RNSG 1140 Nursing Skills for the Articulating Students
Course Description:
Validation of current skills and procedures in a variety of settings; application of a
systematic problem solving process and critical thinking skills. Focus on the
expansion of the scientific knowledge and principles underlying nursing skills and
procedures; and competency in knowledge, judgment, skills and professional values
within a legal/ethical framework.
Course Objectives:
Using critical thinking and the nursing process, the student will:
1. Use scientific principles as a basis for performing nursing skills.
2. Select appropriate equipment for designated skills.
3. Perform skills in an organized and efficient manner.
4. Integrate appropriate client assessment data before and after implementation of
designated skills.
5. Document accurate and relevant data related to implemented skills.
Course Content
Physical Assessment
Physical Assessment
1. Principles and concepts related to physical assessment
2. Obtain a comprehensive Health History
a. Personal data
b. Chief complaint
c. Duration
d. History of present illness
e. Past Health History
f. Review of systems
3. Perform comprehensive head-toe assessment
4. Normal and abnormal findings
5. Documentation
6. Use and purpose of comprehensive, focused and shift assessments
Therapeutic Communication
1. Variables that effect communication.
2. Principles of effective communication
3. Verbal versus non verbal
4. Goals of therapeutic communication
5. Active listening
6. Demonstrate specific therapeutic techniques
7. Non therapeutic techniques
Non-Parenteral and Parenteral Medications
1. Principles and concepts of non-parenteral and parentereal medications
2. Non-parenteral medications
a. Preparation and administration of pharmaceutical preparations
b. Routes: oral, topical, eye, eye and nose drops, vaginal instillations
rectal suppositories, inhalants
3. Routine, PRN, and one time medications
4. Charting medications
5. Sign-out for controlled substances
6. Parenteral medications
a. Preparation and administration
b. Routes: IM, SQ, ID
c. Identify IM and SQ landmarks using anatomical landmarks
d. Identify ID sites
e. IM administration using Z-track method
7. Syringes
a. Parts of a syringe
b. Size of needle and syringe with appropriate medication
8. Aspirating fluid from vials and ampules
9. Administration of Insulin
a. Techniques for drawing, mixing and administering
b. Types of insulin as to onset, peak and duration
IV Therapy
1. Principles and concepts related to intravenous therapy
2. IV therapy
a. Initiating IV therapy
b. Select appropriate needle, tubing, solutions
3. Convert IV to saline lock
4. Change IV tubing and containers
5. Assess peripheral IV
6. IV solutions and medications
a. Piggyback and IV medications
b. Adding meds to primary bag and volume administration sets
c. Use of a pump for solutions and medications
7. Discontinuing an IV
8. Blood administration
9. Documentation
a. Initiation of IV therapy
b. Conversion of an IV to saline lock
c. Tubing and container changes
d. Site assessment
e. IV medications
f. Discontinuing IV therapy
g. Blood administration
Phlebotomy
1. Identify appropriate vein
2. Perform venipuncture using syringe, vacutainer and butterfly set ups
3. Collect specimens for blood cultures
4. Proper disposal of equipment
Central Venous Catheters
1. Principles and concepts related to central lines and TPN
2. Clients who need TPN
3. Purpose of major components of TPN
4. Principles of TPN administration
5. Complications of TPN: metabolic, mechanical, infection
6. Assisting with insertion and care of central lines
7. Central lines
a. Types
b. Dressing change, irrigation, and removal of each type
8. Assessment of a central line
9. Demonstrate irrigating central lines
10. Performing central line dressing changes
11. Drawing blood from a central line or a PICC line
Nutrition and Elimination
NG Intubation
1. Principles and concepts related to gastric intubation.
2. Nasogastric/gastric tubes
a. Lavage
b. Gavage
3. Types of tubes and use
a. Nasogastric
b. Salem Sump
c. Flexible feeding
d. Gastrostomy
e. Jejunostomy
f. PEG
4.
5.
6.
7.
8.
