Syllabus Handout
for
Fall 2013
Adult Nursing IV
NURS 2140 9A
INSTRUCTORS:
Diana Blum, RN, MSN
Jane Miller, RN, MSN
Welcome to Metropolitan Community College
Metropolitan Community College
Course Syllabus – 2013 Fall
COURSE IDENTIFICATION
Title:
Prefix/Section:
Credit Hours:
Begins/Ends:
No-Class Days:
Meeting Day/Time:
Last Day to Withdraw
Class Location:
Lab Location:
Course Web Address:
Adult Nursing IV
NURS 2140 9A
5 credit hours, 3.5 hour lecture a week, 8 hours clinical per week.
Saturday, September 7, 2013 to Saturday, November 16, 2013
N/A
Saturdays, 8:00 noon to 11:30 p.m.
Clinical, see clinical schedule for clinical times
Saturday, November 2, 2013
SOC-Mahoney Bldg, RM 510
SOC-Mahoney Bldg, RM 505
http://www.mccneb.edu/academics/alliedhealth/index.asp
CONTACT INFORMATION
Instructor Name:
Office Telephone:
Email Address:
Website:
Office Hours:
Diana Blum, RN, MSN
402-738-4651
dblum3@mccneb.edu
faculty@mccneb.edu/dblum3
Tuesdays, 8:00 a.m. – 8:30 a.m.,
11:00 a.m. - 12:00 noon & 2:30p – 4:00p
Saturdays, 7:30 a.m. – 8:00 a.m. & 11:30 a.m. – 3:30 p.m.
Instructor Name:
Office Telephone:
Email Address:
Office Hours:
Jane Miller, RN, MSN
402-738-4785
jemiller16@mccneb.edu
Saturdays, 11:30 a.m. – 5:30 p.m. (subject to change)
Nursing Program Tutor:
Office Telephone:
Email Address:
Office Hours:
Alice Ludwig
402-738-4786
aludwig@mccneb.edu
Tuesdays, Wednesdays & Thursdays, 11:00 a.m. – 3:00 p.m.
Office Location:
Facsimile:
Academic Program Area:
SOC, Mahoney RM 513
402-738-4552
Health Careers
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COURSE INFORMATION
Course Description
Adult Nursing IV is a continuation and advancement of pathophysiological
manifestations treatment modalities, and nursing interventions through utilization of the critical
thinking process and subsequent safe decision outcomes.
Course Prerequisites
NURS 2520, NURS 2410.
Course Objectives
1.
Demonstrate an advanced understanding of each pathophysiological
manifestation, treatment modality, and advanced physiological realms through
case studies, discussion, lecture, and examinations by obtainment of 76% or
higher grades.
2.
Demonstrate advancement toward critical thinking skills with subsequent safe
decision outcomes.
3.
Demonstrate mastery of medication math calculations by obtainment of 100% on
exam (with total 3 attempts).
4.
Demonstrate an understanding of pathophysiological modalities through safe,
competent care and the utilization of the nursing process.
5.
Integrate knowledge from research as influences current and/or future practice.
Clinical Objectives
Refer to “NURS 2140 Clinical Evaluation” attached to this syllabus.
Required & Supplemental Materials:
Required textbooks:
1. Nursing Diagnosis Handbook: A Guide to Planning Care: 9th ed Ackley ISBN:
9780232071503
2. Laboratory and diagnostic tests, 8th ed, Corbett ISBN: 0132373327
3. Davis’s Drug Guide for Nurses, 13th ED 2013, Vallerand, FA Davis
ISBN:9780803628373
4. Math for Nurses: Stassi, M; Kaplan publishing, 2nd ed ISBN: 9781607140474
5. Mosby’s Dictionary of Medicine, Nursing and Health Professions. Mosby 2007, 8th ed
ISBN: 978032304975
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6. Pearson package #0133158217 Ball ped, olds maternity, Osborn med/surg, Kozier ISBN:
9780133158212
7. Pearson package #013313475X Osborn + MNL
8. 2013 Intravenous Medications. Gahart, B. Mosby ISBN: 9780323084819
9. Flip and See ECG, Cohn 4th ed Mosby 2012 ISBN: 9780323084529
10. Pearson package 0133095940 Kozier + MNL 9th edition text with 9th ed MNL
My Nursing Lab has weekly assignments due. When you log in, look for a clock on the calendar.
ASSESSMENT OF STUDENT WORK
Methods of Instruction:
Classroom – A variety of teaching strategies may be used in presenting theory content, such
as: case study, discussion, exams, guest speakers, lecture-discussion, concept mapping, roleplay, and questioning. Instructional strategies to be used may include: handouts, videos, and
PowerPoints.
Instructional guides – will be used to stress important points for each lecture. The guides may
be in various forms which may include critical thinking scenarios, questions, prioritizing, and
concept mapping, for example.
Methods of Assessing Student Progress:
Student progress is evaluated using a variety of methods including written examinations/quizzes,
clinical observation of client care, written process recordings, nursing care plans, charting,
assessment of skills in clinical settings.
Selected Testing/Assessment Methods:
Examinations/quizzes include multiple choice and more than 1 answer type questions. Written
assignments include written nursing careplans or concept maps, and other written assignments
appropriate to the clinical setting or classroom. Faculty observation of student completion of
skills are primary methods of evaluating students in the clinical practicum setting.
