NU 16045: Medical Surgical Nursing
Associate Degree Nursing
Arkansas Northeastern College
First Day Handout
Term:
Class Meeting Days:
Location:
Class Meeting Hours:
Clinical Days:
Clinical Hours:
Instructor:
Office:
Phone:
Email:
Office Hours:
Instructor:
Office:
Phone:
Email:
Office Hours:
I.
Spring 2014
Monday and Wednesday
Allied Health Building (Main Campus), Room 103
1:30 PM- 4:45 PM
Tuesday, Thursday, or Friday
TBA
Shauna Winchester, MSN, RN
Main Campus
870-780-1229
swinchester@smail.anc.edu
As posted and by appointment
Instructor:
Office:
Phone:
Email:
Office Hours:
Sherrita C. Fitzhugh, MSN, RN
Main Campus
870-824-6257/731-445-1899
sfitzhugh@smail.anc.edu
As posted and by appointment
Tonya Pankey, MSN, RN
Main Campus
870-780-1223
tpankeu@smail.anc.edu
As posted and by appointment
Welcome!
The faculty welcomes you into this introductory course of the Associate Degree Nursing
program.
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II.
Course Catalog Description
This 8 week course focuses on identifying influencing factors specific to focal stimuli
that promote or inhibit adaptation. The student is introduced to the basic concepts of
health care and nursing interventions to manipulate the focal stimuli. The clinical
component directs the student to intervene in those illness problems which are acutetemporary interruptions in adaptive modes
III.
Course Overview
This course focuses on identifying influencing factors specific to focal stimuli that
promote or inhibit adaptation. The student is introduced to basic concepts of health care
and nursing interventions to manipulate the focal stimuli. The clinical component directs
the student to intervene in those illness problems, which are acute-temporary
interruptions in adaptive modes.
IV.
Course Rationale
A study of the biological, psychological, and sociological concepts applicable to basic
adaptation needs of the individual. Topics include physiologic adaptive responses
related to the surgical client, the client receiving IV therapy and clients with fluid and
electrolyte, oncologic, hematologic, hepatic and biliary, gastrointestinal, and endocrine
disturbances.
V.
Course Outcomes
Classroom Outcomes:
Upon completion of this course the student will be provided the opportunity to:
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Compare and contrast body system responses to recognize normal versus abnormal
responses for a Medical Surgical client in the acute care setting (Program Outcomes 1,
4).
Formulate appropriate nursing interventions and recognize appropriate medical
treatment for clients with selected medical and/or surgical conditions, with an
emphasis on client safety and comfort (Program Outcomes 1, 4, 6)
Formulate expected client outcomes for the client with fluid and electrolyte imbalance,
surgical and oncological disorders, and diseases of the gastrointestinal, hepatic and
biliary, hematological, or endocrine systems (Program Outcomes 1, 3, 4, 6).
Identify specific nutritional alterations associated with the disease processes as
discussed in this course (Program Outcomes 1, 4).
Identify specific ethnic, cultural, and socially diverse considerations for the Medical
Surgical client from a regional, national, and global perspective (Program Outcomes 4,
7).
Set goals for own learning with evidence of self-direction (Program Outcomes 8).
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Clinical Outcomes
Upon completion of this course the student will be provided the opportunity to:
 Integrate and apply the principles from the natural and behavioral sciences,
humanities, and nursing sciences to the adaptive responses associated within the
individual client in the acute care setting (Program Outcomes 1, 4).
 Develop and utilize skills in systematic assessment and data interpretation (Program
Outcomes 1, 4).
 Plan for selective therapeutic nursing interactions according to established priorities of
the nursing process and critical thinking to meet the specific needs of the Medical
Surgical client (Program Outcomes 1, 3, 4, 6).
 Implement nursing interventions according to appropriate guidelines for the Medical
Surgical client (Program Outcomes 1, 3, 4, 6).
 Evaluate the effectiveness of nursing interventions by reviewing nursing care objectives
and the plan of care concurrently with intervention (Program Outcomes 1, 3, 4).
 Modify interaction with the client to promote optimum adaptation of the Medical
Surgical client (Program Outcomes 5).
 Apply teaching - learning principles to meet individual needs of the client in the acute
care setting (Program Outcomes 3, 5).
 Demonstrate professional and collaborative behaviors of the associate nurse as a
member of the health team (Program Outcomes 2, 5).
Clinical Simulation Outcomes:
Clinical simulation scenarios are designed to address core nursing concepts to mimic real-life
client care in a controlled environment.
Upon completion of the simulation scenarios, participation in case studies, and clinical
activities, the student will be provided the opportunity to:
 Identify primary nursing diagnosis.
 Identify relevant patient history information.
 Explain physical findings and diagnostics related to patient condition.
 Prioritize nursing interventions.
 Implement developmentally appropriate and culturally competent nursing
interventions based on patient care needs.
 Implement physician orders appropriately.
 Implement patient safety measures.
 Safely administer and verbalize therapeutic effectiveness and possible adverse
reactions of medication administration.
 Provide relevant family-centered education.
 Demonstrate therapeutic and confidential communication.
 Demonstrate direct and accurate communication with interprofessional team
members.
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VI.
Demonstrate effective team work.
Demonstrate proficiency in documentation using electronic health record
documentation.