Supplies and equipment for insertion of tubes
Insert and discontinue various types of tubes
Safety factors in caring for clients with tubes
Feedings and medications via nasogastric/gastric tubes
Documentation
Ostomies
1. Principles and concepts related to care of an ostomy
a. Maintaining skin integrity
b. Client teaching
c. Irrigation
d. Application of a pouch
2. Types of ostomies
a. Colostomy
b. Ileostomy
c. Urostomy
d. Ureterostomy
e. Ileoconduit
3. Factors influencing client’s reaction to a stoma
4. Identify clients who might need a stoma
5. Types of pouch appliances and their use
6. Irrigating a colostomy and applying a pouch
7. Critical elements to teach clients about stoma care
Catheterization
1. Principles and concepts related to urethral catheterization, irrigation and
removal
2. Purposes of catheterization and irrigation
3. Types of clients needing catheterization
4. Types of catheterizations: straight, intermittent, indwelling
5. Relationship between catheterization and some infections
6. Discontinue indwelling foley
7. Insert a urethral catheter
8. Procedure for continuous bladder irrigation
9. Nursing actions related to maintenance of suprapubic catheters
Wound Care and Dressing Change
1. Principles and concepts related to asepsis and wound care
2. Sterile techniques
- Demonstrate the ability to create and maintain a sterile field
- Demonstrate the ability to don sterile gloves
- Open a sterile pack in the correct sequence
- Pour liquid onto a sterile field
- Add sterile items to a sterile field
- Remove items from a sterile field
- Differentiate between sterile and non-sterile items
2. Characteristics of types of wounds
a. Surgical
b. Trauma
c. Disease
d. Dehiscence
3. Potential for complications: infection and gangrene
4. Types of wound closures and healing
a. First intention
b. Second intention
c. Third (tertiary) intention
5. Stages of skin breakdown
a. Stage I
b. Stage II
c. Stage III
c. Stage IV
6. Purpose of wound dressing
7. Appropriate wound dressings
a. Red, yellow and black wound classification
b. Vascular ulcers
8. Demonstrate wound irrigation, packing and dressing change
Oxygenation
Trach Suctioning
1. Principles and concepts related to NT suctioning
2. Purpose of NT suctioning
3. Types of clients needing NT suctioning
4. Assessment data indicating need for NT suctioning
5. Complications of NT suctioning
6. Perform NT suctioning, tracheostomy suctioning and tracheostomy care
7. Demonstrate application of various oxygen delivery devices
8. Safety during administration of oxygen therapy
9. Effectiveness of various oxygen delivery devices
Underwater Chest Drainage
1. Principles and concepts related to closed chest drainage
2. Function of apical and anterior chest tubes
3. Functions of the three chambers of drainage system
4. Set up of the drainage system
5. Preparation of the client for underwater chest drainage system
6. Drainage: color, amount, consistency expected
7. Indicators of underwater chest drainage
a. Correct
b. Malfunctioning
8. Clamping of chest tubes
9. Specimen collection from drainage system
10. Problem solving
The Surgical Client
Surgical Admission and Discharge
1. Principles and concepts related to admission and discharge
2. Concepts related to admission and discharge
a. Advance directives
b. Power of attorney
3. Health history upon admission
4. Physical assessment upon admission
5. Information prior to discharge: METHODS
a. Medications
b. Economics and environment
c. Treatment and transportation
d. Health education
e. Outpatient referrals
f. Diet
g. Social support
Pre-Op Phase
1. Principles and concepts related to pre-operative client
2. Collect Pre-op Assessment data (PERSON)
3. Clients “at risk” for surgical procedures
4. Effects of aging related to surgical client
5. Informed consent:
a. Legal implications
b. Role of the RN
6. Assess pre-operative client:
a. Ability to maintain basic needs (PERSON)
b. Diagnostic test
c. Recognition of actual problem
d. Recognition of potential post-operative
7. Plan of Care for pre-operative client: Nursing diagnoses and
interventions:
a. Teaching learning
b. Medications
c. Check list
d. Nursing actions: organization, sequencing
8. Pre-operative teaching requirements
Post-Op Phase
1. Assessment of client’s ability/inability to maintain basic needs
(PERSON):
a. Recovery room period
b. Environment
c. Primary goals of nursing care
d. Safe nursing care
e. Discharge: scoring system
f. Post-recovery room period
e. Common post-operative problems
2. Assist the post-surgical client to maintain basic needs (PERSON):
a. Surgical wound assessment
Complications: evisceration, dehiscence
b. Management of drains: Penrose, Jackson-Pratt, Hemovac
c. Respiratory skills
d. Appropriate foods for clear liquid, modified full liquid, soft and
regular diet
e. Documentation
3. Teaching topics for the client experiencing the stressors of surgery
4. Plan of Care: evaluation of interventions and modifications
5. Discharge planning: METHODS