Evaluation:
Final course grades are based on the following letter scale:
93-100 = A
84-92 = B
78-83 = C
70-77 = D
Below 70 = F
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Student’s course grade will be determined as follows:
ATI – See Schedule
Exam # 1 Diabetes (in class) 25 points
Exam # 2 Renal (take home) 25 points
Exam # 3 ACS/Vascular
50 points
Exam # 4 Tele Project
100 points
Exam # 5 Shock and Burn
25 points
Exam # 6 Heme Exam
25 points
Exam # 7 Acid/Base Exam 50 points
Exam # 8 Respiratory Exam 50 points
Comprehensive Final
100 points
Unit exams are equivalent to 65% of the grade. ATI is equivalent to5% of the grade. Renal paper
is equivalent to 5% of the grade (Guidelines will be handed out in class). Telemetry Project is
Equivalent to 5% of the grade. The final exam is worth 20% of the grade.
There will be no rounding of grades, i.e., a 75.7 = 75%. A final course grade of 78% is required
to continue in the program.
Clinical will be graded on a satisfactory/unsatisfactory basis. Refer to clinical evaluation
attached to this syllabus. Students must obtain satisfactory on all assignments, and skills
performances to obtain a satisfactory evaluation for the clinical component. Students must pass
the math exam with a 100% before they can pass medications on the unit. Students are
allowed three attempts to pass the math exam with a 100%. Failure to pass the exam after
three attempts will result in failure of the course.
To satisfactorily complete a nursing course, the student must receive a “C” (78%) or above in the
theory course and a pass in the corresponding clinical component. Failure by a student in either
theory or clinical will necessitate repeating the entire course (both theory and clinical
components).
Make-up Test Procedures:
If it is necessary to be absent during an assigned test period, the student must make up the
exam prior to the next scheduled class date. Failure to do so will result in a zero for the exam.
The student may miss one exam without penalty, as long as the test is made up within the
specified time period. If the student misses more than one exam, the exam may be made up,
but the maximum score allowed is 80% for the second missed exam, 50% for all others missed.
The final examination must be taken on the scheduled date and at the scheduled time.
Students may not enter the classroom after the testing has begun. If the student is not in the
classroom when tests are being distributed the student must follow the provision for make up test
procedures.
When necessary to make up an examination, it will be placed in the testing center. It is the
student’s responsibility to make an appointment and take the test within the specified period of
time.
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Exceptions to these guidelines may be considered, but only if the student consults with the
instructor in advance.
Late Assignments:
Assignments are expected to be completed and turned in by the dates stipulated on the course
calendar and the individual instructor due dates. It is the responsibility of the student to notify the
clinical/course instructor of any delay in meeting the stated/written deadlines. Habitual lateness
in handing in assigned work can contribute to course failure.
Maintenance of Student Records:
Examination reviews will be held following all student completion and/or grading of scheduled
exams. Courteous and respectful behavior is expected of every student present to facilitate the
learning experience afforded by the review. Students may request to review the exams
individually, by appointment. Appointments must be made individually with faculty of the
course. Course faculty will keep all exams/quizzes.
Every effort will be made to return all tests and written assignments in a timely manner for
review.
ASSESSMENT OF STUDENT LEARNING PROGRAM:
Metropolitan Community College is committed to continuous improvement of teaching and
learning. You may be asked to help us to accomplish this objective. For example, you may be
asked to respond to surveys or questionnaires. In other cases, tests or assignments you are
required to do for this course may be shared with faculty and used for assessment purposes.
INSTRUCTOR’S EXPECTATIONS OF STUDENTS
Methods of Learning:
Students are expected to participate in all theory and clinical sessions. Assigned readings are to
be completed prior to attending the class/clinical session scheduled for the specific topic.
Written assignments, theory, and clinical assignments must be completed by specified dates.
Due dates for written theory assignments and some clinical assignments will be on the class
schedule. Due dates for written clinical assignments will be given with clinical information if
not on class schedule. Assignments not handed in by the due date will receive a zero, and will
not be accepted.
Pre-clinical lab preparation is a must. Students are expected to come to the clinical practicum
setting prepared to give care to their clients. Being prepared includes such things as looking up
medications, knowing the diagnosis of the clients, being prepared to do procedures/treatments,
having data related to prior laboratory and previous assessments completed before clinical, and
having a written plan of care. Faculty will provide students with clinical expectations the day of
orientation to the clinical facility. Students not prepared for clinical assignment, will be sent
home and will be subject to the clinical attendance policy per the Nursing Program
Policy/Procedure Student Manual.
Class Attendance:
Promptness: This is of high importance for success in this class. If a student should miss a
class for any reason he/she is expected to cover, on his/her own, the material he/she missed. All
work must be made up to the satisfaction of the instructor involved. For absences on days when
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exams/quizzes are given, refer to section related to “makeup test procedure”. It is the student’s
responsibility to notify the Instructor immediately if the student is unable to attend class. If a
student demonstrates unprofessional behavior in the classroom, the student will be asked to
leave. Frequent tardiness and early departures from class can contribute to course failure.
Students who attend no class meetings up to and including the Section Census Date published in
the Class Schedule at www.mccneb.edu/schedule/ may be disenrolled from the class. There is no
appeal for this disenrollment.
