Download Page 1 Module I: Diabetes Mellitus and the

COURSE INFORMATION
COURSE PREFIX NO.:
COURSE TITLE:
LECTURE HRS. /WK.:
LAB HRS. /WK. AVERAGE:
CREDIT HRS. /SEMESTER:
NUR /LANU 159
NURSING CARE MANAGEMENT II
4.5
1.5
6.0
Distance Learning Attendance/VA Statement
Textbook Information
COURSE DESCRIPTION
This course focuses on the delivery of nursing care to an increasing number of individuals
experiencing health problems emphasizing selected physiological systems.
COURSE CONTENT
Module I: Diabetes Mellitus and the Cardiovascular System – Hypertension and
Vascular Disorders
•
•
•
Differentiate normal from common abnormal findings related to the cardiovascular
system and hypertension.
Differentiate normal from common abnormal findings related to the cardiovascular
system and vascular disorders.
Describe the pathophysiology and clinical manifestations of diabetes mellitus.
Module II: Female Reproductive Problems, Male Reproductive Problems, Adult
Renal and Urologic Problems, Hypovolemic Shock and Fluid and
Electrolyte and Acid / Base Balance
•
•
•
•
Describe the diagnostic studies and collaborative care of male reproductive problems.
Describe the diagnostic studies and collaborative care of women’s health problems.
Explain the pathophysiology of dysfunctions of adult renal and urologic systems.
Explain the pathophysiology of dysfunctions pediatric renal and urologic systems.
Module III: Adult Upper and Lower Gastrointestinal problems, Cancer and Adult
Musculoskeletal problems.
•
•
•
•
•
Explain how the nursing process is used to provide intermediate nursing care for
pediatric patients experiencing respiratory dysfunction.
Differentiate among the three major classifications of shock in relationship to cause and
precipitating factors.
Describe the nursing care involved in the adult patient with upper gastrointestinal
problems.
Describe the nursing care involved in the adult patient with lower gastrointestinal
problems.
Describe the nursing care involved in the pediatric patient with upper gastrointestinal
problems.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 1
•
Describe the nursing care involved in the pediatric patient with lower gastrointestinal
problems.
Module IV:
Pediatric Respiratory, Upper and Lower Gastrointestinal, Renal and
Musculoskeletal problems.
•
•
•
Explain the role of the nurse in the prevention, detection and care of a patient with
cancer.
Describe the clinical manifestations of pediatric musculoskeletal problems.
Describe the clinical manifestations of adult musculoskeletal problems.
STUDENT LEARNING OUTCOMES
Upon completion of NUR/LANU 159, Nursing Care Management II, the student will be able to
function, at an intermediate level, in the roles of Provider of Care, Manager of Care, and
Member within the Discipline of Nursing by demonstrating the following:
I.
Caring: Demonstrates concepts of caring and holism when providing nursing care.
II. Communication: Use effective professional verbal and written communication skills
while interacting with patients, peers, faculty, and other healthcare professionals.
III. Critical Thinking: Demonstrate critical thinking skills during the delivery of patient care.
IV. Teaching/Learning: Use principles of teaching/learning in order to promote, facilitate,
maintain, and restore optimal health.
V. Professional Behaviors: Functions in the role of a professional nurse with patients
across the lifespan using a holistic approach.
VI. Nursing Process: Demonstrates clinical decision making skills using the nursing
process during the delivery of patient care.
MINIMAL STANDARDS
The student will demonstrate student learning outcomes as stated in the syllabus. Student
evaluation for the course includes a graded theory component and a clinical component. A
student must achieve a final grade of 80% or better in the theory component in order to
successfully complete the course. A final average grade below 80% constitutes failure of the
course. In addition, a satisfactory rating in the clinical setting is required to successfully
complete this course. A copy of the clinical evaluation tool is included in the syllabus
addendum.
Determination of Grade
A 91 – 100
B 86 – 90
C 80 – 85
D 70 – 79
F Below 70
Average of Module Exams
Cumulative Final Exam
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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ATI Test Required
Completion of a non-proctored ATI Nutrition test is required by the scheduled due date (see
course calendar).
EVALUATION AND GRADING STRATEGIES
A. Theory Component
Achievement in theory will be measured by module exams and a cumulative final examination.
Any student who has an average grade of 91(A) or above on all exams will qualify to exempt the
final exam. In order to qualify for the exemption, all unit exams must be taken on the date
scheduled. Any student taking make-up exams will not qualify to exempt the final exam,
regardless of the cumulative exam average. All exams will be used to calculate final
exemptions.
Grades will be rounded to the nearest whole number after final computation of grades.
Any student found guilty of cheating or being involved in plagiarism will be given a grade of “0”
on an exam or written work and will be subject to further disciplinary action.
B. Clinical Component
Achievement in clinical competency will be measured by observation and addressing the
Student Learning Outcomes of student performance. Each week, the student will submit a
weekly evaluation addressing the learning outcomes. This evaluation tool must be submitted
electronically at the assigned time each week to the clinical instructor. The clinical instructor will
evaluate the student each week using the criteria on the Evaluation of Clinical Performance
Tool. In order to pass the clinical portion of this course, a final evaluation of satisfactory (S) is
required. If the student is unsuccessful in meeting the learning outcomes on the final evaluation
tool, the student will receive a grade of (U) unsatisfactory. This will constitute failure of the
course, regardless of the theory grade.
ATTENDANCE
In order to meet the objectives of class and clinical and to promote professional accountability,
the following requirements for attendance will be enforced:
• Students must attend 90% of all class requirements.
• Students must attend 100% of all clinical activities.
• Students who are tardy for scheduled classes will not be allowed to interrupt the class;
they may enter the classroom at the first break.
• Absences from a clinical assignment without notifying the instructor prior to the start of
the clinical day will result in a grade of a clinical Unsatisfactory.
ACADEMIC INTEGRITY
Students are expected to meet high standards of academic honesty and integrity. Academic
misconduct includes, but is not limited to, cheating, copying another student’s work, using
unauthorized equipment or materials during a test, obtaining, using, buying or selling the
contents of a test, falsifying or inventing information such as reports or laboratory results,
plagiarism, and collusion. Students who are found guilty of academic dishonesty may be
assigned a lower grade for the assignment including a grade of zero, may be required to repeat
or resubmit the assignment, may be assigned a failing grade for the course, or be required to
withdraw from the course. Students may also be subject to further disciplinary action.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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ELECTRONIC DEVICES
Permission from the Instructor must be obtained for any taping in the classroom of lectures,
activities, and case studies prior to class. There will be ABSOLUTELY no electronic devices
permitted during exam reviews. All telephones must be off, or on vibrate, when attending
lecture.
METHODS OF INSTRUCTION
Learning Management System ( D2L), assigned reading, audiovisuals and computer lab
experience, handouts, written assignments, discussion, individual conferences, professional
articles, and study guides/learning exercises.
COMPUTER REQUIREMENTS
Nursing courses use the Internet. It is recommended that students have a computer
manufactured no earlier than 2008 with a Windows XP, Vista, or Windows 7 operating system.
more information on supported browsers and system requirements can be found at
http://etc.yorktech.com/DistanceLearning/Browsers.htm. Students must have access to the
Internet - preferably with a DSL or cable modem or access to the campus open computer labs.
ENTRY-LEVEL SKILLS: See Clinical Evaluation Tool
PREREQUISITES: PREREQUISITES: COL 101/LANU Elective; ENG 101/ ENGL 101; BIO
210/BIO 243 & 243L; NUR 104/LANU 104; NUR 206/LANU 206; NUR 106/LANU 106
CO- REQUISITES: BIO 211/BIOL 244,244L; PSY 201/PSYC 101
LEARNING ACTIVITIES/ASSIGNMENTS*
*Students may be required to complete additional learning activities to enhance knowledge.
DISABILITIES STATEMENT
York Technical College: Any student who feels she/he may need an accommodation on the
impact of a disability should contact the Special Resources Officers (SR) at 803-327-8007 in
Student Services. The SRO coordinates reasonable accommodations for students with
documented disabilities.
University of South Carolina Lancaster: Students who may need accommodations for a
disability should contact The Office of Disability Services by phone at 803-313-7448 or by email
[email protected]. Information on Disability Services at USCL may be accessed at
http://bulletin.usclancaster.sc.edu/content.php?catoid=74&navoid=9060.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Addendum: Nursing Care Management II - NUR/LANU 159
York Technical College Campus
Carol Crain, MSN, RN
803-981-7027
[email protected]
Office hours by appointment
Office B Building - 7D
Jane Fleischer, MSN, RN – Coordinator
803-981-7046
[email protected]
Office hours by appointment
Office B Building – 7 C
Linda McClung, MSN, RN – Adjunct Faculty
408-872-0988
[email protected]
USCL Campus
Claudine Jones, MSN, RN
803-313-7166
[email protected]
Office hours by appointment
Office – Hubbard 211
Holly Hendrick, MSN, RN – Adjunct Faculty
704-564-3568
[email protected]
RESOURCES:
Required:
James, S. R., & Ashwill, J. W. (2013). Nursing care of children: Principles & practice
(4th ed.). St. Louis, MA: Saunders.
