Monday
June 1
Classes Begin
Mental Health Nursing
0830-1500-Unit I
June 8
Clinical Day– Perform
Windshield Surveys in teams
Clinical Day
June 15
Present Windshield Survey
Unit 2 continued
Clinical day
June 22
Mental Health Nursing ATI
Final
Start Cardiac, Ch. 37
Tuesday
June 2
Mental Health Nursing
Unit I continued
ONLINE
June 9
Mental Health
Case Study
Clinical Day
June 16
Mental Health
Unit 2 continued
ONLINE
June 23
Clinical Day
June 3
Wednesday
June 10
June 17
June 24
June 29
Clinical Day
June 30
Clinical Day
July 1
Thursday
June 4
Mental Health Nursing
Unit I continued
June 5
Friday
June 11
Test #1
Mental Health
Unit 2
June 18
Test #2
June 25
Cardiac Content
Unit 3 Ch. 37, 38
July 2
Cardiac Ch. 38
June 12
June 19
June 26
July 3
Happy
Independence
Day Tomorrow!

Monday
July 6
Clinical—ACLS
Durand B
July 13
Clinical
July 20
Clinical
July 27
Capstone
Simulation—
Code-Blue
August 3
Tuesday
July 7
Clinical—ACLS
Durand B
July 14
Clinical
Rough Draft of paper due via e-mail
July 21
Clinical
July 8
July 15
July 22
Wednesday
July 28 July 29
August 4
FINAL EXAM
August 5
Thursday
July 9
Test #3-Cardiac
Unit 4-Periop Concepts Ch.
16-18
July 10
Friday
July 16
Unit 4 continued
Oncology Ch. 23-24
July 17
World’s Largest
Baby Shower
TOMORROW
July 23
Unit 4 continued-Skin and
Burns, Ch. 26-28
July 24
July 30
Test #4-Ch. 23, 24, 26, 27,
28
July 31
August 6 August 7

Course Title:
Course Number:
Course Description:
Credit Hours:
Weekly Course Schedule:
Location:
Course Instructor(s):
Rationale:
Next Course in Sequence:
Department of Registered Nursing
Nursing Process II
NURS 2167
Nursing Process II is a 10 week course and is a continuation of Nursing Process I for the LPN-RN Bridge student. The student learning outcomes of Human Flourishing,
Nursing Judgment, Professional Identity and Spirit of Inquiry are expanded upon in this course with core competencies focusing on medical surgical and psychiatric nursing. Course goals include continuing the transition from LPN to RN, expanding the student’s knowledge base and skills and developing professional behaviors appropriate to the ADN role.
--Mental Health Nursing Concepts
--Cardiac Nursing Concepts
--Oncology Nursing Concepts
--Perioperative Nursing Concepts
--Skin/Burn Nursing Concepts
7 semester credit hours
4 hours of lecture/week
3 hour credit/week for clinical = 3 x 3 = 9 x 15 weeks for a total of 135 clinical hours
Clinical is Mondays, Tuesdays, or TBA. Theory is 0830-1230 on Thursday.
Shelia Howerton APN, MSN, RN Carla Jacobs, MSN, RN
Office: M 175 Office: M 172
Hours: Hours:
Wednesday: online or by appt. Wednesday: online or by appt.
Thursday 8-4 if not in class Thursday: 1-3 pm
Friday: By appointment Friday: By appointment
Phone: (870)391-3235, (870)480-6461 Phone: (870)391-3535, (870)577-0496
E-Mail: showerton@northark.edu E-Mail: cjacobs@northark.edu
Focus is placed on the use of the nursing process and continued development in the role of the Registered Nurse. Clinical laboratory experience is in the on-campus nursing lab and in affiliated health care agencies providing students the opportunity to enhance professional nursing skills. Students will evaluate personal progress in attaining personal goals.
Prerequisites:
Corequisite:
Nursing 2158, Nursing 1011
Nursing 2031
Upon successful completion of Nursing 2167 and Nursing 2031, the student may progress to
Nursing 2178 and Nursing 2021.
OR Consider
4 theory credits
3 lab credits
6 hrs/lecture/wk
13.5hrs/clinical/wk

Northark General Learning
Outcomes
Course Outcomes/Objectives/
Competencies:
The learning outcomes of general education will be common to all students regardless of major. When students have completed the general education component of their studies, they should be able to:
1. Apply critical thinking and problem solving skills across disciplines.
2. Apply life skills in areas such as teamwork, interpersonal relationships, ethics, and study habits.
3. Communicate clearly in written or oral formats.
4. Use technology appropriate for learning.
5. Discuss issues of a diverse global society.
6. Demonstrate math and/or statistical skills.
Student Learning Outcomes Core Competencies
Human Flourishing Communication
Patient Centered Care
Cultural Diversity
Nursing Judgment Safety/Quality Improvement
Evidence Based Practice
Spirit of Inquiry
Managing Care
Collaboration/Teamwork
Clinical Decision Making
Clinical Reasoning
Professional Identity Professional Behavior
Legal/Ethical
Teaching/Learning
Informatics
Course Outcomes:
Upon successful completion of this course, the student will be able to:
Human Flourishing
1.
Employ teaching-learning principles and the nursing process to provide comprehensive, holistic care. Measured by teaching-learning assignment in the clinical setting.
2.
Relate cultural, social, spiritual, environmental and historical influences which affect the provision of care to clients and communities. Measured by a Windshield Survey, reflective journaling, written assignments and clinical evaluation.
3.
Demonstrate caring interventions that assist the client in meeting their needs.
Measured by exams and clinical evaluations.
4.
Communicate effectively with peers, faculty, clients and health care personnel. Measured
by evaluation of clinical practice and journal entries.
Nursing Judgment
5.
Illustrate use of the nursing process to provide safe, comprehensive and holistic nursing care to clients experiencing alterations in mental-health, acute care and community nursing settings. Measured by clinical evaluations and simulation.
6.
Demonstrate safe delivery of patient-centered care in acute and community settings.
Measured by clinical evaluations and written assignments.
7.
Collaborate with the client, family and interdisciplinary team members in planning care and evaluating outcomes. Measured by clinical evaluation, mental and physical health
alteration.

Required Textbooks:
Professional Identity
8.
Practice in the role of the Associate Degree Nurse as defined by the Northark School of
Nursing, its philosophy, conceptual framework, subconcepts and competency statement.
Measured by participation in post-conference discussion of skills used and barriers experienced in the role of ADN with specific focus on delegation, safety, and leadership.
9.
Demonstrate basic management and leadership characteristics for the ADN role.
Measured by clinical evaluations and clinical assignments.
Spirit of Inquiry
10.
Utilize evidence-based practice while assisting the client and family to adapt physiologically, psychologically, and socially to stressors which occur across the lifespan.
Measured by written exams and clinical practice.
11.
Investigate the concepts of coping and adaptation that are basic to human functioning in health and illness across the lifespan. Measured by clinical and written assignments in
mental health and acute care nursing.
Ignatavivius, M. and Workman, L. (2013). Medical-Surgical Nursing: Patient
Centered Collaborative Care, 7 th Ed., St. Louis, MO: Elsevier-Saunders
Drug Handbook (Student's choice - current) - Recommend: Davis Drug Guide.
Evolve Elsevier Adaptive Learning and Quizzes.
Syllabi for Nursing 2167 -- Nursing Processes II.
ATI Reference books
Instructional/Teaching Method: Major Teaching-Learning Activities:
Teacher:Lecture
Discussion
Demonstrations
Audiovisual presentations
Learner: Discussion
Small group conferences
Role playing
Independent study guides
Simulation experiences
Computer assisted instruction
Outline of Course
Requirements:
Reflective journaling
Course Requirements:
1. The student is expected to attend class, laboratory sessions, and clinical.
2. The student is expected to be prepared for classroom, laboratory activities, and clinical.
3. The student is expected to complete all written assignments as directed by the instructor.
Course Evaluation Procedures:
Method of Evaluation:
4. The student is expected to meet all course outcomes.
5. The student is to write examinations on designated dates.
The course grade is determined as follows:
Unit Examination ............................................ 67%
Portfolio ......................................................... 13%
Comprehensive Final ...................................... 20%
Clinical Component is Pass/Fail

Clinical Policies &
Evaluation:
Weight of each Method:
Minimum Performance
Level on each criteria:
A 91-100
B 84-90
C
D
79-83
70-78
F 69 & below
The portfolio assignments grade is added ONLY after the student has achieved a 79% or above on all examinations.
Students must pass the clinical component of the course in order to progress in the program.
If the student fails the clinical component, the theory grade drops to a "D" and the student cannot progress in the program
See RN Program Handbook for complete information regarding clinical policies and evaluations.
The clinical performance grade will be either "satisfactory" or "unsatisfactory". The clinical grade will be determined by the evaluation of the student's actual performance in meeting the Nursing Process II clinical competencies and other clinically related nursing assignments. The clinical grade is as follows:
S = Satisfactory
Students meet minimum requirements for the course clinical outcomes.
N = Needs Improvement
Student did not meet minimum requirements for 1 or more core competency for that program outcome. If an N is received, then the student and instructor are expected to:
1.
2.
Discuss the issue during the clinical rotation.
The instructor will document the discussion on the clinical formative evaluation tool.
3.
4.
The instructor will fill out the clinical warning form.
The student will formulate a remediation plan to be presented to the clinical instructor and course coordinator.
(if applicable)
5. If after remediation, the student receives another NI, the process will be repeated once more.
If the student receives 3 N’s in the same outcome category, such as Human
Flourishing on separate occasions during a course clinical rotation then they will receive a U for that clinical rotation and will be dismissed from the program.
U = Unsatisfactory
Student did not demonstrate essential skills for patient safety, professional behavior etc. as stated in the RN Handbook. If the student participates in any of the reasons for dismissal as listed in the RN Handbook they will receive a U on the clinical formative evaluation tool.
Conferences and Evaluations:
Instructors are available for conferences during posted office hours and/or by appointment.
The student or the instructor(s) may initiate conferences concerning the

