MEDICATION WORKSHEET
Student Name___________________________________
Pt. Initials_________
RM#__________
Dr.____________________________
Diagnosis: ____________________________________ Allergies: _____________________________________________Last BM: ___________
MEDICATION
(Brand/Generic)
Lanoxin/digoxin
Dose: 0.25mg PO
Frequency: daily
Time: 0900
MEDICATION
(Brand/Generic)
KCL/Potassium
chloride
CLASS
Antidysrhythmic
Cardiac
glycoside
Normal Dose:
0.063-0.5mg PO
daily
CLASS
Electrolyte
replacement
LAB
RELEVENT
TO MED
Digoxin level
1.5ng/ml
K+ 4.2mEq/L
Ca+ 9.1 mg/dl
Mg+ 1.7mg/dl
LAB
RELEVENT
TO MED
LAB NORMS
Dig: 0.5-2ng/ml
K+: 3.5-5.5mEq/L
Ca+: 8.4-10.2
mg/dl
Mg+: 1.6-2.6 mg/dl
LAB NORMS
K+ 3.5-5.5mEq/L
K+ 4.2mEq/L
Dose: 20 mEq PO
Frequency: daily
Time: 0900
MEDICATION
(Brand/Generic)
Lasix/furosemide
Dose: 20 mg PO
Frequency: BID
Time: 0900, 1800
MEDICATION
(Brand/Generic)
Keflex/cephalexin
Dose: 500 mg PO
q 6 hr
Frequency:
Time: 0900, 1500,
2100, 0300
Loop diuretic
LAB
RELEVENT
TO MED
Normal Dose:
20-80 mg PO per
day
K+ 4.2mEq/L
Other
electrolytes (see
above)
CLASS
LAB
RELEVENT
TO MED
Antinfective
1st generation
cephalosporin
Normal Dose:
1-2 gm PO qd
Culture results
Hepatic enzymes
WBC: 14.3
Urinalysis
Bacteria
REASON
FOR
TAKING
CHF
Slows and
strengthens
heart
REASON
FOR
TAKING
Adverse effects:
Hypo K+ (weakness, fatigue, arrhythmias,
polyuria, polydipsia)
Hyper K+ (fatigue, muscle weakness,
paresthesia, confusion, dyspnea)
Replace K+
due to
diuretic use
LAB NORMS
IMPLEMENTATION
Monitor BP, pulse, weight, I&O.
REASON
FOR
TAKING
K+ 3.5-5.5mEq/L
Adverse effects:
Low electrolyte levels
Hypotension, tinnitus, blurred vision, weakness,
cramps, photosensitivity.
Normal Dose:
40-100 mEq PO
divided
CLASS
IMPLEMENTATION
Take Apical pulse x 1 min, hold if <60 or >100.
Notify MD for changes in rate,quality
Monitor I&O, weight
Assess lungs for rales, crackles
Adverse effects:
Symptoms of CHF: dyspnea, weight gain, edema
Signs of toxicity: abd pain, N&V, bradycardia,
visual disturbances,
IMPLEMENTATION
Monitor pulse & BP
Take with food for GI upset
LAB NORMS
WBC 5.0-10.0 x 10
3rd
No bacteria
IMPLEMENTATION
Note allergies
May give on full or empty stomach
Administer around the clock
Refrigerate oral suspension
Adverse effects:
Dizziness, diarrhea, anorexia, N&V,
superinfection
PATIENT TEACHING
Do not double dose
How to take pulse
Report dyspnea, weight
gain, edema
PATIENT TEACHING
Avoid salt substitutes.
Report weakness, tingling,
fatigue, diarrhea, N&V.
Foods high in K+:
Avocados, bananas,
broccoli, tomatoes,
peaches, nuts, potatoes,
cantaloupe, dried fruit,
peaches, spinach.
PATIENT TEACHING
Change positions slowly,
eat foods high in K+ (see
above), Use sunscreen
Remove
fluid and
decrease
hypertension
REASON
FOR
TAKING
Mild UTI
PATIENT TEACHING
Finish all med
Take missed dose ASAP,
do not double dose.
Report failure to resolve
Notify MD fever, diarrhea
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING
OBJECTIVE CRITERIA FOR GRADING NURSES’ NOTES
Your charting is expected to reflect a level significantly beyond the nurses’ aid ability as you move through
this program. Your assessments, observations, and documentation must reflect “professionalism” and
“technical ability”.
From now until graduation your charting will be evaluated almost daily. The following criteria provide
guidelines for the daily evaluations. If, after being instructed to improve in an area, a student consistently
fails to improve or to follow through, or requires repeated reminders, the student shall receive an
unsatisfactory grade.
Know and apply the following guidelines and you will be able to successfully meet the charting objectives.
1. Record legibly.
2. Properly record information pertaining to the patient which will assure safety for the patient,
hospital, or health worker.
3. Describe the exact time, effect, and reaction of the patient to therapy or treatment rendered.
4. Describe the character and amount of drainage, vomitus, stools, urine, or hemorrhage (bleeding)
from the body.
5. Describe the type, onset, location, and duration of pain.
6. Note the time, visit, examination, and reaction of the patient to the visit of physician or other health
worker.
7. Describe the patient’s condition - usual, unusual, or changed.
8. Adapt to requirements of different health facility requirements.
9. Use clear, concise terms which plainly describe a situation pertaining to the patient and will be
quickly understood.
10. Record facts, do not include opinions or feelings
SO always looks to provide you, a nursing professional, with important tips to help you avoid
malpractice. Below is an example to save for you files.
DO'S AND DON'TS OF DOCUMENTATION
These tips will help you improve your charting.
Not only can good documentation help you defend yourself in a malpractice lawsuit, it can also
keep you out of court in the first place. You have to make sure it’s complete, correct, and timely.
If it’s not, it could be used against you in a lawsuit. The documentation “do’s” and “don’ts”
included in this article can help. They’re excerpted from the Nurses Service Organization’s 1day seminar “Avoiding Nursing Malpractice.”
DO’S…
DON’TS…
 Check that you have the correct chart
 Don’t chart a symptom, such as “c/o
pain,” without also charting what you
did about it.
before you begin writing.
 Make sure your documentation
reflects the nursing process and your
professional capabilities.
 Write legibly
 Chart the time you gave a medication,
the administered route, and the
patient’s response.
 Record each phone call to a
physician, including the exact time,
message, and response.
 Chart a patient’s refusal to allow
treatment or take medication. Be sure
to report this to your manager and the
patient’s physician.
 Chart patient care at the time you
provide it. If you remember an
important point after you’ve
completed your documentation, chart
the information with a notation that
it’s a “late entry.” Include the date
and time of the late entry.
 Don’t alter a patient’s record. This is
a criminal offense. Do not use white
out or obliterate. Place a single line
through the mistake only.
 Don’t use shorthand or abbreviations
that aren’t widely accepted.
 Don’t write imprecise descriptions,
such as “bed soaked” or “a large
amount.”
 Don’t give excuses, such as
“medication not given because not
available”.
 Don’t chart what someone else said,
heard, felt, or smelled unless the
information is critical. In that case,
use quotations and attribute the
remarks appropriately.
 Don’t chart care ahead of time.
Something may happen and you may
be unable to actually give that care
you’ve charted. Charting care that
you haven’t done is considered
fraud
PRACTICE NURSES NOTES
Rm:________ Initials: ________ Dx: ______________
Student’s Name: __________________________ Facility:________________________
Date
2/19
Time
0730
0830
0840
0915
1140
1220
#3 Acute pain r/t ineffective relief of leg spasm AEB “S” frequently
verbalizes reports of inadequate relief. States most of the time 9/10 on pain
scale. “O” moaning softly, facial grimacing, pulse 118, B/P 162/88.
I1: Instructed in abdominal breathing during muscle spasms.
---------------------------------------------------------------------------------L. Cleveland, SVN.
#3 I2: Coached during episode of left leg spasm, pain 8/10. E1: Able to
demonstrate abdominal breathing. E2: Focused on breathing, but restless
after about 45 seconds of controlled breathing. Requested pain medication
for 10/10 pain level. -------------------------------------------L. Cleveland, SVN.
#3 I3: Administered meperidine 50mg IM for severe left leg spasm.
---------------------------------------------------------------------- L. Cleveland, SVN.
#3 E3 Stated pain reduced to 4/10. Pulse 82, B/P 126/82. Able to talk and
assist with bath without c/o pain. I4: Encouraged to use radio with earphones
during episodes of spasms, with imagery.
E4: Stated she thought she would rather try the breathing exercises at this
time.------------------------------------------------------------- L. Cleveland, SVN.
#3 I3: Administered meperidine 50mg IM for left leg spasm, 7/10. Using
breathing techniques during episode of spasm. E1: verbalized the breathing
is helping her deal with the pain. ------------------------------- L. Cleveland, SVN.
#3 I5: Reassessed pain relief. E5: Sleeping with shades closed and curtain
drawn. ---------------------------------------------------------- L. Cleveland, SVN.
