PLAINVIEW COURSE SYLLABUS COURSE TITLE: VNSG 1429 – MEDICAL-SURGICAL NURSING I INSTRUCTOR: SUZANNE GRIFFIN, R.N., A.A.S., A.D.N. OFFICE LOCATION & PHONE / E-MAIL: PLAINVIEW CENTER – PC 104 F 806-296-9611 X4405 / sgriffin@southplainscollege.edu OFFICE HOURS: MT (0900 – 1000 and 1300 - 1600) Wk. of 1-16-12 through Wk. of 2-28-12 MT (1000 – 1100 and 1300 – 1600) Wk. of 3-5-12 through Wk. of 5-7-12 WTRF (By Appointment) SOUTH PLAINS COLLEGE IMPROVES EACH STUDENT’S LIFE ************************************************************************************** COURSE DESCRIPTION: The course of study is the application of the nursing process to the care of adult patients experiencing medical-surgical conditions in the health-illness continuum. A variety of health care settings are utilized. This course covers physiology and basic pathophysiology causes of illness, communicable diseases and disease transmission and prevention. The role of the vocational nurse in preventive health measures, health promotion, referral to community health resources, patient/family education, therapeutic and rehabilitative aspects will be presented. Discussion/projects for ethical issues and critical thinking are incorporated in the course. COURSE LEARNING OUTCOMES: The student will identify the components of the health-illness continuum; identify prevalent medical-surgical conditions affecting the adult; and utilize the nursing process to assist in developing a plan of care for selected medial-surgical conditions. COURSE COMPETENCIES: The student must complete this course with a grade of 75% or above based on the following objectives: 1. 2. 3. 4. Compare and contrast normal body functioning with that of pathological variations. Formulate a plan of care utilizing the nursing process for various medical-surgical conditions. Integrate knowledge attained in diet therapy to identify appropriate modifications for each disease entity. Rationale medical treatment and identify appropriate implications for nursing interventions. ACADEMIC INTEGRITY: Refer to the Plainview Student Handbook (page 23) and the SPC Catalog (page 23). SCANS AND FOUNDATION SKILLS: C – 1, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20. F – 1, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20. 1 VERIFICATION OF WORKPLACE COMPETENCIES: NCLEX-PN Licensure Exam eligibility following successful completion of the one-year vocational nursing program. TEXTBOOK: Christensen, Barbara Lauritsen, RN, MS and Kockrow, Elaine Oden, RN, MS (2011) Adult Health Nursing, Sixth Edition, Mosby Study Guide to accompany text. Cohen, Barbara J., BA, MSEd and Taylor, Jason James (2009) Memmler’s: The Human Body in Health and Disease Eleventh Edition, Lippincott, Williams, & Wilkins Alfaro-LeFevre, Rosalinda, RN, MSN, ANEF (2010) Applying Nursing Process: A Tool for Critical Thinking Seventh Edition, Lippincott, Williams, & Wilkins ATTENDANCE POLICY: Refer to the SPC Catalog (page 20) and the Plainview Student Handbook (page 14). This course is a 4 semester hour course with 8 hours allowable absence. If the allowable absences are exceeded, the student will be dropped from this class. Each 50-minute class is considered 1 hour. A tardy will be given if the student is absent within the first 15 minutes of a class period. If the student misses more than 15 minutes of any 50 minute session, a one hour absence will be assigned for that class period. Three tardies will accumulate to count as one hour absence. COURSE REQUIREMENTS: 1. 2. 3. 4. 5. 6. 7. 8. 