NURS 1327 Transition from Vocational to Professional Nursing

RNSG 1327 – Transition to Professional Nursing Practice

Unit II – Associate Degree Nursing Competencies

Part A – Technical Competencies

Behavioral Objectives / Content Outline / Clinical Objectives / Learning Opportunities /
1.  Review the role of the nurse in the safe administration of medications, including intravenous therapy. / I.  Pharmacological Safety
A.  Medication administration
1.  Source of information
2.  Drug information
3.  Factors affecting disage variation/drug actions
4.  Roles of the health care team
5.  Drug orders
6.  Nurse’s role
7.  Five rights
8.  Routes of administration
9.  Calculating dosages
10.  Psychological issues
11.  Recording of medications
12.  Medication errors
13.  Medication reconciliation
B.  Fluid and electrolyte balance
1.  Body fluid distributions
2.  Electrolyte composition of body fluid
3.  Methods of movement
4.  Regulatory mechanisms
5.  Fluid imbalance
a.  Dehydration
b.  Hypovolemia
c.  Hypervolemia
6.  Electrolyte imbalance
7.  Assessment of hydration
C.  Intravenous therapy
1.  Types of solutions
2.  Regulating flow rates
3.  Intravenous piggy back medications
4.  Intravenous push medications
5.  Complications of IV therapy / Take client history using structured and unstructured data collection tools to obtain physical, psychosocial, spiritual, cultural, familial, occupational, environmental information, risk factors, and client resources.
Perform assessment to identify health needs and monitor for change in health status.
Validate, report, and document assessment data using assessment tools.
Perform therapeutic and preventive nursing measures and administer treatments and medications as authorized by law and determined by the BON.
Collaborate with other health care providers with treatments and procedures. / Read:
Berman & Snyder (2012)
Adams (2011)
Lewis (2011)
McKinney (2009)
Estes (2010)
Required: MyNursingLab
Module 4 – Physiological Aspects of Nursing
Lesson 13 – Fluid & Electrolyte
Lesson 14 – Medication Administration
Module 3 - Assessing Health Status
Lesson 1: Health History
Lesson 2: Techniques of Physical Assessment
Lesson 3: Vital signs
Do pretest, content, and posttest
Videos at HSC:
#1116 – Denver Developmental Screening Test

CD-ROM:

# 4096 – The Ten Minute Assessment of the Adult (on Blackboard)
TVCC Library – Nursing Education in Video http://tvcc.ent.sirsi.net/client/tvcclibraries
2.  Identify factors to be included in assessing clients across the life span in a variety of settings. / II.  Health history/assessment
A.  Data collection
1.  Ethical considerations
2.  Interview techniques
a.  Reducing anxiety
b.  Cultural awareness
c.  Personal awareness
B.  Content of the interview
1.  Biographical data (demographics)
2.  Informant/client profile
a.  Height
b.  Weight
c.  Growth chart
d.  Age
e.  Sex
f.  Race
3.  Chief complaint
4.  History of present illness (or present concern) (HPI)
a.  Location
b.  Radiation
c.  Quality
d.  Quantity
e.  Associated manifestations
f.  Aggravating factors
g.  Alleviating factors
h.  Setting
i.  Timing
5.  Prior medical history (PMH)
a.  Medication – Prescription & over the counter
b.  Medical illnesses
(1)  Childhood
(2)  Adult
c.  Allergies
d.  Surgeries and diagnostic procedures
e.  Hospitalizations
f.  Immunizations
g.  Trauma
h.  Transfusions
6.  Family History
a.  Hereditary
b.  Communicable
c.  Environmental
d.  Blood vs. adopted
7.  Social History
a.  Tobacco
b.  Alcohol
c.  Illicit drugs
d.  Marital status/family structure/role in the family
e.  Living arrangements/sexual practices
f.  Economic status/sources of income
g.  Occupational history
h.  Education
i.  Mode of transportation/travel history
j.  Availability of help
k.  Social/recreation activities
l.  Home environment
(1)  Physical
(2)  Psychosocial
m.  Work environment
n.  Developmental considerations (Erickson’s Stages of Development)
(1)  Infant
(2)  Child
(3)  Denver Developmental Screening Test (DDST)
(4)  Adolescent
(5)  Adult
(6)  Gerontologic
(7)  Functional Assessment
(8)  Pregnant client
(9)  Special needs client
8.  Review of systems
a.  General
b.  Neurological
c.  Psychological
d.  Skin
e.  Eyes
f.  Ears
g.  Nose and sinuses
h.  Mouth
i.  Throat/neck
j.  Respiratory
k.  Cardiovascular
l.  Breasts
m.  Gastrointestinal
n.  Urinary
o.  Musculoskeletal
p.  Female reproductive
q.  Male reproductive
r.  Nutrition
s.  Endocrine
t.  Lymph nodes
u.  Hematological
9.  Cultural assessment
a.  Racial and ethnic groups
b.  Cultural beliefs
c.  Self-care practices
d.  Major beliefs and values
e.  Language barriers and communication styles
f.  Role of family
g.  Spousal relationships
h.  Parenting styles
10.  Spiritual assessment
a.  Nature of clients spiritual beliefs
b.  Nature of clients spiritual support
c.  How beliefs impact health care
d.  State of well-being or distress
11.  Nutritional assessment
a.  Appearance
b.  Daily intake
c.  Appetite
d.  Difficulty eating, chewing, swallowing
e.  Dental
f.  Vitamin and mineral supplements / Rapid physical assessment
Documentation
Physical Assessment of a Child
Fluid & electrolyte balance
C.  Physical examination
1.  Techniques
a.  Measurement
b.  Inspection
c.  Auscultation
d.  Percussion
e.  Palpation
2.  General appearance
3.  Vital signs
a.  Respirations
b.  Pulse
(1)  Sites
(2)  Rate
(3)  Rhythm
c.  Temperature
d.  Blood pressure
4.  Skin
a.  Color
b.  Moisture
c.  Texture
d.  Turgor
e.  Edema
5.  Hair
a.  Color
b.  Distribution
c.  Texture
d.  Scalp
6.  Nails
a.  Color
b.  Shape
c.  Configuration
7.  Head and neck
a.  Shape
b.  Symmetry
c.  Thyroid gland
d.  Lymph nodes
e.  Tracheal position
f.  Masses
g.  Tenderness
h.  Carotid bruits
8.  Ear
a.  External ear
b.  Middle ear
c.  Inner ear
d.  Auditory screening (voice whisper test)
e.  Color
f.  Size
g.  Placement
9.  Nose
a.  Shape
b.  Patency
c.  Sinuses
d.  Internal inspection
10.  Eyes
a.  Vision acuity
b.  Color vision
c.  Visual fields
d.  Lacrimal ducts
e.  Drainage
f.  Extraocular muscle function
g.  Pupil
11.  Mouth and throat
a.  Breath
b.  Lips
c.  Tongue
d.  Buccal Mucosa
e.  Gums
f.  Teeth
g.  Palate
12.  Breasts and regional nodes
a.  Color
b.  Shape
c.  Size and symmetry
d.  Contour
e.  Lesions and masses
f.  Discharge
g.  Supraclavicular nodes
h.  Infraclavicular nodes
i.  Axillary nodes
13.  Thorax and lungs
a.  Shape of thorax
b.  Symmetry of chest wall
c.  Presence of superficial veins
d.  Costal angle
e.  Angle of ribs
f.  Intercostal spaces
g.  Muscles of respiration
h.  Respirations
i.  Thoracic expansion
j.  Tactile fremitus
k.  Breath sounds
14.  Heart and peripheral vasculature
a.  Precordium
(1)  PMI
(2)  Lifts, thrills
(3)  Jugular venous distention
(4)  Heart sounds
b.  Peripheral vasculature
(1)  Capillary refill time
(2)  Arterial pulses
(3)  Homans sign
15.  Abdomen
a.  Contour
b.  Symmetry
c.  Pigmentation and color
d.  Scars
e.  Striae
f.  Respiratory movement
g.  Masses and nodules
h.  Pulsation
i.  Vascular sounds
j.  Liver
k.  Spleen
l.  Stomach
m.  Abdomen guarding
(1)  Tenderness
(2)  Pain
(3)  Rebound tenderness
n.  Inguinal lymph nodes
o.  Bowel
(1)  Bowel movements
(2)  Constipation
(3)  Bowel sounds
p.  Urinary tract
(1)  Voiding
16.  Musculoskeletal
a.  Overall appearance
b.  Posture
c.  Gait
d.  Mobility
e.  Joint contour
f.  Range of motion
g.  Muscle strength
h.  Assistive devices
17.  Genitalia
a.  Female
(1)  Pubic hair distribution
(2)  Skin color/condition
(3)  External structures
(4)  Vaginal introitus
(5)  Urethral meatus
(6)  Discharge
(7)  CVA tenderness
b.  Male
(1)  Pubic hair distribution
(2)  Penis
(3)  Scrotum
(4)  Perineum
(5)  Urethral meatus
(6)  Discharge
(7)  CVA tenderness
18.  Rectal
a.  Fissures
b.  Hemorrhoids
c.  Sphincter tone
19.  Neurological/mental status
a.  Facial expression, affect
b.  Level of consciousness (LOC)
c.  Sensory assessment
d.  Motion & position sense
e.  Romberg
f.  Involuntary movements, tremors
g.  Cranial nerves
h.  Reflexes
D.  Radiological and laboratory information
E.  Problem formulation
3.  Review the nurse’s role in reporting and documenting pertinent client information. / III. Reporting/Documenting Client Care
A.  Reporting
1.  Principles of effective reporting
a.  SBAR
B.  Documenting
1.  Principles of documentation
2.  Methods of charting
3.  Legal and practice standards

N: Syllabus/Transition/Transition Unit II Part A Revised 03/13