General Policies:
Attendance Policy:
Other Available Resources: student's performance or status in the classroom or clinical component of the course as needed.
Clinical Experience:
Concurrent clinical experience is provided in appropriate clinical settings.
Specific hours and locations for clinical assignment will be announced in class.
The type of clinical assignments may vary by institution and specific unit because of variations in hospital policy and procedures and patient populations. The level of clinical assignment will vary according to the needs and abilities of each student.
Students are responsible for maintaining standards of care and competencies achieved in prior semesters. Students are required to be prepared and adapt to variations in the patient care assignment.
Students will be oriented to their assigned clinical site by the clinical instructor.
Expectations for clinical performance and written clinical assignments will be included in the orientation.
All general policies in the Nursing Program Handbook and the Northark Student
Handbook are adhered to in this course. Review the RN Program Handbook for this course. See the course coordinator or your clinical instructor if you have any questions.
Absence from clinical requires that the student notify appropriate persons.
Clinical instructors will describe the procedure for specific clinical sites. Make up clinical experiences will be done during the assigned time at the end of the semester (during final exam week). Maximum of 12 clinical hours may be made up per semester. Any absences in excess of 12 hours will result in dismissal from the program. (See attendance policy in the RN Program Handbook.
Northark’s Jenzabar Portal is like a “digital commons”, or a student and staff center on the web. This new portal connects students to instructors, counselors, and staff with a single point of access. You will be able to find your classes, connect to
BlackBoard, and find groups that you are involved in, like Honors, PBL, Rodeo or other clubs. With one login and password, you have 24/7 access to your campus email, calendars, chat rooms or on-line exams. Without any other login, you can see your Campus Connect services. You can customize your home page as well!
SMARTHINKING is a web-based tutoring system that connects students to qualified einstructors (on-line tutors) anytime, from any internet connection. This service supplements on-campus courses, distance-education courses and the Northark
Learning Assistance Center. This service is FREE to currently enrolled students. Find the link to SMARTHINKING on the Northark Web page, student tab. When you click on this link, instructions for starting your own account are provided. This is a service purchased by the Title III grant.
Atomic Learning provides web-based software training for more than 100 applications that students and educators use every day. The web-site has short, easy-to-understand tutorial movies and resources that can be used like a help-desk for computer questions. This is a FREE service to students and staff (it even answers questions about i-Pods!). Go to: http://highed.atomiclearning.com
. Northark students should type in:
Username: northark

Resources Needed for This
Class:
Available on Campus Resources:
Assistance available for this course:
Login: pioneers.
Learn about your personal preference for taking in new information, and how you can study differently to get the most out of your education. Students who take this assessment find out how they prefer to learn, how teachers may prefer to teach, and how to meet in the middle! Students can maximize their time and success in school by following some timetested strategies for “Studying Without Tears (SWOT)”.

Personal computer – The student is expected to have access to a computer with these system requirements. If you have any problems with your computer, i.e., computer crashes, internet goes down, or etc., it is your responsibility to have a backup plan.

E-Mail Account – A Northark e-mail account was issued to you automatically when you enrolled in your classes. To access your e-mail, navigate to
Northark’s Web site at www.northark.edu
. On the Students tab, you should see a link to Student E-mail. You may also access your e-mail from web.mail.northark.edu. Your email address will be your username@mail.northark.edu
o Computers:
 JPH business Building – Computers are available in rooms B206, 207,
208, 209 & 302. (See schedule on the wall beside Mary Bausch’s
Office on the 2nd Floor.
 Libraries – There are computers available for all Northark students on the north and south campuses.
 North Campus: Monday-Friday, 7:30 a.m.–4:30 p.m.
 South Campus: Monday-Thursday, 7:30 a.m.-9:00 p.m.; Friday,
7:30 a.m.-5:00 p.m.; Saturday, 8:00 a.m.-5:00 p.m.
 South Campus Library houses the Testing Center. Call George
Laking at 391-3533 for hours. o Learning Commons has computers/printers, tutors and writing help.
If you are having any issues in your on-line course, the first person you should contact is your instructor by e-mail. If you need technical assistance for log-on issues, contact Brenda Freitas (Northark IT Department) at bfrietas@northark.edu or 870-391-3275.
Changes made to the syllabus will be posted on portal or announced in class. Provision for changing the
Syllabus (if applicable):
Statement of Student responsibilities:
As a student at North Arkansas College, you share the responsibility for your success.
The only way you can benefit from the many opportunities offered to you by the college is by doing your part.
As a student, you are responsible to:
1. Read the college catalog and all materials you receive during registration.
These materials tell you what the college expects from you.
2. Read the syllabus for each class. The syllabus tells you what the instructor expects from you.
3. Attend all class meetings. Something important to learning happens during every class period. If you must miss a class meeting, talk to the instructor in advance about what you should do.

ADA Statement:
Syllabus Acknowledgement:
4. Be on time. If you come in after class has started, you disrupt the entire class.
5. Never interrupt another class to talk to the instructor or a student in that class.
6. Be prepared for class. Complete reading assignments and other homework before class so that you can understand the lecture and participate in discussion. Always have pen/pencil, paper, and other specific tools for class.
7. Learn to take good notes. Write down ideas rather than word-for-word statements by the instructor.
8. Allow time to use all the resources available to you at the college. Visit your instructor during office hours for help with material or assignments you do not understand; use the library; use the tapes, computers, and other resources in Learning Assistance
Center.
9. Treat others with respect. Part of the college experience is being exposed to people with ideas, values, and backgrounds different from yours. Listen to others and evaluate ideas on their own merit.
North Arkansas College complies with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990. Students with disabilities who need special accommodations should make their requests in the following way: (1) talk to the instructor after class or during office hours about their disability or special need related to classroom work; and/or (2) contact Special Services in Room M149 and ask to speak to Kim Brecklein.
The syllabus acknowledgement must be returned via file exchange by the 10 th day of the semester.

NURSING 2167
Unit I: Foundations for Mental Health Nursing
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Discuss the basic concepts of mental health nursing.
2.
List all variables involved in a thorough assessment of the mental health client.
3.
Identify unique considerations when dealing with mental health at differing ages.
4.
Have a basic knowledge of criteria for diagnosis for mental health disorders.
5.
Identify pertinent ethical issues in the practice of psychiatric nursing.
6.
Consider legal and ethical issues in the practice of mental healthcare.
7.
Describe the rights of the client in a psychiatric setting.
CONTENT
I.
Basic Mental Health Concepts
A.
Assessment
1.
Psychosocial History
2.
Mental Status Examination
3.
Level of Consciousness
4.
Physical Appearance
5.
Behavior
6.
Cognitive and Intellectual Abilities
7.
Standard Screening Tests a.
Mini-Mental Examination b.
Glasgow Coma Scale
B.
Considerations Across the Lifespan
1.
Children and Adolescents
2.
The Older Adult
C.
Mental Health Diagnoses
1.
Diagnostic and Statistical Manual of
Mental Disorders
II.
Legal and Ethical Issues
A.
Legal Rights of Mental Health Patients
B.
Ethical Issues
1.
Beneficence
2.
Autonomy
3.
Justice
4.
Fidelity
5.
Veracity
C.
Confidentiality
D.
Resources for Ethical Concerns
E.
Types of Commitment
1.
Voluntary
2.
Involuntary
F.
Seclusion and Restraint
G.
Tort Law
H.
Documentation
LEARNER ACTIVITIES
ATI Chapter 1.
American Psychiatric Association: http://www.psych.org
Movie: Bellevue Inside Out
ATI Chapter 2. http://nursingworld.org
www.aha.org

OBJECTICVES/OUTCOMES
8.
Use therapeutic communication with clients experiencing mental illness.
9.
Discuss use of defense mechanisms for coping with anxiety.
10.
Identify the necessity for both developing a therapeutic relationship with the psychiatric client and the setting of boundaries.
11.
Discuss the pros and cons of various mental health treatment settings and the services they provide.
Identify barriers to effective treatment for special populations.
CONTENT
III.
Effective Communication
A.
Basic Communication
B.
Therapeutic Communication
C.
Nursing Process
D.
Skills and Techniques
E.
Barriers to Effective Communication
IV.
Stress and Defense Mechanisms
A.
Defense Mechanisms
B.
Anxiety
1.
Assessment of Anxiety
2.
Levels of Anxiety
3.
Nursing Interventions
V.
Creating/Maintaining a Therapeutic and
Safe Environment
A.
Nurse-Client Relationships
B.
Benefits of Therapeutic Relationships
C.
Phases
1.
Orientation
2.
Working
3.
Termination
D.
Boundaries
VI.
Diverse Practice Settings
A.
History of Mental Health Nursing
B.
Acute Care Mental Health Settings
C.
Community Mental Health Care
1.
Levels of Prevention
2.
Community-Based Mental Health
Programs
D.
Roles of Nurses in Diverse Settings
ATI Chapter 3.
LEARNER ACTIVITIES
Role playing exercises Case Study.
ATI Chapter 4.
Discuss a stressful experience and examine mechanisms used to cope with the situation.
ATI Chapter 5.
Professional Boundaries in Nursing (Article)
ATI Chapter 6

