Table of Contents
Table of Contents:
Course Description
Entry /Exit Competencies
Unit Hours
Prerequisites
Course Placement
Required Texts/Resources
Learning Activities
Student Learning Outcomes
Course Objectives
Clinical Objectives
Faculty Responsibilities
Student Responsibilities/Personal Data Device
Student-Faculty Communication
Attendance Policy/Simulation
Standards of Conduct
Disciplinary Action
Evaluation of Clinical Performance
Methods of Instruction
Methods of Evaluation
ATI – Testing Invoice
Grading Policy/Examinations
Examinations/Distribution of Grades
Guidelines for Assignments
Article Critique Guideline
Article Critique Grade sheet
Cardiac Assignment Guideline
Cardiac Assignment Grade sheet
Module Objectives:
Leadership & Management IA
Leadership & Management IB – Disaster
O2CO2 IVA – Respiratory
O2CO2 IVB - Cardiovascular
Pre Test Code Blue Simulation
Post Test Code Blue Simulation
Physical Integrity IVA – Trauma/MOF
Excretory Need IV – Renal
21-23
24-25
26-32
33-47
42
44
48-49
50-56
Appendixes: A
B
C
D
E
F
57-60
61-65
66
67
68-69
70
Anecdotal Notes
APA Format
Geri Log
ICU RN Checklist
ICU nursing flow sheet (2 pages)
RN Guide – Provider of Care
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1
3
3
3
3
3
3-4
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4
4
5-6
7
7
8
8
9
10
13
13
13
14
15
16
17
17
18
19
20
G Manager of Care Evaluation
H Health and Nursing Resources
I ABG Practice
J Practice Math Questions
K Grading Summary Sheet
L NCLEX Information
M ATI INFORMATION
N Class Schedule
Clinical Evaluation Tool (handout-14 pages)
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71
72-74
75
76-77
78
79
81
84
N 254 COURSE DESCRIPTION:
This course focuses on pathophysiologic concepts and nursing management essential to
critical care and emergency nursing. Clients with acute and chronic cardiopulmonary,
hepatic, renal, and multi-system failure will be selected for critical care clinical
experiences. Leadership and management skills are introduced and applied in the clinical
setting. Students apply the nursing process and prioritize nursing care for a group of
clients with multiple need imbalances. The role of the nurse in the management of client
care following a disaster is presented
N 254 ENTRY COMPETENCIES:
Ability to complete a nursing physical assessment. Knowledge of the pathophysiology of
the cardiac, respiratory, renal, musculoskeletal, and peripheral vascular systems.
Knowledge of the nursing responsibilities associated with the common abnormalities of
the cardiac, respiratory, renal, musculoskeletal, and peripheral vascular systems.
Knowledge of the nursing responsibilities associated with the care of clients with
electrolyte imbalances, pain management, hematology, oncology, gastrointestinal,
maternal/gynecological, pediatric, growth and developmental and psychosocial needs.
N 254 EXIT COMPETENCIES:
A comprehensive exit exam is required of all senior students completing the nursing
program. Students take this exam upon passing Nursing 254 and must achieve a
satisfactorily passing score prior to completing Nursing 255. If a student does not meet
the passing score on this examination after two attempts he or she will be given an
incomplete for N255. (See ECC Nursing Student Handbook 2009-2010)??
N 254 7 UNIT HOURS:
This is a seven-unit nursing course, consisting of lecture and lab.
N 254 PREREQUISITES:
Successful completion of all previous nursing courses.
N 254 COURSE PLACEMENT:
This course is offered in the final semester of nursing.
N 254 REQUIRED TEXTS/EQUIPMENT:
Aschenbrenner, D., Cleveland, L.W., & Venable, S.J. (2007). Drug therapy in nursing.
Philadelphia: Lippincott, Williams, and Wilkins.
Chernecky, C. & Berger, B. (2004). Laboratory Test & Diagnostic Procedures (4th ed.).
St. Louis: Saunders.
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Corwin, E. J. (2007). Handbook of pathophysiology (2nd or 3rd ed.). Philadelphia:
Lippincott.
Deglin, J.H. & Vallerand, A.H. (2009). Davis’s drug guide for nurses (11th ed.).
Philadelphia: F.A. Davis Co.
Dudek, S. (2006). Nutrition handbook for nursing practice (5th ed.). Philadelphia:
Lippincott.
Monahan, F. D., Sands, J.K., Marek, J.F. Neighbors, M., & Green, C. (2007). Phipps
medical-surgical nursing health and illness perspectives (8th ed.). St. Louis:
Mosby.
Pickar,G. (2007). Dosage calculations (8th ed.). Clifton Park, NY: DelMar.
Potter, P. A. & Perry, A.G. (2005). Fundamentals of nursing, concepts, process, and
practice (6th ed.). St. Louis: Mosby.
Preusser, B.A. (2005). Critical thinking in medical-surgical settings: A case study
approach. (4thd ed.). St. Louis: Elsevier Mosby.
Tappen, S.A., Weiss, S.A. & Whitehead, D.K. (2007). Essentials of nursing leadership
and management (5th ed.). Philadelphia: F. A. Davis Co.
Seven Par Score Answer Sheets (# F-1712-PAR-2) required for testing.
N 254 LEARNING ACTIVITIES:
See individual lecture objectives.
N 254 STUDENT LEARNING OUTCOMES:
At the end of Nursing 254 the student will begin to model effective leadership and team
member behaviors while prioritizing nursing care for a group of clients with multiple
need imbalances.
N 254 COURSE OBJECTIVES:
At the completion of this course, the student will demonstrate the following objectives:
1. Utilize the principles of leadership and management in providing nursing care
of a selected group of hospitalized clients.
2. Apply the pathophysiologic concepts for selected cardiovascular, hepatic,
respiratory, and renal disorders and utilize the nursing process in the provision
the victims of a disaster.
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3. Evaluate clinical findings and the rationale for intervention in planning
nursing care for a selected group of clients with multiple need imbalances.
4. Execute nursing procedures according to established standards of critical care,
emergency, and disaster nursing.
5. Apply the principles of pharmacology in the care of clients with multiple need
imbalances.
6. Correlate laboratory values with the appropriate nursing interventions for
clients with multiple need imbalances.
7. Apply legal and ethical guidelines to the care of clients with multiple need
imbalances.
8. Apply nursing care to a group of clients in both intensive care units and the
emergency room with multiple need imbalances.
9. Prioritize nursing interventions for the victims of a disaster.
N 254 CLINICAL OBJECTIVES:
Role as Member within the Discipline of Nursing/Role as Student Nurse
1. Prioritize care for:
a. one critical care patient in the
ICU/CVICU/PCU UNIT
b. three patients in the
i. DOU/AOU UNIT AND MEDICAL-SURGICAL FLOOR
ii one patient undergoing pre/post angio catheterization
iii a group of three to four patients in the ER
c. patients undergoing dialysis
i. hemodialysis/peritoneal dialysis
2. Perform a comprehensive health assessment for all assigned
hospitalized patients, including health history, physical assessment,
structural variables, and nursing diagnosis pertinent to the admitting
diagnosis.
a. Assess baseline/update vital signs
i. Utilize a variety of pain scales
ii. Assess patients with cardiovascular dysfunctions and
compare with normative data
iii. Assess patients with respiratory dysfunctions and compare
with normative data
b. Complete shift am/pm assessment according to agency protocol
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3. Interpret labs and V/S before/after administering medications
4. Initiate/update nursing diagnosis based on data gathered for all
patients according to agency protocol
a. Verbalize and correlate pathophysiology with nursing diagnosis
b. Verbalize and correlate pathophysiology with medical diagnosis
5. Review and interpret laboratory values for each assigned patient and modify
nursing care according to the results
a. Chemistry panel
b. Albumin
c. Pre albumin
d. Glucose
e. HDL/LDL
f. VLDL
g. TSH/T-4
h. CBC
i. WBC with differential
j. Cardiac enzymes (Troponin, LDH, CPK, CPK-MB)
k. Renal panel (Bun/Creat)
l. ABGs
m. Coagulation studies: PT/PTT/INR
n. Cardiac diagnostic tests
o. Hemodynamic monitoring/related pathophysiology/normal values
p. Angiogram
6. Check crash cart and identify all items
7. Monitor and maintain oxygenation needs for patients
a. FiO2
b. Closed suctioning
c. Endotracheal tube
d. Ventilator
e. Chest tube(s)
Role as Manager of Care
1. Implement National Patient Safety Goals in the hospital setting during patient care.
2. Participate in disaster drill activities (Drill & preparation prior to drill)
2. Coordinate a patient care conference
3. Complete the following for at least one patient:
a. Admission
b. Discharge
c. Transfer patients (as available)
d. Preparation for test(s)/surgery
e. Receive patients from test(s)/surgery.
4. Complete leadership assignment as designated by clinical instructor
5. Delegate and evaluate patient care provided by assistive personnel in a
timely manner
6. Arrange appropriate channels of communication related to patient care
with the following individuals:
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a. Safe patient handoff
b. Staff nurse (receive/provide/update report)
c. Physician/PA/NP (Primary care provider)
7. Deliver patient care in a cost-effective manner
8. Participate in a mock code; identify the different nursing roles.
N 254 FACULTY RESPONSIBILITIES:
The role of the teacher will be to facilitate the learning process and to motivate,
encourage, and advise the student in the classroom and clinical setting. Faculty will
present weekly lectures. Faculty will be available to students during office hours.
N 254 STUDENT RESPONSIBILITIES:
Students will be responsible for arriving to lecture and clinical on time, having completed
reading assignments. Students will be responsible for reviewing previously learned
material for class. Students are encouraged to take an active role in their own teaching.
The student is responsible for demonstrating all behavioral objectives of the course.
Clinical evaluation is based on demonstrated ability to achieve all course objectives by
the last day of classes. Course expectations include attendance and experiential learning.
The student is expected to utilize the library, learning resource center, and the CAI lab.
The student is also expected to arrive at the clinical agency in proper attire and prepared
to meet specific objectives. The student is expected to focus on meeting objectives while
attending clinic.
N254 PERSONAL DATA DEVICE POLICY:
Use of Personal Data Devices will enable students the ability to use Personal Data
Devices (PDA’s), Palm Pilots, iPhones, and other electronic devices for accessing clinical
related references, while providing focused patient with optimum patient privacy
according to HIPPA regulations.
 Personal electronic devices at no time shall store, copy, or photograph any
Personal Health Information (PHI) from the clinical facility. This is a direct
violation of HIPPA regulations on patient privacy. Students found in violation of
this will receive an unsatisfactory for the entire course.

Students will have the ability to utilize personal electronic devices when allowed
by their clinical facility, solely for the purpose of attaining patient related data
from texts and references on their device.

Students shall not utilize personal devices as telephones, texting devices or
cameras in the patient care areas.
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
Any student using an electronic device must show their clinical instructor the
reference material on their device. Access to the internet is not sufficient reason
to use an electronic device.

Any repeated offense using electronic device inappropriately in the clinical setting
will result in an “unsatisfactory” clinical evaluation in the area of professionalism.
Students will be ineligible for the director’s award, will have a record of such
offense in their academic file and will receive a failing grade for the nursing
course.
The student must fill out appropriate forms prior to use and meet with their clinical
instructor per policy.
N 254 STUDENT-FACULTY COMMUNICATION:
Faculty office hours for full-time faculty are posted on faculty offices. For the didactic
component of the course, students should communicate with the lecturer. For the clinical
component of the course, students should communicate with the clinical instructor(s).
Students are expected to contact the lead instructor if they are unable to resolve an issue
with their clinical instructor. All students and faculty have El Camino College E-mail
addresses.
N 254 ATTENDANCE POLICY:
Course expectations include attendance and experiential learning. Punctuality is a
professional expectation. Students MUST notify the assigned clinical unit/instructor of
an anticipated absence or tardy at least one hour prior to their scheduled time. If a student
is unable to take an exam as scheduled (due to illness or emergency), the student must
notify the faculty member and/or nursing department immediately. No make up tests are
allowed. The student must provide the faculty with documentation to validate the
absence. If the documentation is inappropriate or invalid, the student will be dropped
officially from the class.
Due to El Camino College insurance requirements, students must pay tuition before
beginning clinical courses. Students will not be permitted to attend courses in which
they are not enrolled. Proof of payment must be provided to the instructor during the first
week of class.
Course expectations include attendance and experiential learning. Punctuality is a
professional expectation. Two (2) times late to class/clinic will be counted as one
absence. “Clinical practice must be sufficient to meet course objectives and standards of
competent performance” (CCR 1443.5). Faculty will evaluate extenuating circumstances
on an individual basis. Students MUST notify the assigned clinical unit/instructor of and
anticipated absence or tardy at least one-half hour prior to their scheduled time.
If a student is unable to take an exam as scheduled (due to illness or emergency), the
student must notify the faculty member or nursing office (310) 660-3281 immediately. A
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make-up test must be arranged and completed by the student prior to attending clinical or
the next scheduled lecture. The student must provide the faculty with documentation to
validate the absence. If the documentation is inappropriate or invalid, the student will
receive a grade of “F” for the exam.
