Associate Degree Nursing Department RNSG 1219 Integrated Nursing Skills 1 Prepared by: Tana Hafner-Burton, MHN, MSN, RN, CAPA Christy Scales, MS, MSN, RN Wendy Stewart, MSN, RN, CNE Jocelyn Wiltz, MSN, RN Fall 2015 1
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August 25 Day 1 August 27 Day 2 September 1 Day 3 September 3 Day 4 September 8 Day 5 September 10 Day 6 September 15 Day 7 September 17 Day 8 September 22 Day 9 September 24 Day 10 September 29 Day 11 October 1 Day 12 October 6 Day 13 October 8 Day 14 October 13 Day 15 October 15 Nursing Skills I Fall 2015 Orientation to Course Dosage Calculation Part 1: #1: Refresher Math Bed making Evolve Instructions from Elsevier Sales Rep Dosage Calculation Part 1: #2:Conversions, Reading Med Labs & Military Time EDGT Infection Control/PPE Dosage Calculation Part 1: # 3: Dimensional Analysis & Oral Medications Safety (Body Mechanics, transfers, gait belts, restraints & Range of Motion, Antiembolism stockings (TEDs) & Pneumatic Compression Devices, Conscious & Unconscious Clients) Dosage Calculation Part 1: #4: Injectables Vital Signs across the lifespan EDGT Modules (all 3 due) Dosage Calculation Part 1 #5: Body Weight Calculation & Review Smart Phone Case Study Vital Sign Practice & Check off Intake & Output, Elastic Bandages (ACE Wraps) Check offs on Peer Skills & Vital Signs Oral Medication administration across the lifespan Qualifying Dosage Exam (Part I: through Body weights) Injections across the lifespan Nursing Process Lab Injection Practice Immunizations Check off : Injections 3
Day 16 October 20 Day 17 October 22 Day 18 October 27 Day 19 October 29 Day 20 November 3 Day 21 November 5 Day 22 November 10 Day 23 November 12 Day 24 November 17 Day 25 November 19 Day 26 November 24 Day 27 December 1 Day 28 December 3 Day 29 PEG Meds & G buttons Wound Care Check offs: PEG Meds, & Wound Care Injections due Check offs Due: PEG Meds & Wound Care Fluids & Electrolyte Lab Dosage Part 2: # 1 IV Flow rate Heat & Cold Enemas & Digital Removal Dosage Part 2: #2 IV Infusion Times Specimen Collection Labs & Diagnostic Tests Highlights & Normals Dosage Part 2 #3: Titrations & Heparin Infusion Calculations Nutrition Lab Nutrition Lab (con t) Open Lab All Skills Due ATI DISCLAIMER The instructor reserves the right to modify this syllabus as needed and will notify the students of any changes using the ACC e-mail or MyBlackboard e-mail or announcements. 4
RNSG 1219 Due Dates Due Date/Time Dosage Part I: #1 Skills Online Mod. 2 Exam: Infection Control Dosage Part I #2 Skills Online Mod. 1 Exam: Safety Dosage Part I #3 EDGT Documentation Modules Dosage Part I #4 Skills Online Mod. 5 Exam: Safe Med. Admin Skills Online Mod. 6 Exam :Non-parenteral Meds Dosage Part I #5 Skills Online Mod. 7 Exam: Injections Skills Online Mod. 15 Exam: Enteral Nutrition Skills Online Mod. 18 Exam: Wound Care Skills Online Mod. 17/Post Test 1: Overview Bowel Elimination Skills Online Mod. 17/Post Test 2: Enemas Dosage Part II #1 Skills Online Mod. 3 Exam: Specimen Collection Dosage Part II #2 Dosage Part II #3 Skills Checklist Fri. Aug. 28 @ 1130pm Wed. Sept. 2 nd @1130pm Fri. Sept. 4 @1130pm Wed. Sept. 9 @ 1130pm Fri. Sept. 11 @ 1130pm Thurs. Sept. 17 th @1130pm Fri. Sept. 18 @ 1130pm Wed. Sept. 23 @ 1130pm Wed. Sept. 23@ 1130pm Fri. Sept. 25 @ 1130pm Wed. Oct. 7 th @ 1130pm Wed. Oct. 21 @ 1130pm Wed. Oct. 21 @ 1130pm Wed. Nov. 4 @ 1130pm Wed. Nov. 4 @ 1130pm Fri, Nov. 6 @ 1130pm Wed. Nov. 11 @ 1130pm Fri. Nov. 13 @ 1130pm Fri. Nov. 20 @ 1130pm Thurs. Dec. 3 @ 130pm **Reminder- to receive credit, assignments must be submitted by the due date. ** NOTE: The Evolve Online Skills module post-tests are different from the Module Exams. In most cases, you will be doing the Module Exams EXCEPT for Bowel Elimination. You will need to make a grade of at least 75% to receive credit for the Exam. 5