OBJECTICVES/OUTCOMES
12.
Have a basic understanding of therapies employed in addressing mental health issues.
13.
Understand the basic dynamics often seen in members during group or family therapy.
14.
Identify therapeutic stress reduction techniques utilized in the mental health setting.
15.
Be able to discuss current indications for brain stimulation therapies and nursing care involved in each type of therapy.
CONTENT
VII.
Psychoanalysis, Psychotherapy and
Behavioral Therapies
A.
Psychoanalysis
B.
Cognitive Therapy
C.
Behavioral Therapy
1.
Modeling
2.
Operant Conditioning
3.
Systemic Desensitization
4.
Aversion Therapy
5.
Miscellaneous
VIII.
Group and Family Therapy
A.
Phases of Group Development
1.
Initial
2.
Working
3.
Termination
B.
Characteristics of Families
1.
Healthy
2.
Dysfunctional
C.
Other Concepts
1.
Scapegoating
2.
Triangulation
3.
Multi-operational Issues
D.
Family Therapy
IX.
Stress Management
A.
Assessment
B.
patient-Centered Care
1.
Cognitive Techniques
2.
Behavioral Techniques
3.
Journal Writing
4.
Priority Restructuring
5.
Biofeedback
6.
Mindfulness
7.
Assertiveness Training
8.
Other Techniques
X.
Brain Stimulation Therapies
A.
Electroconvulsive Therapies
ATI Chapter 7.
ATI Chapter 8.
ATI Chapter 9.
ATI Chapter 10.
LEARNER ACTIVITIES

B.
Transcranial Magnetic Stimulation
C.
Vagus Nerve Stimulation

OBJECTICVES/OUTCOMES
16.
Differentiate between stress as a healthy response and anxiety disorders.
17.
Discuss the various classifications of depression and implications for management.
18.
Identify the typical pattern of onset of bipolar disorders and the behaviors often shown comorbidly.
19.
Identify manifestations of patients with psychotic disorders that interfere with interpersonal relationships, self-care and ability to work.
CONTENT
XI.
Anxiety Disorders
A.
Panic Disorders
B.
Phobias
1.
Social Phobia
2.
Agoraphobia
3.
Specific Phobias
C.
Generalized Anxiety Disorder
D.
Obsessive-Compulsive and Related
Disorders
1.
OCD
2.
Hoarding
E.
Trauma and Stressor-Related
XII.
Depressive Disorders
A.
Overview
B.
Assessment
1.
Risk Factors
2.
Subjective and Objective
3.
Standardized Screening Tools
C.
patient-Centered Care
1.
Medications
2.
Other Therapeutic Modalities
XIII.
Bipolar Disorders
A.
Overview
B.
Assessment
1.
Manic Characteristics
2.
Depressive Characteristics
3.
Standardized Screening Tools
XIV.
Psychotic Disorders
A.
Overview
B.
Assessment
1.
Positive and Negative Symptoms
2.
Cognitive Symptoms
3.
Affective Symptoms
C.
Delusions
D.
Alterations in Speech
ATI Chapter 11.
LEARNER ACTIVITIES
ATI Chapter 12.
ATI Chapter 13.
ATI Chapter 14.

OBJECTICVES/OUTCOMES
20.
Recognize that the client with personality disorders may not perceive it as dysfunctional and identify therapeutic care measures to help in the situation.
21.
Be able to state the importance of identifying cognitive disorders such as Alzheimer’s disease form other mental health disorders such as depression.
22.
Verbalize behaviors that are identifiable in both substance abuse disorders and process addictions.
CONTENT
XV.
Personality Disorder
A.
The 10 Personality Disorders
1.
Cluster A
2.
Cluster B
3.
Cluster C
B.
Patient-Centered Care
1.
Safety
2.
Medication
3.
Teamwork/Collaboration
XVI.
Cognitive Disorders
A.
Risk Factors
B.
Delirium
1.
Onset
2.
Manifestations
3.
Cause
4.
Outcome
C.
Alzheimer’s Stages
D.
Defense Mechanisms Used in Cognitive
Disorders
E.
Lab, Diagnostic Test, Screening Tools
XVII.
Substance Abuse and Addictive Disorders
A.
Risk Factors
B.
Subjective and Objective Data
C.
CNS Depressants
1.
Alcohol
2.
Sedatives/Hypnotics
3.
Cannabis
D.
CNS Stimulants
1.
Cocaine
2.
Amphetamines
3.
Tobacco
4.
Opioids
5.
Inhalants
6.
Hallucinogens
ATI Chapter 15.
LEARNER ACTIVITIES
ATI Chapter 16.
ATI Chapter 17.

OBJECTICVES/OUTCOMES
.
23.
Recognize the high mortality and suicide risk associated with eating disorders.
CONTENT
XVIII.
Eating Disorders
A.
Anorexia Nervosa
B.
Bulimia Nervosa
C.
Binge-Eating Disorder
D.
Objective Data
1.
Mental Status
2.
VS and Weight
3.
Physical Exam
4.
Reproductive Status
E.
Nursing Care
1.
Establish Realistic Goal
2.
Promote Cognitive-Behavioral
Therapies
3.
Monitor Physical Status
ATI Chapter 18.
LEARNER ACTIVITIES

NURSING 2167
Unit 2: Psychopharmacological Therapies
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Discuss common psychopharmacologic therapies.
2.
Develop a teaching plan for clients and families for implementation of the prescribed treatment regime.
3.
Describe the categories of drugs used to treat mental illness and their mechanisms of action, side effects and special nursing interventions.
4.
Identify common barriers to maintaining the medication regimen.
5.
Discuss the nurse’s role in educating clients and families about current medication management.
CONTENT
I.
Medication for Anxiety Disorders
A.
Benzodiazepines
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
B.
Atypical Anxiolytics/Nonbarbiturate
Antiolytics
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
C.
Selective Serotonin Reuptake Inhibitors
(SSRIs)
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
II.
Medication for Depressive Disorders
A.
Tricyclic Antidepressants
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
B.
Selective Serotonin Reuptake Inhibitors
(SSRIs)
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
C.
Monoamine Oxidate Inhibitor (MAOIs)
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
LEARNER ACTIVITIES
Read: ATI Chapter 19.
Kee pgs 297-300
391-394
MaxiLearn Card pg 83
Anti-anxiety benzodiazepine
Read: Kee pgs 399-400.
MaxiLearn Card pg 75
Antidepressants – SSRI
Read: ATI Chapter 20
Kee pages 396-403
MaxiLearn Card pgs 75, 76, 77 and 78.

OBJECTICVES/OUTCOMES CONTENT
III.
Medication for Bipolar Disorders
A.
Mood Stabilizer
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
B.
Antiepileptic Drugs (AEDs)
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
IV.
Medication for Psychotic Disorders
A.
First Generation Antipsychotics
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
B.
Second Generation Antipsychotics
(Atypical)
1.
Complications
2.
Contraindications
3.
Nursing Considerations
V.
Medication for Children and Adolescents
A.
CNS Stimulants
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
B.
Norepinephrine Selective Reuptake
Inhibitor
1.
Action
2.
Complications
3.
Contraindications
4.
Nursing Considerations
LEARNER ACTIVITIES
Read: ATI Chapter 21
Kee pgs 403-406 and
309-317
MaxiLearn 82, 86
Read: ATI Chapter 22
Kee pgs 382-390
MaxiLearn Card pgs 80, 81
Read: ATI Chapter 23
Kee pgs 287-292

OBJECTICVES/OUTCOMES CONTENT
VI.
Medications for Substance Abuse Disorders
A.
Alcohol Detoxification
1.
Action
2.
Nursing Interventions/Education
B.
Maintenance Following Detoxification
1.
Action
2.
Nursing Interventions/Education
C.
Withdrawal/Abstinence from Opiods
1.
Action
2.
Nursing Interventions/Education
D.
Withdrawal/Abstinence from Nicotine
1.
Action
2.
Nursing Interventions/Education
LEARNER ACTIVITIES
Read: ATI Chapter 24
Kee Chapter 9