9. Student is expected to read assigned material and be prepared for class discussion. Audiovisual information is used to assist the student in integration of key components and application of content. Participation in group work and completion of all assigned worksheets focusing on application using nursing process approach with theory to allow the student to use the problem solving approach to total patient care of medical and surgical patients. Attention and participation in guest lectures utilizing community resources of medicalsurgical expertise. Demonstration of appropriate knowledge-based medical/surgical principles in simulated clinical situations utilizing the problem-solving nursing-process approach. Demonstrate continued growth in ability to apply principles of medical-surgical nursing to the clinical situation with adaptation to the individual client needs. Development and demonstration of increased skill in integrating database of client assessment with appropriate outcome based goals and interventions. Intermittent review quizzes, six unit exams, and a comprehensive final exam will be given. / ATI Benchmark. Written assignments are to be neat and legible. They may be computer generated using black as font color and 12 as font size or hand written using black ink and must be double spaced and on one side of the paper only. Paper edges must be without frayed edges. Points will be deducted accordingly as per instructor discretion. Computer assisted programs are assigned for corresponding units of study and are identified in the syllabus. Due dates will be announced in class and these completed programs will be recorded as classwork. ATI Skill Modules utilized in VNSG 1402 and VNSG 1260 may also be assigned and/or the student is encouraged to utilize this valuable resource. ATI PN Adult 2 Medical Surgical Review Module is another resource for student use and assignments may be made and expected to be completed. As with CAI programs, completed ATI assignments will be recorded as classswork. GRADING: UNIT EXAMS / FINAL EXAM PROJECT CLASSWORK 90% 5% 5% A B C D F 90 – 100 80 – 89 75 – 79 74-70 69 or below SCHEDULE OF CLASSES: JAN 17 COURSE INTRODUCTION WITH MOTIVATION EXERCISE SYLLABUS REVIEW JAN 18 NURSING PROCESS REVIEW CRITICAL THINKING EXAMPLES OF NURSING PROCESS CRITICALTHINKING IN THE NURSING PROCESS VIDEO CAI PROGRAMS JAN 23 “JEOPARDY REVIEW” OF THE NURSING PROCESS JAN 24 UNIT EXAM #1 WITH KNOWLEDGE SUMMARY JAN 30 LECTURE PERIOPERATIVE CARE REVIEW LECTURE PREOP RESPONSIBILITIES & CARE GROUP ACTIVITY: PREOP PRIORITIZATION JAN 31 GUEST PRESENTATION: CHP – OR / PACU STAFF LECTURE ANESTHESIA & INTRAOPERATIVE CARE / PACU FEB 6 LECTURE POSTOPERATIVE CARE FEB 7 COMPLETE PERIOPERATIVE CARE LECTURE “NCLEX STYLE” PERIOPERATIVE REVIEW TO TEST YOUR LISTENING AND CRITICAL THINKING SKILLS FEB 13 UNIT EXAM #2 WITH KNOWLEDGE SUMMARY FEB 14 LECTURE FLUID AND ELECTROLYTE BASICS COOP WORKSHEET FEB 20 COMPLETE FLUID VOLUME IMBALANCES LECTURE COMPOSITION IMBALANCES FEB 21 REVIEW COMPOSITION IMBALANCES SCENARIOS LECTURE ACID/BASE IMBALANCES COOP ACID/BASE SCENARIOS FEB 27 LECTURE SHOCK / CAI COMPLETE UNIT 3 FEB 28 UNIT EXAM #3 WITH KNOWLEDGE SUMMARY MAR 5 LECTURE CANCER OVERVIEW INITIATION OF PROJECT PRESENTATIONS * TOPICS & DATES TBA MAR 6 PROJECT PRESENTATIONS WORKDAY MAR 12 – 16 *** SPRING BREAK *** MAR 19 PROJECT PRESENTATIONS MAR 20 UNIT EXAM #4 – PROJECT PRESENTATION COOPS MAR 26 LECTURE NEUROLOGIC NURSING ASSESSMENT MAR 27 QUICK NEURO ASSESSMENT REVIEW NEURO DIAGNOSTIC REVIEW COMMON CARE PROBLEMS & INTERVENTIONS APR 2 NEUROLOGIC DISORDERS APR 3 NEUROLOGIC DISORDERS APR 9 *** EASTER HOLIDAY *** APR 10 MOVIE PRESENTATION: “REGARDING HENRY” APR 11 UNIT EXAM #5 WITH KNOWLEDGE SUMMARY APR 16 LECTURE RESPIRATORY ASSESSMENT NORMAL/ABNORMAL BREATH SOUNDS VIDEO PRESENTATION / TEXT CD BREATH SOUNDS APR 17 GENERAL NURSING INTERVENTIONS FOR RESPIRATORY PATIENTS RESPIRATORY DIAGNOSTICS (HANDOUT) APR 23 LECTURE NON- INFECTIOUS RESPIRATORY DISORDERS APR 24 LECTURE INFECTIOUS RESPIRATORY DISORDERS NURSING CARE REVIEW APR 30 GUEST PRESENTATION – HALE COUNTY HEALTH DEPT. COMPLETE RESPIRATORY DISORDERS FINAL EXAM STUDYGUIDE MAY 1 UNIT EXAM #6 WITH KNOWLEDGE SUMMARY MAY 9 VNSG 1429 FINAL EXAM 4 COURSE OUTLINE: MEDICAL-SURGICAL NURSING I UNIT I CRITICAL THINKING IN THE NURSING PROCESS Group Activity: Working with the Nursing Process Video Review: Critical Thinking in the Nursing Process Alfaro-Lefevre: Chapter 1 pgs. 16, 27-29, and 32-37 ATI: Skills Module HIPAA Objectives: Upon completion, the student should be able to: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. State five functions of the medical-surgical nurse. Describe various practice settings for the medical-surgical nurse. Give two examples