Clinical Attendance:
Refer to Attendance Policy in the Nursing Policy/Procedure Student Manual
WX: After the first class meeting and through the Census Date, the instructor will disenroll
(WX) students who have never attended. The Census Date is listed under the Important Dates for
the course in the official Class Schedule at http://www.mccneb.edu/schedule/.
FX is a final grade given to a student who stops attending a class (participating in a class if it's an
online class), does not return, and fails.
COMMUNICATION EXPECTATIONS:
When you communicate with others in this course, you must follow the Student Code of Conduct
(http://www.mccneb.edu/catalog/studentinformation.asp), which calls for responsible and
cooperative behavior. Please think critically, ask questions, and challenge ideas, but also show
respect for the opinions of others, respond to them politely, and maintain the confidentiality of
thoughts expressed in the class. You may also wish to review information at
http://www.albion.com/netiquette/.
RECORDING IN THE CLASSROOM:
Students may not video or audio record class sessions without the instructor’s knowledge and
permission. If recording of class sessions is authorized as a reasonable accommodation under
Americans with Disabilities Act (ADA), the instructor must have the appropriate documentation
from College Disability Support Services. Permitted recordings are to be used only for the
individual student’s educational review of the class session and may not be reproduced, posted,
sold or distributed to others. Students who violate this policy are subject to disciplinary
procedures as outlined in the Student Conduct Code.
ACADEMIC HONESTY STATEMENT:
Students are reminded that materials they use as sources for classwork may be subject to
copyright protection. Additional information about copyright is provided on the library website
at http://www.mccneb.edu/library or by your instructor. In response to incidents of student
dishonesty (cheating, plagiarism, illegal peer-to-peer file sharing, etc.), the College imposes
specific actions that may include receiving a failing grade on a test, failure in the course,
suspension from the College, or dismissal from the College. Disciplinary procedures are
available in the Advising/Counseling Centers or at http://www.mccneb.edu/procedures/V4_Student_Conduct_and_Discipline.pdf.
STUDENT WITHDRAWAL:
If you cannot participate in and complete this course, you should officially withdraw through My
Services on the MCC My Way portal at http://myway.mccneb.edu or by calling Central
Registration at 402-457-5231 or 1-800-228-9553. Failure to officially withdraw will result in
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either an attendance-related failure (FX) or failing (F) grade. The last date to withdraw is noted
in the CLASS IDENTIFICATION section of this syllabus.
LEARNING SUPPORT
MCC's Academic Resource Centers, Math Centers, and Writing Centers offer friendly,
supportive learning environments that can help students achieve educational success. Staff
members in these centers provide free drop-in assistance with basic computing, reading, math,
and writing skills. Self-paced, computer-assisted instructional support in reading, vocabulary,
typing, English as a Second Language, and online course orientation is also available.
Detailed information about the Academic Resource, Math, and Writing Centers is in the Student
Handbook, College Catalog, and online at http://www.mccneb.edu/arc/.
ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES:
Metropolitan Community College will provide reasonable accommodations for persons with
documented qualifying disabilities. It is the student’s responsibility to request accommodations
from Disability Support Services (DSS) located in each Student Services Office. After students
have arranged for accommodations with DSS, the student and instructor should privately discuss
these accommodations. For further information, please contact DSS or visit
http://www.mccneb.edu/dss/.
TECHNOLOGY SUPPORT
For assistance with student email, passwords, and most other MCC technology, contact the Help
Desk at 457-2900 or mcchelpdesk@mccneb.edu.
TECHNOLOGY RESOURCES:
By using the information technology systems at MCC (including the computer systems and
phones), you acknowledge and consent to the conditions of use as set forth in the Metropolitan
Community College Procedures Memorandum on Acceptable Use of Information Technology
and Resources. It is your responsibility as a student to be familiar with these procedures. The full
text of the Procedures Memorandum may be found at the following website:
http://www.mccneb.edu/procedures/X-15_Technology_Resources_Use.pdf.
[Other pertinent college policies are posted on the CDS website www.mccneb.edu/cds; it is
suggested, but not required, that they be attached to your syllabus.]
REQUIRED ATTACHMENTS
1. SCHEDULE OF ASSIGNMENTS
2. IMPORTANT DATES Note: You may want to include a link Metro’s Academic
Calendar at http://www.mccneb.edu/academics/calendar.asp?Theme=2 )
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NURS 2140 Clinical Component
Location:
Assignments to clinical facility in the acute care setting.
Clinical focus:
Hierarchy of needs, the nursing process, communication, safety, advancement of clinical skills,
advancement of assessment skills, along with advancement of the understanding of
pathophysiology to include medications, labs, diagnostic tests, and other significant data.
Preceptor Experience:
Students may be assigned clinical experience with an RN preceptor. Refer to following page for
specifics.
Clinical Methods of Instruction:
A variety of teaching strategies applicable to the clinical experience will be utilized such as
patient care, case study, demonstration, return demonstration, discussions group and/or
individual, individual supervision, pre/post conferences, journaling, and concept mapping.
Emphasis in Clinical Experience:
Safety is the emphasis in all areas of patient care to include but not limited to; medication
administration and physiological cares.
Assessment of Clinical Student Progress:
The instructor will assess knowledge base through observation, discussion, and questioning
during patient care. Pre and post conferences will be utilized to assess knowledge base through
discussion. The written patient care plan, pre-lab data and ongoing patient care data will be
assessed. Medication administration safety will also be an important area of patient care that will
include verbal questioning and direct observation as to action, therapeutic response, side effects,
and proper administration.