Lewis, S. L., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical surgical
nursing: Assessment and management of clinical problems (8th.). St. Louis, MA: Mosby.
Recommended:
James, S. R., & Ashwill, J. W. (2013). Study guide-Nursing care of children: Principles &
practice (4th ed.). St. Louis, MA: Saunders.
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Study
guide-Medical surgical nursing: Assessment and management of clinical problems (8th ed.).
St. Louis, MA: Mosby.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Resources for Curriculum:
ANA Scope and Standards of Practice – Pediatric Nursing
• Standards 1-6
ANA Scope and Standards of Practice – Gerontological Nursing
• Standards 1-6
ANA Scope and Standards of Practice – Cardiovascular Nursing
• Standards 1-6
National Patient Safety Goals
QSEN Initiatives
METHODS OF EVALUATION/GRADING
•
•
•
•
Final theory grade of 80%
Satisfactory clinical grade by the end of the course
Drug Dose Competency 90% - three (3) attempts
Attend a final clinical evaluation conference
Theory Component – Final grade of 80% or greater
Grading Scale
A – 91 – 100
B – 86 – 90
C – 80 – 85
D – 70 – 79
F – 69 or below
Methodology for Final Grade
Four (4) Module exams
= 80%
Comprehensive Final exam = 20 %
100%
Test Blueprint
Knowledge
Comprehension
Application
Analysis
(+ or – 2.5%)
15%
40%
30%
15%
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module I Exam – 60 Questions
Diabetes Mellitus
Vascular Disorders
Hypertension
Content
Final Exam
75 Questions
20
20
20
6
6
6
18
18
17
17
4
4
5
5
15
15
15
30
5
4
5
8
15
15
15
15
5
4
4
4
Module II Exam – 70 Questions
Female Reproductive Disorders
Male Reproductive Disorders
Adult Renal Disorders
Hypovolemic Shock/ Fluid &
Electrolytes/ Acid & Base Disorders
Module III Exam – 75 Questions
Adult Upper GI Disorders
Adult Lower GI Disorders
Cancer
Adult Musculoskeletal Disorders
Module IV Exam – 60 Questions
Pediatric Respiratory Disorders
Pediatric Upper and Lower GI
Pediatric Renal
Pediatric Musculoskeletal
Grades will be rounded to the nearest whole number after final computation of grades.
Clinical Component – Must achieve a Satisfactory in the following areas:
•
•
•
•
•
•
•
Submit a weekly clinical self-evaluation, via D2L, utilizing the NUR/LANU 159 weekly
evaluation tool. In order to pass the clinical portion of this course, a final evaluation of
satisfactory (S) must be achieved in all learning outcomes on the evaluation tool. If the
student is unsuccessful in meeting these outcomes, they will receive a grade of
unsatisfactory and fail the course regardless of their theory grade.
Develop two satisfactory care maps (first care map submitted will not be graded but will
be for feedback only)
Formal paper from observational experience in the operating room
Satisfactorily complete simulation lab assignment (care of a patient with a
gastrointestinal bleed, care of a patient with pneumonia and care of a patient with a deep
vein thrombosis)
Complete a 2 hour service learning requirement
Nasogastric tube insertion and removal
Medication administration via and NG or PEG tube
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Drug Dose Competency – Three attempts to achieve a competency of 90% or above
•
If the student does not achieve at least a 90% by the second exam, he/she will have one
remaining attempt to pass a similar exam. If the student has not passed the exam with a
90% by the third attempt, the student will receive a failing grade in the clinical
component of the course and will therefore fail the NUR/LANU 159 course.
Technology Requirements
Nursing courses use the Internet. It is recommended that students have a computer
manufactured no earlier than 2008 with a Windows XP, Vista, or Windows 7 operating system.
More information on supported browsers and system requirements can be found at
http://etc.yorktech.com/DistanceLearning/Browsers.htm. Students must have access to the
Internet, preferably with a DSL or cable modem or access to the campus open computer labs.
Nursing Department Standards and Policies (see Nursing Student Manual)
For information on the following policies, please refer to the Nursing Student Manual Spring,
2014
• Exam policy, make-up and review
Section VI
• Academic Policies
Section VIII
• Academic Progression
Section VIII
• Readmission Requirements
Section VIII
• Termination
Section VIII
• Class Room Policies
Section IX
• Clinical Policies
Section X
• Student Conduct Policies
Section XII
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Course Outline/ Objectives
Module I:
Diabetes Mellitus and the Cardiovascular System – Hypertension and
Vascular Disorders
Topic: Diabetes Mellitus
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for a patient with the following types of diabetes:
• Type I diabetes
• Type II diabetes
2. Describe cultural considerations related to Type I and Type II diabetes.
3. Discuss legal and ethical considerations related to diabetes.
Preparation:
Required Reading:
Review anatomy and physiology of the endocrine system.
Chapter 49: 1218-1254
Lewis, 8th edition
th
James/ Ashwill, 4 edition
Chapter 27: 718 - 731
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with risk factors for developing diabetes mellitus.
2. Care for a patient with diabetes mellitus and understand the purpose of the medications
prescribed.
3. Care for a patient with complications related to diabetes mellitus.
Evaluation:
Knowledge of this content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module I:
Diabetes Mellitus and the Cardiovascular System – Hypertension and
Vascular Disorders
Topic: Cardiovascular System – Hypertension and Vascular Disorder
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for a patient with the following cardiovascular conditions:
• Coronary artery disease
• Hypertension
• Peripheral arterial disease
• Intermittent claudication
• Acute arterial occlusion
• Thromboangitis obliterans (Buerger’s disease)
• Raynaud’s phenomenon
• Venous thromboembolism syndrome (VTE)
• Superficial and deep vein thrombosis (DVT)
• Chronic venous insufficiency (CVI)
• Varicose veins
• Pulmonary embolus
2. Describe cultural considerations related to hypertension and vascular disorders
3. Discuss legal and ethical considerations related to hypertension and vascular disorders.
Preparation:
Required Reading:
Cardiac: Hypertension
Lewis, 8th edition:
Chapter 32: 715-737
Chapter 33: 738-759
Cardiac: Vascular Disorders
Lewis, 8th edition:
Chapter 38: 874-896
Chapter 28: 577-580 (Pulmonary Embolism)
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with risk factors for hypertension.
2. Care for a patient with hypertension and understand the purpose of the prescribed
medications.
3. Care for a patient with peripheral vascular disease.
4. Care for a patient with complications related to peripheral vascular disease.
Evaluation:
Knowledge of this content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module II:
Female Reproductive Problems, Male Reproductive Problems, Adult
Renal and Urologic Problems, Hypovolemic Shock and Fluid and
Electrolyte and Acid / Base Balance
Topic:
Female Reproductive Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for a patient with the following female reproductive problems:
• Mastitis and fibrocystic changes
• Breast cancer
• Lymphedema
• Breast reduction and breast augmentation
• Menopause and peri-menopause
• Pelvic inflammatory disease
• Endometriosis
• Cervical and ovarian cancer
• Uterine fibroids
• Premenstrual syndrome
• Uterine prolapse
• Cystocele/ rectocele
• Hysterectomy
2. Describe cultural considerations related to female reproductive problems
3. Discuss legal and ethical considerations related to hypertension and vascular disorders.
Preparation:
Required Reading:
Reproductive System
Lewis, 8th edition Chapter 51: 1287 – 1305
Breast Disorders
Lewis, 8th edition Chapter 52: 1306 – 1329
Female Reproductive Problems
Lewis, 8th edition Chapter 54: 1345 - 1376
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a female patient with problems of the reproductive system.
2. Care for a female patient with cancer of the breast or cancer of the reproductive system.
Evaluation:
Knowledge of this content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module II:
Female Reproductive Problems, Male Reproductive Problems, Adult
Renal and Urologic Problems, Hypovolemic Shock and Fluid and
Electrolyte and Acid / Base Balance
Topic:
Male Reproductive Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for a patient with the following male reproductive problems:
• Benign prostate hyperplasia (BPH)
• Prostate cancer
• Prostatitis
• Hypospadius
• Epispadius
• Problems with prepuce and erectile mechanism
• Cancer of the penis
• Epididymitis
• Orchitis
• Cryptorchidism
• Hydrocele/varicocele
• Testicular torsion
• Testicular cancer
• Erectile dysfunction
• Infertility
2. Describe cultural considerations related to male reproductive problems
3. Discuss legal and ethical considerations related to male reproductive problems.
Preparation:
Required Reading:
Lewis, 8th edition:
Chapter 55: 1377-1403
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a male patient with problems of the reproductive system.
