RANGER COLLEGE Syllabus COURSE NUMBER AND TITLE: RNSG 2535 – Integrated Client Care Management CREDIT HOURS: _5_ HRS/WK LEC: _5_ HRS/WKLAB:_0_ LEC/LAB/HRS/WK COMBINATION: _5_ Name of Instructor: ______________ Office Location:________________ Office Hours:_________ Office Phone:__________________ College E-Mail_________________ I. CATALOG DESCRIPTION Application of client assessment skills, critical thinking, and independent nursing interventions to care for diverse clients/families throughout the life span whose health care needs may be difficult to predict. Emphasis on collaborative clinical decision-making, nursing leadership skills, and client management. Topics include the significance of professional development, trends in nursing and health care, and applicable knowledge, judgment, skills, and professional values within a legal/ethical framework. This course lends itself to an integrated approach. II. REQUIRED BACKGROUND/PREREQUISITES Program Prerequisites: PSYC 2301 Introduction to Psychology ENGL 1301 Composition I BIOL 2302 Anatomy and Physiology I BIOL 2420 Microbiology and Clinical Pathology COSC 1401 Computer Applications Semester I Courses: RNSG 1423 Introduction to Professional Nursing RNSG 1460 Clinical-Nursing (RN training) RNSG 1119 Nursing Skills I BIOL 2402 Anatomy and Physiology II PSYC 2314 Lifespan Growth and Development Semester II Courses: RNSG 2504 Care of Client with Common Health Needs RNSG 1129 Nursing Skills II RNSG 1461 Clinical-Nursing (RN training) RNSG 1311 Nursing Pathophysiology Semester III Courses: RNSG RNSG XXXX 2514 2560 xxxx Care of Client with Complex Health Needs Clinical-Nursing (RN training) Humanities/Fine Arts Elective* 523 III. TEXTBOOK (S); READINGS; MATERIALS Hockenberry, M. Wilson, D. (2009). Wong’s Essentials of Pediatric Nursing. (8th ed.). St. Louis: Elsevier Ignatavicius, D. & Workman, M. (2010). Medical surgical nursing: Critical thinking for collaborative care. (6th ed.). St. Louis: Elsevier. Jarvis, C. (2008). Pocket companion for physical examination and health assessment (5th ed). Mosby Elsevier. Lowdermilk, D., Perry, S. (2007). Maternity & Women’s Health Care. (9th ed.). St. Louis: Elsevier Mosby (2009). Mosby’s nursing video skills: Basic, intermediate, and advanced skills. (3rd ed.). St. Louis: Elsevier. Pagana, K. & Pagana T. (2009). Mosby’s diagnostic and laboratory test reference.(9th ed.). St. Louis: Elsevier. Perry, A. & Potter, P. (2010). Clinical nursing skills and techniques. (7th ed.). St. Louis: Elsevier. Skidmore-Roth, L. (2010). Mosby’s 2010 drug reference. (23rd ed.). St. Louis: Elsevier. Swearingen, P. (2008). All-in-one care planning resource (2nd. ed.). St. Louis: Elsevier. Varcarolis, E. (2006). Foundations of psychiatric mental health nursing: A clinical approach. (5th Ed). St. Louis: Elsevier. IV. METHODS OF INSTRUCTION Lecture, discussion, audio-visual materials V. COURSE OBJECTIVES AND LEARNING OUTCOMES Course specific competencies and learning outcomes flow from Program Outcomes. Program outcomes are the Differentiated Entry-Level Competencies (DELCs), defined and published by the Texas Board of Nursing. (DELCs) are defined in four categories; 1) Provider of Patient Centered care, 2) Patient Safety Advocate, 3) Member of the Health Care Team, and 3) Member of profession. Integral to program and course outcomes are the QSEN Competencies. The QSEN competencies are integrated with DELC competencies throughout the nursing curriculum; progressing from simple to complex. Minimum safe entry-level nursing practice is assessed by the NCLEX-RN licensure exam. The National Council of State Boards of Nursing (NCSBN https://www.ncsbn.org) maintains and revises the NCLEX-RN licensure exam. The NCLEX-RN is revised every three years. Exam revisions are based on comprehensive research of new graduate nurse activities. The NCLEX-RN test blueprint contains weighted assessment categories based on graduate nurse activities. Nurse activities describe expectations, duties, and responsibilities. As Provider of Patient-Centered Care, the student will have the opportunity to: Nurses provide safe, competent nursing care to individuals and families, which reflect values of caring, competence, confidence, and commitment. Using problem solving and critical thinking skills, nurses assess, plan, implement and evaluate nursing care. 524 Coordinators collaborate with other health care providers, coordinate care and delegate specific aspects of nursing care to others as appropriate. Coordinators implement cost-effective nursing care. As advocates for individuals and families effectively manages human and material resources. 1. Apply the Ranger College nursing framework in accordance with the patient’s physical, spiritual, emotional and social needs throughout the life cycle in acute care settings. 2. Integrate theoretical and practical knowledge from nursing, physical and behavioral sciences into the nursing care for clients with complex health care needs. 3. Integrate characteristics, concepts, and processes related to clients and families, including anatomy and physiology; physical and psychosocial growth and development; pathophysiology and psychopathology; ethical reasoning; and cultural and spiritual beliefs and practices related to health, illness, birth, death and dying. 