(#3 – related care plan number located in resident’s chart)
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 52
SAMPLE
BODY MECHANICS
CLINICAL/LAB SKILLS
Upon completion of classroom
assignment, lectures and discussion,
the successful student, during a clinical
assignment, will be able to:
1. Maintain proper body alignment of
all assigned patients.
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF
COMMENTS
I
N
S
T
R
LC
Skills:
1. Gait belt use
12/12/06-MCC-Rm 24-TR- Upon entry into room, observed
pt sliding down in bed, with arm caught underneath body.
Lowered head, repositioned with support under paralyzed Lt.
arm, placed washcloth in palm to prevent contracture.
Raised head and knees.
8/7/06-MMCMS-Rm112-RC- Amb down hall w/belt
10/23/06-MMCMS-Rm 109-AL- Transferred w/belt bed to
chair
11/11/06-FMC-Rm 8-MF-Assisted amb with walker 2x day
both days using gait belt.
Good job - based on your description
you have a good understanding
Please contact instructor to observe you
using gait belt on patient one more
time.
COMMUNICATION
CLINICAL/LAB SKILLS
Upon completion of classroom
assignment, lectures and discussion,
the successful student, during a clinical
assignment, will be able to:
1. Verbally report observations
immediately to both staff and
instructor.
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
LC
4/23/06-FMC-Rm 15-JL-AM B/P 188/112, baseline 146/84
reported to RN who gave pen antihypertensive
4/24/06-FMC-Rm 18-TH-Confused and drowsy 30 min
after prn pain med. Reported to RN, continued to assess VS.
INSTRUCTOR/STAFF
COMMENTS
Good reporting
2. Communicate with instructor, staff,
and peers when requiring assistance.
3. Communicate with instructor and
staff when patient refuses any aspect of
care within 30 minutes.
LC
5/27/06-MMCMS-Rm 118-KL-Refused all am care & bath.
Reported to student sup-team leader & instructor.
Prompt reporting prevented an
incident. Great job.
ELIMINATION NEEDS
8. Demonstrate correct technique for
applying a condom catheter.
9. Discuss & demonstrate correct
technique & procedure while obtaining
a residual urine.
LC
2/11/06-FMC-Rm 22-DL-Voiding frequent small amts
previous shift. MD ordered residual urine straight cath and
keep in >350 residual. DL voided 125ml immediately after
which I inserted 16f foleyw/ 875ml clear yellow urine
returned. Balloon inflated, cath anchored. Pt tolerated well &
verbalize relief. RN notified.
Impressive! You reviewed the procedure
and were very prepared. Also document
asepsis objective.
College of the Siskiyous
Vocational Nursing
Satellite Rotation Clinical Evaluation
Rotation: ____________________________
Student Name: ________________________________
Pre-Conference Date: __________ Time: ___________ Instructor Signature: ______________________
Under no circumstances is the student to remain in the satellite facility if the instructor’s signature is not present above.
Please send the student home immediately and notify the assigned clinical instructor or the director.
ATTENDANCE: Staff, please sign and date each day, arrival and departure
(Student cannot receive credit if signatures are omitted).
Date: ___________Arrival time:___________Departure time:___________Signature:_________________________________
Date: ___________Arrival time:___________Departure time:___________Signature:_________________________________
Date: ___________Arrival time:___________Departure time:___________Signature:_________________________________
Date: ___________Arrival time:___________Departure time:___________Signature:_________________________________
STAFF EVALUATION: 1 = Not consistent in meeting expectations
3 = Exceeds expectations
Objectives
Preconference
Day 1/Date
2 = Meets expectations
N/A = Not applicable to this assignment
Day 2/Date
Postconference
Comments
1. Knowledge
a. Focused on objectives
b. Prepared for assignments
c. Able to identify norms & deviations
d. Transfers theory-demonstrates understanding
e. Demonstrates ability to think critically
2. Nursing Diagnosis:
a. Assesses both subjective & objective data
b. Focuses on goals
c. Implements appropriate intervention
3. Skills:
a. Good organization/meets time frames
b. uses universal precautions and asepsis
c. Consciously exhibits concern for safety of clients
d. Demonstrates competency in skill performance
4. Documentation:
a. Uses correct spelling, terms, etc.
b. Uses correct format
c. Comments/notes are complete/clearly written
5. Communication:
a. Communicates clearly to clients/staff/public
b. Communicates professionally to clients/staff/public
c. Demonstrates active listening skills
6. Attitude:
a. Calm, quiet, respectful to peers, staff, client, public
b. Assumes responsibility for assignments-comes prepared
c. Willing to assist with various tasks/actively participates
d. Demonstrates a cheerful, caring attitude
e. takes initiative/self-directed/actively participates
7. Discipline:
a. Arrives on time/completes required hours
b. Neat appearance in compliance with school dress code
c. Maintains confidentiality/privacy
d. Cooperative
e. Able to accept criticism and suggestion
f. Adheres to school rules - does not need reminders
8. Ethics/Legal Issues:
a. Maintains confidentiality/Privacy
b. Reports omissions or errors ASAP
c. Behaves with honesty and integrity
9. Role Concept:
a. Describe your goals/progress/strengths or areas needing
improvement
Post-conference Date: _________ Time:___________ Instructor Signature: ________________________
College of the Siskiyous Vocational Nursing
Nursing 53 Objectives
Table of Contents
Section
Write Up
Objective
Count
Page #
#
10
15
8
13
5
15
10
25
18
14
35
6
15
45
25
5
14
11
26
27
7
37
2
3
4
5
7
8
10
11
17
23
24
34
35
36
48
56
57
59
61
63
66
67
Asepsis & Infection Control
Basic Physical Assessment
Communication
Diabetes Mellitus
Endocrine Disorders
Fluid, Electrolyte, & Acid Base Balance
Functioning in Groups
Home Health/Contemporary Health Care
Intensive Care Unit/Special Care Unit
Leadership – Student Supervision
Leadership – Satellite Experience
Medication Administration
Nursing Process
Obstetrics & Newborn Nursery
Outpatient Surgery
Recording & Reporting
Respiratory Disorders
Stress Adaptations
Teaching & Learning
Urologic Disorders
Values & Ethics
Public Health/Maternal Child Health
#, ##
#, ##
#, ##
#
##
#, ##
#
#, ##
Skills moved from Nursing 52:
Respiratory skill #16: Pediatric NaCl installation and bulb suction (1)
Reproductive skill # 10: Application of cold compress (1)
Ostomy Care: All objectives (11)
Total Nursing 53: 362
Total with Public Health: 399
Total Objectives Nursing 51, 52, 53: 1243
90%: 1119
95%: 1172
# Written Objectives
# # If no opportunity by the end of Nursing 53, may write out
@ Terminal objectives
* Licensed staff may sign off
1
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
ASEPSIS AND INFECTION CONTROL
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
MEDICAL ASEPSIS
1. Demonstrate competency in
medical asepsis. One omission & this
objective cannot be achieved. @
2. Correctly and consistently employs
precautions in appropriate patient care
activities (emesis, urine, fecal
material, chemsticks, etc.). One
omission & this objective cannot be
achieved. @
3. Correctly and consistently employs
isolation techniques to protect
himself/herself and others when
caring for a patient in an isolation
unit. (Must have a patient in
isolation)
4. Assume responsibility for
implementation of isolation
precautions based on diagnosis or
diagnostic workup.
*
5. Explain MRSA & describe at least
five nursing interventions to prevent
the spread of this organism. #
SURGICAL ASEPSIS
Successful completion of these
objectives shall be recognized when
the student accomplishes them with
no cross-contamination between clean
and unclean items.
6. Correctly perform & document at
least five different sterile procedures
(dressing changes, catheters, etc.).
(5 objectives)
1.
2.
3.
4.
5.
Total (10): ______
2
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
BASIC PHYSICAL ASSESSMENT
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
OBJECTIVE:
1. Perform a physical assessment
including all body systems and
physiologic needs of assigned
patients.
SKILLS:
Demonstrate third semester (N53)
level assessment including all body
systems and physiologic needs of
assigned patients: (Each objective is
to be completed on separate patients)
2. Neurological
3. Sensory-perceptual
4. Musculoskeletal
5. Skin
6. Respiratory
7. Cardiorespiratory.
8. Gastrointestinal
9. Genito-urinary
In addition, correctly assesses &
documents the following:
10. Pain level, location, description,
etc.
11. Focused assessments
12. Neurovascular checks
13. Tubes/drains
14. Oxygen levels
15. Labs, etc.
Total (15): ______
3
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
COMMUNICATION
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Verbally report observations in a
manner demonstrating an
understanding of underlying theory.
*
2. Communicate observations and
assessments that are complete and
relevant. @
3. Communicate with instructor, staff
and peers when requiring assistance.
Document at least three situations in
order to achieve objective.
1.
2.
3.
4. Communicate with instructor and
staff when patient refuses any aspect
of care within 30 minutes. Any one
omission & this objective cannot be
achieved. (Must have at least 1
situation in which care was refused.)
SKILLS:
5. Prepare and present a critical
thinking exercise.
(4 objectives)
Total (8): ______
4
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
DIABETES MELLITUS
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. List interventions you provided
which are specific to the patient’s
diagnosis of diabetes mellitus and
your rationale.