Simulation Policy
Opportunities will be provided for students to participate in the simulation lab and it is
considered part of your clinical experience. It is incumbent upon the student to arrive
promptly for simulation lab as it is considered of equal value to a clinical day. Tardiness
to simulation lab will necessitate making up the simulation day on a non-clinical day to
be assigned by the simulation lab coordinator. The makeup simulation day assigned will
be non-negotiable. The clinical instructor will initiate a CIP for unprofessional behavior.
The student will be required to complete a Simulation Assignment Due to Tardiness
paper that will be due to the simulation facilitator at the end of the simulation day.
N 254 STANDARDS OF STUDENT CONDUCT Board Policy 5138
(See 2009-2010 ECC Catalog)
Attendance
Attendance during Semester
Regular attendance is expected of every student. A student may be dropped from class
when the number of hours absent exceeds the number of units assigned to the course.
However, it is ultimately the responsibility of the student to officially drop the class. This
rule also applies to excessive absences due to illness or medical treatment. The student
who has been absent due to illness or medical appointment must explain the absence
directly to the instructor. The student who has been absent due to a communicable
disease or quarantine must report directly to the Health Center for clearance before
returning to classes.
I. Standards of Conduct
A. General Policy
Conduct at El Camino College must conform to the laws of the State of California,
District policies, and campus rules and regulations. The El Camino College faculty, staff
and administration are dedicated to maintaining an optimal learning environment; the
standards of behavior as outlined in this policy are essential to the maintenance of a
quality college environment. These standards will apply to all students on campus, other
college property or while attending any college-sponsored event. Violation of such laws,
policies, rules and regulations or behavior adversely affecting suitability as a student, will
lead to disciplinary action. Disciplinary actions as noted in Section II may be taken
against any person who engages in behavior defined as misconduct as listed in Section B.
B. Misconduct
1. Dishonesty, including but not limited to cheating, plagiarism or knowingly furnishing
false information to the College.
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2. Forgery, alteration, or misuse of college documents, records, or identification.
3. Continued disruptive behavior, continued willful disobedience, profanity or vulgarity,
or continued defiance of the authority of, or abuse of, college personnel or to anyone on
campus.
4. Participation in hazing or commitment of any act that tends to injure, degrade or
disgrace a student or college personnel.
5. Obstruction or disruption of teaching, research, administration, disciplinary
proceedings, or other authorized college activities including but not limited to its
community service functions or to authorized activities held off campus. Obstruction or
disruption includes but is not limited to the use of skateboards, bicycles, radios, and roller
skates.
6. Persistent, serious misconduct not listed in Items
II. Disciplinary Action
Disciplinary action appropriate to the misconduct as defined above may be taken by an
instructor (see Items II, B-1 and 5 below), the Dean of Student Services or his or her
designee (see Items II, B-1, 2, 3, 4, 6 and 7 below), and the Board of Trustees (see Item II
B-8 below).
B. Discipline
The following types of disciplinary action may be taken or pursued by the college:
1. Warning - A verbal or written notice, given to the student by a faculty member, the
Dean of Student Services or any college manager that continuation or repetition of the
specified conduct may be cause for other disciplinary action.
2. Reprimand - A written reprimand for violation of specified regulations sent to the
student by the Dean of Student Services, noting that continued violations may result in
further disciplinary action. The Dean of Student Services shall place a copy of this
reprimand in the student file.
3. Removal by Instructor - In addition to an instructor’s right to drop a student
permanently from a class when the student is no longer participating i.e. lack of
attendance in the course, an instructor may remove (suspend) a student from his or her
class for the day of the incident and the next class meeting. During this period of
removal, a conference should be held with the instructor and the student to attempt to
resolve the situation that led to the student’s removal and the student shall not be returned
to the class from which he or she was removed without the concurrence of the instructor
of the class.
If a student is suspended for one class meeting, no additional formal disciplinary
procedures are necessary.
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If a student is suspended from class for the day of the incident and the next class
meeting, the instructor shall send a written report of the action to his or her dean who
shall forward this information to the Dean of Student Services, the Vice President of
Student Services, and the President. If the student removed by an instructor is a minor,
the President’s designee (Dean of Student Services) shall ask a parent or guardian of the
student to attend a parent conference regarding the removal as soon as possible. If the
instructor or the parent or guardian so requests, a college administrator shall attend the
conference.
The instructor may recommend to his or her dean that a student be suspended for
longer than two class meetings. If the dean, instructor and student cannot resolve the
problem, the suspension will be referred to the President or the President’s designee
(Dean of Student Services) for possible actions described in Section 6 of this item. 6.
Suspension- The President or the President’s designee (Dean of Student Services) may
suspend a student as follows:
a. From one or more classes for a period of up to ten days of instruction; or
b. From one or more classes for the remainder of the term; or
c. From one or more classes and activities of the community college for one or more
terms. The Dean of Student Services shall send the notice of suspension to the student,
the student file, the Vice President of Student Services, the President of the College and
the Campus Police. Whenever a minor is suspended from the College, the parent or
guardian shall be notified in writing by the President or the President’s designee (Dean of
Student Services).
d. During the period following the initial suspension from class for the day of the incident
and the following class meeting, the student shall be allowed to return to the class until
due process and the disciplinary procedures are completed unless the student is further
suspended as a result of actions taken as defined in Section 6 of this item.
Cheating or Plagiarism
Cheating violates Section I.B.1 of El Camino College’s Board Policy 5138, Standards of
Student Conduct.
The El Camino College faculty, staff and administrators are dedicated to maintaining an
optimal learning environment and will not tolerate academic dishonesty. To uphold the
academic integrity of the institution, all members of the academic community, faculty
and students alike, must assume responsibility for providing an educational environment
of the highest standards characterized by a spirit of academic honesty.
The following statement is part of Board Policy 5138, Standards of Conduct:
“Dishonesty, including but not limited to cheating, plagiarism or knowingly furnishing
false information to the college.’’ When there is evidence of cheating or plagiarism in
classroom work, students may receive an F for that piece of work or may be suspended
from all classes for that term and the following term if deemed appropriate.
Examples of Cheating or Plagiarism are:
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
Representing the words, ideas or work of another as one’s own in any
academic exercise (plagiarism), including the use of commercial term paper
companies;
Copying or allowing another student to copy from one’s paper or answer sheet
during an examination;
Allowing another individual to assume one’s identity for the purpose of
enhancing one’s grade in any of the following: testing, field trips or
attendance;
Falsifying or attempting to falsify attendance records and/or grade rosters;
Changing answers on a previously scored test, assignment or experiment with
the intent to defraud;
Inventing data for the purpose of completing a laboratory experiment or case
study analysis with the intent to defraud;
Giving and/or taking information during an examination by any means such as
sign language, hand signals or secret codes;
Obtaining copies of notes, exams or exam questions by any means other than
distribution from the instructor. (This includes copying and removing exam
questions from the classroom for any purpose.);
Using study aids such as calculators, tape recorders or notes that have been
specifically prohibited by the instructor.
Responsibility of El Camino College Students
It is the responsibility of each student to conduct him/herself in a manner which
encourages learning and promotes honesty; and to act with fairness toward other students
in the classroom. This incorporates the notion that students should not seek an unfair
advantage over other students when completing an assignment, taking an examination or
engaging in any other kind of academic activity.
Consequences for Cheating or Plagiarism
Given alleged violation of the Standards of Conduct, any or all of the following actions
may be imposed:
1. The instructor may assign a failing grade to the examination or assignment in which
the alleged cheating or plagiarism occurred. This action is based on information that the
instructor had.
2. The instructor may dismiss the student from the class or activity for the present and/or
following class session(s) as stipulated in BP5138, section IIB5: Removal by Instructor.
3. The instructor may recommend suspension or expulsion of the student from the college
as stipulated in BP5138, Section IIB6 and 8. This recommendation must be in accordance
with El Camino College’s Due Process and Disciplinary Procedures.
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4. Complete the Academic Dishonesty Report Form and submit it to your Division Office
for distribution.
N 254 EVALUATION OF CLINICAL PERFORMANCE: Handout 14 pages
The hospital clinical experience will be graded on Satisfactory/Needs
Improvement/Unsatisfactory basis. The clinical evaluation tool will be utilized for the
twelve week clinical experience. Students are held responsible for competence in all
previous objectives. If practice or review is needed for any clinical skills the student is
held responsible to seek assistance from the media/skills instructor. The student is
required to update the skills check list (originating from N 150 or153/154 ), using it as a
guideline for self-assessment. The skills check list is to be submitted to the clinical
instructor at the end of the clinical rotation.
The completed skills checklist is to be submitted to your
clinical instructor at the end of the course and returned
to the student for N255.
N 254 METHODS OF INSTRUCTION:
Resume.
Two papers: article critique and cardiac:
Objective multiple examinations: five including a final comprehensive examination.
Multimedia – human simulator.
N 254 METHODS OF EVALUATION:
Examinations (5), resume, (1), article critique (1), cardiac paper (1). Students must
complete this test and provide their results to the clinical instructor by the end of the
fourth week of the semester. Students are required to furnish proof of satisfactory
completion of an ATI examination. Specific examination information is to be provided
by instructor(s). Students must pay their $ 92.01 testing fee to the college cashier and
bring their receipt to lecture on the first day of the course (See page 1
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PLEASE DETACH THIS FORM AND TAKE TO
THE CASHIER’S OFFICE WITH PAYMENT OF
$ 92.01. TAKE THIS RECEIPT TO 1st DAY OF
COURSE
_______________________________________________________________
El Camino College
Department of Nursing
ATI TESTING INVOICE
Student Name:________________
Date__________________________
Student ID #:_________________
Nursing Course
Fee Due
N 254
$92.01
Date Paid
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Cashier Signature
N 254 GRADING POLICY:
EXAMINATION:
Students will provide Par SCORE TEST FORM NO. F-1712-PAR-2 answer sheets for
all examinations. (These are pink full-sheets with room for 200 multiple choice answers).
Please bring two NO. 2 pencils and eraser to the test. Faculty will not discuss the exam
unless all students in the class have taken the exam. An appointment may be made for
individual feedback when necessary. The theory faculty will score all par SCORE answer
sheets. Exam grades will be posted on the same day of the class. Students will be given
their individual par SCORE results to be compared to a list of exam content areas, which
will be posted. Students are encouraged to focus on content and not specific questions on
the exam. All exams will consist of multiple choices and fill-in or matching. Quizzes
may be given at any time and may consist of multiple choice, matching, fill-in or essay.
STUDENTS REQUIRING ACCOMODATION FOR TESTING MUST BRING
VERIFICATION FROM THE SPECIAL RESOURCE CENTER (STUDENT
SERVICE CENTER) TO LECTURING INSTRUCTOR PRIOR TO THE FIRST
EXAM. STUDENTS REQUIRING TEST ACCOMODATIONS NEED TO
SCHEDULE THEMSELVES AT THE RESOURCE CENTER ON THE
CRENSHAW CAMPUS. STUDENTS WHO DO NOT SCHEDULE WITH THE
SPECIAL RESOURCE CENTER WILL TAKE THE EXAM DURING THE
REGULAR SCHEDULED TESTING TIME IN CLASS.
The student must receive at least an average of C- to pass the course. There are no retake
tests allowed in this course, except for extenuating circumstances as described in the
attendance policy. The final exam is a comprehensive exam. Students are to refer to the
Nursing 254 Summary Sheet to monitor their grade. At the end of the semester, please
submit this form with your clinical evaluation to your clinical instructor. The summary
sheet is located in Appendix B. Following is the grading criteria:
% Satisfactory
% Unsatisfactory
92-100 - A
90-91 - A88-89 - B+
83-87 - B
81-82 - B79-80 - C+
77-78 - C
75-76 - C73-74 - D+
65-72 - D
63-64 - D00-62 - F
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The course grade is determined using the Par SCORE computer system with the above
nursing grade criteria. Grading criteria has been established by the Board of Registered
Nursing, with a passing score of 75% or better. Completion of the course requires a
passing grade of C- or better AND a satisfactory clinical performance.
Late papers will not be accepted. All course requirements must be completed to receive
a grade for the course.
N 254 EXAMINATIONS/PAPERS DISTRIBUTION OF GRADES:
Leadership /Management Exam
Renal Exam
Respiratory Exam
Cardiovascular Exam
Disaster experience attendance
Final Exam
Cardiac paper
Article critique
Resume
10%
20%
20%
20%
Required
25%
2.5%
2.0%
0.5%
Total
100%
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N 254 GUIDELINES FOR ASSIGNMENTS
NURSING 254 ARTICLE CRITIQUE
The goal of this assignment is to encourage students to research current literature related
to evidenced-based practice/peer reviewed in medical-surgical nursing. Acceptable
journals are those published within the last five years. Approved journals include the
following: American Journal of Nursing, Nursing Research, Image, Nursing Outlook,
Nursing Standard or any specialty journal such as Emergency Room Nursing. The
journal must be peer reviewed. Unacceptable journals for this assignment include RN
and Nursing 2008. Medline and CINAL are two possible search engines. These types of
articles include an abstract, background literature, problem statement, collect data, and
analyze data. If there is a question as to the legitimacy of a journal, please discuss it with
your clinical instructor.