Course Prerequisites
Math Application for Allied Health or College Algebra
Anatomy and Physiology I/Lab
Anatomy and Physiology II/Lab
General Psychology
English Comp I
Nursing Fundamentals or LPN to RN Transitions in Nursing
Course Co-requisite
NU 16014 Psychiatric Nursing
Developmental Psychology
Computer Fundamentals
VII.
Course Credits
This is a 5 credit hour course.
VIII.
Required Texts and Materials
 Focus on Adult Health. 1st ed. (Lippincott Williams & Wilkins) Pellico
 Illustrated Study Guide for NCLEX-RN Exam (w CD). 8th ed. (Mosby, Incorporated)
 Pharmacology Made Insanely Easy
 Fundamentals of Nursing – Vol. I - Theory, Concepts, and Applications, 2nd ed. (Davis)
Wilkinson & Treas
 Fundamentals of Nursing – Vol. 2 – Thinking, Doing, and Caring, 2nd ed. (Davis)
Wilkinson & Treas
 Skills Video 2e for Fundamentals of Nursing
 ATI Modules (will be distributed during the first week of the course).
 Medical Surgical Nursing (edition 9.0)
 Nutrition (edition 5.0)
 RN Pharmacology for Nursing (edition 6.0)
 Test Successes, (w/CD), 6th ed. (Davis) – Nugent & Vitale
 Taber’s Cyclopedic Medical Dictionary 22nd ed. (Davis)
 Lippincott Manual of Nursing Practice, 10th ed. (Lippincott) – Nettina
 Davis’s Drug Guide for Nurses (w/CD), 13th ed. (Davis) - Deglin
 Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 2nd
ed, (Davis) – Doenges, Moorhouse, & Murr
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 Davis’s Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing
Implications, 4th ed. (Davis) Van Leeuwen & Leth
 APA: The Easy Way! 2nd ed. (Baker)
 IV Supply Bag
 Head phones/ear buds (for audio items on ATI exams)
 Stethoscope Kit – stethoscope, penlight & scissors
IX. Basis for Final Grade
Unit Exams
Comprehensive Final Exam
Other Work (example: Health Assessment, case studies, quizzes, N-CLEX
questions, ATI modules, DocuCare assignments and homework).
ATI Assessment (higher grade of 2 attempts)
Clinical Evaluation
50%
25%
25%
5%
Pass
or
Fail
Total
100%
 Students must achieve an 80% on unit exams and final exam prior to having
other assignments and ATI assessment averaged into the grade
 Students achieving an 80% or greater on units exams and course final must
maintain the 80% average once other assignments are calculated into the
grade to pass the course.
Grading Scale
100-91
90- 85
84 - 80
79- 70
Below 69
X.
A
B
C
D
F
Grade Dissemination
 Instructors will review unit exams with the class as outlined in the Student Handbook.
 Faculty will utilize the myANC Gradebook, a component of the Learning Management
System, to record and disseminate unit exams, course finals and all other assigned work
grades. This system provides students the opportunity to track and be accountable for
their own grade portfolio. Students are responsible for verifying any questionable
grades with the course instructors.
 Unofficial mid-term and official final grades can be accessed by students utilizing Campus
Connect on myANC.
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XI.
Course Policies:
Grades:
 Students must achieve an overall 80% average on all unit exams and course final as
outlined in the Syllabus and FDH prior to other written work and assignments being
averaged into the grade. Students achieving an 80% average in unit exams and course
final must maintain the 80% overall average once other written work assignments are
calculated into the grade to progress to the next nursing course.
 Faculty will utilize the myANC Gradebook to record and post grades. Students not
achieving an average of 80% or greater on the course unit exams and final exam will
receive that score as their final course grade. Other assigned and written work will not
be included in the final grade. Students failing to achieve 80% will not pass and will not
progress to the next nursing course.
 Following unit exams, instructor/student initiated counseling sessions will be provided
for students scoring less than 80%. Students may schedule appointments with
instructors only after the exam has been reviewed in class. Appointments are to discuss
study habits, ways to improve next exam score, study tips, test taking tips, etc. and are
not to be used for exam review. The appointment should take no longer than 15 – 20
minutes.
 Students must achieve a satisfactory clinical performance. Students failing to achieve
satisfactory in clinical performance will not pass the course and will not be allowed to
progress to the next course.
 Students terminated from the program due to failing academic or clinical performance
may apply for re-entry into the program when the course is offered again, pending
available space. Students attempting to reenter the program greater than 1 year
following termination must petition the faculty for re-admittance.
Exams:
 Unit exams are scheduled on the course calendar and may cover handouts, textbook
readings including ATI texts, lecture material, assigned journal articles, and audiovisual
material assigned. Faculty reserve the right to ask any question based on previous
content delivered.
 Each nursing course builds on content from previous courses; therefore, frequent and
periodic testing may occur in all previous course contents areas.
 The Testing Policies noted in the Student Handbook will be enforced with all unit, final,
and ATI exams, along with all Competency Testing.
 All tests must be taken at the scheduled time. Students arriving late may take the unit
exams for only the remaining time that the exam is to be administered.
 Students absent on a day of a scheduled exam will be allowed to make-up only one exam
per course, if the absence is excused. To be considered for excuse, absences must be
accompanied by recognized written documentation. Illness, death in the immediate
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family, appearance in court, and automobile accidents are examples of excused
absences. Unexcused absences will result in a score of zero for the exam grade.
 In event of absence or tardiness from an exam, the student must notify the classroom
instructor and the ADN secretary at the Blytheville Campus.
