Wallawallacommunity College

WallaWallaCommunity College

Nursing Education

Beginning Nursing Concepts II

NURS 102

Spring Quarter 2010

To request accommodations related to a disability, contact Claudia Angus, Ph.D., Coordinator of Disability Support Services, at 527-4262 or email on the Walla Walla Campus. Clarkston students may contact Carol Bennett, at 758-1718 or email .

Every effort is made to ensure accuracy in the syllabus at the time of printing. However, the Walla WallaCommunity College Nursing Education Program reserves the right to change any provision or requirement that is necessitated by circumstances arising during the course. All changes will be provided in writing.

COURSE OUTLINE

Course Identifier:NURS 102

Title: Beginning Nursing Concepts II

Credits: 6

Class Hrs Per Wk:6

Catalog Description: A continuation of NURS 101. The focus is on providing care to clients of all ages experiencing normal life processes or common/chronic disease processes in selected body systems.

Prerequisites: NURS 101 and 111

Corequisites:NURS 112 and 197

Teaching Format:

Lecture/Discussion

Critical Thinking Activities

Small Group Activities

Audio-visual

Computer-based Learning Activities

Location:Walla Walla CampusRoom 1706

Clarkston CampusRoom 2107

Course Topics:Normal Maternal-Newborn

Cardiac I

Peripheral Vascular

Gastrointestinal

Special Senses

Women's Health

Evaluation Devices:Activities

Unit Tests

Comprehensive Final

ATI Tests

COURSE COMPETENCIES:

Critical Thinking

Demonstrate critical thinking in the use of the nursing process.
Demonstrate use of management/leadership principles in the delivery of client/patient care.

Caring

Perform interventions in a safe and effective manner.
Use therapeutic communication.

Professional Behaviors

Demonstrate professional behaviors.

FACULTY CONTACT LIST

NOTE: Students are encouraged to contact the faculty member responsible for the content area or clinical experience that they have a question about. Contact your faculty advisor for academic concerns and advising.

Walla Walla Campus:Nursing Office:509-527-4240

Clarkston Campus:Nursing Office:509-758-1702

Director of Nursing Education: Marilyn D. Galusha, RN, MSN

Walla Walla-based Instructors / Office Number / Email addresses
Kathy Adamski, RN, MN
(Level I Lead Instructor) / 527-4244 /
Cell: 200-0904
Brenda Anderson, RN, MSN / 527-4327 /
Cell: 240-4084
Grace Hiner, RN, MN / 527-4421 /
Clarkston-based Instructors
Carol McFadyen, RN, Ph.D.
(Clarkston Lead Instructor) / 758-1728 /
Todd Carpenter, RN, BSN / 758-1787 /

Office Hours for instructors may be found on the Level I Bulletin Board

BEGINNING NURSING CONCEPTS I

NURS 102

Grading Criteria & Distribution of Points:

CONTENT

POINTS

Normal Maternal-Newborn (4 classes) / 12
Women’s Health / 3
Special Senses (2 classes, Ear, Eye) / 6
Gastrointestinal (4 classes) / 12
Cardiac I (4 classes) / 12
Peripheral Vascular / 3
Sub-Total: Class Activities / 48
ATI PN Maternal-Newborn (60 questions) / 20
ATI PN Nutrition (60 questions) / 20
ATI PN Pharmacology (60 questions) / 20
4 unit tests (9 questions per 3-hour lecture period) / 144
Final Test (5 questions per 3-hour lecture period) / 80
Sub-Total: Tests Only / 284
Total Points available / 332

(All content will be taught via ITV. Faculty will travel part of the time weather permitting.)

**Students must attain 75% or greater cumulative score on tests to achieve a passing grade in NURS 102. Activity points will accumulate as achieved, however, they will not be added to the grade until the end of the quarter and will be added only if the test score is a minimum of 75%.

Course Expectations:

Follow all policies as outlined in Nursing Student Handbook
If absent from class, no points shall be awarded for any learning activities for that lecture.
All assignments must be accounted for before progression (regardless of score achieved).

Testing: Failure to take a test at the scheduled time will result in an automatic reduction of 5% of the available score from the earned score. (See p. 18 of the Nursing Student Handbook).