2. Understand the medications prescribed when caring for a male patient with problems of
the reproductive system.
Evaluation:
Knowledge of this content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module II:
Female Reproductive Problems, Male Reproductive Problems, Adult
Renal and Urologic Problems, Hypovolemic Shock and Fluid and
Electrolyte and Acid / Base Balance
Topic:
Adult Renal and Urologic Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for a patient with the following adult renal and urologic problems:
• Urinary tract infections
• Pyelonephritis (acute and chronic)
• Interstitial cystitis/ painful bladder syndrome
• Glomerulonephritis
• Acute post-streptococcal glomerulonephritis (APSGN)
• Nephrotic syndrome
• Urinary tract calculi/ strictures
• Polycystic kidney disease
• Kidney cancer
• Bladder cancer
• Urinary incontinence
• Urinary retention
• Urinary diversion
2. Describe cultural considerations related to adult renal and urologic problems.
3. Discuss legal and ethical considerations related to renal and urologic problems.
Preparation:
Required Reading
Lewis, 8th edition:
Chapter 45: 1104-1120
Chapter 46: 1121-1163
Review the anatomy and physiology of the urinary system
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with problems related to the renal and urological systems.
2. Understand the medications prescribed for patients with problems of the renal and
urological systems.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module II:
Female Reproductive Problems, Male Reproductive Problems, Adult
Renal and Urologic Problems, Hypovolemic Shock and Fluid and
Electrolyte and Acid / Base Balance
Topic:
Hypovolemic Shock and Fluid and Electrolyte and Acid/ Base Balance
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for a patient with the following conditions:
• Hypovolemic shock
o Stages of shock
• Fluid and electrolyte imbalance
o Sodium
o Potassium
o Calcium
o Phosphate
o Magnesium
o Fluid excess
o Fluid deficit
o Intravenous fluid replacement (hypotonic/ isotonic/ hypertonic)
• Acid/ base imbalance
o Acidosis – Respiratory / Metabolic
o Alkalosis – Respiratory/ Metabolic
2. Describe cultural considerations related to patients with hypovolemic shock, fluid and
electrolyte or acid/ base balance problems.
3. Discuss legal and ethical considerations related to patients with hypovolemic shock, fluid
and electrolyte or acid/ base balance problems.
Preparation:
Required Reading:
Lewis, 8th edition:
James/ Ashwill, 4th edition:
Chapter 67: 1717-1739
(only read Hypovolemic Shock and Care)
Chapter: 17: 309 - 328
Chapter 10: 212 - 216
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with an alteration in fluid and electrolyte and/ or acid base balance.
2. When caring for patients, anticipate the patients at high risk for developing hypovolemic
shock or an alteration in fluid and electrolyte and acid base balance.
Evaluation:
Knowledge of this content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module III:
Adult Upper and Lower Gastrointestinal problems, Cancer and Adult
Musculoskeletal problems.
Topic:
Adult Upper Gastrointestinal problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following upper gastrointestinal
problems:
• Nausea and vomiting
• Oral inflammations and infections
• Oral cancer
• Gastroesophageal reflux disease (GERD)
o Esophagitis
o Incompetent lower esophageal sphincter (LES)
o Barrett’s esophagus
• Hiatal hernia
• Upper GI bleeding
• Esophageal cancer
• Gastritis
• Peptic ulcer disease
• Stomach cancer
• Obesity
2. Describe cultural considerations related to adult patients with upper gastrointestinal
problems.
3. Discuss legal and ethical considerations related to adult patients with upper
gastrointestinal problems.
Preparation:
Required Reading:
Lewis, 8th edition:
Chapter 39: 898-919
Chapter 41: 944-962
Chapter 40: 920-943
Chapter 42: 963-1005
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with an upper gastrointestinal illness and anticipate the complications
that may occur.
2. Care for an obese patient with recent gastric bypass surgery and anticipate the
complications that may occur.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module III:
Adult Upper and Lower Gastrointestinal problems, Cancer and Adult
Musculoskeletal problems.
Topic:
Adult Lower Gastrointestinal problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following lower gastrointestinal
problems:
• Acute abdominal pain
• Irritable bowel disease
• Inflammatory bowel disease
o Crohn’s disease
o Ulcerative colitis
• Intestinal obstruction
• Cancer – colon/ rectal
• Diverticulosis
• Diverticulitis
• Polyps
• Hernia
2. Describe cultural considerations related to adult patients with lower gastrointestinal
problems.
3. Discuss legal and ethical considerations related to adult patients with lower
gastrointestinal problems.
Preparation:
Required Reading:
Lewis, 8th edition:
Chapter 43: 1006-1057
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with problems related to the lower gastrointestinal system and
anticipate potential problems that may occur.
2. Understand the medications prescribed for adult patients with lower gastrointestinal
problems.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module III:
Adult Upper and Lower Gastrointestinal problems, Cancer and Adult
Musculoskeletal problems.
Topic:
Cancer
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following problems:
• Cancer
• Tumors
o Benign neoplasms
o Malignant neoplasms
2. Describe cultural considerations related to patients with cancer.
3. Discuss legal and ethical considerations related to patients with cancer.
Preparation:
Required Reading:
Review normal cell growth and division
Lewis, 8th edition:
Chapter 16: 260-300
James/ Ashwill, 4th edition: Chapter 24: 596 - 604
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a patient with cancer and anticipate the potential complications associated with
the disease.
2. Understand the medications prescribed for a patient with cancer and the potential side
effects associated with those medications.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Module III:
Adult Upper and Lower Gastrointestinal problems, Cancer and Adult
Musculoskeletal problems.
Topic:
Adult Musculoskeletal Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following adult musculoskeletal
problems:
• Osteomyelitis
• Bone tumors/ cancer
• Intervertebral disk disease/ spinal surgery
• Osteoporosis / Paget’s disease
• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Systemic lupus erythematosus
• Fibromyalgia syndrome / Chronic fatigue syndrome
• Strains/ sprains/ dislocations/repetitive strain injury
• Meniscal injury/ ligament injury
• Fractures/ traction
• Compartment syndrome
• Fat embolus syndrome
• Amputations
• Joint surgeries
2. Describe cultural considerations related to adult patients with musculoskeletal problems.
3. Discuss legal and ethical considerations related to adult patients with musculoskeletal
problems.
Preparation:
Required Reading:
Adult Musculoskeletal Problems
Lewis, 8th edition:
Chapter 62: 1568-1582
Chapter 63: 1583-1619
Chapter 64: 1620-1625; 1632-1640
Chapter 65: 1641-1659; 1661-1670
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for an adult with a problem related to the musculoskeletal system.
2. Anticipate complications which may occur in adults with a musculoskeletal problem.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 18
Module IV:
Pediatric Respiratory, Upper and Lower Gastrointestinal, Renal and
Musculoskeletal problems.
Topic:
Pediatric Respiratory Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following pediatric respiratory
problems:
• Otitis media secondary to respiratory infection
• Tonsillitis/ tonsillectomy
• Croup (laryngotracheobronchitis)
• Spasmodic croup
• Bacterial tracheitis
• Epiglottitis
• Bronchitis
• Bronchiolitis/ RSV
• Pneumonia
• Respiratory distress syndrome
• Apnea / SIDS
• Asthma
• Bronchopulmonary dysplasia
• Cystic fibrosis
2. Describe cultural considerations related to pediatric patients with respiratory problems.
3. Discuss legal and ethical considerations related to pediatric patients with respiratory
problems.
Preparation:
Required Reading:
James/ Ashwill, 4th edition:
Chapter 21: 480 – 526
Chapter 17: 369 – 370 (Pertussis only)
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a pediatric patient experiencing respiratory problems.
2. Understand the medications prescribed for the pediatric patient with respiratory
problems.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 19
Module IV:
Pediatric Respiratory, Upper and Lower Gastrointestinal, Renal and
Musculoskeletal problems.
Topic:
Pediatric Upper and Lower Gastrointestinal Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following pediatric upper and lower
problems:
• Cleft lip and palate
• Esophageal atresia/ Tracheal esophageal fistula (EA/ TEF)
• Gastroesophageal reflux disease (GERD)
• Infectious gastroenteritis
• Appendicitis
• Inflammatory bowel disease
o Crohn’s disease
o Ulcerative colitis
• Hypertrophic pyloric stenosis
• Intussusception
• Hirschsprung disease
• Celiac disease
2. Describe cultural considerations related to pediatric patients with upper and lower
gastrointestinal problems.
