VNSG 1402
COURSE SYLLABUS
VNSG 1402 (4:2:7)
APPLIED NURSING SKILLS I
**************
VOCATIONAL NURSING
NURSING DEPARTMENT
HEALTH OCCUPATIONS DIVISION
LEVELLAND CAMPUS
SOUTH PLAINS COLLEGE
FALL 2011
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VNSG 1402
Campuses:
Levelland
COURSE SYLLABUS
COURSE TITLE:
VNSG 1402 Applied Nursing Skills I
INSTRUCTORS:
Jennifer Ponto, R.N., B.S.N.
Hope Alvarado, R.N
Lorie Hudson, LVN
Michelle Coalle, RN, BSN
Bobby Jo Elliott, RN, BSN
OFFICE LOCATION, PHONE:
Jennifer Ponto, RN, BSN
Hope Alvarado, RN
Lorie Hudson, LVN
Michelle Coalle, RN, BSN
Bobby Jo Elliott, RN, BSN
OFFICE HOURS:
TA 204A
TA 204B
TA 204A
TA 204B
TA 204A
716-2471
716-2494
716-2471
716-2494
716-2471
Posted on each instructor’s door
SOUTH PLAINS COLLEGE IMPROVES EACH STUDENT’S LIFE
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I.
GENERAL COURSE INFORMATION
A.
COURSE DESCRIPTION:
Introduction to and application of primary nursing skills. Emphasis on utilization
of the nursing process and related scientific principles.
B.
COURSE LEARNING OUTCOMES:
Following completion of this course, the student will be able to:
1.
Describe the underlying principles of selected nursing skills and their
relationship to diet health status.
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VNSG 1402
C.
2.
Demonstrate satisfactory performance of selected nursing skills utilizing
principles of safety.
3.
Identify the nursing process used to solve basic client care problems across
the life span utilizing appropriate medical terminology.
4.
Identify the biological, psychological, and social needs of the patient.
5.
Demonstrate effective communication skills.
6.
Demonstrate proper documentation techniques.
7.
Demonstrate appropriate patient/family teaching.
COURSE COMPETENCIES:
A
B
C
=
=
=
(100 – 93)
(92 - 83)
(82 – 77)
Below 77 is falling
Passing Grade is 77%
Students must successfully complete assigned check-offs on or before deadline
dates.
D.
ACADEMIC INTEGRITY
Refer to the SPC college catalog. Refer to the SPC VNP student handbook.
E.
SCANS and FOUNDATION SKILLS
C1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15, 16, 17, 18, 19
F 1, 2, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17
F.
VERIFICATION of WORKFORCE COMPETENCIES
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VNSG 1402
No external learning experiences provided but learning experiences in lab provide
setting in which student applies workplace competencies. Successful completion
of the NEAC Competency statements at the level specified by the course (Level
Objectives) will allow the student to continue to advance within the program.
Upon successful completion of the program, students will be eligible to take the
state board exam (NCLEX) for vocational nurse licensure.
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VNSG 1402
II.
SPECIFIC COURSE/INSTRUCTOR REQUIREMENTS
A.
REQUIRED TEXTBOOKS AND OTHER MATERIALS
1. Elkins, Perry, & Potter (2007). Nursing Interventions and Clinical
Skills. St Louis MO: Mosby, 4th Edition.
2. Additional required materials: Mandatory Films as announced by the
instructor
3. Wingard, Bruce: Medical Terminology Complete
4. CD. ISBN 0135126789
B.
ATTENDANCE POLICY: Contact Hours - 144
Please see SPC catalogue and Vocational Nursing Student Handbook. Students
are expected to attend all classes and to remain for the entire class period.
Attendance will be taken at the beginning of class. Students not responding to
roll are marked absent in the attendance record. No more than 18 hours of class
time may be missed, or the student will be withdrawn from the class. Three (3)
tardies count as one (1) hours' absence.
C.
ASSIGNMENT POLICY:
Students will be responsible for filming several skills. These tapes will be handed
in on or before the due date to the instructor. If the skill is not passed on the third
filming, the student will appear before the Admissions Academic Standards
Committee. Practice time and time to film skills may be required outside regular
classroom hours. The nursing skills lab is open extended hours to accommodate
practice time and filming time. Some skills require 4 hours of practice time prior
to filming. This required practice time must be documented by the skills lab
director.
