Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
1. NURSING 1202 STUDY GUIDE UNIT 1-MEDICATION ADMINISTRATION LECTURE CONTENT 1. Describe the ways drugs are identified//classified. 2. Identify and compare resource materials available for gaining knowledge of medications. 3. Describe the nurse's legal responsibilities in drug administration. 4. Describe the physiological mechanisms of drug action, including absorption, distribution, metabolism, and excretion. 5. Describe the effects & the interactions of drugs which nurses need to assess. 6. List and explain the variables influencing drug actions. 7. Discuss the involvement of the nursing process in the administration of medication. LAB CONTENT 1. Discuss the methods of drug delivery. 2. State the factors to consider in choosing the various routes of drug administration. 3. Interpret a drug order and the nursing responsibilities involved. 4. List the steps of setting up patients' medications. CLINICAL ACTIVITIES 1. Demonstrate ability to accurately calculate dosages for all routes of medication administration. 2. Prepare to correctly identify any drug administered to your assigned patients in clinical. 3. Assess each patient's need for and response to drug therapy across the life span. 5. State and practice the "RIGHTS" of drug administration. 4. Properly record all drugs administered. 6. State the steps required to administer oral meds safely to any age group. 5. Safely dispose of contaminated medication equipment used in the administration procedure. 7. Discuss important nursing considerations for safe drug administration via oral, topical, ophthalmic, otic, nasal, inhalation, vaginal, and rectal. 6. Be prepared to relate the drug information that was discussed in class to clinical patient care. 8. Identify the correct equipment required for injections. 7. In the clinical setting, give complete nursing care to one patient, including all medications except intravenous. 9. State the essential steps in mixing selected drugs from vials & ampules. 10. Precisely locate the sites for ID, subQ, & IM injections. 11. Demonstrate how to correctly assess for, draw up, & administer insulins. 12. State the rationales of the steps necessary to safely administer injections to any age group. INDEPENDENT ACTIVITIES KEY: Required Suggested NOTE: For computer assisted instruction marked with a # , students must complete the program with a score of 80% and turn in the printout from the quiz to their clinical instructor prior to the first hospital clinical (10/28 or 11/4). Read Kozier, Erb, Berman & Snyder Fundamentals of Nursing (FON): Ch. 33: p. 785 - 832 (excluding p. 811 nasogastric & gastrostomy meds) and p. 841-851. Read Key & Hayes Pharmacology: Ch. 1-5: p. 2 – 111. Video: Avoiding Medication Errors (KIT. RM 146.A961989) Video: Medicating Children (KIT. RJ560.M4P3) #CAI - Delmar’s: Administering Oral Sublingual, and Buccal Medications #CAI - Delmar’s: Administering Eye and Ear Medications #CAI - Delmar’s: Administering Skin/Topical Medication #CAI - Delmar’s: Administering Nasal Medication #CAI - Delmar’s: Administering Rectal Medication #CAI - Delmar’s: Administering Vaginal Medication #CAI - Delmar’s: Administering Nebulized Medication 1 13. Discuss case studies, according to instructor's preference. TEST # 1 #CAI - Delmar’s: Administering an Intradermal Medication #CAI - Delmar’s: Administering a Subcutaneous Medication #CAI - Delmar’s: Administering an Intramuscular Medication #CAI - Delmar’s: Administering Medications via Z-Track Injection #CAI - Delmar’s: Withdrawing Medication from a Vial #CAI - Delmar’s: Withdrawing Medication from an Ampule #CAI - Delmar’s: Mixing Medications from Two Vials into One Syringe Complete FON Study Guide: Ch. 33. Complete Pharmacology Study Guide: p. 1-49. CAI – PDS - Clinical Nursing Concepts- Parenteral Routes CAI – PDS - Clinical Nursing Concepts- Non-parenteral Routes 2 UNIT 2-SPECIFIC DRUG CATEGORIES LECTURE CONTENT 1. Insulin: a. State the method by which insulin is given and why. b. Identify the classifications of insulin & some of the common types used. c. Discuss the dosages, storage, and administration of insulins. d. Discuss what you would do when an insulin reaction occurs. 