*
2. Provide patient teaching to an
assigned patient including the type(s)
of insulin ordered, onset of action and
when to expect a reaction.
3. Provide proper skin care to a
diabetic patient, including the feet,
and explain to the patient the
importance of such care.
*
4. Describe typical ineffective coping
behaviors related to the diagnosis of
diabetes.
#
5. List five ways a nurse could
provide emotional support and
encouragement to a diabetic patient.
1.
#
2.
3.
4.
5.
5
PAGE 2: DIABETES MELLITUS
CLINICAL/LAB SKILLS
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
SKILLS:
6. Assess, intervene, report and
document symptoms of diabetic
acidosis and insulin shock.
##
7. Assess, intervene, report, and
document symptoms of insulin shock.
##
8. State normal fasting glucose levels.
#
9. Describe normal post-prandial
glucose ranges.
#
10. Assess lab values for a diabetic
patient noting blood sugar,
electrolytes, and A1C hemoglobin
glycosolated values. List normal
values and your patient’s values and
what any abnormal values might
indicate.
11. Instruct a diabetic patient in
preparation and administration of
insulin.
*
12. Instruct a diabetic patient in
performing chemsticks/accuchecks.
*
13. Instruct a diabetic patient in diet
modifications.
*
Total (13): ______
6
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
ENDOCRINE DISORDERS
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Provide basic nursing care to
patients experiencing various
disorders of the endocrine glands.
Describe the disorder.
2. Identify patient with
hypothyroidism and describe patient
teaching.
##
3. Describe the post-operative nursing
care of a patient who had a
thyroidectomy or parathyroidectomy.
State the surgery.
#
4. Describe the patient teaching to
someone receiving corticosteroid
therapy.
#
5. Explain the electrolyte profile of an
individual with an endocrine disorder.
#
Total (5): ______
7
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Recognize signs and symptoms of
fluid and electrolyte imbalances and
report them accurately.
*
2. Discuss appropriate nursing
interventions to prevent fluid
imbalance.
#
3. Discuss appropriate nursing
interventions to prevent electrolyte
imbalance.
#
4. Demonstrate appropriate
monitoring techniques in patients at
risk for fluid imbalance.
*
5. Demonstrate appropriate
monitoring techniques in patients at
risk for electrolyte imbalance.
*
6. Review an assigned patient’s
laboratory values for sodium, chloride
and potassium levels and state
abnormal results.
7. Provide patient teaching regarding
signs and symptoms of both sodium
and potassium deficits.
8. Assess a patient prior to, during,
and immediately after a blood
transfusion for signs of a reaction.
##
8
PAGE 2, FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
9. Prepare and observe a patient
undergoing therapeutic phlebotomy.
Explain the rationale.
INSTRUCTOR/STAFF COMMENTS
*
#
10. Assess a patient for fluid
overload. (Strict I&O’s, correct daily
weights, girth measurement). Must be
documented.
SKILLS:
11. Correctly assess, report and
document pedal edema.
*
12. Accurately calculate the drop rate
of a patient’s prescribed intravenous
infusion.
13. Correctly complete charting
required during a blood transfusion.
14. Correctly discontinue an IV with
appropriate documentation.
15. Correctly discontinue a saline
lock with appropriate documentation.
Total (15): ______
9
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
FUNCTIONING IN GROUPS
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Demonstrate active participation
within the work group.
2. Demonstrate courtesy & respect
toward instructors, peers, staff and
others. List five examples.
@
1.
2.
3.
4.
5.
3. During pre- and post-ward,
contribute in a positive and
constructive manner at all times.
@
4. Demonstrate active listening
during pre- and post-ward.
@
5. Problem solve in a professional
manner. List five examples.
1.
2.
3.
4.
5.
6. Particpates in the Yreka Health
Fair; taking blood pressures and
supporting the College of the
Siskiyous nursing program. (5
objectives)
Total (10): ______
10
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
HOME HEALTH
THE CONTEMPORARY HEALTH CARE SYSTEM
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS
OBJECTIVE
INSTRUCTOR/STAFF
COMMENTS
STAFF
INT.
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a clinical
assignment, will be able to:
1. Completion of patient worksheet (5
objectives)
2. Completion of pre-assignment prep
sheet (3 objectives)
3. Verbalize entry level scope of
practice for vocational nurses or
registered nurses, working in
community health care settings.
4. Describe various job opportunities
for VNs within community settings.
(Not limited to Home Health)
5. Describe some major problems
confronting health care today as it
relates to patient care.
6. Discuss the role of utilization
review/discharge planner in regard to
patient care and home health nursing.
7. Assist in providing basic nursing
care to a patient in a home care
environment reflecting the philosophies
and purposes of home health care
nursing. Complete attached worksheet
in order to receive credit for objectives.
8. Explain how a patient is referred to
the Home Care nurse and how patient
services are paid. (To be typed and
turned in at post-conference) #
N/A
9. Participate in confirming and
following physicians’ orders
communicated to a home health agency
and communicate your evaluation of
patient care to the physician.
10. Give two examples of how patients
benefit from Home Nursing care and
state in what manner. (To be typed and
turned in at post-conference) #
N/A
11. Discuss how the Home Care nurse
can decrease the length of patients’
hospitalization and prevent further
hospitalizations. (To be typed and
turned in at post-conference) #
N/A
11
PAGE 2: HOME HEALTH/THE CONEMPORARY HEALTH CARE SYSTEM
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR COMMENTS
STAFF
INT.
12. Appropriately assist in referral
of a patient to a social service
agency.
13. Explain the Home Care nurse’s
role in the discharge planning of a
hospitalized patient who will be
requiring home health care nursing.
14. Observe the role of the RN in
the home setting and compare with
the responsibilities of the LVN.
15. Assist the Home Care nurse in
meeting and documenting the
patient’s physiological needs during
a home care visit.
16. Assist the Home Care nurse in
meeting and documenting the
patient’s psychosocial needs during
a home care visit.
17. With the assistance and
supervision of the Home Care
nurse, adapt equipment within the
home environment to meet the
needs of the patient. Complete
worksheet in order to receive
objective credit.
18. Adapt communication and
teaching skills to meet the home
care patient’s needs. Complete
worksheet in order to receive credit
for objectives.
19. Identify different home
situations regarding the caregivers
methods of coping with stress
associated with caring for a patient
in his/her home. Complete
worksheet in order to receive credit
for objective. (To be typed and
turned in at post-conference) #
N/A
20. Describe how this experience
will affect your care of patients in
the future, specifically related to
discharge planning activities. (To
be typed and turned in at postconference)
N/A
Total (25): ______
Worksheet (5): ______
Prep Sheet (3): ______
12
HOME HEALTH ROTATION
Fall 2008
North County
1833 S. Oregon – Yreka
842-7325
Kelly Dewey, RN
Secretary: Paulette
DATES
August 27-28
September 3-4
September 10-11
September 17-18
September 24-25
October 1-2
October 8-9
October 15-16
October 22-23
October 29-30
November 5-6
November 12-13
November 19-20
December 3-4
December 10-11
South County
317 Deetz Rd. – Mt. Shasta
926-4142
Coy Welborn, RN
Secretary: Vickie
8:00 am – 4:30 pm
STUDENT
North County
STUDENT
South County
Aura Richert (541) 488-1480
Marion Stephens (530) 598-0052
Chelsie Burt (503) 475-1752
Vanessa Berg (916) 524-8753
Sonia Williams (530) 859-2357
Rhonda Holmes (612) 730-2086
Kristie Fowler (541) 301-0258
Jay Mais (530) 926-3688
Megan Horner (530) 938-4587
Richelle Deveraux (530) 859-0558
Lesli Sellman (530) 926-6680
Chelsey Faria (530) 859-0289
Alexis Najera (530) 926-1258
Mylissa Peck (530) 918-9350
Jen Krock (530) 918-9398
Jeff Wagner (541) 890-7944
Susan LaGrange (530) 842-2984
Erica Droscher (541) 778-9536
Nicole Suter (530) 340-3839
Jenny Oliver (503) 951-8184
Marlo Shipman (541) 295-0635
Melissa Halvorseth (530) 905-0679
Raquel Ferguson (530) 598-5537
Natalie Schurwanz (530) 520-3207
13
Patient Worksheet Home Health Care
After assisting and observing home health care patients, describe the following. (One objective each for a
maximum of 5 objectives).
RN/
LVN
Initials
Date
Chief reason for home
health referral
Modifications of home
environment, in order to
accomplish home care
14
Describe patient teaching
or learning needs
Who in the home
provides the care?
(Spouse, daughter, etc.)
Assess caregivers
ability to cope.
Describe how much
help or time out the
caregiver receives.
PRE-ASSIGNMENT PREPARATION SHEET (3 objectives)
HOME HEALTH ROTATION
Student Name: _______________________________________
Rotation Dates: ____________________
PLEASE READ THE FOLLOWING AND INDICATE THAT YOU UNDERSTAND WHAT IS
EXPECTED OF YOU PRIOR TO YOUR HOME HEALTH ROTATION:
1. Students are to dress in professional and conservative attire. This includes slacks, blouse, school vest
or jacket, and name tag. No jeans, low neck blouses, mid-drift shirts, or sandals are allowed.
