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					    SYLLABUS HANDOUT
          FOR
            Winter 2010

             Adult Nursing V
             NURS 2150 9A

INSTRUCTOR: Kellie Clifford RN MSN




 WELCOME TO METROPOLITAN COMMUNITY COLLEGE



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                      Metropolitan Community College
                             Course Syllabus – WINTER 2010


COURSE IDENTIFICATION

Title:                       Adult Nursing V
Prefix/Section:              NURS 2150
Credit Hours:                5 credits (3 hr lecture/week, 9 hrs/wk clinical)
Begins/Ends/No-Class Days:   Saturday, December 4, 2009 to Saturday, February 26, 2011
Meeting Day/Time:            Saturdays/Time: 8:00 a.m.-11:00 a.m.
Last Day to Withdraw:        Friday, February 11, 2011
Holiday Break:               December 24, 2010 – January 2, 2011
No Class Day:                Monday, January 17, 2011 (Martin Luther King Day)
Delivery Type:               Classroom
Class Location:              SOC-Mahoney Bldg, RM 503/511
Lab Location:                SOC-Mahoney Bldg, RM 505
Course Web Address:          http://www.mccneb.edu/academics/alliedhealth/index.asp
Course Approval:             October 16, 2008


CONTACT INFORMATION

Instructor Name:             Kellie Clifford RN, MSN
Office Location:             SOC-Mahoney Bldg, RM 513
Office Telephone:            402-738-4075
Facsimile:                   402-738-4552
Office Hours:                Tuesdays & Thursdays, 8:30 a.m. – 11:30 a.m.
Email Address:               kkclifford@mccneb.edu
Faculty Web Site:            http://www.mccneb.edu/academics/facultydisplay.asp
Academic Program Area:       Health Careers
Dean’s Office Telephone:     (402) 738-4789 in SOC-Mahoney RM 519
Tutoring:                    Alice Ludwig, RN – SOC-Mahoney RM 513



COURSE INFORMATION

Course Description: Adult Nursing V is a continuation and advancement of previous content and
includes the following content areas as well as treatment modalities, and nursing interventions;
perioperative nursing, bariatrics, emergency, trauma, mass casualty, bioterrorism, neurological
disorders, musculoskeletal and connective tissue diseases, endocrine disorders, infectious
disease, immune dysfunctions, cancer, end of life and transplantation. The critical thinking
process will be utilized with subsequent safe decision outcomes. A clinical component is
included.

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Course Prerequisites: Successful completion of NURS 2140, 2310, 2410, and NURS 2520.
Co-requisite: NURS 2210

Course Objectives: At the completion of this course the nursing student should be able to:
1.     Identify the nursing management of the perioperative patient including special needs of
       the bariatric patient in relation to roles and responsibilities of the RN.
2.     Evaluate the emergency nurse’s role in triaging, critical thinking, and prioritizing patient
       interventions.
3.     Implement assessment and prioritizing in the nursing management of the trauma patient.
4.     Identify assessment and nursing interventions in the management of neurological,
       musculoskeletal and connective tissue disorders..
5.     Identify pathophysiological manifestations and nursing interventions for endocrine,
       infectious, immune dysfunctions, and hepatic disorders.
6.     Explain the role of the RN in end of life care incorporating cultural and religious beliefs
       as appropriate.
7.     Explain transplant criteria, potential complications, and prophylaxis treatment for heart,
       kidney, bone marrow, corneal, and liver organs.
8.     Identify the role of the RN in treatment modalities utilizing the nursing process.
9.     Demonstrate critical thinking skills with subsequent safe decision outcomes.
10.    Demonstrate an understanding of pathophysiological knowledge through safe, competent
       care, utilization of the nursing process and the evaluation of nursing interventions.
11.    Discuss the integration of knowledge from research as it influences current and/or future
       practice.

Clinical Component:
       Clinical experience will take place in the hospital setting and will include medical-
surgical units, intensive care units, surgery, emergency room, and recovery room.

Clinical Objectives:
Refer to NURS 2150 Clinical Evaluation Form attached to this syllabus.

Required & Supplemental Materials:
Required:
Osborne, K. et al (2010). Medical-Surgical Nursing Preparation for Practice. Pearson: Boston

Supplements:
      Pocket Reference for ECG’s Made Easy, 3rd Edition. Achlert, Barbara: Mosby
        2006.
      Gahart, Betty: Intravenous Medications, (2011), Elsevier.
      Mosby’s Dictionary of Medical Nursing and Health Professionals, (2005), 7th Edition.
        Mosby.
      Deglin, Judith: Davis’s Drug Guide for Nurses, (2009), 11th Edition. F.A. Davis.
      Silvestri, Linda: Saunders Comprehensive Review for the NCLEX-RN Examination,
         (2008), Elsevier.
      Stassi, Mary: Math for Nurses, by Kaplan, Kaplan Publishing.

