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NURS 3434-01/3433-1A-1D FAMILY HEALTH NURSING I (Didactics/Clinicals)
Fall 2007
Pre-Requisites: NURS 3306 (Basic Nursing), NURS 3313 (Pharm)
Course Faculty
Mary Jo Distel, MS, RN
Course Coordinator
Daria Close, MSN, RN
Bridwell 308E
Marty Gibson, MSN, RN
Bridwell 312
Robin Lockhart, MSN, RN
Bridwell 318
Bridwell 324
(940) 3974603
(940) 3974390
(940) 3974097
(940) 3974614
maryjo.distel@mwsu.edu
daria.close@mwsu.edu
martha.gibson@mwsu.edu
Robin.lockhart@mwsu.edu
Course Description:
Application of theories and concepts across the span of adult life to include specific
medical-surgical conditions. Emphasis will be placed on integrating previously learned
cognitive, psychomotor, and affective knowledge in the care of the individual client, her/his
family, as well as groups and communities (IFGC) through application of the nursing process.
Credit Hours: Successful completion of both courses awards seven (7) credit hours – NURS
3434 is comprised of four (4) lecture hours per week and NURS 3433 requires nine (9) clinical
hours per week to earn (3) three credit hours.
Placement: Second semester of junior year (BSN)
Learning Experiences: Lecture, discussion, audiovisual aids, assigned readings, and clinical
experiences.
AACN Essentials: For further information regarding the AACN Essentials identified for each
course objective, refer to the BSN Student Handbook.
DELC Competencies: In the DELC Competencies below, the following designations apply:
A: Provider of Care; B: Coordinator of Care; and C: Member of a Profession. For further
information regarding the competencies identified for each course objective, refer to the BSN
Handbook.
Course Objectives
AACN Essentials
DELC
Competencies
Upon completion of this course the student will
be able to:
1.
Apply professional knowledge and theories to
the nursing care of persons and families
throughout the life span.
I: A, B, C, D, E, H
II: A1-3, B1-3, C14, D1-4, E1
III: A1-6, C1-5,8,
D1-18
A: 1f, 1g, 1j, 2a, 3f,
3g, 7a
B: 1e
2
IV: A1-4,7, B1-7
V: A2,4
2.
Integrate effective communication, research and
teaching-learning principles in providing care
for persons and their families.
I: F, G
II: B3, D3
III: B1-11
IV: C1-7
A: 1a, 1g, 1h, 1o, 2a,
2g, 3a, 3c, 3f, 3u, 3w,
3bb, 4a, 4b, 4c, 4k, 5c
B: 3e, 3g, 4b, 4c, 4d,
4f, 4k
3.
Utilize the nursing process in a systematic
manner in the care of IFGC.
A: 1a, 1b, 1m, 1n, 1p,
2f, 2h, 2i, 2o, 3m, 3s,
3x, 5a
4.
Utilize nursing knowledge when implementing
affective, cognitive and psychomotor nursing
skills.
5.
Relate knowledge of higher education concepts
in health to identify nursing interventions.
6.
Demonstrate professional accountability in
providing holistic care in a variety of settings.
7.
Implement nursing interventions with
individuals and their families who present for
nursing care.
I: A, D
III: A1-3, 5, 6, C15,8
V: A8, 10, B7
I: A, B
III: D1-18
IV: A1-10, B1-7
V: A1-13
I: A, B
II: A1-6, C1-8
IV: A1-10, B1-7
I: G, J, K
II: A2-4, D3-4, E13
III: A4 & 7
IV: C3, E3 & 5, G4
&5
V: A11-13, B2-3,
C1-8
I: C
III: D1-18
IV: 1-3, 5, 7
V: A1-3, 5, 7, 9,
B2-4, 6
I: I
II: C1-4, D1-3, E12
III: B12, D8
IV: A1-8, B7, C3,
6, D1-8
V: A11, C3-5
I: E, H
II: A1
IV: A9-10, B4, E12
V: A2
A: 1h, 1k, 4e
C: 3a, 3b
8.
Examine the legal and ethical issues related to
care of individuals and their families in a
variety of settings.
9.
Discuss the evolution of social, cultural, and
historical aspects of health care and their
influences on family health in nursing.
A: 1h, 1j, 2f, 3c
A: 1q, 2f, 3a
A: 1j, 2e, 3d, 3y, 3ee,
4d, 5g,
B: 3g
A: 3a, 3u, 3x, 3cc
A: 1d, 1n, 3i, 3j, 3z,
7f
B: 2d
C: 1a, 1c
Grading Scale
90 - 100 ...........................................................................................................................................A
80 - 89 ............................................................................................................................................. B
74 - 79 ............................................................................................................................................. C
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65 - 73 .............................................................................................................................................D
64 and below ................................................................................................................................... F
Required Textbooks:
Broyles, B., Reiss, B. & Evans, M. (2007). Pharmacological aspects of nursing care
(7th ed). Clifton Park, NY: Thomson Delmar Learning.
Gahart, B. & Nazareno, A. (2007). Handbook of IV medications (23rd ed). St. Louis,
MO: Mosby.
Pagana & Pagana (2003). Manual of diagnostic and laboratory tests (7th ed). St. Louis,
MO: Mosby.
Phipps, W.J., Monahan, F.D., Marek, J.F. & Neighbors, M. (2007). Medical-surgical
nursing: Health and illness perspectives (8th ed.). St. Louis, MO: Mosby.
Spratto, G. & Woods, A. (2007 or 2008). PDR nurse’s drug handbook. Clifton Park,
NY: Thomson Delmar Learning.
Winningham & Preusser (2005). Critical thinking in medical-surgical settings. (3rd ed.).
St. Louis, MO: Mosby.
Zerwekh, J., Claborn, J., & Miller, C.J. (2004). Memory notebook of nursing: Volume I
(3rd ed.). Ingram, TX: Nursing Education Consultants.
Zerwekh, J., Claborn, J., & Miller, C.J. (2007). Memory notebook of nursing: Volume II
(3rd ed). Imgram, TX: Nursing Education Consultants.
MSU and BSN Student Handbooks: Students are responsible for reading, understanding,
and complying with the policies stated in these publications.