Assessment Methods:
The student will be evaluated daily/weekly. The student must achieve a satisfactory for each
objective by the end of the clinical components. If the student does not achieve a satisfactory for
each objective by the end of the clinical experience this indicates that the objectives was not met
and therefore constitutes a clinical failure. Pre-lab requirements must be completed before the
clinical experience. Pre-lab forms and clinical forms must be completed and submitted weekly.
Students are responsible for completion of all assignments. The student must successfully
complete clinical to pass the course. The student will participate in self-evaluation during the
quarter.
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NURS 2140
Class Schedule
Please Note for Exams: Expect incorporation of delegating, prioritizing and pharmacology questions
throughout all exams. Exam questions may be obtained from all sources (textbook, study guides, lecture,
powerpoints, videos, concept maps, and handouts).
Please Note for Lectures: Concept mapping may be utilized in the classroom. The class schedule is
used as a guide and may need to be adjusted per Instructor discretion.
WEEK
1
Sept. 7
Introduction to class. Diabetes Lecture/Renal Lecture.
Take home passed out. Discuss Renal Paper.
2
Sept. 14
Diabetes Exam. Take home due. ACS Lecture.
3
Sept. 21
Vascular Lecture. Renal Paper Due.
4
Sept. 28
ACS/Vascular Exam/Tele Lecture Project discussed.
5
Oct. 5
Vascular Exam/Shock & Burn Lecture. Take home passed out.
6
Oct. 12
Binational Health Fair.
7
Oct. 19
Heme Lecture. Shock and Burn take home due.
8
Oct. 26
Exam on Heme. Fluid/Electrolyte Lecture.
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Nov. 2
Fluid/Electrolyte Exam/Respiratory Lecture.
10
Nov. 9
Respiratory Exam/Review for Final
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Nov. 16
Comprehensive Final
Introduction:
Key elements to implement throughout Advanced Nursing IV
1.
2.
Explore the elements of critical thinking and its application to theory and clinical
realms.
Explore the process of prioritizing patient care.
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UNIT I – Critical Thinking, Prioritizing Patient Care, Diabetes,
and Biliary Disorders.
Objectives:
1.
Differentiate pathophysiology, clinical manifestations of diabetic ketoacidosis (DKA) and
hyperosmolar hyperglycemic state (HHS).
2.
Identify treatment modalities for DKA and HHS.
3.
Review types of insulin, onset/duration, and precautions.
4.
Identify differences in insulin absorption as to site of injection for subcutaneous administration.
5.
Define significant Lab results for diabetes management.
6.
Identify new treatment and research in diabetes realm.
7.
Identify the role of diabetes educators/nurses to include importance of patient teaching in the
following areas:
- Insulin, oral agents
- Activity/exercise
- Nutrition
- Importance of monitoring blood glucose
- Body systems affected
- Preventive/delay of complications
- Importance of follow-up appointments with healthcare professionals.
8.
Identify biliary disorders including signs and symptoms, labs, nursing interventions, and
treatment modalities.
9.
Identify pathophysiology of acute and chronic cholecystitis, clinical manifestations, and surgical
and nonsurgical management.
Required Reading:
Osborn, Watson, Wraa : p. 114-117
Chapter 53 Diabetes
Chapter 46 Biliary Disorders
Supplemental Resources:
Powerpoints
Handouts
Reference Textbooks
10
UNIT II – Renal Disorders, Dialysis, and Basic Concepts
Objectives:
1.
Identify pathophysiology; clinical manifestations and interventions for the following renal
disorders:
A.
Congenital disorders: Polycystic Kidney Disease (PKD)
B.
Obstructive Disorders: Hydronephrosis, Hydroureter, Urethral Stricture.
C.
Infectious Disorders: Pyelonephritis, Renal Abscess, Renal Tuberculosis
D.
Immunologic Renal Disorders: Acute Glomerulonephritis, Rapid Progressive
Glomerulorephritis, Chronic Glomerulonephritis, Nephrotic Syndrome, Immunologic
Interstitial Disorder
E.
Degenerative Disorders: Nephrosclerosis, Renovascular Disease, Diabetic
Nephropathy.
F.
Tumors: Cysts and Benign
2.
Identify pathophysiology, clinical manifestations, and interventions for:
A.
Acute Renal Failure (ARF)
B.
Chronic Renal Failure (CRF)
3.
Identify patients at risk for ARF and CRF.
4.
Compare and contrast hemodialysis and peritoneal dialysis as renal replacement therapy.
5.
Define Hemodialysis nursing care and post-dialysis care.
6.
Identify type of vascular access for hemodialysis.
Required Reading:
Osborn, Watson, Wraa: Chapter 44 and 47
Supplemental Resources:
Powerpoints
Handouts
Reference textbooks
11
UNIT III – Acute Coronary Syndromes
Objectives:
1.
Identify coronary artery anatomy and significance of location of arterial blockage.
2.
Identify cardiac output, stroke volume, and heart rate significance.
3.
Identify normal and abnormal parameters for cardiac output, stroke volume, and heart rate.
4.
Differentiate between unstable angina and acute myocardial infarction.
5.
Identify significant cardiac profiles.