 Students with an excused absence from an exam must make-up the exam by the next
scheduled class or a date approved by the course instructors.
 Instructors will review unit exams one time a semester within one week of taking the
exam and only after all students have completed the exam. Test reviews will take place
at the end of the scheduled class time.
Testing Process
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All student possessions (backpacks, cell phones, water bottles, purses, etc) must be left
at the front of the room during exams. It is recommended that students leave their
belongings in their vehicle during testing. The college is not responsible for any lost or
stolen items.
Students are not permitted to sit at their desk with notes, books, or electronic devices
prior to the test. Any last minute studying must be conducted outside of the classroom.
Students will be allowed to enter the classroom only at the start of class on scheduled
exam days.
Students must dress comfortably without wearing oversized coats and other garments.
Students may not wear hats or caps during exams.
Bring only two pencils into the classroom.
Seating arrangements may be assigned by the instructors.
Students will be issued an exam booklet, an answer sheet, and a cover/scratch sheet
which will require the student’s signature. Cover sheets will be used at all times by
students.
Students are encouraged to use restroom facilities before and after testing. If a
student must be excused, he/she will quietly ask permission.
When the student completes the exam or when time is called, the student will leave all
testing material faced down and covered and quietly leave the area.
Once the student exits the room, the student may not re-enter to complete any portion
of the scantron answer sheet is not permitted. NO EXCEPTIONS.
Students will not congregate outside the classroom doors after completing their test.
Students will keep their voices low while in the hallways on their way outside.
When all students are finished testing, access to the classroom will be allowed for the
beginning of lecture.
Students are discouraged from discussing test questions until all students have tested
and the test has been reviewed.
There will be no discussion of test items between students and faculty on the day of
the test.
In the event of an excused absence, the student is to contact the course instructor to
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schedule a time for the make-up exam.
Faculty will review unit exams and rationales during class time within one week of the
exam. Students who disagree with a keyed answer may request a review of the test
item within 24 hours of test review.
ATI Computerized Testing
Progressive testing is completed within the ADN program. It is used as a valuable teaching
tool and to measure student learning outcomes prior to progressing to the next course.
Specific ATI requirements for each nursing course are included in the course First Day
Handout. The ATI exam for each course is recorded as a percentage (5%) of the overall
course grade.
 Content specific (targeted) ATI exams will be assigned throughout NU 16045 Medical
Surgical Nursing course to help students prepare for unit exams. Targeted ATIs can be
accessed through the “practice assessment tab” in ATI. Due Dates for Targeted ATIs are
indicated on the Course Calendar.
 At the end of NU 16045 Medical Surgical Nursing, students are required to complete 2
ATI exams. The ATI exam with the highest score will be recorded in the grade book.
 Students who do not achieve a minimum of an 80% on either attempt will be required to
complete ATI remediation as outlined below before a third attempt.
 A comprehensive Medical Surgical ATI exam will be taken by students upon completion
of
Advanced Medical Surgical Nursing II during the final semester of the program.
ATI Remediation
It is recommended that each student use the results of ATI to better prepare for the Final
Exam in the course as well as preparing for NCLEX. However, a student that does not
successfully pass the ATI following the second attempt (80% minimum) is required to
submit proof of remediation prior to testing a 3rd time.
Clinical Skills Validation:
Students must satisfactorily complete the competency based skills validation as outlined
in each course syllabus before progressing to the outside clinical component of the
course. Students unsuccessful in the skills validation of the course will receive an “F” for
the course (regardless of a passing grade average) and not be allowed to progress in the
course. Students enrolled in this course are required to successfully demonstrate
following skills related to intravenous therapy:
 preparation of IV fluids and tubing
 venipuncture
 discontinuing an IV
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administering a medication by IV push
Clinical Lab Evaluation
 The Daily Anecdotal Record will be utilized by Clinical Instructors to evaluate
student’s clinical performance in their assigned clinical setting for that day.
Students will be provided their Anecdotal Evaluation on a weekly basis and have
opportunity to discuss areas of strengths and opportunities with their Clinical
Instructor. Students may be assigned additional outside work or additional
clinical rotation hours to further validate satisfactory clinical performance and
subsequently meet the clinical objectives.
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The end of course Clinical Evaluation Tool is (describe as noted on tool) an overall
evaluation of the students clinical performance in a respective Nursing Course.
This evaluation will be graded “S” (satisfactory) or “U” (unsatisfactory.)
Satisfactory performance in the clinical setting is necessary in order to make a
passing grade in any nursing course. Satisfactory is defined as behavior in which
errors may be made, but are recognized and corrected. Unsatisfactory is defined
as behavior in which errors are made but not recognized by the student and
corrected. Unsatisfactory is also unacceptable, unprofessional, and unsafe
performance.
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To receive an over-all passing grade on each end of course clinical rotation, an
overall 0.8 clinical score for the identified objectives must be achieved. In
addition, students who do not meet criteria in three (3) or more individual
behaviors will not pass the clinical component. Failure to pass the clinical
component will result in failure of the nursing course.
Any excused absence will also result in a “U” for that clinical day and must be made up to
eliminate the “U”. Students will not be allow to make up unexcused absences which will
result in a “U” for the missed clinical day and the student receiving an “F” in the course
(regardless of grade average). The student will not be allowed to advance in the nursing
program.
