Download EXAM #1 – 90 minutes - The Medical University of South Carolina

N-373
Adult Health
Summer 2003
MEDICAL UNIVERSITY OF SOUTH CAROLINA
COLLEGE OF NURSING
NURSU 373 – ADULT HEALTH NURSING
Teresa J. Kelechi, PhD, RN
SUMMER 2003
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N-373
Adult Health
Summer 2003
MEDICAL UNIVERSITY OF SOUTH CAROLINA
COLLEGE OF NURSING
COURSE NUMBER:
NURSU 373
COURSE TITLE:
Adult Health Nursing
CREDIT HOUR
ALLOCATION:
PLACEMENT IN
CURRICULUM:
PREREQUISITES:
COURSE
DESCRIPTION:
COURSE LOCATION:
8 Semester Hours, 4 Hours Theory, 4 Hours Clinical (includes Skills Lab
time) (4, 0, 4). [14 clinical practice hours per week for 13 weeks]
Semester III
NURSU 382 Principles of Pathophysiology
NURSU 374 Health Promotion and Disease Prevention Across the Life
Span
This course provides the students an opportunity to apply critical thinking
throughout the nursing process by caring for healthy and ill individuals and
their families across the adult life span. Building upon multidimensional
complexities of the health continuum, the impact of actual or potential
body system disruption on health status is examined within a holistic
context. Therapeutic nursing interventions which foster health promotion
and maintenance, symptom management, and restoration of well-being
for individuals with acute and chronic illness are emphasized. Utilization of
evidence-based findings will be applied in caring for individuals and their
families in the context of their culture and environment.
CON 104
Mondays
1:30 – 4 PM
Thursdays 8:30 - 11:00 AM
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COURSE OBJECTIVES:
At the conclusion of the course, the student will be able to:
1.
Conduct comprehensive nursing assessments of adults incorporating individual, family,
cultural, and environmental variables.
2.
Analyze nursing assessment data and applicable evidence-based research findings to
accurately and effectively design appropriate nursing interventions and evaluate outcomes.
3.
Plan, implement, and evaluate nursing care incorporating health promotion and restoration of
well-being for the client with acute and chronic conditions.
4.
Demonstrate critical thinking and effective communication skills by coordinating etiology,
pathophysiology, and effectiveness of nursing judgment essential to providing safe, costeffective, holistic nursing care for adults experiencing health alterations.
5.
Collaborate and negotiate with interdisciplinary team members, community
resource representatives, clients, and their families in the provision of
professional nursing care.
6.
Utilize information technology from numerous sources to enhance patient care
delivery, patient education, and one’s own knowledge base.
7.
Incorporate professional, ethical, and personal accountability in delivery of
nursing care to the adult.
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REQUIRED TEXTS
Billings, D. (2002). Lippincott’s review for NCLEX-RN (7th ed.). Philadelphia: Lippincott
Williams & Wilkins.*
Doenges, M. E., Moorhouse, M. F., & Geissler, A. C. (2000). Nursing care plans
(5th ed.). Philadelphia: F. A. Davis.*
Dudek, S. G. (2001). Nutrition essentials for nursing practice (4th ed.). Philadelphia:
Lippincott Williams & Wilkins.
Pagana, P., & Pagana, T. (2002). Mosby’s manual of diagnostic and laboratory tests
(2nd ed.). St. Louis: Mosby.*
Smeltzer, S., & Bare, B. (2000). Brunner and Suddarth's textbook of medical-surgical
nursing (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
* If you have already purchased different text books of the same type, there is no need to
purchase the * books. The requirement is that you have a nursing care plan book, a
laboratory and diagnostic test reference, and an NCLEX – RN review text.
OPTIONAL MATERIALS
Anderson, K. N., Novak, P. D., & Keith, J. (2002). Mosby’s medical, nursing, and allied
health dictionary (2001). (6th ed.). St. Louis: Mosby.
Smeltzer, S. C. (2002). Study guide to accompany Brunner and Suddarth’s textbook of
medical-surgical nursing (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Venes, D. (2001). Taber’s cyclopedic medical dictionary (19th ed.). Philadelphia: F. A.
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Summer 2003
Davis Co.