Instructors: Tana Hafner-Burton, MHN, MSN, RN, CAPA Office S 112 Office Telephone: 281-756-5634 office hours posted at office door Email: tburton@alvincollege.edu Christy G. Scales, MS, MSN, RN Office S 117 Office Telephone: 281-756-5618 office hours posted at office door Email: cscales@alvincollege.edu Wendy Stewart, MSN, RN, CNE Office S 114 Office Telephone: 281-756-5612 office hours posted at office door Email: wstewart@alvincollege.edu Jocelyn Wiltz MSN, RN Office S 116 Office Telephone: 281-756-5617 office hours posted at office door Email: jwiltz@alvincollege.edu COMMUNICATING WITH YOUR INSTRUCTOR The preferred method for communicating with your instructors is through the ACC email or calling the instructor s office telephone. Please leave your first and last name, a phone number or e-mail address where you can be contacted and tell us what you need to discuss. We will normally respond within 24 hours Monday- and by the next business day on Friday-Sunday. Office hours are posted at the instructor s office door. COURSE DESCRIPTION Study of the concepts and principles necessary to perform basic nursing skills for care of diverse patients across the life span; demonstrate competence in the performance of nursing procedures. Content includes knowledge, judgment, skills, and professional values within a legal/ethical framework. End-of-Course Outcomes: Apply concepts and principles necessary for the performance of basic nursing skills for care of diverse patients across the life span; and demonstrate competence/clinical reasoning in the performance of basic nursing procedures and practices. Prerequisite: BIOL 2401, BIOL 2402, ENGL 1301, & PSYC 2301 & Admission into the ADN Program Co requisite: PSYC 2314, RNSG 1523 & RNSG 1260 Method of Instruction This is one of the first nursing courses providing the foundation of clinical skills as well as dosage calculations. The skills component of the course is provided in the nursing skills lab. The skills format will include presentations, videos, demonstrations, clinical simulations and opportunities for the student to practice and check-off the skills. Preparation for this portion of the course includes reading the assigned materials, viewing the Online Skills modules through the Evolve website as well as the EDGT website and practicing skills prior to check offs. In the dosage component of this course the student is introduced to the basic arithmetic needed to complete drug dosage calculations. The goal is to educate the student in strategies for calculating drug dosages for safe and accurate medication administration. The classroom portion of the course will be conducted by lecture, discussion and problem solving sessions. The student is expected to come to class prepared, having read the assigned materials, and reviewed the materials assigned. 6
TEXTBOOK INFORMATION For information on the textbook and other course materials, including details about how to order your book online and have it delivered to you, visit the ACC College Store website. The listing of textbook follows: Required Textbooks: Morris, D. G. (2014). Calculate with confidence (6 th ed.). St. Louis, MO: Elsevier Mosby Potter, P., Perry, A., Stockert, P. & Hall, A. (2013). Fundamentals of nursing (8 th ed.). St. Louis, MO: Elsevier Mosby. Potter, P., Perry, A., Stockert, P. & Hall, A. Nursing skills online version 3.0 for fundamentals of nursing (8 th ed.). St. Louis, MO: Mosby. COURSE GOALS & OBJECTIVES: Upon completion of Integrated Nursing Skills 1: RNSG 1219 the student will: 1. Demonstrates novice clinical reasoning skills in the introduction and application of the nursing process to provide safe, quality care, with an emphasis on health promotion. 2. Uses basic communication skills to maintain the basic health status of the patients and their families. 3. Adheres to standards of practice within legal, ethical, and regulatory frameworks of the professional nurse. 4. Demonstrates basic skills using technical equipment and documentation systems that support safe nursing practice. 5. Provides safe quality nursing care at a novice level to the patient. 7
GRADING SUMMARY: POINTS EVALUATIVE METHOD DESCRIPTION 200 Dosage Unit Exams 8 unit exams containing application problems involving dosage calculations. 100 Dosage Qualifying Exam Comprehensive Exam covering the first 5 units of dosage calculation. Must achieve 90% to continue in clinical. 250 Online Skills Modules Each module/post Test is worth 25 points. Must earn a grade of 75% by due date to receive credit. 50 Skills Checklist Essential & Peer Check offs. *Must pass all essential skills due date to pass course. 50 EDGT Documentation Modules (3) Documentation module-must complete all with 100% to receive credit. 