WOOD COUNTY SCHOOL OF PRACTICAL NURSING BASIC NURSING I - HEALTH SCIENCE CORE Time: 29.5 Hours of Theory. This course is part of the Health Science Core - Advanced Standing may be granted for the qualified C.N.A. The Advanced Standing C.N.A. will not be required to attend or test for this course and will receive "Credit" in place of a grade on the transcript. Placement: Nursing I Instructors: Darla Hall, RN, MSN Textbooks: Christensen, Barbara and Kockrow, Elaine. FOUNDATIONS OF NURSING, 6th Edition, Mosby Yearbook Publishing, St. Louis, Missouri, 2011. Christensen, Barbara and Kockrow, Elaine. Study Guide, Foundations of Nursing, 6 th Edition, Mosby Yearbook Publishing, St. Louis, Missouri, 2011. Christensen, Barbara and Kockrow, Elaine. ADULT HEALTH NURSING, 6th Edition, Mosby Yearbook Publishing, St. Louis, Missouri, 2011. Christensen, Barbara, Kockrow, Elaine, Cooper, Kim. Study Guide, Adult Health Nursing, 6th Edition, Mosby Yearbook Publishing, St. Louis, Missouri, 2011. References: Herlihy, Barbara and Nancy Maebias. THE HUMAN BODY IN HEALTH AND ILLNESS, 3rd, W. B. Saunders Company, Philadelphia, Pennsylvania, 2011. Hill, Signe and Howlett, Helen. SUCCESS IN PRACTICAL/VOCATIONAL NURSING, 6th Edition, Saunders Elsevier, St Louis, Missouri, 2009. MOSBY S MEDICAL, NURSING, & ALLIED HEALTH DICTIONARY, 9th Edition, Mosby Yearbook Publishing, St. Louis, Missouri, 2009. Wold, Gloria, Hoffman. BASIC GERIATRIC NURSING. Mosby Elsevier, St. Louis, Missouri 2008. Course Overview: Basic Nursing I is designed to introduce the learner to techniques that will be utilized in the clinical setting while administering basic nursing care to clients in various stages of health and illness. 1
Course 1. Implement basic nursing procedures safely. 2. Function as an effective member of the health care team. 3. Communicate effectively with clients, their significant others, and members of the health care team. Clinical Component: 1. Provide basic care of the client in various stages of health and illness in the acute care setting. 2. Modify basic nursing care for the resident in an extended care facility. Instructor 1. Handout course materials. 2. Lecture and initiate class discussions. 3. Show audiovisuals 4. Demonstrate procedures. 5. Develop and score tests. 6. Observe and score return demonstrations. Student 1. Complete all reading and homework assignments. 2. Take notes and participate in class discussions. 3. View audiovisuals. 4. Complete required return demonstrations for basic nursing skills-pass/fail grade with a maximum of 3 attempts) 5. Complete all quizzes/examinations with a minimum score of 80%. Course Content and Time: Unit I: Medical Asepsis and Infection Control - 7.5 Hours Unit II: Body Mechanics and Immobility - 11 Hours Unit III: Hygiene - 11 Hours UNIT I: MEDICAL ASEPSIS AND INFECTION CONTROL - 7.5 HOURS Pre-class Assignment: Christensen, FOUNDATIONS OF NURSING, Chapter 12. Lesson I - Nature of Infection - 3 Hours Pre-class Assignment: Christensen, pages 266-276 A. Asepsis B. Nursing Process in Asepsis and Infection Control C. Infection Process D. Reducing Risk for Infection E. Healthcare associated infections (HAIs) 2
1. Define terms related to asepsis and infection control using correct spelling. 2. List the links in the chain of infection. 3. Discuss infectious agents: bacteria, viruses, fungi, protozoa. 4. List methods of microorganism transmission. 5. List portals of entry for microorganisms. 6. Identify factors most likely to increase the chance of an individual developing infection. 7. Identify normal body defense mechanisms against infection. 8. Explain the events in the inflammatory response. 9. Identify conditions that lead to the development of nosocomial infections. 1. Transparencies 2. Study Guide, Medical/Surgical Asepsis and Infection Control 3. Handout, Infection Control - The Laws 4. Handout, Medical vs. Surgical Technique. Lesson II - Standard Precautions - 2.5 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 279-283 A. Standard Precautions B. Handwashing 1. Explain the meaning of standard precautions. 2. State the nursing responsibilities in practice of standard precautions. 3. State situations that a nurse should routinely wash their hands. 4. List the steps of the handwashing procedure. 5. Implement correct handwashing technique. 6. Identify the care of the hands when there is a break in the skin. 7. Discuss the importance of proper water temperature when handwashing. 8. State the reasons for proper nail grooming in health care. 9. Explain the importance of hand hygiene using water-free hand cleaning solutions. 1. Practice hand-washing techniques. 2. Demonstrate hand-washing procedure. 3. Guest Speaker: Role of Standard Precautions in Health Care Delivery Lesson III - Isolation Technique - 2 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 283-293 A. CDC Guidelines B. Isolation Techniques C. Specimen Collection Techniques for Patient in Isolation 3
