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Grossmont Vocational Nursing Program
Medical-Surgical-Pediatric Nursing I
Class 63
School Year
2016
Grossmont Vocational Nursing Program
Course:
Medical-Surgical-Pediatric Nursing I
Course Description
Medical-Surgical-Pediatric Nursing is designed to give students theoretical and clinical experiences
within the realm of the Vocational Nurse, which facilitate cognitive, affective, and psychomotor
competency in the care of children, adults, and elderly medical-surgical patients.
Content areas will focus on common disorders of the musculoskeletal, cardiovascular, blood & lymph
and, endocrine systems, diabetes mellitus, fluid and electrolyte imbalances, and developmental
disabilities. It will also include an introduction to supervision and leadership.
Course Objectives: Upon completion of this course, the student will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Define terminology common to each body system and related abnormalities.
Utilize the nursing process in the care of common medical-surgical disorders and conditions.
Compare wellness to illness data on the health continuum.
Discuss the ethical and legal role of the Vocational Nurse in caring for the medical-surgical
patient.
Identify and utilize therapeutic communication with inclusion of cultural diversity issues.
Identify and describe psychosocial needs of the patient.
Identify and describe the major health problems of children and adults from middle age through
later maturity.
Implement and participate in health teaching and rehabilitation, utilizing available resources within
the hospital and community.
Discuss first aid measures used in emergency situations.
Describe the dietary management of disease conditions.
Describe the leadership skills appropriate for the vocational nurse to include guidance, assignment
making, and utilization of resources.
Discuss the processes which assist in the restoration of patients to optimal levels of functioning
Differentiate between the roles of the vocational nurse in hospital and ambulatory care settings.
Complete the appropriate level clinical objectives with a satisfactory grade.
CLASSROOM CONDUCT/CLINCAL EXPERIENCES
1. Refer to Student Responsibilities Related to Classroom Experiences as described in Vocational
Nursing Student Handbook.
2. Refer to Student Responsibilities Related to Clinical Experiences as described in Vocational
Nursing Student Handbook.
COURSE REQUIREMENTS
1. The student is responsible for attending all class sessions.
2. The student is responsible for coming to class prepared to discuss the topics as assigned and to
actively participate in class.
3. Written assignments will be submitted at the beginning of the class periods on the due date.
4. Any works cited when completing a research paper or written assignment shall be noted with a
bibliography submitted with the assignment.
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5. Students are expected to adhere to the standards of honest academic conduct (as outlined in the
Vocational Nursing Student Handbook) at all times.
6. Outside assignments may include, but are not limited to, the following:
 Reading assignments
 Practice problems
 Memorizing and applying formulas
 Internet assignments.
7. Students can be expected to spend a minimum of 2 hours outside of class in preparation for each
hour of class.
8. Guidelines for assignments shall be provided by the instructor.
9. The student is responsible for completing all campus/laboratory skill activities.
10. At the end of the course, the student is expected to submit a written evaluation of the course on
the appropriate forms.
REQUIRED TEXTS
Dahlkemper, T.R., Anderson’s Nursing Leadership, Management, and Professional Practice for the
LPN/LVN in Nursing School and Beyond. (2013) (5th edition). Davis Publishing.
Dudek, S.G., Nutrition Essentials for Nursing Practice (2014) (7th edition). Lippincott Publishing.
Ford, S. Introductory Clinical Pharmacology (2010) (10th Edition), Lippincott Publishing.
Kurzen, C. R., Contemporary Practical/Vocational Nursing (2012) (7th edition) Lippincott Publishing.
Timby, B.K, & Smith, N. E., Introductiory Medical-Surgical Nursing (2014) (11th edition) Lippincott
Publishing.
Van Leeuween, A. M., Poelhuis-Leth. D.J., &Bladh, M.K. Comprehensive Handbook of Laboratory
and Diagnostic Test with Nursing Implications. (2013) (6th edition) . Davis Publishing.
Hatfield, N. T., Introductory Maternity & Pediatric Nursing (2014) (3rd Edition). Lippincott Publishing.
RECOMMENDED TEXTS
Timby, B.K, & Smith, N. E., Workbook for Introductory Medical-Surgical Nursing (2014) (11th
edition) Lippincott Publishing.
TEACHING AND LEARNING METHODS:
1. Lecture/Discussion
2. Small Group Activities/Role Playing
3. Reading and Written Assignments
4. Skill demonstration
5. Viewing of audiovisual materials
6. Library and On-line Internet Research
7. Critical Thinking exercises
8. Independent study
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CLASS PARTICIPATION
Participation includes the following:
1. Being on time.
2. Encouraging others to participate. You can do this by limiting the number of times that you
volunteer information and by directly encouraging others who have difficulty talking in class.
3. Presentations from group activities.
4. Constructive discussions/questions about readings, assignments, and class activities and their
application.5.
5. When taking the observer role, acting as time keeper and giving defined written feedback.
METHODS OF EVALUATION:
1. Written examinations and quizzes covering theory and clinical sessions.
2. Written assignments/homework covering theory and clinical sessions.
3. Evaluation of clinical performance.
CRITERIA FOR EVALUATION
To successfully complete Nursing Science, the student must meet the following guidelines:
1. Achieve an average of at least 75% on all written examinations.
2. Achieve a “Satisfactory” evaluation on written assignments – theory, laboratory or clinical
based. For work receiving a numeric score, “Satisfactory” is considered to be 75% or higher.
3. Achieve a “Satisfactory” on Clinical Evaluation.
4. Attend and participate in class.
GRADING PRACTICES
Progression in the nursing program is contingent upon taking nursing courses in a specifically
designated sequence and achieving a grade of "C" or better in each course.
The letter grade earned by the student will be based on written examinations and assignments covering
both classroom and clinical content.
The grading scale is as follows:
100 – 92
=A
91 – 82
=B
81 – 78
=C
Less than 78%
=F
There is no rounding off of numbers when determining the final course grade.
Progression in the nursing program is contingent upon taking nursing courses in a specifically
designated sequence and achieving a grade of 78% or better in each course.
Students must maintain an exam average of 78% in all subjects in each course in order to pass the
course. If the student does not achieve an average of 78% on exams, he/she will not pass the
course, even if the student has achieved a greater than 78% on other assignments.
Any student who is "at risk" (functioning below the minimally acceptable level of performance in either
the clinical or academic areas of the program) at any time during the program will be given a written
notification, stating areas in which improvement is needed, suggestions for making these improvements,
and a date by which the objectives must be met.
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CLINICAL EVALUATION POLICY
Each student will be responsible for reviewing all clinical objectives as presented in the course syllabus
and the weekly learning guides. Each student is accountable for all previously introduced concepts and
skills. The clinical evaluation is based on the continued application and integration of previously
learned material within the current clinical learning experience.
Students will also be responsible for reviewing the criteria for determining the Satisfactory, Needs
Improvement and Unsafe/ Unacceptable clinical performance ratings (see below).
Clinical instructors will evaluate student progress in a variety of ways, such as: planned and incidental
observation of client assessment, problem identification, care plan development and implementation &
evaluation of client care, as outlined in the course clinical objectives and the weekly learning guides.
