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TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Packet Guide Spring 2013 SECTION Table of Contents 1 ONE Class / Topic / Exam Blueprint 3 TWO Course Overview Instructors Textbooks And Other Materials System For Student Grading And Evaluation Percentage Grade Calculation Clinical Performance Description Of Course Requirements Student Performance Evaluation Profile Policies And Procedures For Nur 2433 Preparation For Scheduled Learning Experiences Student Contract 4 6 6 7 9 10 11 12 14 16 20 THREE Theory Learning Maps 21 FOUR Learning Activities Laboratory Learning Map A Medication Dosage Computation Exam Self-Learning Guide Dosage Calculation Learning Activity 41 42 43 FIVE Acute Care Practicum - Pediatric Clinical Experience Acute Care Clinical Practicum Learning Maps Child Health Assessment Nursing Plan of Care Evaluation Criteria Student Performance Evaluation Profile (SPEP) 50 54 61 75 77 SIX Learning Map for Developmental Observation Experiences Agency Information for Developmental Observation Experiences CDC Developmental Assessment Observation Report Grid Child Development Center Developmental Assmt. Grading Form Child Development Center - What You May See Guidelines - Little Lighthouse Report Little Lighthouse Observation Report Grading Form Wellness Exploration Learning Activity Wellness Exploration Learning Activity Grading Form 79 80 81 82 83 84 87 88 89 1 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SEVEN EIGHT 2 Spring 2013 Appendices Videos Related To Care Of Children Preparation Resourses Revisions Individual Student Test Analysis Grading Forms Learning Activities Laboratory Skill Demonstration #1 Forms for Learning Activities Lab Clinical Forms for Day 1 Child Health Assessment #1 Concept Map Care Plan Evaluation Form #1 Concept Map Care Plan Evaluation Form #2 Student Performance Evaluation Profile (SPEP) #1 Student Performance Evaluation Profile (SPEP) #2 Clinical Forms for Day 2 Child Health Assessment #2 Concept Map Care Plan Evaluation Form #1 Concept Map Care Plan Evaluation Form #2 Clinical School Experience Clinical Forms for CDC, LLH, & WELA Child Development Center Dev. Assmt. Grading Sheet #1 Child Development Center Dev. Assmt. Grading Sheet #2 CDC Developmental Assessment Observation Report Grid Little Lighthouse Observation Report Grading Sheet #1 Little Lighthouse Observation Report Grading Sheet #2 Wellness Exploration Learning Activity Grading Form Student Agreement of Understanding 91 92 94 96 97 98 99 108 109 123 125 127 129 131 132 146 148 150 155 156 157 158 159 160 161 163 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION ONE CLASS 1 TOPIC Physical Development & Assessment Martin Luther King, Jr. Holiday 2 3* 4 5 6 7 8 9 10 11 Nursing Interventions & Variations for the Pediatric Client Communication: Social, Cultural, & Religious Influences* (View Streaming Video PRIOR to Class) Health Promotion: Infant & Family Health Promotion: Toddler Health Promotion: Pre-School Health Promotion: School Age Health Promotion: Adolescent Pediatric Pharmacology* (View Streaming Video PRIOR to Class) Nursing Care of Children with Alterations in Elimination Nursing Care of Children with Alterations in Elimination Exam # 1 (for Classes 1-8 Only) 12 13 14 15 16 17 Nursing Care of Children with Respiratory Dysfunction Nursing Care of Children with Respiratory Dysfunction Nursing Care of Children with Cardiovascular Dysfunction Nursing Care of Children with Cardiovascular Dysfunction Nursing Care of Children with Integumentary Dysfunction Nursing Care of Children with Hematological & Immunologic Dysfunction SPRING BREAK 18 Nursing Care of Children with Alterations in Mobility 19 Nursing Care of Children with Alterations in Mobility 20 Nursing Care of Children with Cognitive & Sensory Dysfunction 21 Nursing Care of Children with Cognitive & Sensory Dysfunction Exam # 2 (for Classes 9-17 Only) 22 23 24 25 Nursing Interventions for Cerebral Dysfunction Nursing Interventions for Cerebral Dysfunction Nursing Care of Children with Endocrine Dysfunction Nursing Care of Children with Endocrine Dysfunction 26 Chronic Illness, Disability, and End of Life Care Exam # 3 (for Classes 18-26 Only) HESI Exam Final Exam - Comprehensive 3 Spring 2013 DATE Jan 14 (Wk. 1) Jan 21 (Wk. 2) Jan 28 (Wk. 3) Feb 4 (Wk. 4) Feb 11 (Wk. 5) Feb 18 (Wk. 6) Feb 22 (Wk. 6) Feb 25 (Wk. 7) Mar 4 (Wk. 8) Mar 11 (Wk. 9) Mar 18-22 Mar 25 (Wk. 10) Apr 1 (Wk. 11) Apr 5 (Wk. 11) Apr 8 (Wk. 12) Apr 15 (Wk. 13) Apr 22 (Wk. 14) Apr 29 (Wk. 15) May 3 (Wk. 15) May 6 (Wk. 16) TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION TWO: COURSE SYLLABUS/PACKET I. II. PLACEMENT: Level 3—Nursing Curriculum CREDIT HOURS: Three (3) - The credit hours are allocated as follows: 1.9 credit hours of Theory 1.1 credit hour of Laboratory/Clinical Practicum, including: 10 hours - Learning Activities Laboratory 12 hours – Acute Care Clinical Experience 6 hours – Clinical School Nurse Experience 8 hours - Child Development Experience 2 hours – Wellness/Health Promotion Exploration Learning Activity 10 hours - Unit and Final Examinations, Collaborative Exams, & Exam Reviews 2 hours – HESI Exam III. COURSE PREREQUISITES: NURS 1457 Nursing of Adults with Major Health Disruptions NURS 1421 Nursing Issues and Perspectives 2 BIO 2164 Microbiology PSY 2023 Developmental Psychology IV. COURSE CO REQUISITES: POS 1113 American Federal Government NURS 2453 Nursing Promotion for Quality of Life NURS 2423 Nursing Care of the Childbearing Family V. COURSE CATALOG DESCRIPTION: Utilizing the nursing process, this course focuses on the nursing care of children and their families. While implementing the role of provider of care and member of the healthcare team, students practice complex skills and implement communication strategies specific to children and their families. Growth and development, health promotion and health problems of children are emphasized in a variety of community and acute care environments. VI. COURSE OUTCOMES: At the end of this course, students will be able to: A. Role Demonstrate an understanding of the theoretical principles essential to the roles of the ADN in the care of infants, children, and adolescents. Implement the roles of the ADN in caring for infants, children, and adolescents. B. Skills/Components Adapt nursing skills in accordance with established standards and professional responsibilities specific to the healthcare of infants, children, and adolescents. C. Communication Communicate with families, children, and adolescents in a caring and therapeutic manner that demonstrates cultural sensitivity. 4 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 D. Nursing Process Utilize critical thinking, functional health patterns, teaching/learning principles, and developmental concepts to plan and implement nursing for infants, children, and adolescents. VII. COURSE OVERVIEW: This course is designed to enhance the student’s understanding of the uniqueness of pediatric well-being and healthcare. The pediatric nursing student will utilize knowledge and principles gained from developmental psychology to apply scientific rationales in the delivery of safe, appropriate, and effective nursing care for selected individuals of the pediatric population and their families, henceforth referred to as the “child and family.” The student is referred to the TCC Nursing Program Philosophy and Conceptual Framework for an understanding of the framing of this course within the TCC nursing program. Health is examined in terms of the promotion, maintenance, and restoration, to the degree possible, of the infant’s, child’s, or adolescent’s health. The child’s internal environment is assessed and evaluated from the perspective of loss of adaptive mechanisms (homeostasis). Nursing concerns related to standardized developmental milestones, common childhood illnesses, congenital anomalies, and syndromes, disease conditions, developmental needs and injuries are analyzed and appropriate plans of care are implemented. Critical thinking, using the nursing process, is utilized to facilitate positive client outcomes. Variables within the child’s external environment are addressed, such as family, communicable disease conditions, safety concerns, accident and violence prevention, and additional variables affecting the family’s health status, morbidity, and mortality. Particular emphasis is devoted to providing safe and developmentally appropriate nursing care based on appropriate scientific nursing principles, and the theoretical works of Erikson, Piaget, and others. Nursing is viewed as practice within the three roles of the Associate Degree Nurse. Child (client) assessment is emphasized, and data is organized within functional health patterns. The concept of caring is operationalized for example when establishing a trusting therapeutic relationship with a child and his/her family. Promoting safety based upon developmental theory and accountability for one’s actions are integral components of this course. Selected nursing skills have been identified to enhance further safety in caring for children. Other foci in the course are effective communication with children and their families, developmentally sensitive implementation of nursing care and health teaching for the child and the family, and utilization of healthcare information systems. An interdisciplinary team approach to pediatric nursing care is fostered, and promoting and implementing atraumatic are underlying concept throughout the course. In addition, principles of child advocacy and cultural sensitivity are integrated throughout the course. Major components of the course are as follows: theory classes, learning activity laboratories (LAL), utilization of community resources, and acute care environments. Application of theoretical knowledge learned in the classroom, and skills practiced in LAL are utilized in wellchild settings and in acute and chronic care settings within the community. Important concepts integrated within the course are access to healthcare, critical thinking, nursing standards, and the impact of various value systems. Clinical experiences are planned opportunities for students to apply theory to practice in the care of children and adolescents by utilizing physical assessment 5 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 and psychosocial data in the identification of problems or needs, planning and implementing nursing care and in evaluating client outcomes based on the nursing care provided. Successful completion of this course and eligibility for progression to the next clinical nursing course is determined by: Satisfactory completion of all components of the course with a grade of 75% or the equivalent, and an earned “satisfactory” on course facets evaluated as “satisfactory” or “unsatisfactory” Achievement of an acceptable level of performance on psychomotor skills An earned score of 90% on the Level 3 medication dosage calculation exam administered within this course An earned semester average of 75% or higher on theory examinations Overall course average of 75% or higher VIII. NURSING DIVISION: Associate Dean: Rick Hollingsworth Nursing Office: MP 256 Telephone: 595-7188 Office Hours: 8:00 -5:00 M–F IX. X. INSTRUCTORS: Course Jan Jones Nolen, MS, RN, CNE, Assistant Professor Coordinator: Office: MC 327 [email protected] Cell Phone: 918.607.6466 Office Hours: By Appointment Faculty: Lori Franklin, MS, RN, Assistant Professor Office: MC 328 [email protected] Cell Phone: 918.830.1561 Office Hours: By Appointment Leslie Guthrie, MS, RN, Assistant Professor Office: MC 338 [email protected] Cell Phone: 918.697.7038 Office Hours: By Appointment TEXTBOOKS AND OTHER MATERIALS: Required: A. Perry, S. E, Hockenberry, M. J., Lowdermilk, D. L., Wilson, D. Maternal Child Nursing Care, 4th ed., Mosby, 2010, ISBN 978-0-323-05720-2 B. Perry, S. E, Hockenberry, M. J., & Lowdermilk, D. L. Studyguide for Maternal Child Nursing Care, revised reprint 4th ed., Mosby, 2011, ISBN 978-0-323-08513-7 C. Wilson, D. & Hockenberry, M. J. Wong’s Clinical Manual of Pediatric Nursing, 8th ed., Mosby, 2012, ISBN 978-0-323-07781-1 D. Pagana, K. D. & Pagana, T. J. Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed., Mosby, 2009, ISBN 978-0-323-0-57479 E. Deglin, J. H. & Vallerand, A. H. Davis' Drug Guide for Nurses, 11th ed., Davis, 2008, IBSN 9780803619111 F. Ackley, B. & Ladwig, G. Guide to Nursing Diagnosis, 2nd ed., Mosby, 2007, ISBN 978-0-323-05192-7 Recommended: A. Schuster, P. M. Concept Mapping A Critical-Thinking Approach to Care Planning, 2nd ed., FA Davis, 2007, ISBN 978-0-803-61567-0 6 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 XI. TEACHING-LEARNING STRATEGIES: Teaching-learning promotes learning opportunities with emphasis on the development of student creativity and critical thinking. Instructional strategies include classroom presentation, assigned readings, small group discussion, audio-visual aids, written assignments, computer assisted instruction (CAI), observations, demonstration, return demonstration, supervised practice, supervised clinical experiences, printed handouts, blackboard postings, pre/post conferences, self directed inquiry and self-evaluation. XII. SYSTEM FOR STUDENT GRADING AND EVALUATION: The student must earn a cumulative Theory examination percentage grade of 75% and earn a grade of 75% and Satisfactory (S) for all clinical components of the course, in order to satisfactorily complete NURS 2433 and be eligible to progress in the TCC Nursing Program. There will be no rounding of grades. A student who earns a cumulative Theory examination grade of 75% or higher but has a Clinical grade below 75% or, an Unsatisfactory (U) in any other component may fail the course and cannot progress to another clinical nursing course or nursing course level in the TCC Nursing Program. Student Exam Review with Faculty-Requirement Students scoring 78% or below on Exams 1 (one) through 3 (three) must make an appointment with the course coordinator to schedule a review of the exam score. If the student does not make and keep the appointment, the students will not be admitted to the proceeding exam. Failure to take exams as scheduled on the course calendar may be penalized 10% of that exam’s final score. The Level 3 Dosage Calculation Examination requires that the student earn 90% or greater to successfully pass this examination. Up to three (3) attempts are allowed to achieve this in order for the student to progress in this course. Collaborative Testing will occur following the three (3) Theory examinations. An additional point will be awarded for each five (5) points that the group’s collaborative score exceeds the average of the passing scores of the group members. Points will only be awarded to students who have individually made at least a 75% on the examination. No more than three (3) points will be awarded per testing opportunity. Example: Group A: Student 1 – 84% Student 2 – 72% Student 3 – 76% Student 4 – 90% Student 5 – 80% Student 6 – 82% Average of Group A’s passing scores (Students 1, 3, 4, 5, 6) = 82.4 Collaborative Group A Score 94 Group Score (94) minus average score of passing individuals (82.4) = 11.6 or 2 points Final Student Scores with extra points: Student 1 – 84% + 2 = 86 Student 2 – 72% + 0 = 72 (did not pass so score remained same) Student 3 – 76% + 2 = 78 Student 4 – 90% + 2 = 92 Student 5 – 80% + 2 = 82 Student 6 – 82% + 2 = 84 7 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Student Preparation Activities: Students are expected to prepare for each theory class. The following procedure will be followed. 1. Students must present written assignments in order to attend each theory class (a total of 13 class sessions). These assignments are identified in the syllabus with each Theory Learning Map (a total of 20 varied topics with related Student Preparation Activities). 2. All assignments (Student Preparation Activities) must be handwritten and/or an original of the workbook. 3. To receive credit, assignments (Student Preparation Activities) can ONLY be handed in at the beginning of class (no later than 9:05 AM). 4. Those students presenting to class without completion of their assignments (Student Preparation Activities) may proceed to a study site to complete the assignment. 5. The students may return to class upon completion of the assignment, but will not awarded credit. Those students will receive a grade of “0” (zero). 6. Those students not attending a class session will receive a grade of “0” (zero) for that/those assignment(s) for that class session. 7. Class attendance allows students to participate in the learning experience. When class is not attended, the learning experience is lost. This is not an attendance policy. 8. Students are responsible to sign the class roster for each class session. If the student does not sign the class roster, they will be considered absent and receive a zero (0) for any assignment(s) (Student Preparation Activity/ies) due that day. 9. The total possible credit that can be received from the Student Preparation Activities is 30 points. 10. Eight (8) individual assignments (Student Preparation Activities) are chosen at random from the 20 varied topics assigned representing the 13 class sessions. No more than one assignment (Student Preparation Activity) will be chosen from any class session. 11. All of the selected assignments (Student Preparation Activities) will be graded. Each one is worth up to five (5) points, Once graded, the lowest two (2) scores will be dropped from each student’s individual total points, resulting in a maximum score of thirty (30) points, which is a portion of the clinical grade. 12. Students must arrange in advance with the course coordinator if unable to attend a class session because of attendance at a college sanctioned or sponsored activity. These students will be eligible to receive credit for the assignment once completed and submitted within the agreed upon time frame. 8 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Health Education Systems, Inc. Standardized Testing Students will complete one (1) Health Education Systems, Inc. (HESI) standard examination during the semester. The time for this examination is noted on the course calendar. The additional point(s) will be added to the student’s overall course percentage at the end of the course if the student has earned a Theory examination average of 75% or greater. The student is awarded one (1) additional point for HESI score at or above 850-899 (acceptable range). The student who achieves a HESI score at or above 900 (recommended range) is awarded 2 additional points at the end of the course. EXAMPLE: HESI Bonus Acceptable Recommended Bonus points Point Grid Student Score Range Score Range Score awarded 900 Student 1 850-899 900 and above 2 Student 1’s score is equal to or exceeds the Recommended Range Score. 899 Student 2 850-899 900 and above 1 Student 2’s score exceeds the Acceptable Range Score but is below the Recommended Range Score.. 849 Student 3 850-899 900 and above 0 Student 3’s score is below the Acceptable Range Score. Posting of Grades: Exam scores are posted on Blackboard within one (1) week of the original exam. Graded observation reports, papers/projects, and care plans are generally returned within one (1) week of receipt from the student or prior to the date that the next one is due (whichever comes first). A. GRADING SCALE: The grading scale for the Tulsa Community College Nursing Program is: 100-90 = A 89-80 = B 79-75 = C 74-60 = D 59-below = F B. PERCENTAGE GRADE CALCULATION: Students MUST achieve an average of 75% on the three (3) Theory examinations in order to have other component scores added to achieve final grade. If the average of all the Student’s Theory and Comprehensive Final examinations is less than 75%, the final course grade will be recorded as the Theory and Comprehensive Final examination average. All clinical activities must also earn a 75% or higher or Satisfactory (S). The percentage grade for this course is determined by: 9 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 1) Theory and Comprehensive Final Examinations: 67% (400 points possible) (a) Theory Examinations (3 at 100 points each) = 300 points/50.25% (16.75% each) Exam I _____/100, Exam II _____/100, Exam III _____/100 (b) Comprehensive Final Examination (100 points) _____/100 = 16.75% 2) CLINICAL Component: 28% (170 points possible) (a) Developmental Agency Observation Reports 1. Child Development Center _____/50 points/8% 2. Little Light House _____/50 points/8% (b) Nursing Concept Map/Care Plan _____/70 points/12% 3) Student Preparation Activities: 5% (30 points possible) (a) Student Preparation Activities _____/30 points/5% (b) Wellness Exploration Learning Activity Pass/Fail 4) HESI Examination: 2 points may be earned and be added to final grade IF THEORY examination grade is 75% or greater AND if Clinical grade is “Satisfactory” AND 75% or greater. (A) maximum of two (2) bonus points can be earned for the semester, and if earned will be added to the student’s overall course points at the end of the semester, after the theory and clinical grades are calculated and combined. Example: Student Student Clinical Total of HESI 2433 Theory Grade = Theory and Test Scoring Grade = 25% of Clinical Bonus Final Grid 75% of grade grade Grade points Grade 86% 95% 88.25% (B) 2 90.25 = Student 1 A 86% 95% 88.25% (B) 1 89.25 = Student 2 B 86% 95% 88.25% (B) 0 88.25 = Student 3 B C. CLINICAL PERFORMANCE: A clinical grade of Satisfactory (S) is determined by earning a satisfactory evaluation on all of the following clinical performance requirements of this course. 