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COURSE ASSESSMENT

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 and
questioning. Instructional strategies to be used may include: Handouts, video, powerpoints, and
study guides.

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, and
assessment of skills in clinical settings.

Selected Testing/Assessment Methods:
 Examinations/quizzes include multiple choice or essay. Written assignments include written
nursing careplans or concept maps, and other written assignments appropriate to the clinical
setting. Faculty observation of student completion of skills are primary methods of evaluating
students in the clinical practicum setting.

Evaluation:
FINAL COURSE GRADE
            60 Points           70% of grade= 6 Unit Exams, 50 questions each
            100 Points          20% of grade= Final exam, 100 questions
            160 Points           5% of grade= My Nursing lab pretests and assignments,
                                                (16) 10 Points each.
                50 Points        5% of grade= Megacode
               910 Points      100%

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

There will be no rounding of grades, i.e., a 77.7 = 77%. 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.




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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/quiz period, the student must make-up that
exam/quiz prior to the next scheduled class date (i.e., if the missed test is on Wednesday, the test
must be made up PRIOR to the next Wednesday). Failure to do so will result in a zero for the
examination. The student may miss one exam/quiz without penalty, as long as the test is made up
within the specific time period. If the student misses more than one exam/quiz, the exam/quiz
may be made up, but the maximum score allowed is an 80%. The instructor may choose to
administer an essay exam to those students who miss exams on the scheduled time. 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.

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.

STUDENT EXPECTATIONS

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.

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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:
Each student is expected to recognize the importance of class attendance and promptness. 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 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

Student Withdrawal:
If you cannot participate in and complete this course, you should officially withdraw by calling
Central Registration at 402-457-5231 or 1-800-228-9553. Failure to officially withdraw will
result in 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.

Academic Honesty Statement:
Students are reminded that materials they may use as sources for this course may be subject to
copyright protection. Additional information about copyright is provided on the library webpage
at http://www.mccneb.edu/library, by your instructor, or by the college’s Copyright Officer. In
response to incidents of student dishonesty (cheating, plagiarism, etc.) the College imposes
specific actions, that may include receiving a failing grade on a test, failure in a course,
suspension from the College, or dismissal from the College. The disciplinary procedures are
available in Student Services

Use of Student Work:


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The ownership of student works submitted in fulfillment of classroom requirements shall remain
with the student(s): By enrolling in classes offered by Metropolitan Community College, the
student gives the College license to mark on, modify, and retain the work as may be required by
the process of instruction, as described in the course syllabus. The institution shall not have the
right to use the work in any other manner without the written consent of the student(s).

Accommodations for Students with Disabilities:
If you have a disability that may substantially limit your ability to participate in this class, please
contact a Disability Support Services Counselor, located in the Student Services Office on each
campus. Metropolitan Community College will provide reasonable accommodations for persons
with documented qualifying disabilities. However, it is the student’s responsibility to request
accommodation. For further information, please contact the Student Services Office at your
campus.


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. This
will be done in accordance with FERPA guidelines.

Technology Resources and Use of College Computers:
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/itprocedures.htm

When using College computers at the computer labs, Learning Centers, Libraries and
classrooms, you need to login with your username and password*. Your username and password
are the same whenever you log into the network (campus computers), SharePoint Services,
student e-mail, WebAdvisor and WebCT (if enrolled in an online or blended course). For other
systems (not listed above), your instructor will provide you with the necessary username and
password information.

The Password Center (http://www.mccneb.edu/password) is a new web resource available to all
students and staff. This web site allows you to change (reset) your password even if you don’t
know your username and password, provided the personal information you enter to verify your
identity, matches the information the College has in it’s database. Verification information
consists of student ID number (or the last 5 digits of your Social Security number), last name,
birth date, street address and ZIP Code.

*Note: If you have not logged in before, your initial password is the first initial of your first
name (in UPPERCASE), the first initial of your last name (in lowercase), followed by your

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student ID number with leading zeros to make the password 9 characters long. For example, if
your name is Chris Doe and your student ID number is 1234, your initial password will be
Cd0001234.
Notice: This syllabus is written as an expectation of class topics, learning activities, and
expected learning outcomes. However, the instructor reserves the right to make changes in this
schedule that may result in enhanced or more effective learning for students. These
modifications will not substantially change the intent or objectives of this course and will be
done within the policies and guidelines of Metropolitan Community College.