4. Correlate the nursing process in implementing and evaluating care for clients with complex health care needs. 5. Incorporate rules and regulations of the NPA as they relate to the implementation and evaluation of the nursing process, established theories, models and approaches that guide nursing practice. 6. Relate aspects unique to the individual client, such as: age, culture, emotional and mental development in implementing and evaluating care for clients with complex health care needs. Integrate characteristics, concepts, processes related to families and mental health, including family development; family communication patterns; and decision making structures. 7. Identify political, economic and societal forces that affect the mental health of individuals and families. 8. Explain how the client’s environment relates to principles and strategies of stress management and crisis intervention. 9. Examine issues and trends in delivery of care for clients/families with mental disorders and available community resources. 10. Implement and evaluate use of critical thinking and evidenced-based practice in delivery of quality health care for clients with complex health care needs. 11. Approach acute care nursing problems utilizing a systematic problem-solving process. 12. Demonstrate the ability to utilize critical thinking skills to make safe and ethical clinical decisions. 13. Apply therapeutic communication skills with diverse clients and families having complex health care needs 14. Assess learning needs of clients to develop and implement teaching plans for clients with complex healthcare needs with evaluation of client learning outcomes. 15. Utilize knowledge of societal trends to identify and communicate client care problems. 16. Demonstrate advanced critical care skills with minimal assistance. As a Patient Safety Advocate, the student will have the opportunity to: 1. Demonstrate knowledge about the Texas Nursing Practice Act and Board Rules 2. Implement measures to promote a safe environment for patients and others 3. Obtain instruction, supervision or training as needed when implementing nursing procedures or practices utilizing Evidence Based Research or Practice. 4. Know, recognize and maintain professional boundaries of the nurse-patient relationship 5. Comply with mandatory reporting requirements of the Texas Nursing Practice Act 6. Understand the concept of “scope of practice” and function within individual scope of practice 525 7. 7. Accept and/or make assignments that take into consideration patient safety and that are commensurate with educational preparation and employing health care institutional policy As a Member of the Healthcare Team, the student will have the opportunity to: 1. Collaborate with other health care providers and clients and their families to provide care and education for clients with complex health care needs with consideration of developmental needs. 2. Analyze the skills required by the associate degree nurse to coordinate care and make referrals on the basis of identified patient needs and knowledge of available resources. 3. Collaborate in multidisciplinary planning to provide care for clients/families with complex health care needs. 4. Develop and implement a plan of care for the diverse client/family across the life span with complex health care needs in a variety of health care settings. As Member of a Profession, the student will have the opportunity to: 1. Demonstrate accountability and responsibility for the quality of nursing care provided for complex patients. 2. Relate behaviors of client advocacy to own professional practice. 3. Compare the concepts of boundaries, safety, and trust development as they relate to providing nursing care for clients with complex health care needs, especially clients with mental health disorders. 4. Examine the roles of various agencies and organizations that promote the quality of care for clients with complex health care needs. 5. Demonstrate a working knowledge of the implications of the Nurse Practice Act. 6. Demonstrate the responsibility of the professional nurse to serve as a role model for students, peers and members of the interdisciplinary healthcare team. 7. Assure quality of care through evaluation of the learning needs of self, peers or others. VI. COURSE OUTLINE Week 1 Content Outline Readings/ Assignments Concepts of Emergency Care and Disaster Preparedness Triage Mechanism of injury Primary survey Heat and cold injuries Drowning Bites and stings Altitude illnesses Emergency preparedness and response Ignatavicious – Ch. 10, 11, 12 526 2 3 4 5 6 7 8 9 10 11 plan Debriefing Bioterrorism Burns Determination of burn depth Fluid shifts Pulmonary problems from burns/inhalation Metabolic changes Carbon Monoxide poisoning Wound healing Position and range-of-motion Rehabilitation Test 1 – Emergency Care, Disaster Preparedness, Burns NCLEX- Preparation session Critically Ill Respiratory Pulmonary Embolism Acute Respiratory Failure Intubation and ventilation Chest trauma Shock Types of shock – hypovolemic, cardiogenic, distributive