N254 Syllabus
Faculty Lecturers:
Saundra Bosfield, RN, MSN
Mary Moon, MSN, RN-C, FNP
Wanda Morris, MN, RN
Dr. Victoria Orton EdD, MSN, RN, FNP
Table of Contents
Table of Contents: 1
Course Description 2
Entry Competencies 2
Unit Hours 2
Prerequisites 3
Course Placement 3
Required Texts/Resources 3
Learning Activities 3
Student Learning Outcomes 4
Course Objectives 4
Clinical Objectives 4
Faculty Responsibilities 6
Student Responsibilities 6
Student-Faculty Communication 7
Attendance Policy 7
Standards of Conduct 7
Disciplinary Action 8
Evaluation of Clinical Performance 11
Anecdotal Note 11
Methods of Instruction 12
Methods of Evaluation 12
ERI – Testing Invoice 12
Grading Policy/Examinations 13
Examinations/Distribution of Grades 14
Guidelines for Assignments 15
Article Critique Guideline 15
Article Critique Grade sheet 16
Cardiac Assignment Guideline 17
Cardiac Assignment Grade sheet 18
Module Objectives:
Leadership & Management IA 19
Excretory Need IV – Renal 22
O2CO2 IVA – Respiratory 27
O2CO2 IVB - Cardiovascular 32
Physical Integrity IVA – Trauma/MOF 40
Leadership & Management IB - Disaster 43
Appendixes: A Anecdotal Notes 45
B APA Format 49
C Geri Log 54
D ICU RN Checklist 55
E ICU nursing flow sheet (2 pages) 56
F RN Guide – Provider of Care 58
G Manager of Care Evaluation 59
H Health and Nursing Resources 60
I EKG Strips 63
J ABG Practice 67
K Practice Math Questions 71
L Grading Summary Sheet 72
M Clinical Evaluation Tool 73
N NCLEX Information 81
O ERI INFORMATION 83
P CHF SIMULATION 84
Q CODE BLUE SIMULATION 86
N 254 COURSE DESCRIPTION:
This course focuses on pathophysiologic concepts and nursing management essential to critical care and emergency nursing. Clients with acute and chronic cardiopulmonary, hepatic, renal, and multi-system failure will be selected for critical care clinical experiences. Leadership and management skills are introduced and applied in the clinical setting. Students apply the nursing process and prioritize nursing care for a group of clients with multiple need imbalances. The role of the nurse in the management of client care following a disaster is presented
N 254 ENTRY COMPETENCIES:
Ability to complete a nursing physical assessment. Knowledge of the pathophysiology of the cardiac, respiratory, renal, musculoskeletal, and peripheral vascular systems. Knowledge of the nursing responsibilities associated with the common abnormalities of the cardiac, respiratory, renal, musculoskeletal, and peripheral vascular systems. Knowledge of the nursing responsibilities associated with the care of clients with electrolyte imbalances, pain management, hematology, oncology, gastrointestinal, maternal/gynecological, pediatric, growth and developmental and psychosocial needs.
N 254 7 UNIT HOURS:
This is a seven-unit nursing course, consisting of lecture and lab.
N 254 PREREQUISITES:
Successful completion of all previous nursing courses.
N 254 COURSE PLACEMENT:
This course is offered in the final semester of nursing.
N 254 REQUIRED TEXTS/EQUIPMENT:
Aschenbrenner, D., Cleveland, L.W., & Venable, S.J. (2007). Drug therapy in nursing. Philadelphia: Lippincott, Williams, and Wilkins.
Corwin, E. J. (2007). Handbook of pathophysiology (2nd or 3rd ed.). Philadelphia: Lippincott.
Deglin, J.H. & Vallerand, A.H. (2003). Davis’s drug guide for nurses (8th ed.). Philadelphia: F.A. Davis Co.
Dudek, S. (2006). Nutrition handbook for nursing practice (5th ed.). Philadelphia: Lippincott.
Monahan, F. D., Sands, J.K., Marek, J.F. Neighbors, M., & Green, C. (2003). Phipps medical-surgical nursing health and illness perspectives (8th ed.). St. Louis: Mosby.
Potter, P. A. & Perry, A.G. (2004). Fundamentals of nursing, concepts, process, and practice (6th ed.). St. Louis: Mosby.
Preusser, B.A. (2005). Critical thinking in medical-surgical settings: A case study approach. (4thd ed.). St. Louis: Elsevier Mosby.
Tappen, S.A., Weiss, S.A. & Whitehead, D.K. (2007). Essentials of nursing leadership and management (5th ed.). Philadelphia: F. A. Davis Co.
Chernecky, C. & Berger, B. (2004). Laboratory Test & Diagnostic Procedures (4th ed). St. Louis: Saunders.
Seven Par Score Answer Sheets (# F-1712-PAR-2) required for testing.