NURSING 2167
Unit 2: Special Populations (cont).
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Discuss various theories related to understanding the grief process.
.
2.
Apply the nursing process to facilitate grieving for clients and families.
3.
Discuss universal and culturally specific mourning rituals.
4.
Discuss the characteristics, risk factors and family dynamics of psychiatric disorders of childhood and adolescence.
5.
Educate clients, families, schools and communities considering psychiatric disorders of young clients.
CONTENT
I.
Care of Those Who are Dying or Grieving
A.
Overview
1.
Theories
2.
Influencing Factors
3.
Assessment
4.
Nursing Interventions
B.
Palliative Care
1.
Assessment
2.
Nursing Interventions
C.
Post Mortem Care
1.
Nursing Interventions
2.
Care of Nurses Grieving
II.
Mental Health Issues of Children and
Adolescents
A.
Overview
B.
Assessment
C.
Depressive Disorders
D.
Anxiety Disorders
1.
Nursing Interventions
E.
Disruptive Impulse Control
1.
Nursing Interventions
F.
Neurodevelopmental Disorders
1.
Nursing Interventions
G.
General Nursing Considerations
LEARNER ACTIVITIES
Read: ATI Chapter 25.
Read: ATI Chapter 26

NURSING 2167
Unit 2: Continued
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Identify the role of the nurse in crisis intervention.
.
2.
Identify populations at risk for suicide.
3.
Differentiate anger, hostility and aggression.
4.
Discuss appropriate nursing interventions for the client in the different phases of anger.
5.
Discuss the characteristics, risk factors and family dynamics of abusive and violent behavior
6.
Explain the role of the nurse when abuse is suspected.
7.
Educate families, clients and communities to prevent abuse and violence.
8.
Examine the incidences of and trends in domestic violence and rape.
9.
Evaluate nursing care of victims of sexual assault.
CONTENT
I.
Crisis Management
A.
Overview
B.
Assessment
C.
Nursing Interventions
II.
Suicide
A.
Overview
B.
Assessment
C.
Nursing Interventions
1.
Medications
III.
Anger Management
A.
Overview
B.
Assessment
1.
Objective
2.
Subjective
C.
Nursing Interventions
1.
Medications
IV.
Family and Community Violence
A.
Overview
B.
Assessment
1.
Types of Violence
2.
Age Specific
C.
Nursing Interventions
V.
Sexual Assault
A.
Overview
B.
Assessment
C.
Nursing Interventions
LEARNER ACTIVITIES
Read: ATI Chapter 27
Read: ATI Chapter 28
Read: ATI Chapter 29
Read: ATI Chapter 30
Read: ATI Chapter 31.

NURSING 2167
UNIT 3 – Cardiac Problems
Course Outcomes: 2-11
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Describe the management of patients with heart failure.
2.
Use the nursing process as a framework for the care of a patient with heart failure.
3.
Develop a teaching plan for a patient with heart failure.
4.
Review current evidence-based published guidelines for the management of heart failure.
5.
Relate the use of pharmacological therapy to the management of heart failure.
6.
Define valvular disorders of the heart and describe the pathophysiology manifestations, and management of patients with mitral and aortic disorders.
7.
Compare types of cardiac valve repair and replacement procedures used to treat valvular problems and the care required by patients undergoing these procedures.
8.
Describe the rationale for medication therapy for patients with mitral valve prolapse, valvular heart disease, rheumatic endocardititis, infective endocarditis and myocarditis.
CONTENT
I.
Heart Failure
A.
Pathophysiology
1.
Classification
2.
Compensatory mechanisms
3.
Etiology
B.
Assessment
1.
Clinical Manifestations
2.
Laboratory and Radiology Assessment
3.
Psychosocial Assessment
C.
Outcomes
D.
Planning and Implementation
1.
Nursing Interventions
2.
Medical Management
3.
Medication Therapy
4.
Self-Management/Home Care
II.
Valvular Heart Disease
A.
Pathophysiology
1.
Mitral Stenosis
2.
Mitral Regurgitation
3.
Mitral Valve Prolapse
4.
Aortic Stenosis
5.
Aortic Regurgitation
B.
Assessment
C.
Interventions
1.
Nursing Care
2.
Medical Management
3.
Medication Therapy
4.
Home Care/Self-Management
LEARNER ACTIVITIES
Read: Iggy Chapter 37.
PowerPoint.
MaxiLearn Cards pg 1 Loop Diuretics pg 2 pg 3
Thiazide Diuretics
Potassium-Sparing Diuretics pg 15 Digoxin
Lab simulation: CHF
ATI Med-Surg, Chapter 32
Heart Failure & Pulmonary Edema
ATI Med-Surg, Chapter 33
Valvular Heart Disease

OBJECTICVES/OUTCOMES
9.
Describe the pathophysiology, clinical manifestations and management of patients with infections of the heart.
10.
Anticipate long-term care and management of patients with cardiomyopathies.
CONTENT
III.
Inflammations and Infections
A.
Infective Endocarditis
1.
pathophysiology
2.
Assessment
3.
Interventions
B.
Pericarditis
1.
Pathophysiology
2.
Assessment
3.
Interventions
C.
Rheumatic Carditis
1.
Pathophysiology
2.
Manifestations
3.
Nursing Interventions
IV.
Cardiomyopathy
A.
Pathophysiology
B.
Assessment
C.
Medical Management
D.
Nursing Interventions
LEARNER ACTIVITIES
ATI Med-Surg, Chapter 34
Inflammatory Disorders

NURSING 2167
UNIT 3: Vascular Problems (continued)
Course Outcomes: 2-11
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Identify and assess for risk factors associated with hypertension.
2.
Define normal blood pressure and categories of abnormal blood pressure. Include age-related considerations.
3.
Incorporate cultural considerations in the treatment of hypertension, lifestyle changes and pharmacological management.
4.
Use the nursing process as a framework for care of a patient with hypertension.
5.
Describe immediate treatment for a hypertensive crisis.
6.
Identify anatomic and physiologic factors that affect peripheral blood flow and tissue oxygenation.
7.
Use appropriate parameters for assessment of peripheral circulation.
8.
Use the nursing process as a framework of care for a patient with peripheral vascular disorders.
9.
Compare preventative management of venous thrombosis, venous insufficiency, leg ulcers, and varicose veins.
10.
Identify key symptoms, management, and post-
CONTENT
I.
Arteriosclerosis and Atherosclerosis
A.
Pathophysiology
B.
Assessment
C.
Interventions
II.
Hypertension
A.
Pathophysiology
1.
Classifications of Hypertension
2.
Etiology and Genetic Risk
B.
Assessment
C.
Health Teaching
D.
Medical Management
E.
Home Care/Self-Management
III.
Peripheral Arterial Disease
A.
Pathophysiology
B.
Assessment
C.
Nursing Interventions
D.
Medical Management
IV.
Aneurysms
A.
Pathophysiology
B.
Assessment
C.
Nursing Interventions
D.
Medical Management
V.
Miscellaneous Disorders
A.
Buerger’s Disease
B.
Thoracic Outlet Syndrome
C.
Raynaud’s Phenomenon
VI.
Venous Thromboembolism
LEARNER ACTIVITIES
Read: Iggy, Chapter 38.
Hypertension Case Study.
MaxiLearn Cards pg 10 Beta Blockers pg 11 Calcium Channel Blockers pg 12 ACE Inhibitors pg 13 ARBs pg 14 Centrally-Acting Anti-hypertensives
Case Study: Peripheral Vascular Disease
Abdominal Aneurysm
ATI Med-Surg, Chapters 35, 36 and 39
Case Study: Deep Vein Thrombosis

surgical care of aortic aneurysms. A.
Pathophysiology
B.
Assessment
C.
Nursing Intervention
D.
Medical Management
VII.
Venous Insufficiency
A.
Pathophysiology
B.
Assessment
C.
Nursing Interventions
D.
Medical Management
VIII.
Miscellaneous Venous Disorders
A.
Varicose Veins
B.
Phlebitis
C.
Vascular Trauma

NURSING 2167
UNIT 4 -- Perioperative Concepts
Course Outcomes: 2-5, 7-9
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Identify legal and ethical considerations related to informed consent.
2.
Summarize factors included in the preoperative assessment to identify surgical risk factors.
3.
Describe preoperative nursing measures that decrease risk for infection and other postoperative complications.
4.
Develop a preoperative teaching plan designed to promote the patients' recovery from anesthesia and surgery.
5.
Describe the immediate preoperative preparation of the patient.
6.
Describe the principles and basic guidelines of surgical asepsis.
7.
Identify adverse affects of surgery and anesthesia.
8.
Compare the various types of anesthesia with regard to uses, advantages, disadvantages, and nursing responsibilities.
9.
Identify the surgical risk factors related to agespecific populations; list nursing interventions to reduce those risks.
10.
Describe the interdisciplinary approach to the care of the patient during surgery.
CONTENT
I.
Overview
A.
Surgical Settings
II.
Patient-Centered Collaborative Care
A.
Preoperative Assessment
1.
History
2.
Physical Assessment
3.
Psychosocial Assessment
4.
Laboratory and Imaging Assessment
B.
Pre-operative Planning and
Implementation
1.
Patient Teaching
2.
Informed Consent
3.
Minimizing Anxiety
4.
Pre-operative patient Preparation
III.
Intraoperative Overview
A.
members of the Surgical Team
B.
Preparation of Surgical Suite and Team
Safety
C.
Anesthesia
1.
Stages of Anesthesia
2.
Types of Anesthesia
3.
Complications of Anesthesia
IV.
Intraoperative Patient-Centered Collaborative
Care
A.
Intra-operative Assessment
B.
Planning and Implementation
1.
Preventing Injury & Complications
V.
Postoperative Overview
LEARNER ACTIVITIES
Read: Iggy Chapter 16.
Video: Perioperative Nursing
ATI Med-Surg, Chapter 96
Preoperative Nursing Care
Read: Iggy Chapter 17.
ATI Med-Surg Chapter 95
Anesthesia and Moderate Sedation
Complete ATI Practice Test - perioperative

