North Arkansas College
Nursing 2128
Medical-Surgical Nursing III
Syllabus
2013
Monday
January 14
0830-1500
Cardiovascular
Ch. 26, 28, 29, 30, 33
January 21
MLK Holiday
No classes
January 28
Tuesday
January 15
0830-1500
Wednesday
January 16
Cardiovascular Cont.
January 22
Thursday
January 17
0830-1220
Friday
January 18
Cardiovascular Cont.
50 NCLEX Questions Due
January 23
January 24
0830-1500
0830-1220
Test # 1-Ch. 26, 28, 29, 30,
33
Respiratory
Ch. 21, 23, 24, & 25
January 29
Respiratory Cont.
50 NCLEX Questions Due
January 30
January 31
January 25
February 1
0830-1220
Clinical
February 4
Clinical
February 5
February 6
1
Clinical
February 11
Clinical
Clinical
February 12
Clinical
February 13
Respiratory Cont.
50 NCLEX Questions Due
February 7
0830-1220
Respiratory Cont.
50 NCLEX Questions Due
February 14
0830-1220
Test # 2 Ch. 21, 23, 24, &
25
Ch. 31 PVD
Ch. 32 HTN
50 NCLEX Questions Due
February 8
February 15
February 18
February 19
Clinical
February 25
February 26
February 27
Clinical
Clinical
March 6
Clinical
March 13
Clinical
2
March 18
50 NCLEX Questions Due
February 28
0830-1220
Test # 3 Ch. 31, 32, & 71
Ch. 27 Dysrhythmias
50 NCLEX Questions Due
March 7
0830-1220
March 1
March 8
Ch. 43-44 – Renal
50 NCLEX Questions Due
March 12
Clinical
February 22
Ch. 71-ER
March 5
March 11
February 21
0830-1220
Clinical
Clinical
March 4
February 20
March 19
March 20
March 14
0830-1220
TEST #4-Ch, 27, 43, 44
Ch. 45, 49–Urinary
Disorders
50 NCLEX Questions Due
March 21
March 15
March 22
 Spring Break 
March 25
Clinical
(Optional ACLS)
March 26
Clinical
(Optional ACLS)
March 27
March 28
0830-1220
ACLS Simulation
Ch. 47,48-Repro-On-Line
50 NCLEX Questions Due
March 29
April 1
April 2
April 3
Preceptor Clinical Starts
(60 hours)
April 4
TEST #5-Ch 45, 47, 48, 49
Begin Neuro-Ch. 60-65
April 5
50 NCLEX Questions Due
April 8
April 9
April 10
April 16
April 17
April 18
April 19
0830-1220
Neuro (cont.)
50 NCLEX Questions Due
Precep Clinical
3
April 22
April 12
0830-1220
Cont. Neuro-Ch. 60-65
50 NCLEX Questions Due
Precep Clinical
April 15
April 11
April 23
April 24
April 25
April 26
0830-1220
TEST #6-Ch. 60-65
On-Line Module:
Eyes/Ears, Ch. 58-59
Skills Capstone Simulation
50 NCLEX Questions Due
May 2
ATI Med/Surg Predictor
Exam
50 NCLEX Questions Due
May 9
0930-1130
Med/Surg III FINAL
May 3
Finish Precep Clinical
April 29
April 30
May 1
May 6
May 7
May 8
May 10
PINNING TONIGHT
Graduation:
Tomorrow, Saturday,
May 11 at 10 a.m.
Medical -Surgical III Instructors
Amy Gipson, MSN, RN
Office Number: A100 A
Office phone: 870-391-3169
Email: agipson@northark.edu
Cell phone: 870- 736-0230
Available to students at the following time:
Monday
Clinical
Tuesday
Clinical
Office Hours:
Wednesday: 9 am - 12 pm; 1 pm- 3 pm
Thursday: 8:30 am- 3 pm (If not in class)
Friday: By appointment
Jennifer James BSN, RN
Office Number: A 100
Office phone: 870- 391-3528
Email: jjames@northark.edu
Cell phone: 501-517-2767
Available to students at the following time:
Monday
Clinical
Tuesday
Clinical
Office Hours:
Wednesday: 8:30 -3:00
Thursday: 8:30-3:00 (If not in class)
Friday: By appointment
NURSING 2128
Course Title: Nursing 2128-- Medical Surgical Nursing III
Course Description:
Medical-Surgical Nursing III provides a study of adult patients experiencing well defined
stressors related to alterations in a variety of systems. This course incorporates nursing judgment
at a higher-level thinking and focuses primarily on emergent or critical care level patients.
Professional Identity of the student is strengthened throughout this course in a variety of ways
which include leadership and management activities. The clinical and preceptor experiences are
designed to provide the student with opportunities for continued flourishing in nursing and to
encourage a spirit of inquiry assisting with the transition from student to professional nurse. The
clinical experience is provided on medical surgical nursing units in acute care facilities.
Credit and Time Allotment:
Eight semester hours
Four hours of lecture/ week
Twelve hours of clinical/ week
Placement: Second level (2nd year, 2nd semester)
Prerequisites: Nursing 1107, 1114, 1124, 1134, 2104, 2114, and Biology 2214-2224
Course Outcomes:
At the end of the course, the student will be able to:
1. Formulate effective therapeutic communication techniques to establish and maintain
therapeutic nurse-patient relationships with patients, families and significant others, small
groups of patients, and colleagues. (Measured by observation in clinical setting and written
critical thinking assignments). [Human Flourishing]
2. Use the Nursing Process to assess, plan, implement, evaluate and prioritize basic care for
critically ill adult clients. (Measured by exams and written clinical assignments).[Nursing
Judgment/Practice]
3. Support and value cultural competence while meeting the multicultural needs of critical
care patients and their families. (Measured by written clinical assignments, clinical
evaluation, and exams). [Human Flourishing]
4. Employ clinical decision making to critically think, analyze clinical problems, and
strategically plan appropriate patient centered solutions consistent with associate degree
nursing practice roles. (Measured by case scenarios, exams, clinical assignments).[Human
Flourishing and Spirit of Inquiry]
5. Use management and leadership skills to provide care for individuals, groups, and
communities in collaboration with other health care providers to ensure continuous and
holistic care. (Measure by exams, clinical instructor evaluation, and case studies).[Nursing
Judgment/Practice]
6. Examine evidence- based practice to support therapies such as ventilation, defibrillation,
dialysis, and cardiac monitors in order to identify the benefits and /or complications relating
to patient care management. (Measured by exams and critical care written
assignment).[Nursing Judgment/Practice]
7. Formulate a patient centered teaching plan to assist patients and families about their plan of
care, medical diagnosis, medication, and treatment regimen. (Measured by exams, written
clinical assignments, and clinical evaluation) [Professional Identity]
8. Apply legal, ethical, and safety considerations while providing care to their patients and
families. (Measured by exams, simulation, clinical instructor evaluation, and clinical written
assignments)[Professional Identity and Nursing Judgment/Practice]
9. Assist patient with self-management in developing and attaining realistic goals. (Measured
by exams, clinical evaluation and written critical thinking assignments.)[Professional
Identity]
10. Identify safety concerns both real and potential to initiate quality improvement through
procedural processes. (Measured by clinical written assignment, journaling, simulation, and
exams)[Nursing Judgment/Practice]
11. Inventory the use of informatics and technological advances to correspond with and support
clinical decision-making as it applies to the critically ill patients. (Measured by exams and
clinical observation)[Professional Identity and Spirit of Inquiry]
12. Evaluate the management of care in organizing delegation activities. (Measured with group
activities and clinical assignments).[Nursing Judgment/Practice]
Major Content:
Management of the client with alterations in:
-Respiratory function
-Cardiovascular, circulatory,
-Hematologic functions, Emergencies,
- IOM/QSEN safety standards,
-Infection control, Renal and urinary function,
-Reproductive issues
-Sensorineural functions
Major Learning Facilitation Activities:
Teacher:
Lecture
Audiovisual presentations
Simulation activities
Demonstrations
Portal utilization
Discussion
Internet websites of interest
Learner:
Discussion
Group presentations
Clinical experience
Portal utilization
Nursing Skills laboratory
Role Play
General Policies:
The Medical Surgical Nursing III course adheres to all policies in the Registered Nursing Program
Handbook and the Northark Student Handbook. You are responsible for knowing the information
in the Registered Nursing Program Handbook for this course.
Absenteeism:
Refer to your Registered Nursing Program Handbook.
Make-Up Exams:
1. All exams should be taken at the scheduled time.
2. The student MUST notify the instructor prior to the exam if the student is unable to take the
exam at the scheduled time. A missed examination is considered a class absence.
3. Arrangements must be made by the student as soon as possible.
4. Student may make-up ONE test only per semester at the instructor’s discretion.
5. Failure to comply with the stated requirements omits the privilege of taking a make-up test
and a zero will be given for the test not taken.