Students will be responsible for completion of all sections in all chapters of the
Medical Terminology textbook. Students were informed during orientation this
textbook will be due the first day of class at 0800. The assignment will be graded
based on the percentage amount of work completed. For example if the textbook
is 100% completed, a grade of 100% will be given. Ten (10) points will be
deducted for each day late.
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VNSG 1402
D.
GRADING POLICY
Unit Exams
Quizzes & Written Assignments
Final Examination
Medical Terminology Textbook
E.
70%
10%
10%
10%
SPECIAL REQUIREMENTS
See student handbook regarding failure to turning required assignments. Students
are required to read assigned text and view assigned films PRIOR to lecture
and/or demonstration. The student is responsible for learning terminology and
abbreviations.
There will be an exam after the completion of each assigned unit, and a
comprehensive final examination at the end of the course. Unit exams will not be
made up. A grade of 0 will be given. The lowest test grade will be dropped.
Always be prepared for an unannounced pop quiz. Quizzes are not eligible for
make-up and a grade of 0 (zero) will be automatically given.
III.
COURSE OUTLINE
A.
UNIT I- FUNDAMENTAL CONCEPTS/INFECTION CONTROL / SAFETY
B.
UNIT II- BASIC NURSING CARE
C.
UNIT III- MOBILITY
D.
UNIT IV- HEALTH ASSESSMENT
E.
UNIT V- PERIOPERTIVE SKILLS / ASEPSIS
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VNSG 1402
IV.
ACCOMMODATIONS
Students with disabilities, including but not limited to physical, psychiatric, or learning
disabilities, who wish to request accommodations in this class should notify the Special
Services Office. 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, 2530.
.
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VNSG 1402
READING ASSIGNMENTS - SKILLS
UNIT I- FUNDAMENTAL CONCEPTS, INFECTION CONTROL AND SAFETY
Universal Precautions
Oxygen Safety
HIPPA/Confidentiality
Patient Right
Nursing Roles/Legal/Ethical
Nurse Safety
Patient Safety
Environmental Safety
Safety Devices
Restraints
Disease Isolation
p. 61-68. film
p. 650-653, film
p. 11, film
p. 4-5
p. 4-7
p. 94, lecture
ch 3
ch 3
ch 3
ch 3
p. 61-63, 69-78
UNIT II- BASIC NURSING CARE
Communication
Nutrition and Diet Therapy
Hygiene
Bedmaking
Elimination
Intake and Output Weighs
Palliative Care
Nursing Process
ch 2
p. 160-171
ch 7
ch 7
p. 176-197
p. 172-174
ch 37
p. 7-11
UNIT III-MOBILITY
Imobility and Complications
Crutches, Canes, Walkers
R Motion
Special Beds
Position/ Patient Transfers
Hot/Cold
Traction/Casts
Pressure ulcers
lecture
ch 6
ch 6
ch 25
ch 6
ch 24
ch 26
ch 22
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VNSG 1402
UNIT IV-ASSESSMENT AND DOCUMENTATION
Specimen Collection / Laboratory Tests
Vital Signs
Health Assessments
Documentation
ch 13
ch 11
ch 12
ch 1, films, lecture
UNIT V
Preparing patient for surgery
Intro operative Techniques
Caring for the Post Operative Patient
Surgical Wound Care
Dressings
Basic Sterile Technique
ch 18
ch 19
ch 20
ch 21
ch 23
ch 5
ADVANCED NURSING SKILLS – MED/SURG I
Oxygenation
Gastric Intubation
A Bleed Bowel Elimination
Altered Urinary Elimination
Altered Senesory Perception
Emergency measures
ch 29
ch 31
ch 32
ch 33
ch 34
ch 35
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VNSG 1402
APPLIED NURSING SKILLS I
Students must wear the school approved lab coat, have hair properly restrained and
conduct self in a professional manner. Students failing to do so will be asked to leave the
lab and will be counted absent. It will be necessary for the student to spend time outside
the scheduled lab and lecture hours to practice skills, film skills and to view required
instructional videos. The lab will be open additional hours as scheduled by the lab
director.
