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BAKERSFIELD COLLEGEASSOCIATE DEGREE NURSING PROGRAM

NURSING B26MEDICAL SURGICAL THEORYINSTRUCTIONAL SYLLABUS

Fall 2009

Julie Gentry RN, MSN, FNPNURSING B26

BAKERSFIELD COLLEGE ASSOCIATE DEGREE NURSING PROGRAMNURSING B26 MEDICAL SURGICAL NURSING

Julie Gentry RN, MSN, FNPNURSING B26

CALENDAR

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WEEK MONTHSOF

INSTRUCTION

MON TUES WED THUR FRI NOTATION

1August 24

LECTURE BEGINS

2September 31

37 Labor Day No Lecture

414 T-Unit 1,2,12

521

628

7October 5 T-Unit 11 and 3

812

919 Mid Term: Unit 1-4, 11-12

1026

11November 2 T: 5-6

129

Veterans Day

13 16 T: Unit 7-8

14 23 Thanksgiving

15 31 Course review

16 December 7Final EXAM: 12:00-1:50pm

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WEEK DATE Unit Topic

Week 1

Aug 24

IntroductionUnit 1&2

Medical Surgical B 26 Professional Issues & Nursing PracticeBio-psychosocial Concepts related to health care

Week 2 Aug 31 Unit 12 Problems of Protection

Week 3 Sept 7 No Class Labor Day

Week 4 Sept 14Unit 11

Test 1 – Units 1-2, 12Fluid, Electrolytes, and Acid-Base Imbalances

Week 5 Sept 21 Unit 3 Problem of Oxygenation (1)

Week 6 Sept 28 Unit 3 Problem of Oxygenation (2)

Week 7 Oct 5Unit 4

Test 2- Units 11,3Problems of Cardiac Output and Tissue Perfusion

Week 8 Oct 12 Unit 5 Problems with Hematological System

Week 9 Oct 19 Mid TermMID TERM Units 1-4, 11-12You will have the whole class time for exam

Week 10 Oct 26Unit 6 Problems of Mobility, Sensation, and

Cognition

Week 11 Nov 2Unit 7

Test 4 –Units 5-6Problems of Digestion, Nutrition, and Elimination

Week 12 Nov 9 Unit 8 Problems of Regulation and Metabolism

Week 13 Nov 16 Unit 9Test 5 – Unit 7-8Problems with Excretion

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Week 14 Nov 23 Unit 10 Problems of Neurological Function

Week 15 Nov 31 Course Review Bring evaluation forms to class

Week 16 Dec 7 Final 1200-1350

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NURS B26

COURSE DESCRIPTIONS&

COURSE POLICIES

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COURSE DESCRIPTION

B 26 builds on knowledge from B 20 – 25 and continues to provide a theoretical and technical knowledge base to care for adult clients and families. Focus is further knowledge, identification and treatment of physiological and pathophysiological health problems in caring for clients with higher acuity and more complex comprehensive nursing needs and to promote and maintain optimal health. Health problems will be covered using a nursing process approach.

Prerequisites: Completion of the first and second semesters of Associate Degree Nursing Program and/or evaluation by program director for skills and knowledge. Credits: 3.0 (54 hours) Theory and 2.5 Clinical. Clinical experience is 154 hours. Concepts presented in theory are applied in a variety of hospital settings. Laboratory emphasis changes from previous semesters and focuses on knowledge necessary to care for clients with higher acuity and more complex comprehensive nursing needs.This course is offered fall and spring semesters. This course is transferable to CSU and private colleges, and is considered CCS: Occupational Education.

Instructor: Julie Gentry RN MSN CENEmail: [email protected] Phone: 661-395-4476Office: MS 153Office hours: Monday 1430-1700

Tuesday (by appt only)Address: Bakersfield College

Allied Health: Julie Gentry RN MSN FNP1801 Panorama DriveBakersfield, Ca 93305

****Open door policy – Students may contact/meet with instructor during scheduled office hours at any time. If the student has special needs, individual time can always be scheduled.

PROGRAM STUDENT OUTCOMESThe Bakersfield College Associate Degree Nursing Program is designed to prepare graduates to competently transition from student to entry-level Registered Nurse as defined by these roles: Provider of Care, Manager of Care, and Member of the Profession. Upon completion of the program, the graduate shall be able to function as a:

Provider of Care – The graduate will provide safe nursing care through therapeutic nursing interventions to clients with critical and complex disease states. The care is characterized by consistent critical thinking and problem-solving skills, clinical competence, accountability, effective communication skills, respect for diverse cultures, with an emphasis on health education and a commitment to the value of caring.

Manager of Care – The graduate will provide safe nursing care consistently utilizing critical thinking skills for clients who have critical and complex disease states. The care

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mailto:[email protected]


is characterized by the ability to assess and establish priority of care for a group of clients and delegation of appropriate aspects of nursing care to licensed and unlicensed personnel and directs their activities. The manager of care collaborates with other members of the health care team, including organizational and community resources, using effective oral and written communication skills. The manager of care recognizes roles and responsibilities within the levels of the career ladder and is competent in using technology to provide evidence-based nursing care.

Member of Profession – The graduate will consistently demonstrate accountability, advocacy, legal/ethical and caring behavior, and responsibility for one’s own professional growth, behavior, and formal/informal education. The student nurse routinely participates in self-evaluation and makes changes to improve the practice of nursing, with the ultimate goal of making positive contributions to the nursing profession.

LEVEL 3 OUTCOMESThe focus of level three is to analyze and utilize theoretical and technical knowledge to care for the more diverse and complex client.

Provider of Care -The student will provide safe nursing care through therapeutic nursing interventions to clients that have increasingly complex outcomes. The care is characterized by the ability to cluster and prioritize increasingly complex nursing interventions, anticipate expected and unexpected outcomes, incorporate comprehensive assessment data into the plan of care, utilize effective communication skills, demonstrate respect for diverse cultures, educate clients regarding health needs, and promote client advocacy with increasing independence.

Manager of Care - The student will provide safe nursing care utilizing critical thinking skills for clients who have increasingly complex outcomes. The care is characterized by the ability to anticipate complications, analyze and utilize the data gained from specialized equipment, plan and evaluate utilization of appropriate resources for cost effective delivery of care and facilitation of communication among the health care team.

Member of Profession - The student will assume responsibility and accountability, with minimal supervision, for the legal and ethical boundaries of nursing. The student consistently recognizes self-limitations and begins to independently utilize various resources to improve abilities, as well as analyze caring behaviors.

COURSE ACTIVITIES

Instructional and learning activities are directly related to the level outcomes and unit objectives with an emphasis on the nursing process. Various learning activities such as lectures/discussions, demonstrations, audiovisual aids, required reading, computer assisted programs, simulated learning exercises, independent study, problem solving exercises, and quizzes/exams may be employed.

COURSE ASSIGNMENTS

Students are required to complete a variety of assignments which may include simulated learning experiences, computer assisted programs and weekly reading and homework assignments in

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order to successfully meet the objectives for Nursing B26. Detailed instructions for each assignment are located in the ASSIGNMENTS section of the syllabus.

COURSE POLICIES

Students are expected to attend each class, be punctual, and assume responsibility for assigned activities. Students are at all times responsible for material presented during their absence. Students are expected to master each objective. No children will be allowed in the classroom.

Recording lectures is permitted at the discretion of the instructor. Students may not record during test preview or review.

COURTESY

Cell Phones and pagers must be turned off or placed in silent mode. Please no talking during the lecture.

Unacceptable Classroom BehaviorUnacceptable classroom behavior/conduct includes, but is not limited to, the following:

Interference with the learning of others

Excessive tardiness

Intimidation of students and/or faculty (angry, hostile, or violent behavior)

Inappropriate non-verbal behavior

Inappropriate/provocative dress/appearance

Use of pagers or cell phones during class time

Dishonesty

Sexual harassment

Use of vulgar/obscene language

Any other behavior deemed by Nursing Faculty as unacceptable and which interferes with the learning or safety of others, including those behaviors and activities listed in the Bakersfield College Student Handbook

SUPPORTIVE SERVICES

Students with disabilities who believe they may need accommodations in this class are encouraged to contact Disabled Student Programs & Services (661-395-4334), FACE 16, as soon as possible to better ensure such accommodations are implemented in a timely fashion.