Evaluation Methods:
Theory Evaluation:
Exam: I - Fluid Regulation and Urinary Elimination............................................................ 20%
II - Digestion and Gastrointestinal Elimination .......................................................... 20%
III - Musculoskeletal Disorders…………………………… ........................ …………20%
IV - Endocrine Function/Dysfunction .......................................................................... 20%
Final Examination-- comprehensive ................................................................................ 20%
Total ........................................................................................................................... 100%
Grades will not be rounded to the next highest score.
Students will be held responsible for lecture/discussion content, all assigned readings, and
audiovisual materials on written exams. When the lecture material is more current than the
textbook, lecture material takes precedence.
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Exams:
One hour will be provided for each unit exam and 2 ½ hour timeframe will be provided for the
comprehensive final exam during finals week.
Each student will provide the course supervisor five (5) blank (no names) 100-question
ParScore scantrons (those used by the nursing department) no later than the second week of class.
The professors will include one of these in each exam booklet at the time of each exam.
Additional Course Requirements:
1.
Students must maintain satisfactory health as determined by the total faculty consensus.
2.
Students must complete all of the components of the course to pass.
3.
Clinical performance, campus and/or clinical laboratory, will be evaluated. Students are
expected to pass both clinical and classroom components of the course. Failure in either
one will constitute failure in the course.
4.
As stated in the BSN Student Handbook, students must maintain a current immunization
record on file at the Vinson Health Clinic plus proof of a current health care provider
CPR card, validated Health Insurance and paid Liability Insurance on file with the
Nursing Programs secretary during the entire semester. In order to attend class or
clinical experiences, each student MUST comply with each of these requirements.
5.
If a student is to be absent from an exam, he/she must notify the course instructor at least
two hours prior to the exam. Failure to comply with this policy will result in a "O" for
the exam. Make-up exams may be constructed differently from the unit test. Make-up
exams will be administered on Friday, December 7, 2007 from 1300-1500 hours.
6.
Four function calculators are allowed during exams. The use of programmable
calculators, statistical calculators and calculators stored on personal data assistant devices
or cell phones are NOT allowed. In addition, sharing a calculator with another student is
NOT allowed and calculators may not make a discernable noise during use.
7.
Faculty reserves the right to make changes to this syllabus at anytime.
Failure Policy:
The faculty reserves the right to recommend to the BSN Program Chair and College Dean
withdrawal of a student from the nursing program for health, legal, or academic reasons,
particularly if patient care is jeopardized. In addition, the student must perform within the ANA
standards of practice and code of ethics.
If student performance falls below acceptable standards of practice, then the student will NOT
successfully complete the clinical component of this course. Certain aspects of these standards
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directly relate to safety in patient care and professionalism in practice. If student performance
drops below the standard in these two areas, then the possibility of successful completion of the
clinical component of the course is unlikely. The faculty recognizes that the issues of patient
safety and professional standards cannot be compromised; therefore, any student who does not
meet these standards will immediately receive a failing clinical evaluation. The severity of these
infractions warrants immediate failure of the clinical component of this course. The ANA
standards or practice and code of ethics are posted in the BSN Student Handbook.
Disruptive Behaviors:
Behaviors that detract from the learning process will NOT be tolerated. Beepers and cellular
phones are to be muted during all class sessions and pre-clinical/clinical experiences so that
others will not be disturbed. In addition, disruptions occurring from students entering or leaving
the classroom during class time are to be avoided. A break will be supplied approximately every
50 minutes during class and students should use this time to their advantage rather than
disrupting class with their activities. Children are not to be brought to class.
Cheating Policy:
The BSN Program does not condone cheating in any form and considers it as a serious offense.
Cheating is defined by the faculty to include dishonesty on examinations and plagiarism.
Plagiarism is further defined as "the act of using source materials of other persons (either
published or unpublished) without following the accepted techniques of crediting, or the
submission for credit of work not the individual's to whom credit is given." (MSU Student
Handbook, Standards of Conduct, Item 10.) Offending material that may constitute plagiarism
includes, but is not limited to, the following: Bibliography cards, formal papers, book reports,
written nursing care plans, etc.
For further information regarding cheating and any subsequent actions to be taken, please refer to
the policy statement in the BSN Student Handbook.
By enrolling in this course, the student expressly grants MSU a “limited right” in all intellectual
property created by the student for the purpose of this course. The “limited right” shall include
but shall not be limited to the right to reproduce the student’s work product in order to verify
originality, and for educational purposes.
MIDWESTERN STATE UNIVERSITY STUDENT HONOR CREED
“As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else to do so.”
As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We
also recognize universities play an important role in helping mold these responsible citizens. We believe students
themselves play an important part in developing responsible citizenship by maintaining a community where integrity
and honorable character are the norm, not the exception.
Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming
our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers
accountable for complete honesty in all university matters.
We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized
material in examinations, or to present, as one’s own work, work or ideas which are not entirely one’s own. We
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recognize that any instructor has the right to expect that all student work is honest, original work. We accept and
acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty
fundamentally rests within each individual student.
We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps
taken by University officials to protect the honor of the University against any who would disgrace the MSU student
body by violating the spirit of this creed.
Written and adopted by the 2002-2003 MSU Student Senate
American Disability Act (ADA) & Disability Support Services:
Midwestern State University does not discriminate on the basis of an individual's disability and
complies with section 504 and the Americans with Disabilities Act in its admissions,
accessibility, and employment of individuals in programs and activities.
MSU provides academic accommodations and auxiliary aids to individuals with disabilities, as
defined by the law, who are otherwise qualified to meet academic employment requirements.
Students with a disability must be registered with Disability Support Services (DSS) before
classroom accommodations can be provided. For assistance, call the campus Disability Support
Services office at (940) 397-4140.
It is the student's responsibility to declare any disabilities. After declaration with the DSS,
preferably at the beginning of each semester, the student needs to contact their individual
instructors to determine any reasonable accommodations that may be required.
NURS 3433 Family Health Nursing I Clinical Requirements
The faculty requests that gifts NOT be given to clinical instructors. The faculty appreciates the
thought, but a note or word of thanks is just as meaningful as a gift.
Clinical Experiences:
This course includes 135 clinical hours.
