Journal of the

American Medical Association, 95 (273):402-7.

Powell, K.E. & Blair, S.N. The public health burdens of sedentary living habits: Theoretical but

realistic estimates. Medicine & Science in Sports & Exercise, 94 (26):951-6.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention &

Health Promotion (1996). Physical activity and health: a report of the surgeon general.

Atlanta: Genger.

INTERNET RESOURCES www.acsm.org American College of Sports Medicine: Guidelines for Exercise Testing

and Prescription (2000). (6th ed.) Lippincott: Philadelphia.

http://umanitoba.fitdv.com Andrews, L.W. The exercise prescription. Your Health,

November 2004.

www.fitness management.com Brehm, B. Exercise Recommendations: Where do they

come from?

www.jaxmed.com Jacqmein, J. Prescription: Exercise. (1999).

www.fitnessmanagement.com Malkin, M. Warming Up, Cooling Down and Stretching.

www.fitnessmanagement.com Westcott, W.; Loud, R.; & Powers, L. Back to Basics:

Benefits of a Standard Exercise Program.

www.pueblo.gsa.gov Exercise and your heart.

83

FOCUS: Wellness Center Experience (Cont’d.)

RULES pertaining to student’s participation in the Wellness Center:

1. ADN students will report promptly at the scheduled time to the Wellness Center.

2. Attendance will be recorded at the Wellness Center desk.

3. Arrangements for absences (i.e., conflicting class schedules) must be made with the Nursing/Wellness

Coordinator prior to scheduled times.

4. If an absence occurs on a theory day, an absence will be recorded in theory class. If an absence occurs

on a clinical day, an absence will be recorded in clinical.

5. Campus lab dress will be followed. Always maintain professionalism while representing the PRCC

Department of Nursing Education ADN program.

6. Protocol at each fitness assessment will be followed as instructed by the Wellness Center Director to

ensure consistency of testing.

7. Metronomes and stopwatches must be returned to a Wellness Center staff member at the shift change.

8. Students at each assessment station must check with Nursing/Wellness Coordinator or Wellness

Center Director before departing to ensure continuity of assessment staff.

LL 4/10

84

PRCC Wellness Center Protocol for Instruction of the Health-Related Fitness Assessment: I. Vital Signs: blood pressure and Resting Heart Rate (Pulse):

Blood Pressure: the pressure exerted by the circulating blood flowing against the walls of the arteries

and veins and the chambers of the heart.

Resting Heart Rate (Pulse): Number of beats per minute caused by the ejection of blood from the heart

as it contracts.

A. Recording of blood pressure.

Equipment needed: Sphygmomanometer, blood pressure cuff, stethoscope

Instructor Preparation: 1. Be sure participants have not been tested at other stations prior to their vital sign recordings.

This may cause inaccurate readings.

2. Report blood pressure recordings of 160/100 or above, or any abnormalities in measuring

blood pressure, to any Wellness Center staff member.

3. Request assistance after two attempts if having difficulty measuring blood pressure.

Procedure: 1. While seated, place the cuff around the upper arm of the participant and inflate to a pressure

greater than the systolic pressure, occluding the artery.

2. Place the diaphragm of the stethoscope over the brachial artery in the antecubital space, and

release the pressure in the cuff. Note the systolic pressure at the first sound which is heard, and

the diastolic pressure, the pressure at which the sounds stop.

B. Recording of resting heart rate (pulse)

Equipment needed: Watch with second hand

Instructor preparation: 1. Note and record the number of beats per minute on the radial artery of the participant.

Procedure: 1. Seek assistance from Wellness Center staff if having difficulty recording pulse.

2. Note any irregularities in the pulse assessment, reporting any abnormalities and/or increases

over 100 beats per minute.

II. Cardiorespiratory Endurance (Aerobic Fitness): The ability of the heart, lungs, and blood vessels to

deliver adequate amounts of oxygen to the cells to meet the demands of prolonged physical activity.

A. Three-minute Step Test: The purpose of this test is to determine a one minute recovery heart

rate after 3 minutes of stepping. This will give an indication of cardiorespiratory fitness.

Equipment needed: Stopwatch or digital watch; 12-inch high step’ metronome set at 96 bpm.

Instructor Preparation: 1. Note that participants are wearing proper shoes and comfortable clothing.

2. Ensure that participants have refrained from smoking, caffeine, and other vigorous exercise

prior to this test.

3. Allow time for participants to warm-up and practice proper cadence of up, up, down, down to

the beat of 96 beats per minute.

85

4. Stop stepping if any participants experience dizziness, excessive shortness of breath, nausea, or

extreme fatigue.

Procedure: 1. Have participants face the step and set the metronome to 96 bpm. The time will begin when

stepping begins: up, up, down, down. Be sure to keep the proper cadence.

2. Have participants sit down immediately after the 3-minute test for a 1-minute pulse check.

Record 1-minute pulse check on data sheet.

III. Muscular Endurance: The ability of a muscle to exert submaximal force repeatedly over a period of

time.

Assessment: Push-up Test

Equipment: None

Instructor Preparation: Allow a brief period of practice for the participants to become familiar with

the range of movement.

Procedure: 1. Male participants begin in the standard “up” position (hand shoulder width apart, back

straight, head up, using the toes as the pivotal point)

Female participants in the modified “knee push-up” position (legs together, lower leg in

contact with mat with ankles plantar-flexed, back straight, hands shoulder width apart, head

up).

2. The participant must lower the body until the chin touches the mat. The stomach should not

touch the mat.

3. For both men and women, the participant’s back must be straight at all times and the

participant must push up to a straight arm position.

4. The maximal number of push-ups performed consecutively without rest is counted as the

score, and the result is compared to normal standard values.