Jewelry and hair are the same as clinical dress code. Students may wear their “whites” if desired.
2. Lunches are often eaten in the car between home visits. You are to prepare and bring your own lunch
every day.
3. You are under the direct supervision of the staff in the home care agency, you are expected to follow
their directives.
4. Please leave all personal problems at home and maintain a professional decorum.
5. If you are ill, you are expected to call the agency by 7 a.m. and your clinical instructor. You are
expected to attend the entire time or you will receive no credit for the day. If you are not making
home visits, utilize the time doing your post assignment written questions.
6. Call the home health agency the day before to find out which patients you will be working with.
I have read and clearly understand the above requirements:
Student Signature: _________________________________________________
BRING THIS FORM AND ANY ADDITIONAL DOCUMENTATION REQUIRED TO YOUR PREROTATION CONFERENCE:
1.
Copies of patient consent forms: _____________________________________
PLEASE ANSWER THE FOLLOWING QUESTIONS:
2.
Briefly explain the rules and regulations you will be expected to observe during your home health
rotation.
15
3.
Briefly review job titles and responsibilities of the various nursing personnel in most home health
agencies.
4.
Please indicate whether the following responsibilities:
I: can be performed by you independently (without supervision)
A: can be performed by you with assistance due to limited student experience, or
S: can be performed by you only under the direct supervision of a licensed nurse.
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
5.
Prepare the following written objectives; neatly typed and in detail. In order to receive credit for
these objectives, they must be turned in on the day of your post-conference.
Hygiene - including special skin care and shaving
Positioning, turning, ROM
Bedmaking
Feeding, assisting with meals
Ambulation, transfers from bed to chair, etc.
Vital signs
Weighing
Bandages, binders & TED stocking application
Soaks, compresses, simple dressings
Catheter care
Intake and output
Enemas, Harris flush
Specimen collection (urine, sputum, stool, wound drainage)
Blood Glucose Testing
Maintaining medical and surgical asepsis
Using universal precautions as appropriate
Sterile dressings
Catheterizations
Catheter irrigations
Suppositories
Cast care
Traction
Colostomy care, ileostomy care
Colostomy irrigation
Ventilator patients
Administer oral or injectable medications
Anything else not on this list!
#8, #10, #11, #19
16
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
INTENSIVE CARE UNIT/SPECIAL CARE UNIT
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS
OBJECTIVE
INSTRUCTOR/STAFF
COMMENTS
STAFF
INT.
Upon completion of classroom assignments,
lectures and discussion, the successful
student, during a clinical assignment in the
ICU will be able to:
INTENSIVE CARE UNIT
The student shall demonstrate initiative and
accountability while working under the direct
supervision of the staff and instructor in a
special care assignment by:
1. Verbalizing understanding of commonly
used medications in the special care unit. (5
objectives, see drug prep sheet)
N/A
2. Completion of Clinical Specialty
Worksheet based on policy and procedures.
(4 objectives)
N/A
3. Completion of ICU patient prep sheet on
each patient cared for during rotation. (2
objective for each day)
N/A
4. Performing head to toe assessment with
ICU nurse at beginning of the shift.
5. Demonstrating ability to follow ICU
procedures in nursing care and assessment
(i.e., vital signs and I&O at least q1h).
Documents care given.
6. Demonstrating responsibility for assuming
patient care within the VN scope of practice.
7. Verbalizing understanding of patient’s
diagnosis and need for ICU admission.
SKILLS:
8. Accurately monitoring vital signs and
promptly reporting changes.
Total count (18): ______
ICU Clinical Specialty Worksheet (4): ______
ICU Clinical Preparation Sheet (4): ______
ICU Drug Preparation Sheet (5): ______
17
NAME ______________________________________
CLINICAL SPECIALTY
WORKSHEET
INTENSIVE CARE UNIT
Prior to your clinical rotation you are expected to complete the following objectives (4 objectives):
1. Review and discuss facility P & P regarding standard physiological monitoring routines.
2. Define the definitive care or flex patient.
3. List major procedures that may be done in the ICU. Discuss the rationale for doing in this environment.
4. Discuss nursing responsibilities for the patient on mechanical ventilation.
18
Name _____________________________________
CLINICAL PREPARATION SHEET
INTENSIVE CARE UNIT
5. List types of ICU patients you are caring for during rotation (Review with instructor daily). (4 objectives)
PATIENT INITIALS,
DIAGNOSIS
FOCUSED
ASSESSMENT
POSSIBLE NURSING
INTERVENTIONS
1.
2.
3.
4.
5.
19
PATIENT
TEACHING
6.
7.
8.
20
Name: __________________________
DRUG PREPARATION SHEET
INTENSIVE CARE UNIT/SPECIAL CARE UNIT
PLEASE NOTE: All drug information must be completed to the test in order to receive credit. Partial credit cannot be given.
Omission of even one drug will result in ZERO objective credit for drug preparation. If you are unable to locate the medication
in your drug book, research other sources. (5 objectives)
You will be given a written quiz before your rotation. You will be expected to pass this quiz with at least 75%. If you do not pass,
you may be allowed 2 additional retakes, provided you can pass prior to your assigned rotation. If you do not pass, you will
loose objectives for the drug prep. In addition, you may loose objectives for that rotation. A key may be checked out prior to
the quiz after showing this completed form to your instructor.
Trade name, generic name,
class
Reason For Use
1. Dobutamine
2. Adenosine
3. Dopamine and Regative
4. Calcium Chloride
5. Atropine
6. Dextrose 50%
7. Epinephrine drip
8. Procanimide
21
Special Considerations
9. Magnesium Sulfate
10. Narcan
11. Propofol
12. Nipride drip
13. Nitroglycerin drip
14. Procainamide drip
15. Zantac drip
16. Digoxin
17. Lasix
18. Potassium Chloride
22
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
LEADERSHIP - STUDENT SUPERVISION
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Provide all SVNs with daily forms,
designate absent students..
2. Counsel students who are tardy,
not prepared for assignments, or do
not meet dress code requirements.
Give specific examples.
(Must resolve a problem in order to
receive the objective)
3. Assign lunch and breaks. Assess
break book for signatures and counsel
SVNs who do not sign prior
appropriately.
Give specific examples.
1.
2.
3.
4. Perform daily chart checks and
document on worksheet. (2 objectives
each worksheet) 8 total objectives.
5. Follow up with students whose
charts are incomplete to gain
compliance in a timely manner.
Give specific examples.
1.
2.
3.
6. Collect daily forms at appropriate
time and make written comments
regarding performance.
Give specific examples.
1.
2.
3.
7. Replace forms– before running out
so that all is prepared for next week.
Give specific examples.
1.
2.
3.
Total (14): ______
23
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
LEADERSHIP AND SUPERVISION (Satellite Rotation)
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS
OBJECTIVE
Upon completion of classroom
assignments, lectures and
discussion, the successful student,
during a clinical assignment, will
be able to:
1. Completion of Drug
Preparation Sheet (5 objectives)
2. Demonstrate the ability to make
effective decisions in the best
interests of the patient and within
your scope of practice.
3. Communicate duties and
assignments clearly to staff and
peers.
4. Demonstrate effective
communication by following the
proper chain of command.
5. Provide encouraging and
supportive nursing care while
demonstrating awareness of the
emotional needs of the long-term
care patient.
6. Provide encouraging and
supportive nursing care while
demonstrating awareness of the
physical needs of the long-term
care patient.
7. Assist in updating and
evaluation of nursing care plans.
8. Make patient rounds for the
purpose of evaluating the patient’s
condition and the effectiveness of
patient care.
9. Assist in the extensive admit
assessment, history and orientation
of the long-term care patient.
10. Assist staff in performing
standard and sterile nursing
procedures. Give 3 different
examples.
1.
2.
3.
24
INSTRUCTOR/STAFF COMMENTS
STAFF
INT.
PAGE 2: LEADERSHIP AND SUPERVISION SATELLITE ROTATION
CLINICAL LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS
OBJECTIVE
11. Assist in coordinating patient
discharge or transfers. Describe
coordination efforts of those
discharged.
12. Develop both a teaching plan
and a tool to use while providing
discharge instructions to a patient
on multiple medications.
(Include with objective for
instructor to sign off.)
13. Observe the charge nurse in
the delegation of nursing duties to
various nursing personnel.
Critique the tasks delegated by the
charge nurse.
14. Assist the charge nurse in
charting responsibilities. Describe
various charting responsibilities
you completed.
15. Attend a patient care
conference.
16. Conduct a teaching session on
a topic related to basic care, to a
small groups of CNAs.
(5 objectives)
17. Observe & describe the
correct procedure for controlled
substance count.
SKILLS:
18. Phone or fax various lab
reports to a physician’s office.
Describe those reports.
19. Note and update the
resuscitation station of all patients.
Identify where this information is
located.
25
INSTRUCTOR/STAFF COMMENTS
STAFF
INT.
PAGE 3: LEADERSHIP & SUPERVISION SATELLITE ROTATION
CLINICAL LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS
OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
STAFF
INT.