Clinical Absences:
Students are expected to attend all clinical experiences. Clinical instructors need the information
obtained during clinical experiences to appropriately evaluate student performance in the clinical
component of this course. Clinical absenteeism totaling more than 10% (13.5 total clock
hours) of total clinical hours from all clinical experiences (SIMS, post-conferences, clinical
orientations, etc) will result in an automatic failure in the clinical component of this course.
Clinical expectations include the following:
Professional behavior is a requirement of the clinical component of this course. Students are
expected to demonstrate professionalism in their clinical interactions. If a student is disrespectful
or unprepared for a clinical experience, the student will be sent home and receive, at a minimum,
a 12-hour clinical absence for that experience.
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Students are to complete a pre-clinical assignment prior to attending each of the four simulation
experiences. These written assignments constitute a total of 8 hours of clinical. Failure to
complete these assignments prior to attending the experience will result in the student being sent
home and being considered absent from the two-hour prep experience. The student is to have the
Simulation Center staff sign the pre-clinical assignment indicating the student arrived with the
assignment completed. These assignments are then placed in the clinical folder and submitted to
the student’s clinical instructor.
Students complete 12 hours (four 3-hour sessions) of clinical experiences in the Simulation Lab
at United Regional Health Care center (8th street campus; 4th floor). Tardiness to a simulation
experience will result in the student being sent home and receiving an absence for the three-hour
experience. In order to prevent receiving an absence, students must notify the simulation lab at
(940) 764-8410 (faculty recommend that you put this number in your cell phone directory
so you can keep it handy) prior to the scheduled time of the experience, if the student will be
unable to attend, and reschedule the experience if possible. Rescheduling of experiences is
allowed as space permits; however, once an absence has been accrued, rescheduling of the
experience will not eliminate the absence. All simulation experiences must be completed by
September 26, 2007.
Each student is required to complete the orientation program for the facilities where they are
assigned clinical experiences as well as completing the online facilities orientation for United
Regional Health Care System/Kell West. Students satisfy four (4) clinical hours by completing
these orientations. The online orientation for United Regional/Kell West is due by September
14, 2007 and a cut-off score of at least 90% must be achieved for satisfactory completion of this
requirement. Each day the student is late completing this orientation will constitute
absenteeism of three hours.
Students are responsible for completing a clinical orientation program specific to their clinical
lab. Students complete 8 clinical hours in completing this orientation. Failure to attend your
designated clinical orientation will result in a clinical absence and it is the student’s
responsibility to obtain information shared during this orientation.
Students complete 12 hours of post-conference in four 3-hour sessions. Failure to attend a postconference will constitute an absence. Tardiness to a post-conference will constitute an absence
equivalent to the length of time the student is tardy.
Students complete 84 hours of clinicals in patient care areas. Some of these hours may include
pre-clinical assignments and orientation to the facility and its computer systems. Tardiness of
more than 15 minutes will result in the student being sent home and receiving a full absence of
twelve (12) hours. In order to avoid receiving an absence, students who will not be able to
attend the experience, must notify their preceptor (if applicable) and their clinical instructor prior
to the scheduled time of the experience. Rescheduling of missed experiences is expected as space
permits; however, once an absence has been accrued, rescheduling of the experience will not
eliminate the absence. The patient care experiences must be completed by November 30, 2007.
Students may NOT attend clinical until the preceptor agreement is signed, the preceptor’s RN
license verified and on record with the clinical coordinator or other designated nursing program
staff.
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Students complete seven (7) hours of clinical evaluation. Failure to submit the clinical folder by
the due dates will result in a three (3) hour absence for each date it is late. The clinical folder is
due by 1700 hours on each post-conference date.
Students are NOT allowed to attend clinical experiences during class times.
Students are to schedule their precepted experiences with their preceptor and the clinical
instructor. 48 hours of precepted clinical is to be completed by October 19, 2007 and the other
36 hours is to be completed by November 30, 2007. The clinical instructor, or other designated
faculty, will be readily available to the student and the preceptor during the times the student is
participating in a clinical experience. Therefore, any clinical experience completed without the
knowledge and written approval of the clinical instructor will not be included in the calculation
of achieved clinical hours.
Written Clinical Requirements:
All students will complete a clinical folder that will include each of the following components:
 Completed clinical self-evaluations for each patient care clinical attended. The clinical
evaluation form is presented in this syllabus as well as being available on WebCT.
 Four preclinical assignments completed prior to the simulation experience for each
assignment.
 Any additional written assignments required of the student to evaluate progression in the
clinical component of this course.
 Preceptor signature form which the preceptor signs following each clinical experience
verifying the student completed the experience.
 Student evaluation of the preceptor to be completed at the end of the clinical rotations.
 Documentation regarding some aspect of each clinical experience that illustrates the
student’s experiences during the clinical rotation.
 If the preceptor were to give his/her evaluation of the student to the student, then that
should also be included in the clinical folder.
Remember: Clinical folders are due to the clinical instructor’s office by 1700 on each postconference day.
The contents of the folder are to be bound and each section clearly delineated using labeled
dividers. The contents should be divided in the following manner:
Preclinical simulation assignments
Clinical self-evaluations
Any additional assigned written assignments
Preceptor signature form documenting 84 completed hours of clinical
Student evaluation of preceptor
Clinical stories
Preceptor evaluation of student (if given to the student by the preceptor)
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The front of the folder should be labeled as such:
<Student’s name>
NURS 3407 Family Health Nursing I
Spring 2006
<Clinical instructor’s name>
Dress Code:
Clinical experiences when scrubs are not necessary:
1.
2.
3.
4.
5.
6.
7.
8.
No jeans or shorts.
No tee-shirts, sweatshirts, jerseys or tank-tops.
No sandals or high heels.
Clean and pressed street clothes.
White lab coat with MSU patch on sleeve.
Approved MSU BSN name badge.
Makeup, cologne and jewelry in moderation.
Hair clean, neat and trimmed including facial hair for men.
Acute Care Facility and the Simulation Lab:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Clean and pressed maroon uniform. Dresses or skirts must be knee length or longer.
White lab coat (optional).
MSU patch on left sleeve of maroon smock and on left sleeve of lab coat, if worn.
Clean and well-maintained professional or athletic shoes.
Hair clean, neat and trimmed including facial hair for men. Hair is to be worn in a manner
that prevents it from falling forward over the patient. Hair must be self contained and
unadorned. Clips, pins, ties must be the same color as the hair; no large bows permitted.
