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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 1 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 2 N-373 Adult Health Summer 2003 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. 3 N-373 Adult Health Summer 2003 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. 4 N-373 Adult Health 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 5 N-373 Adult Health Summer 2003 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 6 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 7 N-373 Adult Health 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 8 N-373 Adult Health Summer 2003 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. 9 N-373 Adult Health Summer 2003 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 10 N-373 Adult Health 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). 11 N-373 Adult Health Summer 2003 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 12 N-373 Adult Health Summer 2003 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 13 N-373 Adult Health Summer 2003 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. 14