LEARNING SUPPORT

Metro's Learning, Math, and Writing Centers can help you achieve educational success. The staff
in these centers provide drop-in assistance with basic math, reading, writing and computer skills.
We offer a friendly, supportive learning environment. 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 these services are in the Student Handbook, College Catalog, and
online. Links to these resources are located at http://www.mccneb.edu/learningcenter/.

COLLEGE POLICIES

College policies, such as student rights and responsibilities, academic standards, plagiarism, and
etc. are outlined in the College Catalog and Student Handbook. This information can be
accessed via the online catalog at http://www.mccneb.edu/academics/catalog.asp.

STUDENT WITHDRAWAL: If you cannot attend and complete this course, you should
officially withdraw by calling Central Registration, 457-5231. Failure to officially withdraw will
result in either an instructor withdraw (IW) or failing (F) grade. The last date to withdraw is
identified on the second page of this syllabus handout.

STUDENT CODE OF CONDUCT: The college has a standard code of conduct that involves
consequences for specific academic and non-academic behavior that may result in a failing
grade, probation, or suspension from the college. More complete information about the code of
conduct is located in the Student Services portion of the online catalog
(http://www.mccneb.edu/catalog/studentinformation.asp).

ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES: If you have a disability that
may substantially limit your ability to participate in this class, please contact a Vocational
Special Needs Counselor, located in the Student Services Office on each campus. Metropolitan
Community College will provide reasonable accommodations for persons with documented
qualifying disabilities. However, it is the student’s responsibility to request accommodations.
For further information, please contact the Student Services Office at your campus.

[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.]


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REQUIRED ATTACHMENTS

  SCHEDULE OF ASSIGNMENTS

  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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                           2010/11 Winter Quarter Important Dates
Classes Begin ………………...………………….………………..……….…………… December 1st (W)
Last class day before holiday recess………………………………….…………..December 21st (T) (SA-M)
Holiday recess (College Closed)……………………………….…………December 24-January 2nd (F-SU)
Student Withdrawal Deadline for “W” Grade………………………………………........... Varies by Class*
Classes Resume………………………………………………………………………...........January 3rd (M)
Spring General Registration Begins …………………………….………………………. January 12th (W)
Dr. Martin Luther King Jr. Recess/College Closed………………….…………….………January 17th (M)
Winter Quarter Graduation Application Deadline …………………………….……………February 1st (T)
Fall Quarter Incomplete “I” Grades Due………………………………………………….February 18th (F)
Last Day of Winter Classes…………….…..……………….………………………...February 28th (M)
Grades Due and Posted to WebAdvisor by 5:00 p.m. .........................................................March 2nd (W)

* To view the Last Day for a student to withdraw “drop” a class, go to the class schedule found on line at
http://www.mccneb.edu/schedule/classschedule.asp . Then, find the course section and click on the
Important Dates link next to the course. The refund withdraw 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 being assigned a grade of “F”.




REFUND POLICIES for Credit Courses
A student is responsible for withdrawing “dropping” from a course(s) if unable to attend. Non-
attendance or non-payment does not relieve a student from the obligation to pay. To withdraw “drop”
from a course log on to WebAdvisor https://webadvisor.mccneb.edu and click “Register and Drop
Sections”.

An official schedule change that reduces or terminates a student’s academic credit load may entitle the
student to a refund. The eligibility and amount of a refund is automatically calculated by the date of the
withdrawal. A student may see the refund percentage received through midnight of the same day by
logging into WebAdvisor and clicking on the Tuition Refund Calculator. Note: Schedule changes may


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have implications for students on Financial Aid. Check with the Financial Aid Office prior to any
schedule changes at 457-2330.

The Last Day to Drop for a “W” grade is also the last day for students to change from Credit to
Audit or Audit to Credit with instructor approval. Students must drop by this date to avoid being
assigned a grade of “F”. NOTE: “Last day to drop” refers to grades only.

To view the Last Day to Drop specific to your course section, go to the online class schedule at
http://www.mccneb.edu/schedule/classschedule.asp and click on the Important Dates next to the
course.

The Refund drop dates for each course section are automatically calculated based on the start and
end dates and the number of sessions for the course. NOTE: Refer to refund policy below to
determine the last day to receive a refund for your course.