that illustrate how a focus on health promotion and prevention of illness could decrease health care costs. Define the nursing process and its goals. Discuss the types of data that might be obtained from a chart review. State how a spiritual assessment might help the nurse better to meet the health care needs of the client. Apply techniques of a physical assessment to assess a client. Define critical thinking as an essential in the nursing process regarding client responses and nursing care priorities in client care. Describe how properly to formulate a nursing care plan. Explain why it is important for the nurse to have some knowledge of the client’s cultural attitudes and beliefs. List three expectations that clients have of nurses. Discuss examples of ways in which a nurse might help a client to meet the three overall goals of patient teaching. Identify two ways in which delivering nursing care in the home care setting is different from providing care in the hospital. Outline: I. Caring for Medical-Surgical Patients: Roles of the Vocational Nurse II. Practice Settings for the Medical-Surgical Nurse III. Characteristics of the Nursing Process and Critical Thinking IV. Differences in Nursing Roles V. Underlying Assumptions or Beliefs VI. Applying the Nursing Process in Medical-Surgical Nursing VII. Future Trends VIII. Self-Esteem: The Nurse and the Client IX. Client’s Expectations 5 X. Integrating Health Teaching XI. The Altered Perspective: Delivering Home Care UNIT II CARE OF THE SURGICAL PATIENT Chapter 2 Care of the Surgical Patient CAI: Medi Sim Folder Medical Surgical I o “A Patient with Abdominal Pain” o “A Surgical Patient with Abdominal Pain” Clinical Skills Folder o “Patient Controlled Analgesia” o “Epidural Analgesia” Objectives: Upon completion, the student should be able to: 1. Discuss three technological changes that have made surgery less invasive and have lessened recovery time. 2. Identify the types of patients most at risk for surgical complications and state why each type is at risk. 3. Perform a thorough nursing assessment for a preoperative patient. 4. Prepare patients physically, emotionally, and psychologically for surgical procedures. 5. Plan and implement patient and family teaching to prevent postoperative complications. 6. Compare and contrast various types of anesthesia and the nursing care that is unique to each type. 7. Assess the status of patients during the immediate postoperative period while they are in the recovery area. 8. Discuss the steps in assessing and taking care of a surgical wound. 9. Prepare a general teaching plan for the patient being discharged from the ambulatory or same-day surgery unit. 10. Identify signs and symptoms of common postoperative complications. 11. Provide routine postoperative care for patients who have had various types of surgery. Outline: I. Perioperative Nursing II. Preoperative Phase III. Intraoperative Phase IV. Postoperative Phase V. Nursing Process for the Surgical Patient VI. Discharge: Providing General Information 6 UNIT III FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES Chapter 21 Correcting Fluid, Electrolyte, and Acid-Base Imbalances Memmler’s: Body Fluids with A & P Handout CAI: Vocational Nursing Folder WBS Harkreader – Fundamentals of Nursing o Electrolytes Interactive Folder (CD Required) o Fluids and Electrolytes Clinical Skills Folder o “Blood Administration” o “Platelet Administration” Objectives: Upon completion, the student should be able to: 1. 2. List the various functions fluid performs in the body. Describe three ways in which body fluids are continually being distributed among the fluid compartments. 3. Compare the signs and symptoms of the various electrolyte imbalances. 4. Describe the signs and symptoms of fluid volume deficit and its consequences. 5. Identify three types of patients who might experience a fluid volume excess. 6. State the major causes of acid-base imbalances. 7. Identify intravenous fluids that are isotonic. 8. Discuss the steps in managing an intravenous infusion. 9. Describe the measures used to prevent the complications of IV therapy. 