6. An alternative exam may be administered
Academic Dishonesty:
Refer to the Northark Student Handbook and the Registered Nursing Program Handbook.
Required Textbooks:
Smeltzer, S.C. & Bare, B.G. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
12th Ed., Philadelphia: Lippincott. ISBN/ISSN: 9780781785891
Syllabus for Nursing 2128-- Medical- Surgical Nursing III 2011
Registered Nursing Porgram Handbook
ATI med/surg and pharmacology
Grading:
The course grade is determined as follows:
6 Unit Exams and a comprehensive ATI---------------------70%
Comprehensive Final---------------------------------------------20%
Assignments--------------------------------------------------------10%
Students must have a passing average on unit exams and final before the written assignment
score is added. If a student has less than a passing average (79%) on unit tests and the final the
student will not progress in the program.
Students must pass the clinical component of the course in order to progress in the program. If the
student fails the clinical component with an unsatisfactory summative evaluation, the theory grade
drops to a “D” and the student cannot progress.
Students are encouraged to review unit exams within 1 week after the test was given.
Grading Scale:
A------------------------------ 91-100
B-------------------------------84-90
C-------------------------------79-83
D-------------------------------70-78
F-------------------------------69 & below
Course Requirements:
1.
2.
3.
4.
The student is expected to attend class, laboratory sessions, and clinical.
The student is expected to be prepared for classroom, laboratory activities, and clinical.
The student is expected to complete all written assignments as directed by the instructor.
The student is expected to meet course outcomes.
Classroom
Assignments
Classroom Assignments
Neuro Presentation
4%
NCLEX Questions
6%
Total
10%
NCLEX questions are to be submitted timely according to the course calendar. In addition, the
questions should correlate with the content covered as noted in the content outlines. A score of
80% must be achieved for each set of questions. Submit a printed copy of results only at the
beginning of class on the date they are due. Late questions will not be accepted. If you are using
an NCLEX review book, you must bring the book with the questions you did for instructor to
view. Fifty questions (50) are due on each of the following dates:
January 17 – Cardiovascular
January 24- Cardiovascular
January 31- Respiratory
February 7- Respiratory
February 14- Respiratory
February 21- Peripheral Vascular Disorders/ Hypertension
February 28- Emergency
March 7- Cardiovascular
March 14- Renal/Urinary
March 28- Free week
April 4- Reproduction/breast care
April 11- Neuro
April 18- Neuro
April 25- Fundamentals Review
NEURO PRESENTATIONS
Neurological disorders are to be presented in class. You may choose from the following disorders for
your presentations. You may work in groups of 2-3 people. All topics must be presented.
Huntington’s
Multiple Sclerosis
Myasthenia Gravis
Guillian Barre
Alzheimers
Parkinsons
Meningitis
Creutizfeldt-Jakob
Peripheral Neuropathy
Muschular dystrophy
ALS
Tic Douloureux
Spinal Cord Injury- Focus on discharge planning
You will have 20 minutes for your presentation. Please refer to the grading rubric for required content.
We do not want guest speakers due to time constraints.
Be creative! All groups should include a case scenario. You may act out the scenario or walk through it
with the class. However, you must apply all of the required information into your content at some point.
You may want to do a concept map in class with the students. Be prepared to answer questions from
the audience. You can develop a game or another way to get your classmates involved. You may choose
any method as long as learning occurs and your presentation follows the rubric.
I would like for you to develop a handout regarding the disease process you are covering for fellow
classmates. Please keep it to ONE page. This is to be used as a study guide.
Grading Rubric for Neuro Presentation
5 Points
4 Points
3 Points
2 Points
1 Point
Textbooks and peer
reviewed journals
Referenced at least 1
textbook and 2 peer
reviewed journals (APA)
Referenced at least 1
textbook and 1 journal
(APA Format)
Referenced at least 1
textbook and 2 journal
but did not use APA
Referenced at least
textbook or journal used
may or may not have
used APA format
Did not reference
textbook or journal
Describes disorder
and nursing
interventions,
education, and
safety
Described in detail all four
aspects including
rationales
Described at least 3
aspects including
rationales
Described at least 3
aspects and did not
include rationales
Described at least 2
aspects with or w/o
rationales
Described 1 aspect with
or w/o rationales
Identify treatments,
both
pharmacological
and non-pharm
Identified treatments
including pharm, S/A,
dose as well as detailed
information on non pharm
treatment
Identified treatments
including pharm and non
pharmacological
treatments, but did not
give specific information
on one of the two
Identified treatments
both pharm and non
pharm, but only gave
some of the details about
each such as S/A but not a
dose
Identified both pharm
and non pharm
treatments but gave
minimal details about
both
Identified either pharm
or nonpharm
treatmetments, but not
both
Use creativity, and
incorporate case
scenario
Did not just stand and
talk, but utilized other
teaching strategies, like
skits, role play, games and
had at least 1 case
scenario
Was creative using skits,
role play, games etc, but
did not have a case
scenario
Stood and talked using a
power point and had at
least 1 case scenario
Only talked about
subjects without any
audio/visuals, skits, role
play, etc. Did have at
least 1 case scenario
Talked without any
Audio/visuals, skits,
role play, games, and
did not have a case
scenario
Evidence of
teamwork and
involvement of
classmates
Work was divided equally
and all had parts. Class
was involved and
participated a lot in
teaching
Work was obviously not
equally divided among
members, but the class
did participate a lot in
teaching
Work was divided equally.
Class was minimally
involved in teaching
Work was not equally
divided and class
participated minimally
Work was not equally
divided and there was
almost no participation
from class
Learning
Modules
Assessment of Cardiovascular Function
Course Outcomes: 2, 4, 11, 12
Objectives
After completion of this chapter, the learner should be able to
1) Diagram the anatomy of the heart and examine the
conduction system to mechanical contraction
2) Evaluate cardiac action potential and its role in the
electrical stimulus in the heart.
3) Define terms: depolarization, repolarization, refractory
period, stroke volume, cardiac output/ index, preload,
afterload, contractility, ejection fraction, diastole, systole,
systemic vascular resistance (SVR), ACS
4) List factors controlling HR
5) Critically think to apply factors effecting stroke volume to
examples
6) Contrast between adult, gender, genetic, and
gerontologic heart changes
7) Assess normal cardiac rhythms.
8) Distinguish between the various types of diagnostic
evaluations
Content
Learner Activities
I.
Smeltzer, S. and Bare, B.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. 12th (Ed)
Lippincott. 2010
Anatomic and Physiologic
Overview
II.
Function of the heart: Conduction
system
A. Physiology of Cardiac Conduction
III.
Control of Heart Rate
A. Medications
B. Physiological responses
Read chp 26
IV.
Control of Stroke Volume
A. Medications
B. Physiological responses
Diagram of Heart/
Conduction of Heart
V.
Special considerations
A. Gerontologic Considerations
B. Genetic/ Gender Differences in
Cardiac Structure/ Function
VI.
Assessment
Powerpoint presentation
Audio/Visual
NCLEX review questions
Class activity –
-
critical thinking
exercises
video
teaching plan for COPD
case scenarios
lab simulation
Objectives for Management of Coronary Vascular Disorders
Course Outcomes: 1-12
Objective
Course Content
Learner Activities
After completion of this chapter, the learner should be able to
1.) Relate coronary atherosclerosis to Angina, Myocardial
Infarction, and Sudden Cardiac Death
2.) Assess multicultural considerations that effect a client’s risk
factors
3.) Evaluate the causes of Coronary Artery Disease (CAD) and
patient centered teaching regarding modifiable risk factors
using evidence based research.
4.) Critically appraise the differences between the various types
and treatments of atherosclerosis and angina
5.) Compare/ contrast various pharmacologic interventions and
safety considerations with regards to atherosclerosis, angina,
and myocardial infarction
6.) Formulate a plan of care using the nursing process in a
patient with coronary atherosclerosis and angina.
7.) Differentiate nursing interventions (pre/ post) for various
cardiac surgical interventions (ie. PTCA, Stent placement,
Atherectomy, CABG)
8.) Analyze significant EKG findings from an MI
9.) Manage and identify collaborative team members associated
with the care of the client with atherosclerosis, angina, and
acute coronary syndrome
I. Coronary Atherosclerosis
A. Pathophysiology
B. Clinical
manifestations
C. Assessment
D. Risk factors
E. Medical Management
F. Nursing
interventions
II. Angina
A. Pathophysiology
B. Clinical
manifestations
C. Assessment
D. Risk factors
E. Medical Management
F. Nursing
interventions
III. Acute Coronary
Syndrome/MI
A. Pathophysiology
B. Clinical
manifestations
C. Assessment
D. Risk factors
E. Medical Management
F. Nursing
interventions
Smeltzer, S. and Bare, B. Brunner and
Suddarth’s Textbook of MedicalSurgical Nursing. 12th (Ed) Lippincott .