Mathematics Competency Testing:
Due to the need for accuracy in preparing medications, the mathematics competency
testing will be given each semester of the nursing program. Students will be required to
demonstrate basic mathematical skills in computing drug dosages and must achieve 90%
accuracy. During the first course in nursing (Fundamental of Nursing) the student will
have three chances to achieve the required 90% accuracy. . If the student does not
achieve this requirement, he/she will be given an “F” for the course (regardless of a
passing grade average) and not be allowed to progress to the next nursing course. For
subsequent semesters, students will have to pass the math competency with 90%
accuracy prior to entering the clinical facility. Math competency testing in each course
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following Fundamentals of Nursing the student will have to pass the competency prior to
entering the clinical facility. Any days missed by the student as a result of not passing the
competency will be made-up and cannot exceed the 12 hours. Computing drug dosages
will be part of each test in all nursing courses remaining. Only calculators issued by the
ADN program may be used for competency testing or on exams.
I.V. Competency Testing
In addition to a math competency exam, students in the Medical Surgical Nursing course are
required to successfully complete an I.V. written competency exam with a minimal score of
80% and an I. V. skills validation prior to attending clinical. The student will be given three (3)
attempts to successfully pass each competency (previously listed). If the student does not
achieve this requirement, he/she will be given an “F” for the course (regardless of grade
average) and will not be allowed to progress to the next class.
Written Work Standards:
 All written work unless specified by an instructor is to be submitted on standard 8½ x
11 inch paper.
 All written work is expected to be neat, legible and written according to the APA
(American Psychological Association) format.
 Written work should either be typed or in black ink and follow the instructions
provided by the instructor or indicated on the Course Syllabus or First Day Handout.
 Written work completed in pencil will not be accepted.
 Written assigned work is due at the beginning of class on the assigned day. Anything
handed in after that time will result in a 10% grade deduction for each business day
excluding weekends and holidays. Assignments submitted more than five (5) days late
will not be graded.
 All assignments (written or electronic) must be submitted to meet the course
objectives.
 Work must be submitted in appropriate college level format (APA). Correct spelling,
grammar and sentence structure are important and must be of a quality acceptable for
college level students.
Electronic Submission of Assignments
 Faculty may request that specific assignments be submitted by email attachment or
through the ANC portal.
 Only assignments specified by the faculty will be accepted electronically.
 If an assignment is to be submitted electronically, the student must submit the
assignment from their ANC email account.
 Assignments that are to be submitted electronically are due at the date and time
designated by the faculty. Any late submissions will result in a 10% grade deduction for
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each business day the assignment is late, excluding weekends and holidays. Assignments
submitted more than five (5) days late will not be graded.
Late Work and Make-up Policy:
 Assigned work is due at the beginning of class on the assigned day. Anything handed in
after that time will result in a 10% grade deduction for each scheduled school day the
assignment is late, Saturday and Sunday excluded. Assignments submitted more than
five (5) days late will not be accepted.
 Students absent on a day of a scheduled exam will be allowed to make-up only one exam
per course, if the absence is excused. To be considered for excuse, absences must be
accompanied by recognized written documentation. Illness, death in the immediate
family, appearance in court, and automobile accidents are examples of excused
absences. Unexcused absences will result in a score of zero for the exam grade.
 In event of absence or tardiness from an exam, the student must notify the classroom
instructor and the ADN secretary at the Blytheville Campus.
 There will be no make-up quizzes.
Extra Credit Policy:
 Typically no extra credit assignments are given.
Grades of “Incomplete”:
The current College policy concerning incomplete grades will be followed in this course.
Incomplete grades are given only in situations where unexpected emergencies prevent a
student from completing the course and the remaining work can be completed the next
semester. Your instructor is the final authority on whether you qualify for an incomplete.
Incomplete work must be finished by mid-term of the following semester or the “I” will
automatically be recorded as an “F” on your transcript. Refer to the ATI policy in the ADN
handbook.
XII. Course Policies: Technology and Media
Email: Arkansas Northeastern College has partnered with Google to host email
addresses for ANC students. Created for each student enrolled in the current semester is
a myANCmail account and is the email address your instructor will use to communicate
with you. Access your email account by going to http://mail.google.com/a/smail.anc.edu
and using your first and last names, separated by a period for your username. Your
default password is your Student ID, no hyphens. If you cannot access your student
email, contact the MITS department at 762-1020 ext 1150 or ext 1207 or send an email
to ANChelp@smail.anc.edu.
Internet: Students are encouraged to login to myANC everyday as course assignments
may be posted. The internet is used to view videos as related to specific units within the
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course. Students may access online videos by logging on to
http://www.medcomrn.com/anc/. User ID is the student’s first initial, last name (or other
log in name assigned by instructor. The password is “anc123”.
Laptop Usage:
Students are allowed to utilize computer devices for note taking purposes or to access
digital textbooks in the classroom.
Cell phone Usage: Cell phones must be silenced (vibrate is not acceptable) or turned off
and not visible in the classroom and are prohibited in the clinical setting. Cell phones are
not permitted during exams (ATI computerized exams or written unit exams). Cell
phones are not permitted during the review of exams. In the classroom, students whose
cell phone rings during class or who is text messaging during class time will be asked to
leave the class and not allowed to return until the next scheduled break. A student who
utilizes a cell phone in the clinical setting will receive a clinical absence for the day to be
made-up according to the department policy for clinical absences. The nursing faculty
recognizes that in certain emergency situations the student may need to be available by
cell phone – permission must be obtained from the instructor prior to sending or
receiving calls or text messages.