10. Identify the symptoms of a transfusion reaction and the appropriate measures to be taken when this occurs. 11. Compare interventions for the care of a patient receiving total parenteral nutrition with one undergoing intravenous therapy. 12. Discuss why the elderly have more problems with fluid and electrolyte imbalances. Outline: I. Fluid and Electrolyte Physiology II. Distribution of Body Fluids III. Composition of Body Fluids IV. Fluid Imbalances V. Acid-Base Balance (Hydrogen Ion Concentration) VI. Therapy for Fluid and Electrolyte Imbalances VII. Particular Concerns for the Elderly VIII. Nursing Process for the Patient with a Fluid and Electrolyte Disorder 7 UNIT IV CANCER CARE Chapter 17 Care of the Patient with Cancer CAI: Medi Sim Folder Medical Surgical II o “A Patient Having Surgery for Lung Cancer” Objectives: Upon completion, the student should be able to: 1. 2. 3. Identify characteristics of neoplastic growth. Identify at least five factors that may contribute to the development of a malignancy. State at least four practices that can contribute to prevention and early detection of cancers. 4. Describe ways to include the recommendations of the American Cancer Society for routine checkups and detection of cancer in patient teaching. 5. Discuss the pros and cons of the various treatments available for cancer. 6. State the major problems and appropriate nursing interventions for a patient coping with expected side effects of radiation. 7. Devise a general plan of nursing care for the patient receiving chemotherapy. 8. Discuss the teaching necessary for the patient who has bone marrow suppression from cancer treatment. 9. Identify nursing interventions to help the patient cope with the common problems of cancer and its treatment. 10. Describe appropriate nursing interventions to help patients and families deal with the psychosocial effects of cancer and its treatment. Outline: I. Oncology II. Development, Prevention, and Detection of Cancer III. Hereditary Cancers IV. Cancer Prevention and Early Detection V. Pathophysiology of Cancer VI. Diagnosis of Cancer VII. Cancer Therapies VIII. Advanced Cancer 8 UNIT V NEUROLOGICAL DISORDERS Chapter 14 Care of a Patient with a Neurological Disorder CAI: Interactive Folder o “Nervous I” o “Nervous II” Medi Sim Folder Medical Surgical I o “An Unconscious Head-Injured Patient” Objectives: Upon completion, the student should be able to: 1. Identify four specific ways in which the nurse can contribute to preventing neurologic disorders. 2. Demonstrate a “neurologic check” and describe the basic neurologic nursing assessment. 3. State the appropriate preparation and post-procedural care for patients undergoing lumbar puncture, electroencephalogram, and radiologic studies of the brain and cerebral vessels. 4. Develop a nursing care plan for the patient who is experiencing an increase in intracranial pressure. 5. Identify appropriate interactions to meet all basic needs of the patient who has suffered a head injury and is unconscious. 6. Develop and implement a comprehensive nursing care plan for a patient who has suffered a cerebrovascular accident. 7. Describe the appropriate nursing actions and observations to be carried out for a patient experiencing a seizure. 8. Discuss areas of teaching needed by the patient newly diagnosed with epilepsy. 9. List appropriate nursing interventions necessary to provide comprehensive care for a patient who has suffered a C-5 spinal cord injury. 10. Compare the pathophysiology, diagnosis, and treatment of Parkinson’s disease, multiple sclerosis, Guillain-Barre syndrome, trigeminal neuralgia, and myasthenia gravis. Outline: I. Overview of Anatomy and Physiology II. Assessment of the Neurological System III. Laboratory and Diagnostic Examinations IV. Common Disorders V. Conduction Abnormalities VI. Degenerative Diseases VII. Vascular Problems VIII. Cranial and Peripheral Nerve Disorders IX. Trauma 9 X. Nursing Process for the Patient with a Neurologic Disorder UNIT VI RESPIRATORY DISORDERS Chapter 9 Care of the Patient with a Respiratory Disorder CAI: Interactive Folder o “Respiratory” Objectives: Upon completion, the student should be able to: 1. 