Schedule of Assignments

* 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)
and are objective based.

* Please Note For Lectures: Concept mapping may be utilized in the classroom. The class
schedules is used as a guide and may need to be adjusted per Instructor discretion.




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                   2150 Calendar
                    Winter 2010
                          Unit I
  Week 1            Management of the              Review Syllabus
December 4th       Perioperative Patient,              Lecture
                        Bariatrics                     pretest
   Week 2                 Unit 2                       Exam 1
December 11th     Emergency and Trauma              Perioperative
                         Nursing                       Lecture
                                                     Pretest Due
   Week 3                 Unit 3                       Lecture
December 18th     Bioterrorism and Mass              Pretest Due
                         Casualty
   Week 4                 Unit 4                       Exam 2
 January 8th      Neurological Disorders      ER/Trauma and Bioterrorism
                                                       Lecture
                                                     Pretest Due
   Week 5           Unit 4 continued                   Lecture
 January 18th   Musculoskeletal, Connective          Pretest Due
                    Tissue Disorders
  Week 6                 Unit 5                         Exam 3
January 22nd       Endocrine Disorders         Neurological, Connective
                                              Tissue and Musculoskeletal
                                                        Lecture
                                                      Pretest Due
   Week 7            Unit 5 continued                   Lecture
 January 29th        Hepatic Disorders                Pretest Due
   Week 8                  Unit 6                       Exam 4
 February 5th     Infectious Diseases and       Endocrine and Hepatic
                   Immune Dysfunctions                  Lecture
                                                      Pretest Due
  Week 9                  Unit 7                        Exam 5
February 12th       Cancer, End of Life         Infectious Disease and
                        Transplant               Immune Dysfunction
                                                        Lecture
                                                      Pretest Due
  Week 10                Unit 8                         Exam 6
February 19th           Megacode                  Cancer, End of Life
                                                      Transplant
                                              Assignment for Megacode
                                                          Due

  Week 11              Final Exam
February 26th

                            12
                                 NURS 2150 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, and journaling.

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 observe and assess knowledge base through 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 and will receive a satisfactory (S), or not observed
(NO) or not applicable (NA) on the clinical assessment sheet based on quality of clinical
performance by your clinical instructor. 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.




                                                  13
                            Metropolitan Community College
                        Clinical Experience/Preceptor Supervision


Goal: -Enhance learning on the clinical site, increase collegiality with staff nurses, smooth
           transition to RN role.
      -Build self-confidence
      -Develop problem-solving, critical thinking, and application of theory to practice
      -Develop time management and organizational skills

Student nurse role:
       - formulate individualized learning objectives and share such with staff RN
       - self-directed learner along with self-assessment development
       - develop effective communication skills
       - develop critical thinking, problem solving skills
       - develop clinical skills and prioritizing skills

Assigned staff RN role:
      - develop learning experiences congruent to student’s objectives
      - communicate with faculty as to student’s progress
      - be available at all times for the student
      - maintain high level clinical skills, critical thinking, and nursing interventions
      - discuss each step of process or skill for student to understand
      - share potential problems and how to solve or prevent
      - provide prompts or cues to assist student to retain information
      - supervise all medication administration
      - supervise all invasive procedures
      - emphasize safe practice

 Faculty role:
      - facilitate relationship between staff RN and student
      - monitor learning experiences
      - evaluate student performance with staff RN

  Staff RN characteristics:
       - at least 24 months clinical experience with current active license, BSN preferred
       - comprehensive knowledge, specialty certification or demonstrated expertise in
              area of practice
       - interest in professional growth & mastery of clinical skills
       - patience and enthusiasm
       - nonthreatening and nonjudgmental
       - willingness to share knowledge and skills
       - knowledge of application of nursing theory to practice




                                             14
                       Unit I Management of the Perioperative Patient
                                       Bariatrics


Goal: To increase knowledge base in perioperative nursing and achieve a greater understanding
and empathy to patients who have undergone surgical interventions.

Objective: At completion of this unit you should be able to:
1.     Describe a comprehensive preoperative assessment including the identification of
       surgical risk factors which are significant in perioperative management of the patient.
2.     Evaluate AORN standards of perioperative nursing practice.
3.     Evaluate the roles and responsibilities of the RN in perioperative nursing including
       legal/ethical considerations.
4.     Compare various types of anesthesia and related nursing responsibilities/interventions.
5.     Describe additional knowledge base required by the RN in the operating room (OR).
6.     Describe surgical asepsis.
7.     Identify surgical prepped zones specific for various procedures.
8.     Evaluate roles of surgical team members.
9.     Identify required safety measures specific to OR in all phases of perioperative care to
       decrease risk of infections/complications for all age specific populations.
10.    Identify common positions of the patient for specific procedures including prevention of
       positioning complications.
11.    Discuss steps followed to prepare for surgical procedure.
12.    Evaluate bariatric concerns in OR.
13.    Critique physiological management intraoperatively and postoperatively for the surgical
       patient to prevent postop complications.
14.    Critique documentation requirements for perioperative nursing.