OBJECTICVES/OUTCOMES
11.
Describe the responsibilities of the post- anesthesia care unit nurse in the prevention of immediate postoperative complications.
12.
Discuss postoperative education for patients and family members after surgery.
13.
Identify common postoperative discomforts, complications and their management.
14.
Describe the gerontologic and pediatric considerations related to postoperative management of patients.
15.
Demonstrate sterile dressing technique.
16.
Collaborate with health care team members to perform emergency care procedures for surgical wound dehiscence or wound evisceration.
CONTENT
VI.
Postoperative Patient-Centered Collaborative
Care
A.
Postoperative Assessment
1.
Respiratory System
2.
Cardiovascular System
3.
Urinary System
4.
Gastrointestinal System
5.
Integumentary System
6.
Pain Assessment
B.
Psychosocial Assessment
C.
Laboratory Assessment
D.
Planning and Implementation
1.
Preventing Hypoxemia
2.
Preventing Infection
3.
Managing Pain
E.
Community-Based Care
1.
Teaching for Self-Management
LEARNER ACTIVITIES
Read: Iggy Chapter 18.
ATI Med-Surg, Chapter 97
Post-operative Care

NURSING 2167
UNIT 4 -- Oncology Concepts continued
Course Outcomes: 1-6, 8, 9 and 11
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Relate the structure and function of the normal cell to the changes that occur within a cancer cell.
2.
Define terms relating to tumor growth such as neoplasm, benign, malignant, sarcoma, and carcinoma.
3.
Compare and contrast the characteristics of benign tumors with the characteristics of malignant tumors.
4.
Identify agents and factors that have been found to be carcinogenic.
5.
Evaluate factors which place an individual at a high risk for developing cancer.
6.
Teach patients the American Cancer Society’s seven warning signs of cancer.
7.
Relate the significance of health education and preventive care to the decrease in the incidence of cancer.
8.
Identify community resources for clients with cancer.
9.
Evaluate the various diagnostic approaches available for a client suspected of having cancer.
CONTENT
I.
Cancer Development
A.
Pathophysiology
1.
Biology of Normal Cells
2.
Biology of Abnormal Cells
3.
Cardinogenesis/Oncogenesis
B.
Classification
1.
Cancer Grading, Ploidy, & Staging
C.
Etiology and Genetic Risk
1.
External Factors
2.
Personal Factors
D.
Prevention
1.
Primary
2.
Secondary
II.
Care of the Patient with Cancer
A.
Disease-Related Consequences
1.
Reduced Immunity and Blood
Producing
2.
Altered GI Structure and Function
3.
Motor and Sensory Deficits
4.
Reduced Oxygenation
B.
Management
1.
Surgery a.
prophylactic b.
Curative c.
Palliative d.
Reconstructive or Rehabilitative
2.
Radiation Therapy a.
Delivery Methods and Devices b.
Side Effects
LEARNER ACTIVITIES
Read: Iggy Chapters 23 and 24.
Hockenberry, Chapter 26, pp. 889-890.
Case Study with Concept Map.
ATI Med-Surg, Chapters 90-94
Cancer-Related Disorders

OBJECTICVES/OUTCOMES
10.
Use the nursing process as a framework for the care of patients with cancer.
11.
Compare the roles of surgery, radiation therapy, chemotherapy, hyperthermia, and biological response modifiers in the treatment of cancer.
12.
Assess the psychosocial stresses experienced by the client, family and friends when cancer is diagnosed.
CONTENT
3.
Chemotherapy a.
Drug categories b.
Treatment Issues c.
Side Effects
1) Bone marrow suppression
2) Nausea/vomiting
3) Mucositis
4) Alopecia
5) Cognitive changes
6) Neuropathy
4.
Hormonal Manipulation
5.
Photodynamic Therapy
6.
Immunotherapy: Biological Response
Modifiers
C.
Oncologic Emergencies
1.
Sepsis and Dessiminated Intravascular
Coagulation
2.
Syndrome of Inappropriate Antidiuretic
Hormone
3.
Spinal Cord Compression
4.
Hypercalcemia
5.
Superior Vena Cava Syndrome
6.
Tumor Lysis Syndrome
LEARNER ACTIVITIES

NURSING 2167
UNIT 4 -- Integument Concepts continued
Course Outcomes: 2-9 and 11
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Explain the functions of the skin and its appendages (the hair, nails, sebaceous glands and sweat glands).
2.
Identify and describe primary and secondary skin lesions with their pattern and distribution.
3.
Recognize common skin eruptions and manifestations associated with systemic disease.
4.
Describe the components of physical assessment most useful when examining the skin, hair and nails.
5.
Apply the nursing process as a framework for care of the patient with an abnormal skin condition.
6.
Illustrate procedures used for therapeutic management of skin disorders.
7.
Apply the nursing process as a framework for prevention of skin breakdown.
CONTENT
I.
Anatomy and Physiology Review
A.
Skin, hair, nails and glands
B.
Functions of the skin
C.
Gerontologic and pediatric differences
II.
Assessment
A.
Health history
B.
Physical assessment
C.
Assessing skin lesions
D.
Diagnostic evaluation
E.
Psychosocial assessment
III.
Care of Patient’s with Skin Problems
A.
Minor Skin Irritations
1.
Dryness
2.
Pruritus
3.
Sunburn
4.
Urticaria
B.
Trauma
1.
Phases of Wound Healing
2.
Mechanisms of Wound Healing
C.
Pressure Ulcers
1.
Pathophysiology
2.
Assessment a.
Wound assessment b.
Lab and diagnostic assessments
LEARNER ACTIVITIES
Read: Iggy Chapter 26.
ATI Med-Surg, Chapters 74 & 75
Nursing Care of Clients with Integumentary
Disorders
Read: Iggy Chapter 27.
Read: Best Practice Statement: Care of the Older
Person’s Skin: 2012 (access via Portal)

OBJECTICVES/OUTCOMES
8.
Analyze the health education needs of patients with infections of the skin and parasitic skin diseases.
9.
Apply the nursing process as a framework for care of patients with noninfectious inflammatory dermatoses.
10.
Specify the management and nursing care of patients with cancer of the skin.
11.
Apply the nursing process as a framework for care of the patient with malignant melanoma.
12.
Compare the various types of dermatologic and plastic reconstructive surgeries.
13.
Apply the nursing process as a framework for care of the patient undergoing facial reconstructive surgery.
CONTENT
3.
Analysis and Planning a.
Wound management b.
Preventing infection
D.
Common infections
1.
Bacterial infections
2.
Viral infections
3.
Fungal infections
E.
Cutaneous Anthrax
F.
Parasitic Disorders
1.
Pediculosis
2.
Scabies
3.
Bed bugs
G.
Common inflammations
1.
Psoriasis
H.
Benign tumors
1.
Cysts
2.
Seborrheic Keratoses
3.
Keloids’
4.
Nevs
I.
Skin Cancer
J.
Other skin disorders
1.
Acne
2.
Lichen planus
3.
Pemphigus vulgan’s
4.
Toxic epidermis necrolysis
5.
Stevens-Johnson Syndrome
6.
Leprosy
LEARNER ACTIVITIES

Course Outcomes: 1-8
OBJECTICVES/OUTCOMES
Upon completion of this unit, the student will be able to:
1.
Describe the local and systemic effects of a major burn injury.
2.
Categorize the 3 phases of burn care and the priorities of care for each phase.
3.
Compare and contrast the potential fluid and electrolyte derangements of the three phases of burn management.
4.
Differentiate the treatment of burns in the adult patient, the pediatric patient, and the geriatric patient.
5.
Describe the goals of the following aspects of burn wound care and the nurse's role in each: wound cleaning, topical therapy, wound dressing, dressing changes, wound debridement, and wound grafting.
6.
Outline the nurses role in: pain management, restrictions of activity and joint motion, psychological support of patient and family, nutrition support, pulmonary care, and patient/family education.
CONTENT
I.
Management of Patient with Burn Injury
A.
Pathophysiology of burns
1.
Classification
2.
Local and systemic responses
B.
Phases of burn care
1.
Stage I: emergent/resuscitative phase a.
Emergency management b.
Management of fluid loss and shock c.
Nursing process: burn care during emergent/resuscitative phase
2.
Phase II: acute/intermediate phase a.
Fluid and electrolyte changes b.
Infection prevention c.
The burn wound and care d.
Nursing process: burn care during the acute/intermediate phase
1) minimizing infection
2) Grafting
3) Nutrition
4) Pain Management
3.
Phase III: longer-term rehabilitation a.
Home care and follow-up b.
Gerontological considerations
LEARNER ACTIVITIES
Read: Iggy Chapter 28
1049
Hockenberry (Wong's) Ch. 30, pp 1036-
Read: Sheridan, R. L., et. al. (2012). Burn
Rehabilitation Medscape. (access via Portal or http://emedicine.medscape.com/article/318436overview#a1 ).
ATI Med-Surg, Chapter 75
Burns