Each student will be responsible for submitting to the clinical instructor a weekly anecdotal record
written in black, non-erasable ink. This form will be used by the student as a communication tool to
state objectives that have been met successfully, to explore feelings elicited from clinical assignments,
and to seek assistance from the instructor when clinical objectives have not been met.
The instructor may also institute anecdotal records at any time when an incident occurs in the clinical
area, which demonstrates a potential safety hazard to the client, a lack of preparedness on the part of the
student, or a specific learning difficulty/area of concern.
To achieve a grade of "Satisfactory" in the clinical component of the nursing course, the student
must:
1. Achieve a passing grade or a satisfactory evaluation on all required written clinical assignments.
2. Satisfactorily meet designated clinical objectives and clinical expectations consistently throughout
the course.
3. Regularly attend scheduled meetings of clinical rotations and on-campus laboratory sessions.
4. Successfully pass a written math proficiency test.
LATE PAPERS AND ASSIGNMENTS
Late papers will be graded accordingly. Since assignments have more learning value when completed on
time, late assignments will have points deducted. If the assignment is turned in 1-4 days after the due
date, 5% will be deducted from the grade. If an assignment is 5-7 days late, 10% will be deducted.
Assignments submitted more than 7 days late will have deductions based on the same calculations. For
example, an assignment submitted 3 days late will have a deduction of 5%, an assignment submitted 6
days late will have a 10% deduction, and an assignment submitted 13 days late will have a 15%
deduction.
Assignments are due at the start of the class period, and assignments turned in at any other time during
the class will be considered 1 day late.
All assignments have value and are important to your education; therefore, all assignments must be
completed and turned in to receive credit. Additionally, if an assignment is not submitted within 14 days
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of the due date, the value of the assignment will be deducted from the student’s overall point total. For
example, if a homework assignment is worth 10 points and is not completed and turned in within 14
calendar days, the student will have 10 points deducted from his/her gradebook.
EXAMINATION REVIEW POLICY AND PROCEDURE
Midterm and final exams are not reviewed in class. Individual appointments can be scheduled with
faculty to review the exam. Individual quizzes are reviewed per individual instructors.
MATHEMATICAL PROFICIENCY
Each student is expected to satisfactorily pass the Math examination with 100% accuracy in order to
complete course objectives, which may include the administration of medications based on the ability to
calculate dosages accurately. Students identified as having difficulty with mathematical computations
will be referred for remediation measures.
STATEMENT RELATED TO STUDENTS WITH SPECIAL NEEDS
Students with disabilities, who may need “reasonable accommodations”, should discuss options with the
instructor during the first week of class.
COURSE GRADES
All Quizzes
Written Assignments/ATI
Computer Research Paper
Mid-Term Exam
Final Exam
Total
25%
15%
10%
25%
25%
100%
Quizzes are given at various times throughout the day; if the student is not present at the start of a quiz,
he/she will be permitted to enter the classroom but will only have the original allotted time to complete
the quiz. Additionally, he/she will have an automatic 10% deduction for that quiz. No makeup allowed
for Math and Meds content. Midterms and Final Exams are given at the start of the day and are
timed. If the student is not present at the start of class on the day of an exam, he/she will be
permitted to enter the classroom, but he/she will only have the time remaining to complete the
midterm/final exam. If special considerations are necessary, the student must inform the Instructor
prior to the midterm/exam day. No special considerations given for quizzes.
Introduction to Critical Thinking
Critical thinking in nursing is an essential component of professional accountability and quality nursing
care. The ideal critical thinker is consistently questioning, well informed, trustful of reason, openminded, flexible, fair-minded in evaluation, honest in facing personal biases, cautious in making
judgments, willing to reconsider, clear about issues, organized in complex situations, diligent in seeking
relevant information, and persistent in seeking results.
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The nursing faculty has defined critical thinking as follows: A cognitive (way of thinking) and affective
(utilizing the individual’s emotions or feelings) method of processing (collecting and deciphering
information) that encompasses reflective reasoning (thoughtful decision-making) and problem solving.
ATI Policy
What is ATI?
•
Assessment Technologies Institute® (ATI) offers an assessment driven review program designed
to enhance student NCLEX-RN success.
•
The comprehensive program offers multiple assessment and remediation activities. These
include assessment indicator for academic success, critical thinking, and learning styles, online tutorials,
online practice testing, and proctored testing over the major content areas in nursing. These ATI tools, in
combination with the nursing program content, assist students to prepare more efficiently, as well as
increase confidence and familiarity with nursing content.
•
Data from student testing and remediation can be used for program’s quality improvement and
outcome evaluation.
•
ATI information and orientation resources can be accessed from your student home page. It is
highly recommended that you spend time navigating through these orientation materials.
Modular Study:
ATI provides online review modules that include written and video materials in all content areas.
Students are encouraged to use these modules to supplement course work and instructors may assign
these during the course and/or as part of active learning/remediation following assessments.
Tutorials:
ATI offers unique Tutorials that teach nursing students how to think like a nurse; how to take a nursing
assessment and how to make sound clinical decisions. Nurse Logic is an excellent way to learn the
basics of how nurses think and make decisions. Learning System offers practice tests in specific nursing
content areas that allow students to apply the valuable learning tools from Nurse Logic. Features are
embedded in the Tutorials that help students gain an understanding of the content, such as a Hint Button,
a Talking Glossary, and a Critical Thinking Guide.
Assessments:
Standardized Assessments will help the student to identify what they know as well as areas requiring
active learning/remediation. There are practice assessments available to the student and standardized
proctored assessments that may be scheduled during courses.
Active Learning/Remediation:
Active Learning/Remediation is a process of reviewing content in an area that was not learned or not
fully understood as demonstrated on an assessment. It is intended to help the student review important
information to be successful in courses and on the NCLEX. The student’s individual performance
profile will contain a listing of the topics to review. The student can remediate, using the Focused
Review which contains links to ATI books, media clips and active learning templates.
The instructor has online access to detailed information about the timing and duration of time spent in
the assessment, focused reviews and tutorials by each student. Students can provide documentation that
required ATI work was completed using the “My Transcript” feature under “My Results” of the ATI
Student Home Page or by submitting written Remediation Templates as required.
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ATI Grading Criteria
In addition to individual ATI assignments the following will apply to Practice Assessments and
Proctored Assessments.
Practice Assessment
5 points
Complete Practice Assessment A
Complete Practice Assessment B
Remediation:
Remediation:
 Minimum one hour Focused Review
 Minimum one hour Focused Review
For
each topic missed, complete an active
 For each topic missed, complete an
active learning template/and or identify learning template/and or identify three critical
points to remember.
three critical points to remember.
Proctored Assessment
Level 3
4 points
1 hour Focused Review
Active learning template
And/or three critical points
for each topic to review
Level 2
3 points
2 hour Focused Review
Active learning template
And/or three critical points
for each topic to review
Level 1
0 points
3 hour Focused Review
Active learning template
And/or three critical points
for each topic to review
Below Level 1
0 Points
4 hour Focused Review
Active learning template
And/or three critical points
for each topic to review
2 points
2 points
2 points
2 points
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Subject:
Pediatric Focused Nursing Care
Unit Assignment:
Introductory Maternity & Pediatric Nursing, Unit VIII, Chapters 28-31
Unit IX, Chapters 32-34
Behavioral Objectives: Upon completion of this unit, the student will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Describe 5 methods in which a pediatric nurse uses growth and development principles.