Clinical Objectives:
1.     Experience perioperative nursing in the hospital setting.
2.     Complete perioperative experience form to identify management of the perioperative
       patient.


Required Reading:
   Osborne, K. et al (2010). Medical-Surgical Nursing Preparation for Practice. Pearson: Boston
Chapters 25, 26, 27 & p. 279-284, & p. 319-320

My Nursing Lab: Bring to class completed pretest for Chapters 25, 26, 27.




                                               15
16
                         METROPOLITAN COMMUNITY COLLEGE
                                       NURS 2150
                           Management of the Perioperative Patient

* You may use a separate sheet to complete this form.

Student Nurse____________________________________________________

Medical Diagnosis________________________________________________

Age__________Weight_____________Circle One: Male               Female

Medication Allergies___________________Latex Allergy: Yes               No

Scheduled Procedure:_____________________________________________

Include the following information:

1.     Rationale for procedure:

2.     Preoperative diagnostic labs, procedures, and rationale:

3.     Identify significant assessment data that places the patient at a surgical risk with
       rationales.

4.     Preoperative care; include teaching:
       (follow healthcare facilities policy and procedures, e.g. checklist, documentation)

5.     Identify common medications that need to be discontinued prior to surgery, include
       rationale.

6.     Describe surgical scrub.

7.     Identify surgical attire and rationale.

8.     Describe members of the surgical team and roles of each.

9.     Describe preparation of the surgical suite.

10.    Describe the position of the patient on surgical bed.

11.    Identify safety measures taken during positioning.

12.    Identify areas of body prepped and rationale.



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13.   Identify agent used for prep and rationale.
14.   Identify type of anesthesia used and rationales (e.g. general, MAC, block, local).

15.   Describe anesthesia role throughout perioperative time frame.

16.   Identify the following safety measures:

      RN’s role in pre-op checks prior procedure:_________________________________

      Time out:_____________________________________________________________

      Counts:_______________________________________________________________

      Grounding device and purpose of:___________________________________________

      ______________________________________________________________________

      Other measures (ex. warming devices):______________________________________

17.   Briefly explain how procedure was performed.

18.   Identify specimens sent to lab.______________________________________________

      _______________________________________________________________________

19.   Identify immediate postoperative care: dressings, warmth, etc.

20.   Identify pain management.

21.   Identify documentation procedure by the RN.

22.   Identify post surgical care in Medical Surgical Unit, ICU, or short term care

      _______________________________________________________________________

23.   Identify at least 3 nursing diagnosis appropriate for the specific procedure (may include
      1 immediately post op period and 2 other for 1st 24-48 hours postop).

24.   Identify unexpected outcomes that may have occurred during the patient’s surgical
      experience:

25.   Summarize your perioperative experience including thought, feelings, and/or concerns.




                                                18
                           Unit II Emergency and Trauma Nursing

Objectives: At completion of this unit you will be able to:

1.     Describe care of the emergency room patient using a holistic approach that includes the
       patient, family, and significant others.
2.     Identify patient populations seen in ER to include variance in culture and religion.
3.     Describe priority emergency measures for any patient with an emergency condition.
4.     Critique the scope of emergency nursing practice.
5.     Identify certification requirements of the Certified Emergency Nurse.
6.     Identify the importance of assessing triaging and intervening patients in emergency or
       trauma status.
7.     Identify priorities of care for the patient with multiple injuries.
8.     Differentiate heat related and cold injuries to include pathophysiology, assessment, and
       interventions.
9.     Critique triage classification and priorities.
10.    Prioritize interventions for care of a patient with snake bite and insect bites.
11.    Prioritize care to patients who have experienced lightning injuries.
12.    Critique altitude-related illnesses to include assessment and interventions.
13.    Identify near-drowning interventions.
17.    Identify nursing assessment and emergency interventions for the patient with fractures.
18.    Identify traumatic amputation in the emergency setting.
19.    Evaluate crush syndrome to include nursing assessment and interventions.
20.    Critique complex regional pain syndrome including assessment and interventions.
21.    Critique nursing care in the management of common sports related injuries.
22.    Critique care of stab and gun shot wounds.
23.    Identify interventions for the rape victim.
24.    Identify conditions that a nurse is mandated to report at state level.

