Santa Monica College
Course Outline For
Course Title: Nursing 30L – Intermediate Medical-Surgical
Nursing
Date Submitted: Fall 2003
Updated: Fall 2006
I.
Units:
2.5
IGETC Area:
CSU GE Area:
Transfer:
CSU
Catalog Description:
Prerequisite: Nursing 25, Nursing 25L, Nursing 16, Nursing 17
Corequisite: Nursing 30
The focus of this nursing laboratory course is to provide the continuing
student with the opportunity to apply increasingly complex medicalsurgical concepts of care for adults with health deviations. Students will
assess, plan, provide and evaluate the provision of nursing assistance in
the clinical laboratory. The Orem Self Care Model will be used as a
framework to safely meet nursing needs of the patient with
gastrointestinal, renal, oncological, hematological, female reproductive
and immune system disorders. Students will assess the adult and older
adult’s self care requisites, determine the therapeutic self-care demand and
apply the nursing process. Professional role development is integrated
throughout; along with application of critical thinking, communication
theory, clinical judgment, and sound reasoning. Laboratory experiences
will be held in the acute care or community setting. Course must be taken
concurrently with theoretical component, Nursing 30.
II.
Required Text and References:
1.
2.
3.
4.
5.
6.
Doenges, Marilyn, Nurse’s Pocket Guide: Nursing Diagnoses with
Interventions, 7th ed., F.A. Davis, 2000.
Leukenotte, Annette G., Gerontological Nursing, 3nd ed., Mosby,
2006.
Estes, Health Assessment & Physical Examination, 2nd ed., Delamr
2002.
Fishbach, Frances, Manual of Laboratory Diagnostic Tests, 6th ed.,
Lippincott, 2003.
SMC Nursing Handbook, current edition – available online
Smeltzer & Bare, Brunner’s Textbook of Medical-Surgical Nursing,
10th ed., Lippincott 2004.
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III.
Course Objectives:
Upon completion of Nursing 30, students should be able to:
1. Develop a nursing plan of care for adults and older adults with health
deviation involving the following:
a) gastrointestinal tract – absorption and elimination
b) liver, biliary tract and pancreas
c) immune and auto-immune system
d) hematological system
e) renal system
f) oncological
g) female reproductive system
2. Communicate effectively orally and in writing during clinical practice
with the patient, family, and multi-disciplinary health care team.
3. Predict nursing assistance required for the patient/client by applying
critical thinking and analyzing collected data.
4. Demonstrate behaviors which reflect knowledge of the professional
responsibilities of the beginning manager of care.
5. Apply nursing techniques of disease prevention, health promotion and
health maintenance for adults and older adults.
6. Perform learned behaviors that integrate the role of the professional
nurse into practice and leadership situations.
7. Perform all course related behaviors satisfactorily based on established
critical criteria.
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IV.
Clinical Objectives:
Upon completion of the course students will be able to:
1. Utilize the five step nursing process to provide safe, comprehensive
care to two-three adults or older adults with the following health
system deviations:
a) gastrointestinal tract
b) liver, biliary tract and pancreas
c) immune system
d) hematological
e) renal
f) oncological
g) female reproductive
2. Communicate effectively during clinical situations with
clients/patients, families, peers and the multi-disciplinary health care
team.
3. Teach the patient/client regarding clinical implications of laboratory
and diagnostic procedures commonly associated with the above health
deviations.
4. Perform a focused physical assessment on a patient/client with the
above health system deviations; differentiate normal and abnormal
findings.
5. Analyze changing data presented in a clinical care situation and
demonstrate critical thinking to revise required nursing assistance.
6. Demonstrate the ability to safely administer all medications assigned
clients are receiving via all routes, including oral, subcutaneous,
intramuscular, topical, rectal, inhalation, and intravenous.
7. Correlate effects of medications to patient/client health deviations and
expected outcomes.
8. Present a patient situation utilizing the “grand rounds” format
satisfactorily in small group settings.
9. Integrate leadership behaviors that reflect practice roles of the
professional medical-surgical nurse.
10. Utilize critical thinking strategies which include appropriate
communication skills to prevent disease promote and maintain health
of the adult and older adult.
11. Implement nursing management techniques for clients with alterations
in nutritional intake including total parenteral nutrition, naso-gastric
feedings, gastrostomy and jujenostomy feedings.
12. Implement nursing management techniques for clients with alterations
in function of the lower gastrointestinal tract including ileostomy and
colostomy.
13. Participate in providing nursing assistance during gastrointestinal
procedures in the G.I. lab.
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14. Implement nursing management strategies for clients with cancer who
are receiving chemotherapy to minimize psychological and physical.
discomfort.
15. Implement nursing management strategies for clients experiencing
alterations of renal and bladder function including urinary diversion;
peritoneal dialysis and hemodialysis.
16. Implement nursing management strategies for female clients with
disorders of the reproductive system including pharmacological and
surgical interventions.
17. Participate critically in self evaluation process and achievement of
objectives at midterm and end of course.
18. Perform infusion therapy, including venipuncture, total parenteral
therapy and transfusion of blood components.
V.
Methods of Presentation:
“Hands On” patient care experiences, skills lab assignments, nursing care
plan development, computer aided instruction, post conference
interactions, written assignments and supervised skill practice.
VI.
Course Content:
Coverage
25.0
12.25
12.25
12.25
12.25
12.25
12.25
VII.
Topic
Gastrointestinal tract
Liver, biliary tract and pancreas
Immune system
Hematological
Renal
Oncology
Female reproductive
Methods of Evaluation:
Instructor observation of student performance, utilization of the Socratic
questioning, achievement of clinical objectives, participation in post conference,
satisfactory preparation; compliance with college, nursing program and facility
policies and procedures.
Clinical Grading Scale: Pass/Fail – See Clinical Evaluation Tool – Failure
N30L constitutes an “F” grade in N 30 regardless of the grade achieved in
theory.
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VIII.
Exit Skills N30L:
1. Implement and evaluate a comprehensive plan of care for the patient/client
with a disorder of the gastrointestinal tract.
2. Implement and evaluate comprehensive plans of care for the patient/client
with disorders of the liver, biliary tract and/or pancreas.
3. Provide comprehensive care for the patient/client with disorders of the
immune system
4. Perform required nursing skills safely for the patient/client requiring
venipuncture, infusion therapy, and blood transfusion.
5. Implement and evaluate a comprehensive plan of care for the patient with
cancer.
6. Prioritize nursing interventions for the patient/client with hematological
disorders.
7. Plan and provide comprehensive care for the patient/client with disorder of
the renal system
8. Prioritize nursing interventions for the patient/client with disorders of the
female reproductive system
9. Utilize effective communication skills to collaborate with members of the
health care team to achieve desired patient outcomes.
10. Differentiate plans of care for the adult and the special needs and
requirements of the older adult with selected disorders.
11. Implement critical thinking processes when formulating expected
outcomes for patients who require complex nursing assistance.
12. Perform management behaviors that reflect the role of the professional
registered nurse.
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