Explain how the hospital admission of a child differs from that of an adult.
Describe 3 techniques which can be used by the nurse to make the hospital experience a more
positive one.
Explain the needs of parents in the course of the child’s hospitalization.
Describe 3 alternative methods of feeding infants with health problems.
List at least 2 age appropriate safety measures which may be used for children from infancy
through the teens.
Identify 3 methods of restraining infants and children for safety and/or procedures.
Describe differences in collecting urine and blood specimens from young children.
Discuss the principles of fluid balance and methods of calculating I & O and hydration status.
Calculate pediatric medication dosages by body weight and body surface area.
Describe ways in which administering oral and parenteral medications to children differs from
adults.
Identify common communicable diseases, the effect of those diseases on the community, and
reportable and non-reportable communicable diseases.
List required immunizations and ages for each immunization.
Utilize the nursing process to plan and implement a plan of care for the pediatric patient.
Describe how to locate the website for the 2020 National Health goals related to childhood
disorders.
Material to Be Covered In This Unit:
I.
II.
III.
IV.
History of Child Care in America
Nursing Implications of Growth and Development
Differences between Adults and Children
A.
Metabolism
B.
Vital Signs
C.
Urine Output
D.
Teeth
E.
Eating Patterns
F.
Vision
G.
Speech and Communication
Hospitalization of a Child
A.
Preadmission programs
B.
Admission
C.
Hospital Policies
D.
Parent Participation
E.
Discharge Instructions
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V.
VI.
VII.
VIII.
IX.
X.
Characteristics of a Pediatric Nurse
Safety
A.
Age appropriate accident prevention
Common Pediatric Procedures
A.
Bathing
B.
Feedings
1. Formula
2. Solids
3. Special considerations
C.
Restraints
D.
Urine collection
E.
Venipuncture
F.
Lumbar puncture
G.
Oxygen therapy
H.
Intake and Output
I.
Weight
Medication Administration
A.
General principles
B.
Methods of Calculation
Common Communicable Diseases - Immunizations
Techniques utilized by outpatient nurse to elicit child participation.
A.
Role of play in child therapy
B.
Communication skills needed
Clinical Application:
1. Explain the concepts of “prevention” and “health maintenance” as they pertain to children.
2. Identify at least three nursing considerations related to immunizations.
3. Accurately assess pulse, respiration, temperature, blood pressure, height, and weight for infants and
children of different ages.
4. Implement nursing measures to ensure the safety of the pediatric patient during a hospital admission.
5. Bathe an infant during a hospital stay.
6. Implement nursing measures for a pediatric patient with fever lower than 102˚ F (38.8˚ C) and
higher than 102˚ F (38.8˚ C).
7. Accurately and safely administer PO and IM medications to an infant, a toddler, a preschool child,
and a school-age child.
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Unit Topic: Management of Developmental Disorders
Unit Assignment:
Introductory Maternity & Pediatric Nursing:
Unit X: Chapter 35: The Child with a Sensory/Neurological Disorder: pages 762-780.
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1. Describe developmental disability/mental retardation in children and adults.
2. Identify 2020 National Health Goals related to cognitive health disorders of children.
2. Discuss common mental disorders present in the DD patient.
3. Define autism, cerebral palsy and fetal alcohol syndrome.
4. Discuss major management approaches to problems related to developmental disabilities.
5. Discuss parenting needs in relation to the emotional and cognitive needs of the child.
6. Define behavior modification and active treatment.
7. Discuss the implications of inclusion and proactive intervention.
8. Describe three behavioral approaches to management problems.
9. Identify agencies in the community to help DD children and families.
Material to Be Covered In This Unit:
I. Nature of Developmental Disabilities
A. Definition
B. Causes
1. Genetic
2. Prenatal
3. Post-natal
4. Injury
C. Causes and Management of Behavior Problems
1. Common Mental Disorders
2. Related Developmental Disorders: Autism and Cerebral Palsy
3. Fetal Alcohol Syndrome
II. Intelligence quotient
A. Definition
B. Testing
C. D.D. ranges
1. Borderline
2. Mild
3. Moderate
4. Severe
5. Profound
III. Services and Treatments- Community Agencies Able to Assist Clients
A. Patient’s Rights
B. Education
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C. Training
D. Home-based and Day Center Programs
E. Home sites
F. Work sites
G. Community Agencies
IV. Behavioral Modifications
A. Definition active treatment
B. Program Planning
C. Techniques
1. Shaping
2. Modeling
3. Extinction
4. Chaining –reverse chaining
5. Fading
V. Syndromes Cause & Management
A. Chromosomal-Prader-Willi, Angelmans, Down
B. Toxins- Fetal Alcohol Syndrome
C. Infections – Rubella
D. Prenatal – Rh incompatibilities
Clinical Application:
1. Identify assessment findings that indicate developmental disability/mental retardation in adult
and pediatric clients.
2. Utilize the nursing process to provide care to individuals with developmental disorders
across the life span.
3. Identify community resources appropriate for referral for patients/families with developmental
disorders.
4. Implement behavior management programs for the developmentally disabled.
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Unit Topic:
Management of Patients with Problems of the Hematologic and Lymphatic
Systems; Disorders of the Immune Response
Unit Assignment:
Introductory Medical-Surgical Nursing:
Unit 7: Caring for Clients with Hematopoietic and Lymphatic Disorders
Chapters 30-32
Unit 8: Caring for Clients with Immune Disorders
Chapters 33-35
Introductory Maternity & Pediatric Nursing:
Unit X: The Child with a Cardiovascular/Hematologic Disorder
Chapter 37
Nutrition Essentials for Nursing Practice
Unit Three: Nutrition in Clinical Practice
Chapter 22
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1. Compare and contrast different types of anemia’s in terms of pathophysiology, assessment and
nursing interventions.
2. Identify 2020 National Health Goals related to children with hematologic disorders.
3. Discuss the subjective and objective data gathered during a hematologic assessment of patients with
suspected hematologic disorders.
4. Compare the functions of the lymphatic system with those of the blood.
5. Describe the assessment information that can be obtained from a complete blood count (CBC).
6. Describe the pathology and clinical signs and symptoms of the following hematological disorders:
anemias, leukemia, sickle cell disease, hemophilia, Hodgkin’s and non-Hodgkin’s disease, and
multiple myeloma.
7. Identify 2020 National Health Goals related to immune disorders in children that nurses can help the
nation achieve.
8. Describe the immune process as it relates to childhood illnesses.
9. Explain Kawasaki Disease and state the most serious concern for the child suffering from it.
10. Describe the nursing interventions used to prevent infections in patients with leucopenia
(neutropenic precautions).
11. From the NANDA list of nursing diagnosis, identify at least four nursing diagnosis that are
commonly used for patients with a blood or lymphatic disorder and choose appropriate nursing
interventions for each.
12. Identify nutritional deficiencies that can lead to anemia.
13. Discuss the application of the nursing process for a patient with HIV/AIDS across the life span.
Material to Be Covered In This Unit:
I.
Hematopoietic System
A.