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Live captioning: Students with disabilities who are in need of live captioning in this class are encouraged to contact Disabled Student Programs & Services 661-395-4694 as soon as possible to better ensure such accommodation is implemented in a timely fashion

The Student Handbook also outlines a variety of services available to meet your academic needs

ATTENDANCE

The Bakersfield College attendance policies will be observed. If a combination of absences or tardies totals the equivalent of more than two weeks (two days), the student can either drop the course or receive a letter grade of “F”. It is the student’s responsibility to drop the course. Leaving class early will equal a tardy. Note: two (2) tardies equal one absence – NO EXCEPTIONS

EXAMS/QUIZZES

Students are responsible for the material presented during their absence. The opportunity to make up one missed exam will only be allowed if the student informs the instructor prior to the scheduled exam. Students will not be allowed to retake any exam or quiz on which an unsatisfactory grade was earned. Calculators are permitted during exams (no cell phones or palm pilot calculators are allowed).

All cell phones and pagers must be turned off during exams unless prior arrangements are made with the instructor. Ringing or vibrating phones will result in a five point deduction from the student’s exam.

REVIEW OF EXAMS

Students may make arrangements with the instructor to review the individual exam up to 2 weeks after the exam is returned the student in class. The final exam will not be reviewed.

ACADEMIC HONESTY

There will be zero tolerance for academic dishonesty, including plagiarism. Plagiarism is the intentional use of another person’s ideas, data, information, or work without giving credit. If the student is caught cheating, the test will be collected, a zero (0) grade will be recorded, and the student will be directed to leave the classroom. The student is required to meet with the Director of Allied Health to discuss his/her standing in the program. Please refer to the statements on academic honesty in your Bakersfield College Catalog, Associate Degree Nursing Student Handbook, and the Bakersfield College Class Schedule

COURSE EVALUATION

Nursing B26 course evaluation is a requirement of the course. The evaluation will be conducted week 15 of the semester. Students are expected to bring one survey answer form, Form 20-s, to

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complete the Theory and Instructor Evaluation as well as the correct number of forms to complete the clinical site and instructor evaluation.

STUDENT EVALUATION

Evaluation is an ongoing, essential process in education, by which the student is, appraised of his/her progress in meeting the level outcomes and unit objectives. Scoring for this course is based on the accumulation of points from exams and a cumulative final exam. The exams will be reviewed in class. The final exam will not be reviewed.

Grading Scale Weighted grades in percentages

100 – 90 = A

89 – 80 = B

79 – 75 = C

74 – 70 = D

69 – 0 = F

Exams _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 30%

Mid Term Exam_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _33%

Community Service Project _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2%

ATI/CARP_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ __ 2%

Final Cumulative Exam _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33%

The student must achieve a cumulative score of 75% or greater in order to successfully complete the course.

REQUIRED TEXTS AND MATERIALS

Leadership and Nursing Care Management (3rd edition) Huber, D. Saunders/Elsevier Co

Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Prentice Hall

Gentry, J. (2009). Bakersfield College Associate Degree Nursing Program. Instructional syllabus Theory and Clinical, B26

Nursing Practice Act with Regulations and Related Statutes. http://www.rn.ca.gov.

Comprehensive Assessment and Review Program (CARP) by ATI.

The CARP textbook/resource package includes books, DVDs, practice tests with thousands of NCLEX-style questions as well as proctored exams.

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COURSE CONTENT

I. Review Program and Course Learning OutcomesII. Review SyllabusIII. Discuss Policies, Expectations and Requirements

PROFESSIONAL ISSUES AND NURSING PRACTICE

I. Role of The Medical Surgical NurseA. Review and Reinforce Roles of:

1. Provider of Care2. Manager of Care3. Member of The Profession

B. Review and Expand:1. Advocacy2. Caregiver3. Delegation4. Teacher5. Communicator6. Diversity7. Team Leader8. Primary Care9. Collaborative Care10. Multidisciplinary Care

II. Role of The Perioperative NurseA. Review Roles and Concepts of Perioperative NursingB. Implement Roles of The Perioperative Nurse Under Direct Supervision of RN

III. Critical Thinking A. Utilize Critical Thinking SkillsB. Nursing ProcessC. Evidence Based-Practice

IV. Caring and ComfortA. Review and Reinforce:

1. Role of Caring2. Nursing Theory Related to Caring3. Implications When Nurses’ and Clients’ Perceptions of Caring Might Differ4. Ways to Convey Caring Through Presence and touch 5. Active Listening

V. Community Based CareA. Review

1. Ambulatory Care2. Home Care

a. Home Care Management With Altered Oxygen3. Long Term Care4. Transitional Care

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5. Rehabilitationa. Pulmonary Rehabilitation

6. Managed CareB. Collaborative Management

1. Age Appropriate Care 2. Diagnostic/Lab Data 3. Diversity4. Nutrition 5. Nursing Diagnosis/Interventions6. Pharmacology7. Safety8. Surgical/Nonsurgical9. Teaching/Learning

VI. Leadership A. Leadership StylesB. ManagementC. Goal Setting, Priorities, Decision Making, DelegationD. Stress and Time ManagementE. Team and Group ProcessesF. Organizational Culture and Climate/Trends in NursingG. Professional/Employment IssuesH. Documentation /AssessmentI. Nurse Practice ActJ. Legal /Ethical Issues

BIOPSYCHOSOCIAL CONCEPTS RELATED TO HEALTH CARE

I. Communication and Conflict ResolutionA. Interdisciplinary Communication

1. Differentiate Between Aggressive, Assertive, Passive and Responsive Behavior and Determine The Effects of Each

2. Analyze How Effective Communication Principles Relate to Leadership and Management

3. Formulate Guidelines For Making Effective Telephone Calls to PhysiciansB. Review and Implement and Reinforce Conflict Resolution Strategies As Presented in

Psychiatric Nursing1. Accommodation2. Avoidance3. Collaboration4. Competition5. Compromise

II. PainA. Differentiate Between Types of Pain and Therapies For Each:

1. Mild2. Moderate3. Severe

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B. Describe Pain Management For The Burn Client1. Utilization of Analgesics 2. Nursing Care Priorities

NURSING PRACTICE FOR MEDICAL – SURGICAL DISORDERS

I. Problems of Oxygenation

A. Respiratory System1. Review Anatomy and Physiology 2. Health History3. Focused Physical Exam of Respiratory System4. Clinical Manifestations of Altered Respiratory Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in function of Oxygenation1. Medical – Surgical Disorders

a. Chest Trauma1. Penetrating2. Blunt3. Pulmonary Contusion4. Pneumothorax

i. Closedii. Open

5. Hemothoraxb. Empyemac. Pleural Effusiond. Neoplasms (Lung Cancer)

2. Etiology3. Pathophysiology4. Clinical Manifestations5. Complications6. Collaborative Management

a. Age Appropriate Careb. Diagnostic/Laboratory Datac. Diversityd. Nutritione. Nursing Diagnoses/Interventionsf. Pharmacologyg. Safetyh. Surgical Managementi. Teaching/Learning

C. Interventions for Clients with Problems in Oxygenation1. Artificial Airways

a. Incorporate Use and Care of:b. Oralc. Nasopharyngeal Airway

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d. Laryngeal Mask Airwaye. Tracheostomyf. Identify ETT

2. Oxygen Delivery Systemsa. Introduce and Appropriate Use and Care of:

1. Trach Shield2. Blowby (T-Tube)

3. Arterial Blood Gasesa. Review Normal/Abnormal Values b. Differentiate Between:

1. Respiratory Acid/Alkalosis2. Metabolic Acid/Alkalosis

c. Correlate ABG Results to Specific Client Condition4. Suctioning

a. Review Maintenance and Types Suctioning (Oral, Nasal, Pharyngeal, and Tracheal)

b. Expanded Focus On Caring For Client With Tracheostomy

II. Problems of Cardiac Output and Tissue Perfusion

A. Cardiovascular System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Cardiovascular System4. Clinical Manifestations of Altered Cardiac Function5. Nursing Diagnoses6. Diagnostics – Identify Abnormal Values