3. Discuss legal and ethical considerations related to pediatric patients with upper and
lower gastrointestinal problems.
Preparation:
Required Reading:
James / Ashwill, 4th edition: Chapter 19: 407 - 445
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a pediatric patient with alterations of the gastrointestinal system.
2. Understand the medications prescribed and surgeries for the child with a problem
related to the upper or lower gastrointestinal system
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 20
Module IV:
Pediatric Respiratory, Upper and Lower Gastrointestinal, Renal and
Musculoskeletal problems.
Topic:
Pediatric Renal Problems
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following pediatric renal problems:
• Vesicoureteral reflux
• Urinary tract infections
• Hypospadias
• Epispadius
• Acute post-streptococcal glomerulonephritis
• Glomerulonephritis
• Nephrotic syndrome
• Wilm’s tumor
2. Describe cultural considerations related to pediatric patients with renal problems.
3. Discuss legal and ethical considerations related to pediatric patients with renal problems.
Preparation:
Required Reading:
James/ Ashwill, 4th edition:
Chapter 20: 454 – 474;
Chapter 24: 632- 622 (Wilm’s Tumor)
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a child with a problem related to the renal system.
2. Understand the medications prescribed for a child with renal problems.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool.
.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 21
Module IV:
Pediatric Respiratory, Upper and Lower Gastrointestinal, Renal and
Musculoskeletal problems.
Topic:
Pediatric Musculoskeletal
Objectives: Upon completion of this unit of study, the student will:
1. Describe the etiology, clinical manifestations, diagnostic findings, drug therapy, dietary
needs and nursing care for an adult patient with the following pediatric musculoskeletal
problems:
• Fractures/ traction
• Compartment syndrome
• Fat emboli
• Osteomyelitis
• Scoliosis
• Kyphosis/ lordosis
• Developmental dysplasia of the hip (DDH)
• Legg Calve Perthes disease
• Slipped capital femoral epiphysis
• Club foot/ limb defects
• Muscular dystrophy
• Osteogenesis imperfect
• Juvenile arthritis (JA)
• Bone cancers
2. Describe cultural considerations related to pediatric patients with musculoskeletal
problems.
3. Discuss legal and ethical considerations related to pediatric patients with
musculoskeletal problems.
Preparation:
Required Reading:
Pediatric Musculoskeletal Problems
James/ Ashwill, 4th edition:
Chapter 24: 618- 622
Chapter 26: 661- 698
Recommended resources:
http://davisplus.fadavis.com/Nursing
https://evolve.elsevier.com/cs/Satellite/StudentHome?Audience=Student
Clinical Focus:
1. Care for a child with a problem related to the musculoskeletal system.
2. Anticipate complications which may occur in children with a musculoskeletal problem.
Evaluation:
Evaluation of this unit content will be evaluated as indicated on the test blueprints and on
the Clinical Evaluation Tool
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 22
YTC/USCL ADN Program
NUR/LANU 159 - 2014
Campus Clinical Lab
Objectives: Upon completion of this unit of study, the student will:
1.
Understand the appropriate techniques involved in:
a.
Monitoring an IV site
b.
Sterile dressing change (sterile gloving)
c.
Isolation requirements
d.
NG tube insertion and flushing
e.
Medication administration via an NG or PEG tube
f.
Insertion and removal of a urinary catheter
2.
Demonstrate documentation principles related to the above clinical skills and
patient response.
3.
Demonstrate correct procedures for NG tube insertion and flushing and
medication administration via an NG tube and a PEG tube
4.
Demonstrate accountability for previous learning (urinary catheterization).
5
Demonstrate professional attitudes and behaviors during lab activities.
Preparation:
Required Reading:
• Wilkinson & Treas Volume 2 (2nd Ed.). pgs. 336 – 340; 348 – 363;
447 – 449; 613 - 637
Recommended resources:
• http://davisplus.fadavis.com/Wilkinson
• Review documentation from NUR/LANU 106 and 206
Lab Focus:
• Identify the nurse’s role in monitoring and IV site.
• Identify the concept of sterility during a dressing change or donning gloves
• Discuss the reasons for placing a patient in isolation (contact, enteric, droplet)
• Demonstrate the correct technique for NG tube insertion and flushing
• Demonstrate the correct technique for medication administration via an NG or
PEG tube
• Review technique for insertion and removal of a urinary catheter
Evaluation:
• Knowledge of this lab content will be evaluated as indicated on the Clinical
Evaluation tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 23
PROCEDURE CHECKLIST
Chapter 26: Inserting Nasogastric and Nasoenteric Tubes
Check (√) Yes or No
PROCEDURE STEPS
Yes
Before during, and after the procedure, follows
“Principles-Based Checklist to Use with All Procedures,"
including: Identifies the patient according to agency policy;
attends appropriately to standard precautions, hand hygiene,
safety, privacy, and body mechanics.
1. Prepares the tube.
a. Plastic tube: Places in a basin of warm water for
10 minutes.
b. Rubber tube: Places in a basin of ice for 10 minutes
c. small-bore tube: Inserts stylet or guidewire and secures
into position according to agency policy. (Small-bore
tubes may come with the guidewire in them. Leaves the
wire in place until tube is positioned and placement
checked on x-ray. Once wire is removed, does not reinsert
it.)
2. Assists patient into a high Fowler's position, pillow head and
shoulders.
Variations:
a. If patient is comatose, places patient into a low Fowler's
position. Asks a co-worker help position patient's head for
insertion.
b. If patient is confused and combative, asks a co-worker to
assist with insertion.
3. Checks patency of nares; chooses appropriate naris.
4. Measures the tube length correctly.
a. Nasogastric (NG) tube: Measures from the tip of the nose
to the earlobe, and from the earlobe to the xiphoid process.
Marks the length with tape or indelible ink on the (NE)
tube.
b. Nasoenteric (NE) tube: Adds 8-10 cm (3-4 in.), or as
directed, to NG measurement and marks with tape or
indelible ink.
5. Stands on patient's right side if right-handed and left side if
left handed. Drapes a linen-saver pad over patient's chest and
hands him an emesis basin and facial tissues.
6. Prepares fixation device or cuts a 10-cm (4- in.) piece of
hypoallergenic tape; splits the bottom end lengthways.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
No
COMMENTS
Page 24
Chapter 26: Inserting Nasogastric and Nasoenteric Tubes (continued)
PROCEDURE STEPS
7. Arranges a signal for patient to communicate if he wants
to stop.
Yes
No
COMMENTS
8. Dons procedure gloves, if not done previously.
9. Wraps 10-15 cm (5-6 in.) of end of the tube tightly
around index finger, then releases it.
10. Lubricates the distal 10 cm (4 in.) of the tube with a water-
soluble lubricant.
11. If patient is awake, alert, and able to swallow, hands him a
glass of water with a straw.
12. Instructs patient to hold his head straight up and extend his
neck back against the pillow (slight hyperextension).
13. Begins to insert the NG tube:
14.
15.
16.
17.
a. Grasps the tube above the lubricant with the curved end
pointing downward.
b. Gently inserts the tip of the tube into the nostril. Advances
the tube slowly along floor of nasal passage, on the lateral
side, aiming toward the near ear.
c. If resistance is felt when the tube reaches the nasopharynx,
uses gentle pressure, but does not force the tube to
advance.
d. Provides tissues if patient's eyes tear.
e. Continues insertion until just past the nasopharynx by
gently rotating the tube toward the opposite naris.
Stops briefly for patient to relax; explains that the next step
requires him to swallow.
Directs patient to flex his head toward the chest, take a small
sip of water, and swallow.
Rotates the tube 180° and directs patient to sip and swallow
the water while the nurse slowly advances the tube.
Advances tube 5-10 cm (2--4 in.) with each swallow until
marked length is reached.
a. If patient gags, stops advancing the tube and instructs
patient to take deep breaths and drink a few sips of water.
b. If patient gags, stops advancing the tube and instructs
patient to take deep breaths and drink a few sips of water.
c. If the tube is coiled in the back of the throat, patient
coughs excessively during insertion, the tube does not
advance with each swallow, or patient develops
respiratory distress, withdraws the tube and allows patient
to rest before reinserting.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 25
Chapter 26: Inserting Nasogastric and Nasoenteric Tubes (continued)
PROCEDLURE STEPS
Yes No COMMENTS
d. Variation: To advance the tube into the small
intestine: After the tube is in the stomach, positions
patient on his right side; advances the tube 5-7.5 cm
(2-3 in.) hourly, over several hours (up to 24 hours) until
radiography confirms placement
18. When the tube is in place, secures it temporarily with
one piece of tape so it does not move while the nurse confirms
placement.