Required Reading:

Osborne: Chapter 43, pg. 53-54, p. 75, p. 714-729, p. 1558-1559, p. 2167-2168, Chart 60-2,
Chapters 56, 73, 74.

My Nursing Lab: Bring to class pretest Chapters 56, 73, 74.




                                                19
             Unit III Bioterrorism and Mass Casualty Nursing Including Triage


Objectives: At completion of this unit you should be able to:
1.     Critique triage classification in the mass casualty scenario.
2.     Identify mass casualty principles.
3.     Describe the mass casualty response plan.
4.     Compare and contrast the many types of bioterrorist agents including signs and
       symptoms, and treatment options.
5.     Identify purpose of debriefing.
6.     Participate in case scenarios’ situations related to mass casualty, bioterrorism, and
       emergencies.
7.     Discuss prioritization of patient movement in a mass casualty situation.

Assignments

Reading: Osborne: Chapter 72.

My Nursing Lab: Bring to class completed pretest Chapter 72.




                                                20
                      Unit IV Neurological, Musculoskeletal Disorders
                                Connective Tissue Disease

Objectives: At completion of this unit you should be able to:
1.     Identify seizure disorders.
2.     Explain types of seizure disorders, including diagnostic tests and nursing interventions.
3.     Describe movement disorders.
4.     Explain dementia disorders of Alzheimer’s disease.
5.     Describe disorders of vertigo.
6.     Describe the presentation of headaches to include migraine, cluster, and tension.
7.     Explain movement disorders.
8.     Describe nursing management of the coma condition.
9.     Correlate nutritional deficiencies that cause neurologic syndrome.
10.    Differentiate visual field defects to include closed-angle, open angle glaucoma, macular
       degeneration, and retinal occlusion.
11.    Compare types of spinal cord injuries to include prioritization assessment, nursing
       diagnosis, and interventions for best patient outcomes.
12.    Explore traumatic brain injury to include assessment, nursing interventions,
       medical and surgical interventions.
13.    Identify nursing assessment, interventions and management of the patient with increased
       Intracranial Pressure (ICP)
14.    Describe assessment and interventions for patients with musculoskeletal problems.
15.    Describe the common levels of lower extremity amputation.
16.    Describe the role of the nurse in regards to caring for the patient with an amputation.


Assignments

Osborne: p. 697, p. 1816-1818, p. 2291-2295, Chapter 29, 31, 32, 55, 71

Review
Chapter 60.

My Nursing Lab: Bring to class completed pretest Chapters 29, 32.




                                               21
                                 Unit V Endocrine Disorders
                                      Hepatic Disorders

Objectives: At completion of this unit you should be able to:
1.     Recall physiology of the endocrine system.
2.     Compare clinical manifestations associated with hypofunction and hyperfunction of the
       pituitary glands.
3.     Explain interventions for treatment of disorders of the pituitary glands.
4.     Identify teaching priorities for the patient taking hormone replacement therapy for
       pituitary glands.
5.     Prioritize nursing care for the patient immediately post-transphenoidal hypophsectory.
6.     Describe disorders of the posterior pituitary glands including assessment interventions.
7.     Describe disorders of the adrenal glands to include clinical manifestations and treatment
       modalities.
8.     Identify clinical manifestations for thyroid and parathyroid disorders.
9.     Explore assessment findings and treatment modalities for thyroid and parathyroid
       disorders.
10.    Identify metabolic functions of the liver and liver disease including cirrhosis, surgical
       management, non-surgical management, and postop care.
11.    Explain liver function tests and clinical manifestations of liver dysfunction.
12.    Identify jaundice, portal hypertension, ascites, varices, nutritional deficiencies, and
       hepatic coma to pathophysiological alterations in the liver to include nursing and medical
       management.
13.    Discuss the management of esophageal varices.
14.    Compare the various types of hepatitis, their cause, prevention, manifestation,
       management, prognosis, and home health needs.

Assignments

Reading: Osborne: Chapter 46, 51, 52.

My Nursing Lab: Bring to class completed pretest Chapters 46, 51, 52.
.