5. Terminate test if: a.) You fail to maintain the appropriate form; b.) If you stop for any period

of time; c.) Males accomplish 39 push-ups and female accomplish 33 push-ups.

IV. Flexibility: the ability of a joint to move freely through its full range of motion.

Assessment: Modified Sit-and-Reach Test

Equipment needed: Acuflex I sit-and-reach flexibility tester.

Instructor Preparation: Be sure participants properly warm-up before the test. Have participant

perform the following stretches:

a.) Calf/hamstring stretch; b.) Seated toe touch; c.) Knees-to-the-chest.

Procedure: 1. Have participants remove shoes for the test. Have them sit on the floor with hips, back, and

head against a wall, legs fully extended, and the bottom of the feet against the Acuflex I.

2. Place participant’s hands (one on top of the other) out in front and have them reach forward as

far as possible without letting the hips, back or head come off the wall. Another person should

then slide the indicator along the top of the box until the end of the indicator touches the tips of

their fingers. The indicator must then be held firmly in place throughout the rest of the test.

86

3. The head and back now can come off the wall, and participants may reach forward gradually

three times. The third time stretching forward as far as possible on the indicator, holding the

final position for at least 2 seconds. Be sure to keep the back of the knees against the floor

throughout the test. Record the final number of inches reached to the nearest half inch.

4. Two trials are allowed and an average of the two scores is used as the final test score.

LL 4/10

87

TOPIC: Campus Lab - Communication

FOCUS: Communication Group Experience

OBJECTIVES:

PROVIDER OF CARE

1. Discuss therapeutic and nontherapeutic communication.

2. Discuss the Nurse-Patient relationship.

3. Demonstrate therapeutic communication through skits and/or role play.

MANAGER OF CARE

4. Discuss group dynamics and its effect on the health care team and patient care.

5. Participate in group activities as assigned by the instructor.

6. Discuss actions that can increase the effectiveness of a group.


7. Practice communication in a clear and concise manner.

8. Demonstrate professional behavior during the communication group experience.

9. Follow the policies and procedures of the school of nursing.

10. Complete self-evaluation of communication group performance.

PRESENTATION

Discussion

Role play

Concept mapping

Handouts

STUDENT PREPARATION

REQUIRED

1. Make a poster OR a video/DVD/Power Point presentation of “My Life.” (See the samples at

the end of this handout.) You should present what you want your classmates to know about

you. If you have questions about this assignment, please ask instructor. Please include all of

the information/descriptions shown in the sample poster.

2. Review Chapters 1, 2, 3, 5, 7, 8, 9, 10, 15 in Riley textbook.

3. Review class notes on communication and group dynamics.

4. Be prepared to present this project to your communication group.

5. Be prepared to participate in group activities as assigned.

6. If you present on VHS video, DVD, or flash drive, make sure that you clear this with me

several days before your communication group will meet in order to make sure our computer is

compatible to your program. Also arrange with me to use the power point projector several

days ahead. It is difficult to connect your lap top to our set-up in the class room. We have

Windows XP, Microsoft Office 2003, PowerPoint 2003 on our classroom computer.

7. BRING ALL NURSING TEXTBOOKS THIS DAY TO CLASS TO USE AS

REFERENCES FOR SKITS THAT YOU WILL PERFORM.

88

FOCUS: Communication Group Experience (Cont’d.)

STUDENT PREPARATION

REQUIRED

7. MATERIALS TO BRING:

a. “My Life‖ poster or “My Life” VHS Video/CD/DVD

b. Pen and paper

c. Riley textbook (Communication in Nursing)

d. SAMPLE POSTER-- You can use descriptions, photos, pictures from magazines,

and/or drawings on poster paper. Make the poster neat. I am not evaluating you on

your artistic ability. Include all of the items listed below:

****************************************************************************************

* *

* *

MY LIFE

Name

*Hobbies(before nursing school) *3 reasons why I entered the nursing profession

*Important people in my life *Previous jobs/professions/degrees

*My favorite nurse or *How will my previous jobs/professions/

nurse role model degrees help me in nursing

* *3 major goals to work toward

after becoming an RN

* *

VHS VIDEO/CD/DVD

If using video or DVD, you must have someone video you presenting the same information that is required on

the poster. The video/DVD should be 3-4 minutes long. You should state your name. If you use a CD, you

must present it verbally to the group.

8. TIME: If scheduled for Am, the time is 8:15 – 10:50 a.m.

If scheduled for Pm, the time is 12:15 noon – 2:50 p.m. Note: See calendar for dates for your

advisee group

9. PLACE: Wait in the student lounge for instructor to tell you where we will meet.

10. DRESS: Campus lab attire: See syllabus for this description.

11. The student must receive a satisfactory evaluation for this communication group experience in

order to pass NUR 1110.

RD 3/10

89

TOPIC: Clinical – Communication

FOCUS: Communication Day Experience

OBJECTIVES:

PROVIDER OF CARE

1. Discuss therapeutic and non-therapeutic communication in a group setting.

2. Discuss, as a group, specific clinical situations, hypothetical and past clinical experiences.

3. Demonstrate therapeutic communication through skits and/or role play.

4. Complete an NPI (nurse-patient interaction) on a patient in the clinical area before attending

communication lab experience.

5. Participate in the teaching of assigned relaxation techniques.

6. Participate in the implementation of relaxation techniques

7. Evaluate student performance in skits and/or role play.

MANAGER OF CARE

8. Demonstrate adequate time management in accomplishing assigned tasks

9. Complete work in assigned time.

10. Display promptness in attendance.

MEMBER WITHIN THE DICIPLINE OF NURSING

11. Follow the policies and procedures of the school of nursing.

12. Demonstrate professional behavior during clinical.

13. Complete an interview with a seasoned RN.

14. Complete self-evaluation of clinical performance.

PRESENTATION

Interviews--discussion

Group discussion

Role play

Videos

STUDENT PREPARATION

REQUIRED

1. Potter and Perry, Basic Nursing (7th ed.), Chapters 10, 18, 24.

2. Balzer/Riley, Communication in Nursing, Chapters 1, 2, 5, 18-22.

***If you have already read these pages, just review them and be ready to discuss material.

Also review objectives for Unit 2 and 7 and any handouts given in these units.