Jewelry may include a wedding ring, a watch and one pair of earrings that do not dangle
and are no larger than a dime. A single neck chain is allowed.
An approved MSU BSN name badge is to be worn at all times.
No cologne or perfume; makeup in moderation.
Nails must be maintained as clean, neat and trimmed short with NO polish.
Artificial nails are not permitted by the health care agencies.
Clinical Objectives:
1.
Use the nursing process to provide optimum care for patients with a focus on the concepts
of fluid regulation and urinary elimination, alterations in mobility and musculoskeletal
disorders, digestion and gastrointestinal elimination, and endocrine production and
associated disorders.
a.
b.
c.
d.
Collect comprehensive data on each assigned patient.
Interpret data in a meaningful way.
Establish meaningful and measurable goals.
Implement all nursing activities in a safe and therapeutic manner.
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e.
2.
Evaluate nursing actions and modify the plan of care as needed.
Correctly and safely administer all medications.
a.
b.
c.
d.
e.
f.
g.
Correctly calculate medication dosages.
Correctly perform subcutaneous and intramuscular injections.
Correctly administer intravenous medications.
Correctly calculate drip rates and monitor all intravenous solutions.
Consistently use the five rights of medication administration and assess for
medication allergies.
Accurately document medication administration.
Demonstrate knowledge of medication; therapeutic and non-therapeutic effects.
3.
Effectively communicate. Document findings accurately in the medical record using
appropriate terminology.
4.
Display a professional attitude, appearance and behavior at all times.
a.
b.
c.
5.
Accept constructive feedback in a positive manner.
Actively seek individual learning opportunities.
Comply with the MSU-approved dress codes.
Describe the role of the professional nurse in each assigned setting and his/her ability to
contribute to optimal patient outcomes.
Tips to remember:
1.
Administer medication and perform procedures ONLY under the direct supervision of
the clinical instructor or designated staff RN.
2.
Introduce yourself to your patient and his/her nurse both when you go to collect data and
provide patient care. Keep in mind that pre-clinical is intended as a time to collect patient
data; students will NOT participate in "hands on" experiences of any kind during pre-lab
times.
3.
Be specific when discussing with the staff nurse the patient care activities you will
perform during your shift.
4.
NEVER disconnect or adjust any piece of equipment unless instructed to do so by your
clinical instructor or staff nurse.
5.
You may assist nurses with their nursing care; however, your primary patient(s) should be
your first priority.
6.
Students will NOT be allowed to initiate blood transfusions or chemotherapy, or to
manipulate pain control pumps.
7.
Prior to administering any medication you are to know the action, safe dosages,
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appropriateness of the drug for this particular client, therapeutic and side effects,
interaction effects and nursing considerations. Do NOT administer a drug if you are
unfamiliar with these aspects of the drug.
8.
NEVER give a medication prepared for administration by another nurse.
Clinical Evaluation:
The organizing framework for clinical evaluation is the DELC competencies and represents the
clinical objectives to be accomplished during the semester. A sample of the clinical evaluation
tool which will be used in this course is located at the end of this syllabus. See form entitled
“N3433 Clinical Evaluation Tool” for a sample of this document.
Individual clinical instructors may utilize various data collection tools during clinical
components of the course including:
Observation of clinical performance
Oral reports/presentations
Medication calculations/exercises/tests
Any additional assignments required by clinical instructor
Preceptor evaluations of students
Infractions constituting a clinical failure:
3 incidents of actual or potential medication errors.
2 incidents of attending clinical poorly prepared in caring for the patient.
3 failures to recognize the concepts of nursing tasks/skills.
Incidents of disregarding professional ethics or standards of care which may include:
Nonconforming to the dress code
Unprofessional/inappropriate language or gestures
Unprofessional/inappropriate behavior
Disregarding patient confidentiality
Patient negligence
Leaving the premises without permission
Omissions
Falsification and/or lying
Failing to provide for patient safety will result in an automatic clinical failure.
Definitions:
Medication errors, actual or potential, are defined as any break in the 6 rights in administering
any substance orally, parenterally, enterally, topically, or by inhalation. Failure to accurately
assess medication allergies, drug interactions and drug incompatibilities also constitutes a
medication error. The 6 rights of medication administration include: right patient, right drug,
right dose, right route, right time, and right documentation.
Poor clinical preparedness is defined as attending clinical with an incomplete preclinical exercise
or with poor understanding of the patient's condition and treatments.
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Failure to recognize the concepts of nursing tasks/skills refers to not being able to describe the
steps involved in performing nursing procedures prior to, in a timely manner, initiating the
procedure in patient care.
Infractions involving a lack of professional behavior or ethics are evaluated on an individual
basis to ensure any extenuating circumstances can be considered. The nature of the infraction
will be taken into consideration before determining the severity of the infraction.
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Unit I: Concepts and Theories Related to Fluid Regulation, Acid-base Balance and
Urinary Elimination
Objectives:
1. Recognize changes across the life span related to fluid regulation, acid-base balance and
urinary elimination.
2. Utilize the nursing process in caring for persons of all ages experiencing disorders
associated with fluid regulation, acid-base balance and urinary elimination.
3. Utilize teaching-learning theories in assisting persons to achieve optimal health.
4. Apply critical thinking skills in analyzing fluid regulation, acid-base balance and urinary
elimination research findings.
5. Demonstrate professional accountability in providing holistic care to persons with fluid
regulation and urinary elimination concerns in a variety of settings.
6. Implement nursing interventions for clients with fluid regulation, acid-base balance and
urinary elimination dysfunctions.
7. Discuss the major social, cultural, economic, psychological, spiritual and historical
aspects of caring for persons with fluid regulation, acid-base balance and urinary
elimination dysfunction.
8. Examine the legal and ethical issues relating to care of clients with fluid regulation, acidbase balance and urinary elimination dysfunctions.
9. Examine the impact burns have on the regulation of fluid and electrolytes and acid-base
balance.
10. Analyze the individual's health status in regards to diagnostic findings, prescribed
treatment effects and pathophysiological processes.
11. Demonstrate knowledge of the pathophysiological processes associated with altered fluid
regulation, acid-base imbalance and impaired urinary elimination.