650 TOTAL COURSE POINTS A= 585-650 (90-100%) B= 520-584 (80-89%) C= 488-519 (75-79%) (No grade below C is acceptable for progression in nursing. D= 455-487 (70-74%) F= < 454 and below GRADING Dosage Unit Exams: Unit objectives from the syllabus provide a blueprint and study guide for testing. Each unit exam is worth 25 points and consists of application problems involving calculations. Time allotted for each exam is posted. Dosage unit exams will be administered via the internet. Computer issues are not a reason for extending the testing deadline. Exams must be taken before the due date and time to receive credit. Computers are available at several locations on campus for student use in completing exams. The final exam must be taken on campus at the designated times. Dosage Qualifying Exam Comprehensive exam containing 20 application problems from Dosages Part I (first 5 Dosage Units). This is taken prior to going into the clinical area. 8
Online Skills Modules (Evolve) There are 8 assigned Module Exams and 2 assigned Post tests of the Online Skills modules on the Evolve website. These are required to be completed and passed with 75% accuracy by the due date in order to receive credit for the Exam/Post test. All of the modules are assigned prior to the date that the skill will be practiced in lab. If the module is not completed on time, a grade of zero will be recorded. Skills Checklist There are 3 Essential Skills which are listed first on the Skills Checklist. For the essential skills, the student must be checked off by clinical faculty. For basic skills, the student will be checked off by peers, and evaluated by the instructor. The student will have 3 attempts to receive a satisfactory prior to remediation. The student must keep current on essential skills and maintain documentation on the skills check list, which is kept on file in the SKILLS classroom; clinical attendance may not be allowed if the student has not successfully been checked off by each skill due-date. In addition, these same skills may be evaluated during the Course Simulations. All Skills have a due date. Points will not be awarded if due dates are not met. However, to pass the course, all skills must be performed satisfactorily within 4 attempts. EDGT Documentation Module Students complete a documentation module using www.edgt.com. This module discusses the guidelines of documentation, the purposes of patient records and identifies several methods of documentation. All 3 modules must be completed with a score of 100% by the due date to receive credit. LATE COURSE WORK POLICY Students are expected to have their assignments completed by the due dates. Late work will not be accepted. I...Incomplete. No Incompletes or I grades will be given except for extreme circumstances. If an I grade is assigned and the course work is not completed by the pre-arranged time limit, this grade will convert to an F. W...Withdrawal. It is recommended that the student talk to the instructor before withdrawing. Current course withdrawal information can be found in the printed version of the ACC Schedule for this semester or online at ACC Course Withdrawal Instructions. Students who file withdrawal requests by the published deadline and have not exceeded the withdrawal maximum will receive a grade of W. CLASS ATTENDANCE POLICY Students that attend classes are more successful in nursing courses, therefore it is expected that students attend all classes. Refer to the ACC Student Handbook regarding attendance policies. Attendance records will be maintained for each class period. Individual students are responsible for course content and reading for any missed days. Tardiness disrupts class and the learning process. Therefore, students are expected to be on time at the beginning of class and after the break. Students who arrive late will need to wait until class break to enter the classroom. Excessive absences may result in withdrawal from the course. TARDINESS Tardiness is an unprofessional behavior that is disruptive to classmates and to instructors. The 9