The assignment is to perform a literature search in an area covered within one of the
N 254 theory modules. The student will submit a copy of the literature search AND a
copy the article. Additionally, the student is to analyze the study utilizing the following
guidelines:
Article Critique: 100 points (2.0% of the total grade)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Review of Content – 20 points
Relevance of findings – 20 points
Identify specific N 254 Objective relationship and relevancy to course – 10 points
Overall Purpose/goal of the article – 10 points
Supports/refutes current practice and rationale – 10 points
Student’s opinion (minimum two details) – 5 points
Spelling (3), grammar (4), and punctuation (3) – 10 points
Reference page (3) and cover sheet (2) in APA format; proper citation (3) within text 10 points
Submission of literature search (2).
Copy of article and search engine (5 points).
Please submit your paper with six headings for #’s 1-6 above. Please limit the critique to
two typewritten pages. All papers are to be formatted on the computer. Please back-up
your work. Support services are available in the Student Learning Center, however, this
service may require advance planning on the part of the student. Students maintain
responsibility to proof-read/edit their own papers.
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NURSING 254 ARTICLE CRITIQUE GRADING SHEET
Name________________________
Date submitted____________________
Total Points_______________________________
Review of Content (20) ____________________________________________________
Relevance of Findings (20) _________________________________________________
Specific N 254 Course Objective (10) ________________________________________
Purpose/Goal of the Article (10) _____________________________________________
Supports/Refutes Current Practice and Rationale (10) ____________________________
Student’s Opinion (minimum two ideas) (5) __________________________________
Grammar (4) _____________________________________________________________
Spelling (3) ______________________________________________________________
Organization (3) __________________________________________________________
APA format within text (4) _________________________________________________
APA format - Cover Sheet (3) ______________________________________________
APA format - Reference Page (3) ___________________________________________
Copy of article and search engine (5)_________________________________________
18
NURSING 254 CARDIAC ASSIGNMENT
Select a client with a cardiac diagnosis such as CHF, MI, Acute Coronary Syndrome,
Unstable Angina, Cardiomyopathy, Pericarditis or any other cardiac diagnosis. The client
may have more than one cardiac diagnosis and your paper should include all cardiac
diagnoses that are relevant. Write a three-to-four-page paper analyzing all aspects
described below. An organized paper that includes correct spelling, grammar, and
punctuation is expected in a college level paper. The paper must be submitted to your
clinical instructor on or prior to, the due date. The paper will be worth 100 points and
constitutes 2.5 % of your total grade. Include all sections listed below and submit the
Grading Sheet with the paper.
Situation
Describe the chief complaint and the situation surrounding the admission in a concise and
clear format. Discuss each diagnosis by clearly explaining the etiology and the
pathophysiology involved. Discuss cardiac risk factors of the client. Describe abnormal
findings from your physical assessment and how they relate to the disease process.
Interpretation of Data:
Discuss the hospital course as well as diagnostic data such as 12 lead EKG, cardiac
monitoring, cardiac enzymes, electrolyte profile and hemodynamic values if they are
available. Discuss any other tests as appropriate. Discuss the reason that the particular
test was ordered and the meaning of the test results.
Goals of treatment:
Based on current literature, discuss options of how this condition should be treated. Also
discuss if the treatment rendered could be described as evidence based practice.
Nursing diagnosis: Discuss the most important NANDA approved nursing diagnosis.
Collaborative Interventions and Rationale:
Discuss collaborative interventions and why they were ordered for the patient. Discuss if
the prescribed collaborative interventions were effective. Please state the following
disciplines used such as; Discharge Planning, Cardiac Rehab, OT/PT, etc if they apply.
Evaluation:
Examine the existing nursing care plan of your client. Were the goals stated on the
nursing care plan met or unmet at the time you evaluated them? Would you change the
care plan in any way? You may include a copy of the clients care plan as an addendum to
your paper.
APA Format:
The paper is to be typed in APA format which includes double spacing, Times New
Roman, size12 font. APA format includes a cover sheet and a reference. Papers may not
exceed three pages, excluding the reference cited page and the cover sheet. A minimum
of two references must be cited.
19
NURSING 254 CARDIAC ASSIGNMENT GRADING SHEET
Name________________________
Date/s of care_____________________
Client Initials___________________
Date submitted____________________
Total Points_______________________________
Situation
(10)__________________________________________________________________
Interpretation of data
(20)_________________________________________________________________
Goal of treatment
(10)_______________________________________________________________
Nursing diagnosis (ACTUAL- NOT POTENTIAL/AT RISK)
(5)__________________________________________________________________
Collaborative Interventions and Rationale
(20)________________________________________________________________
Evaluation
(10)_________________________________________________________________
APA format
(5)___________________________________________________________________
Grammar
(10)__________________________________________________________________
Spelling
(5) ____________________________________________________________________
Organization
(3) __________________________________________________________________
Punctuation
(2)___________________________________________________________________
20
El Camino College
Nursing 254
Leadership and Management IA
Course Objectives:
1. Utilize the principles of leadership and management in providing nursing care of a
selected group of hospitalized clients.
2. Apply legal and ethical guidelines to the care of clients with multiple need
imbalances.
3.Execute nursing procedures according to established standards of critical care,
emergency, and disaster nursing.
4. Understand the concept of evidence based practice and apply evidence-based nursing
to clinical practice in order to meet the standard of care (National Patient Safety Goals).
Student Learning Objectives:
1. Identify current nursing practice issues: professional, ethical, and legal as well as
social and economic concerns.
2. Differentiate between the role of leadership styles: autocratic, democratic & laissezfaire, and their impact upon the organizational structure of a healthcare system.
3. Discuss the common theories of leadership:
a. Trait theory
b. Behavioral theory.
4. Compare selected theories of leadership and management and apply them to
leadership styles.
5. Compare and contrast the following patient care delivery systems:
a. Total Patient Care
b. Functional nursing
c. Team nursing
d. Primary nursing
e. Case management
6. Identify the principles of leadership that result in effective problem-solving and
conflict resolution.
21
7. Propose, then discuss a plan to resolve issues related to budgeting, risk management,
staffing, team management, quality improvement, performance improvement, and
networking utilizing leadership principles.
8. Discuss how economic change is affecting health care organizations and nursing
practice.
9. Compare and contrast the job descriptions of the following positions:
a. Director of Nursing
b. Unit Manager
c. Charge Nurse
d. Staff Nurse
e. Licensed Vocational/Practical Nurse (LVN/LPN)
f. Certified Nursing Assistant
g. Unit Secretary
h. Unlicensed Assistive Personnel
10. Compare and contrast various types of programs which prepare nursing students for
licensure in terms of:
a. Educational requirements
b. Potential for practice and advancement
11. Analyze the scope of nursing practice and binding regulations as defined by the
Board of Registered Nursing (BRN) pertaining to:
a. Clinical Nurse Specialist
b. Advanced Practice Nurses (certification programs – CRNA, CNM, NP)
c. Interim Permit (IP)
d. Licensed Vocational/Practical Nurse (LVN/LPN)
e. Unlicensed Assistive Personnel
12. Analyze appropriate delegation strategies and nursing liability by the registered nurse
to unlicensed assistive personnel.
13. Compare and contrast the advantages and disadvantages of varying shift reports,
including but not limited to:
a.
b.
c.
d.
e.
f.
Verbal
Written
Taped
Critical Pathways
Transfer Report
Walking Rounds
14. Analyze an evidence-based/research based article.
15. Demonstrate professional resume presentation.
22
N-254 LEARNING ACTIVITIES: LEADERSHIP & MANAGEMENT IA
Required Readings:
ERES PASSWORD FOR N 254: N254210
Monahan, F. D., Sands, J.K., Marek, J.F., Neighbors, M., & Green, C.
(2007). Medical-surgical nursing health and illness perspectives (8th ed.). St. Louis:
Mosby.
Tappen, S.A., Wise, S.A., & Whitehead, D.K. (2006). Essentials of nursing leadership
and management, (5th ed). Philadelphia: F.A. Davis Co.
Recommended Readings:
Austin, S. (2008). 7 legal tips for safe nursing practice. Nursing2008. 3(38) 34-39.
Brooke, P. (2009). Legally speaking when can you say No. Nursing2009. July 42-47.
Colonghi, P. (2009). Mentoring? Take the Lead. Nursing Management. March, 15-17.
Keefe, S. (2006). Trading up to nursing. Advance for Nurses. 3(11), 23-24.
Keefe, S. (2006). Collaborative quest. Advance for Nurses, 3(24), 12-14, 42.
Lower, J. (2006). Transitioning to charge nurse. Advance for Nurses, 3(22), 15-17.
Pope,B., Rodzen, L., Spross, G., (2008). Raising the SBAR.Nursing 2008. 3(38), 4143.
23
EL CAMINO COLLEGE
NURSING 254
LEADERSHIP & MANAGEMENT I B
Course Objectives:
1. Prioritize and assign fellow students in a team leader role for an assigned clinical
area and coordinate activities with clinical instructor.
2. Prioritize nursing interventions for the victims of a disaster.
3. Participate in a Mock Disaster Drill at a local hospital to be assigned by
instructor(s).
4. Execute nursing procedures according to established standards of critical care,
emergency, and disaster nursing.
Student Learning Objectives:
1. Discuss the role as a team leader and considerations in planning for the care of the
patients and work flow.
2. Discuss the role of the nurse in a disaster:
a. Before disaster hits
b. During a disaster
c. After disaster hits
3. Describe how local/state/federal agencies and organizations might respond to a
disaster.
3. Identify the impact of disasters on the delivery of nursing care:
a. American Red Cross (Disaster Health Services)
b. World Health Organization (WHO)
c. Profile of disaster
d. Stages of disaster
e. Triage
4. Identify the community resources and coordination of health care services
required during disasters.
a. Natural (List supplies to be kept on hand and nursing interventions to be
implemented pre/post earthquake or any other natural disaster
b. Human-related
24
N-254 LEARNING ACTIVITIES: LEADERSHIP & MANAGEMENT B (Required)
Causer, C, & Guterl, G.O., James, E. & Saunders, K. (2006). Are we ready? Advance for
nurses, 3(19), 19-22. www.advanceweb.com (9/4/06)
Habel, M. (2006). RN’s shelter victims of disaster, Nurse Week, 1918, 15-17.
www.nurse.com
Phipps, W. J., Monahan, F. D., Sands, J.K., Marek, J.F., Neighbors, M., & Green, C.
(2007). Medical-surgical nursing health and illness perspectives (8th ed.). St. Louis: Mosby.
Wilshire, L., Hassmiller, S.B., & Wodicka, K.A. (2004). Disaster preparedness and response for nurses.
www.nursingsociety.org/education/case-studies/SP0004.html
Recommended Readings:
Keefe, S. (2006). VA polytrauma units. Advance for Nurses, 3(11), 21-22.
Chaffee, M. (2006). Making the decision to report to work in a disaster. AJN, 106(9),
106-109.
Patterson, K. (2006). Echoes of disaster. Nurseweek, 19(18), 8-9. www.nurseweek.com
25
EL CAMINO COLLEGE
NURSING 254
O2CO2 NEED IV A
Course Objectives:
1. Apply the pathophysiologic concepts for selected respiratory disorders and utilize
the nursing process and the provision of nursing care.
1. Apply the principles of pharmacology and the care of clients with multiple need
imbalances.
2. Correlate laboratory values with the appropriate nursing interventions with clients
with multiple need imbalances.
3. Apply nursing care to a group of clients in both intensive care units and the
emergency room with multiple need imbalances.
4. Understand the concept of evidence-based practice and apply evidence-based
nursing to clinical practice in order to meet the standard of care (National patient
safety goals).
5. Compare and contrast the current clinical guidelines and up-to date evidence
based guidelines.
6. Implement research-supported interventions based on evidence-based clinical
practice guidelines (EBCPGs) according to a health organization’s policy and
procedure.
Student Learning Objectives:
1. Review the functional anatomy of the pulmonary system and the process involved
in oxygenation.
2. Differentiate between the physiologic mechanisms of pulmonary gas exchange,
pulmonary circulation, and control of ventilation.
3. Evaluate the effects of the aging process on the O2-CO2 exchange and analyze
gerontological considerations related to the care of the aging client with
respiratory dysfunction.
a. Pharmacological factors
b. Nutritional factors
c. Basic Needs
d. Activity level
4. Interpret lab results, develop nursing diagnosis, and prioritize nursing care of
clients with abnormal findings:
26
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Arterial Blood Gases (ABGs)
Pulse Oximetry
Chest X-ray
Blood and sputum cultures
Bronchoscopy
Pulmonary function tests (PFTs)
Thoracentesis
Lung scan
VQ scan
Pulmonary angiography
1. Evaluate the causes, compensatory mechanisms, and collaborative management of
the client with the following acid-base disorders:
a. Respiratory Acidosis
b. Respiratory Alkalosis
c. Metabolic Acidosis
d. Metabolic Alkalosis
2. Discuss the etiology, clinical manifestations, goals of treatment, complications,
nursing management, and health teaching for the client experiencing one of the
following conditions:
a.
b.
c.
d.
e.
f.
g.
h.
i.
Pneumonia (consolidation)
Pleural effusion
Pneumothorax
Acute Respiratory Distress Syndrome (ARDS)
Pulmonary Embolism
Pulmonary Edema
Pleurisy
Oxygen toxicity
Hypoxia/Hypoxemia
7. Discuss the action, side effects, and nursing responsibilities of each of the
following drug classifications in clients experiencing an O2/CO2 deficit.
a.
b.
c.
d.
e.
f.
g.