MAJOR COURSE FACULTY
Name
Office
Office Phone
Home Phone
Dr. Teresa Kelechi
(Course Coordinator)
CON 309
792-4602
406-1540
Dr. Nancy Finch
CON 316
792-1591
720-4567
Beeper 792-2123 #12082
Clinical Faculty
Mailboxes
Amy Corder
CON 319
762-2066
Beeper 512-1435
Dr. Nancy Finch
CON 316
720-4567
Beeper 792-2123 #12082
Rhonda Flynn
CON 319
792-2286 (unit)
Mary Lee Lavelle
CON 319
795-7787
Beeper 792-2123 #11767
Pam Pelchy
CON 319
270-5525
Beeper 807-8047
Carey Yarbrough
CON 319
207-8646
Tamela Sill, Teaching Assistant
TEACHING STRATEGIES
Lecture, audiovisual aids, assigned readings and films, clinical patient care
conferences, pre and post conferences, supervised clinical practice, written patient
assessments, and nursing care plans.
EVALUATION METHODS
Satisfactory completion of:
Grades
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Four tests (25% each)………………………………………………………………. 100%
Care plans/unit project …………………………………………………………….. Pass/fail
Class date/time/location
Monday
May 19
1:30 to 4 PM
Room 104
Tuesday
May 20
8 AM to 5 PM
Room 104
Wednesday
May 21
8 AM to 5 PM
Skills lab
Thursday
May 22
8:30 to 11:00 AM
Room 104
Monday
May 26
Thursday
May 29
8:30 to 11:00 AM
Room 104
Monday
June 2
1:30 to 4 PM
Room 104
Thursday
June 5
8:30 to 10:00 AM
Room 104
Monday
June 9
1:30 to 4 PM
Topic
Orientation to course
Introduction of clinical
instructors
Readings
Orientation to OR
Sandra Daffin
Lower extremity wound care
Teresa Kelechi
Pressure ulcer care
Lynette Franklin
Ostomy care
Phyllis Bonham
Central line care
Chest tube care
Enteral feeding tube care
Tracheostomy care
IV site care
Assessment review
Review procedures in
your nursing textbook
Gas Exchange and
Respiratory Function
Dr. Nancy Finch
Memorial Day
All students must
attend
Clinical groups 1, 2, 3
attend from 8 AM to
Noon
Clinical groups 4, 5, 6
attend from 1 PM to 5
PM
Chapters 19 - 22
No Class
Cardiovascular, Circulatory,
and Hematologic Function
Dr. Nancy Finch
Cardiovascular, Circulatory,
and Hematologic Function
Chapter 23 - 27
Chapter 28 - 30
Exam #1 review
Dr. Teresa Kelechi
EXAM #1 – 90 minutes
Material covered May 20 –
June 7
Digestive and
Gastrointestinal Function
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Chapters 31 - 34
N-373
Room 104
Thursday
June 12
8:30 to 11:00 AM
Room 104
Monday
June 16
1:30 to 4 PM
Room 104
Thursday
June 19
8:30 to 11:00 AM
Room 104
Monday
June 23
1:30 to 4 PM
Room 104
Thursday
June 26
8:30 to 11:00 PM
Room 104
Monday
June 30
1:30 to 3 PM
Room 104
Thursday
July 3
Monday
July 7
1:30 to 4 PM
Room 104
Thursday
July 10
8:30 to 11:00 AM
Room 104
Monday
July 14
1:30 to 4 PM
Room 104
Thursday
July 17
8:30 to 11:00 AM
Room 104
Monday
July 21
1:30 to 4 PM
Room 104
Adult Health
Summer 2003
Rhonda Flynn
Digestive and
Gastrointestinal Function
Chapters 34 - 35
TBA
Metabolic and Endocrine
Function
Chapters 36, 38
Dr. Teresa Kelechi
Metabolic and Endocrine
Function - Diabetes
Chapter 37
Pam Arnold, MSN, CDE
Urinary Function
Chapters 39, 40
Dr. Teresa Kelechi
Renal Function
Chapter 41
Exam #2 Review
Kristin Larson, MSN, ANP
EXAM #2 – 90 minutes
Material covered June 13 –
June 26
NO CLASS
Health of the Older Adult
Chapter 11
Dr. Elaine Amella
Neurological Function
Chapters 56, 57
Carolyn Stewart, MSN, ANP
Neurological Function
Chapters 58, 59
Dr. Nancy
Finch/CarolynStewart
Sensorineurological Function
Chapters 54, 55
Dr. Teresa Kelechi
Integumentary Function
Chapters 51 – 53
Exam #3 Review
Dr. Teresa Kelechi
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Summer 2003
Thursday
July 24
8:30 to 10:00 AM
Room 104
EXAM #3 – 90 minutes
Monday
July 28
1:30 to 4 PM
Room 104
Thursday
July 31
8:30 to 11:00 AM
Room 104
Monday
August 4
1:30 to 4 PM
Room 104
Thursday
August 7
8:30 to 11:00 AM
Room 104
Monday
August 11
1:30 to 4 PM
Room 104
Thursday
August 14
8:30 to 10:00 AM
Room 104
Immunological Function
Chapters 46 - 50
Dr. Nancy Finch
Musculoskeletal Function
Chapters 60 - 62
Dr. Teresa Kelechi
Musculoskeletal Function
Male Reproductive Function
Chapters 62, 63
Chapter 45
Material covered July 7 –
July 21
Dr. Nancy Finch
Female Reproductive
Function
Chapters 42 - 44
Sharon Bond, MSN, CNM
Practice Questions
Course evaluation
Exam #4 Review
EXAM #4 – 90 minutes
Material covered July 28 –
August 7
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COURSE AND COLLEGE POLICIES
Students are held responsible for reading and following all course-related policies
stated in the COLLEGE OF NURSING STUDENT HANDBOOK. Course-related
policies pertain to class and clinical attendance, clinical preparation, tests, preparation
and written work. Please refer to the section on student complaint procedures if
needed.