expectation is for students to be seated and ready to start class when it is scheduled. Please sync your clocks to the classroom clock. Each student is given two free pass with tardies. After two tardies, the student who is late to class will lose five points from the total course grade for each tardy. CLASSROOM PROTOCOL It is the right of each student to participate in his or her learning, and it is the responsibility of each student to not interfere with the learning of other students. It is the expectation of the college that each student assumes the responsibility to follow college policies and procedures governing campus and classroom conduct. This information is published in the ACC Student Handbook. http://www.alvincollege.edu/resources/pdfs/student_handbook.pdf ACC ACADEMIC SUCCESS AND SUPPORT SERVICES: Americans with Disabilities Act ACC complies with ADA and 504 Federal guidelines by affording equal access to individuals who are seeking an education. Students who have a disability and would like classroom accommodations must register first with the Office of Disability Services, A 136, (281)756-3533. Instructors are not able to provide accommodations until the proper process has been followed. Behavioral Intervention Team (BIT) Letting someone know The Behavioral Intervention Team (BIT) at Alvin Community College is committed to improving community safety. College faculty, staff, students and community members may communicate safety concerns to the BIT team by email, bitcore@alvincollege.edu or through an electronic reporting option located on the BIT page of the college website. The ACC Library is an excellent source for research and writing help. Quiet rooms are available for studying and doing class work. For more information, visit the ACC Library Website or call 281-756-3559. The ACC Tutoring/Learning Lab, located upstairs in building A, provides students with a variety of services including tutoring (math, writing, and other disciplines); computers and printers; a testing facility; and tables/carrels. Call 281-756-3566 or visit the ACC Tutoring/Learning Lab Website for more information. MyBlackboard Support for MYBlackboard can be obtained by completing the Online Support Form. WEBACCESS, Passwords or ACC Computer Lab Information- -Help Desk Website or contact the IT Dept. Help Desk at 281-756-3544. 10
Dosages Calculation Part I I. Review of Basic Math (DECs: III B1,2, D1a, c) A. Fractions 1. Compare the relative value of fractions. 2. Add and subtract fractions. 3. Multiply and divide fractions. 4. Reduce fractions to lowest terms. B. Decimals 1. Read and write decimals. 2. Compare the relative value of decimals. 3. Change fractions to decimals and decimals to fractions. 4. Add, subtract, multiply, and divide decimals, including decimal fractions. 5. Round off decimals appropriately. Learning Opportunities: Morris, Chapters 2, 3 & 5 Practice exemplary problems Work problems throughout the chapters. II. Systems of Measurement (DECs: III B1,2, D1a, c) A. Metric System 1. Express metric measures correctly using rules of the metric system. 2. State from memory common equivalents in the metric system that are used for medication administration. 3. Convert between common metric units. B. Units of Measurement 1. Identify dosages measured in units. 2. Explain dosages measured as percentages. 3. Express dosages using ratio strengths. 4. Recognize dosages measured in millequivalents. 5. State the meaning of a given percent solution. C. Reading Medication Labels 1. Identify brand names, generic names, drug forms, dosages, expiration dates and lot numbers on drug labels. 2. Give examples of drugs with look-alike drug names. D. Military Time 1. Identify how to read military time. 11
Learning Opportunities: Morris, Chapters 6, 7(Household Systems only), 8 & 9 Practice exemplary problems on the board. Work problems throughout the chapters. III. Dimensional Analysis and Oral Medications (DECs: III B1,2, D1a, c) A. Dimensional Analysis Calculation Method 1. State dimensional analysis techniques to solve a given calculation problem. 2. Set up application problems using the dimensional analysis method. 3. Solve application problems using the dimensional analysis method. 4. Converting within and between systems. a. Recall equivalents/conversions from metric and household systems to convert a given measure. b. Convert a unit of measure to its equivalent within the same system. c. Use common conversions to solve application problems. B. Oral Medications 1. Calculate oral dosages from tablets, capsules and liquids using dimensional analysis. 2. Calculate the amount of drug to be given per day in divided doses. Learning Opportunities: Morris, Chapter 16 & 17 Practice exemplary problems on the board. Work problems throughout the chapter. IV. Injections (DECs: III B1,2, D1a,c) A. Injections 1. Identify the various types of syringes used for injections. 2. Read and measure dosages on a syringe. 3. Read medication labels on parenteral medications. 4. Calculate dosages of parenteral medications already in solution. 5. Identify appropriate syringes with which to administer dosages calculated. B. Reconstitution of Powdered drugs 1. Understand preparation of a solution from powdered medication according to directions on the vial or other resources. 2. Identify essential information to be placed on the vial of a medication after it is reconstituted. 3. Calculate doses from reconstituted medications. C. Insulin 1. Identify important information on insulin labels. 2. Read calibrations on U-100 insulin syringe. 3. Measure insulin in single doses. 12