Antihypertensives
Antiarrhythmics
Anticoagulants
Bronchodilators
Thrombolytics
Diuretics
Peak and trough
8. Evaluate the medical indications for use, potential complications, safety factors,
and nursing interventions in caring for a client with:
27
a. Chest tubes
i. Dry
ii. Wet
b. Oxygen therapy (high & low flow methods)
c. Artificial airways
i. Endotracheal tubes
ii Tracheostomy – cuffed vs uncuffed
iii Postive pressure mechanical ventilator
iv Closed suctioning
9. Discuss the rationale for use of the ventilator as well as the role of the registered
nurse and the respiratory therapist when caring for clients with the following:
a.
b.
c.
d.
e.
f.
Controlled Mechanical Ventilator (CMV)
Assist-Control (AC) or Assisted Mandatory Ventilation (AMV)
Intermittent Mandatory Ventilation (IMV)
Synchronized IMV (SIMV)
Positive end-expiratory pressure (PEEP)
Continuous positive airway pressure (CPAP)
10. Compare methods used for weaning a client from mechanical ventilation.
11. Describe and prioritize nursing care for weaning a client from mechanical
ventilation.
12. Identify community resources available for persons with chronic respiratory
problems.
13. Evaluate and discuss the dietary needs of clients with respiratory dysfunction:
a. Carbohydrate
b. Protein
c. Fat
e. Electrolytes (especially sodium and potassium)
f. Fluid intake
g.Vitamins and minerals
h.Tube feeding
28
Clinical Objectives:
Clinical Objectives (Activities for Clinical Experience)
Evidence
1. Assess clients with respiratory dysfunction and compare with
normative data with emphasis on:
1.1. Lung sounds
1.2. Alteration in pulmonary function
1.3. Cardiac effort
1.4. Vital signs
1.5. Pulmonary function test
1.6. Incentive spirometry
1.7. Pulse oxymetry
1.8. Chest X-ray
1.9. Electrocardiogram
1.10. Arterial Blood Gases
1.11. Laboratory assessment
1.12. Blood coagulation studies
2.
Identify relationship(s) in objective 1.
3.
Perform a physical assessment of the pulmonary system to
include inspection, palpation, percussion, and auscultation.
4.
Differentiate differences between normal and abnormal during
breath/lung sounds
5.
Compare and contrast assessment findings of clients with
different types of pulmonary disorders.
6.
Formulate care plans to assist clients with respiratory
dysfunction in the objective 1.
7.
Formulate specific nursing priorities in supporting the client’s
vital functions, maintaining an adequate airway and
oxygenation, correcting the injuries, and minimizing the
consequences of the traumatic injuries.
8.
Demonstrate a beginning knowledge of emergency management
to deliver safe, quality emergency care under a variety of
stressful circumstances.
8.1. Code Blue Simulation
9.
Demonstrate skills necessary to:
9.1. Administer oxygen
9.2. Draw blood
9.3. Check hemoglobin and hematocrit
9.4. Measure oxygen saturation
9.5. Handle ABG sample
9.6. Maintain intra arterial and intra venous lines (peripheral and
central)
9.7. Suction set up
9.8. Insert nasogastric/ oropharygeal/ nasopharyngeal tubes
9.9. Set up chest tubes
9.10. Maintain endotracheal tube, tracheostomy tubes and
29
mechanical ventilator
9.11. Administration of electrolytes, fluids, and medications
9.12. Sputum collection
10.
Prepare for endoscopy/bronchoscopy
10.1. Arterial blood gases
10.2. ECG
10.3. Serum electrolytes
10.4. Blood coagulation studies
10.5.Throracenthesis and Paracenthesis
10.6. Endoscopy/Bronchoscopy
10.7. Chest tubes
10.8. Mechanical ventilator with PEEP
10.9. Oxygen therapy
10.10. Artificial airways
10.11. Tracheostomy tubes
10.12. Endotracheal tubes
10.13. Suctioning airway
11.
Demonstrate analyzing and interpreting abilities necessary to:
11.1.
Sputum culture and sensitivities
11.2.
ABG
11.3.
Blood coagulation
11.4.
CBC
11.5.
Oxygen therapy
11.6.
Blood, body fluid, and urine culture
11.7.
Hepatic panel
11.8.
Urinalysis
11.9.
Blood chemistry
12.
Explain the significance of specific pulmonary function tests
13.
Describe the process of gathering an arterial blood sample
14.
Apply respiratory supporting equipments
14.1 Hand held nebulizer
13.
Differentiate the clinical significance of age-related physiologic
changes and the expected nursing considerations or
interventions used in caring for older critical care clients.
14. Compare and contrast the age-related changes in hepatic function
and the accompanying pharmacokinetic changes to the
administration of various respiratory medications
15. Function as an integral part of the health care team in the
clinical care setting and emergency.
16.
Apply evidence-based clinical practice guidelines properly and
timely to up-to-date researched respiratory problems according
to health care organization policy and procedure
16.1 Pneumonia
16.2 Ventilator Associated Pneumonia (VAP)
16.3 Tube feeding
16.4 Asthma
30
17.
16.5 Thromboembolism
16.6 Central lines
16.7 Antibiotics
16.8 Endotracheal tube care
16.9Norsocomial infections
16.10 Medication management
Identify the adequate community resources and coordination of
health care services.
LEARNING ACTIVITIES: (O2-CO2 NEED IVA)
1. Required Readings:
Phipps, W. J., Monahan, F. D., Sands, J.K., Marek, J.F., Neighbors, M., & Green, C.
(2007). Medical-surgical nursing health and illness perspectives (8th ed.). St. Louis:
Mosby.
2. Recommended Readings
Astle, S. (2007). Taking your patient off a ventilator, RN, 70(5), 34-40.
Beattie, S. (2007). Respiratory distress, RN, 70(7), 34-39.
Crawford, A. & Harris, H. (2008) Help your patients breathe easier, RN, 71(1), 21-27.
Kallus, C. (2009). Where’s respiratory? Nursing 2009, 39(6), 6.
Kallus, C. (2009). Building a solid understanding of mechanical ventilation. Nursing
2009, 39(6), 22-29.
Paragas, J. (2008). Keeping the beat with pulse oximetry, Nursing 2008, 38(11), 56HN156HN2.
Parchinsky, C. (2006). Go with the flow of chest tube therapy, Nursing 2006, 36(3), 41.
Pruitt, B. & Jacobs, M. (2006). How can you prevent ventilator-associated
pneumonia? Nursing 2006, 36(2), 36-41.
Selected websites:
www. Nursingcenter.com; www.aacn.com; www.rnweb.com
www.ajn.com; www.trauma.org
31
3. CD’s: NURS687B Acute Respiratory Disorders Self-Grading Tests (2006)
NURS687Y01 Acute Respiratory Disorder Pulmonary Embolism (2006)
NURS687Y02 Acute Respiratory Disorder Pleural Effusion & Hemothorax
NURS687Y03 Acute Respiratory Disorder Pneumothorax &Tension
Pneumothorax (2006)
NURS687Y04 Acute Respiratory Disorders Acute Respiratory Distress
Syndrome (2006)
4. Media/skills Laboratory: Chest tubes, Tracheostomy
5. Group Discussions & Case Studies---to be arranged on the first day of respiratory
lecture
6. Clinical Laboratory: Care for patients with acute or chronic respiratory failure
Care for patients who have chest tube, tracheostomy, endotracheal tube, and
ventilator assistance.
7. Other: Worksheet for Arterial Blood Gases.
8. EVALUATION:
Theory: Multiple choice exam with fill-in the blank and five mathematical calculations
32
EL CAMINO COLLEGE
NURSING 254
O2CO2 NEED IVB
Course Objectives:
1. Apply the pathophysiologic concepts for selected cardiovascular disorders and
utilize the nursing process and the provision of nursing care.
2. Apply the principles of pharmacology and the care of clients with multiple need
imbalances.
3. Correlate laboratory values with the appropriate nursing interventions with clients
with multiple need imbalances.
4. Apply nursing care to a group of clients in both intensive care units and the
emergency room with multiple need imbalances.
5. Understand the concept of evidence-based practice and apply evidence-based
nursing to clinical practice in order to meet the standard of care (National patient
safety goals).
6. Compare and contrast the current clinical guidelines and up-to date evidence
based guidelines.
7. Implement research-supported interventions based on evidence-based clinical
practice guidelines (EBCPGs) according to a health organization’s policy and
procedure.
8. Participate in a Code Blue Simulation and prior complete Pre & Post Code Blue
Tests and view Code Blue CD’s
Student Learning Objectives:
1. Describe basic components of a cardiac assessment
2. Describe the normal anatomy of the cardiac system, the flow of blood through the
cardiac cycle and associated normal heart sounds.
a. S1
b. S2
3. Correlate the normal conduction system of the heart in relation to the cardiac
cycle.
4. Identify the waves and intervals of the cardiac cycle:
33
a. PR interval
b. QRS interval
c. ST segment
d. R to R interval
e. T wave.
5. Identify the following rhythms/dysrhythmias and describe clinical symptoms:
a. Normal sinus rhythm (NSR)
b. Sinus bradycardia
c. Sinus tachycardia
d. Presence/absence of P wave
e. Atrial Fibrillation/Atrial flutter
f. First degree heart-block
g. Paced rhythm
h. Premature ventricular contraction (PVC)
h. Asystole
i. Ventricular tachycardia
j. Ventricular fibrillation
k. Asystole
6. Differentiate between normal and abnormal heart sounds and explain the clinical
significance of:
a. Physiologic Split S2
b. S3
c. S4
d. Murmurs
e. Friction rub
7. Explain how these factors affect cardiac output:
a. Preload
b. After-load
c. Contractility
d. Heart rate
e. Stroke volume
8. Compare and contrast normal anatomy and physiology of the cardiovascular system
with pathological changes that occur with the following:
34
a. Diabetes
b. Angina Pectoris (stable & unstable)
c. Myocardial Infarction (MI)
d. Heart Failure (ventricular)
e. Coronary Artery Disease/Acute Coronary Syndrome
f. Cardiac Valve Problems
g. Cardiac Inflammatory Problems
h. Cardiomyopathy
9. Describe the causes, clinical manifestations, nursing diagnosis with interventions,
goals of treatment, diagnostic tests, and complications for the following:
a. Diabetes
b. Angina Pectoris (stable & unstable)
c. Myocardial Infarction (MI)
d. Heart Failure (ventricular)
e. Coronary Artery Disease/Acute Coronary Syndrome
f. Cardiac Valve Problems
g. Cardiac Inflammatory Problems
h. Cardiomyopathy
10. Differentiate between the signs and symptoms, EKG changes, and the nursing and
medical interventions of angina and myocardial infarction.
11. Describe invasive treatments for Coronary Artery Disease including nursing
diagnosis, goals of treatment, and complications
a. Coronary Artery Bypass Graft (CABG)
b. Percutaneous Transluminal Coronary Angioplasty (PTCA)
12. Contrast modifiable versus non modifiable cardiac risk factors and nursing
implications:
a. Smoking
b. Weight
c. Sex
d. Culture
35
e. Exercise
f. Hypertension
g. Diabetes
13. Discuss aspects of health teaching relevant to clients with cardiovascular diseases.
a. Diet
b. Activity
c. Medication
d. Stress Management
14. Evaluate and discuss the following dietary needs for client with cardiovascular
disease:
a. Carbohydrates
b. Protein
c. Fat
d. Electrolytes
e. Fluids
f. Minerals
15. Evaluate the significance of the following labs:
a. CPK/CPK-MB
b. Troponin
c. LDH
d. PTT/PT
e. Potassium
f. Lipid panel
g. b-type naturetic peptide (BNP)
h. High Sensitivity C-Reactive Protein (HSCRP)
i. SGOT/SGPT (ALT/
16. Discuss the importance of monitoring serum potassium levels for the clients
receiving potassium and diuretics.
36
17. Categorize the following classes of drugs related to the action, side effects, and
nursing responsibilities of each for the following drugs:
a. Cardiac Glycosides (digitalization, digoxin toxicity)
b. Antihypertensives
c. Antithrombolitic/Anticoagulant/Antiplatelet:
e. Antianginal
f. Diuretics
g. Antiarrythmics
18. Discuss the clinical significance of the following hemodynamic measurements:
a. Heart Rate
b. Blood Pressure
c. Right Atrial Pressure/Central Venous Pressure
d. Pulmonary Capillary Wedge Pressure
e. Systemic Vascular Resistance
f. Cardiac Output
g. Cardiac Index
19. Compare the different types of pacemakers:
a. Demand
b. Fixed
c. A-V Sequential
d. Automatic Internal Cardiac Defibrillator (AICD)
20. Identify gerontologic considerations related to the care of the elderly with
cardiovascular disorders, including, but not limited to:
a. Physiologic changes
b. Pharmacological factors
21. Identify community resources available for persons with cardiovascular disorders.
22. Participate in a Code Blue Simulation and complete Pre & Post Code Blue
Simulation tests prior to attendance. View Code Blue CD’s and EKG practice.
37
Clinical Objectives:
Clinical Objectives (Activities for Clinical Experience)
1. Perform a physical assessment of the cardiac system to include
inspection and auscultation.