A student may utilize a smart phone to record lecture. If this is done the cell phone must
be placed on the instructor’s podium prior to class starting. If the cell phone is not on
the podium prior to class beginning, then the student must wait until a break is offered
to place the cell phone in the appropriate location for recording.
Classroom Devices: Tape recorders or other audio devices may be used to audio record
lectures. Only calculators provided by instructors are permitted during exams.
Computer Labs: In addition to general-purpose classrooms, a number of computer
laboratories are provided for instructional and student use. These networked
laboratories are state-of-the-art and fully equipped with computers, printers, Internet
connections, and the latest software. The labs are open to students enrolled in one or
more credit hours at the college.
Technology Support: A lab assistant is generally present in the computer lab in B202 for
assistance in using the college computers. These assistants cannot help with course
assignments; specific questions regarding the technology requirements for each course
should be directed to the instructor of the course. Problems with myANC or college
email accounts should be addressed by email to ANCHelp@smail.anc.edu.
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Clinical Simulation Laboratory Experiences: Clinical experiences will be supplemented
and enhanced through the use of clinical simulation. The simulation laboratory
experiences will be supervised by a designated instructor.
Compressed Video for Distance Learning: In order to provide simultaneous and
equivalent learning experiences for all nursing campuses, lecture and other learning
experiences are transmitted via compressed video to all locations. A qualified nursing
instructor is always available on each campus in addition to the compressed video.
XIII. Course Policies: Student Expectations
Disability Access: Arkansas Northeastern College is committed to providing reasonable
accommodations for all persons with disabilities. This First Day Handout is available in
alternate formats upon request. Students with disabilities who need accommodations in
this course must contact the instructor at the beginning of the semester to discuss
needed accommodations. No accommodations will be provided until the student has
met with the instructor to request accommodations. Students who need
accommodations must be registered with Johnny Moore in Statehouse Hall, 762-3180.
Attendance Policy:
Classroom Attendance
 Students must give their scholastic obligations first priority. The student must notify
both the instructor by phone and the ADN secretary on the Blytheville campus prior to
the start of class in the event of an absence or tardiness.
 Because important knowledge is delivered in each classroom lecture, the student is
expected to attend all lectures. If a student is absent, he/she assumes the
responsibility and is accountable for information given during absence. Absence(s) may
result in a low test score which might prevent progression in the nursing program.
Students exceeding more than three absences will meet with their academic advisor or
course instructor to identify issues that might impact the student’s ability to attend
class or the student’s ability to complete the nursing program.
 Students reporting to class lecture more than ten (10) minutes after the lecture has
started will be permitted to enter at the instructor’s discretion. Quizzes missed during
the student’s tardiness will not be made up (no exceptions).
 Students absent on a day of a scheduled exam will be allowed to make-up only one
exam per course, if the absence is excused. To be considered for excuse, absences
must be accompanied by recognized written documentation. Illness, death in the
immediate family, appearance in court, and automobile accidents are examples of
excused absences. Unexcused absences will receive a zero for the exam grade.
 In the event of an absence or tardiness from an exam, the student must notify the
course instructor and the ADN secretary by phone prior to the beginning of the exam.
Failure to provide notification as outlined above will result in an unexcused absence.
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Clinical/Campus Laboratory Attendance
 Regular and prompt attendance for all clinical assignments is required. Absence
prevents achievement of course and clinical objectives and will result in unsuccessful
completion of the course. Two (2) excused 6-hour clinicals or one (1) excused 12-hour
clinical day per semester may be allowed. All excused absences will be made up prior
to the end of the semester.
 Students exceeding 12 hours of excused clinical absence may present an exception
form for faculty review. The exception form and required documentation must be
presented on the first day of class following the absence. To be considered for
exception, clinical absence in excess of 12 hours must be excused and be accompanied
by acceptable written documentation. Illness, death in the immediate family,
appearance in court, and automobile accidents are examples of excused absences.
Unexcused absences will result in an unsatisfactory clinical grade. A clinical exception
request will be allowed only once during the program. Clinical absence in excess of 24
hours will not be considered for exception.
 In the event of an absence or tardiness from any clinical assignment, the student must
make every attempt to notify the clinical instructor, facility assigned, and the ADN
secretary by phone prior to the beginning of clinical.
1.
Contact the ADN secretary first, to leave a message.
2.
Contact the clinical instructor and assigned clinical facility.
Unexcused Absences
No unexcused absences will be allowed. Any student with an unexcused absence will
receive a grade of “F” for the course (regardless of average) and dismissal from the
program.
Professionalism Policy: Registered Nursing students are expected to exhibit professional
behavior. The Code of Ethics for Nurses applies to any setting the student may find
themselves in.
Additional Information:
 All students must comply with the uniform code as designated by the ANC Department of
Nursing. No jeans, shorts or tennis shoes are allowed in the clinical area. While in the
clinical area preparing for clinical, lab coats and street clothes are required.
 Each student is expected to meet the assigned client(s), review the chart, medication
record, and become familiar with procedures planned for the following clinical day. The
student will then prepare a nursing care plan and medication cards for each medication.
The care plans and medication cards are to be turned into the clinical instructor the day
of the clinical experience. Failure to adequately prepare will result in an unsatisfactory
clinical grade and/or dismissal of the student from the assigned clinical experience.