B. Alterations in Cardiac Function1. Medical –Surgical Disorders

a. Myocardial Infarctionb. Permanent Pacemakersc. Chronic Congestive Heart Failured. Inflammatory Heart Disease

1. Infective Endocarditis2. Pericarditis3. Myocarditis4. Rheumatic Carditis

2. Etiology 3. Pathophysiology4. Clinical Manifestations5. Complications6. Collaborative Management

Age Appropriate Care Diagnostic/Lab Data DiversityNutrition Nursing Diagnoses/interventions

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PharmacologySafetySurgical/NonsurgicalTeaching/Learning

C. Shock1. Review Types of Shock2. Differentiate Shock Types3. Discuss Management:

a. Distributive1. Anaphylactic

b. Hypovolemic ShockD. Interventions for Clients with Problems in Cardiac Function

1. Cardiac Emergencya. Review:

1. Crash Cart and BLS 2. Systematic Approach3. Code Team

2. Introduce Rapid Response Team3. Clinical Aim

a. Activate Code Blueb. Participate in Code Bluec. Record Code Blue

III. Problems of Hematological System

A. Hematological System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Hematological System4. Clinical Manifestations of Altered Hematological Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Hematological Function1. Medical –Surgical Disorders

a. Anemia1. Review Definition, Types and Causes, Associated Labs2. Aplastic – Define and Differentiate 3. Hemorrhagic

i. Acuteii. Chronic

b. Leukemiac. Lymphoma

1. Hodgkin’s2. Non Hodgkin’s

d. Lymphedema2. Etiology 3. Pathophysiology

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4. Clinical Manifestations5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnoses/interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

III. Problems of Mobility, Sensation, and Cognition

A. Musculoskeletal System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Musculoskeletal System4. Clinical Manifestations of Altered Musculoskeletal Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Musculskeletal Function1. Medical –Surgical Disorders

a. Neoplasms (Bone Cancer)2. Etiology (Types of Bone CA)3. Pathophysiology4. Clinical Manifestations 5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnoses/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

IV. Problems of Digestion, Nutrition, and Elimination

A. Gastrointestinal System (GI)1. Anatomy and Physiology2. Health History3. Focused Physical Exam of GI System4. Clinical Manifestations of Altered GI Function5. Nursing Diagnoses

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6. DiagnosticsB. Alterations in Gastrointestinal Function

1. Medical –Surgical Disordersa. Cirrhosisb. Hepatitisc. Neoplasms (GI Cancer)

1. Esophageal 2. Gastric 3. Pancreatic4. Colorectal

d. Acute Pancreatitise. Review Chronic Pancreatitis

2. Etiology 3. Pathophysiology4. Clinical Manifestations 5. Complications6. Collaborative Management


C. Interventions for Clients with Gastrointestinal Problems1. Gastric Surgeries

a. Billroth I/Billroth IIb. Pyloroplastyc. Anthrectomyd. Vagotomye. Gastrectomy

2. Clinical Manifestations 3. Complications

D. Collaborative Management1. Age Appropriate Care 2. Diagnostic/Lab Data 3. Diversity4. Nutrition 5. Nursing Diagnosis/Interventions6. Pharmacology7. Safety8. Surgical/Nonsurgical9. Teaching/Learning

V. Problems of Regulation and Metabolism

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A. Endocrine System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Endocrine System4. Clinical Manifestations of Altered Endocrine Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Metabolic Function1. Medical –Surgical Disorders

a. Diabetic Ketoacidosis (DKA)b. HHNSc. Thyroid/Parathyroid

2. Etiology3. Pathophysiology4. Clinical Manifestations5. Complications6. Collaborative Management

a. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnosis/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

VI. Problems of Excretion

A. Renal System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Renal System4. Clinical Manifestations of Altered Renal Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Renal Function1. Medical –Surgical Disorders

a. Chronic Renal Failure/Uremiab. Tumors

1. Prostate2. Renal3. Testicular

2. Etiology 3. Pathophysiology4. Clinical Manifestations5. Complications

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6. Collaborative Managementa. Age Appropriate Care b. Diagnostic/Lab Data c. Diversityd. Nutrition e. Nursing Diagnosis/Interventionsf. Pharmacologyg. Safetyh. Surgical/Nonsurgicali. Teaching/Learning

VII. Problems of Neurological Function

A. Neurological System1. Anatomy and Physiology2. Health History3. Focused Physical Exam of Neurological System4. Clinical Manifestations of Altered Neurological Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Neurological Function1. Medical –Surgical Disorders

a. Neoplasms1. Primary2. Secondary

b. Inflammatory Brain Conditions1. Bacterial Meningitis2. Viral Meningitis3. Encephalitis4. Brain Abscess

c. Myasthenia Gravisd. Multiple Sclerosise. ALS



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VIII. Fluid, Electrolyte, and Acid-Base Imbalances

A. Intravascular Access Devices1. Differentiate Types of Accesses 2. Differentiate Care For Accesses 3. Describe Blood Component Therapy and Associated Nursing Care 4. Describe Care of Client Who Is Receiving TPN

a. Compositionb. Methods of Administrationc. Catheter Placementd. Potential Complicationse. Nursing Management

5. Describe Long Term Antimicrobial Therapy

IX. Problems of Protection

A. Immune System1. Review Anatomy and Physiology2. Obtain Health History3. Focused Physical Examination of Immune System4. Clinical Manifestations of Altered Immune Function5. Nursing Diagnoses6. Diagnostics

B. Alterations in Immunological Function1. Medical –Surgical Disorders

a. Neoplasmsb. SLE



C. Integumentary Disorders1. Anatomy and Physiology2. Health History3. Focused Physical Examination of Integumentary System4. Clinical Manifestations of Altered Integumentary Function5. Nursing Diagnoses6. Diagnostics

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D. Alterations in Integumentary Function1. Medical –Surgical Disorders

a. Burns 2. Etiology3. Pathophysiology4. Clinical Manifestations

a. Types of Burnb. Classificationc. Depth of Burnd. Percent of Body Surface

1. Adult 2. Children

5. Complications6. Collaborative Management


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COURSE INTRODUCTION AND LEVEL OBJECTIVES

INTRODUCTIONThe first lecture is designed to introduce the nursing student to the instructional syllabus. The syllabus is developed to foster independent student learning and to promote student accountability in the educational process. The syllabus is used to clarify specific objectives and assignments relating to the course. This is a level three course, which is focused on the further development of the theoretical, and technical knowledge base needed to care for adult clients across the lifespan who have more diverse and complex disease states.

OBJECTIVESUpon completion of this unit, the student will be able to:

A. Theory 1. Explain the roles of the provider of care, manager of care and member of the

profession.2. Recall the level objectives introduced in the first year of the nursing program3. Identify course objectives for level 3 course.4. Explain course expectations related to lecture outline and instructional syllabus5. Review textbook assignments according to lecture outline.6. Understand the stated grading system for this theory class.7. Relate course and unit objectives to appropriate level objectives.8. Review the student handbook9. Recognize student participation and responsibility10. Adhere to course attendance policy.

B. Clinical 1. Provide and manage total nursing care for adult and geriatric clients and families

with moderate to high acuity using effective communication skills in assessment and implementation after receiving clinical assignment the night before.

2. Demonstrate professionalism by being accountable in the total nursing care provided to all client’s cared for during the rotation.

3. Identify and implement health teaching for all clients who have moderate to high acuity with disease states presented in Level 3 Medical-Surgical Nursing course.

4. Identify vital sign and physical assessment parameters for all clients during the Level 3 Medical-Surgical Nursing course rotation.

5. Demonstrate level 3 nursing interventions for all clients with moderate to high acuity during the Level 3 Medical-Surgical Nursing course rotation.

6. Administer medications to clients whose disease process is included on the course outline for Level 3 Medical-Surgical Nursing, which includes discussion of action, side effects, purpose and nursing considerations for medications being administered.

7. Identify the specific learning activities as well as the evaluation criteria used to measure the student’s competence in both the clinical and laboratory setting.