Anatomy and Physiology
1. Bone marrow
2. Erythrocytes
3. Leukocytes
4. Platelets
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II.
III.
Diagnostic and Laboratory Tests
Common Hematologic Treatments
A.
Transfusions of Colloid Solutions
B.
Transfusions of Blood and Blood Products
C.
Blood Donation
D.
Bone Marrow and Peripheral Stem Cell Transplantations
IV. Red Blood Cell Disorders
A.
Polycythemia Vera
B.
Anemia
1. Iron-Deficiency
2. Hemolytic
3. Pernicious
4. Aplastic Pancytopenia
5. Sickle Cell Anemia
6. Thalassemia
7. Hypovolemic
a. Acute Hemorrhagic
b. Chronic Hemorrhagic
IVa. Cancers specific to Pediatrics
A. ALL
B. AML
C. Osteogenic Sarcoma
D. Ewing Sarcoma
E. Neuroblastoma
F. Rhabdomysosarcoma
G. Nephroblastoma (Wilm’s tumor)
V.
White Blood Cell Disorders
A.
Neutropenia
B.
Agranulocytosis
C.
Leukemia
1. Acute Lymphoid Leukemia
2. Acute Myeloid Leukemia
VI.
Platelets and Clotting Disorders
A.
Thrombocythemia
B.
Thrombocytopenia
C.
Disseminated Intravascular Coagulation
D.
Hemophilia
VII. Lymphatic System Disorders
A.
Hodgkin’s Disease
B.
Non-Hodgkin’s Lymphomas
C.
Multiple Myeloma
VIII. Nutrition
VIX. Hematopoiesis
X.
Occlusive, Inflammatory and Infectious Disorders
A.
Lymphedema
B.
Lymphangitis and Lymphadenitis
C.
Infectious Mononucleosis
X. HIV & AIDS
A. Pathopysiology
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B. Pharmacological treatment
C. Nursing process
D. Public health consideration
E. Prevention
Clinical Application
1. Implement appropriate nursing interventions to manage disorders identified after review of
laboratory data.
2. Utilize the nursing process to care for patients with disorders of white blood cells.
3. Utilize the nursing process to care for patients with disorders of red blood cells.
4. Utilize the nursing process to manage anemia.
5.
Assess the patient receiving a blood transfusion.
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Unit Topic:
Management of Patients with Cancer
Unit Assignment:
Introductory Medical-Surgical Nursing:
Unit 4: Caring for Clients with Multisystem Disorders
Chapter 18
Unit 7: Caring for Clients with Hematopoietic and Lymphatic Disorders
Chapters 30-32
Unit 8: Caring for Clients with Immune Disorders
Chapters 33-35
Introductory Maternity & Pediatric Nursing:
Unit X: The Child with a Cardiovascular/Hematologic Disorder
Chapter 37
Nutrition Essentials for Nursing Practice
Unit Three: Nutrition in Clinical Practice
Chapter 22
Internet Research
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Define the terms carcinoma, sarcoma, leukemia, and lymphoma.
Name the seven warning signs of cancer.
List and discuss risk factors for acquiring cancer.
List methods of early detection of cancer.
Name five tests used to detect and diagnose cancer.
Discuss the emotional impact associated with cancer diagnosis.
Discuss communication techniques used in nursing management of the cancer patient and those
appropriate to children, adults, and the elderly.
List non-traditional methods of treatment of cancer.
Name community agencies available to the terminally ill cancer patient. Include those specific to
parents of children with cancer.
Describe the types of radiation therapy and list the side effects.
Discuss nursing care of the patient receiving chemotherapy, including the safety principles of time,
distance, and shielding.
Develop a plan to manage the nutritional needs of a patient receiving chemotherapy, with specific
problems such as: anorexia, nausea, vomiting, diarrhea, and stomatitis, fatigue, and secondary
infections.
Discuss Total Parenteral Nutrition (TPN) and reasons for its use.
List the different drugs used in treating cancer and discuss the side effects and nursing
management of patients being treated for cancer.
Teach patient self-breast exam techniques.
Material to Be Covered In This Unit:
I.
Pathology and Epidemiology of Cancer
II. Etiology of Cancer
III. Signs & Symptoms
IV. Prevention and Control
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A. Education of the Public
B. Seven warning signals
C. Diagnostic Tests
1. Laboratory Tests
2. X-Rays
3. Radioisotopes
4. Biopsy
5. Endoscopic examinations
6. Cytology
7. Ultrasound
V. Treatment
A. Surgery
B. Radiotherapy
C. Chemotherapy
D. Supportive Therapy and Emotional Support
VI. Nursing Management of a Patient Receiving Treatment
A. General Care
B. Nutrition –TPN
C. Pain Management
D. Side Effects of Treatment
VII. Nontraditional Methods of Treatment
VIII. Research
IX. Community Agencies
Clinical Application
1.
2.
3.
4.
Describe nursing care related to each of the four major types of cancer treatments.
Utilize the nursing process to care for patients with cancer during chemotherapy.
Utilize therapeutic communication when caring for patients diagnosed with cancer.
Participate in the development and implementation of a nutritional plan for the patient with cancer.
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Unit Topic: Management of Patients with Problems of the Musculoskeletal System
Unit Assignment:
Introductory Medical-Surgical Nursing:
Unit 15: Caring for the Clients with Musculoskeletal Disorders
Chapters 60-63
Introductory Maternity & Pediatric Nursing:
Unit X: The Child with a Health Disorder
Chapter 40
Behavioral Objectives: Upon completion of this unit, the student will be able to:
1.
2.
Describe five functions of the skeletal system.
Discuss common musculoskeletal disorders using the nursing process in the pediatric, adult and
elderly patient.
3. Identify 2020 National Health Goals related to musculoskeletal disorders in children.
4. Identify elements of the nursing assessment of the musculoskeletal system, including therapeutic
communication and psychological factors.
5. Describe the differences between rheumatoid arthritis and degenerative joint disease.
6. List common diagnostic and laboratory test used in the evaluation of musculoskeletal disorders.
7. Identify six types of fractures and three types of hip fractures.
8. Describe the common signs and symptoms and treatment modalities of fractures.
9. Describe two types of reduction procedures.
10. Describe crutch gaits and list elements of patient education related to using crutches.
11. Discuss the nursing care for the patient with an amputation with special emphasis on rehabilitation.
12. Identify nutritional considerations for patients with musculoskeletal disorders.
MATERIAL TO BE COVERED IN THIS UNIT:
I.
II.
III.
IV.
V.
Anatomy and Physiology review
Assessment of Musculoskeletal Function
A. Posture and gait
B.
Circulatory assessment
C.
Neuromuscular assessment
D.
5 P’s: pulselessness, parasthesia, pallor, puffiiness, pain
Diagnostic Tests
A.
Radiographic studies
B.
Endoscopic examination
C.
Aspiration
D.
Electrographic procedure
E.
Nursing Management
Nursing Process of the Adult, Elderly and Pediatric Patient
A.
Assessment
B.
Identifying problems and planning
C.
Teaching
D.
Nutritional considerations
E.
Pharmacology
F.
Special gerontologic considerations
Traumatic injuries
17
VI.
VII.
VIII.
IX.
X.