Grading Scale – See Nursing Student Handbook

Assessment Technologies Institute (ATI) Testing

Three (3) proctored computerized Content Mastery Examinations will be administered this quarter: PN Maternal-Newborn, PN Nutrition, PN Pharmacology

Prior to taking a Content Mastery Examination, each student must complete a non-proctored, online practice test and achieve a score of 90%. This non-proctored, online practice test can be taken more than once, however, a 90% must be achieved. The student will not be allowed to take the proctored exam if the online practice exam is not completed by the due date. Test ID and Password codes will be provided.

The student’s score on the non-proctored, online practice test will be verified on the ATI website by the designated instructor on the due date.

An ATI “Proficiency Level II” cut score must be achieved. This is considered minimum competency.

Failure to achieve a “Proficiency Level II” on the first proctored exam shall require remediation prior to retesting. A student has a maximum of five attempts on a Content Mastery Exam to reach the minimum proficiency Level 2 cut score. The first retake of a Content Mastery Exam is free of charge. Subsequent retakes will result in a cost to the student.

Failure to achieve a “Proficiency Level II” prior to the end of Springquarter will result in an Incomplete “I” grade contract.

Failure to clear the “I” grade contract by the end of the first two weeks of the next quarter will result in the conversion of the “I” grade to a C- and the student will not be allowed to progress.

The points available on the ATI Content Mastery Testswill be included in the “Tests Only” points for NURS 102 and will be allocated on a curved scale basis. Points will be prorated with the highest percentage score earning 100% of the available points. The score earned on the first attempt of a Content Mastery Exam will be the score on which a student’s earned points are calculated.

NURS 102 Syllabus

Spring2010

Final, 3.22.10

Women’s Health
Topic / Objectives / Assignments/Comments
Review of A&P
Contraception
Infertility
Diagnostic Testing
Health Promotion
GYN Surgery
Endometriosis
Sexually Transmitted Disease
Warning signs of cancer
Breast Self Examination
Diagnostic Procedures
Benign Breast Disorders
NCP for breast malignancy / 1.Review the anatomy and physiology of the female reproductive tract, including the physiology of menstruation
2.Describe the teaching needed for correct use of contraceptive Methods

Mechanical Barrier methods
Hormonal Contraceptives
Vaginal Spermicides

3.Define infertility and describe the nurse’s role in working with infertile couples
4.Discuss the nursing care of the women undergoing diagnostic testing for reproductive disorders

Pelvic exam/ Pap smear
Schiller’s Test
Colposcopy
Cervical/Endometrial Biopsy
Cervical Conization
Ultrasound

5.Describe health promotion activities for the women experiencing menopause

Gerontological Considerations

6.Use the nursing process to provide care to a client undergoing GYN surgery

Laporoscopy
Dilatation & Curettage (D&C)
Hysterectomy, Vaginal, Abdominal
Anterior & Posterior Repair (A&P Repair)

7.Compare and contrast the signs and symptoms, medical management and nursing care of the client with Endometriosis vs. Pelvic Inflammatory Disease (PID)
8.Identify the cause, treatment and prevention of the following sexually transmitted diseases (STD)

Syphilis
Gonorrhea
Herpes
Chlamydia
Human Papilloma Virus
Trichimonas
Candidiasis
HIV/AIDS

9.Identify warning signs of cervical, ovarian, endometrial cancer
10.Describe the method for teaching breast self examination (BSE) to a client
11.Describe the nursing care of clients undergoing diagnostic procedures of the breast

Mammography
Ultrasonography
Breast Biopsy

12. Describe the nursing care of clients with benign breast disorders
13. Use the nursing process to develop a nursing care plan for a client with a malignant lesion in the breast / Lewis, et al. (7th ed.)
Ch. 51, pp. 1325-1342 (Esp figs 51-3, 51-4, 51-5)
Leifer, (5th ed.)
Ch. 11, pp. 260-266
Leifer, (5th ed.)
Ch. 11, pp. 268-272
Lewis, et al. (7th ed.)
Ch. 54, pp. 1382-1383
Lewis, et al. (7th ed.)
Ch. 51,pp. 1338-1341, Table 51-12
Lewis, et al. (7th ed.)
Ch. 51, pp. 1330-1331
Ch. 51, p. 1340, Table 51-12
Lewis, et al. (7th ed.)
Ch. 54, pp. 1404-1409
Lewis, et al. (7th ed.)
Ch. 54, pp. 1395-1398
Lewis, et al. (7th ed.)
Ch. 11, pp. 254-258
Lewis, et al. (7th ed.)
Ch. 54, pp. 1400-1404
Lewis, et al. (7th ed.)
Ch. 11 pp. 250-251and Skill 11-1
Lewis, et al. (7th ed.)
Ch. 52, pp. 1344-1348
Lewis, et al. (7th ed.)
Ch. 52, pp. 1356-1360
Normal Maternal-Newborn (Class #1)
Topic / Objectives / Assignments/Comments
Introduction
Antepartum
EDD
Signs of Pregnancy
Assessment
Fetal
Development
Nutritional Needs /