4. Measure combined insulin doses. Learning Opportunitie: Morris, Chapters 18, 19, & 20 Classroom: Practice exemplary problems on the board. Practice problems throughout the chapter V. Dosage Calculation based on Body Weight & Body Surface (DECs: III B1,2, D1a,c) A. Basics 1. Convert body weight from pounds to kilograms 2. Convert body weight from kilograms to pounds. 3. Calculate dosages based on milligram per kilogram 4. Determine whether a dosage is safe. B. BSAs & BMIs 1. Calculate dosages using body surface area (BSA). 2. Calculate dosages using BMI Learning Opportunities Morris, Chapter 25 Learning Activities Classroom activity: Work exemplary problems on the board Practice problems throughout chapter 13
Upon completion of Integrated Nursing Skills I RNSG 1219, the student will successfully demonstrate and check-off integrated nursing skills as outlined. I. Topic: Bed making, Bathing (II Provider of patient-centered Care: A-1-a; D-1-a, b, c; 3-a, E-5, 12; H-3-a, b; F-1) (III Patient Safety Advocate: B-1-a, b) (SCANS C1, C3, C9). Learning Objectives: 1. Describe factors that influence personal hygiene practices. 2. Explain how to make an occupied and unoccupied bed. 3. Explain crib making. 4. Identify items used for hair care, nail care, dentures, and oral care. 5. Describe infant holding, bathing, and feeding. 6. Describe how hygiene care for the older adult differs from that for the younger client. 1. Read Potter and Perry Chapter 39. 2. Evolve Online Skills Mobile videos: Hand washing & Infection Control. 3. Practice making occupied and unoccupied beds, plus crib making. 4. Practice bathing. II. Documentation (DECS Knowledge II Provider of Patient Centered Care: B 10, C2a, E 11a, b, c ) Learning Objectives: 1. Discuss guidelines for documentation. 2. State purposes of patient records. 3. Identify types of documentation. Complete 3 documentation modules at www.edgt.com III. Topic: Infection Control (II Provider of Patient Centered Care: B-6, 8) (III Patient Safety Advocate: B-1-b, 2, 3; C-2; F-2) (SCANS C1, C2, C3, C9) See Evolve Online Skills Module for learning objectives. 1. EVOLVE Online Skills Module 2 and associated Potter and Perry Text. 2. Practice sterile gloving. 3. Correctly don mask, eyewear, gown and gloves; for care of clients with "standard" or "transmission-based" precautions. 4. Practice and demonstrate isolation technique. IV. Topic: Safety (III Patient Safety Advocate: B-1-a, b; 2 D-a, b, c ;) (SCANS C9) See Evolve Online Skills Module for learning objectives. 14
1. EVOLVE module 1 and associated Potter and Perry Text. 2. Transfer clients using various modalities. 3. Become familiar with various types of restraints. 4. Discuss safety precautions when providing care to an unconscious vs A Conscious client. V. Topic: Range of Motion, Anti-embolism stockings (TEDs) & Pneumatic Compression Devices (III Patient Safety Advocate: B-1-a, b) Learning Objectives: 1. Compare and contract active and passive range of motion exercises. 2. State activities of daily living that maintain functional joint motion. 3. Explain rationale for use of anti-embolism stockings, and pneumatic compression devices. Learning Activities 1. Read Potter and Perry Text: pp. 553, 1136-1139, 1149-1152, 1158. 2. Demonstrate performance of range of motion exercises of all joints. 3. Practice applying and removing anti embolism stockings. 4. Familiarize self with Pneumatic Compression devices. VI. Topic: Vital Signs (II Provider of patient centered Care: E-4-b; F-1, 20) See Evolve Online Skills Module for learning objectives. Learning Activities 1. EVOLVE Online Skills Module 4 and associated Potter and Perry Text. 2. Practice taking and documenting vital signs of patients from infants through geriatrics. VII. Topic: Smart Phone (DECs II C3, E10, F2a, IVE3a) Learning Objectives: 1. Identify the usefulness of the Smart Phone in the clinical setting. 