3. Materials to bring:

a. ALL NURSING TEXTBOOKS TO CLASS THESE BOTH DAYS

b. Paper; pen; pencil

90

FOCUS: Communication Day Experience (Cont’d.)


REQUIRED (Cont‘d.)

3. Materials to bring: (Cont’d.)

c. Bring the handouts regarding communication given in Units 2 and 8 this semester, as

we will use them as references.

d. Bring your completed Nurse-Patient Interaction Form.

e. Bring your completed Interview form (Interview with a seasoned RN).

4. DRESS

a. Adhere to campus lab attire for campus lab (clinical). This dress code is required

for communication. Remember to wear your lab coat with your name pin.

b. Follow regulations given in the NUR 1110 SYLLABUS—please review.

5. TIME AND LOCATION

a. 8:00 AM – 2:00 PM--Be at PRCC nursing student lounge at 7:50 am. Wait in student

lounge.

b. There will be a working lunch. You will be given assignments to do during lunch.

Bring a sandwich, etc. to eat during lunch. Don't bring any food that has to be

heated. While you are eating, you will be watching a video and writing answers to

questions. We will not order out or leave campus to eat.

6. Be on time. This is a clinical day and is very important to your education as a nursing

student. You must receive a satisfactory evaluation for communication day experience in

order to pass NUR 1110.

a. If you are unable to come to this clinical, you must call the instructor who is teaching

the communication day experience in advance to let her know of your absence. Please

call the office of this instructor and leave a message on her voice mail. This voice mail

is checked each morning before class. You must give your reason for not coming, and

it must be valid. Please do not come if you have a communicable disease, as we will

be in a classroom/lab together most of the day. If the student has a valid excuse for the

absence, the student will be allowed to complete make-up work assigned by that

instructor.

b. If you do not call in advance, the instructor will not know what has happened to you. If

you do not call, you will be counted as a "no-show." Then you may have to meet with

the fundamental faculty/or the nursing attendance committee upon your return to

campus. There is a possibility that you may be given a critical incident, and/or

dismissed from the nursing program.

c. If you have any questions regarding communication day, please ask the communication

instructor as she is your resource person and your instructor for this day.

d. Students must have reading assignments completed and assigned work/papers ready to

turn in at 8:00 am on communication day. You should have already conducted a

therapeutic interaction with a patient at the clinical facility. You must complete Nurse-

Patient Interaction Form (NPI) before you come to communication clinical. If the

completed NPI form is turned in late, the student will be assigned a second NPI to

complete on a different patient, for a total of two NPI’s.

RD 3/10

91

Student Name: ________________________________________________

Clinical Advisor:_______________________________



NUR 1110 – FUNDAMENTALS

COMMUNICATION DAY LAB – MRS. DALE

FALL, 2010

INTERVIEW WITH A SEASONED RN

DIRECTIONS: Interview an RN who has been actively working in nursing for the past 5 or more years.

You may interview them in person or on the phone. Make a copy of this page, complete it each question, and

turn it in on the second communication lab day.

1. WHAT ARE YOUR RECOLLECTIONS OF YOUR EARLY NURSING STUDENT DAYS?

WHAT TYPE OF DEGREE DID YOU RECEIVE?

2. HOW MANY YEARS HAVE YOU ACTIVELY PRACTICED NURSING AS AN RN?

3. WHAT AREA OF NURSING PRACTICE IS YOUR FAVORITE AND WHY?

4. HOW DO YOU BALANCE FAMILY AND CAREER?

5. HAVE YOU EVER EXPERIENCED BURNOUT? IF YES, WHAT DID YOU DO TO DEAL

WITH IT?

6. WHAT DO YOU DO FOR FUN AND RELAXATION?

7. WHAT DO YOU SEE AS THE FUTURE OF NURSING?

RD 3/10 -------------Adapted from: Raymer, M. (2006). 10 questions. MODRN, 2,(3), p. 14.

92


93

NURSING I

CRITICAL BEHAVIORS

FALL 2010

94


95

PRCC Department of Nursing Education NAME

Associate Degree Nursing ADVISOR/

CRITICAL BEHAVIORS EVALUATOR

PERFORMANCE

DATE

START TIME:

END TIME:

HANDWASHING

To successfully complete this check-off, the total critical behaviors must be performed satisfactorily. S U

1. Do not touch outside or inside of sink.

2. Lather hands and arms well using friction and giving special attention to areas between fingers.

3. Clean fingernails.

4. Rinse thoroughly and in correct direction.

5. Dry hands thoroughly from finger tips to elbows. Use separate paper towels for each arm.

6. Turn off water with paper towels if faucet is hand operated.

7. Complete within allotted time: 2 minutes

COMMENTS:

MS 04/10

96


97




PERFORMANCE

DATE

START TIME:

END TIME:

HYGIENE


1. Check physician/nursing order.

2. Wash hands.

3. Introduce self.

4. Identify patient.

5. Assess patient.

6. Explain procedure. (Include patient teaching.)

7. Check safety precautions:

A. Vital signs if appropriate

B. Side Rails

C. Brakes locked

D. Appropriate height of bed

E. Tube placement

F. Environment

G. Appropriate help and equipment

H. Proper body mechanics

8. Don clean gloves.

9. Provide for privacy.

10. Give the following care:

A. Oral

B. Bath

C. Perineal

D. Back Rub (Always ask your patient first)

E. Hair, Grooming

F. Bed change

98

HYGIENE (Cont’d.)