6.
Identify fibrinolytic therapy indications, contraindications, and nursing interventions.
7.
Identify indicators for pre and post management for cardiac catheterization, angioplasty, and
stent insertion.
8.
Identify hemodynamic monitoring as diagnostic tools including nursing management.
9.
Identify use of Intra-Aortic Balloon Pump to include indications for, management of, and
identification of complications.
10.
Identify indicators for coronary artery-bypass graft (CABG) to include pre and post-operative
management and nursing interventions.
11.
Identify nursing interventions for patient with cardiomyopathy.
12.
Identify nursing interventions for patient with congestive heart failure.
13.
Identify valvular disorders treatment modalities, and management.
14.
Review pericarditis and endocarditis, treatment modalities and management.
15.
Review significance of the following cardiac medication to include nursing responsibilities and
patient teaching
A.
Anticoagulants
B.
Nitrates
C.
Beta Blockers
D.
Calcium Channel Blockers
E.
Antiarrythmics
F.
Morphine
G.
Vasopressors
16.
Identify cardiogenic IV medications per pump.
17.
Calculate drip rates, safe administration, and titration of IV cardiac medications.
18.
Identify cardiac transplant criteria and nursing interventions of the transplant patients.
19.
Identify medical and/or nursing research that may affect change of practice in the future.
Required Reading:
Osborn, Watson, Wraa: Review Chapter 24, 37, 40, 41, and 42
Supplemental Resources:
Powerpoints
Handouts
Reference Textbooks
12
UNIT IV – Vascular Problems, Stroke, Aneurysms, and
Hypertensive Crisis
Objectives:
1.
Review peripheral arterial disease (PAD) and use of the ankle-brachial index (ABI) as a
diagnostic tool.
2.
Identify nonsurgical and surgical interventions for management of PAD and approximate
nursing interventions.
3.
Identify chronic versus acute peripheral arterial occlusion and proper interventions.
4.
Identify aneurysms of central arteries and peripheral arteries.
5.
Identify nonsurgical and surgical interventions in aneurysm treatment and nursing interventions.
6.
Identify venous thromboembolism (VTE) pathophysiology treatment modalities, and nursing
interventions.
7.
Identify hypertensive crisis signs and symptoms, and treatment.
8.
Identify types of strokes, clinical manifestations, assessment tools, surgical, nonsurgical
interventions and nursing interventions.
Required Reading:
Osborn, Watson, Wraa: Chapter 21, 30, and 43
Supplemental Resources:
Powerpoints
Handouts
Reference Textbooks
13
UNIT V – Cardiac Pacers, Radiofrequency Catheter Ablation, Cardioversion, ECG Interpretation
and Introduction to Advanced Cardiac Life Support Protocol
Objectives:
1.
Identify indications for pacemakers.
2.
Define temporary pacing, permanent pacing and implantable cardioverter/defibrillator (ICD).
3.
Identify modes of pacing.
4.
Identify use of automatic defibrillator units that are available outside health care facilities.
5.
Define continuous electrocardiographic monitoring (ECG)
6.
Identify ECG complexes, segments, intervals, and rates.
7.
Identify between ECG complexes and artifact.
8.
Perform ECG rhythm strips.
9.
Identify normal rhythms and dysrhythmias.
10.
Identify importance of airway management in emergency cardiac care.
11.
Identify correct dysrhythmia terminology.
12.
Identify cardiac emergency medication including mechanism of action, indications
contraindications, and safe administration.
13.
Identify dysrhythmias that are indications for defibrillation.
14.
Identify dysrhythmias that are indications for cardioversion.
15.
Define cardioversion and medical/nursing interventions.
16.
Identify Advanced Cardiac Life Support protocol as supported by the American Heart
Association.
17.
Given critical thinking and challenges, in relation to patient assessment of data, identify correct
and safe nursing intervention in emergency cardiac care.
18.
Define introduction to 12 lead ECG analysis.
19.
Identify the purpose of radiofrequency catheter ablation.
20.
Identify teaching for patients with permanent pacemakers or ICDs.
21.
Identify the patient and family need to express feelings of anxiety and fear.
22.
Identify coping mechanisms with possible lifestyle changes associated with patient’s condition.
Required Reading:
1 Osborn, Watson, Wraa: Chapters 38 and 39
Supplemental Resources:
Powerpoints
Handouts
ACLS materials by the American Heart Association
Reference Textbooks
14
UNIT VI – Types of Shocks and Burns
Objectives:
1.
Define pathophysiology of shock, including classifications.
2.
Identify physiologic events during shock if progresses.
3.
Identify etiology of shock including hypovolemic, cardiogenic, distributive, and obstructive
shock.
4.
Identify clinical manifestations treatment modalities, and nursing interventions for each type of
shock.
5.
Identify he potential for multiple organs dysfunction syndrome (MOBS)
6.
Define intervention activities for shock prevention.
7.
Identify clinical manifestations of depth of burn injuries: superficial, partial thickness, and full
thickness and treatment modalities.
8.
Define mportance of assessment skills and gathering of important data in determining
treatment in the emergent phase of burns.
9.
Identify burn etiology and significance of in treatment.
10.
Identify vascular changes resulting from burn injuries including fluid shifts, electrolyte changes,
gastrointestinal involvement, cardiac, pulmonary, skin, metabolic changes, and immunologic
changes.