1.
Class attendance on test days is a course requirement. See policy Student
Handbook regarding procedure
- Missed test date
- Make up arrangements
2.
Skills laboratory and clinical attendance is a mandatory course requirement. In
the event that you are unable to attend a clinical, you must call the clinical
instructor or the unit to report your absence immediately. Missing a
clinical without calling the instructor/unit will result in an unsatisfactory for
the day.
3.
No student will administer an intravenous medication (i.e., piggyback) without the
presence of an RN (clinical faculty or designated staff RN) at the bedside for the
administration of the drug.
4.
No student will administer an IV push medication without the presence of
the clinical faculty.
CLINICAL EXPERIENCES
Each student will have the following clinical experiences:
1.
2.
3.
4.
Skills laboratory experience
Acute care hospital clinical experience (MUSC, Roper, VA).
One surgical observation
Provide care to at least two patients during the hospital rotation
Pre-planning time and clinical patient conferences are a part of the clinical
experience.
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CLINICAL COURSE REQUIREMENTS AND EVALUATION CRITERIA
The following is a list of the requirements for the course:
1. Identification of learning needs
2. Care planning (Nursing Care Plan Packet to include pre-planning worksheet,
nursing assessment form, care plan form, and self evaluation log)
3. Unit project
4. Hospital admission assessment
5. OR and procedure observation experience
6. Final evaluation of learning needs
1. Identification of Learning Needs:
Students are requested to submit their learning needs on the Learning Needs
Identification Form (see Forms) at the beginning of the semester to their clinical faculty
to facilitate relevant learning assignments throughout the semester. At the end of the
semester, students are requested to submit a brief narrative description of whether
learning needs were met.
2. Care Planning:
Care Planning Packet includes: pre-planning worksheet, assessment form, care plan
sheet, references and self evaluation log (see Forms)
Pre-planning for care is essential to clinical practice and is considered as part of your
clinical hours. You are credited with 2 clinical hours towards preparation of the preplanning requirements.
To be considered prepared for clinical you must have the following information
on the Pre-Planning Worksheet (see Forms) about your patient(s) and show it to
your clinical instructor on the first clinical day. The information should include:
 Chief complaint/medical diagnosis(es)
 Allergies
 History of present illness - A brief and up-to-date summary of the history and
current status of the patient’s present illness and any other ongoing health
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




Summer 2003
problems requiring treatment, preventive measures, or surveillance. The past
history/previous hospitalization and past surgical history is to be included.
Pathophysiology (brief description) related to the medical diagnosis
Nursing diagnoses (top three) relating to the medical diagnosis
e.g. Medical Diagnosis: Guillain-Barré Syndrome
Associated Nursing Diagnoses:
1.
Risk for ineffective breathing pattern and gas exchange related to
(R/T) rapidly progressive weakness and impending respiratory
failure.
2.
Impaired physical mobility R/T paralysis as evidenced by . . .
Medication information (classification, reason for taking, expected action and
times of administration for each medication the patient is receiving.
Laboratory/diagnostic tests and any procedure or treatments and results (if
available), purpose of study, significance of deviation from normal
The information obtained must be shown to faculty at the beginning of the
first clinical day of the week. Pre-planning hints are available (see Preplanning hints).
All required pre-planning written work (the pre-plan worksheet) must be shown to
faculty on the first clinical day. In the event that the student’s written worsheet is
incomplete, the student will be receive an unsatisfactory grade for the day for
being unprepared for clinical.
The entire care plan packet including pre-planning worksheet is due the Tuesday
following clinical.