19. Verifies tube placement at the bedside by a combination
of methods:
a. Inspects the posterior pharynx for the presence of coiled
b
b. Aspirates stomach contents and measures pH; notes
color and consistency of aspirate.
c. Confirms "a" and "b" by injecting air into the NG tube and
(See Clinical Insight 26-7 in Volume 2.)
20. If tube is not in stomach, advances it another 2.5-5 cm
(I- 2 in.) and repeats steps 17 through 19.
21. After confirming placement, clamps or connects the end
of the tube.
22. Secures the tube with tape or a tube fixation device.
Tape:
1. Applies skin adhesive to patient's nose and allows it
to dry.
2. Using the 2-inch split tape, removes gloves and
applies the intact end of the tape to patient's nose.
3. Wraps the 5-cm (2-in.) strips around the tube where it
exits the nose.
4. Alternatively, uses the 2.5-cm (I-in.) tape; applies
one end to patient's nose, wraps the middle around the
tube, and secures the other end to the opposite side of
the nose.
Alternative: Uses a fixation device: Places the wide end
of the pad over the bridge of the nose; positions the
connector around the tube where it exits the nose.
23. Curves and tapes the tube to patient's cheek (unless
contraindicated by the fixation device).
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 26
Chapter 26: Inserting Nasogastric and Nasoenteric Tubes (continued)
PROCEDURE STEPS
Yes No COMMENTS
24. Ties a slipknot around the tube with a rubber band near the
connection; secures the rubber band to patient's gown with a
safety pin. Alternatively, uses tape instead of a rubber band.
25. Elevates the head of the bed to 30° unless contraindicated.
26. Marks the tube where it enters the naris with tape or indelible
ink. Measures the length from the naris to the connector, and
records.
Recommendation: Pass
Student:
Instructor:
Needs more practice
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Date:
Date:
Page 27
Chapter 26: Removing Nasogastric or Nasoenteric Tube
Check (√) Yes or No
PROCEDURE STEPS
Yes
Before during, and after the procedure, follows “Principles-Based
Checklist to Use with All Procedures.” Including: Identifies the
patient according to agency policy; attends appropriately to
standard precautions, hand hygiene, safety, privacy, and body
mechanics.
1. Checks patient’s health record to confirm the prescription for
removal.
2. For feeding tubes, waits at least 30 minutes after feeding is
finished to remove tube.
3. Assists patient to a sitting or high Fowler’s position.
4. Places disposable plastic bag on the bed or within reach
5. Hands patient facial tissue.
6. Explains that the procedure may cause some gagging or
discomfort, but that it will be brief.
7. Drapes a linen-saver pad across patient’s chest.
8. Dons procedure gloves.
9. If a NG tube is connected, turns off suction and disconnects
the tube.
10. Stands on patient’s right side if right-handed, and on left side
if left-handed.
11. Attaches the syringe to the proximal end of the NG or NE
tube and flushes with 10 mL of air or normal saline.
12. Unpins the tube from patient’s gown and then untapes the
tube from patient’s nose. Uses adhesive remover as needed.
13. Clamps or pinches the open end of the tube.
14. Holds gauze up to patient’s nose and is ready to grasp the tube
with a towel in the opposite hand. Asks patient to hold his
breath.
15. Quickly, steadily, and smoothly withdraws the tube and
places it in the plastic bag.
16. If patient cannot do so. Cleans patient’s nares and provides
mouth care.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
No
COMMENTS
Page 28
Chapter 26: Removing Nasogastric and Nasoenteric Tube (continued)
PROCEDURE STEPS
Yes No COMMENTS
17. If the tube was connected to suction, measures the output and
notes the characteristic of the content
18. Removes gloves and disposes of gloves, tube, and any
drainage equipment in the nearest receptacle, according to
facility policy
Recommendation: Pass
Student:
Instructor:
Needs more practice
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Date:
Date:
Page 29
Chapter 37: Managing Gastric Suction
Check (√) Yes or No
PROCEDURE STEPS
Yes
Before, during, and after the procedure, follows “Principles-Based
Checklist to Use with All Procedures,” including: Identifies the
patient according to agency policy: attends appropriately to
standard precautions, hand hygiene, safety, privacy and body
mechanics
Initial Equipment Setup:
1. Places the collection container in the holder. Plugs power cord
into a grounded outlet if using portable suction.
2. Connects the short tubing between the container and the
suction source (“vacuum”).
3. Connects the long suction tubing to the container. If available,
connects a stopcock to the open end nearest patient.
4. Don clean nonsterile gloves
5. After nasogastric (NG) tube is inserted and placement
verified, attaches the end of the NG tube to the suction tubing
6. If using a Salem sump tube, instills 10-20 mL of air into the
vent lumen.
7. Secures NG tube to the patient’s nose and to the gown.
8. Turns on suction source to prescribed amount.
9. Opens stopcock (if one is used).
10. Observes that drainage appears in the collection container.
Emptying the Suction Container:
1. Dons clean nonsterile gloves.
2. Turns off suction source.
3. Closes stopcock on the tubing, or clamps tubing.
4. Notes color, odor, and amount of drainage. If the suction
canister is not marked for measuring, removes cap from the
lid of the suction container and pours drainage into a
graduated container to measure the amount
5. Empties and washes the graduated container of the suction
canister.
6. Wipes the port of the suction canister with an alcohol wipe,
places the container in the holder, and closes the stopper on
the port.
7. Turns on suction sources to prescribed amount; turns on the
stop cock or unclamps tubing.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
No
COMMENTS
Page 30
Chapter 37: Managing Gastric Suction (continued)
PROCEDURE STEPS
Yes No
8. Observes for proper functioning of the suction and for patency
of the tubing.
9. Removes and discards gloves; performs hand hygiene.
Irrigating the Nasogastric Tubing:
1. Places a linen-saver pad under the NG tube.
2. Opens the irrigation set and pours saline into the basin.
3. Don clean nonsterile gloves.
4. Checks for correct placement of the NG tube.
5. Fills the syringe with 30-50 mL of saline and places it on the
linen-saver pad.
6. Clamps the NG tube or turns off the stopcock. Disconnects
the NG tube from the suction tubing.
7. Holds the drainage tubing up until suction clears it, then lays
it on the linen-saver pad or hooks it over the suction machine.
8. Turns off suction machine.
9. Unclamps the NG tube or turns on the stopcock.
10. With the syringe, instills the irrigant slowly into the NG tube.
a. Does not force the solution
b. Does not instill fluid into the air vent.
12. Lowers the end of the NG tue and withdraws fluid. Instills
and withdraws until fluid flows freely in and out.
1. If using a double-lumen NG tube, injects 30 mL of air into
the “pigtail.”
13. Reclamps the NG tube or turns off the stopcock.
14. Reconnects the NG tube to the suction tube, releases clamp or
turns on the stopcock.
15. Reattaches the NG tube to patient’s clothing with pin or tape.
16. Provides comfort measures (e.g., Mouth care).
17. Removes and discards gloves; performs hand hygiene.
Providing Comfort Measures:
1. Dons clean nonsterile gloves (unless done in conjunction with
tube irrigation, proceding).
2. Provides mouth care and mouthwash as desired; does not use
lemon-glycerin swabs.
3. Applies water-soluble lubricant if lips are dry or crusty.
4. Removes nasal secretions with a tissue or damp cloth.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
COMMENTS
Page 31
Chapter 37: Managing Gastric Suction (continued)
PROCEDURE STEPS
Yes No
5. Uses a moist cotton-tip applicator to cleanse inside each
nostril. If secretions are encrusted, uses hydrogen peroxide
followed with water.
6. Applies water-soluble lubricant inside each nostril.
7. Checks that tape or tube fixation device is secure. If it is not ,
replaces it.
Recommendation: Pass
Student:
Instructor:
COMMENTS
Needs more practice
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Date:
Date:
Page 32
Chapter 23: Administering Medication Through an Enteral Tube
Check (√) Yes or No
PROCEDURE STEPS
Yes
Before, during, and after the procedure, follows “Principles-Based
Checklist to Use with All Procedures,” including: Identifies the
patient according to agency policy: attends appropriately to
standard precautions, hand hygiene, safety, privacy and body
mechanics
1. Prepares and administers medications according to
:Medication Guidelines: Steps to Follow for All
Medications.”
2. Follows steps in Procedure Checklist Chapter 23:
Administering Oral Medications
a. If pouring from a multidose container, does not touch the
medication.
b. Pours the correct dosage.
c. Breaks only scored tablets or uses a pill cutter.
d. For liquid medications, shakes bottle as necessary,
maintains medical asepsis, does not drip on label, wipes
only outside of bottle lip if dripping occurs.
e. Measures at eye level.
3. Checks to be sure medication can be crushed and given via
enteral tube.