2. Pain relievers / Anti-Inflammatories a. Identify the 3 classifications of analgesics. b. Identify how narcotics are controlled. c. Identify the classifications, actions, side effects, and nursing implications of the most common narcotic analgesics. d. Identify the classifications, actions, side effects, and nursing implications of the most common agonist-antagonists. LAB CONTENT CLINICAL ACTIVITIES 1. Be prepared to relate the drug information to patient care that was discussed in class. INDEPENDENT ACTIVITIES Read Pharmacology: Ch. 48: p. 733-748. Ch. 18: p. 258-275. Ch. 26: p. 372-381. Ch. 27: p. 391-406. Ch. 28: p. 407-422. Ch. 29: p. 423-429. Ch. 30: p. 433-434, 436-440. Also read Davis’s handbook for the drugs discussed in this unit. #CAI - Delmar’s: Administering Patient-Controlled Analgesia CAI - Delmar’s: Administering Epidural Analgesia CAI - Delmar’s: Managing Controlled Substances CAI - Delmar’s: Assisting with the Insertion and Maintenance of an Epidural Catheter Complete Pharmacology Study Guide: Video: Pain Management: Pharmacologic Treatment Strategies (KIT.RB 127.P37 2002v2) CAI – Mastering Clinical Skills: Epidural Analgesia CAI – Mastering Clinical Skills: Patient Controlled Analgesia e. Describe patient-controlled analgesia and the nursing implications. f. Describe epidural pain control and the nursing implications. g. Discuss the types adjuvants & the purposes of using them 3 h. Describe the use of NSAIDs, side effects, & the nursing implications.. i. Apply the nursing process to the use of pain relievers. 3. Anti-Infectives a. Define terms related to antiinfectives b. Discuss how an anti-infective is chosen. c. Nursing implications with antiinfectives. d. Know the 5 ways antibiotics are grouped based on their mechanism of action. e. Identify the actions, side effects, and nursing implications of the following classifications of antiinfectives: i. Beta-lactam antibiotics ii. Cephalosporins iii. Vancomycin iv. Fluoroquinolones v. Aminoglycosides vi. Sulfonamides vii. Tetracyclines viii. Macrolides ix. Common miscellaneous anti-infectives f. Identify the actions, side effects, and nursing implications of common antifungals. g. Discuss Complementary antiinfectives. TEST #2 4 UNIT 3-ELIMINATION LECTURE CONTENT 1. Urinary elimination a. Describe the functions of: nephron, glomerular filtrate, bladder, urethra, urinary meatus. b. Understand the physiological process of urine production. c. State several factors that affect normal elimination. d. Compare and contrast common alterations in urinary elimination patterns. e. List and explain the data needed to assess a person's urinary function: nursing history, physical assessment and urine assessment. f. Describe some common diagnostic measures and nursing implications to assess the urinary system. g. Describe some common interventions to maintain normal urinary elimination and to assist patients with urinary problems of urinary incontinence and retention. h. Discuss nursing measures to reduce UTI in the catheterized patient. LAB CONTENT CLINICAL ACTIVITIES 1. Describe how to collect a urine specimen that is a clean-catch and from a foley. 1. Routinely assess assigned patients for normal urinary elimination. 2. Describe how to apply an external catheter. 2. Identify nursing diagnoses appropriate for alterations in urinary elimination. 3. Discuss types of urinary catheters and their purposes: a. straight b. foley catheter c. 3-way catheter 3. Appropriately apply nursing measures to attain normal urinary elimination. 4. When given the opportunity, properly obtain urine specimens for the lab. 4. Discuss the following procedures: a. Inserting a urinary catheter. b. Care of the catheters c. Removing a urinary catheter. d. Self-catheterization 5. When given the opportunity, properly obtain urine specimens for the lab. 5. Discuss urinary irrigations. 7. Understand the physiological aspects of normal defecation. 6. Using 100% aseptic technique, demonstrate the insertion of a urinary catheter. 