8. Maintain skills checklist.

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ASSIGNMENT

1. Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition2. Leadership and Nursing Care Management, Huber 3rd Edition3. Instructional syllabus: Lecture and Laboratory

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UNIT 1 – PROFESSIONAL ISSUES AND NURSING PRACTICE

INTRODUCTIONThe goal of this unit is to provide the learner with key information about the role of the medical-surgical nurse and the perioperative nurse. This unit will also discuss community based care and leadership. Concepts of critical thinking, caring and comfort, and diversity will be integrated throughout the unit. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria

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

A. Theory1. Analyze and expand on what the term advocacy means and also demonstrate its

concept.[Huber, pg. 231-232]2. Outline the roles and concepts of the perioperative nurse [Lemone and Burke, pg

12-15].3. Define evidence based practice, and understand the benefits of using evidence

based practice vs. non-evidence based practice [Huber, pg 461,473-474].4. Develop and Practice ways to convey caring thru presence, touch and active

listening.5. Review and reinforce ways to use appropriate communication skills [Huber, pg

412-413].6. Distinguish the differences between ambulatory care, home care, long term care,

rehabilitation and managed care [Lemone and Burke Chp 3]. 7. Formulate guidelines that will help the nurse meet legal responsibilities related to

ethical dilemmas.[Huber, pg 744-745].8. Reinforce diversity and cultural concepts related to clients [Huber, pg 610-614].9. Define and identify the nurses’ role in quality control, quality assurance and

quality improvement [Huber, pg. 843-846].10. Diagram guidelines for conducting an effective appraisal interview.11. Define risk management and how it relates to quality improvement [Huber, pg .

860-861].12. Formulate guidelines for effective delegation and discuss why nurse managers fail

to delegate and the implications for nursing practice.[Huber, pg. 546-550]. 13. Apply techniques that will assist in making effective assignments. [See # 12].14. Differentiate between learning and understanding and discuss the implications of

each.15. Design a personal plan to deal effectively with personal and professional stress,

and also formulate a plan for keeping organized when in the role of a nurse [Huber, pg. 100-101].

16. Develop techniques that will assist the nurse leader in encouraging positive team participation.

17. Differentiate between a policy and a procedure [Huber, pg 220].18. Apply the nursing process to assessing the needs of the health care team members.

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B. Clinical1. Provide and manage total nursing care for adult and geriatric clients and families with

moderate to high acuity using effective communication skills in assessment and implementation.

2. Demonstrate professionalism by being accountable in the total nursing care provided to all client’s cared for during the rotation.

3. Implement the role of the perioperative nurse under direct supervision of an RN.4. Identify and implement health teaching for all clients with moderate to high acuity

with disease processes presented in Level III Medical-Surgical Nursing course.5. Identify vital sign and physical assessment parameters for all clients during the Level

III Medical-Surgical Nursing course rotation.6. Demonstrate level 3 nursing interventions for all clients with moderate to high acuity

during the Level III Medical-Surgical Nursing course rotation.7. Under supervision, proficiently deliver PO, SQ, IM, topical, and IV medications.8. Proficiently care for 2 clients after receiving clinical assignment the night before. 9. Present an ethical dilemma encountered in student’s own experience.10. Demonstrate ways to convey caring thru presence, touch and active listening.

Understanding the Role of the Registered Nurse and Interim PermitteeCALIFORNIA BOARD OF REGISTERED NURSINGAccording to the Nursing Practice Act, the California Code of Regulations, and Selected Sections of Title XXII

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UNIT 2 – BIOPSYCHOSOCIAL CONCEPTS RELATED TO HEALTH CARE

INTRODUCTIONThe goal of this unit is to provide the learner with the key information about the role of the medical-surgical nurse in regards to communication and conflict resolution. Pain management is also included in this unit and will provide the learner with increased knowledge in pain management for all clients including those with cancer

OBJECTIVES:

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

A. Theory1. Differentiate between aggressive, assertive, passive and responsive behavior and

determine the effects of each. [Huber, Chp. 24)2. Analyze how effective communication principles relate to leadership and

management. [Huber, Chp. 24]3. Formulate guidelines for making effective telephone calls to physicians.4. Differentiate between types of pain and therapies for mild, moderate and severe

pain. [Lemone and Burke, pg. 173-177]5. Describe pain management for the oncological client [Lemone and Burke, pg 381]6. Reinforce cultural factors related to pain management.

C. Clinical1. Develop a plan of care for a patient utilizing a PCA pump for pain management.2. Review and implement the facility protocol for PCA pumps and the required

nursing assessment and interventions.3. Develop and implement a plan of care incorporating pharmacological and non-

pharmacological pain control interventions for a client in pain.4. Utilize pain assessment tool for client in pain and devise nursing interventions. 5. Demonstrate appropriate pain assessment/ treatment documentation7. Apply effective communication techniques when speaking with physicians and

other healthcare providers.

ASSIGNMENT

1. Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th EditionChapter 9

2. Leadership and Nursing Care Management, Huber 3rd Edition, 2006Chapter 20 & 24

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Unit 3 Problems of Oxygenation

Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Applicable information Ch 36-39

The goal of this unit is to provide the learner with the key information needed to care for a client with altered oxygenation related to specific respiratory disorders. Unit 3 provides an in depth review of assessment parameters for clients with respiratory problems. The module contains information on nursing care of the client with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the respiratory system and contrast normal

assessment from abnormals associated with Chest Trauma, pleuritis, empyema, pleural effusion and lung cancer.

2. Compare and contrast how factors such as: Chest Trauma, hemothorax, pneumothorax, pleuritis, empyema, pleural effusion and lung cancer affect ventilation and respiration (gas exchange).

3. Identify specific topics for consideration during a health history interview of clients with health problems involving the respiratory system.

4. Describe normal variations in assessment findings for the older adult.5. Describe surgical procedures used to treat: Chest Trauma, hemothorax,

pneumothorax, pleuritis, empyema, pleural effusion and lung cancer, and nursing responsibilities in caring for clients undergoing these procedures.

6. Discuss treatment options for oral and laryngeal cancers with their implications for the client’s body image and functional health.

7. Describe the nursing implications for oxygen therapy and medications used to treat respiratory disorders.

8. Describe the nursing implications for medications used to promote ventilation and gas exchange.

B. Clinical1. Identify assessment abnormalities in clients with moderate to high acuity with

following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.

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3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.

4. Develop a pulmonary rehabilitation plan of care for a client returning home on oxygen.

5. Assess the need and perform tracheostomy care and suctioning for an assigned client.

6. Identify and implement health teachings for the client with following disorders: Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.

7. Present an ethical or legal issue associated with clients with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer.

8. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Chest trauma, Pleuritis, Empyema, Pleural Effusion and Lung cancer

9. Practice and/or use the computerized charting in the clinical setting.

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UNIT 4-PROBLEMS OF CARDIAC OUTPUT AND TISSUE PERFUSIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Chapter 30-32

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with altered oxygenation related to specific cardiovascular disorders. Unit 4 provides an in depth review of clients with cardiac problems. The unit contains information on nursing care of the client with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the cardiovascular system.2. Identify normal heart sounds and relate them to the corresponding events in the

cardiac cycle.3. Explain cardiac output and explain the influence of various factors in its

regulation.4. Describe normal variations in assessment findings for the older adult.5. Identify manifestations of Cardiac Emergency, Permanent Pacemakers, Chronic

CHF, Inflammatory Heart Diseases and Shock.6. Compare and contrast the pathophysiology and manifestations of Cardiac

Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

7. Relate the outcomes of diagnostic tests and procedures to the pathophysiology of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock and implications of client responses to the disorder and associated nursing care for each.

8. Discuss nursing implications for medications and treatments used in the prevention, treatment and management of Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

9. Explain risk factors and preventive measures for Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

B. Clinical

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1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

4. Identify and implement health teachings for the client with following disorders: Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

5. Present an ethical or legal issue associated with clients with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Cardiac Emergency, Permanent Pacemakers, Chronic CHF, Inflammatory Heart Diseases and Shock.


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UNIT 5-PROBLEMS OF HEMATOLOGICAL SYSTEMMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 33 – 35

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of the hematological system. Unit 5 contains information on nursing care of clients with Anemia, Leukemia, Lymphoma, and Lymphedema. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the hematologic, peripheral vascular and

lymphatic systems and relate it to Anemia, Leukemia, Lymphoma, and Lymphedema.