Anaphalyxis Sepsis Capillary leak syndrome Test 2 – Respiratory and Shock NCLEX Preparation session Critically ill cardiac Hemodynamic monitoring Dysrhythmias Ignatavicious Ch. 28 Ignatavicious Ch. 34 Ignatavicious Ch. 39 Ignatavicious Ch. 35, 36 Cardiac (Cont’d) Acute coronary syndromes Unstable angina Myocardial infarction Angioplasty Cardiopulmonary bypass Test 3 - Cardiac NCLEX Preparation session Problems of Central Nervous System Spinal Cord Injuries Spinal cord tumors Amytrophic lateral sclerosis Autonomic dysreflexia Critically ill neuro Traumatic brain injury TIA Stroke Ignatavicious – Ch. 45 Ignatavicious Ch. 47 527 12 13 14 15 16 Brain tumors Brain abscess Hematologic Problems Stem cell transplant Disseminated intravascular coagulation Sickle cell disease Blood transfusion therapy Anemia Ignatavicious Ch. 42 Hockenberry Ch. 26 Loudermilk Ch. 31 Test 4 – CNS, neuro, and hematology problems NCLEX Review Course NCLEX Review Course Final Exam VII. COURSE/CLASSROOM POLICIES 1. Attendance/Lateness It is imperative that students attend lecture, clinical, and laboratory experiences as scheduled. A week’s worth of cumulative absences in any one course will result in faculty evaluation of the student’s ability to meet course objectives and may result in failure of the course. Three tardies (over 5 minutes late for lecture, campus laboratory, or clinical) will equal 1 hour of absence. 2. Class Participation Students are expected to take an active role in the learning experience. 3. Missed Exams/Assignments/Make-Up Policy A student not present to take an assigned nursing examination may receive a grade of zero for that examination. A student may be allowed to make-up an examination under the following circumstance: a. Absence is due to serious illness/hospitalization of the student or an *immediate family member. Documentation by a health care provider will be required at the time the student requests a make-up exam for the day they were ill. b. Absence is due to a death in the *immediate family. Documentation will be required. c. An absence the faculty and/or Department Head deems as unavoidable. *Immediate – family member living in the same household or outside household totally dependent on the student for care such as a spouse, parent, child, sibling, grandparent or grandchild. To be eligible for a make-up exam in the above circumstances, the student must notify their instructor prior to the absence, and must make arrangements within 48 hours after the absence for the retake. Faculty have the right to offer an alternative form of the exam and/or to deduct up to 10 points from the exam grade. Clinical/Skills Lab Absences During Exam Week: A student who is absent from clinical or skills lab up to 48 hours preceding an assigned nursing examination must present documentation from a health care provider at the time of the exam in order to be eligible to take the test. Students without this documentation will not be allowed to take the exam and thus will receive a grade of “0”. The student must see a health care provider on the day of the absence with the excuse dated accordingly. Documentation (excuses) dated after the date of the clinical absence will not be accepted. Faculty has the right to offer an alternate form of the exam and/or to deduct up to 10 points from the exam grade. 528 Online Testing: Exams in online courses are always considered an independent student activity – NOT a group activity (unless otherwise indicated by your course instructor.) Students are expected to take exams alone and not in a study group. This means that you cannot refer to your textbook or any other materials while you are taking the exam. It is inappropriate to share answers with other students. It is inappropriate to talk to other students while you are taking the test. Students who do not follow the honor code will be subject to disciplinary action. 4. Lab and clinical safety/health Learning Lab Center The primary objective of the Ranger College Learning Lab Center is to promote excellence in clinical learning through low to medium fidelity lab experiences learning/teaching for students and faculty by providing an environment to evaluate basic and advanced skills/behaviors. CLINICAL LAB POLICIES • Students are never to discuss events or scenarios occurring during lab clinical simulation experiences except during debriefing sessions. “What happens in clinical simulation during lab stays in clinical simulation during lab…” There is zero tolerance for academic dishonesty. • Students are to dress for lab as if attending clinical. Scrubs, name badges and uniform policies are enforced. • Faculty are responsible for supervising all students brought to the lab for training. • Universal Precautions are to be followed at all times as are all safety guidelines used in the clinical setting. Sharps and syringes are to be disposed of in appropriate containers. Anyone sustaining an injury must report it immediately to their instructor. • Equipment may not be removed from the lab for practice nor are the labs to be used for practicing clinical skills unless supervised by faculty or staff. • Students may be recorded during