11. Wash hands.

12. Chart care given including observations and patient’s response.

13. Complete within allotted time: 1 hour

COMMENTS:

AE 3/10

99




PERFORMANCE

DATE

START TIME:

END TIME:

BEDMAKING To successfully complete this check-off, the total critical behaviors must be performed satisfactorily. S U


2. Wash hands.

3. Introduce self.


5. Assess patient.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Handle linens using principles of medical asepsis.

9. Remove attached equipment.

10. Provide for patient comfort and privacy

11. Provide special equipment necessary for specified bed.

12. Make specified bed.

100

BEDMAKING (Cont’d.)


13. Ensure a smooth, wrinkle-free bottom surface.

14. Place top linen appropriately, including correct folding of draw sheet.

15. Replace attached equipment.

16. Reposition bed and side rails appropriately.

17. Wash hands.

18. Chart care given including observations and patient response.

19. Complete within allotted time: 6 mins.

COMMENTS:

AE 3/10

101




PERFORMANCE

DATE

START TIME:

END TIME:

PROMOTING REST, ACTIVITY, AND SAFETY

(Basic Body Mechanics, Moving, Turning, Positioning, Transfer, ROM, and Ambulation)



2. Wash hands.

3. Introduce self.


5. Assess patient. Determine all needs, patient’s abilities, and limitations. Prioritize.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Keep weight balanced above base of support and back straight.

9. Enlarge base of support in direction in which force is to be applied.

10. Support joints and limbs appropriately during exercise/movement.

11. Position, move, turn, transfer and/or ambulate patient correctly in a coordinated manner

according to direction of instructor.

102

PROMOTING REST, ACTIVITY, AND SAFETY: (Basic Body Mechanics, Moving, Turning, Positioning, Transfer,

ROM, and Ambulation) (Cont?d.)


12. Demonstrate knowledge of normal joint function using slow, smooth, rhythmic movement.

(Repeating each movement at least 3 times.)

A. Neck (Remove pillow)

1. Flex and Extend

2. Lateral Rotation

3. Lateral Flexion

B. Shoulder

1. Flex and Extend

2. Abduct and Adduct

3. Internal and External Rotation

C. Elbow

1. Flex and Extend

2. Supination and Pronation

D. Wrist

1. Hyper extend, Extend, Flex

E. Fingers

1. Flex and Extend


F. Thumb


2. Opposition

G. Hip

1. Flex and Extend

2. Adduct and Abduct

3. Internally and Externally Rotate

{Knee - Flex and Extend only - Done with Hip Movement)

H. Ankle and Foot

1. Dorsiflex

2. Plantar Flex

3. Invert and Evert Foot

I. Toes

1. Flex and Extend

2. Adduct and Abduct

13. Evaluate patient for comfort, level of fatigue, and body alignment.

14. Wash

15. Chart ROM performed including observations and patient?s response.

16. Complete within allotted time: 30 minutes or as specified. COMMENTS:

AE 3/10

103




PERFORMANCE

DATE

START TIME:

END TIME:

TEMPERATURE, PULSE, AND RESPIRATION



2. Wash hands.

3. Introduce self.


5. Assess patient.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment


H. Proper body mechanics 8. Temperature: Place thermometer in clean sheath/cover.

A. ORAL - Shake down thermometer and place under patient’s tongue.

Time for 3 minutes for routine procedure, remove, read, and record.

B. RECTAL - Apply gloves. Shake down thermometer and lubricate bulb end. Insert 1.5 inches

into rectum (Adult). Leave in place for three minutes. Remove, clean, read thermometer,

and record.

C. AXILLARY - Place thermometer in patient's axilla with stem upward. Leave thermometer in

place for 3 minutes. Remove, read and record.

D. DIGITAL READINGS - Follow manufacturer's directions for use and record.

104

TEMPERATURE, PULSE, AND RESPIRATION (Cont?d.)


9. Pulse:

A. RADIAL PULSE - Place first fingers over appropriate pulse site, accurately count for

1 minute, and record within 2 counts of evaluator's findings.

B. APICAL PULSE - Listen and accurately count the heart rate with a stethoscope over the apex

of the heart for one full minute and record within 2 counts of the evaluator’s findings.

10. Respiration: Accurately count the respirations for 1 minute and record within one count of

Evaluator’s findings.

11. Retake if findings are abnormal and report abnormal vital signs.

12. Wash hands.



COMMENTS:

HC 3/10

105




PERFORMANCE

DATE

START TIME:

END TIME:

BLOOD PRESSURE



2. Wash hands.

3. Introduce self.


5. Assess patient.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Apply blood pressure cuff correctly.

9. Place diaphragm of stethoscope over brachial artery.

10. Accurately note pressure at point where you first hear regular sound

11. Accurately note pressure at point which sound disappears.

(Repeat steps 8-11 once if necessary to confirm reading.)

12. Record appropriately within 4 mmHg of evaluator’s findings.

106

BLOOD PRESSURE (Cont’d.)


13. Retake and report any abnormal reading.

14. Wipe blood pressure cuff and stethoscope with alcohol swabs.

15. Wash hands.

16. Chart care given including observation and patient response.


COMMENTS:

HC 3/10

107




PERFORMANCE

DATE

START TIME:

END TIME:

NASOGASTRIC INTUBATION


INSERTING A NASOGASTRIC TUBE:


2. Introduce yourself.

3. Wash hands.


5. Assess patient.




B. Side rails

C. Brakes locked


E. Tube placement (Omit if Tube Insertion)

F. Environment



I. Check for allergies

8. Determine length of tube to be inserted and mark.

9. Glove and put on goggles.

10. Lubricate and insert tube.

108

NASOGASTRIC INTUBATION (Cont?d.)