N 254 LEARNING ACTIVITIES:
See individual lecture objectives.
N 254 STUDENT LEARNING OUTCOMES:
At the end of Nursing 254 the student will begin to model effective leadership and team member behaviors while prioritizing nursing care for a group of clients with multiple need imbalances.
N 254 COURSE OBJECTIVES:
At the completion of this course, the student will demonstrate the following objectives:
- Utilize the principles of leadership and management in providing nursing care of a selected group of hospitalized clients.
- Apply the pathophysiologic concepts for selected cardiovascular, hepatic, respiratory, and renal disorders and utilize the nursing process in the provision the victims of a disaster.
- Evaluate clinical findings and the rationale for intervention in planning nursing care for a selected group of clients with multiple need imbalances.
4. Execute nursing procedures according to established standards of critical care, emergency, and disaster nursing.
5. Apply the principles of pharmacology in the care of clients with multiple need imbalances.
6. Correlate laboratory values with the appropriate nursing interventions for clients with multiple need imbalances.
7. Apply legal and ethical guidelines to the care of clients with multiple need imbalances.
8. Apply nursing care to a group of clients in both intensive care units and the emergency room with multiple need imbalances.
9. Prioritize nursing interventions for the victims of a disaster.
N 254 CLINICAL OBJECTIVES:
Role as Member within the Discipline of Nursing/Role as Student Nurse
1. Prioritize care for:
a. one critical care patient in the
ICU/CVICU/PCU UNIT
b. three patients in the
i. DOU/AOU UNIT AND MEDICAL-SURGICAL FLOOR
ii one patient undergoing pre/post angio catheterization
iii a group of three to four patients in the ER
c. patients undergoing dialysis
i. hemodialysis/peritoneal dialysis
2. Perform a comprehensive health assessment for all assigned
hospitalized patients, including health history, physical assessment,
structural variables, and nursing diagnosis pertinent to the admitting
diagnosis.
a. Assess baseline/update vital signs
i. Utilize a variety if pain scales
ii. Assess patients with cardiovascular dysfunctions and
compare with normative data
iii. Assess patients with respiratory dysfunctions and compare
with normative data
b. Complete AM assessment according to agency protocol
3. Interpret labs and V/S before/after administering medications
(vancomycin, gentamycin, a& digoxin)
4. Initiate/update nursing diagnosis based on data gathered for all
patients according to agency protocol
a. Verbalize and correlate pathophysiology with nursing diagnosis
b. Verbalize and correlate pathophysiology with medical diagnosis
5. Review and interpret laboratory values for each assigned patient and modify
nursing care according to the results
a. Chemistry panel
b. Albumin
c. Pre albumin
d. Glucose
e. HDL/LDL
f. VLDL
g. TSH/T-4
h. CBC
i. WBC with differential
j. Cardiac enzymes (Troponin, LDH, CPK, CPK-MB)
k. Renal panel (Bun/Creat)
l. ABGs
m. Coag studies: PT/PTT/INR
n. Cardiac diagnostic tests
o. Hemodynamic monitoring/related pathophysiology/normal values
p. Angiogram
6. Check crash cart and identify all items
7. Monitor and maintain oxygenation needs for patients
a. FiO2
b. Closed suctioning
c. Endotracheal tube
d. Ventilator
e. Chest tube(s)
Role as Manager of Care
1. Participate in disaster drill activities (Drill & preparation prior to drill)
2. Coordinate a patient care conference
3. Complete the following for at least one patient:
a. Admission
b. Discharge
c. Transfer patients (as available)
d. Preparation for test(s)/surgery
e. Receive patients from test(s)/surgery.
4. Complete leadership assignment as designated by clinical instructor
5. Delegate and evaluate patient care provided by assistive personnel in a
Timely manner
6. Arrange appropriate channels of communication related to patient care
with the following individuals:
a. Staff nurse (receive/provide/update report)
b. Physician/PA/NP (Primary care provider)
7. Deliver patient care in a cost-effective manner
8. Participate in a mock code; identify the different nursing roles.
N 254 FACULTY RESPONSIBILITIES:
The role of the teacher will be to facilitate the learning process and to motivate, encourage, and advise the student in the classroom and clinical setting. Faculty will present weekly lectures. Faculty will be available to students during office hours.
N 254 STUDENT RESPONSIBILITIES:
Students will be responsible for arriving to lecture and clinical on time, having completed reading assignments. Students will be responsible for reviewing previously learned material for class. Students are encouraged to take an active role in their own teaching.
The student is responsible for demonstrating all behavioral objectives of the course. Clinical evaluation is based on demonstrated ability to achieve all course objectives by the last day of classes. Course expectations include attendance and experiential learning.
The student is expected to utilize the library, learning resource center, and the CAI lab. The student is also expected to arrive at the clinical agency in proper attire and prepared to meet specific objectives. The student is expected to focus on meeting objectives while attending clinic.