A. Sprains/Strains
B. Dislocations
C. Fractures
D. Repetitive motion disorders
Medical and Surgical Management
A.
Traction
B.
Closed reduction
C.
Open reduction
D.
Internal fixation
E.
External fixation
F.
Cast care
G.
Crutch walking (review)
Care of the Adult and Pediatric Patient with a Fracture,
A.
Nursing process
1.
Assessment
2.
Planning
3.
Implementation
4.
Evaluation
5. Teaching
B.
Complications
C.
Medical and Surgical Management
D.
Nursing Management
Inflammatory Disorders
A. Rheumatoid
B. Degenerative Joint disease
1. Drug management
2. Medical and surgical management
C. Gout
D. Bursitis
E. Osteomyelitis
F. Lupus Erythematosis
Other Orthopedic Disorders
A. Degenerative joint disease: Osteoarthritis
B. Osteoporosis
C. Osteomyelitis
D. Paget’s disease
E. Spinal curvatures
F. Rickets
Structural Disorders
A.
Low back pain
B.
Osteoporosis
C.
Osteomalacia
D.
Pagets’ disease
E.
Disorders of the feet
1. halux valgus (bunions)
2. hammertoe
F. Disorders of the upper extremities
XI. Management of Pediatric Musculoskeletal Disorders
18
A. Flat feet (Pes Planus)
B. Bowlegs (Genu Varum)
C. Knock knees (Fenu Valgum)
D. Blount disease (Tibia Vara)
E. Toeing-in
F. Growing pains
G. Osteogenesis Imperfecta
H. Legg-Calve’ Perthes disease
I. Osgood-Schlatter disease
J. Slipped Capital Femoral Epiphysis
XII. Bone Tumors
A. Benign
B. Malignant: sarcoma
XIII. Orthopedic Surgery
A.
Pre-operative
B.
Post-operative
XIV. Muscular Disorders
A. Duchenne’s Muscular Dystrophy
B. Toricollis
C. Patients in a Cast
D. Patients in Traction
XV. Amputation
A. Nursing Management
1. Emotional and Psychological Problems
2. Pre-operative and Post-operative Assessment
3. Diagnostic Tests
4. Medical Management
5. Nutritional considerations
6. Pharmacological considerations
7. Post-operative Nursing Interventions:
a. Prevent contractures
b. Phantom pain
c. Bandaging, stump shaping
d. Prosthesis
e. Patient education
f. Rehabilitation
XVI. Surgical Intervention
A. Arthroplasty: Knee & Hip
XVII. Nutritional Considerations: Pediatric, Adult, and Elderly
Clinical Application
1. Utilize the nursing process to care for a patient with a disorder of the musculoskeletal system,
including cast care, pre- and postoperative care of a patient after amputation, and care for a patient
after orthopedic surgery.
2. Identify medications commonly used for the treatment of minor musculoskeletal pain and
inflammation.
3. Identify and implement the appropriate use for musculoskeletal relaxants.
4. Compare the actions of various anti-inflammatory and muscle relaxant agents.
19
5. Describe adverse reactions frequently found in the use of anti-arthritis medications.
6. Perform an assessment to evaluate a patient with skeletal muscle disorder.
7. Implement nursing assessments to monitor therapeutic response and the development of side effects
to expect and report form skeletal muscle relaxant therapy.
8. Safely administer medications while caring for a patient with a musculoskeletal problem.
20
Unit Topic:
Management of Patients with Problems of the Endocrine System
Unit Assignment:
Introductory Medical-Surgical Nursing: Caring for the Clients with Endocrine Disorders:
Unit 12: Chapters 49-51
Introductory Maternity & Pediatric Nursing:
Unit X: Chapter 38 The Child with a Gastrointestinal/Endocrine Disorder
Nutrition Essentials for Nursing Practice
Unit Three: Nutrition in Clinical Practice
Chapter 19
BEHAVIORAL OBJECTIVES - Upon completion of this unit, the student will be able to:
1. Describe the diagnostic tests used to determine endocrine gland dysfunctions.
2. Utilize the nursing process to define the nurse’s role in assessment, implementation, and evaluation
of patient care with disorders of thyroid, parathyroid, adrenal, and pituitary gland including the child,
adolescent, and the elderly.
3. Identify 2020 National Health Goal related to childhood endocrine disorders.
4. Describe the use of pharmacologic agents in the endocrine disorders, as above.
5. Compare and contrast the nutritional effects of hyper and hypothyroidism.
6. Discuss dietary management for a patient with abnormal blood calcium.
7. Distinguish between Addison’s disease and Cushing’s disease. List types of foods used in treatment
of each.
8. List important points in communication with and teaching patients with common endocrine
disorders.
Material to Be Covered In This Unit:
I.
II.
III.
IV.
Major Endocrine Glands and Their Hormones
Diagnostic Test
Pituitary Gland Disorders
A. Disorders of the Anterior lobe
1. Growth Hormone Deficiency in
a. Children
b. Adults
2. Growth Hormone Excess in
a. Children
b. Adults
B. Disorders of the Posterior lobe
1. Syndrome of inappropriate antidiuretic hormone
2. Diabetes Insipidus
C. Pituitary Neoplasms
Thyroid Gland Disorder
A. Hyperthyroid and Hypothyroid
B. Hashimoto’s Thyroiditis
C. Simple goiter
21
V.
VI.
D. Thyroid neoplasm
1. Thyroidectomy
Parathyroid Gland Disorders
Adrenal Gland Disorders
A. Cushing’s Syndrome
B. Primary Aldosteronism
C. Addison’s Disease
D. Adrenal Neoplasms
Clinical Application
1. Identify common laboratory tests and radiology procedures performed to evaluate functioning of the
pituitary, thyroid, parathyroid, adrenals, and pancreas.
2. Define and differentiate between the major tests used to test blood glucose levels.
3. Utilize the nursing process to provide nursing care for a patient with an endocrine disorder of the
pituitary, thyroid parathyroid, and pancreas.
4. Define and differentiate between gigantism and acromegaly and SIADH and diabetes insipidus.
State at least three nursing considerations for each.
5. State pre and postoperative nursing considerations for a patient who is undergoing a thyroidectomy.
6. State the three main criteria for the diagnosis of diabetes mellitus.
22
Unit Topic:
Management of Diabetes
Unit Assignment:
Introductory Medical-Surgical Nursing: Caring for the Clients with Endocrine Disorders:
Unit 12: Chapters 49-51
Introductory Maternity & Pediatric Nursing:
Unit X: Chapter 38, The Child with a Gastrointestinal/Endocrine Disorder
Nutrition Essentials for Nursing Practice
Unit Three: Nutrition in Clinical Practice
Chapter 19 & 21
Complete study guide in this syllabus: Due first DM lecture day
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1. Relate the normal function of the pancreas and other endocrine glands to the abnormalities involved
with diabetes mellitus.
2. Differentiate types of diabetes mellitus and describe their etiology.
3. List signs and symptoms of diabetes mellitus.
4. List and describe the tests used to diagnose diabetes mellitus.
5. Differentiate between hypoglycemia and hyperglycemia symptoms and treatment.
6. Discuss diabetes Type I and state specific age-related implications, including eating habits, selfimage, and long-term effects.