4. Crushes tablet and mixes with approximately 20 mL water (or
obtains liquid medication).
5. If several medications are to be given, mixes each one
separately.
6. Places patient in a high Fowler’s position if possible.
7. Checks nasogastric tube placement by aspirating stomach
contents or measuring the pH of the aspirate, if possible.
Other, less accurate, methods are injecting air into the feeding
tube and auscultating, or asking patient to speak.
8. Checks for residual volume
9a. Flushes the tube, uses the correct type and size syringe.
9b. To flush the tube, removes the bulb or plunger from the
syringe, attaches barrel to the tube, and pours in 20-30 mL of
water
NUR/LANU 159 – Nursing Care Management II- Spring 2014
No
COMMENTS
Page 33
Chapter 23: Administering Medication Through an Enteral Tube (continued)
PROCEDURE STEPS
Yes No COMMENTS
10. Instills medication by depressing the syringe plunger of using
the barrel of the syringe as a funnel and pouring in the
medication. Smaller tubes require instilling with a 30- to 60mL syringe; the medication can be poured with larger tubes.
11. Flushes the medication through the tube by instilling an
additional 20-30 mL of water.
12. If giving more than one medication, gives each separately and
flushes after each.
13. Has patient maintain a sitting position (if able) for at least 30
minutes after medication administration.
Recommendation: Pass
Student:
Instructor:
Needs more practice
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Date:
Date:
Page 34
NUR/LANU 159
OBJECTIVES FOR SURGERY AND OUTPATIENT SURGERY
Address the following objectives in the written reaction paper while observing in the Surgery
areas:
1. Describe how the nursing process and critical thinking are used.
2. Describe procedures utilized to protect the surgery patient both physically and
psychologically.
3. Describe the preoperative teaching plan and preparation of the pre-surgical patient.
4. Describe collaboration and communication observed between the health professionals in
the outpatient surgery and surgical areas.
5. Discuss the cultural sensitivity issues specific to these areas.
6. Describe steps utilized in ensuring an aseptic environment.
7. Describe the observed role of the ADN nurse in the outpatient surgery and surgical areas.
8. Describe legal and ethical parameters used in the care of patients in the outpatient surgery
and surgical areas.
9. Discuss the potential impact of the surgical experience on the observed patient.
REQUIREMENTS
1.
Morning of surgery: - EAT BREAKFAST!! This seems to decrease the incidence of
fainting and nausea.
2.
Using the rubric for this assignment, type formal paper addressing all of the above
objectives. Submit the paper electronically to your clinical instructor within one week of
your assigned day. All electronic papers must be saved and sent in either Microsoft Word
or Rich Text. Evaluations from the facility representatives should also be turned in at this
time in a sealed envelope.
3.
A satisfactory grade must be earned as part of the clinical experience of the course.
4.
If you are unable to attend your scheduled rotation, call your clinical instructor and the
surgical area you are assigned to the morning you are scheduled.
No medications are to be administered or procedures performed by students in this area.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 35
NUR/LANU 159
Grading Rubric Observational Experience Paper
Introduction:
Paragraph includes topic introduced sufficiently, contents of paper clear;
approximately 5 sentences in length:
Body:
• Describe the utilization of the nursing process and critical thinking during
the observed surgery (provide examples of each).
•
•
•
•
•
•
5 points
10 points
Describe procedures utilized to protect the observed surgical patient both
physically and psychologically (provide examples of each).
10 points
Describe the preoperative teaching plan and preparation of the observed
pre-surgical patient.
8 points
Describe collaboration and communication between health care
professionals during the observed surgery (provide examples of each).
8 points
Describe the cultural sensitivity issues specific to the observed patient
(provide examples).
8 points
Describe steps utilized in ensuring an aseptic environment during the observed
surgery (provide examples).
8 points
Describe the role of the ADN nurse in the observed outpatient surgery and surgical
areas (provide examples of each).
8 points
•
Describe the legal (4 pts.) and ethical issues (4 pts.) in the care of the observed patient
in the surgical area (provide examples of each).
8 points
•
Discuss the potential impact of the surgical experience on the observed patient
(provide examples of discharge issues, life style changes etc.).
Conclusion:
• Summarize the observed experience and refer to introductory paragraph
•
Correct grammar/punctuation/spelling/sentence structure
4 points
5 points
10 points
•
Correct APA format with two references cited in body of paper/ reference page/
title page; One paragraph per objective; paper approximately three pages in length
Total:
E= 91-100 points
S= 80-90 points
N= < 80 points
8 points
100 points
For each day late 5 points will be taken off total score
A late paper will constitute an Unsatisfactory clinical rating and will be documented on the clinical
evaluation tool.
NUR/LANU 159 – Nursing Care Management II- Spring 2014
Page 36
YORK TECHNICAL COLLEGE/UNIVERSITY OF SOUTH CAROLINA LANCASTER
ADN NURSING PROGRAM
Student Evaluation Form
Thank you for allowing the nursing students from the York Technical College/University of South
Carolina Lancaster Nursing program to utilize your facility. The faculty appreciate your
willingness to help students expand their knowledge base while in the community. Please
check the column that most clearly characterizes your appraisal of this student nurse in the
community clinical setting.
Student Nurse:
Date:
Facility:
Evaluator:
Category
Excellent
Average
Needs Improvement (please comment)
Personal Appearance
Clinical Knowledge
Professionalism
Motivation
Preparation Experience
Punctuality
Interpersonal Skills
Additional Comments:
Thank you very much for your time. Please place completed form in the envelope provided,
sign across the seal, and return sealed envelope to the student.
If you have any questions or concerns, please contact us at any time.
Jane Fleischer, RN, MSN (w) 981-7046
NUR/LANU 159 – Nursing Care Management II- Spring 2014
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Service Learning and Teaching Activity
Nursing is not an isolated activity. It reaches beyond care to the individual patient and extends into the
community. The nursing faculty encourages each student to volunteer in activities within the church,
community, neighborhood, or school. This project will allow the student to bring the content from the
classroom into the community setting.
Guidelines
1.
Select a 2 hour service learning and teaching activity.
2.
Obtain permission from the agency where you will conduct the activity and discuss with them a
teaching need in that setting. Use previous knowledge gained from Wilkinson & Treas Chapter
24 and from your teaching project in NUR/LANU 104 to plan and perform a teaching activity for
the selected population.
3.
Preapproval is required from your instructor at least 2 weeks before the service learning/ teaching
activity.
4.
Document your service learning activity in your weekly evaluation tool and address the
following:
a.
Identify the location of the service learning.
b.
Discuss the identified teaching need and the overall learning objective.
c.
Describe how you met this need; what you taught and how you disseminated the
information.
d.
Describe the impact this service learning activity had on your personal and professional
growth.
5.
Address the objectives of this activity in the clinical evaluation tool for March 5 or 6, 2014.
Submit this signed sheet to your clinical instructor during post- conference on March 5 or 6, 2014.
* If late, an Unsatisfactory clinical rating will be earned by the student.
Validation Sheet:
Student Name:
Date Project Complete:
Director/Manager/Leader:
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SIM LAB – NUR/LANU 159
Scenario # 1
Location: Medical – Surgical Unit
History / Information:
Ta Wang
Age: 35
Weight: 95 kg
Location: Medical-Surgical Unit
Background
Past Medical History: The patient was in good health until his accident. He was parasurfing three days
ago when he lost control and slammed into some rocks off shore. He was brought to the Emergency
Department (ED) via ambulance with a fractured leg. X-rays confirmed a fracture of the left femur. Two
days ago, he was taken to the Operating Room (OR) for an open reduction internal fixation (ORIF) of his
left femur. His recovery has been unremarkable.
Allergies: No known allergies
Medications: None
Code Status: Full Code
Social/Family History: Patient is not married but lives with his girlfriend in a two-story, single-family
home. He is athletic and exercises five times a week. He works in construction. The patient’s mother and
father are both in good health.
Handoff Report
Situation:
The patient is a 35-year-old male who underwent an ORIF of his left femur three days ago. He is alert and
oriented to person, place and time. He is currently experiencing acute pain in the left calf which he
rates 10 out of 10.
Background:
Patient had a parasurfing accident three days ago when he lost control of his board and slammed into
some rocks off shore. He was initially admitted to the ED and later transferred to the Medical-Surgical
Unit.