6. Provide good catheter care to all patients with retention catheters. STUDENT ACTIVITIES Read FON: Ch. 47: p. 1256-1288. CAI - Delmar’s: Applying a Condom Catheter #CAI - Delmar’s: Inserting an Indwelling Catheter :Male #CAI - Delmar’s: Inserting an Indwelling Catheter: Female CAI - Delmar’s: Routine Catheter Care CAI - Delmar’s: Obtaining a Residual Urine Specimen from an Indwelling Catheter CAI - Delmar’s: Irrigating a Urinary Catheter CAI - Delmar’s: Irrigating the Bladder Using a Closed-System Catheter CAI - Delmar’s: Removing an Indwelling Catheter CAI - Delmar’s: Testing Urine for Specific Gravity, Ketones, Glucose, and Occult Blood CAI - Delmar’s: Collecting a CleanCatch, Midstream Urine Specimen Complete FON Study Guide: Ch. 47. Video: Urethral Catheterization (KIT. RC901.7.C2 B2) CAI – Mastering Clinical Skills: Urinary Catheters 5 2. Fecal elimination a. Discuss factors which influence fecal elimination. b. Describe some common fecal elimination problems. c. List and explain the data needed to assess fecal elimination function: history, physical assessment, fecal characteristics, and diagnostic tests. d. Describe some nursing measures that promote regular defecation and relieve problems. 7. Explain the steps to perform the following: a. Guaiac test for occult blood. b. Administer an S.S. or saline enema. c. Adminster a Fleets enema. d. Remove a fecal impaction 8. Describe what a rectal tube is and its purposes. 8. Routinely assess assigned patient’s fecal elimination patterns for malfunctions. 9. Identify nursing diagnoses related to alterations in elimination. 10. When given the opportunity, properly obtain fecal specimens for the lab. 11. Appropriately apply nursing measures that will maintain or attain normal fecal elimination. Read FON: Ch. 46: p. 1225-1253. CAI - Delmar’s: Testing for Occult Blood with a Hemoccult Slide #CAI - Delmar’s: Administering an Enema CAI - Delmar’s: Digital Removal of a Fecal Impaction CAI - Delmar’s: Inserting a Rectal Tube CAI - Delmar’s: Irrigating and Cleaning a Stoma CAI - Delmar’s: Changing a Bowel Diversion Ostomy Appliance: Pouching a Stoma CAI - Delmar’s: Managing Irritated Peristomal Skin e. Differentiate between an ileostomy and a colostomy. f. Discuss how to change a bag on an ileostomy or colostomy. Complete FON Study Guide: Ch. 46 Video: Cleansing Enemas (KIT. RT87.E5 B3) TEST #3 6 UNIT 4-FLUIDS AND ELECTROLYTES/ACID BASE BALANCE CLASSROOM 1. Describe body fluid distribution and composition. 2. Define the terms: isotonic, hypotonic, and hypertonic fluids. 3. Explain the various types of fluid movement: diffusion, osmosis, filtration, and active transport. 4. Discuss the factors which affect the body's fluid balance. 5. List the clinical features of evaluating a patient's fluid status: history, physical assessment, & diagnostic tests. 6. Discuss the assessment of a patient in hypovolemic shock. 7. Discuss fluid deficits and excesses in various age groups. 8. Differentiate the major electrolytes of the body and the importance of each. 9. Discuss some major factors which affect the body's electrolyte balance. 10. List and explain the data needed to assess a patient for an electrolyte imbalance: history, physical assessment, and lab tests. 11. Discuss some clinical cases of electrolyte imbalances. LAB CONTENT 1. . 1. Identify and describe the essential parts of IV infusion equipment. 2. Discuss the physiological and psychological considerations that are important in parenteral administration. 3. Demonstrate the following parenteral procedures: a. Change primary IV solutions. b. Change primary IV tubing. c. Maintain the IV infusion. d. Regulate the infusion flow rates. e. Change IV dressings. f. Discontinuing IV infusions. 4. Discuss the procedures: a. Administrating an IVPB. b. Administrating an IVP. 5. Identify the types of mechanical problems that are commonly encountered with IV infusion systems and the appropriate nursing measures to cope with them. 6. Accurately document initiation of IV procedures, nursing interventions related to IV therapy, and assessment of the patient receiving an IV infusion. CLINICAL ACTIVITIES STUDENT ACTIVITIES 1. Accurately assess your assigned patients for fluid and electrolyte imbalances. Read FON: Ch. 50: p. 1351-1368 and 1404 -1406. . Read Pharmacology: Ch. 14: p. 203220. CAI - Mosby’s: Fluids and Electrolytes CAI - Delmar’s: Preparing an IV Solution CAI - Delmar’s: Adding Medications to an IV Solution CAI - Delmar’s: Administering Medications via Secondary Administration Sets CAI - Delmar’s: Administering Medications via IV Bolus or IV Push CAI - Delmar’s: Administering Medications via Volume-Control Sets CAI - Delmar’s: Preparing the IV Bag and Tubing CAI - Delmar’s: Setting the IV Flow Rate CAI - Delmar’s: Assessing and Maintaining an IV Insertion Site CAI - Delmar’s: Changing the IV Solution CAI - Delmar’s: Discontinuing the IV and Changing to a Saline or Heparin Lock CAI - Delmar’s: Changing the IV Gown #CAI – PDS - Clinical Nursing Concepts & Skills - Fluid & Electrolyte Balance, 2 scenarios #CAI – PDS - Clinical Nursing Concepts & Skills – Acid-Base Balance, 4 scenarios 2. Determine if your patients are in an acid-base imbalance. 