Download VNSG 2214 Applied Nursing Skills III

Trinity Valley Community College
Vocational Nursing Program
VNSG 2214 – Applied Skills III
Course Objective and Rudimentary Outline Content
I.
Introduction
A. Function within a directed scope of practice and in accordance with the policies and
procedures of the employing health care institution of practice setting.
B. Integrate concepts from basic sciences and humanities to delivery safe and
compassionate care in the delivery of patient care.
C. Demonstrate basic knowledge of disease prevention and health promotion in delivery of
care to patients and their families.
D. Foster coping mechanisms of patients and their families during alterations in health
status and end of life.
E. Inform patient of Patients Bill of Rights.
F. Encourage active engagement of patients and their families in care.
G. Communicate ethical and legal concerns through established channels of
communication.
H. Use basic therapeutic communications skills when interacting with patients, their
families, and other professionals.
I. Use Standards of Nursing Practice to provide safe and effective patient and family care
according to The Texas Nurse Practice Act and Texas Board of Nurses rules and
regulations.
J. Use evidence based findings to develop interdisciplinary policies and procedures related
to a safe environment including safe disposal of medications and hazardous materials.
K. Identify aspects of professionalism, character, and nursing behaviors which contribute
to the well-being of patients across the lifespan.
L. Discuss care of patients across the lifespan with regards to the nurse scope of practice,
legalities, confidentiality, and ethical decision making.
M. Discuss components of patient teaching as they apply to patients across the lifespan and
their families.
N. Discuss the impact of cultural diversity, ethnicity, and socioeconomic status of patients
across the lifespan.
O. Discuss the Nursing Process of patients across the lifespan in relation to:
1.
Focus assessment and identifying alterations of patient responses to therapeutic
interventions in comparison to the expected outcomes.
2.
Setting priorities in planning and evaluating patient care.
3.
Identifying changes in patient status and life threatening situations.
P. Discuss patient advocacy, consumer rights and responsibilities of patients across the
lifespan.
Q. Identify principles of patient referral and resources to facilitate continuity of care,
restoration, maintenance of health, and prevention of illness in patients across the
lifespan.
R. Discuss the role of the family and significant others involved in providing care and
support of patients across the lifespan.
S. Uses systemic problem solving and clinical reasoning in the care of patients across the
lifespan.
T. Uses evidence based practice with valid scientific sources to provide quality
improvement in the care of patients across the lifespan.
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II.
III.
U. Identify the role and function, including collaboration and communication within the
health care/interdisciplinary team.
Phlebotomy
II.I Identify equipment used in phlebotomy.
A. Equipment
1.
Vacutainer
2.
Vacutainer needle
3.
Butterfly needle
4.
Purple top tube
5.
Red top tube
6.
“Tiger top” tube
7.
Blue top tube
8.
Grey top tube
9.
Culture tubes
II.II Describe nursing responsibilities when performing vena puncture.
A. Nursing
1.
Professionalism
2.
Infection control
3.
Site identification
4.
Confidentiality
5.
Safety
II.III Discuss and identify laboratory tests that are commonly ordered for the critically ill or
injured patient and discuss their significance in patient care.
A. Tests
1.
Complete blood count
2.
Electrolytes and other chemistries
3.
PT, PTT, INR
4.
Cardiac enzymes
5.
Liver enzymes
6.
Renal function studies
7.
Serum drug level
II.IV Skills performance
A. Perform with instructor to check off
1.
Draw “blood” from a lab manikin using butterfly tubing and vacutainer.
2.
Documentation
Intravenous Therapy
III.I Discuss safety factors related to nursing interventions in IV therapy.
A. Safety factors
1.
Perform 6 rights
2.
Knowledge of infusion rate
3.
Knowledge of types of solutions
4.
Knowledge of drip rate
5.
Know whether medication is added to the primary fluid
6.
Site assessment
7.
Guidelines for changing dressing/bag/tubing/site
8.
Guidelines for removing air bubbles from IV tubing
III.II Discuss complications of IV therapy, potential decompensation and normal vs. abnormal
health data.
A. Complications
1.
Pyrogenic reactions
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IV.
V.
2.
Speed shock
3.
Fluid overload
4.
Air embolism
5.
Thrombophlebitis
6.
Tissue damage and/or necrosis
7.
Hematoma
8.
Infiltration
III.III Discuss nursing responsibilities when administering IVPB medication.
A. IVPB medication administration
1.
Use of IV port/medication lock
2.
Lowering primary container
3.
Timing secondary administration
4.
Checking compatibility
5.
Monitoring patient for possible adverse effects
III.IV Skills performance
A. Perform with instructor check off
1.
Veinpuncture using angiocath and butterfly equipment
2.
IV site care
3.
Conversion of IV to saline lock followed by saline flush
4.
Administration of IV piggyback medication
5.
Changing IV tubing
6.
Using a volume control set
7.
Documentation
Blood Administration
IV.I Discuss the role of vocational nurse in blood administration.
A. LVN role
1.
Gathering equipment
2.
Assist in proper patient ID
3.
Patient monitoring after RN initiates transfusion
a. Vital signs
b. Lab values
4.
Complications, identify/recognize abnormal health data
a. Anaphylaxis
b. Speed shock
c. Fluid overload
d. Embolus
e. Administer Benadryl if ordered
f. Return unused blood and/or blood bag to lab
IV.II Skills performance
A. Perform
1.
Assist a registered nurse who is administering blood at clinical site.
Chest Tubes
V.I Discuss the purpose of water seal drainage.
A. Water seal drainage
1.
Evacuation of body fluids or air from chest cavity
2.
Re-expand the lung
V.II Discuss safety factors when caring for a patient with chest tubes.
A. Safety
1.
Do not disconnect chest tube from drainage system.
2.
Palpate skin around chest tube insertion for free air.
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VI.
3.
Reinforce connections with tape to prevent tubes from pulling apart.
4.
Keep drainage system below chest level.
5.
Auscultate breath sounds frequently.
6.
Do not empty drainage system.
7.
Keep drainage system upright.
8.
Maintain suction pressure as directed.
V.III Identify/recognize signs of decompensation and normal vs. abnormal health data.
V.IV Skills performance
A. Perform
1.
Assist a registered nurse set up a closed chest drainage system at clinical site.
Hospital Emergencies
VI.I Discuss the role of the LVN in each emergency situation within scope of practice.
A. LVN role in emergencies
1.
Cardiopulmonary arrest
a. ACLS protocol
b. Record resuscitation activities
2.
External disaster
a. Command post for direction
b. Work in assigned area
3.
Combative person
a. Remove patients from harmful area
b. Note anyone of suspicious nature and report to authorities
4.
Severe weather
a. Remove patients from areas near windows or glass
b. Stay informed as to weather conditions.
5.
Abductions
a. Go to assigned exit per instruction
b. Examine all bags or wraps for small children or babies
c. Notify hospital authorities of suspicious person
6.
Fire
a. Follow rules of “RACE”
1)
R = rescue
2)
A = sound the alarm
3)
C = confine fire to one area
4)
E = extinguish fire with appropriate fire Extinguisher
7.
Gas leak (Ethyloxide)
VI.II Discuss assessment data that is collected for a patient who is critically ill or injured.
A. Data collection
1.
Airway
2.
Breathing
3.
Circulation
4.
Lab
5.
X-ray
6.
Other
VI.III Skills performance
A. Perform
1.
Find policies and procedures for all hospital emergencies in policy and procedure
book at clinical site.
V:\word\syllabus\vocation\level ii\skills iii\vnsg 2214
Reviewed 11/2013
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