The student must submit a successfully completed video for several skills on or before the
assigned due date. See Student Handbook and Clinical Guidelines and syllabi for
Applied Nursing Skills I for penalty if not in compliance.
It will be the student's responsibility to identify self on the tape, to speak coherently and
in an appropriate volume, have all equipment organized, perform the skill properly, and
to turn in the tape personally to the instructor on or before the deadline.
NO NOTES OR PROMPTING MAY BE USED DURING THE TAPING.
The tape submitted must NOT be edited by the student or others. A new tape, rewound to
the beginning of the skill to be viewed, must be submitted or it will not be graded by the
instructor. Students who do not meet the deadline requirements will be considered failing
that component. This may result in course failure.
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VNSG 1402
ASSESSMENT GUIDELINES
Neuro:
LOC/Orientation
Pupil response & eye movement
Visual Acuity
Hearing
Olfactory
Reflexes
Movement of extremities/Sensation/Gait
Cardiac
Peripheral edema, NVD
Palp: PMI, periph. pulses, Homan's sign
Percussion: Heart size
Auscultation S1 S2 murmurs/extra sounds, heart rate + rhythm
(regular or irregular)
Respiratory:
Insp. Chest wall movement, cyanosis. Breast Exam? Difficulty
breathing?
Percussion, Palpation
Ausc. Breath sounds/extra sounds, resp. rate, rhythm, effort
G/I:
Insp: Abd. shape, stool appearance?
Ausc: Bowel Sounds/Bruit
Palp: Tenderness? Organ Enlargement?
Percus: Edge of liver? Abnormal findings?
G/U:
Appearance of external genitalia? Catheter? Urine appearance.
Discharge/Skin lesions, Uncircumcised, Testicles Descended,
Abnormalities?
Musculoskeletal:
Deformities, contractures, fractures/casts/splints
Pain, Movement, Stiffness, Full ROM, Assist with ADL's?
Skin:
Color, Turgor, Skin Breakdown, abnormalities
Invasive
tools/lines:
Describe appropriately.
Wound Inspection:
Describe appropriately.
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VNSG 1402
TERMINOLOGY FOR PHYSICAL ASSESSMENT
Normal Terms Underlined
Neuro: Alert/lethargic/comatose (or use Glasgow Coma Scale)
Oriented X 3 or: Unable to state time, place, etc.
Pupils, Pupils Equally Reactive to Light (PERL), Cranial nerves III, IV, VI intact
or eyes able to move in all directions
Visual Acuity-20/20 or "able to read a clock at
feet or newsprint at
inches"
Olfactory-able to smell coffee with one nostril occluded
Hearing-Able to hear whispers or able to hear tuning fork at 4-6 inches
Reflexes-DTR's 2+ patellar and brachial/radial (Deep tendon reflexes)
Movement-Moves all extremities well, gait normal (or limping, etc.)
Sensation-able to distinguish between hot/cold, sharp/dull sensation _______(list
part of body)
Cardiac-Peripheral edema (or 1 + 2 + etc.) no neck vein distention with HOB8 45E
PMI-Palpated 5th intercostal space; peripheral pulses 3+ - (best to list R + L
radial pulses & R + L pedal pulses) Homan's sign negative
Percussion- heart size WNL (within normal limits)