2010.
Read ch. 28
Power Point
Staging
Audio/Visual
NCLEX review questions
Class Activities
-
-
12- lead key hand outs
Videos: Angina,
pharmacology of an MI,
Cardiac rehab
Case vignette on MI
Course Outcomes: 1-12
Management of Patients With
Structural, Infectious, and Inflammatory Cardiac Disorders
Objectives
After completion of this chapter, the learner should be
able to
I.
1.) Evaluate valvular disorders of the heart and
describe the pathophysiology, clinical
manifestations, and management of patients with
mitral and aortic disorders.
2.) Design a patient centered teaching plan for
patients with structural cardiac disorders using
evidence based approach.
7.) Formulate a plan of care to manage patients with
disorders in structural, infectious, and
inflammatory cardiac disorders.
Review the various types of valve repair and
replacement procedures as well as pre, post, and
home care:
a. Valvuloplasty
b. Valve Replacement
c. Septal repair
III.
Pathophysiology, clinical manifestations,
Assessment and Diagnostic Findings, Medical
Management, Nursing process with
Cardiomyopathy
a. Dilated
b. Hypertrophic
c. Restricted
d. Arrhythmogenic right ventricular
e. Unclassified
IV.
Pathophysiology, clinical manifestations,
assessment/ diagnostic findings, medical
management, nursing management related to
infectious diseases of the heart:
a. Rheumatic endocarditis
b. Infective endocarditis
c. Myocarditis
d. Pericarditis
5.) Evaluate the pathophysiology, clinical
manifestations, and management of patients with
infections of the heart.
6.) Describe the rationale for prophylactic antibiotic
therapy for patients with mitral valve prolapse,
valvular heart disease, rheumatic endocarditis,
infective endocarditis, and myocarditis.
Learner Activities
Smeltzer, S. and Bare, B. Brunner
and Suddarth’s Textbook of
Medical-Surgical Nursing. 122h
(Ed) Lippincott . 2010.
Read Ch. 29
Power Point
Audio/Visuals
II.
3.) Analyze the pathophysiology, clinical
manifestations, and management of patients with
cardiomyopathies.
4.) Examine quality improvement strategies to
improve safety concerns of acutely ill patients
with structural, infectious, and inflammatory
cardiac disorders.
Course Content
Pathophysiology, clinical manifestations,
assessment/ diagnostic findings, medical
management, nursing management of:
a. Mitral Valve Prolapse
b. Mitral Regurgitation
c. Mitral Stenosis
d. Aortic Regurgitation
e. Aortic Stenosis
f. Valvular heart disorders
NCLEX review questions
Critical thinking exericises
Class activities:
- Concept mapping
- Group discussion
- Case studies
- Lab simulation
Objectives for Management of Patients with Complications from Heart Disease
Course Outcomes: 1-12
Objectives
After completion of this chapter, the learner should be
able to
1.) Diagram the management of care for patients
with heart failure.
2.) Formulate a comprehensive teaching plan for
patients with heart failure.
3.) Analyze laboratory finding related to patients
with heart disease.
4.) Differentiate between left sided and right sided
heart failure.
5.) Explore medications used with patients who
have heart disease.
6.) Differentiate manifestations and nursing
interventions among patients who have
thromboembolism, pulmonary edema,
pericardial effusion, cardiac tamponade, and
cardiogenic shock.
7.) Justify interventions by medical personnel in
patients experiencing cardiac arrest.
8.) Examine gerontologic considerations among
patients with heart disease.
9.) Inventory medical management and nursing
interventions for patients experiencing
pericardial effusion, cardiac tamponade,
Course content
I.
Pathophysiology, clinical manifestations,
assessment/diagnostic findings, medical
management, nursing management of:
a.
b.
c.
d.
e.
f.
Heart failure
Cardiac tamponade
Thromboembolism
Pericardial effusion
Cardiogenic shock
Cardiac arrest
Learner Activities
Smeltzer, S. and Bare, B. Brunner
and Suddarth’s Textbook of
Medical-Surgical Nursing. 12th
(Ed) Lippincott . 2010.
Read ch. 30
Powerpoint presentation
Audio/Visuals
NCLEX review questions
Class activities:
- Concept mapping
- Group discussion
- Case studies
Objectives for Hematology
Course outcomes: 1-12
Objectives
After completion of this chapter, the learner should be able to
Course content
I.
II.
1.) Compare underlying pathophysiology of various anemias.
2.) Formulate a teaching plan using evidence based research,
including diet, for a client with iron deficiency anemia.
3.) Using informatics, examine guidelines for medication regimen for
a patients with various types of anemias.
III.
4.) Design a care plan for a patient with a coagulation disorder.
5.) Assess lab values of various hematologic disorders including
Leukemia, Hodgkin’s disease, and various bleeding disorders.
6.) Analyze the clotting cascade and integrate various clotting
disorders, anticoagulants, as well as blood components.
7.) Identify proper transfusion techniques, potential safety risks, and
possible reactions for various types of blood components.
8.) Debate the legal/ethical and safety aspects of refusing blood
products.
IV.
V.
VI.
VII.
VIII.
9.) Compare cultural differences regarding blood disorders.
IX.
X.
XI.
XII.
Anatomic / Physiologic Overview
Management of Hematologic Disorders
including:
a. Clinical Manifestations,
Assessment/ Diagnostic Findings,
Complications
b. Medical/ Nursing Management
Hypoproliferative Anemias
a. Iron Deficiency
b. Renal Disease
c. Aplastic
d. Megaloblastic
e. Myelodysplastic Syndromes (MDS)
Hemolytic Anemias
Polycythemias
a. Polycythemia Vera
b. Secondary Polycythemia
Leukopenia/ Neutropenia
Lymphomas
a. Hodgkin’s Disease
b. Non- Hodgkin’s
c. Multiple Myeloma
Bleeding Disorders
a. Thrombocytopenia
b. ITP
c. Platelet Defects
d. Hemophilia
Acquired Coag Disorders
a. Liver Disease
b. Vit. K Deficiency
c. Disseminated Intravascular
Coagulation (DIC)
Therapies for Blood Disorders
Procuring Blood/ Blood Products
Transfusion Complications
Learner Activities
Smeltzer, S. and Bare, B.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. 12th (Ed)
Lippincott . 2010.
Read ch. 33
Powerpoint presentation
Group activity with given
hematological disorder
Audio/Visuals
NCLEX review questions
NCLEX questions
Class activities:
- Concept mapping
- Group discussion
- Case studies
Respiratory Assessment & Management of Chest and Lower Respiratory Tract Disorders
Course Outcomes: 1-12
Outcomes
Upon completion of this chapter, the learner should be able to:
1.) Examine clients at a risk for atelectasis and nursing interventions.
2.) Compare the various lung infections with regard to causes,
manifestations, nursing management, complications, and prevention.
3.) Test the nursing process as a framework for care of the client with
pneumonia.
4.) Relate pleurisy, pleural effusion, and empyema to pulmonary
infection.
5.) Relate cultural and societal influences r/t smoking and air pollution to
lung disorders.
6.) Relate the therapeutic management techniques of acute respiratory
distress syndrome to the underlying pathophysiology of the
syndrome.
7.) Evaluate risk factors and safety concerns appropriate for prevention
and management of pulmonary embolism.
8.) Analyze the modes of therapy and related nursing management r/t
clinical decision making for patients with lung cancer.
9.) Evaluate legal/ethical dilemmas related to clients with
respiratory system cancers.
10.) Inventory the complications and nursing management of chest trauma
and their clinical manifestations.
11.) Use therapeutic communication to teach client regarding
prevention and management of pulmonary disease.
Content
Learner Activities
I. Atelectasis
Smeltzer, S. and Bare, B. Brunner and
Suddarth’s Textbook of Medical-Surgical
Nursing. 12th (Ed) Lippincott. 2010
II. Respiratory Infections
A. Pneumonia
B. Pulmonary Tuberculosis
C. Lung Abscess
D. Empyema
E. Pleurisy
F. Pleural Effusion
III. Respiratory Failure
IV. Acute Respiratory Distress
Syndrome
V. Pulmonary Disorders
A. Pulmonary Hypertension
B. Cor Pulmonale
C. Pulmonary Embolism
VI. Other pulmonary disorders
A. Pneumoconioses
B. Lung cancer
C. Trauma
1. Blunt
2. Penetrating
3. Pneumothorax
4. Cardiac Tamponade
5. Subcutaneous
Emphysema
Review Chapters 21 & 23
Power point
Audio Visual
NCLEX review questions
Staging
Class activity
critical thinking exercises
discussion questions
concept Mapping
Outcomes : 1-12
Respiratory Care Modalities
Outcomes
Content
Learner Activities
Upon completion of this chapter, the learner should be able to:
1.) Analyze the nursing management for clients receiving oxygen
therapy, intermittent positive-pressure breathing, mini-nebulizer
therapy, incentive spirometry, chest physiotherapy, and breathing
retraining.