1. Clinical Facility-Based Learning Experiences: Weeks listed are based on the four weeks of acute-care pediatric clinical experiences. (a) Clinical Day 1: Orientation to clinical unit and completed Pediatric Assessment Form and Growth Grid with required Satisfactory (S) grade (b) Clinical Day 2: Complete Pediatric Assessment Form, Concept Map, Growth Grid, and Medication Sheet submitted with required grade of 75% or higher. (c) Clinical Day 3: School Nurse Experience: Complete “Plan for Schoolage/Adolescent Child” form, document clinical experience using objectives A-E on the Learning Map. With required Satisfactory (S) grade. 10 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 2. 3. Clinical Skill Components (a) Medication Dosage Calculation (90% minimum pass score – not included in cumulative grade score) (b) Psychomotor Skill (Pediatric Medication Administration – Pass/Fail) (c) Completed Pediatric Assessment Form, Concept Map, Growth Grid, and Medication Sheet submitted with required grade of 75% or higher Student Performance Evaluation Profile (SPEP) (a) Safe Provider of Care: Performance of safe actions and nursing interactions related to the role of Provider of Care = Satisfactory/Unsatisfactory (b) Professional Behaviors: Demonstration of professional behaviors as defined in the Student Performance Evaluation Profile (SPEP) = Satisfactory/Unsatisfactory (c) Nursing Role Behaviors: Performance of all Nursing Role Behaviors = Satisfactory/Unsatisfactory XIII. DESCRIPTION OF COURSE REQUIREMENTS: A. EXAMINATIONS: Three (3) unit examinations will be administered to evaluate student acquisition of theoretical knowledge and principles, as well as application of knowledge and principles to clinical scenarios. Exams are given according to the enclosed schedule (see calendar). Regularly scheduled exams consist of 50 items and are worth 100 points each. Students will complete one (1) Health Education Systems, Inc. (HESI) standard examination during the semester. The time for this examination is noted on the course calendar. This is in addition to the three (3) Theory examinations. If the student has earned a Theory examination average of 75% or greater, a student may earn one (1) bonus point for a composite score above the “Acceptable” level, as established by HESI. A student, who achieves a composite score at or above the “Recommended” level as established by HESI, may earn two (2) bonus points. B. ACUTE CARE CLINICAL PRACTICUM: An acute care clinical setting will provide students the opportunity to interact with infants, children, and adolescents who have short- or long-term health problems. During the clinical practicum the student will gather, assess, analyze, plan, implement, and evaluate a plan of nursing care for his/her selected client. The plan of nursing care will be student written. When possible, the student will consult with other disciplines involved in the client’s care. Accurate, complete, and developmentally appropriate plans of nursing care are viewed as an integral component of safe nursing practice. Students are to keep each week’s evaluated plan of nursing care (clinical paper work). These plans of care can be requested by the clinical instructor at any time to assist in assessing the student’s progress in the utilization of the nursing process in planning client care. Should the student’s written plan of care be evaluated as “unsatisfactory,” it will be reflected as an “I” or an “N” in the appropriate objectives/behaviors listed on the Student Performance Evaluation Profile (SPEP). The final grade of the care plan(s) must be 75% or higher for the student to pass the course. Any revision or make-up for clinical work is at the discretion of faculty. 11 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 C. DEVELOPMENTAL AGENCY OBSERVATION REPORTS: Well children will be observed at a local preschool and a developmental assessment will be documented and submitted for learning evaluation. In addition, each student will interact with a selected child in a preschool dedicated to fostering optimum development of special needs children, and the student will write a developmental assessment documenting particular needs and student interactions with the selected child. A student must achieve a passing grade of 75% on each of the LLH and CDC assignments to pass the course. If a student is asked to resubmit the assignment, the maximum grade that can be awarded is 75% (or 53 points). Any revision or make-up for the developmental agency observation experiences/reports is at the discretion of the Course Coordinator. D. PSYCHOMOTOR SKILL COMPONENTS: In the Learning Activities Laboratory (LAL), students will be given the opportunity to learn and practice nursing skills related to the care of children. Students will demonstrate specific skills successfully within prescribed time limits. Faculty will evaluate students’ abilities to perform psychomotor skill using skill checklists found in the Learning Resources Packet. The psychomotor skill evaluated is Pediatric Medication Administration. The student may have three (3) opportunities to complete the skill successfully. The skill must be completed successfully within a specified time (see skill sheet in packet). Failure to demonstrate these skills successfully will result in failure of the course. E. MEDICATION DOSAGE CALCULATION EXAM: The student must demonstrate mastery of pediatric dosage calculation by achieving a score of 90% or greater on a written calculation examination. Students are to write all calculations next to each dosage problem within the exam booklet. The student may have three (3) opportunities to complete successfully this examination. The grade is recorded as Pass/Fail; a passing grade is 90% or greater. The student is not allowed to administer medication during the clinical experience until the examination is passed. Failure to pass the medication examination will be reflected in the weekly Student Performance Examination Profile (SPEP). Failure of this examination results in failure of the course. F. PERFORMANCE OF PROFESSIONAL BEHAVIORS: Professional behavior is expected of each student during all clinical components of this course. Performance of these behaviors is evaluated by faculty in the assigned clinical setting following each clinical practicum. These experiences incorporate theory classes, Learning Activities Laboratory (LAL), hospital and clinic facilities, and community agencies. A description of desired behaviors can be found in the SPEP. The procedure used to document student performance on the SPEP is described in the following section (XIV). XIV. STUDENT PERFORMANCE EVALUATION PROFILE: The Student Performance Evaluation Profile (SPEP) identifies objectives that reflect desired professional behaviors described within the Roles of the Associate Degree Nurse. Upon completion of each clinical day, the SPEP is used by the faculty members to record the student’s ability to demonstrate: safe and effective nursing care, professional responsibility, and 12 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 commitment to learning and self-development. A cumulative overall evaluation of “Satisfactory” on the SPEP is required to complete successfully the clinical component of this course and to progress to the next sequential clinical course within the Nursing Program. 1. Evaluation of student performance will be based on how consistently performance behaviors (objectives) are met each clinical week. 2. Achievement of the objective is documented as “Satisfactory” if performance of a clinical objective is consistently demonstrated by the student. A check mark is written beside that objective on the SPEP. 3. A student demonstrating excellence in the performance of a particular objective may receive a plus sign (+) beside that objective on the SPEP. 4. If a student is unable to demonstrate consistent performance of a particular objective, or an objective is not applicable during a specific week’s clinical experience, or if the student’s performance of an objective is not observed by the faculty, one of the following symbols is recorded on the SPEP for that particular objective (behavior): I= Student needs improvement to meet behavior N = Student does not or frequently does not meet this behavior NA = Behavior not applicable for that week O = Behavior not observed by the instructor S= Satisfactory performance U = Unsatisfactory performance = Object consistently met “satisfactorily” += Student exceeded expectations in completion of behavior NOTE: SPEP Items with an asterisk (*) are Critical Behaviors and must be met Satisfactorily. 5. A student who consistently demonstrates achievement of all clinical objectives with fewer than three (3) “N’s” for the week earns a “Satisfactory” clinical performance and an “S” will be recorded for the weekly evaluation. 6. A student who receives two (2) consecutive weeks of “I” for the same objective must show improvement the third week or the student will receive an evaluation of “N,” indicating that the objective was not achieved. 7. A student earning an “N” for three (3) or more clinical performance objectives within one week has demonstrated Unsatisfactory clinical performance for the week, and a “U” will be recorded for the weekly performance evaluation. 8. Some clinical performance objectives are marked with an asterisk (*). If a student does not satisfactorily meet an objective marked with an asterisk (*), the student will receive an “N” for that objective and will receive a “U” for that clinical week. 9. Any student earning a “U” for any week will have a counseling form completed by the clinical instructor, documenting student performance and recommendations for improvement. The instructor will hold a conference with the student. A copy of the signed counseling form will be placed in the student’s permanent file. 13 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 10. The student will be placed on Probation if two (2) weeks of Unsatisfactory (U) clinical performance are documented. Three (3) weeks of Unsatisfactory clinical performance during the course constitutes failure of the clinical portion of NURS 2433. (Refer to the TCC Nursing Program Student Handbook for more information regarding Unsatisfactory clinical performance.) 11. The student is expected to demonstrate progressive development in the performance of clinical skills and problem solving during the clinical component of the course and should strive to have all objectives evaluated as being satisfactorily met. 12. If a student is a NO CALL/NO SHOW for clinical practicum, the student’s performance is “Unsatisfactory” for the week and a “U” is recorded on the SPEP. XV. POLICIES AND PROCEDURES FOR NURS 2433: The student enrolled in NURS 2433, Nursing Care of Children and Families, is responsible for knowing and complying with all of the policies published in the TCC Student Code of Conduct and Policy Handbook, and the TCC Associate Degree Nursing Program Student Handbook. The student should review both policy documents periodically during this course. In addition, the student is responsible for complying with the following policies and procedures specific to NURS 2433. These statements apply to theory classes, learning activity laboratories, clinical practice experiences, and all other scheduled course activities. A. ATTENDANCE: Professional learning responsibility includes attendance and contribution to theory class and clinical conference discussion. Students are EXPECTED to attend theory class and points can be earned by attendance; however, learning activity laboratories, clinical practice experiences and all other scheduled course learning activities are REQUIRED. B. EMERGENCIES OR ILLNESS: The student is expected to notify the Course Coordinator (Jan Jones Nolen - 918-6076466) and the School of Nursing Office prior to any scheduled course learning experience or appointment in the event of an emergency or illness that prevents the student’s attendance. The course learning experiences include theory class, learning activity laboratory, faculty appointments course examinations, and the HESI exam. It is the responsibility of the student to contact the instructor as soon as possible to arrange a makeup experience for the missed learning activity or conference. The student should leave his/her name, telephone number, where the student can be reached, scheduled time for the activity and the name of the assigned faculty instructor. A student who has a fever, an upper respiratory infection, a GI disturbance, or any type of infectious condition should not attend clinical practicum. If this occurs, the student should follow the procedure outlined for a clinical practicum absence. C. ABSENCE OR NONATTENDANCE: The faculty may initiate an administrative withdrawal (AW) for consistent nonattendance of any component of the course. An official withdrawal from the course, regardless of the reason, prevents the student from attending any further course activities. 14 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 1. Theory: It is the student’s responsibility to obtain any handouts, class notes, and any information/announcements that may have been made if the student was absent. 2. Clinical Practicum: Clinical practicum includes learning activities laboratory, acute care clinical experiences, Child Development Center, The Little Lighthouse, supervised practices, skills, and computer assisted instruction (CAI) time scheduled with faculty. Whenever a student is unable to participate in a scheduled clinical experience, it is the student’s responsibility to notify the clinical facility/unit, and the TCC Nursing Division of the absence one (1) hour before the clinical experience is scheduled to begin. It is also the student’s responsibility to contact the clinical instructor immediately after the absence to arrange for a clinical make-up experience. Clinical make-up time may be scheduled on different days or on evenings or weekends, depending on the availability of clinical experiences. The student may be assigned alternative learning experiences as make-up work. A student who does not call PRIOR to the clinical practicum and who does not arrive for the clinical practicum in a timely manner is considered a “NO CALL/NO SHOW”. Review the above definition of clinical practicum. All missed time must be “made up” to complete course objectives. 3. Clinical Skill Components: If a student is a No Call/No Show for a scheduled clinical skill component, it will be recorded as an unsuccessful attempt, and the allowed time listed as missed clinical time. 4. Learning Activities Laboratory/ Developmental Agency Visits: Attendance is mandatory for these activities. If students are unable to attend their scheduled times, the NURS 2433 Coordinator must be contacted to schedule make-up, if allowed. 5. Scheduled Examinations: Students are to take ALL examinations as scheduled. Students must notify the Nursing Division Office (595-7188) and the respective Course Coordinator prior to missing any scheduled exam. The Course Coordinator may request a written explanation from the student to determine if the absence will be excused. Missing an exam for work is NOT a valid excuse). Students failing to notify the Nursing Division Office (and the Course Coordinator) prior to missing an examination are considered “No Call-No Show” and may receive a zero “0” for that exam. Unavoidable absences will be considered on an individual basis. Make-up exams may be taken in the “Testing Center” and require a minimum notice of 24 hours for scheduling purposes. 15 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 All make-up exams must be scheduled with the respective Course Coordinator and will be scheduled during Week 14 or Week 15 of the semester. It is the responsibility of the student to contact the Course Coordinator to ensure that the missed exam is scheduled. In the event a student misses more than two exams per course, 10% of the points possible will be deducted from any subsequent missed examinations. D. UNSAFE NURSING PRACTICE AND UNPROFESSIONAL CONDUCT: Should a student demonstrate unsafe nursing practice(s) or unprofessional conduct, nursing faculty will implement one or more of the consequences described in the TCC Nursing Program Student Handbook. E. PREPARATION FOR SCHEDULED LEARNING EXPERIENCES: 1. Theory: Classes are designed to assist students to synthesize new learning into a nursing framework. Students are expected to prepare for class in order to optimize classroom learning. Preparation includes: (a) identifying the correct theory class focus from the printed course calendar (b) locating the corresponding Theory Learning Map in the NURS 2433 Learning Resource Packet (c) reviewing of the expected learning outcomes (d) reading and completing assignments and other preparation materials in order to answer the Critical Thinking Questions 2. Clinical Practicum: A student reporting to the assigned clinical area unprepared or demonstrating unprofessional conduct and/or appearance may be dismissed for that day at the discretion of the instructor and an Unsatisfactory weekly performance will be recorded on the SPEP. The student would then be expected to arrange a makeup clinical experience with the clinical instructor. 3. Clinical Learning Activities Laboratory: Students are expected to participate in all LAL learning activities. A learning map corresponding to each LAL activity will guide the student’s preparation. The faculty role in this laboratory is to assist the student to clarify and verify information, and to validate competent performance of specified skills. 4. Developmental Agency Experiences: Students are expected to read and follow the learning maps for each visit. Written reports are due as specified in the learning map. 5. Student Agreement of Understanding: At the beginning of the course, each student will read and sign the “Student Agreement of Understanding” confirming the concepts, components, grading format, and other related materials for successful completion of NURS 2433. 