3. When the opportunity arises, be prepared to: a. Assemble the proper equipment & solutions for IV administration. b. Change IV tubing as indicated using aseptic technique. c. Change IV dressings as indicated using aseptic technique. d. Discontinue IV infusions. 4. Routinely calculate assigned patients' IV flow rates & regulate as indicated. 5. Routinely observe for any patient complications or mechanical malfunctions during parenteral therapy and apply the correct nursing measures. 7 12. Describe pH as related to the body's acid-base balance. 13. Discuss the 3 major body regulators for acid-base balance. 14. Discuss the 4 major acid-base imbalances and how to assess a patient's status. 15. Discuss some clinical cases of acidbase imbalances. 16. Identify the purpose, uses, and legal implications of IV therapy. Complete FON Study Guide: Ch. 50 Complete Pharmacology Study Guide: Ch. 14. Video: Assessing fluids and electrolytes. KIT.RC630.M31989X Video: Signs & symptoms of fluid & electrolyte imbalances. RD52.F59 S54 2002 Video: Maintaining the IV System (KIT. RM 170.M35 1994) Video: Detecting & Managing IV Therapy Problems (KIT. RM170.D4) 17. Differentiate the types of isotonic, hypotonic, & hypertonic solutions commonly used in IV therapy. 18. Discuss some common IV medications and how to administer them. TEST #4 8 UNIT 5-PERIOPERATIVE CARE & OXYGENATION LECTURE CONTENT 1. Preioperative Care a. Describe the ways surgeries are classified. b. Discuss factors that increase surgical risks in patients. c. List and explain the data to include in the preop assessment of a surgical patient: history, physical assessment, and diagnostic tests. d. Identify the essential features of an informed consent for a surgical procedure. e. List and explain the nursing responsibilities for the patient prior to surgery. f. Discuss the required content of preop teaching. g. Identify the common types of anesthesia that may be used in surgery. h. Describe the effects of general and regional anesthesia. i. Discuss the SN role in the OR. LAB CONTENT 1. . 1. Discuss the reasons for GI intubation. 2. Explain the uses of the commonly used types of GI intubations. 3. Discuss the following procedures: a. Inserting an N/G tube. b. Charting, nursing Dx & nursing orders. c. Removing an N/G tube. d. Irrigating an N/G or feeding tube. e. Maintaining an N/G or feeding tube. f. Review giving meds per tube. g. Avoiding complications that commonly occur with them. 4. Identify the assessment data pertinent to wounds. 5. Discuss the types of drains most often seen with wounds. 6. Discuss the nursing responsibilities involved with sutures. 7. Discuss how to properly clean and dress a wound: a. Sterile dressing change. b. Irrigating a wound. c. Packing a wound. d. Wet-to-dry dressings. e. Securing dressings. 8. Discuss the proper procedure for irrigating a wound. CLINICAL ACTIVITIES 1. When the opportunity arises, be prepared to use the techniques of GI intubation, irrigation, and feeding. 2. With the opportunity, be prepared to : a. Provide appropriate preop teaching. b. Prepare pt's skin before surgery. c. Adequately prepare & record patient’s care on the day of surgery. d. Accompany patients to surgery. e. Accompany patients to the PAR. 3. When given the opportunity, be prepared to: a. Assess pertinent data of the patient's postop condition and accurately record it. b. Prepare a postop nursing care plan. c. Provide nursing measures to relieve postop discomfort and prevent complications. 