20. Transcribe admit orders
and/or assist in taking new
orders.
21. Perform initial admission
assessment and chart correctly.
22. Initiate a care plan entry on
a new problem developed by a
patient.
23. Communicate to pharmacy
any new orders and/or changes
in orders.
24. Administer all medications
to a team of patients. Includes
drug prep/cards and follow-up
documentation.
25. Communicate changes in a
patient condition to a physician.
26. Administer treatments.
27. Perform weekly skin
assessment.
28. Draw blood for lab work (if
already completed venipuncture
section if IV therapy course).
Total (35) _____
Teaching (5) _____
Drug Prep Sheet (5) _____
26
Leadership And Supervision
(Satellite Experience)
VOCATIONAL NURSING 53
PLEASE NOTE: All drug information must be completed prior to the test in order to receive credit. Partial credit cannot be
given. Omission of even one drug will result in ZERO objective credit for drug preparation. If you are unable to locate the
medication in your drug book, research other sources. (5 objectives)
You will be given a written quiz before your rotation. You will be expected to pass this quiz with at least 75%. If you do not pass,
you may be allowed 2 additional retakes, provided you can pass prior to your assigned rotation. If you do not pass, you will
loose objectives for the drug prep. In addition, you may loose objectives for that rotation. A key may be checked out prior to
the quiz after showing this completed form to your instructor.
Generic Name/Trade
Name
Drug Class
1. fluticasone &
salmetrol / Advair
Diskus
Dose
Reason for Use
2. atenolol / Tenormin
3. diltiazem / Cardizem
4. warfarin / Coumadin
5. lanoxin / Digoxin
6. phenytoin / Dilantin
7. metformin /
Glucophage
8. isosorbide
mononitrate / Imdur
27
Special Considerations
Generic Name/Trade
Name
Drug Class
9.Insulin: Humulin
70/30, Regular, NPH
Dose
Reason for Use
10. K+ / K-Dur
11. furosemide / Lasix
12. escitalopram /
Lexapro
13. atorvastatin /
Lipitor
14. benazepril /
Lotensin
15. lovastatin /
Mevacor
16. gabapentin /
Neurontin
17. Nitroglycerin Patch
18. paroxetine / Paxil
19. clopidogrel /
Plavix
20. Prednisone
28
Special Considerations
Generic Name/Trade
Name
Drug Class
21. lansoprazole /
Prevacid
Dose
Reason for Use
23 risperidone /
Risperdal
22. carbidopalevodopa / Sinemet:
24. levothyroxine /
Synthroid
25. hydrocodone and
acetaminophen /
Vicodin
29
Special Considerations
Planned Teaching Schedule
Shasta View
Name
Date of
presentation
Pre-Conference
Date
1.
2.
3.
4.
5.
6.
7.
Using a mechanical lift
Caring for a colostomy
Positioning the resident
Range of motion exercises
Ambulating the resident/assisted fall
Measuring I & O
Measuring height & weight
(standing-bedridden-wheelchair)
8. Coughing & deep breathing
& use of splint
9. Applying elastic stockings &
use of thromboguards
10. Giving a cool water bath
11. Use of inspirometer/nasal cannula/O2
12. Condom catheter
13. Feeding residents
14. Stool/Urine collection
15. Heat/Ice application
16. Communication w/residents & staff
17. Grooming
18. Basic emergency care
19. Infection control
20. Non pharmacologic Comfort Measures
21. Caused of Mental Confusion
22. Accident Prevention in Long Term Care
23. Elder abuse
24. Confidentiality/ HIPPA
25. Sleep Pattern of the Elderly
26. Sensory Alterations
27. Fire Safety (RACE)
 Each third semester vocational nursing student is required to do a 20-30 minute teaching segment to CNA’s in a skilled nursing facility.
The teaching segment will be scheduled on a day the student is scheduled to be in clinical rotation.
 Prior to the presentation, complete the attached In-service Education forms. These include a lesson plan, brief description of the course,
behavioral objectives, method of instruction and a post-test. The post-test should consist of 10 questions. The In-service Education
form should be completed prior to, and reviewed with instructor, at pre-conference appointment.
 Teaching content must be consistent with the CNA text. A copy of this text will be kept in the classroom for your reference.
 Questions used for the post-test should be based on the behavioral objectives.
 The Director of Staff Development will complete an evaluation of the student’s teaching skills in order to give feedback to the student and
the instructor.
 This is a great opportunity to practice teaching skills in a controlled environment with a supportive individual. Do the best you can and
enjoy!
Objectives (5): _____
30
INSERVICE EDUCATION FORM
1.
Lesson Plan
Subject:
Estimated time:
2.
Brief Description of Course:
3.
Behavioral Objectives: Upon completion of the course, the participant will be able to:
4.
Method of Instruction:
31
Emp. # _____________
Name: ________________________
Post Test
Name: ____________________________________________
32
Date: ___________________________
EVALUATION
MICRO TEACHING PRESENTATION
THIRD SEMESTER VN STUDENTS
COLLEGE OF THE SISKIYOUS
STUDENT NAME: _____________________________________________________
DATE: ________________________________
LENGTH OF TIME OF PRESENTATION:
_____ 10 mins.
_____ 15 mins.
_____ 20 mins.
_____ 25 mins.
_____ 30 mins.
EXCELLENT
GOOD
FAIR
NOT DONE OR
NOT
APPLICABLE
1
Knowledge of subject
3
2
1
N
2
Demonstration of skill
3
2
1
N
3
Organization of material presented
3
2
1
N
4
Ability to answer questions from
group
3
2
1
N
5
Professional presentation
3
2
1
N
6
Usefulness of material presented
3
2
1
N
7
Other:
Comments: How will this information improve your patient care?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Signature (Optional): _______________________________________________
33
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
MEDICATION ADMINISTRATION 53
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Administer all medications
correctly. (No occurrence reports) All
meds all patients.
2. Demonstrate ability to correctly
calculate dosage administration.
List 3 examples.
1.
2.
3.
3. Assess, document and provide
patient teaching needs relevant to their
medication regimen.
1.
2.
List 3 examples.
3.
4. Demonstrate responsibility and
accountability should a medication
error occur. # #
5. Adhere to time frame constraints
for medication administration. All
meds should be given within 30
minutes before or after on med-surg &
60 minutes before or after on SNF.
SKILLS:
Patient teaching to include:
1. Relevant information about the
medication, written material, &
thorough documentation.
List 3 examples.
1.
2.
3.
Total (6): ______
34
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
NURSING PROCESS
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will demonstrate
understanding of the nursing process
by successful completion of three of
the following care plans: *
1. An assigned simple medical
patient.
Instructor approval: _____________
2. An assigned “at risk” surgical
patient, including nursing
interventions to prevent or mitigate
problems.
Instructor approval: _____________
3. An assigned pediatric patient (6
weeks - 14 years). OR
Instructor approval: _____________
4. An assigned complex medical or
surgical patient.
Instructor approval: _____________
*Patient selections must be obtained
from medical-surgical rotations with
prior approval from instructor.
Student should have provided handson care for two consecutive days.
(These care plans are worth 15% of
N53 theory grade.) (Each care plan
worth up to 5 clinical objectives.)
Clinical Objectives for Care Plans
A = 91% - 5 objectives
B = 82% - 4 objectives
C = 75% - 3 objectives
D = 65% - 2 objectives
F = under 65% - 1 objective
Total: (15) _______
35
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
OBSTETRICS AND NEWBORN NURSERY
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Preparation sheet accurately and
completely prepared prior to OB
rotation. (20 objectives)
2. Verbalizes understanding of
commonly used medications in OB
and newborn nursery. (5 objectives)
3. Demonstrates ability to follow
admitting procedures according to
hospital policy & physician orders.
4. Observes, assists, and supports a
woman in labor.
# # (If no patient in labor by the end
of NUR 53, may write up how you, as
an LVN, would achieve this
objective.)
5. Assists with the nursing care
during the delivery of a newborn,
including assessment, evaluation, ID,
VS’s, medications, bath.
# # (If no patient in labor by the end
of NUR 53, may write up how you, as
an LVN, would achieve this
objective.)
6. Provides nursing care during the
post-partum recovery stage (4th stage
of labor).
7. Assumes the teaching role to the
post-partum family.
8. Observes and/or provides nursing
care to the cesarean mother.
9. Observes and assists physician
with circumcision. Provide patient
teaching for post-circumcision
assessment and care.
##
36
INSTRUCTOR/STAFF COMMENTS
OB & Newborn Nursery
Page 2
CLINICAL/LAB SKILLS
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
10. Explain precautions to prevent
newborn abduction while describing
technique.
#
11. Accurately charts newborn and
post-partum care on appropriate
charts.
12. Demonstrates ability to assess and
meet physical needs of the laboring
and post partum patient.
13. Demonstrates ability to assess and
meet psychological needs of the
laboring and post partum patient.
SKILLS:
1. Complete OB check/admit record
2. Correctly attach fetal monitor.
##
3. Explain the difference between
early, late and variable deceleration.
#
4. Perform fundal massage.
##
5. Assist with first ambulation postpartum.
6. Assess post-partum patient for
urinary elimination.