Assessment:
Vital signs: HR 92, BP 138/86, RR 18, SpO2 98% on room air and temperature 37.5C
Cardiovascular: Sinus tachycardia. Slight edema to left calf. Left pedal pulse 1+; Right pedal pulse 2+
Respiratory: Breath sounds clear
GI: Hypoactive bowel sounds
GU: Voided 800 mL during previous shift
Extremities: Sequential compression devices on bilaterally. Left femur surgical site dressing dry and
intact
Skin: Pink, warm and dry
Neurological: Alert and oriented to person, place and time. Pupils equal and reactive to light and
accommodation
IVs: Saline lock in right forearm
Labs: Morning lab results pending
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Fall Risk: High risk for falls
Pain: Complains of acute pain in left calf, rated 10 out of 10
Recommendations:
Perform complete assessment and monitor for postoperative complications
Initial Healthcare Provider’s Orders:
Initial Healthcare Provider’s Orders:
Admit to Medical-Surgical Unit
Status Post ORIF
Full code
Regular diet
Out of bed with assistance
Vital signs every four hours
Notify healthcare provider of any acute changes
Continuous pulse oximetry monitoring
Saline lock
Enoxaparin 40 mg SUBCUT daily
ALPRAZolam 0.5 mg PO at bedtime PRN for insomnia
Ampicillin 3 g in 100 mL NS IV piggyback every12 hours
HYDROcodone 5 mg/acetaminophen 325 mg 1 tab PO every 4 hours mild PRN
HYDROmorphone 1 mg IV every 4 hours PRN for severe pain
DiphenhydrAMINE 25 mg PO every 4 hours PRN for pruritus
Ondansetron 4 mg IV every 6 hours for nausea
Acetaminophen 650 mg PO every 4 hours PRN for temperature greater than 38C
Docusate sodium 100 mg PO BID (discontinue for loose stools)
Antiembolism stockings
Incentive spirometer every hour while awake
CBC, PT, PTT, INR every AM
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Preparation Questions for Scenario # 1:
1. Describe the nursing management of the orthopedic postoperative patient. Include potential
complications and how each is prevented.
2. What is the pathophysiology of deep vein thrombosis (DVT)?
3. What is the medical and nursing management of the patient with a DVT?
4. What is the action of heparin?
5. What should the assessment of patient receiving heparin include?
6. What patient education should be provided to the patient who has undergone an ORIF?
7. What discharge planning needs are anticipated for this patient?
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Scenario # 2
Location: Medical - Surgical Unit
History / Information:
Leo Halgren
Age: 55
Weight: 80 kg
Background
Past Medical History: No significant medical history
Allergies: No known allergies
Medications: None
Code Status: Full code
Social/Family History: Plumber works 40 hours a week. Divorced with three independent adult children
and two grandchildren. Recently engaged and plans to be married within the next six months. Lives
with his fiancée. His father died of colon cancer before the age 60. Patient has smoked 2 packs a day for
most of his adult life
Handoff Report
Situation:
The patient is a 55-year-old male who is one day postoperative after an abdominal-perineal (A-P)
resection for colorectal cancer, colostomy, lymph nodes dissection and liver biopsy. His surgical
dressings are dry and intact, his nasogastric tube is draining minimal secretions and he has been resting
comfortably since returning from surgery.
Background:
He presented to his healthcare provider with complaints of fatigue, rectal bleeding and a change in
bowel patterns (constipation alternating with diarrhea). Initial diagnostic testing revealed anemia,
a carcinoembryonic antigen level of 22 and a positive CT scan showing a mass in the sigmoid rectal
region. He has had no other significant medical history.
Assessment:
Vital signs: HR 92, BP 144/80, RR 24, and SpO2 95% on room air. Temperature 37.7C
General Appearance: Well-nourished, appears stated age
Cardiovascular: Sinus rhythm
Respiratory: Clear breath sounds
GI: Bowel sounds absent. Abdomen non-distended, soft and tender to the touch. Abdominal-perineal
dressing dry and intact. Nasogastric tube in place and set to low continuous suction and minimal
secretions present in tube. Colostomy intact with small amount of mucus drainage
GU: A urinary catheter has drained 200 mL clear amber urine over the past 3 hours
Extremities: Good movement and strength all four extremities
Skin: Warm, dry, mucous membranes pale. Turgor adequate
Neurological: Groggy and oriented to person, place and time. Pupils equal, round, reactive to light and
accommodation. No neurological deficits
IVs: 20-gauge IV D5 ½ NS with 20 mEq KCl infusing at 125 mL/hour and morphine PCA pump in right
forearm
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Labs: Lab values are pending
Pain: Complains of abdominal pain 5 out of 10
Recommendations:
Implement orders and monitor for instability.
Initial Healthcare Provider’s Orders:
Admit to Medical-Surgical Unit
Diagnosis: Colon cancer status post abdominal-perineal resection, colostomy, lymph nodes dissection
and liver biopsy
Full code
NPO
Bedrest for today, then bathroom privileges with assistance in the AM
Vital signs every 4 hours
Notify healthcare provider of any acute changes
Continuous pulse oximetry monitoring while on PCA
Morphine sulfate PCA: 1 mg/mL concentration. Patient-delivered bolus dose=1 mL. Delay interval = 15
minutes. Basal infusion rate= 0mL/hr. Four-hour limit = 16mL
For breakthrough pain: morphine 2 mg bolus every two hours PRN. For pruritus: diphenhydrAMINE
hydrochloride 25 mg IV push every 6 hours. If respiratory rate is less than or equal to 8 breaths per
minute or patient is difficult to arouse: 1) stop PCA infusion, 2) administer naloxone 0.04mg IV push
every 2 minutes until ventilation is adequate. Notify physician STAT
Metoclopramide 10mg IV every 6 hours PRN nausea
D5 1/2 NS with 20 mEq KCl at 125 mL/hour
CeFAZolin 1000 mg IV piggyback every 8 hours
MetroNIDAZOLE 500 mg IV piggyback every 6 hours
Famotidine 20 mg IV piggyback every 12 hours
Enoxaparin 40 mg SUBCUT every day
Intake and output every shift, include all drains
Urinary catheter to gravity
Sequential compression devices while in bed
Nasogastric tube to low continuous suction; Irrigate with NS PRN
Colostomy with appliance, empty PRN
Empty compression-bulb wound drain every shift and PRN
Incentive spirometer every hour while awake
AM Labs: CBC, electrolytes, BUN, creatinine, glucose
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Preparation Questions for Scenario # 2:
1. What are risk factors associated with the development of colorectal cancer?
2. What preoperative teaching should be done to prepare a patient for an A-P resection and a
permanent colostomy?
3. What is the most common type of cancer to affect the colon?
4. Discuss the manner in which colorectal cancer can metastasize.
5. What is the significance of staging cancer and how does this correlate with prognosis?
6. Discuss the psychosocial and emotional issues following an A-P resection and a colostomy.
7. What therapeutic interventions would be anticipated for a patient following this type of
abdominal surgery?
8. Identify nursing strategies to decrease the risk of postoperative complications following an A-P
resection and colostomy.
9. Discuss the development and treatment of postoperative pneumonia (nosocomial).
10. Identify the appropriate discharge teaching/planning needs for a patient recovering from this
major surgery.
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Scenario # 3
Location: Medical – Surgical Unit
History/ Information:
Randal Bellemy
Age: 67
Weight: 77 kg
Past Medical History: A former smoker, he is in general good health. He had surgical repair of a broken
hand at age 35 secondary to a work-related accident. He has been experiencing arthritis-related pain
and swelling in his hands for the past two years
Allergies: No known drug allergies
Medications: Four regular aspirin every three to four hours
Code Status: Full code
Social/Family History: Retired machinist. Married with two adult children. Spouse at bedside. He has a
10 pack-year history of smoking. Quit smoking 3 years ago. Denies drug use. Reports drinking one to two
alcoholic drinks every evening
Handoff Report
Situation:
The patient is a 67-year-old male patient admitted to the Medical-Surgical Unit complaining of
abdominal pain lasting one week and worsening over the past 2 days. In the Emergency Department
(ED), two IVs were started, and lab results indicated a critically low hemoglobin and hematocrit. A
gastroenterology procedure was completed and the patient is scheduled for an endoscopy later today.
He is being admitted with a suspected diagnosis of gastrointestinal bleed secondary to aspirin abuse.
He arrived to the Medical-Surgical Unit with a basin of coffee ground emesis and a bedpan of frank
bloody stool. He is complaining of abdominal pain he describes as “aching, gnawing and burning.” His
wife is at the bedside.
Background:
The patient has experienced joint pain and swelling in his hands for the past two years. About a month
ago, he began taking four regular aspirin every three to four hours because he heard it helped arthritis
and was good for his heart. His family brought him to the ED after he complained of severe abdominal
pain and being extremely tired. He vomited twice at home and his wife described his emesis as dark
brown liquid with something that looked like coffee grounds. The family also stated that he looked
really pale.