Clinical Objectives:
12. Demonstrate knowledge of the physiological principles involved in restoration of fluid
regulation and urinary elimination.
13. Implement nursing interventions that lessen the effects of altered fluid regulation and
impaired urinary elimination.
14. Correlate lab findings with clinical symptomatology and treatment modalities.
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15. Apply the nursing process to the patient with a fluid regulation or urinary elimination
disorder.
16. Demonstrate knowledge of the principles of dialysis and its effects on patients.
17. Demonstrate effective interpersonal communication in assisting individuals and their
families to understand their plan of care.
Required Readings:
Phipps, Monahan, Sands, Marek, & Neighbors (8th ed.). pp. 359-420, 943-1039, 1910-1945.
Broyles, Reiss, & Evans (8th ed.), pp. 73-93; 144-180; 1027-1031.
Cook, L.S. (2003). IV fluid resuscitation. Journal of Infusion Nursing, 26(5), 296-303.
Metheny, N. (1997). Focusing on the dangers of D5W. Nursing97 (October), 55-59.
Pruitt, W. (2004). Interpreting arterial blood gases: Easy as ABC. Nursing2004, 34(8), 50-53.
Zerwekh, J. (2003). End-of-life hydration – benefit or burden? Nursing2003(February), 32hn132hn3.
Content Outline:
I.
II.
III.
IV.
V.
Assessment of the patient in regards to fluid regulation, acid-base balance and urinary
elimination.
Diagnostic tests and parameters in determining fluid regulation, acid-base balance and
urinary elimination.
Pharmacology utilized in the disorders of fluid regulation, acid-base balance and urinary
elimination.
Nursing care of the persons with fluid regulation, acid-base balance and urinary
elimination disorders.
A.
History and trends
B.
Legal and ethical issues
C.
Nursing process
D.
Teaching-learning
E.
Communication
F.
Research
G.
Nursing's role in medical therapies.
H.
Social, economic, psychological, cultural and spiritual care.
Nursing interventions in the care of persons with fluid regulation, acid-base balance and
urinary elimination disorders.
A.
IV therapy and electrolyte replacement therapy.
B.
Calculation of fluid and electrolyte needs.
C.
Measurement of fluid intake and output.
D.
Monitoring laboratory results in determining fluid and electrolyte status.
E.
Catheter care
F.
Burn management
G.
Renal failure treatments
H.
Renal calculi interventions
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I.
Acid-base balance
Unit II: Concepts and Theories Concerning Alterations in Digestion and Gastrointestinal
Elimination
Objectives:
1. Recognize changes in digestion and gastrointestinal function across the life span.
2. Utilize the nursing process in caring for persons of all ages experiencing alterations in
digestion and gastrointestinal functions.
3. Utilize teaching-learning theories in assisting persons to achieve optimal health in regards
to the concepts of digestion and gastrointestinal function.
4. Demonstrate effective interpersonal communications in assisting individuals and their
families to understand the concepts of digestion and gastrointestinal functions.
5. Apply critical thinking skills in analyzing digestion and gastrointestinal research findings.
6. Demonstrate professional accountability in providing holistic care to persons with
digestive and gastrointestinal concerns in a variety of settings.
7. Implement appropriate nursing interventions for persons with alterations in digestive
gastrointestinal functioning.
or
8. Examine the legal and ethical issues relating to care of clients with alterations in digestion
and gastrointestinal disorders.
9. Discuss the major social, cultural, economic, psychological, spiritual and historical
aspects of caring for persons with digestive and gastrointestinal disorders.
10. Analyze the individual's health status in regards to diagnostic findings, prescribed
treatment effects and pathophysiological processes.
Clinical Objectives:
11. Demonstrate knowledge of the principles involved in restoration of digestive and
gastrointestinal functions.
12. Utilize current treatment options available in the restoration of digestive and gastrointestinal functions.
13. Implement nursing interventions that lessen the effects of impaired digestive and
gastrointestinal functions.
14. Recognize manifestations of impaired digestive or gastrointestinal functions.
16
15. Apply the nursing process to the client experiencing digestive or gastrointestinal
disorders.
16. Demonstrate effective interpersonal communication in assisting individuals and their
families to understand their plan of care.
Required Readings:
Phipps, Monahan, Sands, Marek & Neighbors (8th ed.), pp. 1165-1302.
Broyles, Reiss, & Evans (7th ed.), pp. 219-232; 539-613.
Lewis, A. (1999). Gastrointestinal emergency. Nursing 1999, April, pp. 52-54.
Lord, L. (2001). How to insert a large-bore nasogastric tube. Nursing 2001, Sept.,
pp. 46-48.
McConnell, E. (2001). What’s behind intestinal obstruction? Nursing 2001, Oct.,
pp. 58-63.
O’Brien, B., Davis, S. & Erwin-Toth, P. (1999). G-tube site care: a practical guide. RN,
Feb, pp. 52-56.
Rayhorn, N. & Rayhorn, D. (2002). An in-depth look at inflammatory bowel disease.
Nursing 2002, July, pp. 37-43.
Town, J. (1997). Bringing acute abdomen into focus. Nursing 1997, May, pp. 52-57.
Content Outline:
I. Assessment of the client in regards to digestive and gastrointestinal structure and
II. Diagnostic tools and parameters used in determining digestive and gastrointestinal
disorders.
III. Pharmacology utilized in the management of digestive and gastrointestinal disorders.
IV. Nursing care of the persons with alterations in digestion and gastrointestinal function.
A. History and trends
B. Legal and ethical issues
C. Nursing process
D. Teaching-learning
E. Communication
F. Research
G. Nursing’s role in medical therapies
H. Social, cultural, economic, psychological and spiritual care
V.
Nursing interventions in the care of persons experiencing digestive or gastrointestinal
disorders
A. Assessment of the digestive and gastrointestinal tracts/functions
B. Management of clients with problems of the mouth and esophagus
C. Management of clients with problems of the stomach and duodenum
D. Management of clients with problems of the gallbladder and pancreas
E. Management of clients with problems of the intestines
function.
17
Unit III: Concepts and Theories Concerning Alterations in the Musculoskeletal System
Objectives:
1. Recognize changes in musculoskeletal function across the adult life span.
2. Utilize the nursing process in caring for adults experiencing alterations of
musculoskeletal function.