2. Assess clients with cardiac dysfunction and compare with normative data
with emphasis on:
2.1 Heart sounds
2.2 Alteration in cardiac function
2.3 Vital signs
2.4 Electrocardiogram
2.5 Cardiac Output
2.6 PCWP
2.7 Chest X-ray
2.8 Laboratory assessment
2.9 Blood coagulation studies
3. Identify the normal conduction system of the heart in relation to cardiac
cycle
4. Differentiate differences between normal and abnormal heart sounds
during auscultation
4.1S1
4.2S2
4.3S3
4.4 S4
5. Compare and contrast assessment findings of clients with pathological
changes that occur with the following
5.1 Diabetes
5.2 Angina Pectoris (stable & unstable)
5.3 Myocardial Infarction
5.4 Heart Failure (ventricular)
5.5 Coronary Artery Disease/Acute Coronary Syndrome
5.6 Cardiac Valve Problems
5.7 Cardiac Inflammatory Problems
5.8 Cardiomyopathy
6. Formulate care plans to assist clients with cardiac dysfunction in the
objective 8.
7. Formulate specific nursing priorities in supporting the client’s vital
functions, maintaining adequate cardiac circulation and oxygenation,
correcting the injuries, and minimizing the consequences of the
traumatic injuries.
8. Demonstrate skills necessary to identify the following EKG rhythms:
8.1 Normal sinus rhythm
8.2 Sinus Bradycardia
8.3 Sinus Tachycardia
8.4 Paced rhythm
8.5 Ventricular tachycardia
8.6 Ventricular Fibrillation
8.7 Atrial Fibrillation
8.8 Atrial Flutter
8.9 Asystole
9. Prepare for patients for the following procedures:
38
Evidence
9.1 Coronary angiogram
9.2 Percutaneous Transluminal Coronary Angioplasty(PTCA)
9.3 Stress testing
9.4 Stress Echo
9.5 Thallium Treadmill
9.6 CABG
9.7 Cardioversion
10. Demonstrate abilities necessary to analyze and interpret:
10.1 Troponin levels
10.2 CPK-C-MB levels
10.3 Lipid Panel
10.4 Blood coagulation studies
10.5 CBC
10.6 BNP
10.7 Homocysteine
10.8 CRP
10.9 EKG
10.10 PCAW pressure
10.11 CVP pressure
10.12 Blood chemistry
11 Explain the significance of specific cardiac function tests
12 Describe the process of gathering an arterial blood sample
13 Apply cardiac supporting equipment
14. Differentiate the clinical significance of age-related physiologic
15. Identify pharmacological implications related to cardiac illness
16. Function as an integral part of the health care team in the clinical care
setting and emergency.
17. Apply evidence-based clinical practice guidelines properly and timely to
up-to-date researched cardiology problems according to health care
organization policy and procedure
17.1 Angina Pectoris (stable & unstable)
17.2 Myocardial Infarction (MI)
17.3 Heart Failure (ventricular)
17.4Coronary Artery Disease/Acute Coronary Syndrome
17.5 Cardiac Valve Problems
17.6 Cardiac Inflammatory Problems
17.7Cardiomyopathy
18.
19.
20.
Identify the adequate community resources and coordination of health
care services.
Demonstrate a beginning knowledge of emergency management to
deliver safe, quality emergency care under a variety of stressful
circumstances.
Demonstrate a beginning knowledge of emergency management to
deliver safe, quality emergency care under a variety of stressful
circumstances.
20.1. Code Blue Simulation
39
N-254 LEARNING ACTIVITIES: O2-CO2 NEED IVB
1. Required Readings:
Monahan, F. D., Sands, J.K., Marek, J.F., Neighbors, M., & Green, C.
(2007). Medical-surgical nursing health and illness perspectives (8th ed.). St. Louis: Mosby.
Dudek, S. (2007) Nutrition handbook for nursing practice (5th ed.), Philadelphia:
Lippincott. Chapter 18.
2. Recommended Readings:
Cheek, D. J. (2006). New respect for the member endothelium, Nursing 2006, 36(3), 4447.
Cheek, D.J., Hawkins, J.S., McIntire Sherrod, M. (2009). Unlocking the secrets of 2
common cardiac conditions, Nursing 2009, January, 52-56.
Christensen, D. M. (2008), Extreme Heart Makeover, Nursing 2008, May,48-54.
Craig, K.J. (2006). How to provide transcutaneous pacing, Nursing 2005, 35(10), 52-53.
Craig, K.J. (2006). Heart attack, Nursing 2006, 36(5), 43.
Craig, K.J. (2006). Understanding the new AHA guidelines, part III, Nursing
2006, 36(6), 52-53.
Fortino-Mullen, M., O’Brien, N. (2008) Caring for a patient after coronary artery bypass
graft surgery. March, 46-52.
Goldich, G. (2006) Understanding the 12-lead ECG part I, Nursing 2006, 36(11), 36-41.
Goldich, G. (2006) Understanding the 12-lead ECG part II, Nursing 2006, 36(12),36-41.
Hadaway, L.C. (2006). Keeping central line infection at bay, Nursing 2006, 36(4), 58-63.
Hansen , C. (2006). From fish to flaxseed: Reducing cardiac risk with Omega-3
Fatty Acids, Advance for Nurse Practitioner, 14(5), 51-53.
Llackey, S. A. (2006). Suppressing the scourge of AMI, Nursing 2006, 36(5), 36-42.
Morgan, E. (2006). Pericardial Tamponade”, Nursing 2006, 36(2), 88.
Overbaugh, K. (2009) Acute Coronary Syndrome. AJN.109(5), 42-53
3.CD’s: NURS675D01Clinical Simulation in Medical-Surgical Nursing
Hypertension & Heart Failure (2005)
NURS 675 D01A Clinical Simulation in Medical-Surgical Nursing
Hypertension & Heart Failure (2005)
40
4. Software’s: Required Code Blue CDs X’s-4 prior to code blue simulation experience
Must bring a copy of EKG for admission to simulation--TBA
NURS 688 B Cardiac Disorders : Coronary Artery Disease
Self-Grading Tests (2006)
NURS688Y01 Cardiac Disorders : Coronary Artery Disease
Coronary Artery Disease Part 1 (2006)
NURS688Y02 Cardiac Disorders : Coronary Artery Disease
Coronary Artery Disease Part 2 (2006)
5. Media/Skills Lab: Swan Ganz/Pulmonary Artery line set-up
6. Clinical Laboratory :
7. Other
See general guidelines for assignments: One cardiac assignment
8. EVALUATION: Theory: Multiple choice examination - all objectives
41
Pre Test Code Blue Simulation
Name:
Score:
1. The code blue team is responsible for managing the pt’s airway.
True
False
2. The first thing the nurse should do after finding patient unresponsive
is to activate code blue response. True
False
3. When the nurse who finds a patient apneic and pulseless Start CPR
and he must note the time.
True
False
4. Placing apneic and pulseless patient on a monitor is the first priority.
True
False
5. Patients with intact gag reflex should be pre-medicated before
intubation.
T
F
6. Pre-oxygenation before placing an ET tube is not necessary for patient
s with a diminished LOC.
T
F
7. The color on the end tidal CO2 detector turns to green when carbon
dioxide is exhaled.
T
F
8. It is important for anesthesiologist to note the depth of the ET tube at
the lip line.
T
F
9. Before defibrillating a patient, a physician assures that the ambu-bag
is disconnected from the ET tube. T
F
10.A patient in ventricular fibrillation should be intubated before
defibibrilated.
T
F
11. The D5W is the choice of the fluid. T
F
12.Getting an ABG in early resuscitation is critical. T
42
F
13. Nurse drawing up and administering medication in a Code Blue is no
need special training. T
F
14. Epinephrine is the first –line drug for asystole. T
F
15. The person doing CPR may need a stool to give effective
compressions. T
F
16.Staff performing compressions should switch roles with another
person every two minutes.
T
F
17. It is important that documentation of a code be accurate because the
information may be entered into a research data base looking at the
methods to improve patient outcomes during resuscitation. T
F
18.Family members should be discouraged from being in the room of
their loved-one during resuscitation.
T
F
43
Post Test Cardiac Simulation CD
Name:
Score:
Case 1 Patient : Richard Clarke, a 56-year-old man admitted to an adult surgical
floor for left knee replacement. Past medical history is unremarkable. He has
been in good health and takes no medications.
1. His nurse enters the room to do morning vital signs and finds him slumped
over. The first she should do is:
a. Push the Code Blue button.
b. Start CPR
c. Establish unresponsiveness
d. Leave the room to call his physician
2. It has been established that Mr. Clarke is pulseless and apneic. His nurse has
started CPR and activated the code team. A second nurse from the floor has
brought in the code cart and had began bag-valve-mask ventilations. The
Medication Nurse is the first member of the resuscitation team to arrive and
should:
a. Administer a dose of epinephrine.
b. Place Mr. Clarke on a monitor.
c. Go to the cart and get equipment ready for venous access.
d. Wait for the Team Leader to arrive for instruction.
3. Anesthesia is next to arrive. The equipment she will need immediately
includes:
a. A 4.0 ET tube
b. A laryngoscope.
c. Either a size of 3 straight or curved blade
d. B and c
e. All of the above
4. The rest of the team arrives. The Team Leader notes that Mr. Clarke is in
ventricular tachycardia. His order is to ask:
a. One of the bedside nurses to get venous access
b. The Anesthesiologist to intubate
c. The Procedure Physician to intubate
d. The Medication Nurse to give a dose of epinephrine IM.
5. After intubation, what information should the Anesthesiologist share with the
Documenter?
a. The ET tube is an 8 cuff tube
b. The marking at the lip line is 27 mm.
c. Breath sounds are equal and bilateral.
d. The color on the end tidal CO2 has turned to gold
e. All of the above
44
6. The nurse doing compressions should hand off the job to someone else:
a. At the end of 4 minute cycle
b. Every two minutes or each time a shock is given
c. Every 3 to 5 minutes or whenever a dose of epinephrine is given.
d. When the pulse returns.
7. The medication nurse takes out a bristojet of epinephrine, which contains:
a. 1 mg of epinephrine in 20 mls.
b. 10 mg epinephrine in 10 mls.
c. 1 mg epinephrine in 10 mls.
d. 10 mg epinephrine in 1 ml.
8. The Team Leader reviews “H” and “T” causes of the pulseless arrhythmia.
The five “H”s she considers are:
a. Hypothermia, hypovolemia, hypo-or hyperkalemia, hypoxia, and
hydrogen ion imbalance (acidosis)
b. Hypothermia b. Hypervolemia,, hypo-or hyperkalemia, hypoxia, and
hydrogen ion imbalance (acidosis)
c. Hyperthermia, hypovolemia, hypo-or hyperkalemia, hypoxia, and
hydrogen ion imbalance (acidosis)
d. Hypothermia, hypovolemia, hypo-or hyperkalemia, hypoxia, and
hydrogen ion imbalance (alkalosis)
9. The five “T” she considers include:
a. Toxins, tamponade, tension Pneumothorax, thrombosis, and thyroid
dysfunction.
b. Toxins, tamponade, tension Pneumothorax, thrombosis, and trauma
c. Tuberculosis, tamponade, tension Pneumothorax, thrombosis, and
trauma
d. Toxins, third cranial nerve compression, tension Pneumothorax, and
trauma.
10. During the course of this resuscitation, it is important the Team Leader to :
a. Review the interventions that have occurred with the documenter to
assure that, if needed they are repeated in a timely manner.
b. Ensure compressions are effective by asking someone at the bedside
to palpate a central pulse.
c. Make sure the family, if not in the room, is kept informed of the
patient’s status.
d. A and b
e. All of the above
Case 2 Patient: Morgan Jefferson, a 4 year-old girl, is transported to the Emergency
Department from an urgent care center. The physician who saw her there made a
45
tentative diagnosis of meningococcemia, a virulent and sometimes deadly bacterial
infection causing both sepsis and meningitis.
11. The Team Leader is informed by the prehospital providers that her heart is 34
and compressions are being performed, she is being manually ventilated and
has no venous access.
a. Continuing compressions if heart rate is still below 60 beats per
minute
b. Intubating to establish a patent, secure airway.
c. Gaining immediate venous access for fluid and medication
administration.
d. Measuring the patient using the Broselow Pediatric Emergency Tape
to establish her weight drug doses, and equipment sizes.
e. All of the above
12. The Procedure Physician is unable to gain venous access, so he decides to
place an intraosseous (IO) needle, which:
a. Is placed in the proximal femur
b. Can be used to administer fluids and some, but not all, medications.
c. Allows for medications and fluids to enter the bloodstream through the
vasculature in the bone marrow.
d. A and c
e. All of the above
13. One of the bedside nurses is hanging IV fluids to go into the IO. The fluid of
the choice would be:
a. Normal saline
b. D5 ½ normal saline
c. D5W
d. 10% glucose
14. According to the Broselow Pediatric Emergency Tape, this patient weighs
about 17 kg. For the first bolus, she should get ____ml.
a. 170
b. 340
c. 510
d. 680
15. The Anesthesiologist is having a hard time visualizing the vocal cords during
intubation. He should:
a. Take as long as he needs to ensure the ET tube is placed in the trachea.
b. Ask for a surgeon to perform tracheostomy.
c. Stop the procedure and ask the nurse assisting him to hyperventilate
the patient for a minute after which he will attempt intubation again.
d. Ask the Medication Nurse for a larger ET tube.