Clinical Objectives for Specific Rotations- if you do not rotate through a particular area, then the objectives do not apply. Answer the objectives and e-mail to instructor by Thursday morning of clinical week.
Respiratory Therapy Assignment
If you rotate with a respiratory therapist then meet the following objectives: (you do not have to write to them but you will see this content on exams)
Student Learning Outcomes
1.
Auscultate at least 3 client’s breath sounds using appropriate assessment techniques. Discuss your findings with the RT.
2.
Observe at least one ventilator client. Notice the settings on the ventilator.
Identify the following on the ventilator a.
What classification of ventilator is being used? (positive pressure, negative pressure?) b.
If positive pressure what type is it? c.
What is the ventilator mode? (assist-control, intermittent, synchronized – see your med-surg text book) d.
What is the tidal volume set at? e.
What is the FiO2 setting? f.
What is the sensitivity setting? g.
Inspiratory-expiratory ratio h.
Sigh setting i.
PEEP
3.
Observe the respiratory therapist administering pulmonary treatments (such as updrafts, use of incentive sprirometers, chest percussion). What were the common medications administered and why were they being given?
4.
Observe the RT drawing ABGs and interpret the findings if available for at least one client.
5.
If the RT obtains EKG’s then look at them and identify heart rate, rhythm and any dysrhythmias.
Physician Office Clinical Rotation
During the clinical rotation at the physician offices the student should be able to:
1.
Identify the role of the RN in the practice.
2.
Discuss communication methods used in the clinical setting.
3.
Relate the client’s diagnosis with specific medical interventions.
4.
Identify use of wellness interventions to promote health in the community population.
5.
How was the concept of human growth and development applied to various age groups of clients that are seen in the clinic setting?
Home Health
1. Describe the nursing functions during a home visit.
2. Describe two patients you visited; include diagnosis, assessment, treatment and nursing care.
3. Describe some differences observed between the hospital setting and home health.

Wound Care Clinic
Student Learning Outcomes
1.
Observe nursing process and describe therapeutic communication skills demonstrated by the wound care nurse.
2.
Identify and describe at least two methods for wound care.
3.
Identify 3 different types of wounds and the interventions used for each type of wound.
4.
Utilize best practice to assess a client’s wound status. Describe how this was done.
5.
Relate 3 examples of wound healing to co-morbidities that the client may be experiencing (such as diabetes or peripheral vascular disease).
6.
Identify the services that wound care program provides to the community.
7.
How is a patient accepted into the wound care program? Is a referral necessary?
8.
Identify safety and infection control practices used during wound care. What PPE (personal protective equipment) was used?
9.
Discuss one patient visit. Include: a.
The assessment involve b.
Nursing care provided c.
Education/instructions given to patient or caregiver d.
Documentation
10. Discuss the nurses’ interdisciplinary collaboration with the healthcare team (i.e. physical therapist, social worker, occupational therapist, dietitian, physician, etc.)
11. Define osteomyelitis? How is it treated? What is the pathophysiology involved?
12. How does the hyperbaric chamber help with wound healing?
Emergency Department
1. Explain the concept of triage and prioritization.
2. Design a case study with answers regarding how you would perform an initial trauma assessment.
3. Contrast how assessment differs in the ED vs. other areas of the hospital.
4. Describe the coping mechanisms used by patients, families, and staff in the ED.
5. Evaluate the legal implications of ED nursing care: child abuse, blood ETOH, DOA’s, poison control, treatment of minors, psychiatric emergencies, physical restraint, and reporting incidents to law enforcement.
Behavioral Health Center
1. Explain the difference in delivery of care in mental-health setting area as compared to acute care nursing.
2. Describe how group therapy is used.
3. What therapeutic communication techniques did you see used?
4. Summarize your day. What type of disorders did you see, what medications were they on, what therapeutic activities did they participate in? (describe 3 different patients)

Hospice House
1. What positions are included in the hospice team?
2. Describe the roles of each position.
3. How was therapeutic communication and empathy used?
4. What was the patient and family’s view on death and dying?
5. What makes one eligible for hospice care?
6. Research Arkansas Medicaid and describe what is and is not covered (e.g. level of care, medication, length of coverage…)
7. Write a short paragraph contrasting how hospice nursing differs from acute care nursing.
Critical Care
**This assignment will take several hours to complete. Do your own work, but break it up into pieces so it doesn’t seem so difficult.
1. Describe the psychosocial aspects of caring for the critically ill patient and his/her family. Incorporate how these aspects apply to your patient and his/her family. List 2 priority psychosocial nursing dx interventions.
2. Explain how to evaluate the level of consciousness of a critically ill patient. (Refer to Iggy chapter on neurological assessment.) Detail how the Glascow Coma Scale is used and what the scoring indicates. List 2 priority nursing dx for a patient with a neurological deficit or decreased LOC.
3. Describe nursing responsibilities for intubation, extubation *including accidental extubation), and care of a patient on a ventilator. List 2 priority nursing dx interventions.
4. Describe the use of and nursing responsibilities associated with using monitoring equipment (Swan Ganz catheter, telemetry, pacemakers, defibrillators, CVP, and arterial lines).
5. Discuss meds used in ICU for sedation. Give the class, name, titrated dosing, and indications for use.
6. Discuss indications and criteria for use of tPA. Explain dosage, administration, and responsibilities of administration.
7. Identify 3 types of medications and indications administered by respiratory therapy.
8. Interpret 1 set of ABS with treatment. (To include with written assignment.)
9. Interpret 3 patient ECG strips with treatment. (To include with written assignment.)
*Include bibliography where info was obtained.
GI Lab
1. What are the roles of the nurses in the GI lab?
2. Discuss adverse events that can occur during an endoscopic procedure.
3. Summarize at least 3 patients observed. Include procedure, signs and symptoms leading to procedure. What was found-treatment?

Charge Nurse
1. Analyze the utilization of the nursing process in the role of charge nurse.
2. Examine the responsibilities of the charge nurse.
3. Identify the knowledge and skills needed by the charge nurse to function effectively.
4. Appraise how a charge nurse organizes his/her time, prioritizes, and delegates either assignments or patient care.
Perioperative Clinical
The nursing student will complete rotation in the OR and PACU in order to gain knowledge of the activity, expectations, role of the surgical nurse and the nurses’ contribution to the surgical team as well as the responsibility to the patient.
Operating Room
1.
Describe the nursing responsibilities for preparing a patient for surgery. Refer to the textbook for information on preoperative care.
2.
Describe the nursing responsibilities of the scrub nurse and the circulating nurse. Refer to textbook for information on intraoperative care and management.
3.
List two priority nursing diagnoses for the patient in the OR.
4.
Contrast medical and surgical asepsis.
5.
Describe the preparation of the patient as to administration of their regularly scheduled medications. If you have had a patient in a unit that was taken to surgery what was the process for managing the patient’s medications?
6.
What anesthesia was administered to the patient?
7.
Study Chart 17-4 on page 281 (Iggy text). Note positioning of the patient during procedure.
Postanesthesia Care Unit (PACU)
1.
Describe nursing responsibilities to the patient in the PACU. Refer to the textbook on postoperative care.
2.
List two priority nursing diagnoses for the patient in PACU.
3.
Identify factors that can lead to hospital acquired infections. List three practices that are in place to reduce risk of infection for the patient.
4.
Complete the perioperative clinical worksheet.

Student Name _________________________________________________ Date __________________
Preoperative Data
Initials ____ Age _____ M/F Drug Allergies _________________________________________________
Surgical Procedure _____________________________________________________________________
Medical Diagnosis ______________________________________________________________________
Medications ___________________________________________________________________________
Assessment:
CNS ___________________________________ CV __________________________________________
Resp __________________________________ GI/GU _______________________________________
MS ____________________________________ Skin ________________________________________
VS _____________________________________ Pulse Ox ______________ Pain rating (0-10) _______
IV fluids ________________________________ Anxiety level _________________________________
Teaching done? _______________________________________________________________________
Pre-procedure labs? ECG? _______________________________________________________________
Support system ________________________________________________________________________
Intraoperative Data
VS _____________________________________________________________ Pulse Ox _____________
O2 source/rate ________________________________________________________________________
Anesthetic agents administered ___________________________________________________________
IV fluids ______________________________________________________________________________
Blood products ________________________________________________________________________
Urine output _____________________________________ Suction _____________________________
Postoperative Data
O2 source/Rate/Lung Sounds _____________________________________________________________
Time __________ LOC ____________________ VS ______________________ Pulse ox ____________
Time __________ LOC ____________________ VS ______________________ Pulse ox ____________
Time __________ LOC ____________________ VS ______________________ Pulse ox ____________
Time __________ LOC ____________________ VS ______________________ Pulse ox ____________
Surgical site assessment _________________________________________________________________
IV fluids ______________________________________________________________________________
Blood products ________________________________________________________________________
Urine output ___________________________________ Drainage _______________________________
Medications __________________________________________________________________________
Pain (0-10) ___________ Anxiety __________ Discharge Instructions/Follow up ____________________
_____________________________________________________________________________________

Outpatient Surgery
During the rotation, the nursing student will complete the following in writing:
1.
Describe the difference in nursing responsibilities for the patient facing outpatient surgery and the patient facing in-hospital surgery.
2.
Explain the significance of the surgical prep and the importance of technique.
3.
Describe the technique for administering pre-op meds and the nursing responsibilities before and after administration.
4.
Prepare drug cards on all drugs administered.
5.
Discuss the nursing responsibilities of caring for the pediatric surgical patient.
6.
Assess the need for family support and education, and identify a plan for meeting this need.
7.
Explain the assessment of and documentation for patients returning to OPSU.
8.
Prepare a teaching plan for an individual having outpatient surgery.
9.
Discuss the discharge criteria to determine a patient’s readiness to go home.
10.
Examine the legal implications for the nurse in discharging patients who have received medication and/or anesthesia.