Identify the goals of maternal newborn care and the roles of the providers of care

Calculate estimated date of delivery (EDD) using:

Nagele’s Rule
McDonald’s Rule

3. Differentiate between presumptive, probable, and positive signs of pregnancy
4. Relate the physiologic and psychosocial changes during pregnancy to variations in assessment of the pregnant client

Reproductive system
Breasts
Systemic changes
Management of common discomforts of pregnancy

5. Describe the development of the fetus during each month of pregnancy and factors that effect fetal development

Organogenesis
Critical Period
Teratogens

6. Identify the assessment measures completed during prenatal care

Health assessment
Laboratory and diagnostic testing
Physical examination
Risk assessment

7. Describe the nutritional needs of the pregnant mother and assessment measures indicating adequate nutrition

Weight gain pattern and Assessment of nutrient intake

/ Leifer (5th ed.)
Ch. 1, pp. 6-7
Ch. 4, pp. 44 – 77
Leifer (5th ed.)
Box 4-3, p. 48
Leifer (5th ed.)
Table 4-6, pp. 73 - 76
Leifer (5th ed.)
Ch. 3, pp. 31 – 40
Leifer (5th ed.)
Table 4-2, p. 53
NORMAL Maternal-Newborn (Class #2)
Topic / Objectives / Assignments/Comments
Postpartum
Physiologic
needs
Assessment/
Documentation
Nursing care
plan
Medications /

Describe the physiologic changes that occur during the postpartum period

Involution
Lochia
Perineum/episiotomy
Systemic changes
Changes in vital signs
Breasts/lactation

Complete an assessment of a postpartum client and document assessment findings using correct terminology

Health History
Laboratory data
Physical assessment
Psychosocial assessment

Develop a nursing care plan to meet the needs of the postpartum client

Pain
Risk for Infection
Sleep Pattern Disturbance
Alteration in Nutrition
Alteration in Elimination
Altered Tissue Perfusion (peripheral), Risk for
Altered Sexuality Patterns, Risk for
Altered Parenting, Risk for

Identify the actions, therapeutic effect, and nursing implications for medications given in the postpartum period

Oxytoxics
Pain medications
Stool softeners/Laxatives
Rubella vaccine
RhoGam

/ Leifer (5th ed.)
Ch. 9, pp. 148, 199-214
Leifer (5th ed.)
Box 9 – 1, p. 201
Box 9 – 2, p. 211
Leifer (5th ed.)
Nursing Care Plan 9 -1, pp. 209 - 212
NORMAL Maternal-Newborn (Class #3)
Topic / Objectives / Assignments/Comments
Newborn
Physiologic function
Assessment/ Documentation
Medications
Teaching Plan / 1Relate the changes in physiologic function that occur at birth to assessment and care of the newborn

Respiratory system
Circulatory system
Thermoregulation
GI system
Renal function
Hepatic function
Immunologic function
Neurologic function

2Complete an assessment of the newborn and document findings using correct terminology

Physical Assessment
Gestational Age assessment
Behavioral Assessment

3.Identify the actions, therapeutic effects, and nursing implications of medications given to the newborn

Vitamin K
Erythromycin ointment

4.Develop a teaching plan to meet the needs of parents of a newborn

Daily care
Sleeping
Crying
Circumcision care
Continued Health Maintenance
Car safety
Meeting the nutritional needs of the newborn

Breast feeding
Bottle feeding / Leifer (5th ed.)
Ch. 9, pp. 215–234
Ch. 12, pp. 279–303
Leifer (5th ed.) p. 151
Normal Maternal-Newborn (Class #4)
Topic / Objectives / Assignments/Comments
Preparation for Childbirth
Intrapartum Care
Signs of Labor
Labor Progress
Maternal / Fetal Response
Danger Signs / 1.Identify the components of childbirth education classes