Auscultation-Normal S1 + S2, no murmurs or extra sounds, rate __________
Rhythm Regular
Respiratory
Symmetrical chest wall movement; no cyanosis (or list cyanosis in lips, etc.) no
apparent resp. distress, resp. deep, even and regular
Percussion-Resonant sounds, Palpation-no areas of tenderness over chest wall
Auscultation - clear breath sounds throughout or describe rales/rhonchi/wheezes
GI
Inspection: Abd. shape flat (or distended, etc.) stool appearance
Ausc. Bowel sounds active X4 quadrants (or absent RU O) No bruits heard
Palp. No abd. wall tenderness, no masses palpated, edge of liver palpated under
R. rib cage (or liver palpated 2 finger breadths below rib cage, etc.)
Percussion-Normal tympanic sounds - Edge of liver percussed at R. rib cage
G/U
Male: Penis circumcised or uncircumcised, testicles descended, urine clear
yellow, voiding or catheter, no skin lesions not, no discharge noted
Female: External genitalia normal in appearance, No bleeding/discharge or skin
lesions noted, urine clear yellow, voiding (or catheter)
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VNSG 1402
Terminology for PHYSICAL ASSESSMENT cont’d
Musculoskeletal
dressing-
No obvious deformities or contractures, full ROM, able to carry out full ADL's or
("unable to lift Rt. shoulder above shoulder level" or "needs assistance with
able to put clothes on, but not button/zipper"
Skin
Color normal for race, no cyanosis or jaundice noted; skin turgor elastic, no skin
breakdown or lesions noted
(If skin lesion/breakdown noted must include an accurate description of lesion:
Location, area, size, drainage, etc.)
Note: surgical incisions, areas of trauma, etc.
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VNSG 1402
NURSING PROCESS
Mrs. J.W.
Mrs. J. W. is an 89 year old female. She walking with some friends to the bank, when
she tripped and fell forward. She broke her right ankle and sustained a cut on her right forehead
when her glasses broke. She was helped to her friend’s car and taken to your hospital. In the
emergency room, she received a temporary cast. Her laceration was sutured and dressed with a
sterile dressing. Fortunately, she did not sustain any neurological or eye injuries. She was
transferred to your nursing unit and you are asked to assist in planning her care.
When you enter her room, you find Mrs. W. crying and rubbing her forehead and ankle
saying “it hurts something awful.” She is talking in a rapid manner, and is relating the nature of
her injuries to her multiple, concerned family members and friends. She says she is still upset at
herself for “being clumsy” and is wondering if she will be able to walk normally again, if the
ankle does not heal. She says she is a retired registered nurse. She is widowed, with grown
children and 15 grandchildren. She has had high blood pressure, treated with medication. She
has had back surgery 3 years ago and hip replacement surgery 4 years ago.
When you examine her, you note that her dressing over her forehead is dry. The
temporary cast is in place on her right ankle. Her toes are pink and warm on her right foot. She
is wearing a green flowered nightgown. Her doctor has ordered pain medication as needed, and
crutch training. She tells you she cannot use crutches because her ankle hurts much and besides,
she says she’s “too old to be learning something new.” She says she is also worried about falling
again, because she can’t get around by herself, and her glasses are broken. Her family informs
you they can’t find her spare glasses because she can’t remember where they are. Mrs. W’s
family also says she may not call the nurses for help getting up because “she knows how hard
nurses work, and she doesn’t want to bother them.”
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VNSG 1402
NURSING PROCESS
Mr. RL
Mr. RL is a 29 year old male. He was traveling from his home country of Israel to a
religious conference when he began to experience abdominal pain. It became so severe he
requested treatment in the emergency room of your hospital. Diagnostic tests and examinations
revealed acute appendicitis, and an emergency appendectomy was performed. After surgery, he
transferred to your nursing unit and you are asked to assist in planning his care.
Report from the recovery room nurses is given to you, with a brief description of the
procedure performed and the patient’s progress. The recovery room nurse tells you he can speak
only a few simple words of English, and is saying something about a rabbi. His vital signs were
stable in the recovery room and there has been no bleeding at the surgical site. When you enter
the room, the patient’s eyes are moist with tears. He has an apprehensive look on his face. He is
pointing to his abdomen. His vital signs are stable and the rest of his physical assessment is
normal. After a few days, when his doctor has ordered a soft diet, he refuses all foods because
they were not prepared in a kosher manner. He has lost 2 pounds. You have not seen any
visitors in his room. The patient continues to appear apprehensive and tearful at times.
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VNSG 1402
Determine the 24-hour intake and output from Mrs. King, who had chest surgery this morning.
0700 to 1500. Returned to her room at 0900. She had received 800 ml IV fluid and 250 ml of
transfused blood in surgery. She had 400 ml from her chest tube and 700 ml in her bladder
catheter bag. 1015: Vomited 250 ml. 1200: vomited 200 ml. The MD was notified of the
vomiting and medication was given. She had 400 ml from her chest tube and MD ordered
another transfusion of 250 ml. By 1500 she had received another 850 ml of IV fluid, had 700
ml more urine and 500 ml from her chest tube. She was NPO.