2.) Formulate a teaching plan using therapeutic communication that
encourages self management for clients receiving oxygen therapy
in a home care setting.
3.) Evaluate the nursing management and collaboration, with other
healthcare members, of a client with an endotracheal tube and for
a client with a tracheostomy.
4.) Demonstrate tracheostomy care and suctioning.
5.) Manage the care of a client on a ventilator using the nursing
process.
6.) Examine legal/ethical and cultural considerations regarding
extubation of clients with irreversible brain injuries.
7.) Critically think to analyze the principle of chest drainage and the
nursing responsibilities using clinical decision making related to
the care of the client with a chest tube.
8.) Explore evidence based practice to support care of client with
acute pulmonary complications.
9.) Construct a teaching plan prioritizing care of pre and post
operative client having thoracic surgery.
10.) Describe the nursing care for a client with an endotracheal tube
and for a client with a tracheostomy.
11.) Demonstrate tracheostomy care and suctioning.
I. Noninvasive Therapies
A. Oxygen
1. Types of administration
2. safety
3. client education
B. IPPB
C. Nebulizer
D. Incentive Spirometry
E. Chest Physiotherapy
F. BiPAP; CPAP
Smeltzer, S. and Bare, B. Brunner and
Suddarth’s Textbook of MedicalSurgical Nursing. 12th (Ed) Lippincott.
2010
II. Airway management
A. Endotracheal intubation
B. Tracheostomy
C. Mechanical Ventilation
1. Types of vents
2. Assessment
3. Weaning
NCLEX review questions
III. Thoracic Surgery
A. Preoperative Nursing
Care
B. Postoperative Nursing care
C. Care of chest tubes
D. Application of Nursing Process
Lab – tracheostomy care, cleaning , and
suctioning
– care of chest tubes
– care of client on a ventilator
- oxygen delivery devices
- care of central lines
Read Chp 25: Respiratory Care
Modalities
Power Point
Video
Class activity
critical thinking exercises
discussion questions
concept mapping
group teaching
Lab at NARMC
Ventilator care
Management of Patients with Chronic Obstructive Pulmonary Disorders
Course Outcomes: 1-12
Outcomes
Content
Learner Activities
Upon completion of this chapter, the learner should be able to:
I. Chronic Obstructive Pulmonary Disease
Smeltzer, S. and Bare, B. Brunner
and
Suddarth’s
Textbook
of
Medical-Surgical Nursing. 12th (Ed)
Lippincott. 2010
1.) Evaluate the pathophysiology of COPD, asthma, and cystic fibrosis.
A. Pathophysiology
2.) Distinguish between the healthcare team members while planning
care for a patient with COPD, asthma, and cystic fibrosis.
B. Manifestations
3.) Examine major risk factors for developing COPD and nursing
interventions to minimize or prevent these risk factors.
C. Assessment and Diagnostics
D. Medical and nursing management.
NCLEX review questions
4.) Test the nursing process as a framework for care of the patient with
COPD.
5.) Formulate a patient centered teaching plan using therapeutic
communication designed from evidence based guidelines for a
client with COPD.
6.) Discuss major risk factors for developing COPD and nursing
interventions to minimize or prevent these risk factors.
7.) Critically evaluate risk factors related to asthmatic exacerbations.
8.) Assess the safety concerns and management of care of an acute
asthmatic exacerbation.
9.) Diagram the safety and clinical indications of medications used in
asthma management.
10.) Explore educational needs of a client with asthma as well as selfmanagement strategies.
11.) Examine the legal/ethical considerations related to genetic testing
of at risk individuals or fetuses.
Read chapter 24
II. Asthma
A. Pathophysiology
B. Manifestations
C. Assessment and Diagnostics
D. Medical and nursing Management
E. Medications
Class activity –
-
critical thinking exercises
video
teaching plan for COPD
case scenarios
lab simulation
Objectives for Assessment and Management of Patients with Vascular Disorders and Hypertension
Course obj. 1-12
Objectives
After completion of this chapter, the learner should be able to
Course content
I.
Anatomic and Physiologic
Overview
II.
Gerontologic considerations
regarding patho of vascular
system
III.
Assessment
A. Health History
B. Clinical Manifestations
C. Diagnostic Evaluation
1.) Describe the pathophysiology as it relates to the vascular system.
2.) Differentiate pathological vascular differences in the geriatric client in relation to
prevalent vascular disorders seen in this population.
3.) Using the nursing process, compare the management of care and assessment with
venous disorders and arterial disorders.
4.) Formulate a patient centered teaching plan, utilizing evidence based practice, related to
vascular disorders.
5.) Propose measures to increase safety and quality improvement in patients with an
occlusive arterial or venous diagnosis
IV.
6.) Inventory differences the nurse might find in a culturally diverse population when
assessing and teaching clients with vascular disorders
7.) Devise a plan of care that critically analyzes anticoagulant therapy
a. Arterial insufficiencies
b. Thromboangitis obiterans
(Beurger’s Disease)
c. Various Aneurysms
d. Arterial Embolism/
Thrombosis
e. Reynaud’s
f. Venous Disorders
g. Lymphatic Disorders
8.) Evaluate signs, symptoms, and management of various arterial disease processes(aneurysms, dissecting aorta, arterial embolism/thrombosis, Raynaud’s phenomenon)
9.) Identify signs, symptoms, and management of various venous disorders (deep vein
thrombosis, venous thrombosis, venous stasis, varicose veins, thrombophlebitis)
10.) Evaluate current trends involving risk factors affecting HTN
11.) Diagram various classifications of hypertension as well as follow up and
management considerations.
12.) Evaluate organ systems at risk for damage with a dx HTN
Review patho, risk factors,
prevention, clinical
manifestations, medical
management, nursing process
related to:
V.
Hypertension
A. Types, risks, patho,
assessment, clinical s/s, &
treatments
Learner Activities
Smeltzer, S. and Bare, B.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. 12th (Ed) Lippincott.
2010
Read chp 31 & 32
Powerpoint presentation
Audio/Visuals
NCLEX review questions
Class activities:
-
Concept mapping
Group discussion
Case studies
Heparin orders
Emergency Nursing
Objectives
Upon completion of this chapter, the learner should be
able to:
1.) Inventory the collaborative members and their
functions when dealing with forensic evidence
2.) Differentiate between traumatic injuries and
anticipated safety concerns.
3.) Demonstrate appropriate techniques of cervical
spine alignment in an emergency situation.
4.) Employ therapeutic communication to teach
patients regarding anaphylactic reactions and
prevention.
5.) Formulate a plan of care using evidence based
practice related to snake, spider, and/or tick
bites and possible reactions to treatments.
6.) Evaluate a variety of etiologies related to
poisonings and the anticipated findings with
assessment.
7.) Compare the dynamics of an emergency
situation from a multicultural aspect.
8.) Examine stress related illness as it relates to
legal, ethical, and safety issues in an emergency
situation.
9.) Explore management of care when dealing with
a violent or suicidal patient using clinical decision
making skills.
Course content
I.
II.
III.
IV.
V.
VI.
Collection of forensic evidence
a. Sexual assault
Injuries
a. Prevention
b. Trauma
c. Intra-abdominal
d. Crush
e. Fractures
Anaphylactic Reaction
a. Insect stings
b. Medications
Bites
a. Snake, spider, tick
Poisoning
a. Ingested
b. Carbon monoxide
c. Alcohol
Stress related
a. Violent behaviors
b. Posttraumatic stress disorder
c. Underactive, depressed and
suicidal patients
Learner Activities
Smeltzer, S. and Bare, B. Brunner and
Suddarth’s Textbook of Medical-Surgical
Nursing. 12th (Ed) Lippincott. 2010.
Read Chapter 71
Powerpoint presentation
Audio/Visuals
NCLEX review questions
Learner activities
 Concept mapping
 Group activities
 Depression scale
 Role “c spine” pt onto board
and apply cervical collar
Management of Patients with Dysrhythmias and Conduction Problems
Course Outcomes: 1-12
Objectives
After completion of this chapter, the learner should be able to
Content
I.
1.) Evaluate electrocardiogram and justify clinical decisions based on appraisal.
2.) Differentriate between the various cardiac dysrhythmias in order to manage
client care.
3.) Diagram the dysrhythmias, collaborative team members, and possible
treatments.
4.) Compare and contrast the different modalities of treatment for cardiac
dysrhythmias.
5.) Formulate a patient centered teaching plan using that enforces evidence
based care for the client with Atrial fibrillation.
6.) Test the nursing process related to management of the client with a cardiac
dysrhythmia.
7.) Design safety measures to ensure quality improvement during management
of a client experiencing cardiac arrest.