11.
Identify prioritization of treatment of burns from emergent phase, acute phase, and rehabilitative
phase of burn injury.
12.
Compare and contrast the Browder-Lund chart and Rule of Nines chart in calculating total body
surface area (TBSA) in a burn injury.
13.
Apply the Parkland Formula together with the TBSA in establishing correct fluid replacement
in the emergent phase.
14.
Identify airway management in burn injury.
15.
Identify compensatory responses to burn injury.
16.
Evaluate laboratory profiles during the emergent phase of burn injury.
17.
Identify the role of burn centers.
18.
Identify surgical management in burn injury.
19.
Identify pain management in burn injury and treatments.
20.
Define prevention of infection interventions
21.
Identify wound care management to include debridement, dressings, and types of grafts.
22.
Compare and contrast type of grafts available.
23.
Identify nutrition requirements in burn injury.
24.
Identify nursing interventions for prevention of complications such as patient position, range of
motion, ambulation, pressure dressings and post-op cares utilized to prevent complications of
burns.
25.
Identify research in the burn realm that may affect future burn interventions.
26.
Identify current/future therapies in the treatment of burn patients.
Required Reading:
Osborn, Watson, Wraa: Chapter 61 and 68
Supplemental Resources:
Powerpoints, Handouts, Reference textbooks and Lab textbook.
Metropolitan Community College
15
UNIT VII – Hematological Dysfunction
Objectives:
1.
Identify red blood cell disorders, clinical manifestations and interventions to include:
anemia and the common types of:
A.
Sickle Cell
B.
Glucose-6-Phosphate Dehydrogenase (G6PD)
C.
Autoimmune Hemolytic
D.
Iron deficiency
E.
Vitamin B12 Deficiency
F.
Folic Acid Deficiency
G.
Aplastic
H.
Anemia
2.
Identify Polycythemia Vera, clinical manifestations and interventions.
3.
Identify white blood cell disorders, clinical manifestations, and interventions to include:
A.
Leukemia
B.
Malignant Lymphoma
C.
Hodgkin’s Lymphoma
D.
Non-Hodgkin’s Lymphoma
E.
Multiple Myeloma
4.
Identify coagulation disorders, clinical manifestations, and interventions to include:
A.
Autoimmune Thrombocytopenic Purpura
B.
Thrombotic Thrombocytopenic Purpura
C.
Hemophilia
D.
Disseminated Intravascular Coagulation (DIC)
Required Reading:
Osborn, Watson, Wraa: Chapter 22, 62, and 63
Supplemental Resources:
Powerpoints
Handouts
Lab textbook
Reference textbooks
Metropolitan Community College
16
UNIT VIII – Fluid and Electrolytes
Acid/Base Balance
Objectives:
1.
Discuss the nurse’s role in understanding fluid and electrolytes as needed for safe IV therapy.
2.
Examine the importance of maintaining homeostasis.
3.
Review Extracellular Fluid (ECF), Intracellular Fluid (ICF), and interstitial fluid dynamics.
4.
Examine solute and solvent in relation to osmotic pressure and importance of maintaining
homeostasis.
5.
Identify the major electrolytes, their functions and location.
6.
Describe the following abnormalities of fluid and electrolyte balance, and evaluate how each
abnormality affects homeostasis:
A.
Hypovolemia
B.
Hypervolemia
C.
Hyponatremia
D.
Hypernatremia
E.
Hypokalemia
F.
Hyperkalemia
G.
Hypocalcemia
H.
Hypercalcemia
I.
Hypermagnesemia
J.
Hypomagnesemia
K.
Hyperphosphatemia
L.
Hypophosphatemia
M.
Hyperchloremia
N.
Hypochloremia
7.
Discuss differences between isotonic, hypertonic, and hypotonic IV solutions and their actions. in
osmosis, indications for, and contraindications in various pathophysiological conditions.
8.
Identify normal acid-base balance.
9.
Examine the following abnormalities in acid-base balance.
A.
Respiratory acidosis
B.
Respiratory alkalosis
C.
Metabolic acidosis
D.
Metabolic alkalosis
E.
Compensation
10.
Identify the body’s regulatory mechanism for acid-base balance (buffer systems)
11.
Examine hormonal regulation of fluid and electrolyte balance.
Required Reading:
Osborn, Watson, Wraa: Chapter 18, 19, and 22
Supplemental Resources:
Powerpoints
Handouts
Lab textbook and Reference Textbooks
Metropolitan Community College
17
UNIT IX – Acute Respiratory Problems
Objectives:
1.
Identify patients at risk for pulmonary embolism (PE).
2.
Identify clinical manifestations of pulmonary embolism.
3.
Identify diagnostic tools for determination of pulmonary embolus.
4.
Identify treatment of pulmonary embolism to include oxygenation, nonsurgical management,
surgical management, and nursing interventions.
5.
Identify intervention for prevention of pulmonary embolism.
6.
Identify patient education necessary for management of pulmonary embolism.
7.
Identify pathophysiology and causes of acute respiratory failure.
8.
Identify interventions for acute respiratory failure.
9.
Define pathophysiology and causes of acute respiratory distress syndrome (ARDS)
10.
Identify clinical manifestations, diagnostic assessment, and interventions for patient with ARDS.
11.
Identify the patient who requires intubation and mechanical ventilation.