46
16. The Team Leader asks for 0.17 mg of epinephrine to be administered IO. The
concentration of the drug in the bristojet is 1:10,000. How much volume of
epinephrine should administer?
a. 0.08 mls
b. 0.17 mls
c. 1.7 mls
d. 17 mls
17. Several doses of epinephrine and fluid boluses, the patient’s heart rate
increased to 120 beats per minute. The Team Leader now asks that:
a. Another doses of epinephrine be given the heart will remain elevated
b. Compressions be stopped
c. Maintenance fluids of D5W be started.
d. All of the above
18. When the ET tube was placed, the marking was 15 mm at the lip line. The
Anesthesiologist now notes it is at 17 mm. He would expect that:
a. Breath sounds are diminished on the right
b. Breath sounds are diminished on the left.
c. Heart rate may fall
d. A and c
e. B and c
19. The patient’s mother has requested to be in the room during the resuscitation.
The Team Leader should:
a. Not allow her in because she will be too emotional and get in the
way
b. Allow her to come into the room as long as she stands in a corner
away from the bedside and team.
c. Have her come into the room with a staff person bedside her,
explaining what is going on.
d. Request that she just stand in the doorway and watch the team
47
EL CAMINO COLLEGE
NURSING 254
PHYSICAL INTEGRITY IVA
Course Objectives:
1. Apply the pathophysiologic concepts for clients with alteration of multiple
systems imbalances and utilize the nursing process and the provision of nursing care.
2. Apply the principles of pharmacology and the care of clients with multiple need
imbalances.
3. Correlate laboratory values with the appropriate nursing interventions with clients
with multiple need imbalances.
4. Apply nursing care to a group of clients in both intensive care units and the
emergency room with multiple need imbalances.
5. Evaluate clinical findings and the rationale for intervention in planning nursing
care for a selected group of clients with multiple need imbalances.
Student Learning Objectives:
1. Compare the collaborative care, pathophysiology, drug therapy, and nutritional
needs of the multiple organ dysfunction syndrome (MODS) client in different types
of shock.
a.
b.
c.
d.
e.
Cardiogenic
Hypovolemic
Anaphylactic
Neurogenic
Septic
2. Identify etiology, pathophysiology, clinical manifestations, and collaborative
management of clients experiencing varying forms of trauma
a. Blunt
b. Penetrating
3. Define and explain the clinical manifestations and management of multiple organ
dysfunction syndrome (MODS) by body system:
a.
b.
c.
d.
Cardiovascular
Central nervous system (CNS)
Gastrointestinal (GI)
Hepatic
48
e.
f.
g.
h.
i. Hepatic failure
ii. Cirrhosis
Renal
Respiratory
Burns
Disseminated intravascular coagulation (DIC)
4. Discuss common assessment and diagnostic test findings for MODS (multisystem failure, utilizing the sequential organ failure assessment (SOFA).
5. Formulate nursing diagnosis with goals and interventions for clients with multiple
organ dysfunction syndrome (MODS).
6. Discuss the role of the emergency room nurse in the delivery of client care.
9. Discuss the various functions of the registered nurse during a code blue.
10. Explain the pathophysiology, assessment and collaborative care of selected
environmental emergencies:
a. Thermoregulation
b. Near-drowning
c. Bites (snake, animal, and human)
N-254
LEARNING ACTIVITIES: PHYSICAL INTEGRITY IVA
Required Readings:
Corwin, E. (2007). Handbook of pathophysiology. (3rd ed.). Philadelphia, PA:
Lippincott.
Farwell, L. (2006). Cardiogenic shock. Advance for Nurses. 3(11), 15-17.
Kleinpell, R. M. (2006). Surviving sepsis. Advance for Nurses, 3(19), 13-16.
Phipps, W. J., Monahan, F. D., Sands, J.K., Marek, J.F., Neighbors, M., & Green, C.
(2007). Medical-surgical nursing health and illness perspectives (8th ed.). St. Louis:
Mosby.
Recommended Readings:
Duhon, J.L. (2006). When organs fail one by one. RN, 69(5), 44-49.
Pirrung, J.M., Woods, M. (2009) An upward trend in motorcycle crashes. Nursing 2009.
February, 28-34.
Rivera, C. (2009). Every minute counts. Nursing Management. May, 38-44
49
EL CAMINO COLLEGE
NURSING 254
Excretory Need IV
Course Objectives:
1. Apply the pathophysiologic concepts for selected renal disorders and utilize the
nursing process in the provision of nursing care.
2. Apply the principles of pharmacology in the care of clients with multiple need
imbalances.
3. Correlate laboratory values with the appropriate nursing interventions for clients
with multiple need imbalances.
4. Apply nursing care to a group of clients in both intensive care units and the
emergency room with multiple need imbalances.
5. Apply evidence based practice in the management of nosocmial infections related
to various catheters.
Student Learning Objectives:
1. Review the physiology of the renal system and the principles of osmosis, diffusion,
filtration, ultra-filtration, and the effects of hypertonic, hypotonic, and isotonic
solutions.
2. Analyze renal hemodynamics in relation to renal function.
a. Autoregulation
b. Neural control
c. Hormonal control
3. Discuss gerontological considerations related to the care of the client with renal
dysfunction with an emphasis on:
a. Physiologic changes
b. Pharmacological factors
4. Explain and interpret results of the most commonly used diagnostic procedures and
laboratory tests in determining urinary/renal functioning, related nursing care, and the
interpretation of abnormal findings for the following:
a. BUN/Creatnine
b. Chem panel
c. Intravenous pyelogram
d. Cystocopy
e. Urine analysis with culture and sensitivity
f. 24-hour urine collection
50
5. Compare and contrast commonly occurring pathophysiological causes which can
result in acute renal failure:
a. Prerenal
b. Intrarenal
c. Postrenal
6. Differentiate between acute renal failure (ARF), chronic
renal failure (CRF), and end stage renal disease (ESRD).
7. Identify and discuss the etiology, pathophysiology, clinical manifestations (skin, fluid
balance, V/S, neurological changes), medical management, nursing diagnosis and nursing
interventions for the following:
a. Acute renal failure
b. Chronic renal failure (anemia/uremia)
c. Glomerulonephritis
d. Nephrotic Syndrome
e. Pyelonephritis
f. End Stage Renal Failure
8. Compare and contrast laboratory values, clinical signs and symptoms, and nursing
interventions for each of the following:
a. Sodium-deficit/excess
b. Potassium-deficit/excess
c. Phosphorus-deficit/excess
d. Calcium-deficit/excess
e. Magnesium-deficit/excess
f. ABGs
g. Blood Urea Nitrogen (BUN)
h. Creatinine
i. CBC/anemia/erythropoetin
9. Differentiate between the following modes of renal dialysis:
a. Hemodialysis
b. Peritoneal dialysis
10. Formulate nursing diagnosis with goals and interventions for the adult/older adult
experiencing:
a. Hemodialysis
i. CRRT
ii. CVVH
iii. CVAH
b. Peritoneal dialysis
11. Differentiate between varying venous access devices:
51
a. Arteriovenous Shunt
b. Arteriovenous Graft
c. Arteriovenous Fistula
d. Subclavian/Femoral Venous Catheter
12. Discuss principles, complications, and nursing management of:
a. Arteriovenous Shunt
b. Arteriovenous Graft
c. Arteriovenous Fistula
d. Subclavian/Femoral Venous Catheter
13. Evaluate and discuss the following dietary needs for clients with acute and chronic
renal failure:
a. Carbohydrate
b. Protein
c. Fat
e. Electrolytes (especially sodium and potassium)
f. Fluid intake
g. Vitamins and minerals
14. Differentiate common medications used in the treatment of clients with renal failure:
a. Phosphate binders
b. Anticoagulants
c. Epogen (EPO)
15. Explain the pharmacological management of medication in clients undergoing
dialysis:
a. Pre dialysis
b. Post dialysis
16. Identify community resources available for clients with chronic renal failure and end stage
renal disease (ESRD).
17. Prioritize nursing interventions related to abnormal findings of laboratory tests and
diagnostic procedures for clients with renal disorders.
52
Activities for Clinical Experience (Clinical Objectives)
Activities to be Completed
1. The student will promote quality client care through
excellence in clinical practice, research, and evidencebased decision making.
Evidence
2. Identify the purposes and the nurse’s role in caring for
a patient undergoing the following diagnostic
procedures:
a. Cystoscopy
b. Abdominal ultrasonography (ultrasound)
c. Intravenous Pyelogram (IVP) or retrograde pyelogram
d. Hemodialysis or Peritoneal Dialysis
3. Identify the purpose for the following tests and the nurses’
role in collection and interpretation of the following tests:
a. Urine chemistry
b. Blood urea nitrogen (BUN)
c. Serum creatinine
d. Urine culture and sensitivity
e. Urinalysis
f. Timed urine collection
g. Clearance tests
h. Complete Blood Count ( With Differential)
i. Serum electrolytes
4. Provide a means of collecting urine in a system that allows
ambulation:
a.
Indwelling Foley catheter
a.
b.
c.
d.
e.
Voided clean catch method
Supra Pubic catheter
In and Out catheterization
Urinary diversions: Illeal conduit or Kock pouch
Urinary leg bag attached to indwelling catheter or a
condom catheter
Activities to be Completed
5. Demonstrate ability to plan and provide means for
preventing incontinency.
6. Prevent urinary tract infections (UTI) in clients at risk for
UTI.
7. Demonstrate correct placement and attachment of the
urinary drainage bag to the bottom bed linen.
53
Evidence
8. Identify the nurses’ role in the following:
a. Measure Intake and Output.
b. Perform catheterization and providing client teaching to
male and female clients.
c. Know rationale for and gather the correct equipment used,
by nurses, for urinary elimination.
d. Remove an indwelling catheter.
e. Demonstrate ability to apply a condom catheter and attach
a urinary leg collection bag
f. Teach clients (or significant others) how to care for
urinary catheters and urinary diversion devices, answer
questions and assess the level of understanding.
g. Know rationale for continuous bladder irrigation and
know how to measure urine output from it.
h. Apply a Urinary Diversion Pouch.
i. Empty and measure urine contents from urinary devices.
j. Use correct equipment to assess for renal calculi.
k. Correctly label specimens, place them in correct
containers, and know when to send them to the laboratory.
l. Demonstrate the clamping protocol used in clients with
urinary catheters.
m. Know the primary structures and function of the urinary
system: The kidneys, ureters, bladder, and urethra.
n. Know the rationale and nursing responsibilities for clients
on fluid restriction.
o. Demonstrate knowledge of how to perform bladder
irrigation.
q. Locate where the policy and procedure books (the unit
students are assigned to) are, and read the policies and
procedures regarding clients with elimination problems.
8. Identify the nurses’ role in caring for clients diagnosed
with:
a. Urinary tract infections (UTIs)
i. Cystitis
ii. Pyelonephritis
54
b. Glomerulonephritis
c. Renal Calculi
d. Benign prostatic hypertrophy (BPH)
e. Acute renal failure
f. Chronic renal failure
g. End Stage Renal Failure
h. Nephrotic Syndrome
9. Identify the nurses’ role in caring for
a. Arterial Venous shunts
b. Grafts, Fistulas
c. Subclavian catheters
10. Perform a client needs assessment and identify
interventions to prevent complications and assist clients cope
with problems and/or treatment.
11. Identify stressors regarding the excretory needs of the
clients.
a. Plan care to reduce stressors
b. Plan care and interventions that reduce already
existing medical/psychosocially problems
c. Listen to concerns
d. Answer questions
e. Provide client teaching
12. Formulate four care plans addressing different
elimination problems of clients.
13. Provide nursing care, (assessment, nursing diagnosis,
planning, intervening, and evaluating) in the clinical
setting, to clients with alterations in urinary
elimination.
14. Identify the purposes and the nurse’s role in caring
for a patient on a Renal Diet:
a. Assess client’s hydration status
b. Check physician’s diet order and client’s food tray
c. Assess client’s ability to eat
d. Assess client’s desire to eat
15. State rational for obtaining client’s weight and use of
appropriate weighing scale.
16. Demonstrate ability to safely weigh clients and use
conversions.
a. Use of a Bed Scale
b. Use of a Upright scale
c. Use of a wheelchair
d. Convert pounds to kilograms and kilograms to pounds
17. Identify the correct client, safely administer medications.
Students will administer medications only when the
instructor is present.
55
N-254 LEARNING ACTIVITIES: EXCRETORY NEED IV
Required Readings:
Dudek, S. (2006). Nutrition handbook for nursing practice (5th ed.). Philadelphia:
Lippincott.
Phipps, W. J., Monahan, F. D., Sands, J.K., Marek, J.F., Neighbors, M., & Green, C.
(2007). Medical-surgical nursing health and illness perspectives (8th ed.). St. Louis:
Mosby
Recommended Readings:
Beattie, S. (2007) Hemorrhage, RN, 70(8), 30-35.
Kohtz, C,. & Thompson, M. (2007). Preventing contrast medium-induced nephropathy,
AJN, 107(9), 40-49.