1500 to 2300. Pt allowed sips of water as tolerated. 1700: 1/2-oz water. 1830:1/2-oz water.
Had 400 ml chest tube drainage noted and MD notified. 500 ml blood transfusion given.
2000:1/2 oz water 2120:1/2 oz water. 2230:1/2-oz water. By 2300 had 1200 ml IV fluid,
another 50 ml chest tube drainage and there was 950 ml urine in the catheter bag
2300 to 0700. 0115:1/2 oz water 0230:1/2 oz water. At 0600 the MD made early rounds and
left several orders. The catheter was removed per MD order with 775 ml remaining in the bag.
0645 the patient voided 150 ml. The patient was allowed to increase fluids and drank 2 oz of
7-Up. She had received 1200 ml IV fluid. She had 100 ml chest tube drainage.
Use the last page to calculate the intake and output.
Tear off the next page and turn it in.
Thanks!!!
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VNSG 1402
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VNSG 1402
Student’s Name_________________________
Pass
Fail
Commment
Introduction of self, wash hands, explain
Check arm band
General Survey
Vital Signs
LOC
Mood/Affect/Speech
Skin texture/color
Signs of distress?
Other
Neuro/Head & Neck
Pupils
Movement/Sensation
Neck Vein Distention
Cardiac
Apical Pulse Rate/Rhythm
Heart Valves
Other
Respiratory
Signs of Distress
Auscultation Ant. Post.
Percusssion
GI
Inspection
Bowel Sounds
Light palpation
Deep palpation/liver size
Musculoskeletal and Extremeties
ROM
Gait
Peripheral Pulse
Comments/Documentation
Skills Objectives
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VNSG 1402
After completion of these units, the student will be able to:
Unit I
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Demonstrate ability to perform procedures using Standard Protocols for all Nursing
Interventions.
Recognize patient rights and responsibilities.
Demonstrate appropriate use of confidentiality requirements.
Identify exceptions to confidentiality requirements.
Demonstrate personal safety in nursing practice.
Demonstrate appropriate fire, electrical and oxygen safety.
Demonstrate appropriate environmental safety, fall prevention, seizure care and
ability to promote a restrain-free environment.
Demonstrate ability to apply restrains safely.
Recognize importance of medical asepsis.
Perform medical asepsis correctly.
Demonstrate correct isolation technique.
Describe “hand-off communication.”
Recognize various consent issues.
Discuss legal aspects of nursing care.
Unit II
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Utilize appropriate communication techniques.
Identify steps of the nursing process.
Determine patient’s need for daily weights and intake and output measurements.
Correctly measure height, weight and intake and output.
Safely provide patient hygiene.
Assist patients with nutritional needs.
Assist patients with elimination needs, including safe enema administration.
Assist patients with comfort measures and promote sleep.
Identify stages of grieving.
Provide post-mortem care, including patient and family support.
Unit III
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VNSG 1402
1.
2.
3.
4.
5.
6.
7.
8.
Identify immobility complications.
Identify patients at high risk of immobility complications.
Describe nursing interventions to prevent immobility complications.
Demonstrate patient positioning methods to prevent immobility complications.
Describe safe use of special beds and devices to prevent immobility complications..
Describe nursing interventions for patients in casts and traction.
Describe safe use of heat and cold applications.
Demonstrate safe use of ambulation devices.
Unit IV
1.
2.
3.
4.
5.
6.
7.
Describe when vital signs should be measured.
Demonstrate accurate vital sign measurement.
Differentiate between normal and abnormal vital signs.
Describe when patient assessment should be performed.
Demonstrate accurate patient assessment.
Differentiate between normal and abnormal patient assessment.
Demonstrate ability to obtain common specimens.
Unit V
1.
2.
3.
4.
5.
6.
Discuss roles of the perioperative health care team.
Demonstrate ability to perform perioperative care.
Discuss principles of sterile technique.
Demonstrate ability to utilize sterile technique.
Demonstrate ability to provide wound care.
Demonstrate ability to provide urinary catheterization.
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