4. When given the opportunity, be prepared to: a. Identify & gather proper dressing materials. b. Appropriately assess a wound. c. Change a dressing using aseptic technique, securing it well. d. Irrigate or pack a wound using aseptic technique. e. Remove skin sutures. f. Accurately record observations of wound care and nursing care. INDEPENDENT ACTIVITIES Read FON: Ch. 35: p. 897-934, Ch. 34: p. 856-894, Ch. 45: p. 1205-1220, and Ch. 33: p. 811. Read nutrition book on postop diets. CAI – Delmar’s: Applying moist Heat CAI – Delmar’s: Applying Dry Heat CAI – Delmar’s: Applying Cold Treatment CAI – Delmar’s: Applying Antiembolic Stockings CAI – Delmar’s: Applying Pneumatic Compression Device CAI – Delmar’s: Assisting with a Continuous Passive Motion Device CAI – Delmar’s: Administering Preoperative Care CAI – Delmar’s: Preparing A Surgical Site #CAI – Delmar’s: Assessing Immediate Postoperative Care CAI – Delmar’s: Postoperative Exercise Instruction CAI – Delmar’s: Inserting and Maintaining a Nasogastric Tube CAI – Delmar’s: Assessing Placement of a Large Bore Feeding Tube CAI – Delmar’s: Assessing Placement of a Small Bore Feeding Tube CAI – Delmar’s: Removing a Nasogastric Tube CAI – Delmar’s: Feeding and Medicating via a Gastrostomy Tube 9 j. List the nursing responsibilities involved in the immediate postop period and the significance of each. k. Identify postoperative complications, their causes, and the nursing interventions to prevent them. l. Define types of wounds and the phases of the healing process. m. Identify factors that inhibit wound healing and measures to promote the healing process. n. Describe the nursing process involved with the care of wounds. o. Describe the complications of wound healing. 9. Review the correct application of heat/cold to an injured part. 5. Demonstrate the proper applications of 10. List the important data to record on any wound care. 6. In the clinical setting, use appropriate safety measures when applying heat or cold applications to patients. 11. Discuss assigned case studies according to the instructor's preference. bandages and binders. CAI – Delmar’s: Maintaining Gastrointestinal Suction Devices CAI – Delmar’s: Irrigating a Wound CAI – Delmar’s: Packing a Wound CAI – Delmar’s: Cleaning and Dressing a Wound with an Open Drain CAI – Delmar’s: Dressing a Wound with Retention Sutures CAI – Delmar’s: Maintaining a Closed Wound Drainage System CAI – Delmar’s: Care of the Jackson-Pratt Drain Site and Emptying the Drain CAI – Delmar’s: Removing Skin Sutures and Staples CAI – Delmar’s: Preventing and Managing the Pressure Ulcer CAI – Delmar’s: Applying a Pouch to a Draining Wound CAI – Delmar’s: Applying ABD, Tor Breast Binders Complete FON Study Guide: Ch. 33, Ch. 34, & Ch. 35. Video: Pre & Postoperative Care(KIT.RD49.B3) Video: Surgical Wound Care (KIT. RD52.W6B3) Video: Closed Suction - Wound Drainage (KIT.RD51.B3) Video: Nasogastric Intubation (KIT.RT87.157 B3) CAI -Mastering Clinical Skills: GI tubes CAI -Mastering Clinical Skills: Enteral Feedings CAI – PDS - Clinical Nursing Concepts: Perioperative Care, CAI – PDS - Clinical Nursing Concepts: Inflammation, Infection, and Wound Healing 10 2. Oxygenation a. Define terms related to oxygenation. b. Describe factors which affect oxygenation. c. Describe the nursing assessment data that determines a patient's oxygen needs. d. Identify common diagnostic tests for oxygen deficits and explain their value in developing a nursing care plan. 12. Discuss the procedures of: a. Oximetry. b. Oropharyngeal / nasopharyngeal suctioning. c. Incentive spirometer. d. Caring for a pt with a nasal cannula. e. Caring for a pt with a simple face mask. f. Using the Venturi mask. 7. Routinely assess and properly record your assigned patients' oxygen needs. 8. When given the opportunity, a. Collect and send sputum specimens to the lab. b. Take oximetry readings. c. Perform adequate suctioning for assigned patients. d. Teach correct use of spirometry. e. Provide nursing measures for patients with oxygen administration. Read FON: Ch. 48: p. 1291-1315, p. 1318-1322, and p. 1325-1329. CAI - Delmar’s: Administering Oxygen Therapy CAI - Delmar’s: Assisting a Client with Controlled Coughing and Deep Breathing CAI - Delmar’s: Assisting a Client with an Incentive Spirometer CAI - Delmar’s: Administering Pulse Oximetry Video: Respiratory Suctioning (KIT.RC735.15 R3121993) e. List and provide the rationales for measures to maintain or attain normal respiratory function. f. Utilize the nursing process in planning the care of the patient with oxygenation needs. FINAL TEST!!!!!!!! Complete FON Study Guide: Ch 48. CAI - Delmar’s: Administering PulmonaryTherapy and Postural Drainage CAI - Delmar’s: Administering Intermittent Positive-Pressure Breathing Video: Respiratory Therapy: Intro for Nurses(KIT.RM161.R3151993) CAI - Mastering Clinical Skills: Oxygen Administration CAI - Mastering Clinical Skills: Pulse Oximetry 11