16 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 F. WRITTEN ASSIGNMENTS: Late work will not be accepted without prior arrangement with the instructor. Late work may receive a 10% reduction in grade even with prior instructor acknowledgment. G. TAPING OF CLASSES: Students may audiotape classes with the consent of the instructor and peers. It is the student's responsibility to avoid infringing on other students’ right to confidentiality. Consent to tape, duplicate or transcribe is for the use of currently enrolled students only. Taping and selling tapes for profit is considered unprofessional conduct and not condoned. H. PRESENCE OF CHILDREN IN CLASSROOM OR CLINICAL FACILITY: Children are not permitted per TCC policy in any classroom or laboratory. Unattended children are not permitted in any TCC building. Children are not to accompany the student or be left unattended at any clinical practicum facility. I. PAGERS AND CELLULAR PHONES No electronic devices including pagers and cellular phones are permitted to be used in any classroom or clinical practicum. In an emergency, a student may be contacted through the campus police office (918-595-7263.) J. COMMUNICATION MyTCC is the official electronic communication tool used by Tulsa Community College. Each student is provided with an e-mail account, which is used by the college to communicate with students. You may access the site at http://MyTCC.tulsacc.edu. Your user name is your eight-digit student ID number. Your password is the PIN you use to access the Student Web. (Your PIN is initially set as month date and year of birth, using leading zeroes and the last two digits of the year of birth. It is strongly recommended that you change your PIN the first time you access the Student Web.) If you wish to forward mail from MyTCC, you may do so easily. Open the mail channel by clicking on the e-mail icon in the upper right-hand portion of the welcome screen, or the e-mail icon at the bottom of the e-mail channel. Once the e-mail channel opens, click on the options tool at the top of the screen. On the left-hand side of the window that opens, click on Settings. The bottom option allows you to forward e-mail to another account. Be aware that MyTCC does not retain a copy of forwarded mail. If you change or close the account to which you have forwarded mail you will have no record of communications sent by TCC. K. COURSE WITHDRAWAL The deadline to withdraw from a course shall not exceed ¾ the duration of any class. Check the TCC Academic Calendar for the deadline that applies to the course(s). Begin the process with a discussion with the faculty member assigned to the course. Contact the Advisement Office at any TCC campus to initiate withdrawal from a course (‘W’ grade) or to change from Credit to Audit. Withdrawal and/or change to an audit from a course after the drop/add period can alter the financial aid award for the current and future semesters. Students may receive an outstanding bill from TCC if the recalculation leaves a balance due to TCC. Students who stop participating in the course and fail to 17 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 withdraw may receive a course grade of “F,” which may have financial consequences for the students. L. DUE PROCESS Students of the TCC Nursing Program retain the right to have grievances addressed in a fair and timely manner, and will be accorded full due process by the faculty and administration of the program and college. In a similar manner, the TCC Nursing Program also has the right to address unprofessional behaviors (according to the “Uniform Health Sciences Academic Standards, Probation, Temporary Exclusions, Dismissals, and Readmission Procedures”) and inadequate academic progress (according to the “Academic Grievance Procedure and Due Process Guidelines”) as outlined in the TCC Nursing Program Student Handbook and posted on Nursing Connections. This statement serves as notification of these policies and of the student’s responsibility to follow these guidelines in respect to these events. M. ATTENDANCE POLICY FOR CLINICAL AND LABORATORY The TCC Nursing Program expects that its students will recognize that they have entered a profession in which commitment to full participation in the learning environment is an essential component of what will become a style of life-long learning. Attendance is expected for all educational activities, and is required for seminars and laboratory sessions. In all clinical/laboratory courses, attendance is required as students are considered to be part of the nursing team. Student absences for professional, personal, or family events may be granted at the discretion of the course faculty. The requests will be reviewed by the associate dean if necessary. This policy is designed for special circumstances and it should not be considered a guarantee that a student will be granted the permission. Clinical Absences If a student must miss clinical time due to illness or personal emergency he or she must call the instructor prior to the start of the clinical shift and call the Nursing Division office. The instructor in consultation with the course faculty will determine if make-up time is needed. Decisions as to the need for make-up clinical experiences are based on a student’s progress in meeting course objectives. Missing greater than 10% of planned clinical hours may impede a student’s ability to complete course objectives. If a student does not meet these objectives, the course must be repeated. Laboratory Absences Laboratory is another required learning experience with objectives a student must achieve in order to be successful in a given course. If a student must miss laboratory time due to illness or personal emergency he or she must call the instructor prior to the start of the scheduled lab. Make-up labs will be determined and scheduled by course faculty. Students are responsible for communicating with faculty so that all course objectives are 18 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 completed for the lab portion of any course by the end of the semester. If a student does not meet these objectives, the course must be repeated. 19 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Student Agreement of Understanding By placing your initials by each statement, you are indicating that you understand each of the statements and the course requirements. I understand: 1) I am responsible for applying critical thinking to the concepts presented in this nursing course and for using these concepts as a basis for nursing process and practice. 2) I am responsible for monitoring my own learning. 3) I am responsible for self-evaluation of my academic and clinical performance throughout the course. 4) My CONSISTENT attendance and active participation in classroom, Learning Activity Laboratory (LAL), and clinical experience sessions is necessary to be successful in this course. 5) I must earn 90% or higher on the Level 3 Dosage Calculation Exam to be allowed to pass medications. Failure to achieve 90% or higher after three (3) attempts will result in my failing the course. 6) I must achieve: a) a theory grade of 75% or higher on the theory exams, b) a clinical practicum paperwork grade of 75% or higher, and c) a child development experiences grade of 75% or higher to be eligible pass the course. 7) I may request an appointment with the Course Coordinator for clarification about course requirements, my status in the class, or my current course grade. 8) My preparation for class involves reading the required text. Reading must be completed prior to class attendance. 9) If I have a disability and need special accommodation of any nature, I am responsible for notifying the Course Coordinator immediately. 10) I am responsible for knowing and following the guidelines described in the Tulsa Community College Nursing Student Handbook, Nursing 2433 Course Syllabus, and the Tulsa Community College Student Code of Responsibility and Conduct. 11) Tulsa Community College does not discriminate on the basis of race, color, national origin, sex, age, disability, or veteran status Printed Name: _________________________________________ Student ID: ______________ Signed Name: _________________________________________ Date: ___________________ Witnessed by: Printed Name: ________________________________________ Signed Name: ________________________________________ 20 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 1: Physical & Developmental Assessment Functional Health Patterns: Health-Perception-Health Management Learning Objectives 1. Prepare a child for a physical examination based on his or her developmental needs. 2. Plan a comprehensive physical examination in a sequence appropriate to the child’s age. 3. Recognize expected normal findings for children at various ages. 4. Record the physical examination according to the head-to-toe format. 5. Perform a developmental assessment using a standard screening test (Denver Developmental Screen Tool II– DDST-II). Preparation Resources 1. WPHLW Chapter 34, “Communication, History, Physical, & Developmental Assessment,” pp. 886927. 2. Clinical Manual of Pediatric Nursing, pp. 18-74, 114-147, 180. Critical Thinking Questions 1. Discuss the importance of considering the developmental needs of children in preparing them for a physical examination, and identify methods that could be used to prepare them for this experience. 2. What approaches would foster atraumatic assessment of a child’s genitalia? Learning Activities Terminology - *May need to use a medical dictionary Student Preparation Activity (BRING TO CLASS) 1. 2. 3. 4. 1. 2. 3. 4. Lecture/topic discussion PowerPoint Handout Problem-solving activities Practical application activities 21 Spring 2013 CDC Growth Charts Denver II Growth Standards Snellen Screening 1. Using a copy of the Growth Chart, graph the height and weight of your child or the child of a family relative or friend. 2. Using a copy of the Denver Developmental Screen Tool II, highlight the four (4) areas of development assessed by the RN. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 2: Nursing Interventions & Variations for the Pediatric Client Functional Health Patterns: Health-Perception-Health Management Learning Objectives 1. List the essential priorities of nursing care for a child on admission to the hospital. 2. Outline nursing interventions that minimize the stress of loss of control during hospitalization and fear of bodily injury, and enhance compliance through the use of play as a therapeutic intervention. 3. Analyze significant stressors of illness and hospitalization on the child, siblings, and the family. 4. Describe methods of assessing and managing pain in children. 5. Formulate general guidelines for preparing children for procedures, including surgery, informed consent, and issues of emancipation. 6. Implement feeding techniques that encourage food and fluid intake. Learning Activities 1. 2. 3. 4. Lecture/topic discussion Power Point Handouts Problem-solving activities Practical application activities 22 Spring 2013 Preparation Resources 1. WPHLW Chapter 35, “Pain Assessment & Management,” pp. 929950. 2. WPHLW Chapter 44, “Reaction to Illness and Hospitalization,” pp. 12191244. 3. WPHLW Chapter 45, “Pediatric Variations of Nursing Interventions,” pp. 1245-1273 & 1289-1300. 4. Clinical Manual of Pediatric Nursing, pp. 181-202, 209-248 (PAIN SCALES). 5. Growth & Development Handout (Erickson) Terminology - *May need to use a medical dictionary 1. 2. 3. 4. 5. 6. 7. Atraumatic care Emancipated Informed consent Separation anxiety Play therapy Therapeutic play Fear of mutilation Critical Thinking Questions 1. When are children most vulnerable to stress? 2. What determines a child’s reaction to and management of stress? 3. What might stress represent to a child in each of the major developmental periods? 4. What is the impact of stress on the sensitive periods of development? Student Preparation Activity (BRING TO CLASS) 1. Draw the FACES Pain Scale and describe a pain assessment tool appropriate for an infant. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 3: Communication; Social Cultural, & Religious Influences Functional Health Patterns: Health-Perception-Health Management Learning Objectives 1. Analyze strategies and guidelines for communicating with and interviewing the child and family. 2. State the components of a complete health history. 3. Describe two strategies for structural and functional assessment of the family. 4. Describe the subcultural influences on child development in the areas of socialization, education, and aspiration. 5. Identify areas of potential conflict of values and customs for a nurse interacting with a family from a different cultural/ethnic group. 6. Describe three religious groups whose beliefs significantly affect their health practices. 7. Identify guidelines for using an interpreter and phone triage to assess a family. Preparation Resources 1. WPHLW Chapter 32, “Social, Cultural, and Religious Influences on Child Health Promotion,” pp. 822-840. 2. WPHLW Chapter 34, “Communication, History, Physical & Developmental Assessment,” pp. 866886. 3. Clinical Manual of Pediatric Nursing, pp. 217. Critical Thinking Questions 1. Why is it important to include parents in defining and solving their child’s problem? How can the nurse facilitate this process? 2. How does normal cognitive development provide a frame of reference for learning to communicate with children? 3. How do nurses’ own cultural values and beliefs affect their nursing care? Give specific examples of attitudes and their potential consequences. Learning Activities Terminology - *May need to use a medical dictionary Student Preparation Activity (BRING TO CLASS) 1. 2. 3. 4. 5. 6. Using client-friendly pediatric terms describe the following: a) IV start b) Blood draw c) Keeping I & O 1. Lecture/topic discussion – View Streaming Video for this lecture prior to class 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities 23 Spring 2013 Assimilation 1. Culture Cultural Sensitivity 2. Ethnicity 3. Sociogram 4. Transcultural Nursing TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 4: Health Promotion: Infant & Family Functional Health Patterns: Health –Perception-Health Management Learning Objectives 1. Identify the major biologic, psychosocial, cognitive, and social development during the first year. 2. Provide anticipatory guidance to parents regarding common parental concerns during infancy. 3. Provide parents with feeding recommendations for infants. 4. List general contraindications, precautions, and administration routes for immunizations. 5. Provide anticipatory guidance to parents regarding injury prevention based on the infant’s developmental achievements. Learning Activities 1. 2. 3. 4. Lecture/topic discussion Power Point Handout Problem-solving activities Practical application activities 24 Spring 2013 Preparation Resources 1. WPHLW Chapter 36, “The Infant and the Family,” pp. 953-1013. 2. Clinical Manual for Pediatric Nursing, pp. 30-31, 121, 134-139, 149-156, 159, 161, 163, & 173-176. Critical Thinking Questions 1. What behaviors, physical conditions, and environmental condition may place an infant at risk for child abuse? Terminology - *May need to use a medical dictionary Student Preparation Activity (BRING TO CLASS) 1. Apnea 2. Attachment 3. Child Abuse 4. Colic 5. Failure-to Thrive 6. Immunization Schedule 7. Regurgitation 8. Separation anxiety 9. SIDS 10. Spitting up 11. Temperament 1. Create a grid showing the fine motor, gross motor, language, and social development milestones to assess in a fivemonth old well child. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 5: Health Promotion: Toddler & Family Functional Health Patterns: Health-Perception-Health Management Learning Objectives Critical Thinking Questions 1. WPHLW Chapter 37, 1. What are some creative “The Toddler and Family,” guidelines to offer pp. 1017-1041. parents for dealing with 2. Clinical Manual of temper tantrums, Pediatric Nursing, pp. 3-31, negativism, and 94, 121, 125-126, 140-141, regression? 149-152, 156, 159, 161163, 173-177, & 183-186 . Preparation Resources 1. Identify the major biologic, psychosocial, cognitive, and social development during the toddler years. 2. Relate separation anxiety and negativism to developmental tasks. 3. Recognize readiness for toilet training and offer parent guidelines. 4. Provide parents with guidelines for handling temper tantrums. 5. Provide parents with feeding recommendations. 6. Outline a preventive dental hygiene plan for toddlers. 7. Discuss anticipatory guidance to parents regarding injury prevention based on toddler’s developmental achievement. Learning Activities 1. 2. 3. 4. Lecture/topic discussion Power Point Handout Problem-solving activities Practical application activities 25 Spring 2013 Terminology - *May need to use a medical dictionary 1. 2. 3. 4. 5. 6. 7. Autonomy Child Maltreatment Negativism Nursing Caries Regression Ritualism Separation Student Preparation Activity (BRING TO CLASS) 1. Create a grid showing the fine motor, gross motor, language, and social development milestones to assess in an 18-month old well child. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 6: Health Promotion: Pre-school Child & Family Functional Health Patterns: Health-Perception-Health Management Learning Objectives 1. Identify the major biologic, psychosocial, cognitive, and social development during the preschool years. 2. List the benefits of imaginary playmates. 3. Prepare preschoolers for preschoolers or daycare experience. 4. Provide parents with guidelines for sex education. 5. Provide parents with guidelines for dealing with a child’s fears and sleep problems. 6. Recognize feeding patterns of preschoolers. 7. Offer parents interventions related to language development. 8. Identify nursing interventions for a child’s treatment and prevention of communicable diseases. 9. Analyze the areas of history that should arouse suspicion of abuse. Preparation Resources 1. WPHLW Chapter 38, “The Preschooler and Family,” pp. 1043-1075. 2. Clinical Manual of Pediatric Nursing, pp. 3031, 94, 121, 140-143, & 184. Critical Thinking Questions 1. Identify anticipatory guidance that can be provided to parents when their preschooler is preparing to transition from a home daycare setting to a new preschool program. Learning Activities Terminology - *May need to use a medical dictionary Student Preparation Activity (BRING TO CLASS) 1. 2. 3. 4. 1. 2. 3. 4. 1. Lecture/topic discussion Power Point Handout Problem-solving activities Practical application activities 26 Spring 2013 Abuse/Neglect Child Maltreatment Magical Thinking Munchausen’s Syndrome by Proxy 5. Prodromal Symptoms 6. Sleep Terrors 7. Stuttering Create a grid showing the fine motor, gross motor, language and social development milestones to assess in a 3 year-old and 4 year-old well child. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 7: Health Promotion: School-age Child & Family Functional Health Patterns: Health Perception-Health Management Learning Objectives 1. Describe the physical, cognitive, and moral changes that take place during the middle school childhood years. 2. Demonstrate an understanding of the changing interpersonal relationships of changing of schoolage child. 3. Discuss the role of school in the development and the socialization of the school-age child. 4. Implement an appropriate health-teaching plan for the school-age child. 5. Plan a sexuality education session for a group of school-age children. 6. Create a nursing care plan to prevent sport injuries in the middle childhood and adolescence. 7. Describe the most common causes of growth and/or malnutrition failure in later childhood. 8. Evaluate interventions for children with attention deficit disorders or learning disabilities. Learning Activities 1. 2. 3. 4. Lecture/topic discussion Power Point Handout Problem-solving activities Practical application activities 27 Spring 2013 Preparation Resources 1. WPHLW Chapter 39, “The School-age Child and Family,” pp. 10771103. 2. Clinical Manual of Pediatric Nursing, pp. 31, 94, 144-145, 149153, 160, 170, & 178179. 3. Strattera Handout 4. ADD & AD/HD Handout Terminology - *May need to use a medical dictionary 1. ADHD 7. Learning disability 2. Dental caries 8. Pre-pubescence 3. Encopresis 9. PTSD 4. Enuresis 10. Puberty 5. Internet Safety 11. School Phobia 6. Latchkey children Critical Thinking Questions 1. A 9-year-old boy is brought to the clinic by his mother for a school physical examination. His mother is concerned, because the child wants to join the school soccer team this year. On physical examination, the nurse discovers that since last year there has been an increase of 2 inches in height and a 10-pound weight gain. Health history is unchanged from the previous year. The young boy tells the nurse that he rides his bike more now than last year because he has a new “best friend” with whom he can go riding. a. Describe the education that would most benefit this child and his mother. b. Describe how the mother of this 9-year-old boy can foster his development. 2. What comprehensive interventions might the nurse employ in working with the family and school age child newly diagnosed as having ADHD? Student Preparation Activity 1. Search “School aged child and internet safety” for guidelines for parents. List 3 teaching points for families. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 8: Health Promotion: The Adolescent & Family Functional Health Patterns: Health-Perception-Health Management Learning Objectives Preparation Resources 1. Compare the stages of biologic, psychosocial, 1. WPHLW Chapter 40, cognitive, moral, spiritual, and social development “The Adolescent and through adolescence. Family,” pp. 1105-1144. 2. Analyze the development of self-concept. 2. Clinical Manual of 3. Analyze nursing actions to promote proper or Pediatric Nursing, pp. 31, adequate immunizations, nutrition, sleep and rest, 62, 64, 96, 118-120, 146exercise and activity, dental health and personal care, 147, 172, 320. stress reduction, sexuality education, injury 3. http://www.cdc.gov prevention and anticipatory guidelines for family. Immunizations 4. Apply the nursing process related to clients with disorders of the reproductive system, eating disorders, and disorders with behavioral components. Learning Activities 1. 2. 3. 4. Lecture/topic discussion Power Point Handout Problem-solving activities Practical application activities 28 Spring 2013 Terminology - *May need to use a medical dictionary 1. 2. 3. 4. 5. 6. 7. 