11. Check to see if tube is in stomach:

A. Aspirate for gastric contents.

B. Auscultate. Instill 15-20 ml of air and listen with a stethoscope for "crackles" over left

upper gastric area.

12. Secure tube to bridge of nose.

13. Wash hands.

14. Record procedure, specific tube used, size of tube, method used for placement verification,

observations and patient response.

15. Complete in allotted time: 15 minutes

COMMENTS:

PL 4/10

109




PERFORMANCE

DATE

START TIME:

END TIME:

REMOVING A NASOGASTRIC TUBE




3. Wash hands.


5. Assess patient.




B. Side rails

C. Brakes locked



F. Environment





9. Disconnect from suction if applicable.

10. Check for bowel sounds (if none present, listen for 5 min.) then notify physician.

11. Remove tape from nose and check if appropriate. Unpin tube from gown if appropriate.

12. Pinch tube closed.

110

REMOVING A NASOGASTRIC TUBE (Cont‘d.)


13. Have patient take deep breath and exhale.

14. Withdraw tube rapidly and smoothly.

15. Remove gloves.

16. Wash hands.



COMMENTS:

PL 4/10

111




PERFORMANCE

DATE

START TIME:

END TIME:

SALEM/SUMP TUBE IRRIGATION



2. Wash hands.



5. Assess patient:




B. Side rails

C. Brakes locked



F. Environment





9. Check tube for proper placement:

A. Aspirate for stomach contents.

B. Auscultate. Instill 15-20 ml of air and listen with stethoscope for crackles.

10. Gently instill prescribed amount of irrigant

11. Aspirate fluid back and discard or reconnect to suction machine and observe.

12. Instill 10 ml of air in air vent.

13. Remove gloves.

14. Wash hands.

112

NASOGASTRIC TUBE IRRIGATION (Cont‘d.)


15. Record:

A. Type of irrigation (NG irrigation).

B. Type, concentration, and amount of fluid instilled and/or discarded.

C. Appearance and odor of any secretions.

D. Results of procedure.

E. Observations.

F. Patient's response.


COMMENTS:

PL 4/10

113




PERFORMANCE

DATE

START TIME:

END TIME:

TUBE FEEDING



2. Wash hands.



5. Assess patient.

6. Explain procedure.



B. Side rails

C. Brakes locked



F. Environment




8. Place in Fowler’s position.


114

TUBE FEEDING (Cont‘d.)


10. Check tube for proper placement:

-Insert 15-20 ml air, listen with stethoscope over left epigastric area for crackles.

-Aspirate for gastric contents.

Check the amount of residual of gastric contents if the patient is receiving continuous or

scheduled feedings:

-Pull back completely on syringe and measure the amount of residual.

-Determine if the feeding can be given based on your findings.

11. A. Check for bowel sounds.

B. Correctly instill ordered amount of flush.

C. Correctly instill feeding.

12. Clamp or plug tube appropriately.

13. Leave patient in Fowler’s position.

14. Remove gloves.

15. Wash hands.

16. Record procedure in patient's chart: Time, method used for placement verification, amount of

residual, type and amount of feeding, and patient’s tolerance.

17. Complete in allotted time: 15 minutes COMMENTS:

PL 4/10

115




PERFORMANCE

DATE

START TIME:

END TIME:

BASIC PHYSICAL ASSESSMENT



2. Wash hands.

3. Introduce self.


5. Assess patient.


7. Vital Signs. (Temp, pulse, resp, BP, pain scale, O2 sats if needed)


A. Side Rails

B. Brakes locked

C. Appropriate height of bed

D. Tube placement

E. Environment

F. Appropriate help and equipment

G. Proper body mechanics

H. Check for allergies 9. GENERAL OVERVIEW

A. Provide for patient comfort and privacy.

B. Level of consciousness (expected: awake, alert, responsive)

(unexpected: lethargy, obtundation, stupor, coma/disoriented and unresponsive)

C. Orientation to person, place, time, and situation.

D. Assess affect, speech and behaviors.

E. Assess for sleep and rest.

F. General survey

1. Apparent state of health

2. Skin color and obvious lesions

3. Height(tall/short)/weight(emaciated/slender/plump/obese)

build (slender/lanky/muscular/stocky)

4. Posture, gait and motor activity

116

BASIC PHYSICAL ASSESSMENT (Cont‘d.)


10. HEAD AND NECK

A. Inspect

a. Skin (color, hair, wounds and obvious lesions)

b. Face, skull, scalp and hair

c. Pupils (PERRLA).

d. Ears. (alignment, color, drainage, hearing devices)

e. Nose/nares (mucous membranes, deviations, perforations

f. N/G tube feeding or suction system.

g. Oxygen equipment (settings, tubing, excoriations)

h. Lips and mouth: gums, teeth, tongue, and mucous membrane.

i. Trachea (midline, no deviations).

j. Jugular vein distention (supine/Semi-Fowler's position).

B. Palpate

a. Temporal and carotid pulse.

b. Neck and thyroid for masses.

C. Auscultate

a. Carotid for bruits.

b. Thyroid for bruits. 11. UPPER EXTREMITIES

A. Inspect

a. Skin (color, hair, fingernails, wounds and obvious lesions)

b. IV site, IV bag, and pump.

B. Palpate

a. Radial, ulnar and brachial pulses

b. Temperature of skin, bilaterally.