scenarios. Viewing of videos recorded during training are only permitted with faculty members. The videos are the property of the nursing program and students may not possess lab videos or recordings. • Coats, backpacks and other personal belongings are not to be in the lab during clinical simulation and should be secured as directed by the instructor. • All electronic devices are forbidden during clinical experiences during lab. (Cell phones, pagers, any type of recording device, etc.). • After a simulation take your personal belongings with you (i.e. papers, pens, stethoscopes, pen lights etc.). • Food and drink are not permitted in the labs. • If you have a latex allergy, inform your instructor before beginning simulation. • Makeup days may not be available for students absent the day of simulation. Standard Precautions The Center for Disease Control and Prevention (CDC) Recommended Standard Precautions are outlined below. It is the student’s responsibility to maintain compliance with these recommendations in all clinical settings. Standard Precautions Because the potential diseases in a patient’s blood and body fluids cannot be known, blood and body fluid and substance precautions recommended by the CDC should be adhered to for all patients and for all specimens submitted to the laboratory. These precautions, called “standard precautions,” should be 529 followed regardless of any lack of evidence of the patient’s infection status. Routinely use barrier protection to prevent skin and mucous membrane contamination with: a. secretions and excretions, except sweat, regardless of whether or not they contain visible blood b. body fluids of all patients and specimens c. non-intact skin d. mucous membranes Hand Hygiene a. Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn and/or immediately prior to any client interaction or nursing intervention. Perform hand hygiene immediately after gloves are removed, between patient contacts and when otherwise indicated to avoid transfer of microorganisms to other patients or environments. It may be necessary to wash hands between tasks and procedures on the same patient to prevent cross contamination of different body sites. b. Use a plain (non-antimicrobial) soap for routine hand washing. c. Use an antimicrobial agent or waterless antiseptic agent for specific circumstances (e.g., control of outbreaks or hyperendemic infections) as defined by the infection control program. Gloves Wear gloves (clean non-sterile gloves are adequate) when touching blood, body fluids, secretions, excretions and contaminated items. Put on clean gloves just before touching mucous membranes and non-intact skin. Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces and before going to another patient. Perform hand hygiene immediately to avoid transfer of microorganisms to other patients or environments. Mask, Eye Protection, Face Shield Wear a mask and eye protection or a face shield to protect mucous membranes of the eyes, nose and mouth during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions. Gown Wear a gown (a clean nonsterile gown is adequate) to protect skin and prevent soiling of clothing during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions or excretions or cause soiling of clothing. Select a gown that is appropriate for the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly as possible and wash hands to avoid transfer of microorganisms to other patients or environments. Patient Care Equipment Handle used patient care equipment soiled with blood, body fluids, secretions and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing and transfer of microorganisms to other patients and environments. Ensure that reusable equipment is not used for the care of another patient until it has been appropriately cleaned and reprocesses and single use items are properly discarded. 530 Environmental Control Ensure that the hospital has adequate procedures for the routine care, cleaning and disinfection of environmental surfaces, beds, bed rails, bedside equipment and other frequently touched surfaces and that these procedures are being followed. Linen Handle, transport, and process used linen soiled with blood, body fluids, secretions and excretions in a manner that prevents skin and mucous membrane exposures and contamination of clothing and avoids transfer of microorganisms to other patients and environments. Occupational Health and Blood-borne Pathogens a. Take care to prevent injuries when using needles, scalpels and other sharp instruments or devices; when handling sharp instruments after procedures; when cleaning used instruments and when disposing of used needles. Never recap used needles or otherwise manipulate them with both hands or any other technique that involves directing the point of a needle toward any part of the body; rather, use either a one-handed scoop technique or a mechanical device designed for holding the needle sheath. Do not remove used needles from disposable syringes by hand and do not bend, break or otherwise manipulate used needles by hand. Place used disposable syringes and needles, scalpel blades and other sharp items in appropriate puncture-resistant