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Under no circumstances should a student ask another student, clinical facility employee,
or any other person to obtain clinical information for them.
 Prior to the administration of any medication in the clinical area, the student must have
thorough knowledge of the medication. Failure to do so will result in an unsatisfactory
an unsatisfactory clinical grade and/or dismissal of the student from the assigned clinical
experience.
 All students are responsible for maintaining an accurate record of their addresses and
telephone numbers with the nursing department.
 Students with problems or concerns in the clinical/classroom are to discuss the concern
with the instructor first. If the problem or concern is unresolved following the discussion
with the instructor, the student will schedule an appointment with the instructor and the
program director. If the problem/concern remains unresolved, the student will schedule
an appointment with the program director and the dean of nursing.
 In keeping with classroom etiquette, mobile phones, iPods, etc. must be silenced during
all classroom lectures and are prohibited during clinical rotations. Students failing to
adhere to these guidelines may be dismissed from lecture/clinical for the remainder of
the day.
 Students should arrive on time and be seated at the scheduled class time. Students
arriving late may find the door to the classroom locked and may not be permitted to
enter until the class takes a break. Quizzes missed during that time will not be made up.
Academic Integrity Policy: Academic dishonesty in any form will not be tolerated.
Students are expected to do their own work. Plagiarism, using the words of others without
express permission or proper citation, will not be tolerated. Any cheating (giving or
receiving) or other dishonest activity will, at a minimum, result in a zero on that test or
assignment and may be referred, at the discretion of the instructor, to the Department
Chair and/or Vice President of Instruction for further action. If you are uncertain as to what
constitutes academic dishonesty, please consult the Academic Integrity Policy for further
details. http://www.anc.edu/docs/Academic_Integrity_Policy.pdf
Academic Success Center: The Academic & Career Enrichment (ACE) Advising Center is
located in Statehouse Hall in Room S145. The ACE Advising Center advises all new ANC
students. Once a student is progressing through his/her program of study, the student will
be assigned an advisor within that field of study. Prospective students are provided test
prep assistance through the computerized Skills Tutor system for Compass test placement.
The ACE Advising Center also houses a Virtual Career Center including career placement
services, as well as academic tutoring services for enrolled students. The tutoring services
offered are one-on-one tutoring, group tutoring, and group labs for specific classes.
Other Student Support Services: Many departments are ready to assist you reach your
educational goals. Be sure to check with your advisor; the ACE Advising Center, Room S145
and Student Support Services, Room W207; to find the right type of support for you.
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Disclaimer: This First Day Handout was prepared under certain limited assumptions.
Therefore, if the students in the class seem to "fit" the design for the course and if events
occur as planned, the schedule, assignments, and assessments will be followed. The
instructor has the option, however, to eliminate or add assignments and/or assessments if
he/she feels it is in the best interest of the students.
XIV.
Important Dates to Remember
Classes Begin:
January 13, 2014
Martin Luther King Holiday: January 20, 2014
IV Check-offs:
January 21, 2014
IV Competency Exam
January 21, 2014
Math Competency Exam:
January 22, 2014
Clinical Orientation
TBA
President’s Day
February 17, 2014
Health Assessment Due:
February 26, 2014
Mid-term grades
March 7, 2014
XV. Unit Outline and Instructional Outcomes:
See course calendar for assigned reading and videos and dates for assignments and exams.
UNIT I ADAPTIVE RESPONSES FOR THE CLIENT RECEIVING IV THERAPY
Rationale: Nurses provide IV therapy to clients in a variety of settings. Nurses must have the
knowledge and skill to provide this therapy safely for the client.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
1. Demonstrate safe and effective procedure for venipuncture.
2. Plan nursing interventions to include cultural, ethnic, and social diverse populations
when caring for a client receiving intravenous fluid therapy.
3. Describe management of clients receiving parenteral nutrition.
4. Describe measures used for preventing complications of IV therapy.
evaluate a client’s response to blood or blood products.
5. Demonstrate safe and effective management of IV fluids, IV tubing, and electronic IV
flow controllers.
6. Demonstrate understanding of IV site care and infection control principles.
7. Demonstrate skill in procedure of IV infusion to INT conversion and discontinuation of
IV therapy.
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8. Demonstrate correct dosage calculations for medication administration and IV
infusion.
9. Demonstrate proper aseptic technique when obtaining blood specimens peripherally or
through a central line.
10. Describe the role of the nurse when assisting with invasive procedures such as with the
insertion of a central line.
11. Evaluate the clients response to medication (e.g., therapeutic effects, side effects,
adverse reactions).
CONTENT:
1. Venipuncture
2. Tubing and pump preparation
3. IV additives and piggybacks
4. Complications of IV Therapy
5. IV Dosage Calculations
6. Peripheral Intravenous Locks (INTs, saline locks)
7. Implanted Ports and Central Lines
8. Parenteral Nutrition
UNIT II ADAPTIVE RESPONSES FOR THE CLIENT WITH FLUID/ELECTROLYTE IMBALANCE
Rationale: Fluid and electrolyte imbalances and Acid/Base imbalances affect all the client’s
body systems. Thorough knowledge and understanding of these imbalances and the
management of them is essential for the nurse to provide holistic care.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity:
Lesson 1: Acid/Base Imbalances
1. Explain the role of the lungs, kidneys and chemical buffers in maintaining acid-base
balance.