2. Become familiar with the applications of Nursing Central on the Smart Phone. 3. Describe how to use the Smart Phone to complete the medication sheet. Learning Activities 1. Fill out a medication sheet & clinical documentation record. 2. Answer case study questions using smart phone applications. 3. In small groups begin developing a Nursing Care Plan VIII. Intake and Output & Elastic Bandages (ACE Wraps) (DECs: C1a-b; II E-4) Learning Objectives: 1. State when to implement I & O as a factor that contributes to the monitoring of health maintenance or illness prevention. 15
2. Identify accurate I & O measurement. 3. Explain how to properly apply an Elastic Bandage (ACE Wrap) 1. Read Potter & Perry pp. 898-900; 1228-1229 2. Demonstrate correct documentation of intake & output 3. Demonstrate correct application of an elastic bandage. IX. Topic: Administering Oral Medications (II Provider of Patient Centered Care: G-2-a; E-6-a; 8) (III Patient Safety Advocate: B-4) Learning Objectives: 1. Verbalize the rationales related to the oral administration of medications to infants and Children. 2. See Evolve Online Skills Module for additional learning objectives 1. EVOLVE Online Skill Modules 5 & 6 and associated Potter and Perry Text. 2. Review a Medication Administration Record (MAR) and legally document medication given. 3. Video: Medicating children. 4. Demonstrate performance of procedure correctly to the infant and child. X. Topic: Administering Parenteral Medications (II Provider of Patient Centered Care: G-2-a; E- 6-a; 8) (III Patient Safety Advocate: B-4) See Evolve Online Skills Module for learning objectives. 1. Evolve Online Skills Module 7 and associated Potter and Perry Text. 2. Demonstrate correct technique for preparing medications from ampules and vials. 3. Demonstrate safe administration of subcutaneous and intramuscular injections. XI. Immunizations Learning Objectives: 1. Outline immunization requirements during infancy. 2. Discuss contraindications and precautions for vaccine administration. 3. Evaluate general contraindications, precautions, and administration routes for immunizations. 1. Review Center for Disease Control: Immunization guidelines immunizations. XII. Percutaneous Endoscopic Gastrostomy (PEG) Tube & G Buttons (II Provider of Patient Centered Care: D-1-a, b, c, d; E-12) (SCANS C1, C3, C9) 16
See Evolve Online Skills Module 15 for learning objectives. Learning Activities 1. Evolve Online Skills Module 15: and associated Potter and Perry Text. 2. Demonstrate the correct procedure for checking the residual and administering medications and feeding thru the percutaneous endoscopic gastrostomy tube. 3. Demonstrate the correct procedure for checking residual and administering medications And feedings through a G button. XIII. Topic: Wound Care (III Patient Safety Advocate: B-1-a,b; D-a, b, c, F-2) (SCANS C1, C3) See Evolve Online Skills Module for learning objectives. Learning Activities 1. EVOLVE Online Skill Module 18 and associated Potter and Perry Text. 2. Demonstrate several different types of wound care. XIII. Topic: Fluid & Electrolytes Learning Objectives 1. Identify factors affecting homeostasis of normal body fluid and electrolyte balance. 2. Identify risk factors for the cause and effects of fluid and electrolyte imbalances. 3. Describe methods of assessing fluid and electrolyte status. 4. Interpret basic fluid and electrolyte laboratory values. 5. Identify the etiologies, defining characteristics, and treatment modalities for common fluid and electrolyte imbalances. 6. Describe the nursing care to maintain or restore fluid and electrolyte status. Learning Activities HESI Case study: Fluid Balance during Skills Lab (r/t RNSG 1523) XIV. Topic: Heat and Cold Therapy (III Patient Safety Advocate: B-1-a, b; F-2) Learning Objectives: 1. Discuss how heat and cold therapy help to relieve pain. 2. Describe assessment for temperature tolerance. 3. Discuss bodily responses to heat and cold. 4. List factors that influence heat and cold tolerance. 5. Explain correct application of heat and cold therapies. 1. Read Potter & Perry pp. 1209-1212, 979-980. 2. Become familiar with hot and cold therapy and its effects on clients. XV. Topic: Bowel Elimination (II Provider of Patient Centered Care: C-1-a; 3, 4; D-1-a, b, c, d, E-2) (III Patient Safety Advocate: A-4; B-1-a, b, c) See Evolve Online Skills Module 17: Lessons 1 & 2 for learning objectives. 17