2. 3. 4. Assess patients with disorders of the sinuses, pharynx, and larynx. Describe the pre- and postoperative care for the patient undergoing a tonsillectomy. Identify three measures people can take to prevent respiratory disorders. Describe the pre- and post-test care for the patient undergoing the following: chest radiograph, bronchoscopy, and pulmonary function testing. 5. Describe the procedure for nursing assessment of the respiratory system. 6. Compare and contrast commonalities and differences in nursing care for patients with bronchitis, influenza, pneumonia, pleurisy, and empyema. 7. List at least three nursing interventions appropriate for care of patients experiencing the following: persistent cough, increased secretions in the respiratory tract, dyspnea, alteration in nutrition and hydration related to respiratory disorders, and fatigue related to hypoxia. 8. Complete a nursing care plan, including home care, for a patient with chronic airflow limitation (CAL). 9. List four ways a nurse can contribute to prevention and prompt treatment of tuberculosis. 10. Describe the specifics of nursing care for the patient who has had thoracic surgery and has chest tubes in place. 11. Devise a nursing care plan for the tracheostomy patient on oxygen therapy and on a mechanical ventilator. Outline: I. Overview of Anatomy and Physiology II. Assessment of the Respiratory System III. Laboratory and Diagnostic Examinations IV. Disorders of the Upper Airway V. Respiratory Infections VI. Disorders of the Lower Airway VII. Chronic Obstructive Pulmonary Disease VIII. Nursing Process for the Patient with a Respiratory Disorder 10 SCANS COMPETENCIES C-1 C-2 C-3 C-4 TIME – Selects goals – relevant activities, ranks them, allocates time, prepares and follows schedules. MONEY - Uses or prepares budgets, makes forecasts, keeps records and makes adjustments to meet objectives. MATERIALS & FACILITIES – Acquires, stores, allocates and uses materials or space efficiently. HUMAN RESOURCES – Assess skills and distributes work accordingly, evaluates performances and provides feedback. INFORMATION – Acquires and Uses Information C-5 Acquires and evaluates information. C-6 Organizes and maintains information. C-7 Interprets and communicates information. C-8 Uses computers to process information. INTERPERSONAL – Works With Others C-9 Participates as members of a team and contributes to group effort. C-10 Teaches others new skills. C-11 Serves Clients/Customers – works to satisfy customer’s expectations. C-12 Exercise Leadership – Communicates ideas to justify position, persuades and convinces others responsibility challenges existing procedures and policies. C-13 Negotiates – works toward agreements involving exchanges of resources; resolves divergent interests. C-14 Works With Diversity – Works well with men and women from diverse backgrounds. SYSTEMS – Understands Complex Interrelationships C-15 Understands Systems – Knows how social, organizational, and technological systems work and operate effectively with them. C-16 Monitors and Corrects Performance – Distinguishes trends, predicts impacts in system operations. C-17 Improves Designs Systems – Suggests modifications to existing systems and develops new or alternative systems to improve performance. TECHNOLOGY – Works With a Variety of Technologies C-18 Selects Technology – Chooses procedures, tools, or equipment, including computers and related technologies. C-19 Applies Technology to Task – Understands overall intent and proper procedures for setup and operation of equipment. C-20 Maintains and Troubleshoots Equipment – Prevents, identifies, or solves problems with equipment. FOUNDATION SKILLS BASIC SKILLS – Reads, Writes, Performs Arithmetic and Mathematical Operations, Listens and Speaks F-1 Reading – Locates, understands and interprets written information in prose and in documents such as manuals, graphs and schedules. F-2 Writing – Communicates thoughts, ideas, information and messages in writing and creates documents such as letters, directions, manuals, reports, graphs and flow charts. F-3 Arithmetic – Performs basic computations; uses numerical concepts such as whole numbers, etc. F-4 Mathematics – Approaches practical problems by choosing appropriately from a variety of mathematical techniques. F-6 Speaking – Organizes ideas and communicates orally. THINKING SKILLS – Thinks Creatively, Makes Decisions, Solves Problems, Visualizes and Knows How to Learn and Reason 11 F-7 F-8 F-9 F-10 F-11 F-12 F-13 F-14 F-15 F-16 F-17 Creative Thinking – Generates new ideas. Decision Making – Specifies goals and constraints, generates alternatives, considers risks, evaluates and chooses best alternative. Problem Solving – Recognizes problems, devises and implements plan of action. Seeing Things in the Mind’s Eye – Organizes and processes symbols, pictures, graphs, objects and other information. Knowing How to Learn – Uses efficient learning techniques to acquire and apply new knowledge and skills. Reasoning – Discovers a rule or principle underlying the relationship between two or more objects and applies it when solving a problem. PERSONAL QUALITIES – Displays Responsibility, Self-Esteem, Sociability, Self-Management, Integrity and Honesty Responsibility – Exerts a high level of effort and perseveres toward goal attainment. Self-Esteem – Believes in own self-worth and maintains a positive view of self. Sociability – Demonstrates understanding, friendliness, adaptability, empathy and politeness in group settings. Self-Management – Assesses self accuracy, sets personal goals, monitors progress and exhibits self control. Integrity / Honesty – Chooses ethical courses of action. SCANS FOUNDATION AND COMPETENCY SKILLS (by course) Foundations; (F) ECON 230: 1, 2, 3, 4, 5, 8, 9, 10, 11, 12, 17 Competencies: (C) 2, 15 ENGL 1301 1302 1, 2, 5, 7, 8, 9, 11, 12, 13, 15, 16, 17 1, 2, 5, 7, 8, 9, 11, 12, 13, 15, 16, 17 5, 6, 7, 8 5, 6, 7 GOVT 2301 1, 2, 10, 11, 12, 17 15 HIST 1, 2, 5, 10, 11, 12, 17 15 MATH 1314 3, 4, 9, 10, 11, 12 – PSYC 1, 2, 10, 11, 12, 15, 16, 17 4, 14 1302 2301 READ 1314 1, 2, 5, 7, 8, 9, 10, 11, 12, 15, 17 13, 14, 15 1, 5, 6, 7, 8, 9, 10, 12, SPCH 1321 2, 4, 5, 6, 7, 8, 9, 10, 13, 14 1, 5, 6, 7, 14 SOC 1301 1, 2, 5, 8, 9, 10, 11, 12, 15, 16, 17 4, 14 PHYS 1315 1,2,4,10,11,12 – Example for PSYC: Scans: Foundation Skills: Competencies: 1, 2, 10, 11 4, 13 12 4.1.1 Syllabus Statements: Each syllabus should include the following Diversity Statement and the Disabilities Statement appropriate to the location of the course. 4.1.1.1 Diversity Statement: In this class, the teacher will establish and support an environment that values and nurtures individual and group differences and encourages engagement and interaction. Understanding and respecting multiple experiences and perspectives will serve to challenge and stimulate all of us to learn about others, about the large world and about ourselves. By promoting diversity and intellectual exchange, we will not only mirror society as it is, but also model society as it can be. 4.1.1.2. Disabilities Statement: Levelland Campus Students with disabilities, including physical, psychiatric, or learning disabilities, who wish to request accommodations in this class should notify the Special Services Office early in the semester so that the appropriate arrangements may be made. In accordance with federal law, a student requesting accommodations must provide acceptable documentation of his/her disability to the Special Services Coordinator. For more information, call or visit the Special Services Office in the Student Services building. 894-9611 ext 2529. Reese Center and Byron Martin Advanced Technology Center (ATC) Students with disabilities, including physical, psychiatric, or learning disabilities, who wish to request accommodations in this class should notify the Special Services Office early in the semester so that the appropriate arrangements may be made. In accordance with federal law, a student requesting accommodations must provide acceptable documentation of his/her disability to the Special Services Coordinator. For more information, call or visit the Special Services Office in room 809 and 811, Reese Center, Building 8, 885-3048 ext 4654 13