2. Outline a focused physical assessment of the hematologic system.3. Describe normal variations in assessment findings for the older adult.4. Identify manifestations of impairment in the function of the hematologic,

peripheral vascular and lymphatic systems.5. Describe, compare and contrast the pathophysiology, manifestations and

management of Anemia, Leukemia, Lymphoma, and Lymphedema.6. Differentiate Hodgkin’s disease from non-Hodgkin’s lymphomas and describe

nursing interventions for each.


following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema2. Utilizing critical thinking skills develop and evaluate a care plan for a client with

moderate to high acuity and the following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

4. Identify and implement health teachings for the client with following disorders: Anemia, Leukemia, Lymphoma, and Lymphedema

5. Present a ethical or legal issue associated with clients with Anemia, Leukemia, Lymphoma, and Lymphedema

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Anemia, Leukemia, Lymphoma, and Lymphedema


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UNIT 6 – PROBLEMS OF MOBILITY, SENSATION, AND COGNITIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapter 40 – 42 Adding SLE from Unit 12

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with bone cancer as well as review the musculoskeletal system. Unit 6 contains information on nursing care of clients with the different types of bone cancer. Bone cancer will be discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the musculoskeletal system.2. Identify specific topics for consideration during a health history interview of the

client with health problems involving the musculoskeletal system.3. Describe normal variations of the musculoskeletal system in the older adult.4. Discuss the purposes and related nursing interventions for stump care.5. Explain the causes, levels, types and potential complications (infection, delayed

healing, chronic stump pain, phantom pain, and contractures) of an amputation.6. Explain the pathophysiology, manifestations, complications, interdisciplinary

care, and nursing care of neoplastic disorders, bone tumors, and systemic lupus erythematosus.

7. Describe surgical procedures used to treat clients with bone tumors.8. identify common laboratory and diagnostic tests associated with diagnosis,

management and evaluation of clients with disorders of the musculoskeletal system.


bone cancer and SLE.2. Utilizing critical thinking skills develop and evaluate a care plan for a client

diagnosed with bone cancer and SLE with moderate to high acuity. 3. Discuss lab findings and their relationship to appropriate nursing interventions for

clients with bone cancer and SLE.4. Identify and implement health teachings for the client with bone cancer and SLE.5. Present an ethical or legal issue associated with clients with bone cancer and SLE.6. Select nursing interventions that demonstrate patient advocacy when caring for a

patient with cancer and SLE.7. Practice and/or use the computerized charting in the clinical setting.

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UNIT 7-PROBLEMS OF DIGESTION, NUTRITION, AND ELIMINATIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 23-26

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of digestion, nutrition and elimination. Unit 7 contains information on nursing care of clients with Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the gastrointestinal system.2. Describe the pathophysiology of Cirrhosis, Hepatitis, and GI cancer, Gastric

Surgeries and Acute and Chronic Pancreatitis.3. Relate manifestations, diagnostic tests, and surgeries associated with Cirrhosis,

Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.4. Utilize knowledge of normal anatomy and physiology to understand the

manifestations and affects of Cirrhosis, Hepatitis, and GI cancer, Gastric Surgeries and Acute and Chronic Pancreatitis.

5. Describe normal variations of digestion, nutrition and elimination for the older adult.

6. Discuss the purposes, nursing implications, and health education for the client and family of medications used to treat gastrointestinal disorders.

7. Describe surgical procedures of the bowel including Billroth I, Billroth II, colectomy, colostomy, ileostomy, and perianal surgery.

B. Clinical1. Identify assessment abnormalities in clients with moderate to high acuity with the

following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

4. Identify and implement health teachings for the client with any of the following disorders: Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis.

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5. Present an ethical or legal issue associated with clients with Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Cirrhosis, Hepatitis, GI cancer, Gastric surgeries or Acute and Chronic Pancreatitis


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UNIT 8 – PROBLEMS OF REGULATION AND METABOLISMMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition. Chapters 18 – 20

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of regulation and metabolism. Unit 8 contains information on the nursing care of clients with Diabetic Ketoacidosis (DKA), Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the endocrine system.2. Explain the function of the hormones secreted by the endocrine glands.3. Identify specific topics to consider during a health history interview of the client

with health problems involving endocrine function.4. Describe normal variations in assessment findings for the older adult.5. Identify abnormal findings that may indicate malfunction of the glands of the

endocrine system.6. Compare and contrast the manifestations of disorders that result from hyper

function and hypo function of the thyroid, parathyroid and pancreas.7. Provide appropriate nursing care for the client before and after a total and subtotal

thyroidectomy.8. Compare and contrast the manifestations and interdisciplinary care of

hypoglycemia, diabetic Ketoacidosis, and Hyperosmolar hyperglycemic state.9. Discuss lab findings and their relationship to appropriate nursing interventions for

clients with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.


following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Diabetic Ketoacidosis, Hyperosmolar

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Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.

4. Identify and implement health teachings for the client with following disorders: Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.

5. Present an ethical or legal issue associated with clients with Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), Thyroid, and Parathyroid disorders.


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UNIT 9-PROBLEMS OF EXCRETIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 27 – 29

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of excretion. Unit 9 contains information on nursing care of clients with Prostate, Testicular and Renal Cancer. This unit will also include Chronic Renal failure and dialysis. Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy, physiology and function of the genital urinary system.2. Describe normal variations in assessment findings for the older adult.3. Explain the role of the urinary system in maintaining homeostasis.4. Identify specific topics for consideration during a health history assessment

interview of the client with problems involving the urinary system.5. Discuss the nursing implications of medications and treatments prescribed for

clients with urinary tract disorders.6. Describe the pathophysiology of clients with Prostate, Testicular and Renal

Cancer including Chronic Renal failure and dialysis.7. Explain diagnostic studies used to identify disorders of the kidneys and their

effects.8. Compare and contrast dialysis procedures (i.e. hemodialysis and peritoneal) used

to manage chronic renal failure.B. Clinical

1. Identify assessment abnormalities in clients with moderate to high acuity with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

4. Identify and implement health teachings for the client with following disorders: Chronic Renal Failure and Prostate, Testicular and Renal Cancer

5. Present a ethical or legal issue associated with clients with Chronic Renal Failure and Prostate, Testicular and Renal Cancer

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6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Prostate, Testicular and Renal Cancer as well as Chronic Renal Failure


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UNIT 10- PROBLEMS OF NEUROLOGICAL FUNCTIONMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition Chapters 43 – 46

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with problems of neurological function. Unit 10 contains information on nursing care of clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS). Each disorder is discussed in terms of etiology, pathophysiology, clinical manifestations, medical management, and nursing management. Nursing diagnoses and client outcomes are identified. A nursing process approach is used for nursing management with focus on health promotion and self care. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the anatomy and physiology of the neurological system.2. Outline a focused physical assessment of the neurological system.3. Identify specific topics for consideration during a health history assessment

interview of the client with neurologic disorders.4. Identify manifestations of impairment of neurologic function.5. Identify prevalence, incidence, and risk factors for clients with Neoplasms,

Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

6. Compare and contrast the pathophysiology, manifestations, interdisciplinary care, and nursing care of clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

7. Discuss the purposes, nursing implications, and health education for the client and family for medications used to treat Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

8. Discuss surgical options for the treatment of Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

9. Describe the procedures (plasmaphoresis etc.) used to treat selected neurologic disorders.


following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

2. Utilizing critical thinking skills develop and evaluate a care plan for a client with moderate to high acuity and the following disorders: Neoplasms, Inflammatory

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Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

3. Discuss lab findings and their relationship to appropriate nursing interventions for clients with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

4. Identify and implement health teachings for the client with following disorders: Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

5. Present an ethical or legal issue associated with clients with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).

6. Select nursing interventions that demonstrate patient advocacy when caring for a patient with Neoplasms, Inflammatory Brain Conditions, Myasthenia Gravis, Multiple Sclerosis and Amyotrophic Lateral Sclerosis (ALS).