7. Discuss types of insulin and explain nursing management of patients taking insulin.
8. Discus oral medications used in the treatment of diabetes mellitus, including side effects, and
nursing management.
9. Discuss the exchange lists used in the ADA plan.
10. Review the relationship between exercise and diet in the patient with diabetes.
11. Describe the complications of diabetes, including the nursing management of the diabetic with
vascular, visual, kidney, skin infections, and nervous system involvement.
12. Discuss effects of diabetes mellitus on a child’s growth.
13. Discuss the social and psychological aspects of diabetes mellitus.
14. List community resources available to the diabetic patient.
15. Discuss type II Diabetes and state specific areas or problems, which need to be addressed such as
elderly compliance, eating habits, and long-term effects.
23
Answer the following BEFORE the first Diabetes Lecture
Diabetes Mellitus Study Guide
1. What is Diabetes?
2. Define and distinguish the two types of Diabetes Mellitus.
3. List the three classic symptoms of Diabetes Mellitus.
4. Explain the source of keynotes.
5. List three laboratory methods used to diagnose Diabetes Mellitus.
6. List the methods used to treat Diabetes Mellitus.
7. Write the cause of diabetic ketoacidosis.
8. List three main goals in the treatment of diabetic ketoacidosis.
9. List two physiologic signs of hyperosmolar hyperglycemic nonketotic syndrome.
10. List the treatment of hyperosmolar hyperglycemia nonketotic syndrome.
11. Write the cause and treatment of hypoglycemia.
12. List common complications of Diabetes Mellitus.
13. Write the difference between the symptoms of hypoglycemia and hyperglycemia.
14. Be prepared to discuss the nursing management of the client with Diabetes Mellitus.
24
Material to Be Covered In This Unit:
I.
II.
III.
IV.
Pathophysiology
Incidence and Types Diabetes (DM)
Signs and Symptoms of DM
Diagnostic Tests
A.
Urine
B.
Blood
1. Types of Tests
2. Nurse’s Role
V.
Treatment
A.
Insulin
B.
Oral Hypoglycemic Drugs
C.
Diet
D.
Exercise
E.
Nurse’s Role
VI.
Complications
A.
Diabetic Ketoacidosis
B.
Hypoglycemic Reaction
C.
Hyperosmolar Hyperglycemic Nonketoti Syndrome
D.
Vascular Disturbances
E.
Visual Disturbances
F.
Neuropathy
G.
Nephropathy
H.
Skin Infection
I.
Growth Retardation
VII. Nurse’s Role
A.
Teaching
B.
Prevention
VIII.
Social and Psychological Aspects of Diabetes
IX. Research
X.
Patient Education
Clinical Application
1.
2.
3.
4.
Utilize the nursing process to care for the patient diagnosed with diabetes mellitus.
Safely and accurately administer subcutaneous insulin to the diabetic patient.
Plan a day’s menu for a 1600 ADA diet.
Participate in the development and implementation of an education plan for the patient diagnosed
with diabetes mellitus.
25
Unit Topic: Management and Care of Patients with Fluid and Electrolyte Disorders
Unit Assignment:
Introductory Medical-Surgical Nursing: Caring for the Clients with Multisystem Disorders:
Unit 4: Chapter 203
Nutrition Essentials for Nursing Practice
Unit Three: Nutrition in Clinical Practice
Chapter 21
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1. Differentiate among the fluid compartments of the body.
2. Define the components of body fluid.
3. Identify the processes by which water and dissolved chemicals are relocated.
4. Identify major electrolytes and their chief functions.
5. Explain the difference between hypovolemia and dehydration.
6. Discuss hemoconcentration and hemodilution.
7. Discuss the causes of acid base imbalance and describe the symptoms of acidosis and alkalosis.
8. Discuss the nursing management of patients with electrolyte imbalances.
9. Discuss the importance of maintaining a fluid and electrolyte balance in the pediatric patient.
10. Discuss the nursing considerations for possible electrolyte disturbances and dehydration related to
emesis and diarrhea in children.
9. Discuss the nursing management of patients’ with acid base imbalances.
10. State the primary responsibilities of the LVN in maintaining intravenous therapy.
11. Identify chemicals and organs that play major roles in regulating acid base balance.
Material to Be Covered In This Unit:
I. Distribution of Body Fluids
A. Fluid compartment
B. Regulation and transport of body fluids
II. Fluid and Electrolytes
III. Fluid Volume Assessment
IV. Disorders in Fluid and Electrolyte Balance
V. Intravenous Fluid Administration-responsibilities of the LVN
VI. Acid-Base Balance
(Hydrogen Ion Concentration)
A. Respiratory
1. Acidosis
2. Alkalosis
B. Metabolic
1. Acidosis
2. Alkalosis
VII. Nursing Management of patients with disorders of fluid/electrolyte & acid base
26
A. Pediatric
B. Adult
Clinical Application:
1. Utilize the nursing process to provide care for the patient with a fluid and electrolyte disorder across
the life span.
2. Identify abnormal laboratory findings as related to fluids, electrolytes and acid base balance.
3. Identify assessment findings in a pediatric & adult patient that are consistent with fluid volume excess
and deficit.
4. Implement nursing interventions to manage fluid volume deficit and excess for pediatric and adult
patients.
27
Unit Topic:
Management of Leadership and Professional Development
Unit Assignment:
Introductory Medical-Surgical Nursing: Nursing Roles and Responsibilities:
Unit 1: Chapter 6
Anderson’s Nursing Leadership, Management, and Professional Practice for the LPN/LVN in Nursing
School and Beyond:
Unit 1: Chapters 4(finish from first semester) & 5
Unit 2: Chapters 7 & 21
Contemporary Practical/Vocational Nursing
Unit 1: Chapter 4
Unit 3: Chapter 12
Assignments:
Leadership Style Test
Fellowship Style Test
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1. Explain the difference between professional and nonprofessional in terms of education.
2. Identify duties included in the scope of practice of various members of the nursing team.
3. Compare and contrast three styles of leadership.
4. Identify the importance of an informal leader in an organization.
5. Assess your leadership and followership skills.
6. Define nursing informatics.
7. Demonstrate basic skills needed for patient care using computers.
8. Define critical thinking.
9. Discuss the importance of developing critical thinking skills.
10. Discuss at least three aspects of delegation.
11. Describe appropriate content and documentation for a coaching session.
12. Differentiate leadership and management.
13. Describe the role of the LVN in managing client care.
14. Distinguish delegation and supervision.
15. Compare responsibility and accountability
16. Discuss methods to manage time effectively.
Material to Be Covered In This Unit:
I.
II.
III.
IV.
V.
VI.
VII.
The Graduate as a Team Leader/Team Member
Leadership Styles & Supervision
Time Management - Managed Care
Assessment
Evaluation
Guidelines for Effective Leadership & Supervision
Steps to Effective Time Management
Clinical Application
1. Participate in patient care as a team member.
28
2. Participate as a team leader in charge of 5-7 team members.
3. Safely delegate patient care activities according to scope of practice of the LVN and CNA.
29
Unit Topic:
Management of Patients with Problems of the Cardiovascular System
Unit Assignment:
Introductory Medical-Surgical Nursing: Caring for the Clients with Multisystem Disorders:
Unit 6: Chapters 22-29
Introductory Maternity & Pediatric Nursing:
Unit X: Chapter 37, The Child with a Cardiovascular/Hematologic Disorder
Nutrition Essentials for Nursing Practice
Unit Three: Nutrition in Clinical Practice
Chapter 20
Behavioral Objectives - Upon completion of this unit, the student will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Identify elements of heart disease which affect basic need status of patients.