8. Eating Disorders Gynecomastia Internet Safety Menarche Obesity Puberty Pubescence Secondary Amenorrhea Critical Thinking Questions 1. Explain the principles of physical growth that are important for adolescent girls to understand if they are concerned about their weight. 2. Describe three guiding principles to offer to parents of adolescents to help them better communicate with their adolescent child. 3. Describe the characteristics typically seen with adolescent suicide. 4. Explain why peer groups contribute to the development of a sense of identity in the adolescent and why peer groups are an important influence during these years. Student Preparation Activity 1. Create a grid to describe the physiologic changes of the adolescent male and female. Example below: Male Female hormonal Body mass fat bone TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 9: Pediatric Pharmacology Functional Health Patterns: Activity-Exercise; Sleep-Rest; Nutritional-Metabolic; Health-Management Learning Objectives 1. Apply the principles of pharmacokinetics & pharmacodynamics to pediatric medication administration. 2. Discuss key nursing implications as they relate to pediatric medications and administration. 3. Differentiate assessment of a child with fever vs. hyperthermia. 4. Discuss nursing care of the child with fever vs. hyperthermia. 5. Explore the implications of safety mechanisms for pediatric IV fluid administration. Preparation Resources 1. 2. Kee, Hayes, & McQuiston 7th ed. (Pharmacology text), Chapter 5, Section 5F, “Pediatric Drug Calculations” pp. 99-106, & Chapter 11, “Pediatric Pharmacology” pp. 177-185. WPHLW Chapter 45, “Controlling Elevated Temperature” pp. 1259-1261, & “Administration of Medication,” pp. 1273-1289 (also assigned for Skills LAL). Learning Activities Terminology - *May need to use a medical dictionary. 1. Lecture/Class discussion – View Streaming Video prior to class for this lecture 2. Power Point Handout 3. Case Studies 4. Problem solving activities 1. 2. 3. 4. 5. 6. 7. 8. 29 Spring 2013 Developmental Age Fever First Pass Effect Half Life Hyperthermia Pharmacokinetics Pharmacodynamics Set Point Critical Thinking Questions 1. Use the principles of pharmacokinetics and pharmacodynamics to explain why EMLA is not recommended for infants less than 6 months old. Student Preparation Activity (BRING TO CLASS) 1. Make drug cards for the following: a. Acetaminophen b. Ibuprofen c. Morphine 2. Include mg/kg dosages for each medication. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 10-11: Nursing Care of Children with Alterations in Elimination Functional Health Patterns: Elimination Learning Objectives 1. Create a care plan for the infant with acute diarrhea to include fluid replacement. 2. Discuss nursing assessment and care for Wilms’ tumor, celiac disease, and Hirschsprung’s disease. 3. Discuss nursing interventions for the child with structural defects of gastrointestinal & genitourinary system. 4. Describe potential alterations in urinary functions related to fluid and electrolyte balance, acid-base balance, and infection. 5. Identify pharmacologic interventions and teaching related to alterations in the child’s elimination. Preparation Resources 1. WPHLW Chapter 47, “Gastrointestinal Dysfunction,” pp. 1363-1437. 2. WPHLW Chapter 50, “Genitourinary Dysfunction,” pp. 1526-1550. 3. Clinical Manual for Pediatric Nursing, pp. 79-81. 4. http://evolve.elsevier.c om/Wong/clinical Gastrointestinal Dysfunction, Cleft Palate, Esophageal Atresia Learning Activities Terminology - * May need to use a medical dictionary. 1. Lecture/topic discussion 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities 1. 2. 3. 4. 5. 6. 7. 8. 30 Spring 2013 Acute glomerulonephritis Acute infectious diarrhea Celiac disease Chelation Crohn’s disease Enterobiasis (pinworms) Giardiasis Hemolytic-uremic syndrome 9. Hirschsprung disease 10. Hydroephrosis 11. Hypertrophic pyloric stenosis 12. Intussusception 13. Meckel diverticulum 14. Short bowel (gut) syndrome 15. Wilms tumor Critical Thinking Questions 1. What interventions would most benefit the child and parent when they’ve just been given a diagnosis that will result in surgery (i.e. Hirschsprung’s disease). 2. What would be the alterations in lifestyle and psychological reactions to chronic renal failure for the school-aged child? 3. How could you best gather patient fluid and electrolyte imbalance data and contrast that with potential nursing diagnosis and interventions based on scientific rationale to obtain the best patient outcomes? Student Preparation Activity (BRING TO CLASS) 1. List (5) strategies for increasing fluid intake for a toddler. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 12-13: Nursing Care of Children with Respiratory Dysfunction Functional Health Patterns: Activity-Exercise; Sleep-Rest; Nutritional-Metabolic; Health-Management; Coping/Stress-Tolerance Patterns Learning Objectives 1. Preparation Resources 2. 1. Describe the Asthma severity classification system and understand the difference between “quick relief” and “control” meds. 2. Apply the Nursing Process for care of the child with congenital acquired genetic and familial disorders of Asthma & CF. 3. Discuss nursing diagnoses and interventions for the child with respiratory distress and the child with respiratory dysfunction. 4. Develop strategies for preventative and maintenance care for the child with long-term respiratory disorders. 3. 4. 1. WPHLW Chapter 45, “Procedures for Maintaining Respiratory Function,” pp. 1289-1294. 2. WPHLW Chapter 46, “Respiratory Dysfunction,” pp. 1303-1353. 3. Clinical Manual for Pediatric Nursing, pp. 74-79, 163, 269-276, 280-281, & 308-311 4. Internet resources: a. http://www.aaaai.org b. http://www.lungusa.org c. http://www.aanma.org Learning Activities 1. Lecture/topic discussion 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities 31 Spring 2013 d. 1. When an infant has bronchiolitis, what nursing assessment and interventions will be necessary? 2. List two ways the nurse educates children and families on cleaning the nebulizer, spacer, and peak flow meter. Why is this important? 3. What does respiratory distress look like in the infant? School-aged child? 4. How can the child’s/parent’s anxiety affect the child’s oxygenation? How can the nurse help? http://evolve.elsevier.com/Wong/clinical Cystic Fibrosis, Tonsillitis, Respiratory Distress, Bronchiolitis Terminology - *May need to use a medical dictionary. 1. Aerosol Spacer 2. Asthma Trigger 3. Chest Physiotherapy (CPT) 4. Hyperpnea 5. Hypopnea 6. Metered Dose Inhaler (MDI) 7. Nasal Flaring 8. Nebulizer Critical Thinking Questions 9. 10. 11. 12. 13. 14. 15. Orthopnea Peak Expiratory Flow Meter Respigam Retractions Ribavirin Steatorrhea Synagis Student Preparation Activity (BRING TO CLASS) 1. Complete EVOLVE case study: Cystic Fibrosis 2. Present evidence of completion. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 14-15: Nursing Care of Children with Cardiovascular Dysfunction Functional Health Patterns: Activity-Exercise; Nutritional-Metabolic; Health-Management; Coping/Stress Tolerance Learning Objectives 1. Discuss the nurse’s role in performing a pediatric cardiac assessment. 2. Describe nursing care of a client undergoing cardiac catheterization. 3. Compare & contrast pathophysiology of the four hemodynamic classifications of congenital heart defects. 4. Apply the nursing process in care of a child with the specific congenital heart defects included in each classification. 5. Develop a plan to provide pre and post-op care for a pediatric client undergoing cardiac surgery. 6. Discuss nursing care of the child experiencing CHF and/or hypoxia. 7. Describe nursing interventions for a child having a “Tet spell”. 8. Develop plan of care for a child with acquired cardiac disorders: Bacterial Endocarditis, Rheumatic Fever, Hyperlipidemia, & Dysrhythmias. 9. Develop a plan of care for the child with vascular dysfunction: systemic hypertension, Kawasaki Disease, shock, anaphylaxis, & toxic shock syndrome. 32 Spring 2013 Preparation Resources Critical Thinking Questions WPHLW Chapter 8, “Fetal Circulatory System,” p. 179. 2 WPHLW Chapter 24, “Cardiovascular System,” pp. 610-612 (fetal circulation review). 3 WPHLW Chapter 48, “Cardiovascular Dysfunction,” pp. 1442-1488. 4 Clinical Manual for Pediatric Nursing, pp. 82-38 & 312-315. Internet Resources: American Heart Association: http://www.amhrt.org HeartPoint.com: http://www.heartpoint.com Neonatology on the Web: http://www.neonatology.org/neo.clinical.html (click on C for cardiomyopathy, congestive heart failure, congenital heart disease, etc.) Children’s Organ Transplant Association: http://www.cota.org (click on “links”) 1. 1 What commonalities might you observe in care of a child with respiratory dysfunction versus cardiac dysfunction? 2. Why would the nurse also expect to note polycythemia in a child with clubbed fingers? 3. Explain the etiology of the following clinical manifestations of CHF: a) cardiomegaly b) tachycardia c) tachypnea d) gallop rhythm e) oliguria f) diaphoresis g) hepatomegaly h) failure to thrive (FTT) i) decreased exercise tolerance j) decreased peripheral pulses 4. Explain why oxygen therapy is of limited value to the infant with TGV/TGA. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Learning Activities 1. Lecture/topic discussion 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities Terminology - *May need to use a medical dictionary. Student Preparation Activity 1. 2. 1. Complete EVOLVE case study: “Congestive Heart Failure”. 2. Present evidence of completion. 3. 4. 5. 6. 7. 8. 9. 10. 11. 33 Spring 2013 Anaphylaxis Arterial Blood Gases (ABG’s) Cardiomegaly Clubbing Congestive Heart Failure Dysrhythmia Eisenmenger Complex (Syndrome) Endocarditis Hemodynamics High-Density Lipoprotein (HDL) Hypercapnia 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. Hypercyanotic (Tet) Spells Hypoplastic Hypoxemia Hypoxia Ischemia Low-Density Lipoprotein (LDL) Pleural Effusion Pneumothorax Polycythemia Tamponade TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 16: Nursing Care of Children with Integumentary Dysfunction Functional Health Patterns: Nutrition/Metabolic Learning Objectives 1. Assess and plan care for the child with a rash. 2. Differentiate between contact dermatitis and infectious dermatitis. 3. Contrast the manifestations and therapies for bacterial, viral, and fungal infections of the skin. 4. Outline a plan of care for a child with a skin disorder related to insect or animal contacts. 5. Create a plan of care for a child with integumentary dysfunction specifically for the pharmacotherapy. Learning Activities 1. 2. 3. 4. Power Point Handout Lecture/Class discussion Case Studies Problem solving activities 34 Spring 2013 Preparation Resources 1. WPHLW Chapter 53, “Integumentary Dysfunction,” pp. 1632-1661. 2. Clinical Manual of Pediatric Nursing, pp. 40-41, 214-219. Critical Thinking Questions 1. Why is it important for the nurse to understand and recognize the differences in skin lesions caused by inflammation, infection, and/or vector borne bites and stings? 2. What teaching will the school nurse implement to eliminate the spread or treatment of lice? Terminology - *May need to use a medical dictionary 1. 2. 3. 4. 5. 6. 7. 8. Acne Angiogenesis Arthropod Candidiasis Dermatophytoses Diaper Dermatitis Ecchymoses Erosion 9. 10. 11. 12. 13. 14. 15. 16. Erythemia Excoriation Fissure Ichthyosis Keloid Pediculosis Petechiae Pruritus 17. 18. 19. 20. 21. 22. 23. Scabies Scar Secondary lesions Sensitizing agent Tinea Ulcer Verruca Student Preparation Activity (BRING TO CLASS) 1. Choose a medication found in the reading and create a medication card. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 17: Nursing Care with Hematological & Immunologic Dysfunction Functional Health Patterns: Nutritional-Metabolic; Activity-Exercise; Coping-Stress Tolerance; Self-Perception; Value-Belief Learning Objectives Preparation Resources Critical Thinking Questions 1. Identify the goals and responsibilities of the nurse who is caring for a 1. A 4-year-old girl was just diagnosed WPHLW Chapter child with leukemia. 49, “Hematological as having ALL. Develop a plan of 2. Differentiate between Hodgkin disease and Non-Hodgkin lymphoma and Immune care to help meet the immediate related to the pathophysiology and clinical manifestations. Dysfunction,” pp. needs of both child and family. 3. Create a nursing care plan for a child with a hematological 2. How can the nurse apply the 1490-1524. dysfunction. principles of atraumatic care to Clinical Manual of 4. Discuss strategies for preventative and long-term maintenance care of children with chronic diseases Pediatric Nursing: the pediatric client with selected congenital acquired genetic and involving multiple invasive 314-316 familial disorders of Hematological & Immunologic Dysfunction. procedures and fear inducing elements, such as cancer and Internet Resources: diabetes mellitus? Sickle Cell 3. What teaching topics would be Sickle Cell Disease included when teaching daycare Association of America, Inc. providers about hemophilia? Learning Activities Terminology - *May need to use a medical dictionary Student Preparation Activity 1. Lecture/topic discussion 1. Acromegaly 7. Hemophilia 1. Complete EVOLVE case study: “ 2. Power Point Handout 2. Anemia 8. Ischemia Sickle Cell Anemia”. 3. Problem-solving activities 3. Aplastic anemia 9. Myelosuppression 2. Present evidence of completion. 4. Practical application 4. Chelation 10. Remission induction activities 5. Chemotherapeutic agents therapy 6. Epistaxis 11. Sickling 12. Thallasemia 35 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 18-19: Nursing Care of Children with Alterations in Mobility Functional Health Pattern: Activity-Exercise Learning Objectives 1. Plan Care for a child: a. immobilized with an injury or degenerative disease b. in a cast or in traction c. with a congenital skeletal deformity 2. Demonstrate an understanding of the management of a child with systemic lupus erythematous or juvenile rheumatoid arthritis. 3. Devise a nursing plan of care for the child with cerebral palsy. 4. Discuss nursing interventions to maintain or promote mobility and function in the child with spina bifida. 5. Demonstrate understanding of interventions to prevent and/or manage the outcomes of acquired neuromuscular disorders, such as Guillain-Barre syndrome, tetanus, botulism, and spinal cord injuries. Preparation Resources 1. WPHLW Chapter 54, “Musculoskeletal or Articular Dysfunction,” pp. 1676-1715. 2. WPHLW Chapter 55, “Neuromuscular or Muscular Dysfunction,” pp. 1716-1743. 3. Clinical Manual for Pediatric Nursing, pp. 4041& 214-219. 4. http://evolve.elsevier.com/Wong 5. Learning Activities 1. Lecture/class discussion 2. Power Point handout Problem-solving activities 3. Practical application activities 36 Spring 2013 /clinical Scoliosis http://www.crutchdoc.com Student Preparation Activity (BRING TO CLASS) Terminology - *May need to use a medical dictionary 1. 2. 3. 4. 5. Atrophy Botulism Bryant traction Countertraction Developmental dysplasia of the hip 6. Fracture 7. Muscular dystrophies 8. Myelomeningocele 9. 10. 11. 12. 13. 14. Critical Thinking Questions 1. Why do nurses teach the avoidance of honey for infants? 2. Devise creative interventions to encourage neuromuscular development for a child with cerebral palsy. 3. How can the nurse promote the meeting of developmental needs in a child or adolescent with spinal injury? Kyphosis Lordosis Meningocele Osteoblastic formation Osteoclastic formation Osteomyelitis 15. 16. 17. Osteopenia 1. Complete EVOLVE case Scoliosis study: “Fracture”. Skeletal 2. Present evidence of traction completion 18. Skin traction 19. Spina bifida 20. Tetanus TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 20-21: Nursing Care of Children with Cognitive or Sensory Impairment Functional Health Pattern: Cognitive-Perceptual Learning Objectives 1. 2. 3. 4. Analyze assessment data obtained while caring for an infant or child experiencing a cognitive defect. Outline nursing interventions for the infant or child with hearing impairment or visual disorders. Develop a care plan for a child with cognitive impairment that promotes optimum development. Identify guidelines for implementing discipline. Learning Activities 1. 2. 3. 4. Lecture/topic discussion Power Point Handout Problem-solving activities Practical application activities 37 Spring 2013 Preparation Resources Critical Thinking Questions 1. WPHLW Chapter 31, “Limit Setting & Discipline,” pp. 812-814. 2. WPHLW Chapter 42, “Cognitive and Sensory Impairment,” pp. 1177-1201. 1. The nurse is preparing to admit an 8-year-old child to the unit, who received severe eye injuries in a car accident this morning. This child's eyes will be bandaged. What are the child's immediate needs? What particular aspects of therapeutic communication will the nurse engage with the child and family? Terminology - *May need to use a medical dictionary 1. Adaptive Tasks 8. Inattention 2. Autism 9. Impulsivity 3. Behavior Modification 10. Learning disability 4. Cognitive impairment 11. Mainstreaming 5. Deafness 12. Mental retardation 6. Down Syndrome 13. Time out 7. Fragile X Student Preparation Activity 1. List five pediatric strategies to implement positive behaviors in a five year-old. All strategies should be developmentally appropriate. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 22-23: Nursing Care of Children with Cerebral Dysfunction Functional Health Patterns: Cognitive-Perceptual, Activity-Exercise Preparation Learning Objectives Critical Thinking Questions Resources 1. Describe the assessment of level of consciousness for a child. 1. A 9-year-old male was involved in a pedestrian1. WPHLW 2. Formulate a plan of care for an unconscious child. Chapter 51, motor vehicle accident and has not regained 3. Discuss planning nursing care for the child with increased “Cerebral consciousness since the accident. Think intracranial pressure. Dysfunction,” critically to facilitate health promotion, 4. Discuss nursing interventions for a child with head trauma. pp. 1551-1598. maintenance or restoration using the following 5. Outline a plan of care for a child with viral or bacterial 2. Clinical Manual nursing diagnoses: meningitis. of Pediatric a. Risk for Injury r/t altered cerebral function 6. Differentiate the two classifications of epileptic seizures. Nursing, pp. 88b. Risk for impaired skin integrity r/t 7. Identify pharmacologic interventions/teaching related to the 91, 321-323. immobility. care of a child with increased intracranial pressure, loss of c. Self-care deficit r/t inability to feed consciousness, and/or seizure activity. himself. 8. Describe the preoperative and post-operative care of a child d. Altered family process r/t change in child’s with hydrocephalus. health status. e. Risk for infection r/t immobility. Learning Activities 1. Lecture/topic discussion 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities 38 Spring 2013 Terminology - *May need to use a medical dictionary 1. Clonic 9. Near-drowning 2. Encephalitis 10. Neuroblastoma 3. Epidural 11. Postictal hemorrhage 12. Reye Syndrome 4. Febrile Seizure 13. Status epilepticus 5. Hydrocephalus 14. Subdural hemorrhage 6. Ketogenic diet 15. Tonic 7. Meningitis 16. Ventriculoperitoneal 8. Microcephaly shunt Student Preparation Activity 1. Create medication cards (4X6) for the following three medications: 1) Fosphenytoin 2) Dilantin 3) Pancuronium TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 24-25: Nursing Care of Children with Endocrine Imbalance Functional Health Patterns: Nutritional-Metabolic; Activity-Exercise; Coping-Stress Tolerance; Self-Perception; Value-Belief Learning Objectives 1. 2. Describe the nurse’s role in detecting endocrine dysfunction, and intervening when the child or adolescent needs pharmacotherapeutic management and/or surgery. Describe indicators of hypofunction or hyperfunction of various organs within the endocrine system, and discuss the impact of these findings on planned nursing care. Learning Activities 1. Lecture/topic discussion – View Streaming Video prior to class for this lecture 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities 39 Spring 2013 Preparation Resources 1. WPHLW Chapter 52, “Endocrine Dysfunction,” pp. 1600-1630. 2. Internet Resources: http://www.bozemanscience.com Search “Endocrine” Critical Thinking Questions 1. A 16-year-old male is admitted to the hospital in diabetic ketoacidosis (DKA). He has recently begun playing soccer, and has a new group of friends, with whom he has often been out late. He is also eating unplanned, irregular meals. What interventions, including teaching interventions, will the nurse use to promote healthy development & to assist the adolescent to maintain a more euglycemic blood sugar? 