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Unit 11-Fluid, Electrolyte, and Acid-Base ImbalancesMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Unit 3 Chapter 10

INTRODUCTIONThe goal of this unit is to provide the learner with the key information needed to care for a client with intravenous (IV) access devices. Unit 11 contains an in depth review of intravenous therapy. Primarily intravenous devices will be discussed including the types and nursing care associated with each device. Blood Component therapy will also be included in this unit. A nursing process approach is used for nursing management with focus on health promotion and self care. Nursing diagnoses and client outcomes are identified. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 2 to level 3 meeting outcome criteria.


A. Theory1. Review the purpose and types of intravenous (IV) therapy.2. Recall the nursing care related to IV therapy appropriate for patients across the

lifespan.3. Outline the steps to an IV assessment for various types of patients and IV therapy.4. Differentiate the use and care of short and long term catheters for

immunosuppressed clients: Central venous access devicesi. PICC Lines

ii. Port-a-cathiii. Hickman

5. Differentiate and start to evaluate diagnostic exams used to assess appropriateness of IV therapy.

6. Distinguish between the nursing care of the patient with TPN and peripheral IV therapy.

7. Compare and contrast rationales behind long term antimicrobial therapy.8. Relate nursing care to long-term antimicrobial therapy.9. Identify Principles and practice of blood transfusion

B. Clinical1. Care for patients with intravenous access’s2. Utilizing critical thinking skills develop and evaluate a care plan for a client with

moderate to high acuity and an intravenous access device.3. Discuss lab findings and their relationship to appropriate nursing interventions for

clients with intravenous access devices.4. Identify and implement health teachings for the client with intravenous access

devices.5. Present an ethical or legal issue associated with clients with intravenous access

devices.6. Select nursing interventions that demonstrate patient advocacy when caring for a

patient with intravenous access devices.

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7. Identify and implement the steps necessary for blood and blood component transfusion


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Unit 12 REGULATION/PROTECTION NEEDS: CANCERMedical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Chapter 14

INTRODUCTIONThis unit at first reviews the general aspects of cancer that can be applied regardless of the sites. Cancer of the specific body systems is described in more detail in each unit. A nursing process approach is used for nursing management, with emphasis on health promotion and self care.


A. Theory1. Recall selected terms associated with cancer.2. Define cancer and differentiate benign from malignant neoplasms.3. Describe the theories of carcinogenesis.4. Explain and discuss known carcinogens and identify risk factors for cancer.5. Compare the mechanisms and characteristics of normal cells with those of

malignant cells.6. Describe and compare laboratory and diagnostic tests for cancer.7. Discuss the role of chemotherapy in cancer treatment and classify

chemotherapeutic agents8. Discuss the role of surgery, radiation therapy, and biotherapy in the treatment of

cancer.9. Identify causes and discuss the nursing interventions for common oncologic

emergencies.10. Design an appropriate care plan for clients with cancer and their families

regarding cancer diagnosis, treatment, and coping strategies.

B. Clinicala. Assess functional health status of clients with cancer, and monitor, document, and

report abnormal manifestations.b. Incorporate evidence-based research into the plan of nursing care for clients with

cancer.c. Prioritize nursing diagnosis based on assessment data and implement appropriate

nursing interventions for clients with cancer during cancer diagnosis, treatment and rehabilitation.

d. Evaluate the client who has been administered chemotherapeutic medications and assess the need for other medications for pain, nausea, and vomiting, mucosistis, or anemia knowledgeably and safely.

e. Use the nursing process as a framework for planning and providing individualized care and integrating interdisciplinary care for clients with cancer to meet their healthcare needs.

f. Include cultural variations and diverse values in designing and implementing individualized plans of care for clients with cancer.

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g. Design and provide individualized client and family teaching to restore, promote, and maintain clients’ functional status.

h. Revise plan of care as needed provide effective interventions for clients with cancer and their families.

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NURS B26

NURSING B26MEDICAL SURGICAL CLINICAL

INSTRUCTIONAL SYLLABUSFall 2009

Julie Gentry RN, MSN, FNP

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COURSE DESCRIPTIONLaboratory experiences are correlated with theory with emphasis on providing nursing care to the client with increasing complex needs. Concepts presented in Nursing B 26 are applied in a variety of healthcare settings.

Prerequisites: Completion of the first and second semesters of Associate Degree Nursing Program and/or evaluation by program director for skills and knowledge.

LEAD INSTRUCTORSMain Campus Distance EducationAsst. Professor: Lisa Harding, RN MSN CEN Asst. Professor: Julie Gentry RN MSN FNPEmail: [email protected] [email protected]:(661) 395-4728:cell (661)246-6587 (661) 395-4476; Cell (661) 364-3656Location: M S Building Room 178 M S Building Room 153Office Hours: Tuesday 1300-1700 Monday 1430-1730

(may be interrupted for staff meeting) Tuesday by appt onlyWednesday 1300-1530

Address: 1801 Panorama Drive 1801 Panorama DriveBakersfield, CA 93305 Bakersfield, CA 93305

****Open door policy – Students may contact/meet with instructor during scheduled office hours at any time. If the student has special needs, individual time can always be scheduled.

PROFESSIONAL EXPERTS - - - BAKERSFIELD COLLEGEAsst. Professor Lisa Harding, RN Mercy Hospital Truxtun AvenuePhone: (661) 395-4728; Cell (661) 246-6587 (4 West)

Asst. Professor Julie Gentry RN, MSN San Joaquin Community HospitalPhone: (661) 395-4679; Cell (661) 619-8248 (5 North)

Alisha Loken BSN, RN Kern Medical CenterPhone: (661) 821-0105; Cell (310) 948-3707 (3 Center)

Heather Ryall RN BSN San Joaquin Community HospitalCell (661) 204-5615 (4th Floor)

PROFESSIONAL EXPERTS - - - PORTERVILLE COLLEGEGayle Willis RN Sierra View District HospitalPhone: (559) 920-0968

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HUMAN PATIENT SIMULATION / SKILLS LABBakersfield Campus

Nancy Mai RN MSN (661) 395-4679Human Patient Simulator Coordinator

Joy Zamora LVN (661) 395 – 4271Instructional Assistant

TERMINAL OBJECTIVESTerminal objectives facilitate the integration of information relevant to nursing and client care. Upon completion of the program, the graduate will demonstrate the following:

Develop/coordinate/evaluate care to individuals, families, groups, communities, and populations; able to identify the rationale for care and competently deliver this care to an increasingly complex and diverse population in multiple environments, utilizing the nursing process.

Educate clients, families, and health care professionals under their supervision using appropriate teaching principles, strategies and current information.

Demonstrate effective communication with clients, families, and other health care team members in all health care settings.

Advocate for the client, profession, and the interdisciplinary health care team in an effort to ensure that clients, families, and communities are well informed and included in care planning.

Anticipates risks to the client and provides appropriate interventions to achieve optimal client outcomes.

Demonstrate critical thinking to problem solve, organize, and prioritize care for individuals or a group of clients.

Serve as a leader and partner in the interdisciplinary health care team.

Integrates current technology to provide competent client care.

Manage human and fiscal resources in an efficient and cost effective manner.

Accountable for the life-long acquisition of knowledge and skills to effect change in health care practices and outcomes.

Demonstrate accountability for the provision and evaluation of nursing care that conforms to professional standards and incorporates legal and ethical responsibilities of the nurse especially the rights of the clients.

LEVEL 3 TERMINAL OBJECTIVES

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PROVIDER OF CARE

Develop/coordinate/evaluate care to individuals, families, groups, communities, and populations; able to identify the rationale for care and competently deliver this care to an increasingly complex and diverse population in multiple environments, utilizing the nursing process.

Develop, implement, and modify a holistic plan of care for clients with increasingly complex problems.

Anticipate potential problems and prioritize client care for increasingly complex clients

Anticipate and prioritize care of multiple clients/families during clinical rotations.

Justify interventions based on client assessment and pathophysiology of medical diagnosis.

Implement modified interventions.

Integrate supportive data when administering medications.

Demonstrate respect for the client’s uniqueness, developmental level, socio-cultural background, spiritual beliefs, perceptions and values.

Educate clients, families, and health care professionals under their supervision using appropriate teaching principles, strategies and current information.

Individualize and adapt teaching strategies by utilizing the principles of teaching/learningDemonstrate effective communication with clients, families, and other health care team members in all health care settings.