Registered Nursing Program
Definitions and Procedures
Students meet minimum requirements for the program outcomes.
Students did not meet minimum requirements for 1 or more core competencies for that program outcome. If an N is received, then the student and instructor are expected to:
1. Discuss the issue during the clinical rotation.
2. The instructor will document the discussion on the clinical formative evaluation tool.
3. The instructor will fill out the clinical warning form.
4. The student will formulate a simple remediation plan to be presented to the clinical instructor and course coordinator. (if applicable)
5. If after remediation, the student receives another N, the process will be repeated once more.
6. If the student receives 3 N’s in the same program outcome category, such as Human
Flourishing, on separate occasions during a course clinical rotation then they will receive a U for that clinical rotation and will be dismissed from the program.
Student did not demonstrate essential skills for patient safety, professional behavior, etc., as stated on page 37 in the RN Handbook. If the student participates in any of the reasons for dismissal as listed under “Unsafe clinical Practice” in the RN Handbook, they will receive a U on the clinical formative evaluation tool.

North Arkansas College
Department of Nursing
Clinical Warning Form
Student Name__________________________________ Clinical Rotation___________________
The above student has received a “Needs Improvement” evaluation from the clinical instructor. The following area(s) was/were designated as not meeting the minimal requirement.
(circle)
Human Flourishing
Nursing Judgment/Practice
Managing Care,
Spirit of Inquiry
Professional Identity
Communication,
Cultural Diversity
Safety/Quality Improvement,
Collaboration/Teamwork
Clinical Decision Making,
Professional Behavior,
Informatics,
Patient Centered Care,
Evidence Based Practice,
Clinical Reasoning
Teaching-Learning,
Legal-Ethical
Specific area needing improvement –
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Student’s plan for remediation –
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
I acknowledge that I have read and understand the above clinical evaluation.
Student____________________________________________________
Instructor__________________________________________________
Course Coordinator_________________________________________
INC 10-24-12
*Copy given to student, copy to instructor and/or course coordinator, original in student file.
Date_______________
Date_______________
Date_______________

Revised 4-12
10-24-12
North Arkansas College
Department of Nursing RN Program
Semester____________________
Course______________________ Formative Evaluation Tool
Student Name____________________________________________ Clinical Rotation_______________________________________________
S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not Applicable
Fill in Clinical Dates HERE
Communication
Uses effective therapeutic communication skills with patients, health care team, faculty and others
Actively participates in pre/post conferences
Documents appropriately in either writing or in the electronic health record
Patient Centered Care
Assess/plan for patient-family spiritual needs
Respects the individual’s personal spirituality
Assists the patient to meet their spiritual outcomes
Demonstrates compassion for others
Cultural Diversity
Respects & values diverse cultures
Provides culturally competent care
Safety/Quality Improvement
Uses standard precautions, hand hygiene and sterile technique
Administers medications using the 6 rights
Able to verbalize action, side effects, adverse reactions of medications
Recognizes and intervenes for high risk patients
Provides for a safe environment for self, others and patients
Recognizes their role in a disaster preparedness
“Identifies” quality improvement measurements
Evidence Based Practice
Utilizes the nursing process to provide patient care
Uses correct assessment techniques
Identifies appropriate nursing diagnosis
Plans patient care using current trends in health care
Performs appropriate nursing interventions
Evaluates patient outcomes and revises care as needed
Prioritizes patient care
Provides timely patient care
Demonstrates organizational skills
Completes assignments on time
Managing Care
Collaboration/Teamwork
Identifies members of the health care team (lower level)
Compares the roles of the health care team (medium)
Plans patient care with the health care team (higher level)
Provides assistance to other health care team members
Functions as a team member by demonstrating cooperativeness & displaying mutual respect

Fill in Clinical Dates HERE
Clinical Decision Making
Makes clinical judgments to ensure safe care
Uses evidence-based information to evaluate patient outcomes
Identifies problems, issues, and risks to promote health and safety
Seeks out learning opportunities
Explores alternatives to achieve patient goals
Clinical Reasoning
Questions underlying assumptions
Offers new insight to improve quality of care
Professional Behaviors
Professional appearance (uniform and hygiene)
Preparedness (comes to clinical with stethoscope, name tag, pen, etc)
Demonstrates positive attitude
Role model for others
Notifies clinical instructor of absence/tardiness per policy
Does not show pattern of tardiness/absenteeism
Accepts criticism and corrects mistakes willingly
Is self-motivated and directed
Complies with agency and program policy
Teaching and Learning
Utilizes evidence-based teaching interventions
Demonstrates mutual goal-setting
Identifies resources (physical, emotional, spiritual, etc.)
Promotes self-determination of patient and self
Informatics
Utilizes technology to provide safe patient care
Access appropriate resources to support positive patient outcomes
Legal/Ethical
Practices with in the identified role of a student nurse
Maintains confidentiality (HIPAA)
Clinical Instructor Initial HERE
Instructor Comments:
Instructor Signature:_____________________________________
Student Comments:
Date:_____________________
I acknowledge that I have read and understand the above clinical evaluation.
Student Signature:______________________________________ Date:_____________________

Revised 10-12
10-24-12
North Arkansas College
Department of Nursing RN Program
Summative Evaluation Tool
Student Name__________________________________________ Clinical
Rotation_______________________________________________
S = Satisfactory N = Needs Improvement
Communication
U = Unsatisfactory
S, N, U, NA
Semester____________________
Course______________________
NA = Not Applicable
Instructor Comments
Uses effective therapeutic communication skills with patients, health care team, faculty and others
Actively participates in pre/post conferences
Documents appropriately in either writing or in the electronic health record
Patient Centered Care
Assess/plan for patient-family spiritual needs
Respects the individual’s personal spirituality
Assists the patient to meet their spiritual outcomes
Demonstrates compassion for others
Cultural Diversity
Respects & values diverse cultures
Provides culturally competent care
Safety/Quality Improvement
Uses standard precautions, hand hygiene and sterile technique
Administers medications using the 6 rights
Able to verbalize action, side effects, adverse reactions of medications
Recognizes and intervenes for high risk patients
Provides for a safe environment for self, others and patients
Recognizes their role in a disaster preparedness
“Identifies” quality improvement measurements
Evidence Based Practice
Utilizes the nursing process to provide patient care
Uses correct assessment techniques
Identifies appropriate nursing diagnosis
Plans patient care using current trends in heath care
Performs appropriate nursing interventions
Evaluates patient outcomes and revises care as needed
Managing Care
Prioritizes patient care
Provides timely patient care
Demonstrates organizational skills
Completes assignments on time
Collaboration/Teamwork
Identifies members of the health care team (lower level)
Compares the roles of the health care team (medium)
Plans patient care with the health care team (higher level)
Provides assistance to other health care team members
Functions as a team member by demonstrating cooperativeness & displaying mutual respect

Clinical Decision Making
Makes clinical judgments to ensure safe care.
Uses evidence-based information to evaluate patient outcomes.
Identifies problems, issues, and risks to promote health and safety.
Seeks out learning opportunities
Explores alternatives to achieve patient goals
Clinical Reasoning
Questions underlying assumptions
Offers new insight to improve quality of care
Professional Behaviors
Professional appearance (uniform and hygiene)
Preparedness (comes to clinical with stethoscope, name tag, pen, etc)
Demonstrates positive attitude
Role model for others
Notifies clinical instructor of absence/tardiness per policy
Does not show pattern of tardiness/absenteeism
Accepts criticism and corrects mistakes willingly
Is self-motivated and directed
Complies with agency and program policy.
Teaching and Learning
Utilizes evidence-based teaching interventions
Demonstrates mutual goal-setting
Identifies resources (physical, emotional, spiritual, etc.)
Promotes self-determination of patient and self
Informatics
Utilizes technology to provide safe patient care
Access appropriate resources to support positive patient outcomes
Legal/Ethical
Practices with in the identified role of a student nurse
Maintains confidentiality (HIPAA)
PASS FAIL
Student Comments:
I acknowledge that I have read and understand the above clinical evaluation.
Student Signature:_______________________________________________ Date:_____________________
Instructor Signature:_____________________________________________ Date:_____________________

