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									City College of San Francisco

  Department of Vocational

       Nursing 41 - C
                                                            TABLE OF CONTENTS




TABLE OF CONTENTS -----------------------------------------------------------------------------------------   2

COURSE DESCRIPTION & COURSE OBJECTIVES -------------------------------------------------                      3

INSTRUCTIONAL METHODOLOGY -----------------------------------------------------------------------             3

COURSE EVALUATION ---------------------------------------------------------------------------------------     4


BASIC ASSESSMENT SKILLS -----------------------------------------------------------------------------         5-6


MEDICATION ADMINISTRATION -------------------------------------------------------------------------           7


POST-MORTEM CARE ---------------------------------------------------------------------------------------      8


INTEGUMENTARY SYSTEM SKILLS ---------------------------------------------------------------------             9


MUSCULOSKELETAL SYSTEM SKILLS -----------------------------------------------------------------               10


GASTROINTESTINAL SYSTEM SKILLS ----------------------------------------------------------------               11




                                                                     2
                                    City College of San Francisco
                                   Basic Medical/Surgical Skills Lab
                                          Course VOCN 41-C



COURSE TITLE: VOCN 41-C Basic Medical/Surgical Skills Lab

CREDIT IN UNITS: 1 UNIT

COURSE DESCRIPTION:
Introduction to basic medical-surgical assessment skills as well as the nursing skills commonly practiced for
clients with integumentary, musculoskeletal and gastrointestinal disorders.

COURSE OBJECTIVES:

Upon completion of this course, the student vocational nurse will be able to:

1. Describe at least ten (10) of the L VN department's Standard Steps of Nursing Procedures.
2. Assembles the appropriate equipment and provides an accurate description of the purpose of each skill
   performed.
3. Demonstrates each skill satisfactorily.
4. Summarize the nursing responsibilities before, during and after each skill performed.
5. Formulate a patient teaching plan which includes a description, purpose and patient responsibilities
   during each skill performed.
6. Consider the cultural diversity including beliefs and practices of the client.
7. Demonstrate ability to render appropriate nursing care for elderly and clients with psychiatric disorders.
8. Apply critical thinking knowledge, skills and analysis in performing skill lab procedures.
9. Practice and demonstrate specific basic skills procedure utilizing Sim Man simulator.


INSTRUCTIONAL METHODOLOGY

A.      Assignments
        1. Reading assignments from textbooks and handouts.
        2. Instructor led review of each procedure with accompanying demonstrations.
        3. Group practice of each procedure as demonstrated by instructor.
        4. Individual return demonstration of each procedure under the supervision of the skills or clinical lab
            Instructor.
B.      Evaluations
        Students will be evaluated on their ability to perform each skill satisfactorily. Satisfactory performance
        consists of the student implementing the following steps as part of their individual return demonstration.
        1. Verbalize the L VN Department's Standard Steps of Nursing Procedures prior to performing any
            procedure.
        2. Verbalize the purpose of each procedure perfonned.
        3. Identify and collect the appropriate equipment needed to perform each procedure.
        4. Perform each skill under the supervision of an Instructor in either the skills lab or clinical lab.
C.      Texts and other materials
        Textbooks with a focus on the skills within the L VN scope of practice in medical-surgical nursing,
        such as:


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    1. Taylor, Lillis, LeMone, and Lynn,Taylor's Video Guide to Clinical Skills


    2.    Lynn, Taylor’s Clinical Nursing Skills (Second Edition)

    3. Lynn, Skill Checklists to Accompany Taylor's Clinical Nursing Skills,

         (Second Edition)

    4. Stedman Health Professional and Nurse Dictionary

                                                                    th
    5. Timby & Smith, Introductory Medical-Surgical Nursing (9 Edition)

     6. Timby & Smith, Study Guide to Accompany Introductory to Medical-

                              th
         Surgical Nursing ( 9 Edition)

                                                 nd
     7. Lois White, Foundations of Nursing ( 2        edition)

     8. Instructor developed materials such as:
           a. Course syllabus
           b. Outlines and handouts on performance of fundamentals and basic medical-surgical nursing
               skills



COURSE EVALUATION:

   1. Attendance                                                                       = 50%

   2. Performance                                                                         = 50%
              a. Satisfactory completion of each required skill utilizing
                 Skill Performance Checklist in a timely manner
                       1. If total repeat demo equal or exceeds 5x in the Total Skills Performance, there will
                           be 5 % deduction in the total skills lab grade
                       2. Skills demonstration maybe repeated once only.
             b. Requirements
                       1. Adequate practice and preparation prior to skills check off
                       2. Skills lab book
                       3. Gathering supplies and materials prior to skills demonstration.
                       4. Bringing other supplies and materials as indicated
                       5. If REQUIREMENTS NOT MET equal or exceeds 5 skills in the Total Skills
                           Performance, there will 5% deduction in the total skills lab grade.