1. Evolve Online Skills Module 17: Lessons 1 & 2 and associated Potter and Perry Text. 2. Become familiar with enema equipment and how to perform a digital removal. XVI. Topic: Specimen Collection & Labs & Diagnostic Testing (DECs?) See Evolve Online Skills Module 3 for learning objectives. 1. Read associated Potter & Perry textbook 2. Review common labs and associated normal values. 3. Review nursing implications and interventions associated with labs & diagnostic tests. XVII. Nursing Care of Client with Nutritional Alterations Objectives Discuss the anatomy, physiology, pathophysiology, treatment and nursing care of clients with nutritional problems. (SCANS: C 11,15, 18-20: F 1-17) (II.B.1,2,3,7,12) (II.C.1a, 4,5,6) Review the following from previous course(s) 1. Nutrition: Nutrients; (macro-micronutrients-and energy sources) that promote physiological maintenance and homeostasis; development, growth, tissue regeneration, and healing. 2. Review previous Anatomy & Physiology of Gastrointestinal-Hepatic-Endocrine systems. (Student sources from previous course). Review the following Nursing Diagnoses 1. Aspiration risk for (dysphagia) Learning Objectives for class: 1. Define malnutrition and failure to thrive. 2. Identify three major nutritional problems and describe patients at risk. 3. Establish a plan of care to meet the nutritional needs of a patient. 4. Discuss medical nutrition therapy in relation to three medical conditions. 5. Discuss diet counseling and patient teaching in relation to patient expectations. 6. Discuss components of selected therapeutic diets and the rationale for prescribing (Clear Liquid, Full Liquid, Pureed, Mechanical Soft, Soft/Low Residue, High Fiber, Low Sodium, Low Cholesterol, Diabetic, Regular) 7. Ability to identify and monitor patient for dysphagia (position-swallowing technique for patient safety). 8. Discuss interventions for dysphagia. Learning Opportunities: Required readings: HESI Case Study: Altered Nutrition ATI Nutrition for Nursing 5.0 Sources of Nutrition Ingestion, Digestion, Absorption, and 18
Metabolism Nutritional Assessment Guidelines for Healthy Eating Modified Diets Dysphagia: read Potter p 1010, 1018, Skill 44-1 Learning activities: Complete a nursing care plan on a patient with a diagnosis of a stroke. Dosage Calculation Part II I. Intravenous Flow Rates (DECs: III B1, 2, D1a, c) A. Introduction to intravenous therapy and basic intravenous calculations 1. Differentiate between primary and secondary administration sets. 2. Identify the abbreviations used for I.V. fluids. 3. Identify from the I.V. tubing packages the drop factor in gtt/ml. 4. Calculate drip rates using the dimensional analysis method. 5. Calculate flow rates using the dimensional analysis method. Learning Opportunies: Morris, Chapter 22 begin Classroom activity: Work exemplary problems on the board Practice problems throughout chapter II. Calculation of Intravenous Infusion Completion Times 1. Calculate infusion times from ml/hr. 2. Calculate infusion completion times international/military time. Learning Opportunies: Morris, Chapter 22 complete Classroom activity: Work exemplary problems on the board Practice problems throughout chapter III. Critical Care Calculations & Heparin Infusions A. Critical Care Calculations 1. Calculate dosages in mcg/min, mcg/hr & mg/min 2. Calculate dosages in mg/kg/hr, mg/kg/min and mcg/kg/min B. Heparin Infusions (or IV Insulin) 1. State the importance of calculating heparin doses. 2. Calculate units/hr infusing from flow rate. 3. Calculate flow rate from units/hr ordered. 19
Learning Opportunities: Morris: Chapters 23 & 24 Learning Activities Classroom activity: Work exemplary problems on the board Practice problems throughout chapters 20
Student Name Last Name, First Name STUDENT AGREEMENT RNSG 1219 This certifies that I have received a copy of the RNSG 1219 Associate Degree Nursing Syllabus. I have read and understood the syllabus and will abide by its contents. The syllabus has been reviewed with me including: the class schedules course policies attendance policy behavioral expectations assignments Student Signature Date This form is to be signed, dated and turned in to your instructor. The agreement will be placed in your student file. 21