C. Assess

a. Texture of skin & skin turgor

b. Capillary refill.

c. Clubbing of nails

d. Ability to move arms and joint range of motion

e. Equal strength, size and sensation in upper

extremities, bilaterally. 12. ANTERIOR AND POSTERIOR CHEST

A. General

a. Skin (color, hair, wounds, obvious lesions and skin turgor)

b. Chest size and shape

c. Breast and axilla

d. Spine (alignment and deformities)

B. Cardiac

a. Inspect

i. Pulsations

b. Palpate

i. Six anatomical landmarks (note thrills, lifts or heaves)

c. Auscultate

i. Six anatomical landmarks with diaphragm

ii. Six anatomical landmarks with bell

iii. Apical pulse for one full minute (rate, rhythm, quality)

d. Check

i. Telemetry

________________________________________________________________________________________________________

117



C. Respiratory (anterior/posterior/lateral)

a. Inspect

i. Respiratory rate, rhythm, depth and symmetry of movements

ii. Intercostal areas for retractions and bulging

iii. Anteroposterior: lateral ratio

iv. Accessory muscle use

b. Palpate

i. Chest tenderness, masses, and crepitus

ii. Respiratory expansion (symmetrical)

c. Auscultate

i. Lung sounds systematically.

13. ABDOMEN

A. Inspect

a. Skin (color, hair, scars, striae, ascites, herniations,

and lesions)

b. Size, shape, and symmetry of abdomen

c. Umbilicus (color, contour, location, inflammation,

and herniations)

d. Peristalsis and pulsations

e. Wounds and/or drainage

f. Drains and drainage (urinary catheters, wounds drains,

colostomies, etc)

B. Auscultate

a. Bowel sounds in all 4 quadrants (diaphragm).

b. Vascular sounds (7) in the abdomen with the bell (note bruits)

C. Palpate

a. Tenderness, distention and pulsations.

D. Check

a. Urinary elimination.

b. Date of last BM.

c. Buttocks, hips and perineal area for breakdown.

14. LEGS AND FEET

A. Inspect

a. Skin (integrity, color, hair, toenails, wounds, edema,

varicosities, ulcerations, and obvious lesions)

b. Length and position of each leg (alignment and deformities)

B. Palpate

a. Temperature of skin, bilaterally (feet and legs)

b. Femoral, Popliteal, posterior tibial, and dorsalis pedis

pulses

c. Pitting edema

C. Assess

a. Capillary refill.

b. Equal strength and sensation bilaterally (Homan’s sign-contraindicated now)

c. Range of motion

118



15. Wash hands.

16. Chart care given, including observations and patients response

17. Complete within allotted time: 30 mins.

NOTE: Each area is evaluated in its entirety as satisfactory or unsatisfactory.

COMMENTS:

JL 03/10

119




PERFORMANCE

DATE

START TIME:

END TIME:

DONNING STERILE GLOVES


1. Wash hands or use alcohol based sanitizer.

2. Open wrapper without contaminating gloves.

3. Pick up first glove with non-dominant hand, touching only inside surface (folded part of cuff).

4. Put on first glove without allowing outside to touch anything.

5. Pick up second glove from under cuff with fingers of gloved hand.

6. Put on second glove, touching only inside of second glove with bare hand.

7. Repeat procedure if glove(s) become contaminated.

8. Remove gloves appropriately.

9. Wash hands.

10. Chart care given, including observations and patient response.


MS 04/10

120


121




PERFORMANCE

DATE

START TIME:

END TIME:

STERILE DRESSINGS



2. Wash hands or use alcohol based sanitizer.

3. Introduce self.


5. Assess patient.

6. Explain procedure.(Include patient teaching about sterile technique)



B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



I. Check allergies (including tape, latex, cleaning agents)

8. Clean bedside table with alcohol wipes.

9. Open sterile supplies without contaminating.

(Always wash hands or use alcohol based sanitizer prior to opening sterile supplies.)

10. Check the present dressing and remove dressing with clean gloves. (Dispose of correctly.)

Be able to describe the amount of drainage, color, consistency, etc. on the old dressing.

122

STERILE DRESSINGS (Cont‗d.)


11. Assess wound:

A. Edges approximated.

B. Signs of infection (excessive redness, excessive edema, excessive warmth, pain, loss of

function, purulent drainage, foul odor).

C. Hemorrhage or hematoma (Be able to explain).

D. Drainage (Amount, color, odor, consistency).

E. Measure wound correctly. (L x W x D)

F. Count staples/stitches if applicable.

12. Remove gloves properly.

13. Wash hands or use alcohol based sanitizer if available.

14. Maintaining sterile technique:

A. Don sterile gloves.

B. Clean wound as ordered.

C. Apply dressing and secure. (label dressing with time, date, and initials)

15. Dispose of contaminated supplies correctly by rolling up or closing bag touching the outside

only and wash hands/alcohol based sanitizer.

16. Chart care given:

A. Supplies used.

B. Observation made in step 10 (A-F).

C. Patient’s response.


Students please note the below steps as a different way to perform a sterile dressing change:

Steps 1-7 the same as above.

8. Clean beside table with alcohol wipes.

9. Check present dressing and remove dressing with clean gloves. (Dispose of correctly.)

10. Be able to describe the amount of drainage, color, consistency, etc. on the old dressing.

11. Assess the wound:

A. Edges approximated.

B. Signs of infection (excessive redness, excessive edema, excessive warmth, pain, loss of function,

purulent drainage, foul odor.).

C. Hemorrhage or hematoma (Be able to explain).

D. Drainage (Amount, color, odor, consistency).

123

STERILE DRESSINGS (Cont‘d.)

Students please note the below steps as a different way to perform a sterile dressing change: (Cont’d.)