2. How can the nurse apply the principles of atraumatic care to children with chronic diseases involving multiple invasive procedures and fear inducing elements, such as cancer and diabetes mellitus? Terminology - *May need to use a medical dictionary 1. Adrenocortical insufficiency 2. Cushing syndrome 3. Cytochemical markers 4. Exophthalmos 5. Glycosuria 6. Goiter 7. Hyper/hypoglycemia 8. Hyperaldosteronism 9. Hypo/hyperthyroidism 10. 11. 12. 13. 14. 15. 16. 17. Hypopituitarism Ketoacidosis Ketonuria Physiologic anorexia Polydipsia Polyuria Precocious puberty Remission induction therapy Student Preparation Activity 1. Create a table that organizes the clinical picture of the hypersecretion and hyposecretion of the thyroid and parathyroid glands. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION THREE: Theory Learning Maps Class 26: Chronic Illness, Disability, & End of Life Functional Health Pattern: Coping-Stress-Tolerance, Values-Beliefs, Cognitive-Perceptual Learning Objectives Preparation Resources Critical Thinking Questions 1. Recognize the impact of illness or disability on the developmental stages of childhood. 2. Outline nursing interventions that promote the family’s optimum adjustment to the child’s chronic disorder. 3. Identify interventions to aid in the adjustment to the diagnosis of chronic illness, disability, and end of life. 4. Analyze the usual symptoms of the normal grief process in parents and children. 5. Analyze a child’s understanding of and reactions to death and identify appropriate interventions for a child experiencing death in their environment. 1. WPHLW Chapter 41, “Chronic Illness, Disability, & End of Life,” pp. 1146-1174. 2. Clinical Manual of Pediatric Nursing, pp. 291-296. 1. What strategies can the nurse use to cope with the stress of providing care for children who are dying and avoid burnout? 2. How can the nurse apply the principles of atraumatic care to children with chronic diseases involving multiple invasive procedures and fear inducing elements, such as cancer and diabetes mellitus? 3. What guidelines should be followed in informing a child of a life-threatening illness or disability? 4. How can the nurse support the family at the time of the death of a child? Learning Activities 1. Lecture/topic discussion – View Streaming Video prior to class for this lecture 2. Power Point Handout 3. Problem-solving activities 4. Practical application activities 40 Spring 2013 Terminology - *May need to use a medical dictionary 1. Anticipatory grieving 9. Handicap 2. Bereavement 10. Hospice 3. Chronic illness 11. Palliative 4. Congenital disability care 5. Denial 12. People-first 6. Developmental delay language 7. Developmental 13. Technologydisability dependent 8. Disability child Student Preparation Activity 1. Identify three (3) different developmental stages (Erikson) of children 0-18 years of age and list a perception of death connected to each particular developmental group. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FOUR: Learning Activities Laboratory Learning Maps Topic A: Pediatric Dosage Calculation Learning Objectives 1. Use one of the two primary methods to determine pediatric drug dosage. 2. Describe the dosage inaccuracies that may occur with pediatric drug formulas. 3. Calculate drug dosages correctly in practice problems. 41 Spring 2013 Critical Thinking Questions 1. Pharmacology: A Nursing Process Approach, 1. What is the impact of 7th ed. (Key, Hayes, & McQuiston), Unit 1, medication error in Section 4F: Pediatric Drug Calculations, pp. 99the pediatric 106. population? 2. See following “Medication Dosage Computation Examination Self-Learning Guide.” Internet Resources: University of Michigan School of Nursing, Student Clinical Calculation Self-study: http://lessons.ummu.umich.edu/2k/utilize/lesson/i ndex/son-tutorials/math Preparation Resources Learning Activities 1. Pediatric Medication Dosage Review Guide 2. Written Medication Dosage Calculation Exam TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Learning Activity: Medication Dosage Computation Examination Self-Learning Guide The purpose of this self-learning guide is to prepare the student for calculating and administering accurate medication dosages to children. The Physician’s Desk Reference (PDR) and other drug reference books generally provide information regarding usual dosages for children based on Kg (Kilogram) of body weight. The student is expected to utilize this information in combination with formulas and conversions learned in preceding nursing courses to determine what dosages are within the recommended range. The student is also expected to calculate the correct dosage of medication to be administered, based on the quantity on hand. A sample problem and pre-test with specific instructions for completing the test are provided for individual practice. SAMPLE: Order: Amoxil p.o. TID On Hand: Amoxil 500 mg per 5 mL Pediatric dosage (based on PDR): 40 mg/Kg/day (24 hours) How many mg should a child weighing 33 lbs. receive per dose? How many mL should a child weighing 33 lbs. receive per dose? Step 1: Change lbs. to Kg: 33 lb. 2.2 lb./Kg = 15 Kg 33 2.2 = 15 Kg Step 2: Determine how many mg this child can receive per day. 40 mg/Kg/day x 15 Kg = 600 mg/day Step 3: Determine how many mg this child can receive per dose if the medication is to be given TID: 600 mg 3 doses = 200 mg/dose Step 4: Determine how many mL the child should receive per dose: Formula: Desired x Quantity Have 42 Spring 2013 200 mg x 5 mL = 2 mL/dose 500 mg TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Dosage Calculation Learning Activity: Practice Test Learner Name: 1. How many Kilograms (Kg) are in 132 pounds (lbs.)? 2. How many Kg are in 33 lbs.? 3. How many Kg are in 22 lbs.? 4. How many lbs. are in 75 Kg? 5. How many lbs. are in 5 Kg? 6. Pediatric Dosage: Keflex p.o. 50 mg/Kg/day. How many mg should a 20 Kg child receive per day? 7. Pediatric Dosage: Gentamycin 3 mg/Kg/day. How many mg should a 50 Kg child receive per day? 8. Pediatric Dosage: Ceclor 20 mg/Kg/day. How many mg should a 17 Kg child receive per day? 9. Pediatric Dosage: Lasix 2 mg/Kg/day. How many should a 4 Kg child receive per day? 10. Pediatric Dosage: Methicillin IM 100 mg/Kg/day. How many mg should a 40 Kg child receive per day? 11. Order: Carbenicillin IM q 4 h. Pediatric Dosage: 30 mg/Kg/day. How many mg should a 10 Kg child receive per dose? 12. Order: Demerol IV q 3 h for pain - Pediatric Dosage: 6 mg/Kg/day. How many mg should a 7.5 Kg child receive per dose? 13. Order: Morphine IM q 4 h prn pain - Pediatric Dosage: 0.1 mg/Kg/day. How many mg should a 60 Kg child receive per dose? 14. Order: Kanamycin IV TID - Pediatric Dosage: 25 mg/Kg/day. How many mg should a 15 Kg child receive per dose? 15. Order: Amoxil po TID - Pediatric Dosage: 40 mg/Kg/day. How many mg should a 30 Kg child receive per dose? 16. Order: Amikacin IV q 6 h - On Hand: 0.5 g in 10 mL - Pediatric Dosage: 30 mg/Kg/day. 43 Spring 2013 Date: TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 How many mL should a child weighing 32 Kg receive per dose? 17. Order: Diphenhydramine IM q 8 hours - On Hand: 50 mg/cc - Pediatric Dosage: 5 mg/Kg/day. How many cc should a child weighing 15 Kg receive per dose? 18. Order: Streptomycin IM BID - On Hand: 0.4 g/cc - Pediatric Dosage: 40 mg/Kg/day. How many cc should a child weighing 33 lbs. receive per dose? 19. Order: Cephradine IV TID - On Hand: 125mg/5cc - Pediatric Dosage: 30 mg/Kg/day. How many mL should a child weighing 22 lbs. receive per dose? 20. Order: Garamycin IV q 8 h - On Hand: 10 mg/mL - Pediatric Dosage: 2.5 mg/Kg/day. How many mL should a child weighing 52.8 lbs. receive per dose? *These are sample questions. The Dosage Calculation Exam will consist of 20 questions similar to numbers 12-20. 44 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Dosage Calculation Learning Activity: Test Answers 1. 60 Kg 2. 15 Kg 3. 10 Kg 4. 165 lbs. 5. 11 lbs. 6. 1000 mg 7. 150 mg 8. 340 mg 9. 8 mg 10. 4000 mg 11. 50 mg 12. 5.6 mg 13. 1 mg 14. 125 mg 15. 400 mg 16. 4.8 mL 17. 0.5 cc 18. 0.75 cc 19. 4 mL 20. 2 mL 45 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FOUR: Learning Activities Laboratory Learning Maps Topic B: Growth and Development – Assessment Learning Objectives Preparation Resources 1. Utilize Erikson’s stages of development in the process of Pediatric Assessment. 2. Implement strategies of play to foster child’s development. 3. Demonstrate various approaches used for different developmental stages. 4. Analyze the use of nursing interventions designed to meet the developmental aspects of children’s concerns: i.e., intrusiveness, separation anxiety, etc. 5. Practice various aspects of physical examination on manikins. 6. Apply concept mapping to the assessment of the pediatric client and family. 7. Identify assessment needs of the school-age & adolescent in the school setting. 8. Review: Growth Grids DDST Toys Strategies 1. WPHLW Chapter 33, “Developmental Influences on Child Health Promotion,” pp. 842-864. 2. WPHLW Chapter 34, “Communication, History, Physical & Developmental Assessment,” pp. 866-927. 3. Bring Clinical Manual of Pediatric Nursing to LAL. 4. 2 Videotapes to be viewed in the LRC: Communicating With Children and Families: RJ245-1098924 Pediatric Assessment: RJ245-1098929 5. Review Concept Map PP on Bb. Critical Thinking Questions 1.What techniques and strategies can the nurse use to gain the trust of children? 2.How does the concept of atraumatic care apply to the physical examination of children? 3.A two-year-old child has just been admitted and placed in your care. He was treated in the Trauma Center for head injury. How will you safely assess his level of consciousness, mental status, and other aspect of physical examination? 4.A 12-month-old is brought to the primary care physician’s office for a routine checkup. What behaviors would you expect to see? 5.A 10-year-old is brought to the ambulatory surgery center for testing and preoperative teaching prior to an elective tonsillectomy. How should the nurse approach this child’s: a. Intellectual level? b. Developmental level? 1. 2. NOTE: Reading assignments for this Learning Activity Lab may have been previously assigned. 46 Spring 2013 Learning Activities Manikin practice for Pediatric Head-ToToe physical assessments. 2. Videotapes to be viewed in LRC: a. Communicating With Children and Families RJ2451098924, & b. Pediatric Assessment: RJ245-1098929 3. Practice Concept Mapping 1. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FOUR: Learning Activities Laboratory Learning Maps Topic C: Common Nursing Interventions with Children – Pediatric Medication Administration Learning Objectives 1. Demonstrate effective approaches to administer medications to children as well as statements to promote compliance and those to avoid. 2. State safeguards used to administer medications correctly to infants, children, and adolescents. 3. Practice use of appropriate restraint to maintain safety during therapies and procedures. Preparation Resources 1. Videotape to be viewed on your own time: Pain Assessment and Management, RJ245-1098925. 2. WPHLW Chapter 45, “Administration of Medication,” pp. 1273-1289, & “Restraint Methods and Therapeutic Hugging,” pp. 12651266. 3. Clinical Manual of Pediatric Nursing, pp. 232-248 4. Bring Clinical Manual of Pediatric Nursing to LAL. Learning Activities 1. Demonstration 2. Problem-solving activities 3. Psychomotor practice 4. Videotape to be viewed in LAL: Medications & Injections, RJ245-1098927 47 Spring 2013 Critical Thinking Questions 1. As you begin to administer an oral medication to a 3year-old child, she begins crying and coughing vigorously. How do you handle the situation? 2. A mother tells you she uses teaspoons from her kitchen to measure her children’s medications. How would you most appropriately respond to her? 3. You overhear a parent telling a child to behave, “or I’ll have this nurse give you a shot!” How can you respond most therapeutically to the parent and child? 4. You have mixed a pre-school-age child’s oral medication with applesauce. What ethical and practical issues are involved in avoiding telling the child about the medication? Terminology 1. Eutectic Mixture of Local Anesthetics TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FOUR: Learning Activities Laboratory Learning Maps Topic D: Common Nursing Interventions with Children – Pediatric Fluid & Electrolyte Management Learning Objectives Preparation Resources 1. Accurately measure intake and output. 2. Calculate maintenance fluid requirements. 3. Discuss the assessment findings & implications of altered hydration levels. 4. Demonstrate calculation of Intake and Output for child wearing diaper. 5. Demonstrate methods to comfort infant/child. 1. WPHLW Chapter 47, “Fluid Requirements,” p. 1380-1383. 2. Clinical Manual of Pediatric Nursing, pp. 249-254 3. Bring Clinical Manual of Pediatric Nursing to LAL. 48 Spring 2013 Critical Thinking Questions 1. A mildly dehydrated 3-year-old is hesitant to drink liquids. What interventions would encourage liquid intake? Learning Activities 1. Demonstration 2. Problem-solving activities TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FOUR: Learning Activities Laboratory Learning Maps Topic E: Nursing Interventions: Tracheostomy Care Learning Objectives Preparation Resources 1. Compare and contrast the three 1. Tracheostomy Basic Care types of tracheostomy tubes: Insite Media 2005 (Blackboard) uncuffed and cuffed. 2. Discuss when each is used and the nursing assessments and interventions for each. 3. Discuss nursing interventions to facilitate communication with clients who have a tracheostomy. 4. Demonstrate tracheostomy care for a mannequin with a tracheostomy. 49 Spring 2013 Critical Thinking Questions 1. How will the nurse decide if the procedure will be a sterile or clean procedure? 2. Is this a procedure that could be delegated? 3. If a precut dressing for the trach is not available, what would the nurse use for a dressing? Learning Activities 1. During lab experience, the student will demonstrate tracheostomy cleaning to a peer in the lab and receive feedback from the peer. 2. Practice trach dressing change on model and mannequin. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FIVE Acute Care Practicum - Pediatric Clinical Experience Times: Clinical time includes a pre-conference and post-conference, each of which lasts approximately fifteen to thirty minutes. Each conference will focus on each student’s selected patient, the nursing process, and the objectives of the appropriate clinical learning map. Students are expected to contribute to the conference/clinical discussions. Clinical Assignments: The student will be assigned to a client at the beginning of the clinical day. Additional information regarding clinical assignments will be supplied during each clinical orientation; please see the course calendar in this packet. The student is expected to utilize previous medical-surgical knowledge and pediatric knowledge to identify a plan of care. Textbooks are available on the clinical unit for reference. Submission of Written Work: Written work for each clinical week will be due to the appropriate clinical instructor as determined by the course coordinator. See the course syllabus for information regarding failure to submit written work. Written work is due the Monday following the clinical experience. Late work will be penalized and may not be accepted. Growth Chart: The student will complete a gender- and age-appropriate growth chart on each patient that the student selects. These charts can be found on the clinical unit, and the instructor will provide specific instructions regarding appropriate completion of each chart. The completed chart is to be submitted as part of the written work for the clinical week. Intake and Output: Every pediatric patient is on intake and output (I&O), and strict attention is given to this very important assessment data. The student is to use appropriate calibrated containers when measuring all fluids, regardless of whether it is intake or output. The student must assure that I&O calculations are accurate and documented on the patient’s bedside flow sheet throughout each clinical experience. In addition, the student is to give this information to the patient’s assigned staff nurse before leaving the pediatric unit at the conclusion of the clinical experience. The student is to calculate appropriate maintenance fluids for each patient; a worksheet is provided in the learning activity laboratory to provide a guideline for fluid calculation. This calculation must be documented on each patient’s assessment form. Nutrition: Attention to the normal nutritional requirements of the infant, child, or adolescent will be a focus each clinical week, as well as the additional nutritional demands created by the patient’s illness or injury. The specific nutritional requirements of the child must be included in the plan of care, as well as appropriate nursing interventions designed to meet the nutritional needs of the particular pediatric patient. Development: The student must assess the developmental status of each of the student’s selected patients. Using this information, the student must reflect developmentally appropriate patient care. Nursing interventions planned to meet specific patient needs must be stated in developmentally appropriate terms when teaching, when providing instructions during care, when playing with the patient, when providing comfort measures, etc. The student must also remember appropriate therapeutic communication and approaches when working with the pediatric patient’s parents/guardians/significant others. Safety: The safety of the pediatric patient is of utmost importance. Any action by the student, which places the patient in peril, will be managed by the nursing faculty according to the 50 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 parameters stated in the course syllabus and the TCC Nursing Student Handbook. Please review these sources. Patient Discharged During Clinical Experience: If the student’s patient is discharged during the clinical experience, the student is to complete the written plan of nursing care as directed by the clinical instructor. The instructor will assist the student in selecting another pediatric patient or in selecting different clinical learning activities. All written assignments are to be submitted as previously stated in this packet and in the syllabus. Charting: The clinical instructor and/or the staff nurse assigned to the pediatric patient will review all documentation entries before the entries are finalized in either the digital chart or the hardcopy chart. Patient’s Staff Nurse: It is imperative the student maintain a collaborative and professional relationship with the patient’s assigned staff nurse. The staff nurse should never have to guess what the student’s plan of care is, or how the student is caring for the patient. Open communication with the staff nurse is essential. The student must discuss with the staff nurse the student’s nursing care objectives and plan of care for the clinical experience. The student must tell the nurse the length of time that the student will be caring for the patient, and exactly which nursing care tasks the student is responsible for completing, such as administering specific medications. Pediatric nursing is highly specialized and requires frequent interdisciplinary communication and interaction. The student must never guess and should always ask if uncertain. The student is responsible for obtaining report from the patient’s staff nurse (not nurse tech) prior to implementing nursing care, and the student must report off to the patient’s staff nurse at the conclusion of the student’s clinical experience, or when leaving the pediatric unit at any time. Medication Administration: The administration of any medication must be supervised by either the clinical instructor or the pediatric staff nurse. There is no excuse for a medication error, although errors do occur and there are numerous reasons for these potentially fatal mistakes. When medicating infants, children, or adolescents, the right approach is an additional “right” of medication administration. Breaks: Breaks are not guaranteed during clinical experiences because the patient census and needs are extremely variable and difficult to predict. When possible, the clinical instructor will assign a break time to each student. The student is strongly encouraged to eat a nutritious lunch or breakfast prior to the assigned clinical time. Behavior and Dress Code: The student is expected to abide by the Nursing Program’s uniform rules and dress code whenever the student is representing the Nursing Program in clinical areas. The student is encouraged to review these standards prior to the first clinical orientation and periodically during the semester. Instructor: Phone: Cell: Email: 51 Spring 2013 Pager: Office Hours: TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Things to Consider About How We Communicate Professionalism Therapeutic Communication Skills Appearance Awareness of Cultural Differences Awareness of Gender Differences Self confidence Assertiveness PROFESSIONAL IMAGE Tone Problem Solving Skills Language Responsiveness Reactions to Stress & Emotions Communicating with Challenging People Adapted from P. Schuster: Communication: The Key to the Therapeutic Relationship. FA Davis, 2000. 