Assess and consistently utilize effective communication techniques and adapt them for individual situations of clients, families, and health care members

Establish therapeutic relationships in all interactions

Communicate effectively with the expanded health care team with increasing independence

Advocate for the client, profession, and the interdisciplinary health care team in an effort to ensure that clients, families, and communities are well informed and included in care planning.

Utilize increasingly assertive techniques to promote client advocacy.

Validate and clarify with instructor interventions for client advocacy before initiating plan

Anticipates risks to the client and provides appropriate interventions to achieve optimal client outcomes.

Utilize supportive data to identify potential complications and plan for appropriate interventions

MANAGER OF CARE

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Demonstrate critical thinking to problem solve, organize, and prioritize care for individuals or a group of clients.

Demonstrate the ability to anticipate complications associated with complex disease processes.

Cluster and prioritize increasingly complex nursing interventions and complete the charting as appropriate for the clinical situation.

Continue to recognize self limitations and begin to utilize appropriate resources.

Design effective plan for resolving conflict resolution

Incorporate comprehensive assessment of client and relevant data

Serve as a leader and partner in the interdisciplinary health care team.

Participate in nursing and physician rounds to facilitate communication among team members

Make appropriate referrals based on client/family needs Participate in interdisciplinary team meetings

Integrates current technology to provide competent client care. Retrieve and record pertinent information utilizing multiple technological resources. Analyze and utilize the data gained from specialized equipment in delivery of client care

Manage human and fiscal resources in an efficient and cost effective manner. Plan and evaluate utilization of appropriate resources for cost effective delivery of client

care

MEMBER OF THE PROFESSION

Accountable for the life-long acquisition of knowledge and skills to effect change in health care practices and outcomes

Differentiate between credible resources Participates in at least one community project.

Demonstrate accountability for the provision and evaluation of nursing care that conforms to professional standards and incorporates legal and ethical responsibilities of the nurse especially the rights of the clients.

Integrate components of the California Nurse Practice Act in providing care Implement policy regarding State and Federal regulations Develop corrective action plan Accept responsibility and accountability for individual actions and implement a

remediation plan

COURSE ACTIVITIES

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Instructional and learning activities are directly related to the level outcomes and unit objectives with an emphasis on the nursing process. The level outcomes are achieved through a variety of assignments on acute care, rehabilitation care and outpatient settings, or through simulation learning. Various learning activities may be used such as lectures/discussions, demonstrations, audiovisual aids, required reading, computer assisted programs, simulated learning exercises, independent study, problem solving exercises, and quizzes/exams. Students are responsible for nursing process assignments, calculation of age appropriate drug dosages, and nurse as team leading assignments.

COURSE ASSIGNMENTS

Students are required to complete a variety of assignments which may include simulated learning experiences, computer assisted programs and weekly reading and homework assignments in order to successfully meet the objectives for Nursing B26 Clinical. Detailed instructions for each assignment are located in the ASSIGNMENTS section of the syllabus.

CLINICAL LABORATORY GUIDELINES

AttendanceClinical experience is essential for the student to meet all course objectives. For that reason, it is crucial students attend all scheduled clinical experiences. According to the handbook, two days of clinical may be missed for compelling reasons. Failure to meet course objectives will result in failure of the course. Make up days are not allowed. If the clinical instructor determines additional time is required in order to evaluate ability to progress to the next level, you will be notified and a learning contract will be initiated in order to aid in your successful completion of B 26. Lateness is not acceptable! Each tardy will be considered one absence. All absences and tardies must be reported to the clinical instructor by 0600. Do not call and leave a message with the nursing staff on the unit.

Please refer to the Bakersfield College Catalog and the ADN Student Handbook for Guidelines related to: Personal Appearance; Grooming; Uniforms; Jewelry; Alternative lab experience dress code; Dress Code While Obtaining Assignments; Campus Skills Laboratory Dress Code; Photo ID.

Student Orientation to Healthcare Facility

All students must be oriented to the facility where laboratory experience is provided. It is the responsibility of the instructor to provide this orientation either personally or by arrangement with staff members. Orientation shall include but is not limited to the following:

Parking Regulations (include both daytime and evening rules)

Cafeteria Procedure:

Restroom Facilities

Locker Facilities and/or proper location for books, outer clothing, purses, and valuables storage.

Safety and Emergency Procedures:

Absences or Tardiness in the Laboratory Areas:

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Paging System:

Location in Facility of:

Location of Student Assignment and Daily Laboratory Objectives:

Learning Resource Material:

Charting:

Medication Administration:

Supplies:

Orientation to Client Unit:

Introduction to Key Personnel:

Pre and Post Conference Facilities:

Communications During Laboratory Rotation:

Information About Facility:

Telephone Protocol

Limitation of Student Activity - Laboratory Area

Students are not to leave the nursing unit or department to which they are assigned without the permission of the instructor. Students may not undertake care of clients, which have not been assigned by instructor.

Phone Calls/Student Visitors

No personal phone calls should be made or received while in the laboratory areas. Emergency calls are directed to the instructor. Cell phones and pagers should be turned off. Cellular phones are not allowed in the laboratory areas. Also, students may not have visitors while in the laboratory area.

Laptop Computers/PDA’s

No laptop computers are to be used/present in the health care facilities.

PDA’s are to be used only as a resource, not as a word processing device while in the health care facility.

Transportation

Students are responsible for transportation to and from healthcare facilities.

Students assume all liability for traveling to and from healthcare facilities.

Students must park only in designated parking areas.

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ACADEMIC HONESTY

There will be zero tolerance for academic dishonesty, including plagiarism. Plagiarism is the intentional use of another person’s ideas, data, information, or work without giving credit. If the student is caught cheating, the test will be collected, a zero (0) grade will be recorded, and the student will be directed to leave the classroom. The student is required to meet with the Director of Allied Health to discuss his/her standing in the program. Please refer to the statements on academic honesty in your Bakersfield College Catalog, Associate Degree Nursing Student Handbook, and the Bakersfield College Class Schedule

COURSE EVALUATIONSClinical site and instructor evaluations are a requirement for this course. Evaluations will be conducted the last day of each clinical rotation. Students are expected to bring one survey answer form, Form 20-s, for each clinical instructor and site. Also, students are required to turn in 3rd Semester Critical Elements Forms and the Student Self Evaluation Form.

STUDENT EVALUATION

Evaluation is an ongoing, essential process in education, by which the student is, appraised of his/her progress in meeting the level outcomes and unit objectives. Student performance evaluations are based on course level outcomes, written and or oral assignments, and program critical elements. Clinical is graded on the care plan and the Nursing Process score. If you are required to repeat the care plan the highest score possible will be 75%. Student must also demonstrate the ability to consistently transfer classroom knowledge i.e. apply the information/skills at the bedside. If the student earns a no credit for clinical he/she is unable to progress in the program and will receive a failing grade for B26.

Grading Scale For assignments Course GradeA = 90 – 100

B = 80 – 89

C = 75 – 79

D = 70 – 74

F = 69 or less

≥ 75% = Credit≤ 75% = No Credit Medical Surgical Rotation _ _ _ _ _ _ _ _ _ _

Process papers ( 2 ), Daily abbreviated care plans, Clinical assignments _ _ _ _ _ _ _ _ _ _ _ _ _ _ Simulation learning, skills completion lists, presentationFloat out rotations _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Professionalism and participation

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REQUIRED TEXTS AND MATERIALS

Leadership and Nursing Care Management, Huber, D. 3rd Edition

Medical Surgical Nursing Critical Thinking in Client Care, LeMone, & Burke 4th Edition

Gentry, J. (2009). Bakersfield College Associate Degree Nursing Program. Instructional syllabus Theory and Clinical, B26

Nursing Practice Act with Regulations and Related Statutes. http://www.rn.ca.gov.

Information from www.bcmedsurg3.yolasite.com

Comprehensive Assessment and Review Program (CARP) by ATI.


*Each student will need one book of their choice from each of the following categories. Due to limited clinical space, each clinical group needs to determine who will bring which reference to share with the group.