E. Measure wound correctly (L x W x D).

F. Count Staples/Stitches.

12. Remove gloves properly.

13. Wash hands or use alcohol based sanitizer if available.

14. Open sterile supplies without contaminating.

15. Maintaining sterile technique:

A. Don sterile gloves.

B. Clean wound as ordered.

C. Apply dressing and secure.

16. Next follow the above steps 15-17 to complete your check off.

COMMENTS:

MS 04/10

124


125




PERFORMANCE

DATE

START TIME:

END TIME:

CATHETERIZATION

To successfully complete this check-off, the total critical behavior must be performed satisfactorily. S U

1. Pre-Procedure:

A. Check MD/NR order.

B. Wash hands.

C. Identify self.

D. Identify patient.

E. Explain procedure. (Include patient teaching.)



B. Side rails

C. Brakes locked



F. Environment




3. Provide privacy and drape patient.

4. Assess patient. Put on non sterile gloves and goggles, position, and determine suitable and

clean area if necessary (may have to use soap and water to clean perineal area). Determine if

will need extra help to accomplish.

5. Deglove and wash hands.

6. Open catheterization set and arrange field - maintaining sterility. 7. Maintaining sterile technique:

A. Put on sterile gloves.

B. Attach syringe, test balloon, and leave attached to the Foley catheter.

C. Lubricate catheter appropriately.

D. After meatus is identified, cleanse the area surrounding the meatus. Use circular motion

on males. Swab from anterior to posterior on females.

E. Hand used to expose meatus stays in place. Use other sterile-gloved hand to insert sterile

catheter 2 to 3 inches into the female, see urine and advance another 1 inch, or 6 to 9 inches

into the male until bifurcation of catheter.

F. After urine starts to flow and no resistance met, inflate the balloon by injecting all of the

sterile H2O in the pre-filled syringe. (10mL)

126

CATHETERIZATION (Cont‘d.)


8. May deglove.

9. For a Foley catheter, secure the catheter to the patient properly and position the bag appropriately.

10. Wash hands.

11. Record time; type and size of catheter; balloon size and amount of H2O used to inflate balloon;

description and amount of urine; and patient’s response to procedure.

12. Complete within allotted time: 30 minutes or as specified.

COMMENTS:

AE 3/10

127




PERFORMANCE

DATE

START TIME:

END TIME:

CATHETER IRRIGATION


1. Pre-Procedure:


B. Wash hands.

C. Identify self.


E. Assess patient (May have to use soap and water to clean perineal area.)

F. Explain procedure. (Include patient teaching.)

G. Put on non sterile gloves and goggles, position, and determine suitable and clean area.



B. Side rails

C. Brakes locked



F. Environment




4. Wash hands, put on non-sterile gloves. 5. Irrigate catheter using sterile technique:(Open, Closed, Continuous)

A. Instill ordered amount of fluid.

B. Observe fluid return by gravity.

6. Deglove and wash hands. 7. Record:

A. Type, concentration, and amount of fluid used.

B. Appearance and odor of any secretions.

C. Results of procedure.

D. Patient’s response. 8. Complete within allotted time: 20 minutes or as specified.

COMMENTS:

AE 3/10

128


129




PERFORMANCE

DATE

START TIME:

END TIME:

REMOVAL OF A RETENTION CATHETER


1. Pre-Procedure:


B. Wash hands.

C. Identify self.


E. Assess patient. (May have to use soap and water to clean perineal area.) Put on non sterile

gloves and goggles, position, and determine suitable and clean area.




B. Side rails

C. Brakes locked



F. Environment




4. Insert syringe into the balloon inflation tube of catheter and draw out all fluid.

5. Clamp, crimp, or pinch the catheter.

6. Instruct the patient to breath with open mouth and gently withdraw the catheter from the urethra.

7. Measure the urine in the drainage bag before discarding.

8. Assess the frequency and amount of urine voided after catheter removal.

130

REMOVAL OF A RETENTION CATHETER (Cont‘d.)


9. Document:

A. Time of removal.

B. Amount, color, and consistency of urine in bag.

C. Patient's response.

10. Complete within allotted time: 15 minutes or as specified.

COMMENTS:

AE 3/10

131




PERFORMANCE

DATE

START TIME:

END TIME:

ENEMAS


1. Pre-Procedure:


B. Wash hands.

C. Identify self.


E. Assess patient(May have to use soap and water to clear perineal area.)


G. Put on non sterile gloves and goggles, position and determine suitable and clean area.



B. Side rails

C. Brakes locked



F. Environment




4. Procedure:

A. Prepare or secure solution at safe temperature, secure clear tubing of air.

B. Don gloves.

C. Lubricate tip of tubing.

D. Guide patient for comfort and insert tubing 3 to 4 inches.

E. Give fluid with a safe pressure. (Maximum of 18 inches above patient's rectum.)

F. If patient experiences discomfort:

1. Lower container

2. Regulate flow rate accordingly or stop flow temporarily.

3. Discontinue if discomfort persists.

5. Advise as to time for effective results and provide bed pan, BSCC or help to Bath Room as

needed.

132

ENEMAS (Cont‘d.)


6. Dispose of equipment as guided; deglove.

7. Wash hands.

8. Record: Type of enema.

Amount of fluid instilled.

Time administered.

Results.

Patient's response.

9. Complete within allotted time: 25 minutes or as specified. COMMENTS:

PL 3/10

133




PERFORMANCE

DATE

START TIME:

END TIME:

HOT AND COLD APPLICATION



2. Wash hands/alcohol based sanitizer.

3. Introduce self.


5. Assess patient.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Protect patient's skin by covering hot or cold device.

9. Apply hot or cold device to correct area for ordered length of time.

10. Assess skin as indicated.

134

HOT AND COLD APPLICATION (Cont‘d.)


11. Chart care given, include items below:

1. Time.

2. Type of treatment (compress, sitz bath, etc.).

3. Type of solution.

4. Temperature of solution or pad.

5. Area of body applied to.

6. Length of time.

7. Patient's response.

12. Complete within allotted time: (20 mins. or as specified) COMMENTS:

MS 04/10

135




PERFORMANCE

DATE

START TIME:

END TIME:

ISOLATION TECHNIQUE



2. Wash hands/alcohol based sanitizer and enter the room in attire appropriate to specific type of

isolation.