Differentiate between normal and abnormal functions of the heart.
Differentiate between normal and abnormal structure and function of the heart and blood vessels.
Describe the etiology, pathophysiology, sign/symptoms, diagnosis, treatment and complications for
patients with cardiovascular disorders and disease.
Describe common cardiovascular disorders of childhood.
Identify 2020 National Health goals related to children with cardiovascular disorders.
Identify factors that affect cardiac output.
Identify common manifestations of altered cardiac functioning.
Describe commonly employed methods of diagnosis of heart disease and patient care, teaching and
prevention.
Describe care for children and adult undergoing diagnostic tests of the cardiovascular system.
Discuss nutritional guidelines for patients with edema and high cholesterol.
Discuss the management of congestive heart failure in the pediatric patient.
Describe preoperative and postoperative nursing care for the person undergoing cardiovascular
surgery.
Identify three techniques to correct valvular disorders.
Material to Be Covered In This Unit:
I.
II.
III.
IV.
A & P Review
Assessment of a Patient who has a Cardiac Disorder
Diagnostic Tests
A. Laboratory test
B. Angiocardiogram and arteriogram
C. Electrocardiogram
D. Stress test
E. Echocardiogram
F. Nuclear scan
G. Electro physiology study
Cardiac Catheterization
A. Hemodynamic monitoring
B. Nursing considerations
30
V.
VI.
VII.
Patient and Family Teaching
Care of Children Undergoing Cardiac Diagnostic Tests
Abnormal Conditions That May Cause Cardiovascular Disease
A. Arteriosclerosis and atherosclerosis
B. Hypertension
C. Hypotension
VIII. Heart Disorders
A. Conditions Affecting the Heart’s Rhythm
1. Cardiac Dysrhythmias
2. Atrioventricular block
3. Fibrillation
B. Conditions Affecting the Heart’s Pumping Function
1. Congestive heart failure
2. Cardiomyopathy
C.
Infectious and Inflammatory Heart Disorders
1. Chronic Rheumatic Heart Disease
2. Bacterial endocarditis
3. Pericarditis
D.
Coronary Artery Disease
1. Angina
2. Myocardial infarction
VIX. Blood Vessel Disease
A. Inflammatory Disorders
1. Thrombophlebitis
2. Embolism
B. Peripheral Vascular Disease
C. Aneurysms
D. Cerebrovascular Accident
X.
Cardiac Surgical Procedures
A. Valvular Repairs
B. Myocardial Revascularization
C. Repair of Ventricular Aneurysm
D. Repair of Heart Trauma
XI.
Nursing Management: the patient undergoing heart surgery
A. Preoperative Care
B. Intraoperative Period
C. Postoperative Care
XII. Central or Peripheral Vascular Surgical Procedures
A. Vascular grafts
B. Embolectomy and Thrombectomy
C. Endarterectomy
XII. Pediatric Management
Clinical Application
1. Utilizing therapeutic communication techniques outline educational points for rehabilitation for an
adult and elderly recovering from a myocardial infarction to include emotional and psychological
needs.
31
2. Participate in the development and implementation of a nursing care plan for the adult and the
elderly patient with cardiovascular disorders and diseases.
3. Develop a teaching plan for a patient undergoing cardiac surgery.
4. Explain the rationales for ordering the following laboratory tests: CPK, CPK-MB, troponin, and
myoglobin.
5. Utilizing the nursing process, provide pre- and post- procedural care for patients undergoing
diagnostic tests of the cardiovascular system.
6. Identify NANDA diagnoses related to the patient with a cardiovascular disease or disorder.
7. Provide care to patients with cardiovascular disease across the life span.
32
CLINICAL
COMPETENCIES
MATERNAL CHILD HEALTH
EXPECTED COMPETENCY BEHAVIORS
Level II/III
I. Health Maintenance
A. Utilized health maintenance principles:
1. Identifies and functions in clean, dirty, and sterile areas with increasing independence.
2. Explains principles of asepsis as they apply to his/her behaviors.
B. Practices safety awareness:
1. Prevents potential safety hazards by developing a safety awareness attitude.
2. Utilizes equipment and supplies according to the established standards and
procedures, independently.
3. Protects the client’s microbial safety by using basic techniques of asepsis,
incorporating them into teaching methods and evaluating their effectiveness.
4. Follows direction.
5. Utilizes good body mechanics.
6. Reports all accidents or injuries of self or patient to instructor or appropriate staff.
7. Provides unit preparedness without direction.
8. Assists in a meaningful manner in an emergency situation.
9. Utilizes specific equipment and/or instruments with increasing proficiency.
C. Participates in health teaching:
1. Identifies potential teaching needs with increasing independence.
2. Recognizes own limitations and seeks other sources for assistance.
3. Relates and evaluates a specific teaching incident.
4. Provide relevant information of resources available to patients/families.
D. Identifies and adapts nursing care to alternative health concepts encountered:
1. Cultural development differences.
2. Nontraditional methods of therapy.
E. Utilizes knowledge of growth and development principles:
1. Expresses an awareness of the methods and parameters utilized in the assessment of
the well infant/child.
2. Identifies own role as client’s advocate in achieving and maintaining wellness.
3. Assists in providing an environment of the maximal potential.
4. Recognizes the importance of the family and integrates its role into the planning and
implementation of care.
F. Utilizes knowledge of basic nutrition:
1. Researches orders and identifies appropriate formula, feeding, or menu for patients.
2 Selects appropriate foods dependent upon assessment of present status of patients.
3. Identifies and assists with appropriate feeding method.
4. Utilizes appropriate criteria for the evaluation of the individual’s nutritional status.
5. Expresses knowledge of available community programs that provide nutritional
assistance for patients.
33
II. Nursing Process
A.
Assessment:
1. Utilizes acceptable methods for obtaining health data.
2. Utilizes knowledge of normal anatomy and physiology to help detect deviations from
normal.
3. Assists in the identification of the patients needs.
4. Shares data with appropriate team members in the formulation of a plan of care.
B. Planning:
1. Utilizes assessment data in planning care.
2. Correlates and applies principles of care in the management of individual need or
differences.
3. Utilizes priorities in developing a plan of care.
4. Develops a nursing care plan according to individual needs and resources available.
C. Implementation:
1. Initiates a plan of care with increasing independence.
2. Utilizes acceptable procedures.
D. Evaluation:
1. Demonstrates the ability to relate care to defined goals.
2. Charts concisely, utilizing appropriate forms, spelling, grammar, and medical
terminology.
3. Reports significant findings to the appropriate personnel and participates in
future assessments.
III. Interpersonal Relationships
A. Refrains from imposing own values on others and protects patient’s right to privacy.
B. Recognizes individuality of each person.
C. Demonstrates acceptable conduct while communicating with patients, families, staff,
and/or instructor.