52 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Student Questions for Reflection Answer the following questions about professional image & professional development after reading the chapter: 1. What about nursing makes me feel good? 2. What about nursing makes me feel bad? 3. How does my personal image affect my professional image? 4. Is it possible to separate the personal and professional image? Why or why not? 5. What is my current professional developmental stage? 6. What professional developmental tasks are related to my current professional developmental stage? 7. Identify various developmental stages of a group of nurses found in a clinical practice setting. How do they support each other? How do they detract from one another? 8. How can I help another nurse who is trying to meet different developmental tasks than myself? 9. How do I feel about my current nursing position? 10. What type of nurse would I like to be 5 years from today? 11. How could I support someone who is considering a nursing career change? 12. How healthy is my current lifestyle? 13. How do my current lifestyle choices affect my personal health and professional performance? 14. Is it important for a professional nurse to role model a healthy lifestyle? Why or why not? 15. What could I do to move to a healthier lifestyle? Leddy & Pepper's Conceptual Bases for Professional Nursing, 5th Ed. Lucy J. Hood RN, DNSc & Susan K. Leddy RN, PhD Copyright © 2005 Lippincott Williams & Wilkins - All Rights Reserved http://connection.lww.com/products/hood/ReflectionQuestionsCh05.asp Legal Disclaimer: Copyright 2003 Lippincott Williams & Wilkins, 530 Walnut Street, Philadelphia, PA 19106-3621 U.S.A. All rights reserved. Copyright in the documents ("Contents") on the Lippincott Williams & Wilkins Web Servers is owned by Lippincott Williams & Wilkins (LWW), unless otherwise indicated. LWW hereby authorizes you to copy documents published by LWW on the World Wide Web for non-commercial uses within your organization only. In consideration of this authorization, you agree that any copy of these documents which you make shall retain all copyright and other proprietary notices contained herein. 53 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FIVE: Acute Care Clinical Practicum Learning Maps Clinical Day 1: Focus -Introduction to Caring for Acutely or Chronically Ill Children Learning Objectives Preparation Resources Critical Thinking Questions Learning Activities 1. 1. WPHLW Chapter 34, “Communication, History, Physical & Developmental Assessment,” pp. 866-927. 2. Clinical Manual of Pediatric Nursing, Summary of Physical Assessment of the Newborn, pp. 1317; & Physical Assessment, pp. 1874. 3. Review Critical Thinking Questions before clinical to formulate answers and additional questions. 4. Review “Acute Care Practicum Pediatric Information” and “Child Health Assessment Outline (Nursing Process by Functional Health Pattern)” in syllabus. 5. Arrive in complete uniform with tools (stethoscope, penlight, photo ID and name badge, etc.). 6. Bring complete NURS 2433 Clinical Forms Packet to clinical. 1. 1. Orientation to the clinical site. 2. Discuss faculty’s clinical expectations related to timely completion of initial assessment, medication administration, and clarification of paperwork. 3. Discuss implications of medication administration (including narcotics) and IV maintenance with the faculty and peer group. 4. Discuss the role of the Child Life Specialist & how nurses collaborate with them as members of the multidisciplinary team. 5. Review policies & procedure related to exposure to body fluids and other pertinent procedures. 6. Prepare and submit for a pass/failure review by clinical instructor: a. assessment form for the client’s three (3) priority functional health pattern assessments b. growth grid c. self-evaluation d. grading grid Correctly locate necessary items for clinical practice. 2. Locate the MSDS material. 3. Discuss clinical site policies and procedures specific to the care of hospitalized children. 4. Explore the roles of the AD nursing student as they are implemented in the clinical setting. 54 Spring 2013 Make a list of common: (a) family concerns and (b) children’s concerns, which the nurse anticipates encountering in the clinical area. What strategies might the nurse use to assist in managing the concerns? TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FIVE: Acute Clinical Practicum Learning Map Clinical Day 2: Focus - Application of Theory Related to the Nursing Care of Children and Their Families Learning Objectives 1. 2. 3. 4. 5. 6. 7. Employ critical thinking to implement the nursing process by writing an individualized plan of care. Develop and use an efficient and effective sequence for performing client physical examination and pain assessment. Identify specific laboratory values and medications that direct the components of physical examination and care. Incorporate developmental principles into care based on assessed developmental level. Correlate pathophysiology changes with clinical manifestations. Determine interventions that promote O2/CO2 exchange, pain management, coping, mobility, and cognitive/perceptual needs. Communicate findings to nurses and other healthcare providers in a professional manner. Preparation Critical Thinking Resources Questions 1. Identify at least 1. Identify your one personal individual learning goal strengths and for this clinical weaknesses day. related to: 2. Review Critical a. provider of Thinking care, Questions b. manager of before clinical care, & to formulate c. member of answers and the additional healthcare questions. team. Learning Activities 1. During one clinical experience, student will ask the clinical faculty person to observe and provide feedback regarding the development of the plan of care for the assigned infant, child, or adolescent. 2.Prepare and submit for grading by clinical instructor (a grade of 75% or higher must be achieved: a. assessment form b. concept map, including three problems c. growth grid d. medication sheet e. self-evaluation 3. If student did NOT complete the assignment from Day 2 with a grade of 75% or greater, the student will correct the assignment from Day 2 and the two (2) grades will be averaged. The student must achieve an average of 75% or greater on the combined second and third care plan to pass the course. 55 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 SECTION FIVE: Acute Care Clinical Practicum Learning Map Clinical Day 3: Focus-School Experience-Application of Theory Related to the Nursing Care of Children and Their Families Learning Objectives At the end of this school clinical experience, students will be able to: A. Demonstrate an understanding of the theoretical principles essential to the roles of the ADN in the care of children in the school setting. B. Identify the roles of the ADN in caring for children in the school setting. C. Adapt nursing skills in accordance with established standards and professional responsibilities specific to the healthcare of children in the school setting. D. Communicate with children in the school setting in a caring and therapeutic manner that demonstrates cultural sensitivity. E. Identify strategies used by the school nurse to provide information to the school administration and the family using confidential communication techniques. F. Utilize critical thinking, functional health patterns, teaching/learning principles, and developmental concepts to plan and implement nursing for one child in the school setting. 56 Spring 2013 Preparation Resources 1. Identify at least one personal learning goal for this clinical day. Critical Thinking Questions 1. Discuss the role of the school nurse. Learning Activities 1. Choose 3 objectives (A-E) and document evidence based on the experience during the clinical in the school setting. 2. Complete objective F using the “Plan for Schoolaged/Adolescent Child” form. 3. Submit the documentation to the assigned clinical instructor to following Monday after the clinical experience. 4. Grading criteria will be Pass/Fail. Pass criteria will document objectives as instructed by guideline. Fail will demonstrate minimal/incomplete documentation to the clinical experience. A passing grade must be submitted to progress in the clinical rotation. TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Clinical School Experience Focus PURPOSE Within the context of a specific organizational structure and culture, this clinical experience assists students to become aware of the role of the school nurse in the profession of nursing. It provides opportunities for students to develop leadership skills as they implement the nursing process with groups of students. Functioning in the three nursing roles: provider of care, manager of care and member within the discipline of healthcare; students practice problem-solving skills, make decisions about real life situations, and collaborate with teachers and staff in finding solutions to problems seen in the school health setting. STUDENT ACTIVITIES IN THE CLINICAL SCHOOL EXPERIENCE FOCUS At the end of this school clinical experience, students will be able to: 1. Demonstrate an understanding of the theoretical principles essential to the roles of the ADN in the care of children in the school setting. 2. Identify the roles of the ADN in caring for children in the school setting. 3. Adapt nursing skills in accordance with established standards and professional responsibilities specific to the healthcare of children in the school setting. 4. Communicate with children in the school setting in a caring and therapeutic manner that demonstrates cultural sensitivity. 5. Identify strategies used by the school nurse to provide information to the school administration and the family using confidential communication techniques. 6. Utilize critical thinking, functional health patterns, teaching/learning principles, and developmental concepts to plan and implement nursing for one child in the school setting. REQUIREMENTS AND EVALUATION Student clinical performance is evaluated by the nursing preceptor and faculty. The Student Performance Feedback Form is sent from the preceptor to the student’s assigned clinical faculty with documentation of clinical performance. The clinical faculty liaison has the responsibility and authority for establishing whether a student’s performance is satisfactory. The faculty member transfers preceptor feedback to the Student Performance Evaluation (SPEP). Learning Activity for the Student The student will: 1. Choose 3 objectives (A-E on the Learning Map) and document evidence based on the experience during the clinical in the school setting. 2. Complete objective F from the Learning Map using the “Plan for Schoolaged/Adolescent Child” form. 3. Submit the documentation to the assigned clinical instructor to following Monday after the clinical experience. LEARNING RESOURCES 1. All required textbooks. 2. Professional specialty journals from nursing and other disciplines. 3. Nurse Practice Act. 4. Standards of Care 5. Hospital and nursing unit policies and procedures. 6. Various healthcare professionals and staff. 57 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Student Name: ____________________ Date: ____________ Group Letter: __________ Student Performance Feedback Form S = Satisfactory I = Needs Improvement U = Unsatisfactory N/A Not Applicable Please write in the student’s clinical hours and dates: Hours Hours Date Date 3. 4. Role as a Provider of Nursing Care Performs assessment utilizing appropriate skills Utilizes therapeutic communication skills Utilizes the nursing process based on standards of care to arrive at appropriate ongoing clinical decisions Role as a Manager of Client Care Utilizes professional communication skills Prioritizes care for client(s) utilizing appropriate decision making skills Integrates safety into all nursing actions Written and electronic documentation is accurate and appropriate 1. 2. 3. 4. Role as a Manager of the Discipline of Healthcare Displays accountability/responsibility for nursing care of children Practices within the parameters of individual knowledge/experience Follows institutional and TCC policies Shows initiative and assumes responsibility for achieving learning 1. 2. 3. 1. 2. S I U N/A School Site: __________________________________________________ RN Preceptor: Date: ____________ Student Performance Feedback Forms should be done at the completion of the school day. If there are any concerns about student performance, please contact faculty as soon as possible. If the concern needs immediate attention, please use cell number provided. Lori Franklin, 918-830-1561 On the back, describe actions the student can take to improve performance. Please return in attached, selfaddressed, postage paid envelope. Thank you. 58 Spring 2013 TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 TCC Nursing Program NUR 2433 Nursing Care of Children and Their Families STAFF EVALUATION OF PRECEPTOR CLINICAL EXPERIENCE Date: ___________School Site: ____________________________ Group Letter: ___________ Faculty Liaison: _____Lori Franklin_________________________ Please place a check mark in the column, which best describes your experience related to each of the criteria listed below. 1. The instructor made clinical objectives available prior to the clinical experience 2. The instructor was immediately available by pager or phone. 3. The student was prepared and showed initiative during clinical experience. 4. Students shared learning objectives with preceptor. 5. Students interacted appropriately with nursing staff and other health care providers. Comments/Suggestions: Thank you for your input! 59 Spring 2013 1 Strongly Disagree 2 Disagree 3 Undecided 4 Agree 5 Strongly Agree 6 Not Applicable TCC Nursing Program – Nursing Care of Children and Their Families / NURS 2433 Clinical School Experience Focus: Plan for School-age/Adolescent Child Form Nursing Diagnosis: Behavioral Goal: Interventions: 1. 2. 3. Document Impression of the experience: 60 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION FIVE: Child Health Assessment Demographic Data Collection Student’s Name: Infant/child DOB: Gender: Religion : Parents’ Ages: Primary Caregiver: Current Medical Diagnosis: Chief Complaint stated by child/family: Clinical Date: Race: Marital Status: Lives with: Previous Hospitalizations (reason/date): Allergies: Diet ordered: Weight (lbs/kg): FOC (in/cm): Medications Taken at Home: Length/Height (in/cm): Vital Signs Time Result Action Temperature: Pulse: Respirations: Blood Pressure: Pain Rating: Pathophysiology Causing Client’s Hospitalization: Time Result Action (Note: This is not a description of the “reason” for why the client was hospitalized.) _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 61 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Health Assessment/Functional Patterns: Instructions: In each pattern, include client’s strengths, limitations, and pertinent factors influencing health. Refer to Wong Pediatric Manual for Assessment content pp. 3-147. Health Perception Management Pattern Activity-Exercise Pattern 62 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Elimination Pattern Nutritional-Metabolic Pattern 63 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Cognitive Perceptual Pattern Sleep-Rest Pattern 64 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Sexual Reproductive Pattern Coping-Stress Tolerance Pattern 65 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Self-Perception Role Relationship Pattern Value-Belief Pattern 66 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families WHAT ARE VALUES? Values are a part of our experience that affects our behavior. They encompass our attitudes, the standards for our actions and our beliefs. Values are often learned from family, culture, and people around us. In addition, values tell others what is important to us and guide our decision making. We use our resources — time, money and brain power — on the things we value. Values are critical in building character and increasing an overall sense of well-being. Positive values within families… • Promote honesty, integrity, commitment, and loyalty. • Encourage respect for self and others and tolerance of differences. • Require being responsible and accountable for your actions, while practicing self-control. • Teach fairness and treating people equally. • Require consideration, kindness, compassion, and generosity toward others. • Foster being a good citizen who appreciates doing things, which make life, better for self and for other people. Clemson University Extension Office. (2003). Building Family Strengths: Values. Retrieved July 14, 2006, from http://virtual.clemson.edu/groups/psapublishing/Pages/FYD/FL523.pd 67 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Student:_______________________________________________ Clinical Experience Date:_________________ Medications - Page 1 (P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear) Med/Route/Frequency Nursing Implications Reason Prescribed for Client’s Response To Dosage Prescribed/Administered THIS Client Medication (if seen) 68 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families CONCEPT MAP - Working Copy - Carry in Pockets at all times! Key Problem/ND Problem Linkage Supporting Data Meds Key Problem/ND Supporting Data Not sure where this data fits: Meds Labs Labs Client/Family: Key Problem/ND Supporting Data Key Problem/ND Reason for Needing Health Care (hospitalization/medical diagnosis/surgery): Key Assessments: Meds Labs Supporting Data Meds Labs Key Problem/ND Key Problem/ND Key Problem/ND Supporting Data Supporting Data Supporting Data Meds Meds Meds Labs Labs Labs Shuster, P. (2002). Concept mapping: A critical thinking approach to care planning. Philadelphia: FA Davis. 69 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Example of Working Copy of CONCEPT MAP Key Key Problem/ND Problem/ND Delayed Delayed Growth Growth & & Development/Expressive Development/Expressive -speech speech Supporting Data Supporting Data Hx Hx ear ear infections infections Speech articulation articulation problem Speech problem –– less than 50% intelligible less than 50% intelligible Hasn’t Hasn’t been been tested tested in in over over aa year year Meds Labs Meds Labs Key Problem/ND Anxiety/Fear Supporting Data Restless due to confinement Cranky, at times cries Afraid of the dark, uses nightlight Missing preschool Disruption of normal routine Meds Labs Key Problem/ND Respiratory/Ineffective Airway Clearance Supporting Data Wheezing, RR 36, Shallow Resp., SaO2-92%, B/P 116/69, HX ear infections Cont. O2, Pulse Ox Meds Meds/Treatments: Flowvent, Albuterol, Pulmicort, SoluMedrol, NS Spray Labs Problem Linkage Not sure where this data fits in: No assessment data related to activity intolerance but would expect him to have some Client/Family: 5 y/o male, Mom 31, Dad 24, Sep. x3 mos., 3 other sibs at home Reason for Needing Health Care (hospitalization/medical diagnosis/surgery): Asthma Key Assessments: Airway, VS, O2 sat, fluid/nutrition intake Key Problem/ND Altered Family Process Supporting Data Parents separated X 3 months Mom missing work 3 other siblings to care for Meds Labs Key Problem/ND Supporting Data Meds Labs Key Problem/ND Imbalanced Nutrition Less than body requirements Key Problem/ND Supporting Data Supporting Data Sometimes a picky eater Meds Meds Labs Labs Shuster, P. (2002). Concept mapping: A critical thinking approach to care planning. Philadelphia: FA Davis. 70 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Problem #1 (write in): ______________________________________________________________________ General Goal: Behavioral Outcome Objective (Expected Outcome – Short term goal): The client will…__________________________________________________________________________ __________________________________________________________________________ on the day of care. Nursing Intervention (What you did.): Client Response (Evaluation): 1. Implementation (How you did it. Identify specific pediatric strategies when intervention is child-directed.) 1. 2. 2. 2. 3. 3. 3. 4. 4. 4. 5. 5. 5. 