N 254 STUDENT-FACULTIES COMMUNICATION:
Faculty office hours for full-time faculty are posted on faculty offices. For the didactic component of the course, students should communicate with the lecturer. For the clinical component of the course, students should communicate with the clinical instructor(s). Students are expected to contact the lead instructor if they are unable to resolve an issue with their clinical instructor. All students and faculty have El Camino College E-mail addresses.
N 254 ATTENDANCE POLICY:
Course expectations include attendance and experiential learning. Punctuality is a professional expectation. Two (2) times late to class/clinic will be counted as one absence. No more than two absences are permitted. Faculty will evaluate extenuating circumstances on an individual basis. Students MUST notify the assigned clinical unit/instructor of and anticipated absence or tardy at least one-half hour prior to their scheduled time.
If a student is unable to take an exam as scheduled (due to illness or emergency), the student must notify the faculty member or nursing office (310) 660-3281 immediately. A make-up test must be arranged and completed by the student prior to attending clinical or the next scheduled lecture. The student must provide the faculty with documentation to validate the absence. If the documentation is inappropriate or invalid, the student will receive a grade of “F” for the exam.
N 254 STANDARDS OF STUDENT CONDUCT Board Policy 5138
Attendance
Attendance during Semester
Regular attendance is expected of every student. A student may be dropped from class when the number of hours absent exceeds the number of units assigned to the course. However, it is ultimately the responsibility of the student to officially drop the class. This rule also applies to excessive absences due to illness or medical treatment. The student who has been absent due to illness or medical appointment must explain the absence directly to the instructor. The student who has been absent due to a communicable disease or quarantine must report directly to the Health Center for clearance before returning to classes.
I. Standards of Conduct
A. General Policy
Conduct at El Camino College must conform to the laws of the State of California, District policies, and campus rules and regulations. The El Camino College faculty, staff and administration are dedicated to maintaining an optimal learning environment; the standards of behavior as outlined in this policy are essential to the maintenance of a quality college environment. These standards will apply to all students on campus, other college property or while attending any college-sponsored event. Violation of such laws, policies, rules and regulations or behavior adversely affecting suitability as a student, will lead to disciplinary action. Disciplinary actions as noted in Section II may be taken against any person who engages in behavior defined as misconduct as listed in Section B.
B. Misconduct
1. Dishonesty, including but not limited to cheating, plagiarism or knowingly furnishing false information to the College.
2. Forgery, alteration, or misuse of college documents, records, or identification.
7. Continued disruptive behavior, continued willful disobedience, profanity or vulgarity, or continued defiance of the authority of, or abuse of, college personnel or to anyone on campus.
11. Participation in hazing or commitment of any act that tends to injure, degrade or disgrace a student or college personnel.
12. Obstruction or disruption of teaching, research, administration, disciplinary proceedings, or other authorized college activities including but not limited to its community service functions or to authorized activities held off campus. Obstruction or disruption includes but is not limited to the use of skateboards, bicycles, radios, and roller skates.
19. Persistent, serious misconduct not listed in Items 1-18 above.
II. Disciplinary Action
Disciplinary action appropriate to the misconduct as defined above may be taken by an instructor (see Items II, B-1 and 5 below), the Dean of Student Services or his or her designee (see Items II, B-1, 2, 3, 4, 6 and 7 below), and the Board of Trustees (see Item II B-8 below).
B. Discipline
The following types of disciplinary action may be taken or pursued by the college:
1. Warning - A verbal or written notice, given to the student by a faculty member, the Dean of Student Services or any college manager that continuation or repetition of the specified conduct may be cause for other disciplinary action.
2. Reprimand - A written reprimand for violation of specified regulations sent to the student by the Dean of Student Services, noting that continued violations may result in further disciplinary action. The Dean of Student Services shall place a copy of this reprimand in the student file.
5. Removal by Instructor - In addition to an instructor’s right to drop a student permanently from a class when the student is no longer participating i.e. lack of attendance in the course, an instructor may remove (suspend) a student from his or her class for the day of the incident and the next class meeting. During this period of removal, a conference should be held with the instructor and the student to attempt to resolve the situation that led to the student’s removal and the student shall not be returned to the class from which he or she was removed without the concurrence of the instructor of the class.
If a student is suspended for one class meeting, no additional formal disciplinary procedures are necessary.
If a student is suspended from class for the day of the incident and the next class meeting, the instructor shall send a written report of the action to his or her dean who shall forward this information to the Dean of Student Services, the Vice President of Student Services, and the President. If the student removed by an instructor is a minor, the President’s designee (Dean of Student Services) shall ask a parent or guardian of the student to attend a parent conference regarding the removal as soon as possible. If the instructor or the parent or guardian so requests, a college administrator shall attend the conference.