7. Apgar scoring. Describe results on
an assigned NB.
##
8. Observe neonatal resuscitation.
Explain the interventions used.
##
9. Assist & describe procedure for
identification of mother & newborn.
10. With assigned OB staff, assist in
performing the Dubowitz evaluation.
Total (45) _____
Rotation Objectives (20): _____
OB Drug Prep Sheet (5): _____
Speciality Worksheet (20): _____
37
DRUG PREPARATION SHEET
OB
PLEASE NOTE: All drug information must be completed prior to the test in order to receive credit. Partial credit cannot be
given. Omission of even one drug will result in ZERO objective credit for drug preparation. If you are unable to locate the
medication in your drug book, research other sources. (5 objectives)
You will be given a written quiz before your rotation. You will be expected to pass this quiz with at least 75%. If you do not pass,
you may be allowed 2 additional retakes, provided you can pass prior to your assigned rotation. If you do not pass, you will
loose objectives for the drug prep. In addition, you may loose objectives for that rotation. A key may be checked out prior to
the quiz after showing this completed form to your instructor.
(73 possible)
Generic Name/Trade Name
Drug Class
Dose
Reason for Use
Methylergonovine/ Methergine
MgSO4:
Emgel/ Erythromycin Opth
.
Rubella
Docusate/ Colace
Butorphanol/ Stadol
Ibuprofen/ Motrin, Advil
Acetaminophen c Codeine/ Tylelol
with Codeine
Rh immune globulin/ RhoGam
38
Special Considerations
Phytonadione/ Vit K
Terbutaline/ Bricanyl, Brethaire
Oxytocin/ Pitocin
Naloxone (neonatal)/ Narcan
Ca Gluconate/ Kalcinate
Misoprostol/ Cytotec
Fentanyl transdermal/ Duragesic
1% Lidocaine/ Xylocaine
24% Sucrose
1% Lidocaine without Epinephrine/
Xylocaine
39
NAME: _________________________
CLINICAL SPECIALTY WORKSHEET
MATERNAL CHILD
OBSTETRICS AND NEWBORN NURSERY
(20 objectives possible)
1. Prior to your rotation, review videos and/or textbooks to find the information to complete the
following: (1)

Describe how to time contractions

Briefly describe early decelerations

Briefly describe variable decelerations

Briefly describe late decelerations

Describe characteristics of normal, healthy FHT’s
2. Describe the focused assessment for labor admission. (1)
3. Discuss the following warning signs of complications and antipartum nursing interventions. (1)
S.S hemorrhage
Nursing interventions
S/S eclampsia
Nursing interventions
40
S/S urinary retention
Nursing interventions
S/S prolapsed cord
Nursing interventions
S/S fetal distress
Nursing interventions
S/S placental abruptus
Nursing interventions
S/S placental previa
Nursing interventions
4. Define the stages of labor (include contraction characteristics, expected cervical changes, physical
S/S’s. (1)
First stage of labor
Second stage of labor
Third stage of labor
41
5. Define the fourth stage of labor. (2)
A. Frequency of V/S’s
B. Size and position of fundus
1) Describe evaluation of fundus
2) Describe how to document fundal height
3) Describe correct technique to massage fundus
4) Describe how to assess vaginal bleeding
5) Describe the “normal” number of peripads during the fourth stage and subsequent hours
following delivery
6) Describe Post-Partum vaginal bleeding
a) Correct terminology
b) Progressive changes
7) Describe normal progressive involution of uterus
42
8) Describe what you should do prior to first ambulation
9) Describe observations of first voiding. Explain rationale for this.
10) Describe post partum perineal care.
11) Describe patient teaching regarding asepsis (handwashing) before receiving infant or
feeding or nursing infant.
6. Regional anesthesia (1)
A. Discuss three types of regional anesthesia and describe nursing interventions in the use of these:
1) ________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
2) ________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3) ________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
B. Describe proper positioning for a woman post anesthesia.
C. Explain the rationale and need for monitoring.
D. Describe the technique to assess for urinary retention
43
7. Describe patient teaching and instruction to nursing mothers stressing the importance of diet, fluid
intake, beast care and prevention of complications. (1)
Diet: ____________________________________________________________________________
________________________________________________________________________________
Fluid: ___________________________________________________________________________
________________________________________________________________________________
Breast Care: ______________________________________________________________________
________________________________________________________________________________
Prevention: _______________________________________________________________________
________________________________________________________________________________
8. Cesarean birth patient: (1)
A. Describe the care given to a pre-Cesarean birth patient.
B. Describe the care given to an emergency C-birth patient.
C. Describe the care given to a post-Cesarean birth patient.
9. Nursing care of the newborn: (1)
In the Delivery Room:
A. Describe how and when Apgar scoring is done.
B. Describe when neonatal resuscitation is begun.
C. Describe the methods used to provide warmth for the newborn.
D. Describe the identification process.
44
E. Prophylactic agent to prevent ophthalmia neonatorum. Describe agents used.
F. Describe the correct procedure for instillation.
Immediate Care of the Newborn (1 objective)
1.
Describe normal height, weight, head circumference for each sex.
2.
Describe normal temperature expected initially. Describe environmental factors that influence
newborn temperature.
3.
Describe the procedure for inspecting the cord for signs of hemorrhage.
4.
Describe policy to bathe and dress the infant.
5.
Describe methods of maintaining a clear airway as necessary.
6.
Describe and state rationale for positioning infant appropriately to prevent complications.
45
Routine Nursery Care (1 objective)
1.
Describe the hospital policy regarding the correct technique for scrubbing and gowning prior
to handling the infant.
2.
Describe daily inspection of infant during bath.
3.
Describe instruction of the mother in performing a newborn bath.
4.
Describe patient teaching to mother in these techniques:
Bathing:
Lifting:
Holding:
Feeding:
Positioning:
Temperature taking:
10. Describe the policy for correct procedure for transporting infant to the mother. (1)
46
11. Circumcision (1)
1.
Describe post circumcision assessment
2.
Describe post circumcision care
3.
Describe what to teach the mother
12. Describe the procedure to prevent newborn abduction. (1)
13. Discuss the procedure to assist in the discharge of infant and mother. (1)
14. Observe and care for the premature (preterm) infant. (1)
A. Gavage feeding: Describe when you would gavage an infant.
B. Describe the policy for gavage feedings.
15. Assess and meet not only the physical, but also the psychological needs of the laboring woman and
the post partum patient. Describe how you met these objectives. (3) (This objective to be completed
during the rotation)
47
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
OUTPATIENT SURGERY
CLINICAL/LAB SKILLS
Upon completion of classroom
assignments, lecture and discussion, the
successful student, during a clinical
assignment, will be able to:
DESCRIBE HOW YOU COMPLETED THIS
OBJECTIVE
I
N
S
T
R
1. Complete OPS Rotation P&P
completely during rotation. (5 objectives
maximum)
2. Verbalize understanding of commonly
used medications in outpatient surgery.
(5 objectives)
3. Verbalize understanding of types of
surgeries during the OPS rotation (2
objectives per day).
4. Document that required forms and
diagnostic testing has been completed and
appropriately included in the patient’s
chart prior to surgery.
5. Observe and describe the procedure
for signing appropriate consents.
6. Confirm and document the completion
of all pre-operative orders.
7. Assess patient allergies and follow
correct protocol for documentation.
8. Observe patient teaching and
psychological preparation for surgery
during pre-op interview.
9. Prepare the patient for surgery.
(Clothing removal and storage, patient
gown and cap and identification band, use
of restroom, completion of surgical
checklist and pre-op medications.)
10. Observe initiation IV therapy,
observation of IV site, fluids and
equipment and describe nursing
responsibilities after initiation of IV.
48
INSTRUCTOR/STAFF COMMENTS
11. Perform post-operative assessment
and observe for complications (monitor
and document vital signs and a focused
assessment).
12. Complete charting requirements.
13. Provide discharge teaching (dressings,
medications, follow-up visits,
complications to report).
14. Perform nursing procedures required
on non-student assigned patients with
instructor approval.
Total count (25): _______
OPS clinical specialty worksheet (5) _______
OPS clinical preparation sheet (4) _______
OPS drug preparation worksheet (5) _______
Total count: _______
49
DRUG PREPARATION SHEET
OPS
All drug information must be completed prior to the test in order to receive credit. Partial credit will not be given. Omission of
even one drug will result in ZERO objective credit for drug preparation. If you are unable to locate the medication in your drug
book, research other sources. (5 objectives).
You will be given a written quiz before your rotation. You will be expected to pass this quiz with at least 75%. If you do not pass,
you may be allowed to retake provided you can pass prior to your assigned rotation. If you do not pass you may be excused from
the rotation. A key may be checked out prior to the quiz after showing this completed form to your instructor.