Assessment:
Vital Signs: HR 126, BP 146/85, RR 21, SpO2 has been 95% on room air, Temperature 36.4C
General Appearance: Well-groomed male who appears stated age. Appears to be in mild distress due
to abdominal pain
Cardiovascular: Sinus tachycardia with audible S1 and S2. No murmurs
Respiratory: Breath sounds clear
GI: Hyperactive bowel sounds with dark tarry stools. Vomited coffee ground emesis on the way to the
unit. NG tube connected to low intermittent suction inserted after arrival to unit
GU: Has not voided
Extremities: Generalized weakness
Skin: Warm, dry and pale
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Neurological: Alert and oriented to person, place and time. Pupils equal, round and reactive to light
and accommodation. No neurologic deficits
IVs: Two peripheral IV lines inserted with normal saline infusing at a total rate of 125 mL/hour
Labs: Labs in the ED indicated a critically low hemoglobin and hematocrit. Admission labs were
recently drawn and the results should be back. Notify the healthcare provider of critical values
immediately
Fall Risk: High-risk
Pain: Abdominal pain rated 5 out of 10
Recommendations:
Monitor closely for bleeding. Administer medications as needed for comfort.
Initial Healthcare Provider’s Orders:
Admit to Medical-Surgical Unit
Diagnosis: Gastrointestinal bleed
Full code
NPO
Activity as tolerated with assistance
Vital signs every 2 hours
Notify healthcare provider for blood pressure less than 90/45, temperature greater than 38.9C, heart
rate greater than 120 or respiratory rate greater than 25
Notify healthcare provider for critical lab values
Continuous cardiac monitoring
Continuous pulse oximetry
IV fluids: Normal saline IV continuous infusion via two sites for a total of 125 mL/hr
Pantoprazole 80 mg x 1 IV STAT, then daily
Morphine 2.5 mg IV every 4 hours PRN for moderate to severe pain
Promethazine 25 mg IV every 4 hours PRN nausea
Nasogastric tube to low intermittent suction
Gastroenterology consult for endoscopy
STAT labs: CBC; chemistry; PT, PTT; platelet count; type and cross match 2 units packed red blood
cells;
stool test for occult blood
Hemoglobin and hematocrit tomorrow AM
Intake and output every shift
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Preparation Questions for Scenario # 3:
1. What factors increase this patient’s risk for GI Bleed?
2. What are the differences between an upper and lower GI bleed?
3. How are these conditions diagnosed?
4. What are the nursing implications associated with the administration of blood?
5. What should the nurse consider when giving a morphine IV push?
6. What are the nursing implications associated with the administration of IV pantoprazole?
7. If the patient continues to bleed, what further diagnostic/treatment options are available?
8. What should the teaching plan for this patient include?
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York Tech/USCL AD Nursing Program
NUR/LANU 159 – Nursing Care Management II
Final Evaluation of Clinical Performance
Student Name: _________________________ Clinical Instructor:
_________________________ Date: _______________
Upon completion of NUR/LANU 159, Nursing Management II, the student will be able to
function, at an intermediate level, in the roles of Provider of Care, Manager of Care, and
Member within the Discipline of nursing by demonstrating the following:
I. Caring: Demonstrate concepts of caring and holism when providing nursing care.
A. Interacts professionally with respectful deference to the needs, values, and
preferences of the patient and family.
B. Demonstrates attentiveness to the patient’s experience.
C. Establishes positive connectedness and presence.
D. Respects the individual patient’s dignity and autonomy.
II. Communication: Use effective professional verbal and written communication skills
while interacting with patients, peers, faculty, and other healthcare professionals.
A. Interacts with patients in a non-judgmental manner using age-appropriate verbal
and nonverbal behavior.
B. Always communicates respectfully and effectively.
C. Communicates information concerning care to the nurse in charge of the patient
throughout the clinical day and through documentation and hand off report.
D. Keeps instructor and other healthcare team members informed of patient care
issues.
E. Demonstrates progressive improvement in documentation of patient care.
1. Uses professional terminology in documentation.
2. Accurately describes the patient’s clinical picture in documentation.
3. Completes documentation in a timely manner.
4. Uses electronic media for documentation and communication of information
as appropriate.
III. Critical thinking: Demonstrate critical thinking skills during the delivery of patient care.
A. Incorporates prior learned knowledge into planning patient care.
B. Demonstrates rational thinking while implementing patient care.
C. Maintains safety while administering medications (patient’s rights).
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IV. Teaching and learning: Uses principles of teaching/learning in order to promote,
facilitate, maintain, and restore optimal health.
A. Creates, with assistance from instructor, a teaching plan based on the patient’s
needs according to a physical assessment and current evidenced-based practice
to promote optimal patient health.
B. Includes patient and family in teaching plan.
C. Incorporates knowledge about the patient’s beliefs, culture, and intellectual
level into the implementation and evaluation of the teaching plan.
D. After evaluating the patient’s response, identifies areas of needed revision to the
teaching plan.
E. Identifies community resources available to promote, facilitate, maintain, and
restore patient health.
V. Professional behavior: Functions in the role of a professional nurse with patients across
the lifespan using a holistic approach.
A. Professionalism and accountability
1. Displays competence in carrying out patient care skills.
2. Evaluates his/her own abilities, accomplishments, and areas for
improvement on a weekly basis.
3. Follows through with appropriate behaviors/policies when an error has been
made.
4. Is responsible for his/her own actions, without excuses.
5. Is able to identify the impact of his/her actions on the quality of care
provided to his/her patients.
6. Follows written and verbal instructions in a timely manner.
7. Takes responsibility for all aspects of assignment/patient care.
8. Takes the initiative to act upon new physician orders in a timely manner.
B. Legal/ethical
1. Respects the dignity, worth, and confidentially of the patients and their
families.
2. Adheres to the policies of the nursing program, the clinical facility, and the SC
Nursing Practice Act.
C. Self-development and life-long learning
1. Indicates at least three areas of needed self-growth.
2. Identifies available resources if necessary to improve clinical skills.
VI.
Nursing Process: Demonstrates clinical decision making skills using the nursing
process during the delivery of patient care.
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A. Uses assessed data from patient, chart, literature, and other sources while
planning care.
B. Implements patient care related to assessed holistic needs, involving patients in
decision making, and management of care.
C. Correctly and safely administers medications to his/her patients.
D. Calculates dosages correctly, assesses patient parameters, and relates
medication information concerning his/her patients.
E. Evaluates effects of medication and documents accurately.
F. Evaluates patient care given to an established standard.
G. Relates pertinent information concerning medications to the primary nurse.
H. Consistently practices in a safe manner.
I. Incorporates individual patient’s cultural beliefs into the plan of care.
J. Develops clinical care maps/concept maps based on a holistic assessment.
K. Reviews current literature to validate evidence based practice.
L. Identifies patient goals based on assessment finding.
M. Correlates classroom theory to patient situations.
Student’s Name: _____________________________ Clinical Area: _________
Instructor: _____________________________
Final Summary Comments:
*Clinical Performance Rating at Course Completion
Satisfactory
Unsatisfactory
Instructor Signature: __________________________ Date: _________________________
Student Signature: ____________________________ Date: ______________________
Signature of student indicates that he/she has read the evaluation and not necessarily that he/she
agrees with it. Students may attach additional comments.
*Students cannot receive a final satisfactory clinical rating until they have satisfactorily
completed all clinical hours/campus lab hours and received a satisfactory grade on all
specified clinical paper work and activities.
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ACKNOWLEDGMENT OF STUDENT RESPONSIBILITY
NUR/LANU 159
I,
, have read the requirements for the course,
including objectives, evaluation process, and how the course grade is obtained. This material has been
discussed and interpreted by the faculty. I understand the responsibilities, grade point level, and clinical
performance necessary for me to obtain a passing grade in this course.
I understand a final course grade of 80% and a satisfactory clinical skills component in NUR/LANU 159
must be achieved for successful completion of this course. A final course grade below 80% or an overall
unsatisfactory clinical performance does not meet the course requirements for progression in the nursing
program.
I am also aware that if I am involved in any nursing action, judgment, or behavior that is seriously
unethical or endangers a patient’s safety, I will be subject to immediate dismissal resulting in failure of
the course.
I understand that I am required to access the Online Learning Management System used for the course,
throughout the semester and will be held responsible for all information posted. I must have access to a
computer manufactured no earlier than 2008, with a Windows operating system and access to the internet.
I have participated in the HIPAA and Incivility trainings. I will adhere to the guidelines presented. I have
authorized the school to release any personal information as it pertains to my criminal background check
or drug screening results, and student health form for the limited purpose of determining my suitability to
participate in the clinical program.
I have read the Nursing Student Manual – Spring 2014 and will adhere to the policies.
I have sought clarification from faculty for any uncertainties regarding this course.
Student Signature
__________________________________________
Student Name (please print)
______________________________
Date _________________
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