8.) Examine technological advances used to treat life threatening cardiac
dysrhythmias.
9.) Plan pre and post operative care for the client undergoing Pacemaker
placement, ICD insertion, and cardiac conduction surgery.
10.) Debate legal/ethical and safety considerations regarding patients with
implanted devices.
11.) Construct conversations using therapeutic communication with the family of
the client in cardiac arrest.
12.) Using the nursing process, prioritize the plan of care for a patient
experiencing various cardiac dysrhythmias.
Dysrhythmias
A.
Electrocardiogram
B.
Atrial dysrhythmias
C. Junctional dysrhythmias
D. Ventricular Dysrhythmias
E.
II.
Conduction Abnormalities
Learner Activities
Smeltzer, S. and Bare, B. Brunner
and Suddarth’s Textbook of
Medical-Surgical Nursing. 12th
(Ed) Lippincott. 2010
Read chp 27
Powerpoint presentation
Management of Dysrhythmias
Audio/Visuals
A.
Cardioversion
NCLEX review questions
B.
Defibrillation
C. Pacemaker therapy
D. Implantable Cardioverter
Defibrillator (ICD)
E.
Cardiac Conduction Surgery
Cardiac dysrhythmia strips
Class activities:
- Concept mapping
- Group discussion
- Case studies
- Identify dysrhythmia
strip
- Lab simulation
Management of Patients with Renal Disorders
Course Outcomes 1-12
Objectives
Upon completion of this chapter the learner should be able to:
Course content
I.
Fluid and Electrolyte
A. Review F/E disturbances
commonly seen with renal
disorders.
II.
Renal Failure
A. Chronic
B. Acute
1.) Inventory possible fluid and electrolyte disturbances seen in
clients with renal dysfunction.
2.) Differentiate between acute and chronic renal failure.
3.) Use the nursing process as a framework for the care of clients
with acute and chronic renal failure.
4.) Compare and contrast types renal replacement therapies
including hemodialysis, peritoneal dialysis, and kidney
transplantation.
III.
IV.
5.) Examine responsibilities of the different team members
involved in caring for clients with kidney disease.
6.) Identify best practice when caring for a client undergoing
kidney transplant.
7.) Debate ethical dilemmas arising from the treatments of
dialysis and kidney transplants.
8.) Use the nursing process framework for care of clients
undergoing kidney surgery.
9.) Formulate a comprehensive teaching plan for clients with
kidney disease.
Learner Activities
Smeltzer, S. and Bare, B.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. 12th (Ed) Lippincott.
2010
Read Chapter 43 & 44
Dialysis
A. Types of dialysis
Powerpoint presentation
Kidney Transplant
A. Preoperative Management
B. Postoperative
Management
NCLEX review questions
V.
Kidney Surgery Pre/Post op
VI.
Other Health Disorders R/T
Kidney Failure
A. Anemia
B. Pruritus
C. Sleep Disorders
D. Amylordosis
Lecture Capture
Evidence Based Article
Class activities:
-
Concept mapping
Group discussion
Case studies
Objectives for management of patients with Urinary Disorders and Male Reproductive Processes
Course Outcomes
1,2,4-12
Objectives
Upon completion of this chapter, the learner should be able to:
1. Interpret factors contributing to urinary tract infections and
2.
3.
4.
Formulate an evidenced based teaching plan for a client with a
urinary tract infection.
Compare and contrast pyelonephritis, glomerulonephritis, and
nephritic syndrome: causes, pathophysiology, manifestations,
management, and nursing care.
Explore types and care of urinary diversions in the frame of the
nursing process.
5.
Examine legal/ethical issues related to urinary diversions.
6.
Discuss nursing assessment of the male reproductive system and
identify diagnostic test that complement assessment.
7.
Evaluate Evidenced based treatments and causes of male sexual
dysfunction.
8.
Use the nursing process as a framework for care of clients
undergoing a prostatectomy.
9.
Identify clinical manifestations, medical and nursing management of
a client with prostate cancer.
Course content
Learner Activities
Smeltzer, S. and Bare, B. Brunner and
Suddarth’s Textbook of MedicalSurgical Nursing. 12th (Ed) Lippincott.
2010
I. Disorders of the Urinary Tract
A. Lower UTI
B. Upper UTI
1. Pyelonephritis
2. Glomerulonephritis
3. Nephrotic Syndrome
4. Urolithiasis
Read Chapter 45 & 49
Powerpoint presentation
II. Urinary Diversions
Audio/Visuals
A. Ileal Conduit
B. Nephrostomy
C. Uterostomy
D. Koch Pouch
III. Assessment of Male Reproductive
IV. Disorders of Male Sexual Dysfunction
A. Erectile Dysfunction
B. Infections
C. Conditions of the Prostate
D. Conditions affecting the
testes, penis and adjacent
structures
1. Cryptorchidism
2. Testicular Cancer
3. Penile Cancer
V. Surgical interventions and Nursing Care
NCLEX review questions
Class activities
system
-
teaching plan for UTI
-
critical thinking exercises
-
24 hour diet plan for chronic
renal failure client
Management of Patients with Female Reproductive and Breast Disorders
Course Outcomes
Objectives
Course content
Learner Activities
1-12
Upon completion of this chapter the learner should be able to:
1.) Distinguish between the signs and symptoms of the
various types of vaginal infections and the management/
treatment for each.
2.) Formulate a plan of care using clinical decision making
for clients experiencing pelvic inflammatory disease.
3.) Organize a teaching plan for clients with cystocele,
rectocele, and/or enterocele.
4.) Use the nursing process for clients undergoing a
hysterectomy, vulvectomy and oophorectomy.
5.) Compare nursing interventions for clients undergoing
radiation and chemotherapy for cancer of female
reproductive tract.
I.Infections of the Female
Reproductive System
A. Herpes virus type 2
B. Toxic Shock
C. Endocervicitis
D. Pelvic Inflammatory Disease
E. Candidiasis
F. Bacterial Vaginosis
G. Trichomoniasis
H. HPV
I. Chlamydia and Gonorrhea
J. HIV/AIDS
Smeltzer, S. and Bare, B. Brunner and
Suddarth’s Textbook of MedicalSurgical Nursing. 12th (Ed)
Lippincott. 2010
II. Structural Disorders
A. Cystocele, Rectocele
Enterocele, Prolapse
Class activities:
6.) Utilizing evidence based practice, differentiate cultural
barriers to prevention, diagnosis, and treatment of
gynecological infections.
III. Benign Tumors and conditions
A. Vulvar and Ovarian Cysts
B. Fibroids
C. Endometriosis
7.) Examine mandated reporting of various types of
reproductive infections for the purpose of safety and
quality improvement measures among communities.
IV. Benign diseases of the breast
8. Construct a teaching plan for breast self-exam for clients
9. Use the nursing process as a framework for care of the
client with breast cancer
V. Malignant Conditions –Risk
Factors, Assessment, DX, & Tx
A. Gynecological
B. Breast
Read chp 47 & 48
Online learning module
Audio/Visuals
NCLEX review questions
-
-
Concept mapping
Case studies
Teaching plans
Assessment of Neurologic System and Neurologic Dysfunction
Course Outcomes:
1, 2, 4-12
Objectives
Upon completion of this chapter, the learner should be able to:
1.) Recall the structures and functions of the central and
peripheral nervous system.
2.) Justify the significance of physical assessment to the
diagnosis of neurologic dysfunction.
3.) Inventory safety concerns as it relates to the changes in
neurologic function associated with aging.
4.) Differentiate between the technological advances in imaging
and other diagnostic tools related to the neurologic system.
5.) Examine the multiple needs of the client with altered level of
consciousness using the framework of the nursing process.
6.) Evaluate the management of care re: the early and late
clinical manifestations of increased intracranial pressure.
7.) Distinguish between collaborative healthcare team members
involved with patients with altered cerebral function.
8.) Compare the various types of seizures re: assessments and
acute and long term treatments, as well as safety measures.
9.) Organize teaching plan for patient with seizures.
10.) Manage pre and post operative care for a patient having
intracranial surgery.
11.) Explore legal and ethical issues regarding end of life care for
individuals with neurological dysfunctions.
Course content
Learner Activities
I. Anatomic and physiologic
Overview
II. Neurologic Examination
A. Health History
B. Clinical Manifestations
C. Physical Exam
D. Diagnostics
III. Altered Level of Consciousness
A. Pathophysiology
B. Manifestations
C. Assessment and
Diagnostics
D. Medical and Nursing
Management
IV. Increased Intracranial Pressure
A. Pathophysiology
B. Manifestations
C. Assessment and
Diagnostics
D. Medical and Nursing
Management
V. Intracranial Surgery
VI. Seizures
A. Types of seizures
B. Epilepsy
C. Nursing Care
VII. Legal & Ethical Issues Regarding
End-of-Life
Smeltzer, S. and Bare, B. Brunner
and Suddarth’s Textbook of
Medical-Surgical Nursing. 12th
(Ed) Lippincott . 2010.