1. Discuss CDC guidelines related to communicable disease control. 2. Identify the psychological needs of the client in isolation. 3. Discuss the environmental needs of the client in isolation. 4. State the equipment needed to successfully utilize isolation technique. 5. Implement the gowning technique of the nurse working in isolation. 6. Explain the need for gloves when working in an isolation environment. 7. Explain the role of the mask for protection of the nurse and client in the isolation environment. 8. State the various isolation techniques including nursing responsibilities. 9. Discuss the various specimen collection techniques for the patient in isolation. 10.List signs/symptoms of a latex allergy. 1. Review study questions pages 312-314; 2. Video "Infection Control - Handwashing PPE, Handling infectious waste" UNIT II: BODY MECHANICS AND CLIENT MOBILITY - 11 HOURS Pre-class Assignment: Christensen, FOUNDATIONS OF NURSING, Chapter 15 Lesson I: Overview of Body Mechanics - 1 Hour Pre-class Assignment: Foundations of Nursing, Christensen, pages 375-378 A. Appropriate Body Mechanics B. Body Mechanics for Health Care Workers 1. Explain the role of the skeletal system in regulation of movement. 2. Explain the role of the nervous system in regulation of movement. 3. List the advantages of utilizing good body mechanics while performing nursing duties. 4. Define terms related to body mechanics. 5. Identify developmental changes, which occur in the musculoskeletal system. 6. List guidelines for assessment of a client's mobility status. 7. Explain how the nurse can best maintain body balance. 1. Handout, Do s & Don ts, Using Proper Body Mechanics 2. Lab Practice - Proper Alignment - before and/or after class. 3. Study Guide, Body Mechanics and Patient Mobility. 4
Lesson II: Positioning the Client 4 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 378-381 A. Nursing Action/Rationale C. Positioning in Bed B. Assistive Devices for Proper Positioning D. Data Collection 1. Discuss nursing action/rationale to be used when positioning clients. 2. List assistive devices to be used for proper positioning. 3. Explain the use of positioning in relation to health status. 4. Compare Fowler's position with Semi-Fowler's position. 5. Describe the most commonly used positions as discussed in this lesson. 6. List appropriate follow-up assessment related to client positioning. 7. Discuss precautions necessary when turning and positioning a client with hip replacement surgery. 1. DVD, Positioning Techniques. 2. Lab Practice - Positioning Lesson III - Exercise And Ambulation - 4 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 378, 382-388 A. Data Collection B. Types of Exercise 1. Define terms related to immobility and range of motion. 2. Discuss the body's responses to immobility. 3. Contrast the types of exercises. 4. List the five major types of exercise. 5. Identify the ranges of individual joint movement. 4. Discuss how the nurse should explain to the client the value of turning and ambulating. 6. Discuss early signs/symptoms that joint motion is becoming impaired. 1. Transparency "Home Care Guidelines" 2. Lab Practice - Range Of Motion, Ambulation, Mechanical Aids 3. Handout, Joint Types, ADLs, IADLs 4. DVD, Transfer & Ambulation. Lesson IV - Moving the Client - 2 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 388-398 A. Nursing Action/Rationale Moving Clients Up In Bed B. Lifting and Moving Clients Up In Bed 5
C. Turning the Client D. Dangling the Client E. Logrolling F. Transfering the Client G. Nursing Process for Mobility 1. Identify factors influencing activity tolerance emphasizing the physiological, emotional, and developmental aspects. 2. List the essential steps to move and turn a client in bed. 3. List the essential steps to transfer a client from bed to chair or stretcher. 4. Explain safe use of a stretcher or wheelchair. 5. Explain the procedure for performing a three-man carry. 6. Identify conditions that would necessitate logrolling a client. 7. List the steps involved in dangling a client. 8. Discuss areas of nursing responsibility when providing mobility for clients. 9. Explain the proper use of assistive devices. 1. DVD, Moving & Turning. 2. Lab Practice - Moving Clients 3. Review questions, pages 398-399; 4. Unit Exam UNIT III: HYGIENE 11 HOURS Pre-class Assignment: Christensen, FOUNDATIONS OF NURSING, Chapter 18; ADULT HEALTH NURSING, Chapter 3 pages 65-68; Human Body in Health and Illness, Chapter 7, Herlihy. Wold, Gloria, Huffman. Basic Geriatric Nursing. Mosby Elsevier, St. Louis, Missouri, 2008, pages 266-284. Lesson I - Personal Hygiene - 2 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 439-444. Adult Health, Christensen, pages 65-68. A. Skin Anatomy and Physiology B. Factors That Influence Hygienic Practices C. Client s Room Environment D. Data Collection E. Hygienic practices of medical personnel 1. Discuss the overview of anatomy and physiology of the skin in Adult Health and Herlihy 6