Kuchta, K., VanBuskirk, S., & Houglum, M. (2007). Helping patients with end-stage
renal disease. AJN, 107(5), 35-36.
Martchev, Deborah. (2008). Improving quality of life for patients with kidney failure,
RN, 71(4), 31-37.
Robb, M. (2008). Hyperphosphatemia, RN, 70(12), 26-31.
Russell, Sally. (2008). Responding to 2 threats to the kidney, Nursing 2008, 38(2), 36-40.
Zeigler, Shirley A. (2007) Prevent dangerous hemodialysis catheter disconnections,
Nursing 2007, 37(3), 70.
1. Acute renal failure, www.jama.com.
2. Anemia in kidney disease and dialysis, www.kidney.org
Selected websites:
www. aakp.org; www.ajn.com; www.rnweb.com
www.annanurse.org; www.jama.com; www. Kidneyschool.org
www. Nephron.com; www. Kidney.org; www.nursing2008.com
5. Case Studies & Small Group Discussion;
6. Clinical laboratory
6.1 Care for patients with acute or chronic renal failure
6.2 Discussion re: Dialysis
7. EVALUATION: Theory: Multiple-choice exam with fill-in the blank and five math
calculations.
56
Appendix A
NURSING 254
ANECDOTAL CLINICAL NOTES
Name:______________
SPRING/FALL 20_______
SECTION # ____________
CLINICAL AGENCY:_____________
INSTRUCTOR:__________________
Upon completion, the anecdotal notes accurately reflect the student’s perspective of the
clinical experience. They must be completed at the end of the rotation, in addition to the
clinical evaluation tool in order to successfully complete Nursing 254. Use each category
to note how you evidenced safe, professional care that was based on scientific principles.
Please respect HIPPA guidelines by utilizing initials only for patient identifier. Do not
include patients’ names or room number. Include clinical behaviors you routinely
implemented to verify compliance. This form is to be utilized for the entire clinical
rotation. Students are to make weekly entries on the anecdotal notes.
The completed form is to be submitted to your clinical instructor at the
end of the course.
Role as provider of care:
ASSESSMENT
1.
Obtain data through the assessment of the patient
2.
Collect additional data relating to the patient from family, significant others,
health care records, health care members, and other resources
3.
Identify changes in health status that after the patient’s ability to meet needs
4.
Contributes the information to a data base and/or NCP
DIAGNOSIS
1.
Identify actual or potential health care needs on the basis of assessment
2.
Select nursing diagnosis on the basis of analysis and interpretation of data
57
PLAN
1. Establish priorities for care with recognition of patient’s diagnosis and needs
2. Develops a care plan incorporating data related and spiritual beliefs and
physiological, psychosocial, developmental needs and strengths
3. Collaborates with other health team workers in the development of individualized
teaching plans that include health counseling, discharge planning, and
implementation of therapeutic regimen
4. Support patient’s right to make decisions regarding care
IMPLEMENTATION
1. Implements a care plan according to priority of goals
2. Initiates nursing interventions in response to patient’s needs
3. Adjusts priorities for nursing interventions as patient situations changes
4. Demonstrate safe performance of nursing skills
5. Provides for physical safety of the patient
6. Promotes and environment conductive to maintenance or restoration of the
patients ability to carry out activities of daily living
7. Supports the rehabilitation potential of the patient
8. Administrates and monitors the prescribed medical regimen for the patient
undergoing diagnostic tests and/or therapeutic procedures
9. Promotes psychological safety of the patient
58
10. Demonstrates caring behavior in providing nursing care
11. Utilizes communication techniques that assist the patient, family, and significant
others to cope with and resolve problems
12. Accurately communicates verbally and in writing patient behaviors, responses to
nursing interventions, and responses to medical regimen
13. Implements teaching plans that are specific to the patients level of development,
knowledge, and learning needs
14. Assist in providing for the continuity of care in the management of chronic health
needs
EVALUATION
1. Determines the effects of nursing interventions of the status of the patient
2. Participates with the patient. Family, significant others, and members of the health
care team in the evaluation of the patient progress toward goals
3. Revises the care plan as needed
ROLE AS A MEMBER OF CARE
1. Establishes priorities of nursing care for a group of 3-5 patients
2. Function as an effective team member with other health care workers
3. Assists other member of the health care team in a collegial manner
59
4. Utilizes appropriate channels of communication to accomplish goals related to
delivery of patient care
5. Assists in providing the continuity of care within the health care agency
6. Serve as a advocate for clients
7. Seeks assistance from other members of the health care team when a situation
encountered is beyond the students knowledge and experience
8. Practices nursing care in a cost effective manner
ROLE AS A MEMBER WITHIN THE DISCIPLINE OF NURSING:
1. Practices within the ethical and legal framework of nursing
2. Maintains confidentiality of information regarding patients
3. Communicates truthfully and accurately in verbal and written form the patients
behavior and responses to interventions
4. Reports concerns regarding quality of care to the appropriate person
5. Uses information from cultural literature to provide safe nursing care
6. Uses constructive criticism and suggestions for improving nursing practice
60
APPENDIX B
El Camino College Library
A Brief Guide to Citing Sources in the APA Style
May, 2005
Prepared by the Reference Desk Staff at the Schauerman Library
This guide offers a brief explanation of how to prepare a bibliography, or “reference list,”
in the APA (American Psychological Association) style.
• The reference list cites only the works you have used in your paper.
• Works are listed alphabetically by author, and each entry includes these
elements: author, year of publication, title and publishing data.
• The list must be double-spaced. New entries begin at the left-hand margin with
subsequent lines for the same entry indented one-half inch, or five typed spaces.
This guide is based on the Publication Manual of the American Psychological
th
Association (5 ed.). Please refer to the Publication Manual for further and more
complete information.
Schauerman Library Location: REF BF 76.7 P83 2002
To cite books by one author
McDougal, F. J. (2003). Adventures in communal psychotherapy: Selected texts for the
nd
beginning student (2 ed.). Longmont, CO: Ethan and White.
The author’s name is reversed for alphabetizing: last name first, followed by initial(s).
Capitalize the first word in the title, the first word after a colon in the title, and any proper
names. Italicize the title, but not any edition statement, which follows the title in
parentheses.
Publication information: Give the city, and the two-letter postal abbreviation for the
state, for publishers in the United States. Give the city and country for publishers outside
of the United States. Major cities well known for publishing (New York, London,
Amsterdam, etc.) may be listed without state or country abbreviation. If two or more
publisher locations are listed, give the one listed first. Give the publisher’s name in as a
brief a form as possible, omitting words such as “Co.,” “Inc.”, or “Publishers.” Include the
words “Books” and “Press.”
Book by two or more authors, and two books by the same author
Chu, W., Wang, J., & Li, A. (1993). China and America in the next century: Possibilities
and perils. Los Angeles: Far East.
All authors’ names are inverted. Give surnames and initials for all authors. Precede the
last author with an ampersand (&). For two or more works by the same author, arrange
by date:
Chu, W. (1993).
Chu, W. (1995).
Book by a group (corporate) author
Los Angeles Olympic Organizing Committee. (1984). Official Olympic souvenir
program: Games of the XXIIIrd Olympiad. Los Angeles: The Committee.
61
Always use the full, official name of the group author, and alphabetize by the first
significant word.
Book with no author
Camping on the Coast without a permit. (1972). Santa Barbara, CA: Home Grown Press.
If there is no author given for a work, alphabetize the entry by the first significant word in
the title.
Book with an editor or translator
Cheng, D. (Ed.). (2002). Math basics for college success. Redondo Beach, CA: Strand
Press.
Teufelsdroch, D. (1995). Amoral certainties (A.S. Puterbaugh, Trans.). London: Glass
House.
(Original work published 1860).
Treat an editor as an author and invert the name, adding “Ed.” (or “Eds.”) in
parentheses. Translators’ names are listed in parentheses after the title in normal order:
first and middle initials, surname, and then the abbreviation “Trans.” for translator.
Work from an Opposing Viewpoints book
Richman, S. (2000). There is no right to health care. In J.D. Torr (Ed.), Health care:
Opposing viewpoints (pp. 35–46). San Diego: Greenhaven Press.
Include the editor(s), title of the Opposing Viewpoints book, and the page numbers of the
article. The year (2000) refers to the publication date for the book, not the original article.
Work from a Taking Sides book
Adams, R.E. (2000). Transformations: The classic Maya collapse. In J.R.Mitchell &
H.B.Mitchell (Eds.), Taking sides: Clashing views on controversial issues in
world civilizations (pp.118-124). Guilford, CT: Dushkin/McGraw.
PERIODICAL LITERATURE
Newspaper article
Hotz, R. L. (2003, January 23). Walking on air over “incredible discovery”: Scientists say
four-winged dinosaur may be long-sought link to birds. Los Angeles Times, pp. A1, A6.
Give the year, followed by the month and day of publication. Do not italicize the title or
put quotation marks around it. Capitalize all of the major words in the newspaper’s
name. Precede page numbers with “p.” or “pp.” If an article does not appear on
continuous pages, give all the page numbers, separated by commas (e.g. pp. B1, B3, B5
-7).
Magazine article
Poniewozik, J. (2000, April 17). A modern Jurassic family: Discovery’s digital dinos mix
fact and guesswork. Time, 155, 80.
Do not abbreviate the month. Include the volume number in italics following the
magazine’s name and before the article’s page number(s). Note the page numbers only.
Do not include “p.” or “pp.”
62
A journal article with continuous pagination
Kerr, R. A. (2002). A little respect for the asteroid threat. Science, 297, 1785-6.
Include the volume number in italics following the title of the journal and before the page
number(s). Note pages only. Do not include “p.” or “pp.”
An article with two authors in a journal that pages each issue separately
Harris, B. & Sailor, M. (2003). Rap and the bardic tradition: Some observations. Journal
of Communication Studies, 24 (3), 80-102.
Invert both authors’ names, and put the issue number--not italicized--in parentheses
following the volume number.
REFERENCE WORKS
To cite an entire encyclopedia or dictionary
th
Blackpoole, A. (Ed.). (2003). Encyclopedia of alternative psychology (4 ed., Vols. 1-6).
Los Angeles: Ocean View Press.
For works with many editors, you may list the lead editor followed by “et al.”
An article in a reference work, signed
Strawson, G. (1999). Free will. In Routledge encyclopedia of philosophy (Vol. 3, pp. 743753). London: Routledge.
Include the volume number and page numbers where the article is to be found.
ELECTRONIC RESOURCES
Document from an ECC subscription database
If you are citing an article from one of the El Camino College Library subscription
databases listed below, the name of the database alone is sufficient for the citation, and
no URL is needed.
CINAHL
Jenkins, P. (2002). Doping in sports. Lancet 360, 99-100. Retrieved January 24, 2003,
from CINAHL database via the EBSCOHost online system.
Clinical Pharmacology
Acetaminophen; aspirin, ASA; caffeine. (2002). Retrieved March 28, 2003, from the
Clinical Pharmocology database via the EBSCOHost online system.
CountryWatch
Iceland: Economic performance. (2002). Retrieved September 30, 2002, from the
CountryWatch database.
CQ Researcher
Masci, D. (1997, August 22). Evolution vs. creationism. Retrieved December 14, 2001,
from the CQ Researcher [Online] database.
EBSCOhost MasterFILE Premier
Tyrell, R. E., Jr. (1997, May 18). The worst book of the year. American Spectator, 30, 18.
Retrieved April 14, 2000, from the EBSCOHost MasterFILE Premier database.
EBSCOhost Academic Search Elite
Fox, R.L., & Oxley, Z.M. (2000). Gender stereotyping in state executive elections:
Candidate selection and success. Journal of Politics, 65, 833. Retrieved August
12, 2004, from the EBSCOHost Academic Search Elite database.
63
Ethnic NewsWatch
Chesanow, D. (2001, May 15). Leading the way: Asian American artists of the older
generation. International Examiner, 28, 22. Retrieved October 11, 2001, from the
Ethnic NewsWatch database.
Health and Wellness Resource Center
th
Ulterior transactions. (1998). Mosby’s Medical, Nursing, & Allied Health Dictionary (5
ed.). Retrieved December 14, 2001, from the Gale Group’s Health and Wellness
Resource Center database.
Health Reference Center: Academic
Tenore, J. L. (2001). Challenges in eating disorders: Past and present. American Family
Physician, 64, 367. Retrieved October 17, 2002, from the Gale Group’s Health Reference
Center database.
Health Source: Consumer Edition
Weider, J. (2002, June). Turning back the clock. Joe Weider’s Muscle & Fitness, 63, 22.
Retrieved September 27, 2002, from Health Source: Consumer Edition database
via the EBSCOHost online system.
Health Source: Nursing/Academic Edition
Rubin, P. When medical students go off the rails. BMJ: British Medical Journal, 325,
556. Retrieved October 4, 2002, from Health Source: Nursing/Academic Edition
database via the EBSCOHost online system.
Issues and Controversies
Drug Legalization. (2001, January 5). Retrieved October 11, 2001, from Issues and
Controversies@FACTS.com database.
ProQuest
Zernike, K. (2000, April 29). School puts a new spin on earth day after suit. New York
Times, East Coast late ed., B5+. Retrieved May 1, 2000, from the ProQuest
Newspapers database.