Read ch. 60 & 61
Powerpoint presentation
Staging
NCLEX review questions
Audio/Visuals
Class activities:
- Concept mapping
- Group discussion
- Case studies
Management of Patients with Cerebrovascular Disorders & Neurologic Trauma
Course Objectives
Objectives
Course content
Learner Activities
1-12
Upon completion of this chapter, the learner should be able to:
1.) Assess and differentiate between various types of
cerebrovascular disorders.
2.) Identify the risk factors for cerebrovascular disorders and
related measure for prevention using evidence based
practice.
3.) Justify the criteria for t-PA administration and initiation of
therapy.
4.) Relate the principles of nursing management to the care
of a client in the acute stage of an ischemic and
hemorrhagice strokes.
5.) Use the nursing process as a framework for care of a
client with a cerebral aneurysm.
6.) Examine essential elements for family teaching and
preparation for home care of the stroke client.
7.) Differentiate among clients with head injuries according
to mechanism of injury, clinical sign and symptoms,
diagnostic testing, and treatment options.
8.) Use the nursing process as a framework for care of clients
with brain injury.
9.) Identify and educate the population at risk for spinal cord
injury.
10.) Manage three clinical features of the client with
neurogenic shock.
11.) Diagram the pathophysiology of autonomic dysreflexia
and describe the appropriate nursing interventions.
12.) Use the nursing process as a framework for safety and
care of client with spinal cord injury.
13.) Discuss legal/ethical considerations regarding traumatic
brain and spinal cord injuries.
I. Pathophsiology, manifestations,
assessment and diagnostics,
prevention, medical and nursing
management of the following:
A.
B.
C.
D.
Ischemic
Hemorrhagic Stroke
Head Injuries
Spinal Cord Injury
II. Brain Injury
A. concussion
B. contusion
C. Intracranial hemorrhage
Smeltzer, S. and Bare, B.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. 12th (Ed) Lippincott .
2010.
Read Chapter 62 & 63
Power Point
Audio/Visuals
NCLEX review questions
NIHSS (stroke scale)
Class Activity
- critical thinking
exercises
- Discussion
Management of Patients with Neurologic Infections, Autoimmune Disorders, and Neuropathies and
Management of Patients with Oncologic or Degenerative Neurologic Disorders
Course Objectives
Objectives
Course content
Learner Activities
1-12
Upon completion of this chapter, the learner should be able to:
1.) Differentiate using clinical reasoning, the infectious
disorders of the nervous system according to causes,
manifestations, medical care, and nursing management.
2.) Analyze the pathophysiology, clinical manifestations and
medical and nursing management of autoimmune disorders
utilizing evidence based guidelines.
3.) Select collaborative team members and their
responsibilities when treating oncologic disorders.
4.) Differentiate between brain and spinal cord tumors; their
classification, clinical manifestations, diagnosis and medical
and nursing management.
5.) Inventory safety and quality considerations involving clients
receiving chemotherapy.
6.) Use the nursing process as a framework for care of clients
with cerebral metastasis or inoperable brain tumors, and
degenerative neurologic disorders.
7.) Identify resources for clients and families with oncologic
and degenerative neurologic disorders.
8.) Debate legal ethical issues related to end of life care,
euthanasia, and genetic testing.
9.) Formulate a teaching plan using therapeutic communication
which discusses a specific neurological disorder.
10.) Examine multicultural aspects of dealing with degenerative
neurological disorders.
I. Infectious Neurologic Disorders
A. Meningitis
B. Brain Abscesses
C. Herpes Simplex
D. Fungal Encephalitis
E. Creutzfeldt-Jakob
II. Autoimmune Disorders
A. Multiple Sclerosis
B. Myasthenia Gravis
C. Guillian-Barré
D. Tic Douloureux
E. Bell’s Palsy
III. Oncologic Disorders of the Brain and
Spinal Cord
B. Assessment, Clinical
Manifestations, Management,
Diagnostics, Treatments
Iv. Degenerative Disorders
A. Parkinson’s
B. Huntington’s
C. Alzheimer’s
D. ALS
E. MD
F. Degenerative Disc
H. Herniated Disc
Smeltzer, S. and Bare, B. Brunner
and Suddarth’s Textbook of
Medical-Surgical Nursing. 12th
(Ed) Lippincott . 2010.
Read Chapter 64 & 65
Power Point
Audio/Visuals
NCLEX review questions
Class Activity
- critical thinking exercises
- Discussion
- Skits
Class presentations of a
neurological disorder and
teaching plan
Assessment and Management of Patients with Eye and Vision Disorders
Course outcomes: 1-12
Objectives
Upon completion of this chapter, the learner should be able to:
1.) Distinguish between diagnostic tests for assessment of vision
and evaluation of visual and hearing disabilities.
2.) Using the nursing process, examine the clinical features of
ocular disorders, diagnostic assessment and examinations,
medical or surgical management, and client care.
3.) Describe therapeutic effects, safety, and infection control
when using ophthalmic medications.
4.) Formulate a teaching plan for a client discharged after ocular
surgery using therapeutic techniques.
5.) Differentiate collaborative team members associated with
ocular disorders.
6.) Evaluate the manifestations that may be exhibited by a person
with a hearing disorder and communicative techniques.
7.) Differentiate problems of the external and middle ear and the
clinical manifestations, diagnosis, and management.
8.) Compare and contrast innovative technologies available to the
hearing impaired.
Course content
I. Pathophysiology, assessment,
diagnostics, treatments, nursing
management of:
A. Low Vision and Blindness
D. Glaucoma
E. Cataracts
F. Macular Degeneration
G. Conjunctivitis
H. Enucleation
I. Diabetic Retinopathy
J. Hypertensive Eye
II. Hearing Loss nursing management
and treatments
C. Gerontologic
Considerations
III. Conditions of the External Ear
A. Cerumen impaction
B. External Otitis
IV. Conditions of the Middle Ear
A. Perforation of Tympanic
Membrane
B. Otitis Media
V. Conditions of the Inner Ear
A. Meniere’s Disease
B. Vertigo
C. Ototoxicity
Learner Activities
Smeltzer, S. and Bare, B.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. 12th (Ed) Lippincott .
2010.
Read Chapter 58 & 59
On line module
Echo Capture
NCLEX review questions
Class activity
- critical thinking
exercises
- Case scenarios
Simulations
Lab Simulation
Myocardial Ischemia
Case Summary:
This case presents a patient in the Emergency Department, who is complaining of chest pain.
The student will be expected to follow the protocol for the treatment of chest pain suggestive of
ischemia. The patient complains of increasing angina and has an abnormal ECG. Students will
identify ECG rhythm and treat according to ACLS protocol. Students will delegate assignments
in the event of cardiac arrest and use therapeutic communication with family members at the
bedside. Furthermore, students will collaborate with other members of the healthcare team.
Learning Objectives:







Identifies primary nursing diagnosis
Implements patient safety measures
Evaluates patient assessment information including vital signs
Implements therapeutic communication
Implements direct communication to multidisciplinary team members
Demonstrates effective teamwork
Prioritizes and implements physician orders appropriately
Prepare for simulation by completing the following:
1.
2.
3.
4.
5.
Recall ACLS protocol
Review ECG rhythms
Know the signs and symptoms of myocardial ischemia
Understand the roles of the multidisciplinary team in the event of cardiac arrest
Review medications that are commonly used for patients with ischemia and/or cardiac
arrest
End of Course Clinical Capstone
Blood Administration- Course (or program) Competencies/ Outcomes
Upon completion of the lab simulation related to blood administration, the RN student will be able to:
Human Flourishing:
 Teach patient signs and symptoms related to blood transfusion reactions
Nursing Judgment:
 Demonstrate safe administration of blood transfusion per protocol
o This includes math
Spirit of Inquiry:
 Correctly problem solve issues and problems that may arise while giving blood
transfusions
Professional Identity:
 Properly delegate care for a patient receiving blood
Heparin Administration
Upon completion of the lab simulation related to Heparin administration, the RN student will be able
to:
Human Flourishing:
 Teach patient to monitor and watch for possible uncontrolled bleeding
Nursing Judgment:
 Demonstrate safe administration of Heparin per protocol
o This includes math
Spirit of Inquiry:
 Correctly identify and solve problems related to monitoring therapeutic PTT serum
levels
Professional Identity:
 Properly administer Heparin delivery
o 2 licensed nurses must double check protocol, dosing (math), and medication
prep
Port-a cath
Upon completion of the lab simulation related to care of a Port- a cath, the RN student will be able to:
Human Flourishing:
 Teach patient to monitor and watch for signs and symptoms related to infection
Nursing Judgment:
 Access and secure a port-a-cath using proper technique and placement
o This includes sterile technique, needle size selection, and flushing
Spirit of Inquiry:
 Correctly identify and solve problems related to monitoring potential problems related
to care of a port-a-cath
o ie- inability to flush effectively or symptoms of infection
Professional Identity:
 Properly care for accessed port-a- cath
o Assess proper placement and depth
o Dressing change recommendations
o Using filtered tubing for med/ fluid administration if indicated
o Use 10 cc NS for flushing before and after
PICC
Upon completion of the lab simulation related to use of a PICC (Peripherally Inserted Central Catheter)
Line, the RN student will be able to:
Human Flourishing:
 Teach patient to monitor and watch for signs and symptoms related to problems arising
from a PICC
Nursing Judgment:
 Properly draw labs via a PICC line per protocol as ordered
Spirit of Inquiry:
 Correctly analyze labs and give antibiotic per protocol
o Demonstrate ability to set pump correctly based on time and volume
o Use proper tubing
Professional Identity:
 Properly care for PICC
o Assess pulses, skin temp, size (may need to do upper arm circumference q shift),
pain, numbness, or tingling
o Use 10 cc syringes with 10 cc NS to flush lines and use positive pressure by
closing lumen clamp simultaneously with last push of fluid
o A pump must be used for all fluids
o Dressing change recommendations
o Using filtered tubing for med/ fluid administration as indicated
Evaluation Tool – Clinical Capstone Skills
Student _____________________________
At the end of this simulation the student should be able to meet the following objectives.