2. Define terms related to basic hygiene. 3. List factors that influence the practice of an individual's personal hygiene. 4. Discuss cultural considerations related to hygiene practices. 5. Identify developmental changes of the skin. 6. List basic furniture in a typical hospital room. 7. Explain hygienic care needed throughout the day for clients. 8. State ways to maintain client comfort. 9. List areas of data collection to be made during hygiene activities. 10. State considerations when collecting data of darker skinned individuals. 11. Review expectations for the hygienic practices of medical staff personnel. 1. Read assignments. 2. Complete all objectives and Terminology Study Guide 3. Review Anatomy and Physiology, Chapter 7 Lesson II - Bathing and Skin Care - 3.5 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 444-458. Basic Geriatric Nursing, chapter 18. A. Bathing C. Client Teaching B. Care of the Skin D. Decubitus Ulcers 1. Discuss the types of therapeutic baths. 2. List the steps involved in giving an adult a bed bath. 3. Identify safety precautions related to bathing. 4. Explain the procedure for administering the various therapeutic baths. 5. List ways to maintain the client's privacy during the bath procedure. 6. Discuss adaptive techniques for bathing. 7. Identify the procedure for dressing and undressing a patient with an affected extremity. 8. State areas to focus on when teaching the client hygienic practices. 9. Identify ideal room temperature, taking into consideration age and condition. 10. List the steps involved when giving back care. 11. Describe risk factors for developing impaired skin integrity. 12. Identify the main cause of and factors contributing to decubitus ulcers. 13. Explain the four stages of decubitus ulcers. 14. Identify nursing responsibilities in prevention and/or treatment of pressure ulcers. 15. Discuss monitoring and documentation of pressure ulcers. 16. Match stages of pressure ulcers with a description. 1. Videos: "Giving a Bed Bath", "Assisting With a Shower & Shampoo", "Toileting and Incontinent Care", "Tub Bath" (optional) 2. Braden Scale for Predicting Pressure Sore, Risk, page 300. 7
3. Lab Practice - Bathing, Back Care, ADL Equipment. Lab available for independent practice. 4. Transparencies 5. Study for Terminology Test 6. Study Guide- Hygiene and Care of the Patient s Environment Chapter 18, page 125 Lesson III - Accessory Structures Hygiene - 3 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 454-479 A. Oral Hygiene E. Perineal Care B. Hair Care F. Eye, Ear, and Nose Care C. Shaving G. Assisting with Elimination D. Hand, Foot, and Nail Care 1. List common oral hygiene problems. 2. Discuss the steps in oral hygiene care for the dependent client. 3. Explain techniques used in the care of dentures. 4. Discuss hair care of the dependent client. 5. Choose the correct method of shaving a client receiving oxygen, receiving Heparin or Coumadin therapy. 6. List steps involved in shaving a client 7. State contraindications to shampooing, shaving, or nail trimming. 8. Explain the rationale for soaking nails in warm water prior to providing nail care. 9. List steps to providing perineal care. 10. Explain the procedure for providing perineal care to the catheterized client. 11. State the correct procedure for cleansing the eyes. 12. Describe care of eyeglasses, contact lenses, and artificial eyes. 13. Choose the safe method for cleansing the ear. 14. Discuss proper care of assistive hearing devices. 15. Explain nose care for the client receiving oxygen per nasal cannula or the client with a nasogastric tube. 16. Describe normal assessment findings for elimination. 17. Discuss considerations for assisting the client with elimination. 18. Review hygiene and the nursing process. 1. Review A & P text related to eye and ear 2. Videos : "Techniques in Toileting..." "Personal Care - Nails, Beard, Hair, Dressing 3. Lab available for independent practice 8
Lesson IV - Bed Making - 2.5 Hours Pre-class Assignment: Foundations of Nursing, Christensen, pages 469-472 A. General Considerations when Bed Making B. Various Types of Bedmaking 1. State basic medical asepsis techniques used when bed making. 2. Describe accurate body mechanics to be utilized. 3. Describe common positions in which an electric hospital bed may be placed. 4. List the steps to effectively make an unoccupied bed. 5. List the steps to effectively make an occupied bed. 6. Discuss variations in bed making techniques to facilitate client needs. 7. List areas to teach patients related to hygienic practices. 8. Discuss home health considerations related to hygiene practices. 9. Identify when the various bed making procedures are used. 1. Observe the bed making procedure. 2. Lab available for independent practice. 3. Unit Examination 4. Video: "Bedmaking" 5. Return Demonstration for Basic Skills (lifting, moving and turning, restraints, bathing, bedmaking, toileting). Basic Nursing I Revised 07/09 9