3. Utilize teaching-learning theories in assisting adults to achieve optimal health in regards
to the concepts of musculoskeletal functions.
4. Apply critical thinking skills in utilizing musculoskeletal research findings.
5. Demonstrate professional accountability in providing holistic care to persons with
musculoskeletal concerns in a variety of settings.
6. Implement appropriate nursing interventions for adults with bone, joint & muscle
disorders.
7. Examine the legal and ethical issues relating to care of adults with alterations in
musculoskeletal function.
8. Discuss social, cultural, economic, psychological, spiritual & historical aspects of caring
for adults with musculoskeletal disorders/impairment.
9. Analyze the individual’s health status in regards to diagnostic findings, prescribed
treatment effects and pathophysiological processes.
10. Demonstrate knowledge of the pathophysiological processes associated with alterations in
musculoskeletal function.
Clinical Objectives:
11. Demonstrate knowledge of the physiological principles involved in restoration of
musculoskeletal functions.
12. Correlate lab findings with clinical symptomatology and treatment modalities.
13. Implement nursing interventions that lessen the effects of impaired musculoskeletal
functions.
14. Recognize manifestations of impaired musculoskeletal functions.
15. Apply the nursing process to the adult experiencing musculoskeletal disorders.
18
16. Demonstrate effective interpersonal communications in assisting individuals & their
families to understand their plan of care.
Required Readings:
Phipps, Monahan, Sands, Marek, & Neighbors (8th ed.), pp. 1491-1654.
Broyles, Reiss & Evans. (7th ed), pp. 144-257; 258-362.
Journal Articles available on WebCT:
Clontz, A. S. & Walker, L. (2004). Trauma nursing: Amputations. RN. 67(7), 38-43.
Day, M. W. (2003). Recognizing and managing DVT. Nursing, 33(5), 36-41.
Dykes, P. (June 1993). Minding the 5 Ps of neurovascular assessment (pain, pulses,
paresthesia, pallor and paralysis in assessing neurodamage in fractures).
AJN, 93 (12), 33-37.
Lewis, A. M. (1999). Orthopedic and vascular emergencies. Nursing99, 29 (12), 54-56.
Metules, T. (2003). Osteoporosis. RN, 66(11), 56-62.
Peterson, A. M. (April, 1997). Analgesics. RN, 45- 50.
Ramsburg, K. L. (2000). Rheumatoid arthritis. AJN, 100 (11), 40- 43.
Wollman, S. (2003). Sprains and strains. Nursing, 33(9), 47.
Yarnold, B. (1999). Hip fracture: Caring for a fragile population. AJN, 99 (2), 36-40.
Recommended Videos available at the MSU Library Media Center:
RD101.B7 (1999) “Broken bones & how they mend”
RD736.T7 C37 (1995) “Caring for patients in traction”
RD736. E88 C66 (1994) “Continuous passive motion”
R549. H52 (1996) “Hip replacement”
RD561.K59 (1996) “Knee replacement”
Content Outline:
I.
II.
III.
IV.
V.
Assessment of the adult in regards to musculoskeletal structure & function
Tests & parameters in diagnosing musculoskeletal disorders
Pharmacology utilized in the management of musculoskeletal disorders
Nursing care of adults with alterations in musculoskeletal function
a. History & trends
b. Legal & ethical issues
c. Nursing process
d. Teaching-learning
e. Communications
f. Research
g. Nursing’s role in medical therapies
h. Social, cultural, economic, psychological & spiritual care
Nursing interventions in the care of adults experiencing altered musculoskeletal
function/disorders
a. Assessment of the musculoskeletal system
19
b. Management of adults with trauma to the musculoskeletal system
c. Management of adults with inflammatory & degenerative disorders of the
musculoskeletal system.
d. Management of acute and rehabilitative aspects of care to include ADLs, physical
and occupational therapies, cast care, traction management
20
Unit IV: Concepts and Theories Concerning Alterations in Metabolism (Endocrine and
Hepatic Functioning)
Objectives:
1. Recognize normal and abnormal endocrine and hepatic functioning across the adult life
span.
2. Utilize the nursing process in caring for persons experiencing endocrine or hepatic
dysfunction.
3. Utilize teaching-learning theories in assisting persons with altered endocrine or hepatic
functioning to achieve optimal health.
4. Apply critical thinking skills in utilizing endocrine and hepatic-related research studies.
5. Demonstrate professional accountability in providing holistic care to persons with
endocrine or hepatic concerns in a variety of settings.
6. Implement appropriate nursing interventions for persons with endocrine or hepatic
dysfunction.
7. Examine the legal and ethical issues relating to care of patients with alterations in
endocrine or hepatic function.
8. Discuss the major social, cultural, economic, psychological, spiritual and historical
aspects of caring for persons with endocrine or hepatic disorders.
9. Analyze the individual’s health status in regards to diagnostic findings, prescribed
treatment effects and pathophysiological processes.
10. Demonstrate knowledge of the pathophysiological processes associated with
alterations in endocrine or hepatic functioning.
Clinical Objectives:
11. Demonstrate knowledge of the physiological principles involved in the management
and restoration of endocrine and hepatic functions.
12. Correlate laboratory findings with clinical symptomatology and treatment modalities.
13. Implement nursing interventions that lessen the effects of altered endocrine or hepatic
functioning.
14. Recognize manifestations of impaired endocrine or hepatic function.
15. Apply the nursing process to the patient experiencing endocrine or hepatic
dysfunction.
21
16. Demonstrate effective interpersonal communication in assisting individuals and their
families to understand their plan of care.
Reading Assignments:
Phipps, Monahan, Marek, & Neighbors (8th ed.), pp. 1041-1163, pp. 1303-1350.
Broyles, Reiss, & Evans (7th ed.), pp. 788-843.
Recommended Journal Articles
Bartol, T. (2002). Putting a patient with diabetes in the driver’s seat. Nursing2002, 32(2), 53-55.
Cameron, B. L. (2002). Making diabetes management routine. AJN, 102(2), 26-32.
Clarke, K. (2002). No needles needed. Nursing 2002, 32 (5), 49-51.
Fain, J. A. (2002). Delivering insulin ‘round the clock. Nursing 2002, 32 (8), 54- 56.