Today’s Science
The strange case of Jupiter’s moons. (2001, October). Retrieved December 21, 2001,
from Today’s Science@FACTS.com database.
Wilson OmniFile Full Text Mega
Clifford, K. (2000, September). What makes a great painting great? Art News, 99, 136-9.
Retrieved October 11, 2001 from Wilson OmniFile Full Text Mega database.
DOCUMENTS FROM OTHER ELECTRONIC RESOURCES
Special considerations:
• Electronic addresses: Avoid breaking a URL between lines. If necessary, do
so after a slash or before a period, as in the “Document not from a subscription
database” below.
• Magazine/Journal titles: Use italics and capitalize the first letter of each
important word.
• Article/Document titles: Do not use italics, underlining, or quotation marks.
Capitalize the first word, proper nouns, and the first word after a colon.
• Undated Documents: Insert (n.d.) for “no date” after the document title.
64
Article from an Internet-only periodical not associated with a subscription
database
Basic form:
Author, A.A., & Author, B.B. (Date of Publication). Article Title. Journal Title, Volume
Number (Issue number in parentheses, if available). Retrieved month, day, year
from
http:// web address
Example:
Harms, U. (2002, December 15). Biotechnology education in schools. Electronic Journal
of Biotechnology, 2 (3). Retrieved March 18, 2003, from
http://www.ejbiotechnology.info
A nonperiodical Internet document not from a subscription database
Basic form:
Author, A.A, & Author, B.B. (Date of publication). Title of document. Retrieved month,
day, year from http://web address
Note: For large and complex Web sites, such as those found at universities or
government agencies, include the host organization before the URL.
Example:
Barker, J. (2003, January 6). Evaluating Web pages: Techniques to apply and questions
to ask. Retrieved March 12, 2003, from the University of California, Berkeley,
Web site: http://www.lib.berkeley.edu/TeachingLib/Guides/
Internet/Evaluate.html
An Internet Government Report
Basic form:
Sponsoring agency. (Date of Publication). Title. (Publication data). Retrieved month, day,
year from http://web address
Example:
U.S. General Accounting Office. (1999, February). Telemedicine: Federal strategy is
needed to guide investments. (Publication No. GAO/NSAND/HEHS-97-67).
Retrieved September 15, 2000, from General Accounting Office Reports Online
via GPA Access: http://www.access.gpo.gov/su_docs/aces/
aces160.shtml?/gao/index.html
For additional information, visit the APA online:
Electronic Reference Formats Recommended by the APA
http://www.apastyle.org/elecref.html
Frequently Asked Questions about the Publication Manual
http://www.apastyle.org/faqs.html
65
APPENDIX C
66
APPENDIX D
67
APPENDIX E (Sample)
68
69
APPENDIX F
70
APPENDIX G
71
APPENDIX H
72
73
74
APPENDIX I:
ABGs
ARTERIAL BLOOD GAS (ABG) PRACTICE
1
2
3
4
5
pH
7.43
7.45
7.48
7.33
7.33
P02
138
82
79
85
62
PC02
28
33
50
33
48
HC03
19
23
27
20
22
6
7
8
9
10
Answer
ABGs
pH
7.31
7.33
7.52
7.32
7.49
P02
65
66
80
60
92
PC02
58
52
50
52
33
HC03
28
29
21
25
26
Answer
ABGs
11
12
13
14
15
7.31
7.37
7.38
7.30
7.45
Pa02
55
85
99
50
96
PaC02
80
30
25
60
42
HC03
24
21
18
20
27
16
17
18
19
20
pH
Answer
ABGs
pH
7.39
7.43
7.37
7.53
7.51
Pa02
75
90
85
67
82
PaC02
42
30
47
50
33
HC03
24
22
19
30
27
Answer
75
APPENDIX J:
Practice Math Test
1. Your 65 kg patient has an IV order for Dobutamine 500 mg in 250 ml D5W to
infuse at 10 mcg/kg/min. Calculate the flow rate in ml/hr.
2. Your patient is admitted with deep vein thrombosis. The doctor orders an
infusion of 1000 units/hr of heparin from a solution of 1000 ml 0.45% saline with
25,000 units of heparin. At what rate will you set the IV pump?
3. The patient starts to react to the Vincristine and the MD orders Solumedrol 0.5
grams IVPB to run over 30 minutes stat. Stock vials read solumedrol 125 mg per
2 ml. How many vials will you need to make up the accurate dose?
____________________.
4. The nurse checks a heparin sodium drip and finds the flow rate is set at 15 mL/hr.
There is 20,000 units of heparin sodium in 250 mL NS. What is the dosage of
heparin sodium the client is currently receiving?__________
5. The physician orders 2 units of packed red blood cells to be given over 4 hours.
The second unit has a volume of 280 mL, as noted on the bag by the blood bank.
The drop factor on the manual IV is 10. What is the flow rate calculated by the
nurse?__________
6. A 70 kg client is receiving 45 mg nitroprusside (Nipride) in 250 mL of NS at 3
mcg/kg/min. The physician orders state that the nitroprusside (Nipride) drip
should be titrated every 5 minutes by 1 mcg/kg/min increments, to keep systolic
BP less than 180 mm Hg, and greater than 150 mm Hg. Five minutes after starting
the drip, the nurse notes that the client's systolic BP is 194 mm Hg. What is the new
flow rate calculated by the nurse?__________
76
7. A 52 year old male with a diagnosis of acute myocardial infarction is receiving
Lidocaine 2 Grams IV in 500 mL D5W at 2mg/min via infusion pump. Determine
the flow rate in mL/hr.
8. A MI client has been placed on a 5mg Nitroglycerin patch with a transdermal
delivery of 0.2mg/hour everyday at 1000. How many patches will it take to equal
the dose of 5mg?
9. A CABG client is receiving 1000 mL of D5W IV with 25mg of Nitroglycerin to
infuse at 5mcg/min. How would you set the infusion pump to deliver this dose?
10. A diabetic patient’s blood glucose is 149 @ 7:00. Your Medex shows routine
NPH insulin 5 units every AM + sliding scale coverage as listed. How many total
units of insulin are you going to give?__________.
Sliding scale:
0-60: orange juice & D50
61-150: no coverage
151- 200: 2units regular insulin
201-250: 4 units regular insulin
251-300: 6 units regular insulin
301-350: 8 units regular insulin
351-400: 10 units regular insulin
401: call MD.
77
APPENDIX K:
GRADING SUMMARY SHEET
Nursing 254: Fall /Spring- Year 2_________
Student Name:______________
Course Grade:____________
Theory Instructor:_____________________________________
Lab. Instructor:______________ Agency:________________
% of Exam Points
Exams
Leadership/Management
10
Renal
20
Respiratory
20
Cardiovascular
20
Final (Comprehensive)
25
Papers
Resume
0.5
Cardiac Assignment
2.5
Article Critique
2.0
Total Points______________
Theory Grade_____________
Grade
To be turned in at the end of semester
Grading Summary Sheet
(Appendix L) _____
Geriatric Log
(Appendix C) _____
Skills Check list (from FUNDAMENTALS) _____
ICU RN checklist
(Appendix D) _____
Manager of Care Evaluation
(Appendix G) _____
Clinical Evaluation Tool
(Appendix M) _____
Course Evaluation
(Code 2)
______
Clinical Evaluation
(Code 3)
______
Instructor Comments:__________________________________
_________________________________________________
_________________________________________________
78
APPENDIX M
El Camino College
NCLEX INFORMATION
http://www.dca.ca.gov/proflic/Help/faqs.html
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Related Links
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Specialty and Advanced Practice Groups
Nursing Associations
Nursing Groups and Commissions
Licensure by Examination
Applicants must take the National Council Licensure Examination (NCLEX-RN) if they have never
taken and passed, or been licensed as a registered nurse in another state. All applicants must have
completed an educational program meeting all California requirements. If you are lacking any
educational requirements, you must successfully complete an approved course prior to taking the
examination.
All Applicants Must Provide the Following:

Appropriate Fees.
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Completed Application for Licensure by Examination.
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Completed fingerprints using either the Live Scan Process or the Applicant Fingerprint Card
(Hard Card) processing method as directed in the "Instructions for Submitting Fingerprint Cards".
Submit the appropriate nonrefundable TOTAL FEE as directed on the Application Fee Schedule.
NOTE: Application does not include fingerprint cards or live scan form. Fingerprint cards and
livescan forms may be requested on the Requests page.
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One recent 2" x 2" passport-type photograph.
79

Completed Request for Accommodation of Disabilities form(s), if applicable.
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Request for Transcript form(s) completed and forwarded directly from the nursing school(s)
with certified transcripts.

If applicable, documents and/or letters explaining prior convictions or disciplinary action and
attesting to your rehabilitation as directed in Section II of the General Information and Instructions.

IN ADDITION FOR INTERNATIONAL APPLICANTS:
o
A. Send Breakdown of Educational Program for International Nursing Programs form
to your school with the Request for Transcript form. Also provide the Certified English
Translation form to your certified translator if your transcript is not in English. (See
Supplemental Application Instructions for International Graduates with the application.)
o
B. Submit a copy of your license or diploma that allows you to practice professional
nursing in the country where you were educated. If you do not hold a license, a written
explanation is required. Also, provide copies of your certificates for midwifery and psychiatric
nursing, if applicable.
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80
APPENDIX N
El Camino College
ATI INFORMATION
You’re well on your way to your nursing education…
But it is simply a fact that you will encounter some challenges along the way. It’s a
lot of content to absorb in a relatively short period of time, and the stakes are high.
You’ve invested a lot in laying the groundwork for a successful nursing career, and
this is the time when you will make it happen. Rest assured that ATI is here to help
YOU reach your goals!
ATI gives you a wide variety of study tools not only for preparing you for the
NCLEX®, but also for helping you build that nursing knowledge base you are going
to need throughout your nursing career. Would you rather see information on a screen
than read it in a book? We’ve got iPod® videos, DVDs, and interactive online
programs to help you every step of the way! You can check your progress and follow
a personalized study plan designed just for you. Virtual-ATI® NCLEX-RN® Review
A structured, self-paced, online NCLEX-RN® review course with a certified
instructor and personal coach, a customized study plan, review books, DVDs, and 18
practice assessments
An NCLEX-RN®-review powerhouse of 9 online practice assessments, an alternateformat test, a comprehensive assessment, 8 review books, and a study guide full of
test-taking tips
National Council of State Boards of Nursing, Inc.
The National Council of State Boards of Nursing, Inc. (NCSBN), is a not-for-profit
organization whose membership comprises the boards of nursing in the 50 states, the
District of Columbia, and four U.S. territories – American Samoa, Guam, the Northern
Mariana Islands, and the Virgin Islands. To learn more, visit the NCSBN web site at
https://www.ncsbn.org.
Check out this section of our website often, as you never know what else we’ll come up
with to meet your ongoing needs!
Data Collection
ATI collects personal information during the login process used to access the testing
portion of our website. The demographic information we request is used in aggregate in
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group represented by the demographic information we collect.
ATI does not store credit-card information. ATI is PCI-compliant and regularly scanned
by a security company that has been approved by major credit-card companies.
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If appropriate, ATI will use your contact information to send relevant messages via email
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82
N254 Spring 2010 Class Schedule-Crenshaw/LCMH Campus
Class:0800-1205
Clinic:0700-1550
Monday
Tuesday
Wednesday
Thursday
Friday/Saturday
2/15/2010
2/16
Clinic
2/17
Clinic
2/18
Clinic
2/19-20
Clinic
2/23
Clinic
2/24
Clinic
Tuition Proof & ATI Fee
2/25
Clinic
2/26-27
Clinic
3/2
Clinic
3/3
Clinic
3/4
Clinic
3/5-6
Clinic
3/8
L&M/Disaster Exam
Respiratory lecture
3/9
Clinic
3/10
Clinic
3/11
MADDEN
CONFERENCE
3/12-13
Clinic
3/15
Respiratory (Trauma)
3/16
Clinic
3/18
Clinic
3/19-20
Clinic
3/22
Respiratory Exam
Cardiac Lecture
3/23
Clinic
3/17
Clinic
Article Critique due
3/24
Clinic
3/25
Clinic
3/26-27
Clinic
3/29 Cardiac (EKG)
Lecture
3/30
Clinic
3/31
Clinic
4/1
Clinic
4/2-3
Clinic
4/5
Cardiac Lecture
4/6
Clinic
4/7
Clinic
Cardiac paper due
4/8
Clinic
4/9-10
Clinic
4/12 Spring Recess
4/13
4/14
4/15
4/16-17
4/19
Cardiac Exam
Renal Lecture
4/20
Clinic
4/21
4/22
DISASTER
DRILL
4/23-24
Clinic
4/26
Renal Lecture
Math Exit Exam
4/27
Clinic
4/28
Clinic
4/29
Clinic
4/30-5/1
Clinic
5/3
Renal Exam
MOF/Burns/Trauma
5/10
FINAL EXAM
N 255 Orientation
5/4
Clinic
5/5
Clinic
5/6
Clinic
5/7-8
Clinic
5/11
Clinic
5/12
Clinic
5/13
Clinic
5/14-15
Clinic
No Class
2/22/
Orientation; Leadership
& Management lecture
Disaster
3/1/2010
Disaster lecture
Respiraory lecture
Resume due
83