                                               22
                    Unit VI Infectious Disease and Immune Dysfunction


Objectives: At completion of this unit you should be able to:
1.     Identify patients that are immunocompromised.
2.     Describe the autoimmunity processes.
3.     Identify anphylaxis to include assessment, interventions, treatment.
4.     Identify Latex allergy, pathophysiology and management.
5.     Identify respiratory infections to include pneumonia, tuberculosis (TB), acute
       pharyngitis and sinusitis.
6.     Distinguish between human immunodeficiency virus (HIV) and AIDS for clinical
       manifestations and complications.
7.     Identify transmission of HIV/AIDS.
8.     Prioritize nursing diagnosis for a patient with HIV.
9.     Describe technique to reduce risk of infection in immunocompromised patients.
10.    Identify CNS infections to include, meningitis, encephalitis, and brain absess.
11.    Identify opportunistic infections to include candidal thrush, cryptoccocal meningitis,
       histoplasmosis, pneumocystis carinii pneumonia, cytomegalovirus, mycobacterium
       avium complex and toxoplasmosis.
12.    Identify tick-borne infections to include Lyme Disease, Rocky Mountain Spotted Fever.
13.    Explain infections of the eye and ears to include infectious conjunctivitis, otitis media,
       mastoiditis, labrinthitis, Meniere’s Disease.
14.    Describe the management and care of patients with skin infections including: contact,
       parasite, viral, fungal, and bacterial.

Assignments

Osborne: p. 729-734, p. 892-894, p. 937-946, p. 1855-1857, Chapter 20, 59, 60, 61 (p. 1968-
1976), 66, & p. 2305-2311, p. 2353-2355

Review
Chapter 50.

My Nursing Lab: Bring to class completed pretest Chapters 66, 60.




                                                23
                     Unit VII Cancer, End of Life and Transplantation

Objectives: At completion of this unit you should be able to:

1.     Describe the pathophysiology of death.
2.     Describe the purpose of advanced directives.
3.     Discuss philosophies of palliative and Hospice Care.
4.     Describe the role of the nurse and the interdisciplinary team in postmortem care.
5.     Interpret the physical and emotional signs of impending death.
6.     Prioritize interventions for symptoms of the client near death.
7.     Compare how variations in cultures and religious beliefs can impact the experience of
       dying and death.
8.     Describe post-mortem care.
9.     Discuss the ethical and legal obligations of the nurse in regard to end of life care.
10.     Discuss perioperative interventions of heart transplantation.
11.    Discuss selection criteria for kidney donation.
12.    Prioritize nursing care during the first 24 hours post kidney transplantation.
13.    Describe complications of liver transplantation.
14.    Differentiate between sources of stem cell transplants.
15.    Identify interventions for patient who has undergone a bone marrow/stem cell transplant.
16.    Identify pre and post operative care of the corneal transplant patient.
17.    Identify how immune system responds to transplanted tissue or organs.
18.    Explain short and long term side effects of immunosuppression drugs.
19.    Identify rejection prophylaxis.
20.    Identify potential complications of transplantation.
21.    Identify available resources to allow dying patient to receive care in hospice or at home.
22.    Differentiate between benign/malignant tumors.
23.    Identify carcinogenic agents.
24.    Describe the nursing process in caring for a patient undergoing surgery, radiation,
       chemotherapy, and other treatments for cancer.
25.    Discuss the role of RN in assessment and management of common oncological
       emergencies.
26.    Identify components of grief and mourning and the nursing measures to support patient
       and families.
27.    Provide cultural and spiritual care to terminally ill patient and their families.
28.    Discuss communication between the terminally ill patient, their family, and the RN.

Required Reading:

Osborne:      Chapter 17, 27, 64
              p. 1300, p. 1441, p. 2370-2374
              p. 320-321, p. 206, p. 1489
              p. 1917-1920, p. 1865-1866
              p. 1914, p. 1447

My Nursing Lab: Bring to class completed pretest Chapters 17, 64.

                                               24
                                      Unit VIII Mega Code


Objectives: At completion of this unit you should be able to:
1.     Analyze rhythm strips to identify cardiac dysrythmias.
2.     Discuss pharmacological measure to help treat cardiac dysrhymias.
3.     Explain and discuss pacing, defibrillation, cardioversion, and code blue.
4.     Participate in mega code scenarios.

Assignments

Osborne: Chapter 38, 39
Simulation paperwork

Supplements: Handouts
             Powerpoints
             Study Guide

Participate in mega code scenarios.