Fleming, D. R. (2000). Insulin pens: Mightier than the syringe. AJN, 100(11), 44- 48.
Has, L. B. (1998). Pathophysiology of diabetes mellitus. Nurse Practitioner Forum, 9(2), 42-45.
Konick-McMahan, J. (1999). Riding out a diabetic emergency. Nursing 99, 29(9), 34-39.
Malchiodi, L. (2002). Thyroid storm. AJN, 102(5), 33.
Recommended Videos on Reserve at the Library Circulation Desk:
QM371. E53 (1998) “The endocrine system”
QP188. T54 T59 (1997) “The thyroid gland”
RC648. M36 (1996) “Management of endocrine problems”
Content Outline:
I.
Assessment of the patient in regards to metabolic function and dysfunction
II.
Tests and parameters used to diagnose metabolic function and dysfunction
III.
Pharmacology utilized in the management of metabolic disorders
IV.
Nursing care of persons with alterations in metabolic function
A.
History and trends
B.
Legal and ethical issues
C.
Nursing process
D.
Teaching-learning strategies
E.
Communications
F.
Research
G.
Nursing’s role in pertinent medical therapies
H.
Social, cultural, economic, psychological and spiritual care
V.
Nursing assessment and interventions in the care of individuals experiencing endocrine
disorders
A.
Assessment of the endocrine system
B.
Management of persons with thyroid dysfunction
22
C.
D.
E.
VI.
Management of persons with pituitary dysfunction
Management of persons with adrenal gland dysfunction
Management of persons with Type I & Type II diabetes
1.
Safe and effective monitoring of blood sugars
2.
Pharmacological interventions
3.
Diabetes teaching plans
4.
Nutrition
5.
Prevention of complications
Hepatic Function/Dysfunction
A.
Assessment of the hepatic system
B.
Management of persons with problems of the hepatic system
23
3433 T&C FAMILY HEALTH NURSING I
CLINICAL EVALUATION TOOL
Directions:
This tool is based on the three classifications in the DELC Competencies. It delineates the
faculty's expectations of student performance in the clinical component of this course.
Performance criteria are specified for each classification. The student should become familiar with
each performance criteria. The student is expected to document weekly specific examples of
behaviors that are indicative of overall clinical performance. A new form should be used each
week and fastened in a the clinical folder to be submitted during post-conferences. At mid-term
and end-of-semester, faculty will evaluate whether or not the student has satisfactorily met the
clinical requirements of this course. In order for the student to have met the clinical requirements
of the course, he/she must not receive, on the end-of-semester evaluation, an unsatisfactory (U)
rating on any of the performance criteria. Each student is responsible for making copies of the
self-evaluation form for use throughout the semester.
CLASSIFICATION
CRITERIA
PERFORMANCE INDICATOR
Coordinator of Care
Organization of care
The ability to prioritize and organize care activities for one or
activities
more patients: includes the effective utilization of resources.
Coordinator of Care
Interpersonal
The ability to effectively communicate with relevant health care
communication
personnel, the faculty, and the client and his/her family in the
organization and implementation of care activities.
Coordinator of Care
Discharge planning
The ability to identify and coordinate the availability of
resources to meet relevant client needs post-hospitalization.
Should be started on admission and continued throughout the
hospitalization to include referrals to appropriate health care
services.
Provider of Care
Clinical decision-making The ability to reflectively consider all relevant data in
formulating care delivery decisions. The student must be
familiar with disease processes, diagnostic tests and treatments
in order to successfully meet this criterion. Critical thinking
skills should be utilized during the nursing process. The
successful completion of the nursing process is a requirement of
these criteria.
Provider of Care
Patient teaching
The ability to apply developmentally appropriate teachinglearning concepts in providing holistic patient education.
Patient education should be included in the nursing process and
delivered to each patient as appropriate.
Provider of Care
Procedural skills
The ability to implement and document comprehensive, safe
and timely care delivery, including the administration of
medications and performance of invasive procedures. The
student must demonstrate knowledge of procedures of care and
the effects of medications. The student must demonstrate
professional charting skills.
Member of a
Dress
Clinical attire reflects an attitude of competence and
Profession
professionalism.
Member of a
Behavior
Clinical conduct reflects favorably on the student and the BSN
Profession
program and the discipline (i.e. professional demeanor, ethical
decision-making, team worker, punctual, self-directed learner,
etc.) This includes maintaining client confidentiality.
Member of a
Preparation
Written assignments reflect comprehensive critical analysis of
Profession
available patient data in light of relevant scientific knowledge.
The student should be familiar with the patient's history and
physical, diagnostic test results and their meanings, treatments,
treatment effects and scientific rationale for nursing
interventions.
24
N3433 T&C FAMILY HEALTH NURSING I
CLINICAL EVALUATION TOOL
Directions:
The table below gives direction in completing the clinical self-evaluations.
CRITERIA
Organization of care
activities
PERFORMANCE
INDICATOR
The ability to prioritize and
organize care activities for one or
more patients: includes the
effective utilization of resources.
Interpersonal
communication
The ability to effectively
communicate with relevant
health care personnel, the
faculty, and the client and his/her
family in the organization and
implementation of care activities.
Discharge planning
The ability to identify and
coordinate the availability of
resources to meet relevant client
needs post-hospitalization.
Should be started on admission
and continued throughout the
hospitalization to include
referrals to appropriate health
care services.
Clinical decision-making
The ability to reflectively
consider all relevant data in
formulating care delivery
decisions. The student must be
familiar with disease processes,
diagnostic tests and treatments in
order to successfully meet this
criterion. Critical thinking skills
should be utilized during the
nursing process.
The ability to apply
developmentally appropriate
teaching-learning concepts in
providing holistic patient
education. Patient education
should be included in the nursing
process and delivered to each
Patient teaching
Questions to consider when completing this
portion of the self-evaluation
What are you doing to organize your care activities?
What organizational challenges occurred during the
experience? What decisions did you make as to
priority of care activities? What challenges occurred
in prioritizing care? What have you learned
regarding caring for multiple clients? Which
situation during the experience best illustrates
organization of care activities and prioritization of
care activities? What resources were available and
which ones did you need that weren’t available?
What type of things are you communicating with
clients, their families, and other health care
personnel? How do you know that your
communication is effective? Which situation in the
experience best illustrates effective communication?