WEEKLY SCHEDULE: Skills Lab: M @ 1230 - 1430


ATTENDANCE: Review the department's Attendance Policy in your Student Information Booklet


INSTRUCTOR OFFICE HOURS: As Posted



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A.      BASIC ASSESSMENT SKILLS


OBJECTIVES:


1. Utilize the four examination techniques such as inspection, palpation, percussion, and auscultation in
   performing a head to toe assessment.
2. Use the appropriate equipments while performing a head to toe assessment.
3. Proper positioning of the patient while doing the assessment.
4. Verbalize the rationale for performing head to toe assessment
5. Properly assess all body system as follows:
   a. Cardiovascular system
   b. Respiratory system
   c. Gastrointestinal system
   d. Genitourinary system
   e. Musculoskeletal system
6. Demonstrate knowledge on mental –spiritual assessment


CONTENT:

        1.      Examination techniques
                a. Inspection
                b. Palpation
                c. Percussion
                d. Auscultation
        2.      Head-to- Toe Assessment
        3.      Neurological Assessment
                a. Neuro check
                b. Neurovascular check (CSM)
        4.      Cardiovascular Assessment
                a. Heart sounds
                b. Skin signs
                c. Capillary refill
                d. Edema
                e. Pulses
                f. Homan's sign
        5.      Respiratory Assessment
                a. Lung sounds
                b. Oximetry
                c. Work of breathing
        6.      Gastrointestinal Assessment
                a. Bowel sounds
                b. Abdominal girth
        7.      Genitourinary Assessment
                a. Bladder distension
                b. Urine dipstick
        8.      Musculoskeletal Assessment
                a. Range of movement
                b. Ability to ambulate
        9.      Mental-Spiritual Assessment
                a. General appearance

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b.   Grooming and personal hygiene
c.   Posture
d.   Degree of anxiety
e.   Ability to concentrate
f.   Past and present memory




                                 6
B. MEDICATION ADMINISTRATION



OBJECTIVES:

     1. Identify and demonstrate the proper methods of administering different type of medications.
     2. State the 7 Rights prior to administering medications including 3 way patient’s identifier.
     3. Demonstrate knowledge and skills in administering oxygen utilizing different oxygen
        devices and equipments.

CONTENT:

      1.      Oxygen administration
      2.      Oral medications
      3.      Injections
                   a. Intramuscular
                   b. Subcutaneous
                   c. Intradermal
     4.       Topical medications
     5.       Optic medications
                  a. Ointment
                  b. Eye drops
     6.       Otic medications




C.   POST-MORTEM CARE
                                                7
OBJECTIVES:


     1. Identify the health personnel who can only pronounce the client’s death and the person responsible for
        notifying the next of kin.

     2.   Prepare the equipment needed in packing the remains.

     3. Bathe, align, and place identification of the body for viewing by family members.

     4. Wrap the body with the use of a sheet or shroud


     5.   Follow the hospital protocol in transferring the body to the morgue

Content:

     1. The authorized health official who pronounce the patient’s death
     2. Prepare the equipment needed in packing the remains.
     3. Preparation of the body
     4. Hospital protocol in transferring the dead body to the morgue




D.        INTEGUMENTARY SYSTEM SKILLS
                                                      8
Objectives:


        1.    Prepare the supplies and equipments in performing sterile wound dressing.
        2.    Prepare and maintain sterile field throughout the procedure.
        3.    Don sterile gloves correctly and efficiently.
        4.    Apply the principles of wound care.
        5.    Demonstrate the proper steps in applying hot and cold therapy.

Content:

        1.    Sterile Gloving
        2.    Wound Care
              a. Wound Assessment
              b. Dry sterile dressings
              c. Wet to dry sterile dressings
              d. Wet to damp sterile dressings
        3.    Hot and cold applications




                                                 9
E.      MUSCULOSKELETAL SYSTEM SKILLS

Objectives:

        1. Demonstrate the proper and safe use of different assistive devices for :
               a. Ambulation
               b. Immobilization

Content:

        1.      Assistive devices for ambulation
                a. Crutches
                b. Cane
                c. Walker
        2.      Devices for Immobilization
                a. Bandages
                b. Brace
                c. Sling
                d. Extremity immobilizers
                e. Traction




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F.      GASTROINTESTINAL SYSTEM SKILLS

Objectives:

        1.Prepare the different equipments needed for insertion of NGT.
        2.Demonstrate the correct steps in insertion of NG
        3.Demonstrate proper technique for checking NGT/PEG tube
                                      a. placement
                                      b. residual
                                      c. removal
        4.Identify and demonstrate the different ways to prevent lung aspiration
        5.Differentiate and demonstrate gavage and lavage
        6.Demonstrate proper nursing care for patient with clients with PEG and NGT decompression
        7.Prepare necessary equipments for ostomy care .
        8.Demonstrate proper procedure in performing ostomy care

Content:

        1.     Aspiration Precautions
        2.     Nasogastric Tubes (NGT)
               a. Salem sump tube
               b. Gastric decompression
               c. Feeding tube
               d. NGT insertion
               e. Checking NGT placement
               f. Gastric lavage
               g. Checking NGT residual
               h. Gastric gavage
               i. NGT removal
        3.     Enemas
        4.     Rectal tubes
        5.     Ostomy Care
               a. Colostomy
               b. Ileostomy
               c. Appliance application and removal




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