2. Compare metabolic acidosis and alkalosis with regard to causes, clinical manifestations,
diagnosis and management.
3. Compare respiratory acidosis and alkalosis with regard to causes, clinical manifestation,
diagnosis and management.
4. Interpret arterial blood gas measurements.
5. Describe nursing management for client with a fluid and electrolyte disorder.
UNIT III ADAPTIVE RESPONSES FOR THE SURGICAL CLIENT
Rationale: Clients requiring surgery or experiencing shock require special care from nurses. It
is essential that nurses have the knowledge to provide for the client’s needs.
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OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
Lesson 1: Perioperative Nursing Care
1. Describe the three phases of the perioperative period: preoperative, intraoperative, and
postoperative.
2. Describe a comprehensive preoperative assessment to identify surgical risk factors.
3. Identify legal and ethical considerations related to informed consent.
4. Describe preoperative nursing measures that decrease the risk for infection and other
postoperative complications.
5. Describe the immediate preoperative preparation, intraoperative preparation, and
postoperative management off the surgical patient.
6. Identify the nurse’s role in patient safety and regulatory compliance in the perioperative
setting.
7. Identify adverse effects of surgery and anesthesia.
8. Describe the principles of surgical asepsis.
9. Prioritize the delivery of client care of the surgical client.
10. Ensure proper identification of the surgical client.
11. Protect the surgical client from injury (e.g., falls, electrical hazards).
12. Assess the surgical client’s readiness to learn, learning preferences, and barriers to
learning.
UNIT IV PROMOTION AND ADAPTATION FOR THE CLIENT WITH HEMATOLOGIC DISORDERS:
Rationale: Clients with hematologic disorders require special nursing care. It is essential that
nurses have the knowledge to provide that care.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
Lesson 1: Overview of Hematologic Function
1.
2.
3.
4.
5.
Describe the process of hematopoiesis.
Describe the processes involved in maintaining hemostasis.
Analyze laboratory and diagnostic tests used to evaluate hematologic function.
Describe the procedure and patient preparation for a bone marrow biopsy.
Discuss the causes of anemia, neutropenia, and thrombocytopenia.
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6. Utilize the nursing process to formulate a plan of care for a client with anemia,
neutropenia, or thrombocytopenia.
Lesson 2: Nursing Care of Client’s with Hematologic Disorders
1. Differentiate between the different types of anemias, and compare and contrast the
physiologic mechanisms, clinical manifestations, medication management, and nursing
interventions for each.
2. Compare the leukemias in terms of their incidence, physiologic alterations, clinical
manifestations, management, and prognosis.
3. Discuss nursing management for clients with lymphoma or multiple myeloma.
4. Discuss nursing management of clients with bleeding and clotting disorders.
5. Identify therapies for blood disorders; include the nursing implications for the
administration of blood components.
6. Identify pathophysiology and clinical manifestations related to clients with acute
chronic hematological disorders.
7. Evaluate the effectiveness of the treatment regimen for a client with an acute or
chronic hematological conditions.
UNIT V PROMOTION OF ADAPTATION OF THE CLIENT WITH ONCOLOGICAL DISORDERS
Rationale: Knowledge of cancer cell characteristics is needed to identify alterations in affected
system function to determine the appropriate nursing diagnosis, planning, intervention, and
evaluation of client care.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities,
the student will be provided the opportunity to:
Lesson 1: Overview of Cancer
1. Compare the structure and function of the normal cell and the cancer cell.
2. Differentiate between benign and malignant tumors.
3. Identify agents and factors that have been found to be carcinogenic.
4. Describe the nurse's role in cancer prevention and health education.
Lesson 2: Cancer Treatment
1. Differentiate among the purposes of surgical procedures used in cancer management,
diagnosis, prophylaxis, and palliation.
2. Describe the role of the following treatment modalities for cancer: surgery, radiation,
therapy, chemotherapy, biotherapy, and other therapies used to treat cancer.
3. Formulate a nursing care plan for the client receiving chemotherapy and radiation.
4. Describe common nursing diagnoses and collaborative problems of client’s with cancer.
5. Describe the concept of hospice in providing care for clients with advanced cancer.
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6. Recognize signs and symptoms of complications when caring for the oncology client.
7. Implement nursing interventions for treatment and prevention of complications for the
oncology client.
8. Discuss the role of the nurse in assessment and management of common oncologic
emergencies.
UNIT VI PROMOTION OF ADAPTATION FOR THE CLIENT WITH GASTROINTESTINAL
PROBLEMS
Rationale: Clients with gastrointestinal problems require special care. It is essential that nurses
have the knowledge to provide that care.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
Lesson 1: Overview of the Digestive System
1.
Review the anatomy and physiology of the gastrointestinal (GI) system.
2.
Identify metabolic functions of the liver.
3.
Review physical assessment findings of the GI tract.
4.
Identify assessment parameters used to determine the status of the upper and
lower GI tract.
5.
Discuss age-related changes of the GI tract.
Lesson 2: Nursing Management of Clients with Oral & Esophageal Disorders
1.
Describe nursing management of the client with conditions of the oral cavity.
2.
Use the nursing process as a framework for care of clients undergoing neck
dissection.
3.
Describe the various conditions of the esophagus and their clinical
manifestations and management.
4.
Describe the purpose and types of GI intubation.
5.
Educate client regarding an acute or chronic oral or esophageal condition.