Generic/Trade name
Class
Dose/Route
Reason for use
Lidocaine PF
cyclopentolate/
Cyclogyl
phenylephrine/
Mydfrin
ciprofloxacin/
Ciloxin
meperidine HCl/
Demerol
morphine sulfate
midazolam/Versed
diazepam/Valium
ketorolac/Toradol
50
Special
Consideration
Generic/Trade name
Class
Dose/Route
Reason for use
hydromorphone/Dilaudid
oxycodone/Oxycontin
hydrocodone &
acetaminophen/Norco
fentanyl/Sublimazae
dorperidol/Inapsine
Scopolamine
alprazolam/Xanax
ondansetron/Zofran
diphenhyramine/Benadryl
labetolol/Trandate
cephalexin/Keflex
Heparin
51
Special
Consideration
Generic/Trade name
Class
Dose/Route
Reason for use
promethazine/Phenergan
hydroxyzine/Visteril
famotidine/Pepcid
metoclopramide/Reglan
ranitidine/Zantac
52
Special
Consideration
Name: ___________________________________
CLINICAL SPECIALTY WORKSHEET
OUTPATIENT SURGERY (5 objectives)
Prior to your clinical rotation, complete the following:
1.
Discuss facility requirements for preoperative screening:
A. Lab and other diagnostic tests:
B. Procedure to follow when ordered tests not available.
2.
Discuss facility requirements for obtaining consents.
3.
Discuss facility policy regarding immediate pre-op preparation.
4.
Describe history and physical requirements.
53
CLINICAL PREPARATION SHEET
OPS
5. List types of outpatient surgeries scheduled during your rotation (review each day before the rotation) (2 objective per day).
SCHEDULED SURGERY
FOCUSED ASSESSMENT
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
54
PATIENT TEACHING
CLINICAL PREPARATION SHEET
OPS
(Continued)
SCHEDULED SURGERY
FOCUSED ASSESSMENT
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
Dates:
55
PATIENT TEACHING
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
RECORDING AND REPORTING
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Report off on all assigned patients
to the appropriate staff member in a
complete, concise, inclusive and
relevant manner. (Staff member
must initial each time)
1.
2.
3.
4.
5.
2. Chart all pertinent information on
assigned patient (legibly, neatly,
completely).
@
3. Chart procedures using correct
language and terminology.
@
SKILLS:
4. Signs/initials chart forms in correct
format.
@
5. Records all care given on flow
sheets in correct format and on all
forms.
@
Total (5): ______
56
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
RESPIRATORY DISORDERS
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Recognize signs of respiratory
distress such as dyspnea, cyanosis,
Cheyne-Stoke respirations or
hemoptysis, while responding quickly
and appropriately.
*
2. Demonstrate correct nursing skills
in the care of the post-operative
patient to prevent hypostatic
pneumonia.
*
3. Provide nursing care to the patient
with respiratory tract secretions.
*
SKILLS:
4. Instruct in deep breathing
*
5. Instruct in coughing
57
Respiratory Disorders
Page 2
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
6. Instruct in frequent turning
*
7. Position to facilitate easier
breathing
*
8. Demonstrate effective use of
medical asepsis
9. Provide patient teaching in
preventing the spread of infection.
(Teaching card required)
10. Provide patient teaching
regarding the importance of increased
fluids and good nutrition.
*
(Teaching card required)
11. Provide patient teaching
regarding prevention of abdominal
distentions.
*
(Teaching card required)
12. Provide care of the patient with a
tracheotomy using aseptic technique.
13. Aseptically collect a sputum
specimen (explain procedure).
14. Obtain a throat swab specimen
for a C/S.
(Explain the procedure)
Total (14): ______
58
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
STRESS AND ADAPTATION
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Demonstrate appropriate nursing
care to an assigned patient and/or
family member, experiencing
ineffective coping during
hospitalization.
*
2. Describe appropriate coping
behaviors a patient might utilize in a
stressful situation.
#
3. Describe appropriate coping
techniques a student could use in a
stressful situation during a clinical
assignment.
#
4. State five methods the student
could utilize to prevent stress during a
clinical assignment.
#
1.
2.
3.
4.
5.
SKILLS:
Give an example ofyou’re your
demonstrate effective coping during a
clinical assignment by:
5. Remaining outwardly calm.
*
6. Accept criticism and change
behavior accordingly.
*
7. Demonstrate confidence in nursing
abilities.
59
8. Ask appropriate person for help.
*
9. Not allowing personal problems to
affect performance.
10. Performing consistently at best
level.
@
11. Responding appropriately in a
crisis situation.
*
Total (11): ______
60
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
TEACHING AND LEARNING
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Identify the “overt” learning needs
of an assigned patient.
2. Instruct patients in technical
aspects of health care needs.
3. Thoroughly and yet concisely
document both teaching and learning
that has occurred. (Give 3 specific
examples)
1.
2.
3.
4. Identifies the overt learning needs
of an assigned patient and
demonstrates ability to provide
accurate patient information of
various health education needs.
(Document up to 16 different topics.
Include teaching cards.) (16 possible)
SKILLS:
Teach a patient regarding the
following:
5. Insulin
6. Special diet
7. Community resources
8. Discharge instructions
9. Life-style changes
Total (26): _____
61
TEACHING AND LEARNING (Record 1 Objective Each)
Week #
Room #
Pts. Initials
1 __________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
2 __________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
3 __________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
4 __________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
5 __________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
6 __________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
7 _________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
8 _________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
9 _________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
10 ________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
11 ________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
12 ________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
13 ________
(date)
1________
2 _______
3 _______
__________
__________
__________
14 ________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
15 ________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
16 _________
(date)
1 _______
2 _______
3 _______
__________
__________
__________
1 _______
2 _______
3 _______
__________
__________
__________
17 ________
(date)
LEARNING NEED
62
INSTRUCTIONS GIVEN
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
UROLOGIC DISORDERS
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to:
1. Provide appropriate nursing care to
a patient with a urologic disorder.
2. Provide nursing care to a patient
with a urinary catheter with proper
positioning of tubing and maintaining
drainage bag below the level of the
bladder at all times.
3. Accurately describe rationale for
collecting serial urines.
#
4. Describe rationale for restricting
fluids and for forcing fluids as ordered
(urologic patient).
#
5. Appropriately assess a patient with
renal failure.
6. Provide appropriate nursing care to
a patient experiencing renal failure.
*
7. While caring for a patient
experiencing renal failure, provide a
quiet environment conducive to rest
and explain the rationale.
8. Describe nursing interventions for
a patient in renal failure.
#
9. Describe the purpose of the
following labs and tests in relation to
renal failure patients. (3 objectives)
A. BUN
B. Creatinine
C. 24o urine for creatinine clearance
#
63
Urological Disorders
Page 2
CLINICAL/LAB SKILLS
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR COMMENTS
10. Provide appropriate nursing care
to a patient experiencing renal calculi.
##
11. Assess and document pain and/or
bleeding while caring for a patient
diagnosed with a renal calculi.
##
12. Summarize the nursing care
specific to a patient having peritoneal
dialysis.
#
13. Assess and document pain and/or
bleeding while caring for a patient
with a urological infection (cystitis,
urethritis, nephritis, pyelonephritis.)
14. Explain rationale for nursing
interventions provided to a patient
with a nephrostomy tube.
#
15. Provide nursing care to a patient
with a supra pubic catheter while
maintaining sterility and providing
instruction for care and clamping
upon discharge. Explain rationale.
##
SKILLS:
16. Correctly prepare a urologic
patient for diagnostic tests and
examinations.
17. Accurately measure and record
urinary output and/or total shift
output.
*
18. Correctly irrigate a bladder and/or
instill medications as ordered, using
aseptic technique, with appropriate
and accurate documentations.
##
19. On a patient with a 3-way bladder
irrigation, accurately observe and
document; color of urine, size and
number of clots, patency of catheter.
20. Correctly maintain output for a
3-way bladder irrigation.
64
Urological Disorders
Page 3
CLINICAL /LAB SKILLS
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR COMMENTS
21. Remove a retention catheter,
observing for voiding, bleeding,
retention, incontinence. Explain
teaching given to patient.
22. While caring for a patient with a
urologic disorder or infection of the
urinary tract, accurately assess, report
and document quantity voided,
abnormal flow of urine, characteristics
of urine (color, odor, clouding),
change in pattern of voiding, pain and
discomfort, frequency, urgency,
incontinence, burning, bleeding,
quantity retained.
23. Carefully strain all urine as
ordered, with prompt reporting and
recording for a patient with renal
calculi. # #
24. Provide accurate post-surgical
nursing care to a urologic patient,
including proper positioning,
reinforcement of dressing, correct
interpretation of vital sign monitoring,
careful measurement of urinary
output.
25. Irrigate a nephrostomy or
pyelostomy tube.
##
Total (27): ______
65
COLLEGE OF THE SISKIYOUS
VOCATIONAL NURSING 53
VALUES AND ETHICS 53
CLINICAL/LAB SKILLS
I
DESCRIBE HOW YOU COMPLETED THIS OBJECTIVE
INSTRUCTOR/STAFF COMMENTS
Upon completion of classroom
assignments, lectures and discussion,
the successful student, during a
clinical assignment, will be able to
1. Maintain a professional standard of
ethics.
@
2. Maintain professional behaviors.
@
3. Maintain patient confidentiality at
all times. @
4. Demonstrate an understanding &
acceptance of the Nursing 53 student
vocational nursing role in the clinical
setting. @
SKILLS:
5. Maintain appropriate dress code
for community rotation. If one
violation occurs in this area, this
objective cannot be achieved.