During the first and second clinical days, the student will continue to collect data in
order to plan nursing care:
 nursing assessment (document on the nursing assessment form).
 completed list of nursing diagnoses relating to the medical diagnosis and the
nursing assessment (including the previously identified top three from preplanning).
 nursing care plan for one nursing diagnosis to include client goals and
outcomes, nursing interventions/actions, rationale, evaluation of
goals/outcomes.
 references are expected that include nursing textbooks, nursing care plan
texts, as well as general nursing and research articles (must include at least
one research article) related to the patient problems and websites, PDA
software. Do not turn in articles.
A weekly self evaluation log of your progress toward your learning needs/personal
goals in narrative form is to be submitted with the care plan (see Forms).
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The deadline for turning in weekly written work with references (do not turn in articles) is
the Tuesday after the previous clinical week. You will have the weekend to work on the
care plans. However, you are required to be prepared the first clinical day with the preplanning requirements.
On the weeks that you care for two patients, you must do a pre-planning worksheet and
know the medical diagnosis, pathophysiology, history, medications, laboratory and
diagnostic tests, of your 2nd patient. You are not required to submit a nursing
assessment form or care plan form for the second patient. You are required however to
turn in your pre-planning worksheet for this second patient.
GRADING CRITERIA FOR WRITTEN CLINICAL WORK
Clinical – Pass/Fail
1.
Each week, the student will receive a written evaluation of the clinical
requirements on the Weekly Clinical Evaluation Form (see Evaluation). The
student will also receive a midterm and final clinical evaluation and must have a
satisfactory performance in each behavior listed on the Clinical Evaluation Tool
(see Evaluation).
2.
If a student's performance is unsatisfactory for one clinical day, the instructor will
initiate an informal conference with the student. For example, inappropriate
dress, late arrival to clinical, pre-planning incomplete can result in an
unsatisfactory.
3.
Should the student's performance continue to be unsatisfactory for a second
clinical day, the instructor will formulate a formal written contract explaining to the
student deficient areas.
4.
The Coordinator of Nursing 373 is a participant in this latter conference and a
copy of the written contract will be placed in the student's record.
5.
If the conditions of the contract are not met by the student, the student's clinical
performance will be unsatisfactory and the student will receive “0” quality points
for NURSU 373.
CLINICAL WRITTEN WORK
1.
All assignments must be word processed and referenced according to the 5th
edition of the Publication Manual of the American Psychological Association
(pre-planning worksheet and care plan form may be submitted in legible
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handwriting). Deadlines for the unit project, hospital admission assessment) are
as stated by your clinical instructor.
2.
All required written assignments will be considered late if received by faculty after
the scheduled time on the assigned due date. Five (5) points will be subtracted
from the assigned grade for each day it is late (weekends not included). Note:
An exception to this policy will be made only if the student has made prior
arrangements with the respective faculty member. The student must submit all
written course requirements in order to receive a course grade.
You must have a 75% AVERAGE ON THE WRITTEN TESTS AND FINAL EXAM and a
PASS in clinical to successfully complete N373.
3. Unit Project
A written “unit” project is due towards the end of clinical (to be determined by the
instructor). The purpose of this assignment is to identify a patient care issue and to
make recommendations for changes based on current literature. You will be expected
to do a brief presentation to the unit’s nurse manager (5 to 10 minutes), describe your
findings and make recommendations. Students may work independently or in pairs.
The topic is to be approved by the clinical instructor.
1. identify a patient care situation that you have observed related to care of patients on
the unit, i.e., dressings don’t stick, falls, etc.
2. review the salient literature, including evidence-based and clinical articles, standards
of care, clinical guidelines, nursing textbooks, etc.
3. write a two-page paper (APA 5th edition) to include the following areas:
- problem (certain dressings were noted to come loosened from the patient skin)
- significance of the problem to nursing (could lead to infection when the wound
is exposed)
- review of literature
- recommendations
- references
4. attach one evidence-based research article to the paper. The article will be given to
the nurse manager.
5. grade will be pass/fail
4. Hospital Admission Assessment
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Each student is required to assist with the admission process for one patient. The
clinical instructor will make the assignments. The student is required to complete the
hospital’s admission assessment.
5. OR & Procedure Observation Experience
Students will not be required to pre-plan before their surgical experience in the
operating room. However, it is required that students write about a surgery that was
observed and include this in the weekly self-evaluation form. Following the OR
experience, the students will return to their assigned nursing unit to pre-plan for
the following clinical day on their unit.
6. Final Evaluation of Learning Needs
Each student is required to write a brief (no more than one page) summary describing
the clinical experience. Refer back to your Learning Needs Identification Form and
describe what you got out of the course, whether you “over came” your fears, etc. The
summary is due the last week of clinical.
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