12.
Identify procedure for endotracheal intubation including indications for, verifying tube
placement, and nursing care.
13.
Define goals of mechanical ventilation, including types of, controls and settings, and care of the
patient to prevent complications.
14.
Define the weaning process from the ventilator to extubation.
15.
Identify severe acute respiratory syndrome (SARS) as a new respiratory infection including
clinical manifestations, interventions, and isolation of patient.
16.
Identify pathophysiology, clinical manifestations, diagnostic tests, and interventions for the
following:
A.
Tuberculosis
B.
Lung abscess
C.
Aspiration
D.
Pulmonary empyema
E.
Cystic fibrosis
F.
Pulmonary hypertention
G.
Pulmonary edema
H.
Pleurisy
Required Reading:
Osborn, Watson, Wraa: Chapter 33, 34, 35, and 36
Supplemental Resources:
Powerpoints
Handouts
Reference textbooks
Metropolitan Community College
18
2013 Fall Quarter Important Dates
Classes begin ..................................................................................................................... Sep 3 Tu
Census Date/Tenth Day* date ........................................................................................ Sep 16 M
Student Withdrawal Deadline to “drop” a class without receiving a grade ......... Varies by Class**
Student Withdrawal Deadline to “drop” a class with a refund varies**.......See Refund Policy
Summer quarter “I” incomplete grades are due .................................................................. Nov 4 M
Classes end ....................................................................................................................... Nov 18 M
Fall grades due and posted by 7:00 a.m. ........................................................................... Nov 20 W
Thanksgiving Day recess/college closed ................................................................. Nov 28 – Dec 1
Current Student (greater than 50 hours) Winter 2013 (13/WI) Registration begins
Sep 11 W
Current Student (less than 50 hours) Winter 2013 (13/WI) Registration begins ................ Sep18 W
General Registration Winter 2013 Registration begins (13/WI) ........................................ Sep 25W
*Tenth Day is the date on which your enrollment level is checked.
**To view the last day to withdraw “drop” a class to prevent receiving a grade, go to the class
schedule found online at http://www.mccneb.edu/schedule/classschedule.asp . Then, find the
course section and click on the Important Dates link on the same line as the course title. Dates
for each course section are automatically calculated based on the start and end dates and the
number of sessions for a course. A student must withdraw by this date to avoid an “F” grade.
Note: Schedule changes may have implications for students on Financial Aid. Check with the
Financial Aid Office prior to any schedule changes at 402-457-2330. The Census Date is the
date on which Financial Aid Student’s enrollment is checked to determine the type and amount
of authorized funds for the quarter. Payment is based on enrollment as of that date.
 REFUND POLICY for Credit Courses
A student is responsible for withdrawing “dropping” from a course(s) if unable to attend. Nonattendance or non-payment does not relieve a student from the obligation to pay.
An official schedule change that reduces or terminates a student’s academic credit load may
entitle the student to a refund. Go to “My Services” and click “Student Accounts”, then “Tuition
Modeler” to see the refund percentage received through midnight of the same day you “drop”
withdraw from a class.
Metropolitan Community College
19
METROPOLITAN COMMUNITY COLLEGE
NURSING PROGRAM
NURS 2140 CLINICAL EVALUATION
Charting By Exception: If objective criteria is satisfactory, the area will be blank.
Scale for rating clinical performance:
NA = Not Applicable
U=Unsatisfactory
Name:
OBJECTIVE I: Maintain standards of ethical,
professional and legal behavior while
functioning as a safe and competent member of
the interdisciplinary team .
a. Functions within the Scope of Practice
and in accordance with educational level.
1. Protects confidential information.
b. Independently records data on graphic
sheet/client’s care record/flow sheet, I &
O sheets.
c. Maintains safe environment at all times.
1. Uses side-rails appropriately.
2. Call light is within reach.
3. Practices appropriate body mechanics
consistently.
d. Adheres to institutional policies
regarding standard precautions and
security.
1. Hand-washing.
2. Utilizing barrier protectors.
3. Cleaning client area.
4. Handling linen correctly.
e. Administers medications utilizing safe
practices.
NI=Needs Improvement
NO=No Opportunity
Clinical site:
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Instructor Comments
OBJECTIVE II: Demonstrate responsibility
and accountability for nursing practice with an
awareness of the need for continued personal
learning and self-development.
a.
b.
c.
d.
e.
f.
g.
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Demonstrate accountability for own
actions.
1. Keeps busy and takes initiative.
Identifies own strengths and limitations
with guidance from instructor.
Reports promptly and participates in
conferences.
Successfully completes all written
assignments on time and with appropriate
minimum score when applicable.
1. Completes daily pre-lab documents as
assigned.
2. Completes math exam with 100%
(only three attempts per policy).
Demonstrates reliable clinical attendance.
1. Notifies clinical instructor in timely
manner when unable to attend clinical.
Maintains good personal hygiene.
Adheres to acceptable clinical dress.
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Instructor Comments
OBJECTIVE III: Display caring behaviors in
the delivery of nursing care to clients
a.
Accommodates differences of race,
culture.
b.
Demonstrates a respectful attitude
towards others.
c.
Uses appropriate title and tone of voice.
d.
Spends time with client beyond the time
spent providing physical care.
e.
Provides privacy for the client when
appropriate.
f.