containers located as close as practical to the area in which the items were used. Place reusable syringes and needles in a puncture resistant container for transport to the reprocessing area. b. Use mouthpieces, resuscitation bags or other ventilation devices as an alternative to mouth-to-mouth resuscitation methods in areas where the need for resuscitation is predictable. Patient Placement Place a patient who contaminates the environment or who does not (or cannot be expected to) assist in maintaining appropriate hygiene or environmental control in a private room. If a private room is not available, consult with infection control professionals regarding patient placement or other alternatives. Student Occurrence Any student involved in a clinical occurrence (e.g. needle stick, patient or student fall/injury, medication error, etc.) must adhere to the following protocol for reporting the occurrence: 1. Notify the nurse responsible for the patient immediately. 2. Notify the clinical instructor, preceptor and/or faculty member as quickly as possible after the occurrence happens. The clinical instructor, preceptor & faculty will provide information on appropriate actions to be taken. 3. Notify the charge nurse. 4. Be prepared with details necessary for filling out a report and to sign the report as a witness or the person responsible for the occurrence. 5. Meet any Ranger College or facility policy regarding occurrences. 5. Academic Dishonesty Nursing students are expected to maintain an environment of academic integrity. Actions involving scholastic dishonesty violate the professional code of ethics and are disruptive to the academic environment. Students found guilty of scholastic dishonesty are subject to disciplinary action including dismissal from the Associate Degree Nursing Program and Ranger College in accordance with outlined criteria. 531 Examples of scholastic dishonesty include, but are not limited to: CHEATING: Copying from another student’s test. Possessing or using, during a test, materials which are not authorized. Using, buying, stealing, transporting, or soliciting a test, draft of a test, test facsimile, answer key, care plans, or other written works. PLAGIARISM: Using someone else’s work in your academic assignments without appropriate acknowledgment. COLLUSION: Collaborating with another person in preparing academic assignments without authorization. Procedures for discipline due to academic dishonesty have been adopted published Ranger College Student Handbook. 6. Student Behavior Policy Students are expected to observe the following guidelines for classroom behavior: 1. Neither children nor pets may be brought to classes or clinical agencies under any circumstance. Children must not be left unattended in any area of the building. 2. All buildings housing the Associate Degree Nursing Program are nonsmoking facilities. 3. No food or drinks are allowed in classrooms. 4. Students are expected to be seated by the designated starting time for classes. 5. A student deemed disruptive by a faculty member may be asked to leave the classroom. 6. Cell phones must be turned off during class or lab. Pager/beepers, if used, must be set on silence during class or lab. Messages received during lecture may be returned during class breaks. 7. Respectful, formal communication skills are used in online forums. 7. Available Support Services Library facilities are available at the main Ranger campus, the Heartland Mall center, and the Brownwood Public Library. Reference materials are also available via online as well. 8. ADA Statement: Ranger College provides a variety of services for students with learning and/or physical disabilities. The student is responsible for making the initial contact with the Ranger College Counselor. It is advisable to make this contact before or immediately after the semester begins. VIII. ASSESSMENT Exam I Exam II Exam III Exam IV Comp. Final 20% 20% 20% 20% 20% (5% from HESI Med-Surg Exam /and 5% from HESI Exit Exam) 100% 532 *Note: RNSG 1535 and RNSG 2562 must be successfully completed simultaneously to receive credit in either course and graduate. 2010 Top 70 Rank Ordered NCLEX-RN Activities (2010 Test Plan) (Extracted from the 2008 RN Practice Analysis Linking NCLEX-RN to Practice NCSBN Research Brief) 1. Apply principles of infection control (hand washing, room assignment, isolation, aseptic sterile technique, and standard or universal precautions 2. Ensure proper identification of patient when providing care 3. Prepare and administer medications using rights of medication administration 4. Provide care within the legal scope of practice 5. Review pertinent data prior to med administration (vital signs, lab results, allergies, potential interactions) 6. Protect patient from injury (falls, electrical hazards, malfunctioning equipment) 7. Perform calculations required for medication administration 8. Assess and respond to changes in patient’s vital signs 9. Recognize signs and symptoms of complications and intervene appropriately when providing patient care 10. Perform emergency care procedures (CPR, abdominal thrust, respiratory support, external defibrillator) 11. Practices in