3. Introduce self.


5. Assess patient.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Handle equipment appropriately.

9. Correctly bag articles removed from isolation room (double-bag if applicable).

10. Leave the room without contaminating self.

11. Keep door closed at all times.

136

ISOLATION TECHNIQUE (Cont‘d.)


12. Wash hands after leaving room.

13. Chart care given, including observations and patient’s response.

COMMENTS:

MS 04/10

137




PERFORMANCE

DATE

START TIME:

END TIME:

FEEDING THE PATIENT



2. Wash hands.

3. Introduce self.


5. Assess patient.

6. Explain procedure. (Include patient teaching.) 7. Check safety precautions:


B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Position patient appropriately.

9. Assist with hygiene as necessary.

10. Feed patient.

11. Assist with hygiene as necessary.

12. Wash hands.

13. Chart care given; including observations and patient’s response.

14. Complete within allotted time: Varies with patient. COMMENTS:

AE 3/10

138


139




PERFORMANCE

DATE

START TIME:

END TIME:

RECORDING NURSING CARE


1. Use black ink.

2. Write or print legibly.

3. Correct errors without erasures.

4. Record.

5. Use correct abbreviations.

6. Sign or initial all entries as indicated.


COMMENTS:

PL 4/10

140


141




PERFORMANCE

DATE

START TIME:

END TIME:

OXYGEN ADMINISTRATION



2. Wash hands.


5. Assess patient.




B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Position Oxygen cannula, catheter, mask, or tent correctly.

9. Establish correct Oxygen liter flow/concentration.

10. Maintain patient's safety.

11. Wash hands.

12. Record procedure including method of oxygen delivery, flow rate, patient response, and

respiratory assessment. COMMENTS:

HC 3/10

142


143




PERFORMANCE

DATE

START TIME:

END TIME:

ORAL & NASOPHARYNGEAL SUCTIONING



2. Wash hands.

3. Introduce self.


5. Assess patient.

6. Explain procedure. (Include patient teaching.) 7. Check safety precautions:


B. Side Rails

C. Brakes locked


E. Tube placement

F. Environment



8. Place towel around patient’s chest or under chin.

9. Select proper suction pressure for patient and type of suction unit. 10. For Oropharyngeal Suctioning:

A. Apply non-sterile gloves, mask and goggles

B. Connect one end of connecting tubing to suction machine and the other to Yankauer suction

catheter. Fill cup with normal saline/water as ordered

C. Check equipment to see if functioning properly by suctioning small amount of water

D. Remove oxygen mask/nasal cannula, if present

E. Insert catheter into mouth along gum line to pharynx. Move

F. Encourage patient to cough, Replace oxygen mask/nasal cannula

G. Rinse catheter with water/normal saline in cup until tubing is clear of secretions.

Turn off suction

H. Reassess patient’s respiratory status

I. Remove towel, place in laundry. Dispose of equipment properly

J. Wash hands

K. Record amount, consistency, color, odor of secretions. Also patient’s response

144

ORAL & NASOPHARYNGEAL SUCTIONING (Cont‘d.)


11. For Nasopharyngeal Suctioning:

A. Turn suction device on and set vacuum regulator to appropriate negative pressure.

B. If indicated, increase supplemental oxygen to 100% or as ordered

C. Connect tubing to suction machine and other end in convenient location.

D. Open suction kit. Place towel across patient’s chest

E. Open sterile suction catheter package, careful to keep sterile

F. Open sterile basin and fill with sterile normal saline.

G. Open lubricant and sterile catheter package without contamination.

H. Apply mask and goggles.

I. Apply sterile gloves. Pick up sterile catheter with dominant hand. With non-dominant hand

pick up connecting tubing. Secure catheter to tubing.

J. Check to see if equipment is functioning properly by suctioning small amount of normal

saline from basin.

K. Coat distal 6-8 cm of catheter with water-soluble lubricant.

L. Remove oxygen-delivery device with non-dominant hand. Without applying suction, gently

insert catheter with dominant thumb and forefinger into naris for distance of about 16 cm

(distance from tip of nose to base of ear lobe).

M. Apply intermittent suction for up to 10 sec by placing and releasing non-dominant thumb

over vent of catheter and slowly withdraw catheter, rotating it back and forth between non-

dominant thumb and forefinger.

N. Encourage patient to cough. Replace oxygen-delivery system. Remove towel and equipment.

O. Rinse catheter and connecting tubing with normal saline until cleared.

P. Wash hands.

Q. Record: amount, consistency of color, and odor of secretions, and patient’s response to

procedure; pre- and post-suctioning respiratory status.

COMMENTS:

AE 3/10

145



DEPARTMENT OF NURSING EDUATION

STUDENT STATEMENT OF UNDERSTANDING SYLLABUS OF NURSING COURSE

I have received a syllabus for NURSING 1110 (FUNDAMENTALS OF NURSING) and the instructor has

reviewed its contents, including the following information: the evaluation process, required assignments,

attendance requirements, and course calendar.

I understand that I should do my best to complete class assignments before the due dates and spend the

necessary time preparing for tests as directed by my instructor(s).

I understand that if I am having difficulty in the course I should ask questions and seek help from my

instructor(s) and counselors.

I understand that in signing this document I accept and agree to the statements.

_________________________________________ ____________________________ _______________

Student’s Signature PRCC Student ID# Date

Voluntary/Confidential Section:

My desire is for you to be successful in this course. Therefore, feel free to speak with me personally or note

below anything that may adversely affect your performance in this class, i.e. participation in sports or other

activities, learning challenges, health concerns, military service, etc.

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

If you have a disability that qualities under the Americans with Disabilities Act and you require

accommodation, you should contact Tonia Moody at 601-403-1060 for information on appropriate policies and

procedures.

4/10

Syllabus 2010

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