D. Incorporates verbal and nonverbal communication in developing a therapeutic
environment.
IV.
Vocational Nursing Role
A. Exhibits awareness of own role.
B. Recognizes ethical/legal responsibilities.
C. Identifies roles of other health providers.
D. Asserts self when necessary.
E. Functions as a team member.
F. Assignments
1. Demonstrates an ability to complete multiple assignments of relatively
stable patients.
2. Demonstrates an ability to provide care in a semi complex and/or complex situation
with direct supervision.
3. Demonstrates knowledge of community resources available to all patients.
G. Organization
1. Plans and proceeds in sequential, but flexible, manner.
2. Completes assignment(s) in time allotted.
3. Sets appropriate priorities.
H. Learning
1. Researches appropriately and independently.
34
I.
J.
2. Identifies and utilizes learning opportunities.
Researches, identifies, administers, and records medications, according to established
techniques, with supervision.
Demonstrates dependability of work habits.
1. Adheres to attendance policy guidelines.
2. Adheres to student dress code.
3. Submits satisfactory written reports and documents on time.
Revised 1/11
35
Grossmont Vocational Nursing
Medical Surgical Nursing
Expected Competency Behaviors
Level II/III
I. Health Maintenance (Adult & Geriatric)
A. Utilizes health maintenance principles
1. Functions safely in sterile clean, and contaminated areas with
increasing independence
2. Explains and interprets principles of infection control and asepsis
B. Practices safety awareness
1. Considers patients’ safety needs based on age, situation, and
environment
2. Recognizes actual and potential situational/environmental hazards to patient safety
3. Utilizes commonly used equipment and supplies according to established standards
and procedures, independently
4. Utilizes unfamiliar or infrequently-used equipment and supplies with increasing
proficiency
5. Follows directions according to established policies
6. Practices proper body mechanics
7. Reports all accidents or injuries of self or patient to instructor and/or appropriate staff
8. Acts quickly and appropriately in response to emergency situations
C. Participates in health teaching
1. Identifies potential learning needs of patients with increasing independence
2. Recognizes own limitations in the teaching role and seeks other sources for assistance
3. Considers individual differences in planning and implementing teaching in the hospital
or community health setting
4. Shares teaching plan with instructor and/or staff to validate acceptability prior to
implementation
5. Evaluate effectiveness of patient teaching
6. Supports and reinforces teaching of patients and families
D. Adapts nursing care
1. Recognizes and communicates need to adapt nursing care to patients of differing
beliefs and cultures
2. Demonstrates awareness of nontraditional methods of therapy
3. Recognizes the importance of family and other support systems to well-being of
patients, and considers them in plan of care
E. Utilizes concepts from Growth and Development theories
1. Recognizes health care needs based on developmental needs of infants, children, and
mothers
2. Recognizes own strengths and limitations in directing patient toward her/his greatest
potential for health or well-being
F. Utilizes knowledge of basic and therapeutic nutrition
1. Researches diet order and facilitates intake of nutrients within parameters of diet order
2. Contrasts patients’ nutritional needs with actual intake, absorption, and utilization of
nutrients
3. Assists in selection of appropriate and nutritive foods and appropriate feeding method
4. Considers psychosocial impact to patients experiencing digestive disturbances
36
5. Accurately and promptly reports changes in intake or food tolerance
II. Nursing Process
A. Participates in assessment process
1.
Independently employs acceptable and previously-taught methods for obtaining
patient data
2.
Seeks both subjective and objective data to identify and validate patient strengths
and problems
3. Organizes and interprets data to substantiate patient problems in basic need
categories
4.
Shares data with instructor or appropriate staff member to validate conclusions
and/or interpret complex data
5.
Reports changes from previously-reported signs and symptoms promptly
6.
Assumes responsibility for regular ongoing assessment of patient status throughout
clinical day
B. Contributes to plan of care
1. Collaboratively formulates realistic, achievable, and measurable goals for patient care
outcomes of stable patients
2. Sets expected outcomes based on identified actual and potential problems
3. Prioritizes documented problems and goals in formulating plan of care
4. Considers situational and environmental factors in formulating plan of care
5. Collaborates with instructor/staff to suggest alterations of existing nursing measures,
when patient status changes
6. Considers available resources while planning care for patient in the hospital or
community health setting
C. Implements plan of care
1. Adheres to established plan of care
2. Performs nursing measures independently with the scope of practice
3.
Performs unfamiliar or infrequently-prescribed nursing measures with increasing
proficiency under supervision
4. Cites rationale for nursing interventions
5. Adapts commonly-prescribed nursing measures to meet basic needs of home-care
patients, with supervision
6. Demonstrates concern for patients’ total needs during performance of nursing tasks
7. Participates in rehabilitation strategies
D. Contributes to evaluation of patient care outcomes
1. Lists and/or verbalizes patient data that will measure effectiveness of care given
2. Reports appropriate patient care outcomes promptly
3. Gives coherent, comprehensive, organized verbal report to appropriate staff following
care
4.
Completes documentation of care on appropriate hospital forms in a timely manner,
prior to leaving clinical area
5. Uses acceptable abbreviation and medical terminology in documentation
6. Includes pertinent observations, care given, and patient’s responses to care in
documentation
III. Clinical Pharmacology
A. Identifies and describes classification, action, and therapeutic and side effects of
medications
37
B. Administers and records medications according to accepted procedures, with
supervision
C. Employs appropriate, assessment measures to determine effect of drug on patient
D. Reports promptly changes in patient signs and symptoms that may suggest adverse
effects of prescribed medications
E. Demonstrates knowledge of prescribed medications and correlates nursing considerations
and interventions in patient care
IV. Interpersonal Relationships
A. Practices effective communication
1. Refrains from imposing own values on others
2. Recognizes uniqueness of each person
3. Establishes and maintains trust of staff, patients, families, and instructor
4. Incorporates principles of therapeutic communication in interaction with patients
5. Maintains objectivity in collecting and interpreting data
6. Uses assertiveness skills appropriately
7. Accepts constructive criticism
B. Adheres to professional ethics in all settings
C. Seeks assistance and direction, when needed. Clarifies direction with instructor/staff
V. Vocational Nursing Role
A. Accepts increasingly complex role
1. Regularly and independently continues to evaluate own performance
2. Recognizes legal/ethical implications of own behavior
3. Distinguishes between her/his present and emerging role in a hospital vs. home-care
setting
4. Uses wide variety of resources in independent research
5. Seeks out learning opportunities
6. Gives safe, thorough care in multiple patient assignments
7. Prioritizes and organizes care in multiple patient assignments
8. Uses nursing process in care-giving role to complex, unstable patients, under direct
supervision
9. Functions effectively as a team leader
B. Demonstrates dependable work habits
1. Consistently follows directions
2. Consistently arrives on time to clinical site prepared to begin assignments in
accordance with attendance policy guidelines
3. Notifies instructor and/or clinical site of tardiness or absenteeism
4. Demonstrates professionalism in appearance and behavior, adhering to student policies
5. Participates in a positive manner, in clinical conferences and activities
6. Applies appropriate problem solving skills during the performance of clinical activities
7. Functions as a cooperative team member
8. Uses correct grammar and spelling in all written work
Rev. 1/05
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