manner consistent with code of ethics for registered nurses 12. Verify appropriate and or accuracy of treatment order 13. Titrate dosage of medication based on assessment and ordered parameters 14. Maintain patient confidentiality 15. Recognize trends and changes in patient condition and intervene appropriately 16. Perform focused assessment or reassessment (GI, respiratory, cardiac) 17. Monitor and maintain intravenous infusion and maintain sites 18. Administer blood products and evaluate patient response 19. Assess patient for allergies and sensitivities, and intervene as needed (food, latex, environmental) 20. Evaluate appropriateness and accuracy of med order for patient 21. Receive and or transcribe primary health care provider orders 22. Provide and receive report on assigned patients 23. Follow procedures for handling biohazard materials 24. Prioritize workload to manage time effectively 25. Manage patient experiencing side effects and adverse reactions of medication 26. Provide individualized patient centered care consistent with Standards of Practice 27. Perform skin assessment and implement measures to maintain skin integrity and prevent skin breakdown 28. Evaluate and document therapeutic responses to medications 29. Verify the patient comprehends and consents to care and procedures including procedures requiring informed consent 30. Comply with regulations governing controlled substances (counting, wasting narcotics) 31. Act as a patient advocate 32. Perform diagnostic testing (O2 sat, glucose monitoring, occult blood, gastric ph, urine specific gravity) 33. Manage care of patient with impaired ventilation and or oxygenation 34. Collaborate with health care members in other disciplines when providing patient care 35. Perform comprehensive health assessment 36. Use pharmacological measures for pain management as needed 37. Recognize limitations of self and others, seek assistance and or begin corrective measures at earliest opportunity 38. Manage care of patient with fluid and electrolyte imbalance 39. Manage the care of patient with alteration in hemodynamics, tissue perfusion and hemostasis (cerebral, cardiac, peripheral) 40. Assess triage patient to prioritize the order of care delivery 41. Acknowledge and document practice error (incident report or medication error) 42. Identify pathophysiology related to an acute or chronic condition (signs & symptoms) 43. Facilitate appropriate safe use of equipment 533 44. Educate patient and family about medication 45. Use precautions to prevent injury and or complications associated with a procedure or diagnosis 46. Access implanted venous access devices, including tunneled, implanted and central lines 47. Evaluate responses to procedures and treatments 48. Establish and maintain a therapeutic relationship with patient 49. Evaluate the results of diagnostic testing and intervene as needed (lab, EKG) 50. Educate patient, family, staff on infection control measures 51. Insert, maintain, or remove a peripheral IV line 52. Monitor and maintain patients on a ventilator 534 53. Use ergonomic principles when providing care (assistive devices, proper lifting) 54. Initiate, maintain, and or evaluate telemetry monitoring 55. Evaluate effectiveness of treatment regimen for patients with acute or chronic diagnoses 56. Perform procedures necessary for admitting, transferring or discharging patients 57. Report unsafe practice by other health care personnel to internal and or external entities and intervene as appropriate (substance abuse, improper care, staffing practices) 58. Assess patient for potential or actual abuse, neglect, and intervene when appropriate 59. Educate patient about treatments and procedures 60. Manage patient during and following procedure with moderate sedation 61. Provide postoperative care 62. Implement emergency response plans (internal/external disaster) 63. Perform suctioning (oral, nasopharyngeal, Endotracheal, tracheal) 64. Assess potential for violence and initiate/maintain safety precautions (suicide, homicide, and self destructive behavior) 65. Comply with federal/state institutional requirements regarding use of patient restraints and safety devices 66. Use approved abbreviations and standard terminology when documenting 67. Monitor patient hydration status (I&O, edema, signs and symptoms of dehydration) 68. Assess patient need for pain management and intervene as needed using non-pharmacological comfort measures 69. Monitor and maintain arterial lines 70. Recognize non-verbal cues to physical/psychological stressors IX. NON-DISCRIMINATION STATEMENT Admission, employment, and program policies of Ranger College are non-discriminatory in regard to race, creed, color, sex, age, disability, and national origin. X. RECEIPT OF SYLLABUS FORM ALL STUDENTS MUST COMPLETE THE FOLLOWING RECEIPT OF SYLLABUS FORM AND RETURN IT TO THE INSTRUCTOR 535 RECEIPT OF SYLLABUS FORM Legibly print the following information: Name: __________________________ Date:___________________________ “I have received and understand the information in the syllabus for RNSG 1535 and I agree to abide by the stated policies.” Signature of Student: _____________________________ 536