1. Summarize impression of client progress toward behavioral outcome after day of care:* Shuster, P. (2002). Concept mapping: A critical thinking approach to care planning. Philadelphia: FA Davis. *Identify teaching related to FHP Assessment. 71 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Problem #2 (write in): ______________________________________________________________________ General Goal: Behavioral Outcome Objective (Expected Outcome – Short term goal): The client will…__________________________________________________________________________ __________________________________________________________________________ on the day of care. Nursing Intervention (What you did.): Client Response (Evaluation): 1. Implementation (How you did it. Identify specific pediatric strategies when intervention is child-directed.) 1. 2. 2. 2. 3. 3. 3. 4. 4. 4. 5. 5. 5. 1. Summarize impression of client progress toward behavioral outcome after day of care:* Shuster, P. (2002). Concept mapping: A critical thinking approach to care planning. Philadelphia: FA Davis. *Identify teaching related to FHP Assessment. 72 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Problem #3 (write in): ______________________________________________________________________ General Goal: Behavioral Outcome Objective (Expected Outcome – Short term goal): The client will…__________________________________________________________________________ __________________________________________________________________________ on the day of care. Nursing Intervention (What you did.): Client Response (Evaluation): 1. Implementation (How you did it. Identify specific pediatric strategies when intervention is child-directed.) 1. 2. 2. 2. 3. 3. 3. 4. 4. 4. 5. 5. 5. 1. Summarize impression of client progress toward behavioral outcome after day of care:* Overall plan for revision of the plan of care for the three (3) identified problems: Shuster, P. (2002). Concept mapping: A critical thinking approach to care planning. Philadelphia: FA Davis. *Identify teaching related to FHP Assessment. 73 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SELF EVALUATION FORM Student: ________________________________ Clinical Experience Date: _______________ New Terms Learned: Definitions: My learning goals are: Achieved/how: Not Achieved/why: Strengths: I AM, I CAN, and/or I anything that is active and positive! It is about you! Challenges: Knowledge: Knowledge: Skill: Skill: Attitude: Attitude: 74 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION FIVE: Acute Care Clinical Practicum Nursing Plan of Care Evaluation Criteria Concept Map Care Plan Evaluation Please submit 2 copies of this form with your first nursing plan of care. p. 1 Student: Faculty: Date: ANA STANDARD I - ASSESSMENT Points Available (10) Pathophysiology Description 0 0.5 1 Functional Health Patterns (0-7 as indicated below) Check-marks indicate concerns, if any Incomplete Incorrect Complete • Health Perception-Health Management Pattern • Activity-Exercise Pattern • Elimination Pattern • Nutritional-Metabolic Pattern • Cognitive-Perceptual Pattern • Sleep-Rest Pattern • Sexuality-Reproductive Pattern • Coping-Stress Tolerance Pattern • Self Perception-Self Concept Pattern • Role-Relationship Pattern • Value-Belief Pattern Functional Health Pattern Points Earned 0 1 2 3 4 5 6 7 Medication Sheet Correctly Developed 0 0.5 1 Growth Grid Charted 0 0.5 1 Subtotal This Section ANA STANDARD II - NURSING PROBLEM ANALYSES (Steps 1-3 Map - Ch. 3) Points Available (15) Identifies Teaching to Functional Health Pattern Assessment** 0 3 6 Correctly Links Problems 0 0.5 1 Correctly Identifies Reason for Health Care (central box) 0 0.5 1 Key Assessments (central box) 0 1 2 Abnormal Assessment Data in correct boxes 0 1 2 Meds/Treatments/Lab/Diagnostic Tests Categorized in correct boxes 0 0.5 1 Correctly Identified Three (3) Highest Priorities/Problems 0 1 2 Subtotal This Section 75 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION FIVE: Acute Care Clinical Practicum Nursing Plan of Care Evaluation Criteria Concept Map Care Plan Evaluation Student: p. 2 Faculty: Date: ANA Standards III, IV, V, IV Planning (Step 4 Chapter 4) Points Available (30) Problem # 1 Goal Objectives Nursing Interventions to provide for patient/family participation Nursing Implementations to include specific pediatric strategies Problem # 2 Goal Objectives Nursing Interventions to provide for patient/family participation Nursing Implementations to include specific pediatric strategies Problem # 3 Goal Objectives Nursing Interventions to provide for patient/family participation Nursing Implementations to include specific pediatric strategies Subtotal This Section ANA Standard VII & VIII Evaluation (Step 5 Chapter 5) Points Available (15) Problem # 1 Evaluates patient’s behavioral responses to nursing implementations Under impressions, evaluates progress toward outcome objectives :Problem # 2 Evaluates patient’s behavioral responses to nursing implementations Under impressions, evaluates progress toward outcome objectives Problem # 3 Evaluates patient’s behavioral responses to nursing implementations Under impressions, evaluates progress toward outcome objectives Under impressions, explain overall how care plan should be revised. Subtotal This Section Total Points Student signoff: Date: Faculty Signoff: Date: 76 Spring 2013 0 0 0 0 1 1 1 1 2 2 3 3 0 0 0 0 1 1 1 1 2 2 3 3 0 0 0 0 1 1 1 1 2 2 3 3 0 0 1 1 2 2 0 0 1 1 2 2 0 0 0 1 1 1 2 2 3 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION FIVE: Acute Care Clinical Practicum Student Performance Evaluation Profile (SPEP) p. 1 Student Name:_________________________________________________ ID:__________________ EVALUATION CRITERIA INSTRUCTIONS: Review ALL items contained in each category. If ALL items within a primary category are satisfactory, make a single check in the primary white box for the appropriate week. If ANY items are inconsistently met or not met, indicate with the appropriate mark in the specific sub-heading box for the appropriate week. See page 2 for key to indicator marks. ROLE AS PROVIDER OF NURSING CARE 1. Demonstrates critical thinking in all phases of care. Date Week 1.1 Uses systematic method to collect bio-psycho-social, cultural, and spiritual data. 1.2 Validates appropriateness of plan and modifies if needed prior to implementation of planned care. 2. Display behaviors consistent with scientific principles. 2.1 Performs physical exam using all four techniques. 2.2 Accurately performs technical procedures. 3. Demonstrates effective communication patterns. 3.1 Use communication techniques appropriate to client/family/significant others. 3.2 Conveys acceptance/empathy/caring when communicating with clients. 3.3 Incorporates assessment data into client teaching. ROLE AS MANAGER OF CLIENT CARE Student displays accountability and responsibility for management of: 1. Assigned client care 1.1 Assumes responsibility for completion of care required for assigned client. 1.2 Organizes client care in an effective manner. 1.3 Completes client care within a specified time. 2. Client safety *2.1 Provides safe client environment. 2.2 Seeks guidance as needed to implement client care in a safe & effective manner (refer to Appendix A of TCC Nursing Program Student Handbook). 2.3 Identifies indications for and the effects of medication. 2.4 Administers prescribed medications using scientific principles. 3. Resource management 3.1 Uses times purposefully in client care situations. 3.2 Utilizes equipment and supplies appropriately. ROLE AS MEMBER OF THE HEALTHCARE TEAM 1. Displays nursing role behaviors. 1.1 Collaborates with members of healthcare team to plan and/or implement client care. *1.2 Submits completed assignments on time. 2. Functions within the group. 2.1 Individually contributes to group function. 2.2 Contributes effectively within the group. 2.3 Communicates effectively within the group. 3. Displays professional behaviors 3.1 Is punctual for clinical practicum and conferences. *3.2 Demonstrates positive attitude verbally and nonverbally. 3.3 Manages stress in an appropriate and effective manner. *3.4 Maintains client confidentiality. 3.5 Utilizes instructional comments & suggestions to increase knowledge & change behavior. 3.6 Takes initiative to enhance learning. SPEP Items with an asterisk (*) are Critical Behaviors and must be met Satisfactorily. 77 Spring 2013 1 2 3 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION FIVE: Acute Care Clinical Practicum Student Performance Evaluation Profile p. 2 FORMATIVE EVALUATION Symbols Used in Evaluation - Object consistently met “Satisfactorily” + - Exceeded expectations in completion of objective I - Object inconsistently met N - Object not met NA - Object not applicable for this week O - Object not observed by instructor Pediatric Medication Administration Completion of Clinical Objectives: Date Week Total I’s Total N’s Clinical S/U # Hours Absent Care Plan Scores Faculty Initials Student Initials Care Plan Score: Satisfactory 1 2 P/F P/F 3 Unsatisfactory Faculty/Student Comments Date ALL Entries are to be signed and dated by both student and faculty. Student Signature Date Faculty Signature Date Please submit 2 copies of this form with your first clinical paperwork. You will receive a copy when the clinical rotation is completed. 78 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: Learning Map for Developmental Experiences: CDC & LLH Clinical Focus – Childcare in the Community: Child Development Center (Well-Child) and The Little Light House (Special Needs Child) Critical Thinking Questions 1. Compare and contrast NOTE: Entire class attends orientation 1. A 2-year-old says growth & development “no” to the for CDC/LLH. needs of the healthy vs. 1. NURS 2433 syllabus section CDC caretaker when special needs children. asked to go to the & LLH: Take with you to agency. 2. Identify expected 2. WPHLW Ch. 29, Contemporary lunch table. How growth & development Pediatric Nursing, pp. 785-797; should the milestones in the Chapter 30, Community-Based caretaker respond? pediatric population. Nursing Care of the Child & Family, 2. A mother of a 93. Identify implementation pp. 799-805 month-old who of safety measures to 3. WPHLW Ch. 41, “Special Needs,” cries when his protect children in pp. 1154-1164 (Denver II) (LLH). mother leaves is childcare settings (from 4. Clinical Manual of Pediatric Nursing upset by his injury and/or abduction). pp. 121-143,149-158, 159, 163-164, behavior. How 4. Identify application of 180-184. should the strategies to prevent 5. Rehm, R. (2002, March). Creating a caretaker spread of infection context of safety and achievement at intervene? among pediatric school for children who are medically 3. What differences populations and their fragile/technology dependent. in the display of/ care providers. Advances in Nursing Science, 24(3), or response to 5. Compare & contrast the 71-84. separation anxiety role of the care provider would you expect for the well child versus to see among well the special needs child. children versus 6. Discuss prognosis of special needs special needs children children. related to their abilities observed. Learning Objectives 79 Spring 2013 Preparation Resources Learning Activities Orientation Activities: 1. “Family Centered Care” video, Wong, D. RJ 245.W 42, 1996. 2. LLH History video. 3. LLH Volunteer Orientation video. Clinical Activities: 1. Observe well children at the CDC in one age group (you will rotate observation rooms as time permits). 2. Interact and assist with the care of a special needs child at the LLH (you will be assigned). Written Assignments: 1. CDC Observation Report: *Complete one observation grid for the child that was observed. 2. LLH Report: *Complete a typewritten report addressing each of the items on the “guideline for the LLH report” in outline format. 3. Bring Denver II to the Little Light House and Child Development Center. *Mark observations on a Denver II sheet for the child you were assigned and submit with your report. NOTE: The grade sheet should be stapled to the front of each report and submitted in a manila envelope to the Course Coordinator by 9 AM on the Monday following your visit. Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: Agency Information for the Developmental Observation Experiences The LITTLE LIGHT HOUSE (LLH): Address: 5120 East 36th Street South (SE corner of 36th and Yale) Contact: Lindsey Kirk Phone: 918 664-6746 Time: See Calendar (bring a snack if you wish, cold drink machines available) Wear your TCC clinical uniform with your TCC name tag. Please leave personal belongings in your car. Sign-in and you will be directed to one of several classrooms for students who may be sight, hearing, and/or speech-impaired and/or have other special needs. With the teacher’s assistance, select one child to follow for your clinical experience/observation report. Complete the learning objectives as specified in the LLH clinical learning map and submit the required written assignments. Chapman Learning Center Address: SE Corner of 17th & Utica Contact: Charlene Warner Phone: 918 744-2968 Time: See Calendar (bring a snack and drink if you wish). Wear your TCC clinical uniform with your TCC name tag. Please leave personal belongings in your car. Sign-in and you will be directed by the staff to the appropriate areas. You must observe at least one specific child in one of the following age groups: Toddler or Preschool. Complete the learning objectives as specified in the CDC clinical learning map and submit the required developmental assessment grids for the child you observed. Ave Maria House Address: 6161 South Yale Avenue Contact: Janet Cordingley Phone: 918 494-1501 ext. 12502 Time: See Calendar (bring a snack and drink if you wish). Wear your TCC clinical uniform with your TCC name tag. Please leave personal belongings in your car. Sign-in and you will be directed by the staff to the appropriate areas. You must observe at least one specific child in one of the following age groups: Toddler or Preschool. Complete the learning objectives as specified in the CDC clinical learning map and submit the required developmental assessment grids for the child you observed. 80 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: CDC Developmental Assessment Observation Report Grid Age Group Observed: ____________________ Student Name Describe 2 Types of Developmental Stimulation or Play Interactions (include toys) Child’s Age Child’s Gender Date of Visit Describe 2 Specific GROSS Describe 2 Specific FINE Describe 2 Specific LANGUAGE MOTOR Observations MOTOR Observations Observations Describe Nutrition for Age: Expected Norm Vs. Observed Describe 2 Teacher-Initiated Behavioral Guidance/ Discipline Measures: Describe at Least 2 Safety Measures Observed for Age Group and Offer at Least 1 Additional Suggestion: Discuss the Potential for Spread of Infection AND Specific Preventative Measures Taken: Stage of Piaget, including expected behaviors Stage observed, including behaviors supporting that stage Stage of Erikson, including expected behaviors Stage observed, including behaviors supporting that stage 81 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: Child Development Center Developmental Assessment Grading Sheet* Learner Name: ID: Date of Clinical Experience: Describe with specific examples the following components of your observational experiences for the following activities. Points Possible Age, Erikson’s and Piaget’s level for one age group. 4 Describe play for the age group observed. Identify play’s content and social character. Document appropriateness for age observed. 6 Specific descriptive examples of gross motor development. 6 Specific descriptive examples of fine motor development. Submit the Denver II. 6 Specific descriptive examples of language development in the age group. Is language appropriate for the age group? Submit the Denver II. 6 Identify nutrition appropriate for the age group observed; describe foodrelated behaviors and identify the expected nutritional norms for the age group. 4 Identify and describe specific behavioral guidance/discipline measures utilized by the preschool teacher; relate to the development of the child. 4 Describe safety measures observed and offer at least 1 additional suggestion. 6 Describe the potential for spread of infection and preventative measures taken. 6 Points Earned Paperwork submitted. Deadline met accompanied by two grading forms. 2 Total 50 Faculty Signature: Date: *This sheet is to be turned in with the report in a manila envelope with the student’s name clearly written on the outside. Please submit with two copies of this grading form. 82 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: Child Development Center - What You May See 1. You may see some children just looking on. They may be new and have not become acquainted. Children are not forced to play. Some children need to watch others doing things before they are willing to try a new activity. Self-confidence grows with success and thoughtful approval. 2. You may see the teacher ignoring some children who are having an argument. They should settle their own affairs. Intervene only if they are unable to settle it themselves. 3. You may see a teacher ignore a child who is doing something “naughty.” He may be trying to get attention and she will give it to him when he is “good.” 4. You may see a teacher reinforce friendly, gentle, desirable behavior with praise repeatedly! Toddlers prefer to please you! 5. A teacher may interrupt undesirable aggressive behavior by distracting the child with something to do, such as a toy, book or new activity. 6. Children will be trying to put their own clothes on, wash themselves or handle large playthings. Perhaps the teacher could do it quicker and better but through doing this himself the child is learning how to do them. 7. You may hear teachers tell a child to do something instead of not to do something. A child will learn faster if we day “Drink your milk.” Instead of “Stop playing with your milk” or “Here’s a block to hammer on instead of “Stop hammering on the table.” 8. A child may be given a choice between two things. You may hear a teacher say, “Will you wash yourself or shall I do it?” This means he will be washed in any case. Or “Will you play with the clay or the paints?” Here he is free to choose, but he is never given a choice if there is none. Example: Never ask a child, “Do you want to go to bed now?” if you expect him to go then. 9. You may see a teacher take a child’s hand and say, “Come it’s time for fruit juice.” This helps him to know what the words mean. Soon she will not have to take his hand. 10. You may see a teacher showing affection to a child. Little children need cuddling and love. You may see a child follow a teacher around a lot or turn to a teacher for help a great deal. This child is not yet ready to be independent of adults. When he is ready, the teacher will gradually help him to play happily with other children or alone, first using words instead of going to him, then by encouraging smiles when he looks to her for help. 11. You may think there is a great deal of noise. Where a group of children play, there is always some noise. Little children can neither be quiet nor sit still very long. 12. You may see things to pull, push, climb on, etc. These help the muscles to grow strong. Things like clay, paints, dolls and trucks help develop the imagination. THE RULE – Children are not allowed to do anything that will hurt themselves, another person or the surroundings. 83 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: Guidelines - Little Lighthouse Report FORMAT for LLH Report: Report must be typed, double-spaced, size 12 font, Times New Roman with standard margins. Complete sentences must be used. Use each of the topic items as bolded headings for a paragraph (at a minimum) in your report. Example of Paper (Headings): I. Denver II Developmental Assessment II. Priority FHP III. Strategy for Play IV. Work with Child V. Adaptations for Developmental Age VI. Disciplinary Measures VII. Article Discussion VIII. Learning Experience Describe and discuss the topic item under each of the appropriate headings. Double space between sections of the report. Example: This is the first learning behavior. Use it as a bolded heading. Do the same with the other learning behaviors. Denver II Developmental Assessment The child discussed in this paper is a male, age 4 years and 5 months. He was born December 5, 1998, at 41 weeks gestation. This is where you describe and discuss the learning behavior(s) under the appropriate heading. Two copies of the YELLOW Grading Sheet must be placed at front of report. Report must be stapled in the left hand corner and placed in a manila envelope with your name and LLH Report clearly written on the outside when submitted. LLH Report Content I. Perform a developmental assessment using the Denver II assessment sheet provided. 