What challenges are you experiencing in
communicating effectively? What forms of
communication are you using and how do they affect
the effectiveness of your communication?
How did you address the following components of
discharge planning? Diet instruction, disease
management instruction, determining if the client
needs supplies and how to obtain them, assessment
of client ability to care for self and determining
appropriate consults, determining what type of postdischarge setting the client needs and arranging for
referrals, arranging for follow-up care including
ability to obtain the care and afford the care,
treatment instruction and whether the client can
afford the treatment, mobility issues and making
appropriate consults, assistive device instruction,
and assessing support and making appropriate
referrals.
What incidents occurred where you made a
decision? What incidents occurred where the RN
made a decision and what did you think about
his/her decision? What data did you need to
consider in making a decision? What did you learn
regarding disease processes, diagnostic tests and
treatments? How did you see the nursing process in
action during the experience? Which incident best
illustrates your clinical decision-making?
What did you teach your clients? What forms of
instruction did you use? Which situation best
illustrates your patient teaching? How do you know
that your patient teaching was effective? What
follow-up instruction does the client need? What
challenges occurred in attempting to teach your
clients and how did you deal with them?
25
Procedural skills
patient as appropriate.
The ability to implement and
document comprehensive, safe
and timely care delivery,
including the administration of
medications and performance of
invasive procedures. The student
must demonstrate knowledge of
procedures of care and the
effects of medications. The
student must demonstrate
professional charting skills.
Dress
Clinical attire reflects an attitude
of competence and
professionalism.
Behavior
Clinical conduct reflects
favorably on the student and the
BSN program and the discipline
(i.e. professional demeanor,
ethical decision-making, team
worker, punctual, self-directed
learner, etc.) This includes
maintaining client
confidentiality.
The student should be familiar
with the patient's history and
physical, diagnostic test results
and their meanings, treatments,
treatment effects and scientific
rationale for nursing
interventions.
Preparation
What procedural skills did you implement during the
experience? What challenges occurred in
implementing procedural skills and how did you
deal with them? How are you preparing for
medication administration? What are you doing to
familiarize yourself with your client’s medications?
What challenges are occurring in delivering
medications and how are you dealing with them?
What challenges are occurring with documentation
and how are you dealing with them? Which situation
best illustrates effective implementation of
procedural skills, medication administration and/or
documentation? Did you make a medication error
and if so, what did you learn from it?
How do the clients react to your dress? Do they
realize that you are student nurse? How is your dress
assisting or hindering you in delivering care? What
supplies are you carrying with you and are they
sufficient? What are you doing to have your supplies
available when needed? What challenges are you
having in having supplies available? What
challenges are you having with your shoes? Are they
comfortable for the entire shift and if not, what are
you doing to ensure your have comfortable
footwear? How do you know that others view your
dress as professional?
How do you know others view your behavior as
professional? What incident best illustrates your
professionalism? How are you self-directing your
learning? Are you punctual? What challenges are
occurring in maintaining client confidentiality and
how are you dealing with them? What ethical
challenges are occurring and how do you deal with
them? What are you doing that illustrates an ability
to work in a team?
How are you familiarizing yourself with the clients’
history and physical, diagnostic test results,
treatments, treatment effects, and scientific
rationales for nursing interventions? What
challenges are you having in preparing and how are
you dealing with these challenges? Which incident
best illustrates your preparation for clinical?
26
Student Name_________________________________________________
Date of clinical experience______________________
Unit__________________________________
N3433
Weekly Self-Evaluation
This form should be completed following each clinical day. The student is to write specific examples of behaviors
exhibited during the clinical day that document performance evaluation of the criteria. Performance indicators
must be very specific and assist in explaining the student's self-rating of performance. The completed form is to be
fastened in the clnical folder. The folder should be clearly labeled on the front as described in this syllabus. The
folder will be submitted during post-conferences to the student's assigned clinical instructor.
Classification
Coordinator of
Care
Criteria
Organization of
care activities
Interpersonal
communication
Discharge
planning
Provider of
Care
Clinical
decisionmaking
Patient teaching
Procedural
skills
Member of a
Profession
Dress
Behavior
Preparation
S
NI
U
Performance Indicator
27
Student_________________________________
N3433 Clinical Evaluation Mid___ End___ Semester
Classification
Coordinator of Care
S
NI
U
Faculty Comments
Provider of Care
Member of
Profession
Other comments:
Faculty Signature________________________________
Student Signature________________________________
Student Comments:
Date_____________________
28
MIDWESTERN STATE UNIVERSITY
NURS 3433 FAMILY HEALTH NURSING I
PRECEPTOR EVALUATION OF STUDENT
Directions:
Complete form and send to course coordinator, Midwestern State University, Robin Lockhart,
3410 Taft Blvd. Bridwell #318, Wichita Falls, TX 76308. Please check yes, no or N/A and include any comments
regarding the experience.
Student________________________________Agency______________________________Date_______________
Preceptor___________________________________________
Criteria
1. Student was consistently prepared for the
learning experiences.
2. Student’s behavior was consistently
professional and appropriate for the learning
experiences.
3. Student consistently demonstrated critical
thinking when developing a plan and
interventions for this patient population.
4. Student demonstrated an ability to make
appropriate clinical decisions.
5. Student interacted with clients, patients,
families in a professional and courteous
manner.
6. Student consistently interacted with staff in a
professional and courteous manner.
Yes
No
Comments
29
MIDWESTERN STATE UNIVERSITY
NURS 3433 FAMILY HEALTH NURSING I
STUDENT EVALUATION OF PRECEPTOR
Directions:
Complete form and submit to your clinical instructor. Please check yes, no or N/A and include any
comments regarding the experience.
Student________________________________Agency_______________________________Date___________
Preceptor___________________________________________
Criteria
1. Is available to students.
2. Communicates clinical knowledge well.
3. Utilizes student’s strengths and knowledge.
4. Serves as a good role model.
5. Demonstrates effective rapport with
patients.
6. Encourages students to assume increasing
responsibility during semester.
7. Assists student in identifying goals and
needs for the experience.
8. Considers student’s limits according to
level of education.
9. Provides immediate and adequate feedback
to questions.
10. Leads student through decision-making
rather than giving own impressions.
11. Encourages questions.
Yes
No
Comments
30