1. Laboratory and diagnostic reference book

2. Intravenous medication book

3. General medication book

4. Pathophysiology book

5. Nursing Care plan book

PORTFOLIOS

Each student must have their portfolio immediately accessible upon request. Students can expect to present the portfolio at the beginning of each clinical rotation, and during the clinical evaluation process. The portfolio should include:

1. Copies of:

a. Physical Exam

b. TB skin test or Chest X-ray

c. Immunizations

d. Current American Heart Association CPR card

2. ADN Student Handbook

3. Safety Manual

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http://www.bcmedsurg3.yolasite.com/

http://www.rn.ca.gov/


4. Conference/Anecdotal/Probation forms

5. Evaluation Forms (Clinical site/Instructor/Theory)

6. Completed clinical evaluation forms

7. Skills checklist

8. TEAS results

Scantrons: One survey answer form, Form 20-s, for each instructor and clinical rotation, (including float out rotations)

CLINICAL GUIDELINES

1. The student will become acclimated to the environment, including: Physical layout of the facility Location of fire alarms and extinguishers Location of supplies and equipment Charting/Documentation Nurse care plans

2. All accidents and incidents are to be reported to the clinical instructor immediately. It is the student’s responsibility to complete the proper forms and notify the Bakersfield College Health Services Office

3. BREAKS-----Instructor and team leader MUST be notified of any breaks to be taken. When you take a break, another student must watch and be responsible for your client---not the hospital staff. Students are allowed (2)15 min breaks and a 30 min lunch. break. NO OTHER OPTIONS ARE AVAILABLE. In taking a break your work MUST be done on time and be on time to post-conference.

SMOKING AREAS---None.

There is to be no drinking, eating ect.. while on unit. (against infection control guidelines)

4. You may perform procedures that an RN may legally perform once you have demonstrated competency in the skills lab and/or the clinical setting.

5. Listen to report and practice taking notes. Clarify anything that is unclear with your instructor. A verbal report to the instructor is expected on each client you are assigned, inform of significant changes also. Keep the RN informed about everything relating to your clients condition.

6. Read the hospital policy and procedure before performing any procedure. We are guest in this facility and must follow written procedures

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7. Perform a physical assessment each day for each client, and chart according to the hospital policy.

8. Medications: The six rights of medication administration will be followed at all times All medications mus tbe checked by the instructor before you give them. If the

instructor is unavailable, WITH THE INSTRUCTORS PERMISSION you may ask the staff RN to check medications.

The instructor or staff nurse must observe administration of all IV medications. Students are not to handle narcotic keys, or possess computer access numbers to

the automated medication delivery system (Pyxis, Omnicell)

9. Students are responsible for the care of the client/team. If you are unable to complete any part fo the patient care you must notify the instructor immmediately.

10. Students are expected to follow directives in code situations – code blue, red, etc.

11. Post Conference--------1430pm -1530 pm ALL STUDENTS MUST BE ON TIME TO POST-CONFERENCE UNLESS NOTIFIED OTHERWISE

12. Please turn in careplans in a manila envelope, keep all graded assignments together. All assignments will be returned to the student.

POST CONFERENCE

Post conference is an opportunity to apply the information learned in the clinical setting and fosters and enviornment for discussion and learning. Each clinical instructor is responsible for the flow and structure of post conference and may consist of:

Verbal report of disease process Verbal presentation of Journal or news item pertinent to healthcare Field trip/site visit as prearranged by the instructor Role-play among students based on disease process preseented

”Knowing is not enough, we must apply. Willing is not enough, we must do”.Johann von Goethe

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ASSIGNMENTS

SKILLS CHECKLIST

PURPOSE OF THE ASSIGNMENTThe primary objective for this assignment is to provide record keeping for all clinical skills acquired, and to facilitate new learning experiences.

LEARNING OBJECTIVE1. Demonstrate accountability and responsibility for individual leaning needs.2. Practice a series of skill sets to assist in role transition from student to entry level RN

DUE DATESkills checklist are due at the completion of each clinical rotation. (Please submit to your clinical instructor). It is the student’s responsibility to keep up to date on clinical skills checklist.

FORMATEach student is required to maintain their skills checklist throughout the entire rotation in order to fulfill course objectives. It is the student’s responsibility to keep their skills checklist with them during their clinical rotation and keep it up to date. Students are encouraged to have clinical instructors sign off the newly acquired as soon as possible

GRADING CRITERIAStudents will earn either “credit” or “no credit” for this assignment. Successful completion will be based on completion of the assignment, adhering to the format and due dates.

COMMUNITY PROJECTSStudents are required to be in full uniform during community service projects. NO EXCEPTIONS.

PURPOSE OF THE ASSIGNMENTAs a member of the profession it is part of our professional responsibility to participate in community health related events

LEARNING OBJECTIVE1. Integration of standards into aspects of patient care of the client in the community setting.2. Independently collaborate with the interdisciplinary team to uphold State and Federal

regulations

DUE DATEA 250 to 500 word typed paper highlighting the experience. The paper should include your role in the experience, and how the peer group performed as positive or negative role models in the experience. Please include if this is a function you would continue to participate in if it were not an assignment for the course completion. All students are required to participate in one (1) community project (2-4 hours) throughout the course of the semester. The written report is due no later than Dec. 1, 2009.

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FORMATThroughout the semester opportunities will arise for student participation in the community setting. Opportunities will be announced as they become available

OPTION 1Contact Beth-Anne Mulder regarding the RN explorer program and set up a time to assist in the orientation process as directed by the leader of the program.

OPTION 2Contact www.1-800-volunteer.org and identify a community service project to participate in. There are also several opportunities within the BC arena that may benefit from nursing students.

OPTION 3Contact volunteer services at Houchin Blood Bank. Identify areas to assist in volunteering (assist with snacks, mobile donation units etc.) If more hours are needed you may donate blood to your local blood donation center. You must write the experience up related to why this important. The nursing care you witnessed and the role models you witnessed during the event good or bad.

OPTION 4Find a community project of interest to you; health care related is preferred but not totally necessary. Civil responsibility many times goes far beyond health care – clothing drives, toys drives, canned food drives, healthcare education opportunities for younger scout groups, and day care settings or possibly church activities. The program leader information for your project must be included on your written assignment of the experience.

OPTION 5Contact the volunteer services at any local hospice, home health or hospital organization to assist in preplanned health fairs or volunteer opportunities.

GRADING CRITERIAStudents will earn either “credit” or “no credit” for this assignment. Successful completion will be based on completion of the assignment, adhering to the format and due dates. Please do not take this assignment lightly; failure to earn “credit” may result in failure of NURS B26.

SIMULATED LEARNING REQUIREMENT

PURPOSE OF THE ASSIGNMENTSimulated learning provides a mechanism to practice, develop, and apply nursing care in safe interactive, and non threatening healthcare environments. This realistic experience supports critical thinking every step of the way while maintaining realistic experiences in controlled environments to produce standardized experiences.

LEARNING OBJECTIVE

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1. Enhance clinical skills and application at a third semester level.2. Build self confidence in application of knowledge and skills.3. Promote success as a Provider and Manager of care and a Member of the Profession.

DUE DATEEach student must turn in completed Simulation Learning Requirements no later than Tuesday Dec 1, 2009. FORMATAll students are required to complete a minimum of 4 hours of simulated learning experiences throughout the course of the semester. These hours are mandatory as they count towards the clinical hour’s allotment. The simulated learning experiences will be broken down into 4 hour units. Each unit will contain sections developed to enhance skill acquisition, confidence and clinical competence. Students will have 14 weeks to complete the units and simulation hours.Please keep track of your hours and use the Positive Attendance Tracking system (PAT). A minimum of (1) one hour of high fidelity simulation in addition to one of the learning modules created for B26 must be completed in order to obtain a passing grade for this assignment.

GRADING CRITERIAStudents will be awarded 4 hours of clinical time upon completion of each unit. Partial hours will not be awarded. Remember simulation hours counts toward clinical hours, noncompliance will result in missed clinical experience and the student will receive no credit for the clinical portion of B26 and failure of the course. Successful completion will be based on completion of learning module completion, documentation of simulation completion forms and documented hours on the PAT system. Your personal log or hours is your proof should the PAT system fail to record your time successfully.

ATI/CARPComprehensive Assessment and Review Program (CARP) by ATI.


Assignments will be announced in class as they pertain to each lecture or unit as determined by lead faculty.

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