Objective
1. Safely administer blood
products.
2. Safely administer heparin per
protocol.
3. Safely draw lab specimens via
a PICC line per protocol.
4.Safely verify patency and care
for an implanted port
Skill Performed
Student Outcome
1. Checked for signed
consent
2. Obtained supplies
3. Checked blood identifiers
(2 RNs)
4. Educated client
5. Washed hands
6. Check pt ID
7. Checked baseline VS
8. Administer blood per
protocol
9. Chose normal saline as
fluid
10. Set pump at advised rate
1. Calculated loading dose
correctly.
2. Changed dose per PTT
result correctly.
3. Teach appropriately
4. Properly administer with 2
nurses double checking
math and prep
1. Properly draw blood per
protocol
2. Use 10 ml syringe to flush and
use positive pressure with last
push of fluid
1. Check patency of
implanted port
2. Perform dressing change
per protocol
3. Teach appropriately
4. Correctly identify and
solve problems related to
implanted port
Evaluators Signature _______________________________________Date___________________
Clinical Assignments
Clincial Outcomes:
Throughout the 2128 clinical rotation, the nursing student will:
1.
Examine the psychosocial aspects and community resources of caring for the critically ill patient and his/her family.
(Measured by clinical written assignment and/or reflective journaling)
[Professional Identity]
2.
Correctly assess and document changes in level of consciousness. (Measured by clinical evaluation and written
assignment)[Nursing Judgment/Practice]
3.
Describe use of and safe nursing responsibilities related to monitoring equipment (ie- ventilators, telemetry, defibrillators,
CVP and arterial lines, IV pumps, chest tubes, oxygen delivery) (Measured by simulation, written clinical assignment,
and/or post conference discussion)[Nursing Judgment/Practice]
4.
Explain nursing responsibilities for intubation and extubation, and care of a patient on a ventilator. (Measured by post
conference discussion and/or exams)[Nursing Judgment/Practice]
5.
Apply clinical reasoning to compare medications related to the critical care patient. (Measured by exam, clinical written
assignment, simulation, and clinical evaluation)[Spirit of Inquiry]
6.
Explain evidence based practice used in the treatment of dysrthymias, heart failure, ST elevation MI/ non ST MIs, coronary
artery disease, stroke, and hypertension. (Measured by post conference discussion, simulation, written clinical
assignments, and clinical instructor evaluation)[Nursing Judgment/Practice]
7.
Compare and contrast basic ABG's and ECG's and discuss appropriate interventions. (Measured by exam, written
assignment, and post conference discussion) [Nursing Judgment/Practice]
8.
Analyze nursing responsibilities for pre/ post heart catheterization. (Measured by exam and/or post conference discussion)
[Spirit of Inquiry]
9.
Formulate a patient centered teaching plan to manage the care of a home patient post heart cath and/or pacemaker
insertion patient home care instructions. (Measured by written clinical assignment and instructor clinical
evaluation)[Professional Identity]
10. Inventory patient centered care responsibilities of a pre/ post dialysis patient including safe and effective clinical decision
making regarding medication. (Measured by written clinical assignment and instructor post conference discussion)
[Nursing Judgment/Practice and Spirit of Inquiry]
11. Differentiate among various nutritional diets related to: patients on ventilators, COPD, renal disease, heart disease,
hypertension, and trauma. (Measured by exams, post conference discussion, and clinical evaluation)[Nursing
Judgment/Practice]
12. Examine and discuss legal, ethical, and cultural dilemmas for patient care in the ICU and emergency room. (Measured by
reflective journaling and/or post conference discussions)[Human Flourishing and Professional Identity]
13. Demonstrate accountability, organization, prioritization, and safe appropriate delegation in transitioning to a graduate RN.
(Measured by reflective journaling, exams, clinical written assignments, and clinical instructor evaluation)[Nursing
Judgment/Practice]
Clinical Assignments
Nurs 2128
EACH CLINICAL ASSIGNMENT IS DUE PER CLINICAL INSTRUCTOR'S
DIRECTION.
**It is the clinical instructor’s discretion whether or not to except late assignments.**
The only assignment that this does not apply to is the Critical Care assignment due to the time
involved to complete. The assignment may be turned in up to two weeks from when you last
rotated through CCU, CSICU, or MICU.
Journaling
A reflective journal is meant for the writer to be able to think back about an experience learn
about the meaning of the experience. As nursing students, journaling can help you learn about
yourself, a disease process, discover holistic approach to nursing, how to really find value and
demonstrate care to a patient or their family, discover mistakes and make corrections. Journaling
will teach you how to internalize your learning and make it real.
For each clinical date you are to keep a journal. The journal is due every two weeks beginning
two weeks after the start of clinical. Submit your journal to your clinical instructor.
Guidelines:
 You may either handwrite or type the entry.
 No need to write a book; unless you need to.
 Ideas about entries:
o New skills practiced or attempted
o RN professional practices that you noticed
o Your thoughts and feelings in regard to your actions or another's actions, and
interactions you noticed between staff and between staff and patients
o Give examples of caring expressions, either by you or someone else
o Document ethical, cultural, legal encounters you experience and interventions
o Discuss organization, prioritization, and delegation related to patient care
o Discuss how you used therapeutic communication and collaboration in relation to
a patient situations
o What did you learn about social services and community resources
If you need help with learning how to journal, try this help out:
S- Subjective - how you felt about todays clinical
O-Objective - brief account of skills
A- Assessment - of how you did
P- Plan- for improvement or change
Critical Care Written Assignment
**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- intervention.
2. Explain how to evaluate the level of consciousness of a critically ill patient. (Refer to
Brunner 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 dxinterventions.
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
OUTPATIENT SURGERY WRITTEN
ASSIGNMENT
During the rotation, the nursing student will complete the following 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.
CARDIAC REHAB WRITTEN ASSIGNMENTS
During the rotation, the student will complete the following in writing:
1.
What are some goals or objectives of a cardiac rehab program?
2.
What are the criteria for admission to a rehab program?
3.
Describe the progression in a cardiac rehab program.
4.
When is a client discharged from a rehab program?
5.
Prepare a teaching plan for a cardiac rehab client. Consider issues such as, emotional
support, home exercise, diet, smoking, medications, sex, heart disease, and compliance.
CARDIAC CATH LAB WRITTEN
ASSIGNMENT
1. Evaluate nursing responsibilities for pre- op prior to heart cath. Be sure to include:
important considerations for patient history, current medication, known allergies.
2. Prioritize nursing interventions post heart cath.
3. Design a discharge teaching plan for a post cardiac cath pt.
4. List several surgeries the cath lab performs. Give a brief description of each.
5. Describe the nursing care of a client in cath lab.
6. Discuss personnel involved in the cath lab. What are their roles in relation to the patient?
Teaching Plan for Post Heart Catheter or
Pacemaker
1. Describe the post surgical assessment of a patient coming from the cardiac cath lab.
2. What are nursing interventions associated with post procedural heart cath and/or
pacemaker placement?
3. Prepare a teaching plan for a patient being discharged home after a heart cath and/or
pacemaker placement. Include diet, activity, assistance needed, medications, dressing
changes, signs and symptoms of potential problems associated with procedure, when
to call physician or go to the ED, and follow up appointments.
4. Identify barriers to learning.
5. Discuss community services available to assist patient upon discharge.
HEMODIALYSIS WRITTEN ASSIGNMENT
1. Define dialysis and explain three types: hemodialysis, peritoneal dialysis, continuous
ambulatory peritoneal dialysis (CAPD).