                                               25
                                              METROPOLITAN COMMUNITY COLLEGE
                                                           NURSING PROGRAM
                                                  NURS 2150 CLINICAL EVALUATION
Charting By Exception: If objective criteria is satisfactory, the area will be blank.
Scale for rating clinical performance:   U=Unsatisfactory                   NI=Needs Improvement        NO=No Opportunity
NA = Not Applicable

Name:                                                 Clinical site:                                Quarter


  OBJECTIVE I: Maintain standards of ethical,         Wk     Wk        Wk    Wk    Wk    Wk   Wk   Wk     Wk   Wk    Wk     Instructor Comments
  professional and legal behavior while               1      2         3     4     5     6    7    8      9    10    11
  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.




                                                                                    26
OBJECTIVE II: Demonstrate responsibility          Wk   Wk   Wk   Wk   Wk Wk   Wk   Wk   Wk   Wk   Wk   Instructor Comments
and accountability for nursing practice with an   1    2    3    4    5 6     7    8    9    10   11
awareness of the need for continued personal
learning and self-development.

a.   Demonstrate accountability for own
     actions.
     1. Self learner and takes initiative.
b.   Identifies own strengths and limitations
     with guidance from instructor.
c.   Reports promptly and participates in
     conferences.
d.   Successfully completes all written
     assignments on time and with appropriate
     minimum score when applicable.
     1. Completes thorough and accurate
        documentation per agency policy.
     2. Completes daily pre-lab documents as
        assigned.
     3. Completes math exam with 100%
        (only three attempts per policy).
e.   Demonstrates reliable clinical attendance.
     1. Notifies clinical instructor in timely
        manner when unable to attend clinical.
f.   Maintains good personal hygiene.
g.   Adheres to acceptable clinical dress.




                                                                      27
OBJECTIVE III: Display caring                 Wk   Wk   Wk   Wk   Wk Wk   Wk   Wk   Wk   Wk   Wk   Instructor Comments
behaviors in the delivery of nursing care     1    2    3    4    5 6     7    8    9    10   11
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.




                                                                     28
 OBJECTIVE IV: Utilize knowledge from                 Wk   Wk   Wk   Wk   Wk Wk   Wk   Wk   Wk   Wk   Wk   Instructor Comments
 nursing and related disciplines when                 1    2    3    4    5 6     7    8    9    10   11
 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. Identifies priority 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.




                                                                          29
OBJECTIVE IV continued                         Wk   Wk   Wk   Wk   Wk Wk   Wk   Wk   Wk   Wk   Wk   Instructor Comments
 Utilize knowledge from nursing and            1    2    3    4    5 6     7    8    9    10   11
related disciplines when applying the
nursing process in the provision of nursing
care to clients.
           e. Develops a plan of care
              based on the nursing
              diagnosis.
               1.     Establishes goals.
               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 five
               nursing diagnoses and five
               nursing interventions for
               each N.D.

                                                                     30
OBJECTIVE V: Manage the           Wk   Wk   Wk   Wk   Wk Wk   Wk   Wk   Wk   Wk   Wk   Instructor Comments
nursing care of clients with      1    2    3    4    5 6     7    8    9    10   11
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.




                                                                   31
OBJECTIVE VI: Employ effective             Wk   Wk   Wk   Wk   Wk Wk   Wk   Wk   Wk   Wk   Wk   Instructor Comments
communication to establish                 1    2    3    4    5 6     7    8    9    10   11
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.




                                                                  32
OBJECTIVE VII: Utilize the             Wk   Wk   Wk   Wk   Wk Wk    Wk   Wk   Wk   Wk   Wk   Instructor Comments
teaching-learning process to assist    1    2    3    4    5 6      7    8    9    10   11
clients to reach a higher level of
health.

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.




                                                                   33
    OBJECTIVE VIII: Follow the hierarchy of                 Wk     Wk    Wk    Wk    Wk Wk        Wk     Wk     Wk      Wk    Wk    Instructor Comments
    needs when providing nursing care to clients in         1      2     3     4     5 6          7      8      9       10    11
    collaboration with the interdisciplinary team.

    a.    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.
    b.    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:   U=Unsatisfactory                  NI=Needs Improvement             NO=No Opportunity
NA = Not Applicable


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.




                                                                                     34
SUMMARY OF ABSENCES/TARDIES
               Week                       1        2       3         4         5         6         7          8             9   10   11
Hours of absence.

Number of tardies.

Total of absences and tardies



ACKNOWLEDGEMENT OF INSTRUCTOR’S NOTATIONS
                                           1       2       3         4         5         6         7          8             9   10   11
Week
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:




                                                                                    35
FINAL QUARTER EVALUATION




                           36

				
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