Date:
Fluids/Rate:
Sex: M /
F
IV site/Gauge
Age:
NORTHARK HEAD-TO-TOE ASSESSMENT
Admitting Diagnosis:
Vital Signs: Drains/Tubes
(NG, etc)
Diet / I & O:
Blood Sugar:
Skin: ☐ Intact ☐ Dry/Warm ☐ Pink ☐ Cyanotic ☐ Icteric
☐ Cool/Clammy ☐ Diaphoretic ☐ Lesions ☐ Petechiae
Head: ☐ Symmetrical ☐ Asymmetrical ☐ Masses
☐ Non-tender ☐ Tender ☐ Neck supple ☐ Full ROM
Hair: ☐ Evenly distributed ☐ Shiny luster ☐ Dry scalp
☐ Balding ☐ Scalp Lesions
Eyes: ☐ Symmetrical ☐ Asymmetrical ☐ Drainage ☐ Blind
☐ No Drainage ☐ Edema/lid tag/redness ☐ glasses/contacts
Ears: ☐ Symmetrical ☐ Asymmetrical ☐ Otorrhea
☐ Lesions/redness/tenderness/edema ☐ Hearing Aids (L,R,B)
LOC:
Gait:
☐
Speech:
☐
Awake
Oriented to:
Mental Status: ☐ Calm ☐ Anxious ☐ Fearful
☐ Depressed ☐ Other: ____________________________
Pupils: Left: ☐ Equal ☐ Reactive ☒ mm ________
Right ☐ Equal ☐ Reactive ☐ mm________
☐ Clear ☐
Shuffling
☐
☐
☐
Alert
Person
Aphasic ☐
☐
☐
Steady
Not alert
Place
Slurred
☐
☐
☐ Time ☐
Appropriate
Non-ambulatory
Situation
☐ Inappropriate
Nose: ☐ Symmetrical ☐ Nares Patent ☐ Rhinorrhea
☐ Obstruction: ____ R nare ____L nare
Mouth: ☐ Lips moist ☐ Lips dry/cracked ☐ Sores/bleeding
☐ Mucous dry ☐ Teeth missing ☐ Dentures ☐ Gums pink/intact
Head: ☐ Symmetrical ☐ Asymmetrical ☐ Masses
☐ Non-tender ☐ Tender ☐ Neck supple ☐ Full ROM
Pain Scale (circle): 0 1 2 3 4 5 6 7 8 9 10
☐ Right-handed ☐ Left-handed ☐ Unable to assess Description: ☐ No pain ☐ Sharp ☐ Pressure ☐ Dull
☐ Ache ☐ Burning ☐ Chronic ☐ Acute
IV Site: ☐ Asymptomatic ☐ Tenderness ☐ Discoloration
☐ Localized Edema
Location:
Pulses: Rate: ____ ☐ Right Radial ☐ Left Radial ☐ Apical
☐ Right Pedal ☐ Left Pedal ☐ Right Carotid ☐ Left Carotid
☐ Bruits (carotids) Right OR Left
Amplitude____ (1+ weak, 2+ strong , 3+bounding)
Rhythm: ☐ Regular ☐ Irregular
Capillary Refill: ☐ Less than 3 sec ☐ More than 3 sec
Skin Turgor: ☐ Elastic ☐ Tenting ☐ Clubbing
Edema: ☐ No Edema ☐ Edema Location: __________________
☐ Pitting Edema: ☐ 2+ ☐ 3+ ☐ 4+ ☐ Nonpitting (brawny)
Breath Sounds: ☐ Clear ☐ Crackles ☐ Rhonchi ☐ Diminished
☐ Inspiratory Wheezes ☐ Expiratory Wheeze
Location: ☐ RUL ☐ RML ☐ RLL
☐ LUL ☐ LLL
Cough: ☐ No cough ☐ Productive ☐ Non-productive ☐ Frequent
☐ Occas.
Sputum: Color: ______________ Consistency: ______________
Oxygen: ☐ Yes ☐ No Rate:_________ Delivery: __________
☐ Nasal Cannula (NC) ☐ Non-rebreather (NRB) ☐ High flow NC
☐ Vent ☐ Veni-mask ☐ CPAP ☐ Bi-Pap
Abdomen: ☐ Non-tender ☐ Tender ☐ Distended ☐ Flat
☐ Soft ☐ Firm ☐ Ascites
Bowel Sounds: ☐ Active ☐ Inactive ☐ Hypoactive ☐ Hyperactive
Quadrants: ________________________________
Voids: ☐ BRP ☐ Catheter Size: ________FR
Bladder: ☐ Distended ☐ Non-distended
Urine: ☐ Clear ☐ Yellow ☐ Amber ☐ Other:
__________________
☐ Continent ☐ Incontinent
Tube: ☐ NGT: : ☐ G-Tube
☐ Suction ☐ Clamped ☐ Intermittent ☐ Gravity ☐ Continuous
Residual: _______ml ☐ Placement checked
Formula: ______________________ Rate: _____________
Living Arrangement: ☐ Alone ☐ With spouse ☐ With children
☐ Nursing Home ☐ Assisted Living ☐ Homeless ☐ Rehab
Stoma: ☐ Colostomy ☐ Ileostomy ☐ Pink ☐ Red ☐ Blue/Black Cultural Concerns:
LBM: ________ ☐ Soft ☐ Formed ☐ Hard ☐ Loose ☐ Bloody
☐ Brown ☐ Continent ☐ Incontinent ☐ Other: ____________
Spiritual Concerns:
Occupation/Retired:
Erickson’s Stage:
General Concerns:
Site:____________ ☐ Drainage ☐ Dressing Intact ☐ Sutures ☐ Drain Tobacco/Alcohol Use or Exposure:
ROM: Upper body: ☐ Full ☐ Limited ☐ Left Side ☐ Right Side
Lower body: ☐ Full ☐ Limited ☐ Left Side ☐ Right Side
Grips/Extremity Strength: RIGHT ☐ Strong ☐ Weak ☐ Equal
LEFT ☐ Strong ☐ Weak ☐ Equal
☐ Contractures ☐ Arthritis ☐ Amputation –Location______________
☐ Splint – Location _________________________________________
Pulses distal to placement: ☐ Intact ☐ Not intact
☐ Fall Precautions ☐ Fall precaution interventions in place
Assistive Devices: ☐ Walker ☐ Cane ☐ Quad Cane ☐ Trapeze
☐ Crutches ☐ Wheelchair ☐ TED hose ☐ Flowtrons

Student Name ___________________________________________ Date______________________________
Client Age__________ Allergies__________________________________________________________________________
Date of Patient Admit/Surg_______________________________________________________ M/F_________________
CRITICAL THINKING FOR CLINICALS
Primary medical diagnosis and brief pathophysiology:
Lab/Diagnostics:
Lab: H & H_________________________WBC_______K+_______N+_______Glucose_______BUN___________________
PT, PTT,INR_______RBC_______Blood Cultures_______MIC(S/R)___________________________________________
Cardiac Markers (Troponin, CKMB)_______BNP_______D-Dimer_______Creatinine____________________________
Urinalysis____________________Ketones_______Urine Cultures_______________Myoglobin___________________
Phenytoin_________________Digoxin___________Lipase__________Amylase__________Occult Stool___________
H-pylori____________Liver Enzymes______________ABGs_______________________________________________
(try to determine if your patient was alkalotic or acidotic, why is this important?)_____________________________
HDL_______________LDL________________
*Add other lab values specific to your patient
Which ones will you continue to monitor R/T medical dx or meds?
Compare to previous draws or collections? Note any change.
Radiology )C-T scans, films, MRI, Ultrasound)? Why were these done? What were the results and how were they used to diagnose or determine treatment?
Any PRNs? Just list and note if patient has needed them.
Equipment? Vent, Monitors, Drains, Wound Vac, Foley, Bi-Pap, Pumps, Central Lines, Defibrillators, Pacemakers, Stimulators,
Implants, Prostheses or Reconstructive Hardware; Treatments? Respiratory Treatments, GI Procedures, Stress tests, etc.

Medications for Critical Thinking Clinical Assignment
Drug Name
Generic/Trade
Class Adult
Dosing
*note if specific for renal, cardiac, etc.
Routes Uses Actions Specific
Side Effects
Nursing considerations

Drug/food your patient

Interactions

Labs to monitor

Pre-Assessment

How to administer

Client teaching

Identify 2- 3 priority nursing diagnosis. One may be a psychosocial.
Nursing Diagnosis 1
(Related to AEB)
Outcome Desired Specific Interventions with rationale
(you have done to impact this outcome)
DX:
R/T:
AEB:
Nursing Diagnosis 2
(Related to AEB)
Outcome Desired
1.
Rationale:
2.
Rationale:
3.
Rationale:
4.
Rationale:
Specific Interventions with rationale
(you have done to impact this outcome)
DX:
R/T:
AEB:
Nursing Diagnosis 3
(Related to AEB)
DX:
R/T:
AEB:
Outcome Desired
1.
Rationale:
2.
Rationale:
3.
Rationale:
4.
Rationale:
Specific Interventions with rationale
(you have done to impact this outcome)
1.
Rationale:
2.
Rationale:
3.
Rationale:
4.
Rationale:
Actual Outcome observed at end of shift
Actual Outcome observed at end of shift
Actual Outcome observed at end of shift

Related Concepts
Priority Assessments
Related Labs
Priority Problems
Think Out Loud
Priority Teaching/Discharge Goals
Priority Nursing
Interventions