2. Create a table. Write a list of meds that can/ cannot be given prior to dialysis. Explain
why3. Identify the major routes of vascular access for grafts and fistulas.
4. What are the nursing responsibilities of the dialysis nurse?
5. Which labs need to be monitored before, during, and after dialysis treatment? What are
you watching for? Give an example of potential labs prior to and after dialysis treatment.
6. List nutritional needs and rationales for patients on dialysis. What would you teach the
patient/ family about their diet?
7. Identify psychosocial needs of the patient on dialysis. What community resources would
be available to them and their family?
EMERGENCY DEPARTMENT WRITTEN
ASSIGNMENT
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.
CHARGE NURSE ROTATION WRITTEN
ASSIGNMENT
1.
Describe the utilization of the nursing process in the role of charge nurse.
2.
Define responsibilities of the charge nurse.
3.
Identify the knowledge and skills needed by the charge nurse to function
effectively.
4.
Describe how a charge nurse organizes his/her time, prioritizes, and delegates
either assignments or patient care.
TEAM LEADING ROTATION WRITTEN
ASSIGNMENT
1.
Describe utilization of the nursing process in the role of Team Leader.
2.
Analyze the responsibilities of the Team Leader.
3.
Differentiate team leading from primary nursing.
4.
Create and evaluate assignments for other students and explain the reasoning for
the assignments.
Assessment and Management of Problems
Related to Male Reproductive Processes
Joe Smith, 55-year-old patient is admitted to the surgical unit after robotic-assisted laparoscopic radical
prostatectomy with nerve sparring for early stage cancerous tumor confined to the prostate. The client has
six small incisions in the abdomen with small 4x4 dressings with clear dressing dry and intact. The client
has a JP drain in place with clear, red-colored drainage with 50 mL present and an indwelling urinary
catheter draining clear, red-colored urine. The surgeon ordered ketorolac (Toradol) for pain management
and belladonna and opiate (B&O) suppository every 8 hours as needed for bladder spasms.
What nursing care should be provided to the client in the immediate postoperative period?
What potential complications should the nurse observe for, and what actions should the nurse take
if the complication develops?
The surgeon removes the JP drain the next day and discharges the client with the indwelling
urinary catheter to a leg bag. What discharge instructions should the nurse provide the client?
What follow-up care is anticipated for the client?
Optional Activity:
Have students view the following Web site with OR: live, online surgery of a client receiving the roboticassisted laparoscopic radical prostatectomy: http://orlive.com/archives/index.cfm?event=ProcedureRslts&id=37 .
Reference
Smeltzer, S.C. & Bare, B.G. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 12th
Ed., Philadelphia: Lippincott.
Management of Patients with Neurologic Trauma
Melvin Strong, a 19-year-old patient, presents to the emergency department after being ejected from an
automobile. He has a back board with a cervical collar in place. The EMT stated that when he saw the
patient, the patient was unconscious but quickly gained consciousness and was oriented x 3, talking, and
able to move all 4 extremities. Within five minutes, the patient became unable to be aroused, opened his
eyes only to painful stimuli, made incomprehensible sounds, and withdrew from pain. The vital signs are
T: 100°F, BP 180/50, HR 50 bpm, 14 breaths per minute. The left antecubital intravenous site has NS at
125 mL/h. The EMT stated that the patient complained of a severe headache and had an episode of
projectile vomiting before the neurologic decline. The patient’s breathe smells like alcohol. When the
patient arrived, the nurse noted that the patient’s pupils were unequal — the right pupil was larger than
the left pupil — but both pupils reacted to light accommodation.
What do the assessment findings suggest?
What signs and symptoms do the patient exhibit related to increased intracranial pressure?
What medical and surgical treatment does the nurse anticipate for the patient?
What GCS did the patient have initially at the scene of the accident? What GCS did the patient
have when he began deteriorating neurologically?
What nursing interventions should the nurse provide?
Reference
Smeltzer, S.C. & Bare, B.G. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 12th
Ed., Philadelphia: Lippincott.
Management of Patients with Neurologic
Infections, Autoimmune Disorders, and
Neuropathies
Brian Jones, a 22-year-old college student, is admitted from the emergency department to a medicalsurgical unit with the diagnosis of acute bacterial meningitis. The patient presented with the following
vital signs: T: 104°F, BP: 110/70, P: 100 bpm, 20 breaths per minute. The patient presented with a severe,
constant headache and nuchal rigidity.
To what room should the charge nurse assign the patient?
What additional signs and symptoms could a patient diagnosed with bacterial meningitis exhibit?
What diagnostic and lab tests are used to confirm the diagnosis of meningitis?
What medical management should the nurse anticipate for the patient?
What nursing care should be provided for the patient?
Reference
Smeltzer, S.C. & Bare, B.G. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 12th
Ed., Philadelphia: Lippincott.
Independent
Clinical
Practicum
To Our Nurse Preceptors
On behalf of North Arkansas College, the Department of Nursing, Nursing faculty and
students, thank you for your willingness to serve as Nurse Preceptor for students in the final
semester of the Associate Degree Nursing Program.
This Independent Clinical Practicum allows students to apply their cumulative
knowledge and skills in preparation for assuming their future responsibilities as Registered
Nurses. It is important that this 1:1 clinical experience is with RN preceptors who provide direct,
holistic, patient care. We appreciate the effort and energy necessary to accept this volunteer
role in addition to your current work load. Thank you!
Each student will complete 60 hours in a medical-surgical area during the last six weeks
of the semester. Responsibilities for preceptors, faculty, and students are delineated in the
Preceptor Handbook. The mission and philosophy of the Nursing Program is included.
Faculty supports the Independent Clinical Practicum experience and will be available to
the Nurse Preceptor by phone or e-mail. Contact information for specific faculty is available
elsewhere in this packet. The Department of Nursing phone number is 870-391-3270.
The Nursing Program strives to create a learning environment where students can
flourish. We believe you are an important part of this process and want to ensure that this is a
positive experience for you and your agency.
Sincerely,
Cindy Mayo, RN, MSN
Dean of Nursing and Allied Health
North Arkansas College
1515 Pioneer Dr.
Harrison, AR 72601
North Arkansas College
Department of Nursing
Independent Clinical Practicum
Purpose:
An independent clinical practicum provides the nursing student an opportunity to
enhance clinical skills and meet course outcomes with a preceptor whose expertise relates
to the course content.
Selection of Nurse Preceptor:

The Nurse Preceptor must have a minimum of one year of experience in the area in which
the student is precepting.

The Nurse Preceptor should be selected on the basis of excellent clinical skills, expertise in
the clinical specialty area, and a willingness to teach a nursing student.

The Nurse Preceptor must have a current unencumbered RN license.

The Nurse Preceptor must be approved by the agency’s education department and/or the
clinical manager.

A BSN degree or higher is preferred, however, a Registered Nurse meeting the above
criteria and willing to serve as a preceptor is acceptable.
Desired Characteristics of a Nurse Preceptor
Interpersonal Skills

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Clinical Skills
Communicates knowledge to others
Receptive to students and questions
Promotes autonomy in students
Confident and self-directed
Appropriately manages conflict
Demonstrates patience and integrity
 Relates scientific rationales for nursing practice
 Provides current evidence-based nursing care
 Exhibits competence and safety
 Practices problem solving
 Explores appropriate alternatives in providing care
 Communicates complex concepts in simple terms
Professional Role Model

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Demonstrates desirable caring behaviors, attitudes, and values
Respectful of others
Plans learning opportunities for students
Advocates for quality care
Nurse Preceptor Responsibilities:

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

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Sign an agreement which states the purpose of the clinical is to provide the student with
additional learning/experience related to the course.
Recognize that the student will not have a clinical instructor “on site”.
Allow the student to participate in nursing activities at the discretion of the Nurse
Preceptor.
Precept only one student per shift.
Review student’s written outcomes and facilitate learning through selection of
appropriate assignments to meet those outcomes.
Supervise and mentor the student in the clinical area without monetary reimbursement.
Give the student daily specific comments on performance during the clinical experience.
Confer with the ADN faculty regarding the student’s performance as needed.
Participate with faculty in a written evaluation of the student.
Contact the designated course faculty should any questions or concerns arise regarding
the student or a given situation. Contact faculty immediately if a sentinel event occurs.
Contact the student if there is a change in the planned schedule (illness, low census, etc.)
Serve as a mentor, supervisor and role model for the nursing student:
o Quiz the student about knowledge of the medical diagnoses, medications, lab
reports, tests, and appropriate teaching needs.
o Guide the student during the clinical practicum.
o Direct the student’s activities.
o Verbalize critical thinking, clinical judgment, and rationales for decisions
in managing client care.
Agree to be evaluated by the student at the end of the practicum.