Able to recognize measures to support
psycho-social integrity.
g.
Accepts client’s communications without
judging.
h.
Demonstrates an awareness of client’s
religious needs.
i.
Demonstrates a positive attitude through
one’s behavior.
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OBJECTIVE IV: Utilize knowledge from
nursing and related disciplines when applying
the nursing process in the provision of
nursing care to clients.
a.
Assesses the basic human needs
1. Collects data from appropriate
sources, i.e, chart, Kardex, client,
significant others, nursing staff.
2. Demonstrates critical thinking skills
through data collection and
subsequent problem solving.
3. Performs basic physical
assessment, progressing to mastery of
advanced assessment skills.
a. Submits assessment data weekly
and as part of each care plan.
b. Defines diagnostic tests and
relates to client’s condition.
c. Successfully completes wkly
head to toe assessments on
assigned client(s) in clinical area.
d. Participates in the development
of the nursing diagnosis.
1.
Reviews assessment
data.
2.
Identifies the problem (s)
for the client.
3.
Expresses the problems
in the form of a nursing
diagnosis with guidance
from the clinical
instructor.
e. Develops a plan of care based on
the nursing diagnosis with guidance from the clinical instructor.
1. Establishes goals
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OBJECTIVE IV continued
Utilize knowledge from nursing and related
disciplines when applying the nursing process
in the provision of nursing care to clients.
2. Evaluate goals.
3.
Identifies nursing
interventions related to
established goals.
4.
Documents appropriate
rationale and source for each
nursing intervention.
f. Implements the plan of care in
a thorough manner under the
supervision of the clinical
instructor.
1.
Initiates basic care
without direct supervision
of the clinical instructor.
g. Participates in the evaluation of
care.
1.
Observes and describes
changes in client’s status.
2.
Establish new goals as
needed.
h. Successfully completes two
concept maps with four nursing
diagnoses on each NCP per
quarter.
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OBJECTIVE V: Manage the nursing care of
clients with selected health needs in
structured settings in
collaboration with
the interdisciplinary team.
a. Discusses plan of care with appropriate
nursing staff.
b. Informs appropriate staff member if
client assignment requires nursing
action above level of responsibility.
c. Utilizes an organized plan of care.
d. Follows instructions provided by
instructors or appropriate health team
member.
e. Directs questions or problems regarding
nursing care to the instructor.
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3
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4
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Instructor Comments
OBJECTIVE VI: Employ effective
communication to establish relationships with
clients and the interdisciplinary team.
a.
Introduces self and initiates conversation
with client.
b.
Notes client’s verbal and nonverbal
communication.
c.
Explains procedures before beginning.
d.
Reports client concerns and pertinent
observations to appropriate health team
member and instructor in a timely manner.
e.
Gives a concise and comprehensive report to
appropriate health team member at the end of
clinical hours.
f.
Completes wkly reflective journaling.
g.
Communicates effectively with all clients,
families and health care team members at all
times.
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2
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3
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4
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OBJECTIVE VII: Utilize the teaching-learning
process to assist clients to reach a higher level of
health.
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a. Instructs client on health promotion measures.
b. Identifies learning readiness.
c. Identifies assessing for appropriate learning
style for patient.
d. Instructs patient on identified needs.
e. Assesses learning and technique used to
achieve goal.
f. Completes documentation of teaching and
evaluation of learning by the patient.
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OBJECTIVE VIII: Follow the hierarchy of needs
when providing nursing care to clients in
collaboration with the interdisciplinary team.
a.
b.
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Meets the physiologic needs of the client.
1. Feeds client when indicated.
2. Positions client to enhance pulmonary
functions.
3. Maintains recommended level of oral
intake.
4. Provides range of motion exercises.
Meets the safety needs of the client.
1. Demonstrate safe and competent nursing
practice.
2. Identifies factors related to client’s
current condition which may put them
at risk for complications.
Charting By Exception: If objective criteria is satisfactory, the area will be blank.
Scale for rating clinical performance:
NA = Not Applicable
U=Unsatisfactory
NI=Needs Improvement
NO=No Opportunity
EVALUATION: The student will receive a satisfactory, unsatisfactory, needs improvement, no opportunity or not applicable based on the quality of clinical
performance as outlined in the course syllabus. The instructor will rate the student’s performance weekly. The student must achieve a satisfactory for each
objective by the end of the clinical course. If the student does not achieve a satisfactory for each objective by the end of the quarter the grade will be an
unsatisfactory for that objective. An unsatisfactory in any one objective at the end of the quarter indicates that the objective has not been met and therefore
constitutes a clinical failure. (Any unsatisfactory must all be followed by a satisfactory.) The student must successfully pass clinical to pass the course. The
student will participate in self-evaluation during the quarter.
28
SUMMARY OF ABSENCES/TARDIES
Week
Hours of absence.
1
2
3
4
5
6
7
8
9
10
11
9
10
11
Number of tardies.
Total of absences and tardies
ACKNOWLEDGEMENT OF INSTRUCTOR’S NOTATIONS
Week
1
2
3
4
5
6
7
8
Instructor’s initials
Student’s initials
NOTE: Student’s initials indicate that she/he has reviewed instructor’s notations for the previous week of clinical practice.
Instructor’s signature:
Date:
Student’s signature:
Date:
Student’s Comments:
29
FINAL QUARTER EVALUATION
30