Lesson 3: Nursing Management of Clients with Gastric and Duodenal Disorders
1. Compare the etiology, clinical manifestations, and management of acute gastritis,
chronic gastritis, and peptic ulcer.
2. Describe the management of the patient with gastritis.
3. Describe the dietary, pharmacologic, and surgical treatment of peptic ulcer.
4. Describe the nursing management of patients who undergo surgical procedures to
treat obesity.
5. Use the nursing process as a framework for care of patients undergoing gastric
surgery.
6. Educate client regarding an acute or chronic gastric or duodenal condition.
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Lesson 4: Nursing Management of the Client with Intestinal and Rectal Disorders
1. Describe the health care needs of patients with constipation, diarrhea, or fecal
incontinence.
2. Compare the conditions of malabsorption with regard to their pathophysiology, clinical
manifestations, and management.
3. Describe diverticular disease and the care of patients with diverticulitis.
4. Compare and contrast regional enteritis and ulcerative colitis regarding their
pathophysiology, and medical, surgical, and nursing management.
5. Identify the care needs of the patient with inflammatory bowel disease.
6. Describe the responsibilities of the nurse in meeting the needs of the patient with an
ileostomy.
7. Describe the various types of intestinal obstructions, as well as their medical and
nursing management.
8. Describe the pathophysiology, assessment, and management in regards to cancer of
the colon or rectum.
9. Describe anorectal conditions including fissures, fistulas, hemorrhoids, and sexually
transmitted anorectal diseases.
10. Identify the complications of gastric surgery and their prevention and management.
11. Educate client regarding an acute or chronic intestinal or rectal condition.
UNIT VII PROMOTION OF ADAPTATION FOR THE CLIENT WITH HEPATIC AND BILIARY
HEALTH PROBLEMS
Rationale: Clients with hepatic and biliary disorders require special care. It is essential that
nurses have the knowledge to provide that care.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
Lesson 1: Hepatic Disorders
1. Relate jaundice, portal hypertension, ascites, varices, nutritional deficiencies, and hepatic
coma to pathophysiologic alterations of the liver.
2. Describe the medical, surgical, and nursing management of patients with esophageal
varices.
3. Compare the various types of hepatitis and their causes, prevention, clinical
manifestations, management, prognosis, and home health care needs.
4. Discuss medical and nursing management of patients with cancer of the liver.
5. Describe the postoperative nursing care of the patient undergoing liver transplantation.
6. Educate client regarding an acute or chronic hepatic condition.
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Lesson 2: Biliary Disorders
1. Discuss management of cholelithiasis.
2. Differentiate between acute and chronic pancreatitis.
3. Discuss nursing management of patients with acute pancreatitis.
4. Educate client regarding an acute or chronic biliary condition.
UNIT III PROMOTION OF ADAPTATION FOR THE CLIENT WITH ENDOCRINE PROBLEMS:
Rationale: Clients with Endocrine disorders require special care. It is essential that nurses have
the knowledge to provide that care.
OUTCOMES:
Upon completion of learning activities, participation in lecture/discussion, and clinical
activities, the student will be provided the opportunity to:
Lesson 1: Overview of Endocrine Disorders
1. Identify the major endocrine glands of the body, their anatomic location, and the
hormones they secrete.
2. Summarize the major action of the hormones secreted from each of the glands.
3. Describe the negative feedback mechanism and its importance in the regulation of the
biologic processes.
4. Summarize the role of the hypothalamus and the pituitary in regulation of hormone
secretion from the thyroid and the adrenal glands.
5. Name the disorders produced by over and under secretion of the endocrine glands.
6. Describe components of a heath history and physical examination of the endocrine
system.
7. Identify the diagnostic tests used to assess altered function of the endocrine glands.
Lesson 2: Diabetes
1. Differentiate between type 1 and type 2 diabetes.
2. Describe etiologic factors associated with diabetes.
3. Relate the clinical manifestations of diabetes to the associated pathophysiologic
alterations.
4. Identify the diagnostic and clinical significance of blood glucose test results.
5. Explain the dietary modifications used for management of people with diabetes.
6. Describe the relationships among diet, exercise, and medication for people with
diabetes.
7. Develop a plan for teaching insulin self-management.
8. Identify the role of oral antidiabetic agents in diabetic therapy.
9. Differentiate between hyperglycemia with diabetic ketoacidosis and hyperosmolar
nonketotic syndrome.
10. Describe management strategies for a person with diabetes to use during “sick days.”
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11. Describe the major macrovascular, microvascular, and neuropathic complications of
diabetes.
12. Use the nursing process as a framework for care of hospitalized patients with diabetes
Lesson3: Other Endocrine Disorders
1. Identify the disorders associated with each of the endocrine glands.
2. Describe the underlying pathophysiology of each of the endocrine disorders.
3. Identify the risk factors associated with each of the endocrine disorders.
4. Describe the clinical manifestations and assessment of each of the endocrine disorders.
5. Summarize the medical and nursing management of each of the endocrine disorders.
Disclaimer: This First Day Handout was prepared under certain limited assumptions.
Therefore, if the students in the class seem to "fit" the design for the course and if events
occur as planned, the schedule, assignments, and assessments will be followed. The instructor
has the option, however, to eliminate or add assignments and/or assessments if he/she feels it
is in the best interest of the students.
Reviewed & Revised: JAN 2014 SW/SF/TP
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