6. Assume responsibility for
professional conduct during
community rotations.
7. Assume responsibility for
preparation prior to community
rotations. If one violation occurs in
this area, this objective cannot be
achieved.
Total (7): ______
66
PUBLIC HEALTH
MATERNAL CHILD HEALTH
VOCATIONAL NURSING 53
During a scheduled conference with your instructor, complete the following objectives. Develop charts or
teaching cards for each of the following:
1. Discuss causative agents, transmissions, signs and symptoms, treatment, prevention, and long-term effects
of untreated sexually transmitted diseases, dangers to mother and fetus. (See pp. 255-257 in your textbook
and next page of this objective book.) (5 objectives)
2. Contraceptives - Describe common contraceptives and advantages and disadvantages of each. (Include
how each prevents formation or early development of a fertilized ovum. Compare the advantages and
disadvantages of each method and discuss the most reliable methods of contraception.) (See next page.) (5
objectives)
3. Discuss patient teaching for a client starting on birth control pills. (1 objective)
4. Develop comparison chart between cow’s milk and breast milk (e.g., fat, protein, CHO, trace elements,
calories, etc.). (3 objectives)
5. Develop mini-lesson plan for breast feeding mother. (Include five advantages of breast feeding, dietary
modifications a nursing-mother may need to make for herself and her baby, the differences in content of
calories, protein, carbohydrates, fat and minerals between breast milk and cow’s milk, techniques for taking
the baby off the breast, and techniques for holding the breast feeding infant.) (5 objectives)
6. Develop mini-lesson plan for bottle feeding mother. (Include methods of bottle preparation and safety
factors.) (5 objectives)
7. Describe five critical factors to assess hydration of the infant. (2 objectives)
8. Describe four criteria to assess nutritional status of infant. (2 objectives)
9. Compare the food pyramid to the normal diet of a child. Identify potential problem areas and how you
would provide client teaching aimed at correcting deficiencies. (2 objectives)
10. Discuss immunization recommendations for new parents. (Prepare drug cards for each agent on the
current immunization schedule.) (5 objectives)
11. Identify injection sites, needle size and gauge for the following: infant, one year, three years, six years.
(2 objectives)
Total (37) ________
67
During any Nur 53 Tuesday prep conference meeting with your clinical instructor, be able to recite from memory the following methods of contraception, advantages
and disadvantages, failure rate and protection from STDs/HIV. (5 objectives)
Contraceptive methods preventing fertilization.
Contraceptive
Advantages
Disadvantages
Failure
STD/HIV
Technique
Rate
Protection
1. Abstinence
No appliances, preparation, or expense
At times difficult to maintain
0
Yes
2. Coitus
No appliances, preparation, or expense
Sperm often escape prior to withdrawal
19%
No
interruptus
3. Periodic
All forms a-d.
Requires period of abstinence. Planning and
20%
No
abstinence (natural
No appliance or immediate preparation.
records necessary.
family planning)
Relatively inexpensive.
May be acceptable to groups objecting to other
forms of contraception.
Can be used to plan pregnancy as well as to avoid.
a. Calendar
Simple
Requires period of abstinence, planning. Not
20%
No
method (rhythm)
useful when cycles quite variable.
b. Basal body
Relatively simple
Requires period of abstinence, planning. Body
20%
No
temperature
temperature may vary widely if ill, etc.
c. Changes in
Once learned, relatively simple. Useful for women
Requires period of abstinence. More difficult to
20%
No
cervical mucus.
who do not ovulate regularly.
learn to evaluate, more record keeping.
“Billings” or
“ovulation method”
d. Symptotherma
Women using these methods learn more about their
Requires period of abstinence, more complex
20%
No
(employs a-c above bodies. Useful when cervical mucus is atypical
record keeping.
& evaluation of
other signs &
symptoms)
4. Male condom
For femal, protection is responsibility of the male.
Must be carefully applied after erection and
20%
Yes (best
fairly inexpensive. Readily available.
carefully removed after coitus. Interrupts foreplay.
protection)
5. Female condom
Female able to protect self. Can be inserted hours
Must learn application 7 removal technique.
12%
Yes
before coitus. Less likely to tear than male condom.
Safe alternative if sensitive to latex.
6. Diaphragm or
Fairly inexpensive. Highly effective. Can be
Must be fitted by health care provider, carefully
Diaphragm 18%.
Yes
cervical cap with
inserted hours before coitus
positioned by woman. Diaphragm use associated
Cervical cap used (limited)
spermicide
with bladder infections; caps with abnormal
by women never
changes in Pap smears.
pregnant – 18%.
Cervical cap used
by women who
have given birth
vaginally – 36%.
7. Spermacides
Easy to apply. Relatively inexpensive. Readily
Must be applied within 1 hour of intercourse and
21%
Yes
available. Provides vaginal lubrication.
left in place for 8 hours afterward. Some find it
(limited)
messy, irritating, or failing to melt or foam
correctly.
Contraceptive methods preventing ovulation.
1. Combination oral
Use not directly associated with sexual activities.
Several contraindications exist. Possible
3%
No
contraceptives (“the
Easy to use. Ability to stop and conceive.
complications include: heart attack, deep vein
pill”)
Protective effect against ovarian and endometrial
thrombosis, stroke. Careful follow-up necessary.
cancer, pelvic inflammatory disease, and benign
Must remember to take daily. Backup method if more
breast disease.
than one pill is missed. Questionable use during
lactation.
2. Progestin-only
All of the above advantages, plus does not have
Must remember to take at the same time each day.
1.1 to 13.2%
No
oral contraceptives
negative effect on lactation. Less risk of
Backup contraception needed if pill is taken 3 or more
(“mini-pill”)
complications.
hours late. Common side effects: irregular menses,
weight gain.
3. Injectable
No internal appliance. Not directly associated
Contraindications: unexplained vaginal bleeding,
0.3%
No.
progestin (Depo
with sexual activity. Injection lasts 3 months.
acute liver disease, breast cancer or blood clots.
Provera)
Other advantages similar to oral progestin except
Requires injections every 3 months. Common side
not immediately reversible.
effects: irregular menses, weight gain.
Progestin implants
All of the above advantages except duration of
Requires sub-dermal plant with risk of infection,
0.09%
No.
(Norplant
effect is 5 years. Immediately reversible with
bleeding, and prominent appearance of rod under skin.
removal of rods.
Contraindications and side effects similar to those of
injectable progestin.
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During a scheduled conference with your instructor, be able to recite from memory the following commonly
sexually-transmitted diseases including s/s, medical treatment, prevention and effects on the fetus or
newborn. Complete effects on fetus or newborn. Use this chart as your guidelines for completing Maternal
Child Health Objective #1.
Common Sexually Transmitted Diseases
STDs
Gonorrhea
Syphilis
Genital herpes
(herpes
simplex virus
type II)
Chlamydia
Condyloma
HIV/AIDS
Signs/Symptoms
Medical Treatment
Male: dysuria, penile discharge
of whitish fluid or yellowish
purulent matter, eventual
sterility.
Female: often asymptomatic,
but may have vaginal discharge,
pain in lower abdomen, burning
during urination
Primary: Chancre, headache,
enlarged lymph glands.
Secondary: usually
asymptomatic, but may
experience rash, loss of hair,
sore throat, arthritis. Tertiary:
damage to blood vessels, heart,
nerves, eyes.
Male: lesions on glans penis
shaft, scrotal sac, inner thighs.
Female: lesions on vulva,
vaginal surface, cervix, and
buttocks.
Female: none or vaginal
discharge, urinary frequency,
soreness, itching, “fishy” odor.
Male: Dysuria, urinary
frequency, whitish, watery
penile discharge.
Appearance of warts, raised, flat
or cauliflower-like growths on
genitalia, vagina or cervix.
Ceftriaxone (Rocephin)
injection or other
antibacterial and
doxycycline PO
Test positive for HIV, weight
loss, malaise, frequent
infections, opportunistic
infections.
Build up immune
system; treat symptoms;
ZDV, didanosine,
lamivudine, stavudine,
zalcitabine, zidovudine.
Penicillin or other
antibacterial in primary
stage. Symptomatic
relief measures.
Nursing Interventions
& Teaching
Teach that health followup is necessary because
reinfection is possible.
Encourage reporting of
sexual partners so they
can be treated. Protect
self by following standard
precautions during care.
Teach return for periodic
check-ups. Encourage
cooperation with public
health officials to locate
and treat infected
partners.
Acyclovir or
valacyclovir HCI
alleviates symptoms.
Refer to herpes resource
center for support.
Protect self by wearing
gloves during direct care.
Doxycycline
Azithromycin,
Erythromycin base
(pregnancy)
Assessment for signs of
PID in women; education
on modes of transmission.
Freezing, laser therapy,
surgical removal,
topical chemotherapy,
podophyllum resin.
Education about
transmission, prevention
by use of condoms and
monogamous
relationships and
treatment.
Symptomatic psychologic
support, education on
prevention of
transmission.
69
Effects on Fetus or
Newborn