Santa Monica College
Course Outline For
Course Title: Nursing 30L – Intermediate Medical-Surgical Units: 2.5
Nursing IGETC Area:
Date Submitted: Fall 2003 CSU GE Area:
Updated: Fall 2006 Transfer: CSU
I. Catalog Description:
Prerequisite: Nursing 25, Nursing 25L, Nursing 16, Nursing 17
Corequisite: Nursing 30
The focus of this nursing laboratory course is to provide the continuing student with the opportunity to apply increasingly complex medical-surgical concepts of care for adults with health deviations. Students will assess, plan, provide and evaluate the provision of nursing assistance in the clinical laboratory. The Orem Self Care Model will be used as a framework to safely meet nursing needs of the patient with gastrointestinal, renal, oncological, hematological, female reproductive and immune system disorders. Students will assess the adult and older adult’s self care requisites, determine the therapeutic self-care demand and apply the nursing process. Professional role development is integrated throughout; along with application of critical thinking, communication theory, clinical judgment, and sound reasoning. Laboratory experiences will be held in the acute care or community setting. Course must be taken concurrently with theoretical component, Nursing 30.
II. Required Text and References:
1. Doenges, Marilyn, Nurse’s Pocket Guide: Nursing Diagnoses with Interventions, 7th ed., F.A. Davis, 2000.
2. Leukenotte, Annette G., Gerontological Nursing, 3nd ed., Mosby, 2006.
3. Estes, Health Assessment & Physical Examination, 2nd ed., Delamr 2002.
4. Fishbach, Frances, Manual of Laboratory Diagnostic Tests, 6th ed., Lippincott, 2003.
5. SMC Nursing Handbook, current edition – available online
6. Smeltzer & Bare, Brunner’s Textbook of Medical-Surgical Nursing, 10th ed., Lippincott 2004.
III. Course Objectives:
Upon completion of Nursing 30, students should be able to:
1. Develop a nursing plan of care for adults and older adults with health deviation involving the following:
a) gastrointestinal tract – absorption and elimination
b) liver, biliary tract and pancreas
c) immune and auto-immune system
d) hematological system
e) renal system
f) oncological
g) female reproductive system
2. Communicate effectively orally and in writing during clinical practice with the patient, family, and multi-disciplinary health care team.
3. Predict nursing assistance required for the patient/client by applying critical thinking and analyzing collected data.
4. Demonstrate behaviors which reflect knowledge of the professional responsibilities of the beginning manager of care.
5. Apply nursing techniques of disease prevention, health promotion and health maintenance for adults and older adults.
6. Perform learned behaviors that integrate the role of the professional nurse into practice and leadership situations.
7. Perform all course related behaviors satisfactorily based on established critical criteria.
IV. Clinical Objectives:
Upon completion of the course students will be able to:
1. Utilize the five step nursing process to provide safe, comprehensive care to two-three adults or older adults with the following health system deviations:
a) gastrointestinal tract
b) liver, biliary tract and pancreas
c) immune system
d) hematological
e) renal
f) oncological
g) female reproductive
2. Communicate effectively during clinical situations with clients/patients, families, peers and the multi-disciplinary health care team.
3. Teach the patient/client regarding clinical implications of laboratory and diagnostic procedures commonly associated with the above health deviations.
4. Perform a focused physical assessment on a patient/client with the above health system deviations; differentiate normal and abnormal findings.
5. Analyze changing data presented in a clinical care situation and demonstrate critical thinking to revise required nursing assistance.
6. Demonstrate the ability to safely administer all medications assigned clients are receiving via all routes, including oral, subcutaneous, intramuscular, topical, rectal, inhalation, and intravenous.
7. Correlate effects of medications to patient/client health deviations and expected outcomes.
8. Present a patient situation utilizing the “grand rounds” format satisfactorily in small group settings.
9. Integrate leadership behaviors that reflect practice roles of the professional medical-surgical nurse.
10. Utilize critical thinking strategies which include appropriate communication skills to prevent disease promote and maintain health of the adult and older adult.
11. Implement nursing management techniques for clients with alterations in nutritional intake including total parenteral nutrition, naso-gastric feedings, gastrostomy and jujenostomy feedings.
12. Implement nursing management techniques for clients with alterations in function of the lower gastrointestinal tract including ileostomy and colostomy.
13. Participate in providing nursing assistance during gastrointestinal procedures in the G.I. lab.
14. Implement nursing management strategies for clients with cancer who are receiving chemotherapy to minimize psychological and physical. discomfort.
15. Implement nursing management strategies for clients experiencing alterations of renal and bladder function including urinary diversion; peritoneal dialysis and hemodialysis.
16. Implement nursing management strategies for female clients with disorders of the reproductive system including pharmacological and surgical interventions.
17. Participate critically in self evaluation process and achievement of objectives at midterm and end of course.
18. Perform infusion therapy, including venipuncture, total parenteral therapy and transfusion of blood components.
V. Methods of Presentation:
“Hands On” patient care experiences, skills lab assignments, nursing care plan development, computer aided instruction, post conference interactions, written assignments and supervised skill practice.
VI. Course Content:
Coverage Topic
25.0 Gastrointestinal tract
12.25 Liver, biliary tract and pancreas
12.25 Immune system
12.25 Hematological
12.25 Renal
12.25 Oncology
12.25 Female reproductive
VII. Methods of Evaluation:
Instructor observation of student performance, utilization of the Socratic questioning, achievement of clinical objectives, participation in post conference, satisfactory preparation; compliance with college, nursing program and facility policies and procedures.
Clinical Grading Scale: Pass/Fail – See Clinical Evaluation Tool – Failure N30L constitutes an “F” grade in N 30 regardless of the grade achieved in theory.
VIII. Exit Skills N30L:
1. Implement and evaluate a comprehensive plan of care for the patient/client with a disorder of the gastrointestinal tract.
2. Implement and evaluate comprehensive plans of care for the patient/client with disorders of the liver, biliary tract and/or pancreas.
3. Provide comprehensive care for the patient/client with disorders of the immune system
4. Perform required nursing skills safely for the patient/client requiring venipuncture, infusion therapy, and blood transfusion.
5. Implement and evaluate a comprehensive plan of care for the patient with cancer.
6. Prioritize nursing interventions for the patient/client with hematological disorders.
7. Plan and provide comprehensive care for the patient/client with disorder of the renal system
8. Prioritize nursing interventions for the patient/client with disorders of the female reproductive system
9. Utilize effective communication skills to collaborate with members of the health care team to achieve desired patient outcomes.
10. Differentiate plans of care for the adult and the special needs and requirements of the older adult with selected disorders.
11. Implement critical thinking processes when formulating expected outcomes for patients who require complex nursing assistance.
12. Perform management behaviors that reflect the role of the professional registered nurse.
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