1. Identify the child’s gender and chronological age (or adjusted age if a preemie and less than two years in age) with birth date (m/d/y). Birth date is important because weeks and months past a birthday are to be considered in the child’s chronological age calibration. Note if the age is adjusted for prematurity. 2. Review use of the Denver II sheet in Wong’s Clinical Manual of Pediatric Nursing. 3. A true Denver II will not be performed, but the sheet can serve as a reminder to you while you are assessing the child’s developmental skills. 4. Note the differences between the child’s chronological/adjusted age and the child’s developmental age in each of the four main developmental categories listed on the Denver II sheet. It is not uncommon for the child to be at different developmental levels in each of the four developmental categories. 5. Support your developmental assessment with behaviors observed vs. expected but not observed in each of the four developmental categories. (What should the child be doing, and what is the child actually doing?) 84 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families II. A brief assessment (using your visual, auditory, and olfactory senses) will be performed by student and documented in narrative format. Identify ONE priority Functional Health Pattern that supports your assessment from the list below. (Choose ONE of the following): 1. Activity-Exercise a. Does the child have self-care deficits appropriate for age? b. Can the child perform developmental skills appropriate for chronological age? c. Does the child respond appropriately to stimuli? d. Does the child have full range of motion (as evidenced by observation only)? e. Does the child have problems ambulating? f. Does the child have dyspnea and/or shortness of breath at any time? g. Does the child have difficulty manipulating his/her assistive devices(s), if utilized? 2. Nutrition-Metabolic a. Does the child weigh more or less than the recommended range for his/her height, age, and gender? b. What chronic health problems does the child demonstrate? c. What assistive devices are needed for feeding? d. What challenges does the child present in self-feeding, if applicable? e. Is the child at risk for aspiration? If so, how is this addressed? f. What is the feeding environment for this child? 3. Coping-Stress Tolerance a. Does the child demonstrate difficulties in coping at any time? b. What coping mechanisms does the child demonstrate? c. Is the child moving toward independence? d. Does the child demonstrate indications of neglect? 4. Cognitive-Perceptual a. Does the child present with problematic behavior in responds to stimuli? b. Can the child respond appropriately to simple directions or instructions? c. Does the child display any sensory problems? d. Does the child use both sides of the body? e. Does the child display any distraction behaviors (moaning, crying, pacing, rocking, selfstimulation)? IMPORTANT INSTRUCTIONS: After identifying the priority FHP, a narrative will discuss the assessment details demonstrated by the assigned child. Please note: This eliminates the use of a simple Yes/No response. You must explain! Within the narrative, a nursing diagnosis is identified for the child. III. Identify a strategy for play that reflects each one of the areas assessed by the Denver II assessment tool. Discuss how the priority FHP is also supported or not supported within the areas of the Denver II 1. Review each of the Denver II categories and identify a toy, game or method of developmental stimulation that is supported by the child’s assessment. 2. Discuss a strategy to implement play with the child. 3. Evaluate how the toy, game, or method of stimulation is supported or not supported by the priority FHP. IV. Describe how you worked with the particular child you selected or to whom you were assigned. 1. Discuss how you specifically helped the child in the areas of : a. Gross motor skills b. Language skills c. Fine motor-adaptive skills d. Personal-social skills 85 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families V. Describe teaching adaptations for the child’s developmental level. 1. Use of sign language 2. Use of Braille 3. Use of voice-recognition equipment VI. Describe disciplinary measures used with this child and in the classroom. 1. Time-out 2. Redirection 3. Consequences VII. Using the identified article: 1. Review the article: Rehm, R. (2002, March). Creating a context of safety and achievement at school for children who are medically fragile/technology dependent. Advances in Nursing Science, 23(3), 71-84. CINAHL with full text database. 2. Use content from the article to reflect upon the impact of the environment on the children of the LLH. 3. Based on the LLH orientation and any observations that you have: a. This section will reflect the content of the article reviewed and your impression of the impact that the environment has upon the student population at the Little Lighthouse. b. Describe how the multi-disciplinary team at Little Light House is meeting the safety and achievements of the children in the school. c. Discuss how the environment has been modified or developed to support the medically fragile/technology dependent student at Little Lighthouse. d. Evaluate how the role of nurse at the LLH is supported in the article. e. Utilize two (2) citations from the article to support your discussion (use APA format). VIII. Discuss what you learned during this clinical experience. Utilize reflective thinking related to the areas of growth and development, pre-school learning, and special needs children. Reflective thinking can be demonstrated by discussing: 1. What concepts were reinforced? 2. What concepts were new? 3. How can you operationalize these learning and insights, including the actions of the staff and apply them in your future practice. 86 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SIX: The Little Lighthouse Report Grading Sheet* *TWO (2) YELLOW copies of this grading form are to be turned in with the report in a manila envelope with the student’s name and LLH clearly written on the outside. Little Lighthouse Grading Form Name: CWID: Date of Clinical Experience: Address each of the following in a Typewritten, Outlined, Narrative report: Denver II Developmental assessment: Gross Motor, Language, Fine Motor Adaptive, and Personal-Social (Submit Denver II completed and submitted with report). Points Possible 8 Priority FHP: Narrative discussion of one FHP and NDx. Strategy for Play: Identified specific toy, game or stimulation for child. Implementation supported by developmental level. Work with Child: All areas of the Denver II discussed. Adaptations for Developmental Age: Discussed teaching adaptations for the child’s specific disability. Disciplinary measures used with child; be specific. Article Discussion a) Reflects the content of the article reviewed and the student’s impression of the impact that the environment on the student population. b) Describes how the multi-disciplinary team is meeting the safety and achievements of the children. c) Discusses how the environment has been modified or developed to support the medically fragile/technology dependent student. d) Evaluates how the role of nurse at the LLH is supported in the article. e) Utilizes two (2) citations from the article to support discussion, using APA format including references. Discuss what you learned during this experience: Be specific. Paperwork submitted using the designated format: Deadline met accompanied by two (2) YELLOW grading forms. Total: Faculty: 5 6 87 Spring 2013 4 5 4 10 5 3 50 Points Earned Tulsa Community College NURS 2433 Nursing Care of Children and Their Families WELLNESS EXPLORATION LEARNING ACTIVITY 1. PURPOSE: Identify and evaluate the accessibility of resources in the community to promote, maintain, and restore health within the functional health patterns of nutrition-metabolic, elimination, activity-exercise, self-perception, and coping-stress tolerance. The student will: a. Observe the client in the community setting and the efforts to the client and community to promote, maintain, and restore health. b. Participate in a wellness-focused community learning activity to enhance student’s ability to integrate use of wellness concepts and community resources into the nurse’s scope of practice. 2. OUTCOME: Develop the student’s understanding of the nurse’s role of resource identification and referral through participation in a wellness-focused activity for children and their parents in the community setting. 3. GRADING CRITERIA: Pass: Observation experience is arranged by the student following approval by the faculty prior to the experience. The WELA activity is attended as arranged, and the WELA evaluation form is completed and submitted by the student within the designated timeframe. Fail: Failure to arrange, seek approval, attend, or complete and submit the WELA evaluation form within the designated timeframe. Faculty evaluation of the project will be recorded on the WELA evaluation form. This assignment is counted as a part of the clinical grade. The student must earn a “PASS” on this assignment to pass clinical. 4. STUDENT GUIDELINES: The student will: a. Select a specific setting where you may observe the client or community service as they promote, maintain, and restore health issues related to the pediatric population. b. Obtain approval from the Wellness Exploration Learning Activity (WELA) instructor and permission of a contact person at the selected site. The Wellness Exploration Learning Activity objectives will be reviewed with the WELA instructor one (1) week prior to attendance. c. Demonstrate critical thinking skills by analyzing your own leaning needs, answering the questions to meet those needs (focused on the nurse’s leadership aspect of the experience), attending the selected activity, and evaluating the success meeting your expectations as discussed on the previously approved WELA form. Complete within one (1) week of attendance. d. Prepare for the WELA by reading one professional resource and one consumer resource on health maintenance, restoration and promotion activities practiced by the client. Submit copies of the articles with the completed WELA evaluation form. e. Attend the experience at times other than regular clinical time. The student will NOT be released from the regularly scheduled clinical assignments. f. Incorporate the WELA objectives by observing, talking, and participating with the patient or group. DO NOT PROVIDE NURSING CARE OR GIVE ADVICE. 88 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families WELLNESS EXPLORATION LEARNING ACTIVITY (WELA) Approval and Evaluation Form – PART I Directions – PART I: Submit this form to your WELA instructor with the top half completed (1) week prior to the activity you plan on attending. Student Name (Print): __________________________________________ Group: ________ I have contacted and made arrangements to observe the following WELA: Organization/Activity: __________________________________________________________ Supporting Organization: ________________________________________________________ Topic of the WELA: ____________________________________________________________ Contact Person: ________________________________________________________________ Date of Activity: _____________________ Time: __________ Phone Contact: _____________ Please answer the following questions below. 1. What do you expect to gain from this experience (identifying a community resource and attending this specific activity)? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2. How do think you will use this experience in your future practice (process of selecting a community resource and making a referral)? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________ Signature of the WELA instructor indicates approval of the student’s plan as submitted: ______________________________________________ Date of Approval: _______________ *I understand that if there is any concern with this assignment, it is my responsibility to initiate a conference with my clinical instructor to resolve the concern. Student Signature: ______________________________________________________________ 89 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families WELLNESS EXPLORATION LEARNING ACTIVITY (WELA) Approval and Evaluation Form – PART II Directions – PART II: Re-submit the original of this form with the bottom half completed within one week of attending the Wellness Exploration Learning Activity. IN ADDITION, INCLUDE A PHOTOCOPY OF THE COMPLETED FORM. You will submit two [2] completed forms. Were your expectations met (related to the questions answered in Part I)?________ I f so, how? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Describe the nurse’s role in promoting the client and family’s access to community health promotion and wellness resources. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Student Signature: _______________________________________ Date: __________________ Faculty Review: Respond with (Met) or (Not Met) WELA appropriate to population & objectives Student’s Objective meets guideline Attended WELA as scheduled Approval sought within specified timeframe Professional Resource copy attached Evaluation form completed satisfactorily WELA form completed fully & correctly Consumer Resource copy attached WELA form submitted in 1 week for grading Faculty Signature: _____________________________ Date: _____________ Grade: _________ 90 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION VII. APPENDICES 91 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families SECTION SEVEN: Videos Related to Care of Children Whaley & Wong’s Pediatric Video Series “Donna Wong narrates each video and demonstrates techniques for delivering effective, atraumatic nursing care of children and their families.” Vol. 1 Communicating with Children and Families RJ245-1098924 Vol. 2 Pain Assessment and Management RJ245-1098925 Vol. 3 Growth and Development RJ245-1098926 Vol. 4 Medications and Injections RJ245-1098927 Vol. 5 Family-Centered Care RJ245-1098928 Vol. 6 Pediatric Assessment RJ245-1098929 Mosby’s Communication in Nursing Video Series “Issues such as grief and loss and caring for dying clients and families are addressed…includes realistic clinical scenarios and role-plays that graphically demonstrate therapeutic and nontherapeutic communication. Special techniques for more effective communication and collaborative communication with other health care professionals are highlighted.” 1. Basic Principles for Communicating Effectively 2. Communicating with Clients and Colleagues: Effectiveness in the Caring Environment 3. Communicating with Clients and Colleagues from Different Cultures 4. Communicating with Difficult Clients and Colleagues 5. Communicating with Clients with Mental Disorders or Emotional Problems 6. Communicating Across the Lifespan: Children, Families, and the Elderly Mosby’s Nursing Skills Video Series Vol. 3 Applying Restraints RT23 1098678 RT23 1098680 RT23 1098679 RT23 1098681 RT23 1098682 RT23 1098683 RT 73.5 M67B1 1095365 Behavioral Disorders of Childhood Abnormal Psychology, Program 11. J. Nichols. 58 minutes RC 454.W 68 1998, Vol. 11 1090799 DDST RJ 51.D48 1060077 Discusses Disruptive Behaviors (ADHD), Emotional Disorders (Separation Anxiety) and Development Disorders (Autism). Describes how the criteria differ from children from adults, discusses behavioral problems in terms of frequency, intensity and duration. Describes use of token economies, and the nurturing/structuring of the environment. 92 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Behavioral Treatment of Autistic Children 44 minutes. 1998 RJ 506 A9B342 1097353 Clothing is in kind of a time warp! Excellent demonstrations of typical behaviors. Demonstrates application of operant conditioning as part of therapy. Shows 20-year followup on two people in a study. Demonstrates the use of the scientific method. Touch is used therapeutically. Nursing Content Review: Corresponds with NCLEX-RN comprehensive Review Book, 7th ed. By Patricia A. Hoefler 1-800-200-9191 Meds, Inc. Psychiatric Nursing Video 6: 35 minutes. Psychoactive Substance Use Disorders, Substance Abuse 1099698 RT 55.P792 Video 7: 50 minutes. OMD, Eating Disorders, Developmental Disabilities, Personality Disorders, Family Violence, Child Abuse, Rape, Legal Aspects 1099699 RT 55. P792 Pediatric Nursing Video 1: Growth and Development, Pt. 1, 50 minutes. Stress of Hospitalization, Strategies for Health Promotion/Stress Reduction, Characteristics of Development, Life Span and Development, Infant 1099703 RT 55.P345 Video 2: Growth and Development, Pt. 2, 40 minutes. Toddler, Preschool, School Age Child, Adolescence 1099704 RT 55.P345 Video 3: Nursing Care of the Child with Congenital Anomalies, 55 minutes. Congenital Heart Defects, Neurological Defects, Musculoskeletal Defects, Gastrointestinal Defects 1099705 RT55.P345 Video 4: Nursing Care of the Child with Acute Illness, 50 minutes. Common Problems, Fever, Vomiting, Gastroenteritis, Respiratory Infections. 1099706 RT 55.P345 Video 5: Child Surgical Care. 25 minutes. Pre-and Post-Op Care, Common Problems 1099707 RT 55.P345 Video 6: Children as Accident Victims, 45 minutes. General Emergency Care, Types of Accidents. 10999708 RT 55.P345 Video 7: Children with Chronic Problems, 55 minutes. Allergic Disorders, Collagen Disorders, Endocrine Disorders, Hematological Disorders, Neurologic/Musculoskeletal Disorders, Renal Disorders, Metabolic Disorders. 1099709 RT 55.P345 93 Spring 2013 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families PREPARATION RESOURCES REVISION (Clinical Manual of Pediatric Nursing) Class Old pp. 19-77, 143-166, & 181-195 Physical & Developmental Assessment pp. 253-259, 267-276, & 289Nursing Interventions & 300 & (PAIN SCALES) P. Variations for the Pediatric 308, pp. 310-312, & 316-317. Client pp. 3-6, 15-18, & 33-36. Communication; Social, Cultural, & Religious <><><><><><><><><><> Pediatric Pharmacology pp. 429-435 Nursing Care of Children with Alterations in Elimination pp. 367-375, 415-426, & 562Nursing Care of Children 575 with Respiratory Dysfunction pp. 34, 128-140, 160-164, Health Promotion: Infant & 181-187, 207-208, 213, 217Family 218, 223, 225-230, & 237-241 Health Promotion: Toddler pp. 34, 128, 131-140, 160-161, 165, 188-189, 208, 213, 218& Family 221, 229-231, 237-242, & 246247 pp. 34, 128, 160-161, 190-191, Health Promotion: 208-209, 242, 246-247, & 250 Preschool Child & Family pp. 44-45, 256-268, & 589 Nursing Care of Children with Integumentary Dysfunction pp. 108, 407-408, 483-485, & Nursing Care of Children 517-519 with Alterations in Mobility pp. 95-96, & 439-444 Nursing Care of Children with Cardiovascular Dysfunction pp. 34, 129-139, 192-193, 198Health Promotion: School201, 214, 232-235, 242-244, age Child 246, & 496-497 pp. 35, 57, 66, 143-144, 149, Health Promotion: The 152-154, 157-158, 214, 236, Adolescent & Family 244-246, 494, & 520 94 Spring 2013 New pp. 18-74, 114-147, 180 pp. 181-202, 209-248 (PAIN SCALES) pp. 2-17 <><><><><><><><><><> pp. 79-81 pp. 74-79, 163, 269-276, 280281, & 308-311 pp. 30-31, 121, 134-139, 149156, 159, 161, 163, & 173-176 pp. 3-31, 94, 121, 125-126, 140-141, 149-152, 156, 159, 161-163, 173-177, & 183-186 pp. 30-31, 94, 121, 140-143, & 184 pp. 40-41, 214-219 pp. 40-41& 214-219 pp. 82-38 & 312-315 pp. 31, 94, 144-145, 149-153, 160, 170, & 178-179 pp. 31, 62, 64, 96, 118-120, 146-147, 172, 320 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families Class Old New Chronic Illness, Disability, & End of Life Nursing Care of Children with Cerebral Dysfunction Nursing Care of Children with Endocrine Dysfunction pp. 330-332, 339-341, & 500-502 pp. 291-296 pp. 100-106 & 464-470 pp. 88-91, 321-323 95 Spring 2013 pp. 475-477 Tulsa Community College NURS 2433 Nursing Care of Children and Their Families School of Nursing and Health Sciences Individual Student Test Analysis Semester:_____ Date:_____ Test #:_____ # Items On The Test:_____ # Correct:_____ # Missed:_____ Final Score:_____ Questions Missed # Q # Subject Misread Question 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Summary 96 Spring 2013 Misunderstood Question Read Into The Question Missed Important Keyword In Question Did Not Remember/ Recognize Subject Matter Did Not Understand Subject Material Did Not Recognize Rational For Correct Answer Guessed Wrong Changed Answer Marked Scantron Incorrectly Did Not Read All Responses Carefully Used Incorrect Rationale For Selecting Responses Tulsa Community College NURS 2433 Nursing Care of Children and Their Families 97 Spring 2013