Expectations during labor & delivery
Managing discomfort during labor

Conscious relaxation
Controlled breathing
Cutaneous stimulation
Focusing

Medications

2.Identify the signs of labor

Preliminary
True vs.: False Labor

3.Discuss the effect on labor progress for the following components of labor:

Passage
Passenger
Powers
Psyche

4.Describe the maternal and fetal response during each stage of labor

First Stage

Latent Phase
Active Phase
Transition

Second Stage
Third Stage
Fourth Stage

5.Describe nursing interventions related to pain control measures during labor

Epidural

6.Identify the fetal and maternal danger signs during labor and delivery / Leifer (5th ed.)
Ch. 7, pp. 154-156
Leifer (5th ed.)
Ch. 6, pp. 115-148
Leifer (5th ed.)
Table 6 – 3, p. 140-141
Peripheral Vascular
Topic / Objectives / Assignments/Comments
Review of A & P
Assessment
Pathophysiology
Diagnostic Testing
Medications
Arterial vs.: venous disease
Health Maintenance /

Apply knowledge of the anatomy and physiology of the Peripheral Vascular System in providing care to clients with disorders of this system.

Arteries, capillaries, and veins
Factors affecting blood flow

Diameter of the vessel
Elastic recoil
Viscosity of blood
Age related considerations

Describe variations in assessment data for the client with disorders of the Peripheral Vascular System, and Arterial Disorders

Clinical manifestations of vascular dysfunction

Pain
Intermittent claudication
Rest pain
Venous insufficiency
Ischemic neuropathy
Ulceration or gangrene
Changes in skin color, temperature, and integrity
Bruits
Abdominal pulsations

History
Risk factors
Physical examination

Review the pathophysiology and factors related to arteriosclerosis and atherosclerosis

Describe the nursing care of clients undergoing diagnostic testing and relate findings to the care of clients with peripheral vascular disorders.

Common arterial diagnostic studies
Common venous diagnostic studies

Identify the actions, therapeutic effects and nursing implications of medications used to treat peripheral vascular diseases.

Hypolipedemics
Anticoagulants
Vasodilators
Antiplatelet aggregation agents

Differentiate pathophysiology, assessment and medical management of arterial vascular disease from venous vascular disease. Include:

Aneurysms
Buerger's Disease
Raynaud's Phenomenon
Venous Thrombosis
Varicose Veins

Describe the goals of medical management of peripheral arterial and venous vascular disease and health maintenance activities to meet the goals.

Diet
Lifestyle
Medications
Safety
Prevention of complications

Develop a teaching plan for a client with peripheral vascular disease

Readiness model for Smoking Cessation
Nursing Diagnosis of patients with Peripheral Arterial Disease of the Lower Extremities

/ Lewis, et al. (7th ed.)
Ch. 38, pp. 892-924
Silvestri (3rd ed.)
(Saunders NCLEX-PN)
pp. 711-728.
Lewis et al (7th ed.)
Ch. 38
Review anatomy and physiology of peripheral vascular system.
Lewis et al (7th ed.)
Ch. 38
Silvestri (3rd ed.)
(Saunders NCLEX-PN)
pp. 729-747

Doenges et al (11ed.)

(Nurse’s Pocket Guide)

Nursing Diagnosis:

“ Ineffective Tissue Perfusion, Peripheral”
Information located throughout chapters assigned

Doenges et al (11ed.)

(Nurse’s Pocket Guide)

Nursing Diagnosis:

“ Knowledge Deficit”,
Nursing Diagnosis:
“Ineffective Health Maintenance”
Cardiac I Class # 1
Topic / Objective / Assignments/Comments
Function of the Heart
Assessment
Laboratory/ Diagnostic Studies
Medication
Nursing Diagnoses /

Apply knowledge of the anatomy & physiology of the cardiac system to care of the client with cardiac disorders

Blood flow

Regulation of impulses

Normal sinus rhythm
Age related changes

Identify significance of variations from normal assessment findings for both the adult and child with cardiac disease

S1 and S2
S3 and S4
Murmurs

Describe nursing interventions to prepare a client for and/or in response to findings from common laboratory and diagnostic studies:

EKG/ Holter Monitoring
Echocardiogram
Cardiac catheterization

Identify the actions, side effects, and nursing implications for the following classes of medications:

Beta-Adrenergic Receptor Blockers (Beta Blockers)

atenolol (Tenormin)
propranolol (Inderal)

Calcium Channel Blockers

diltiazem (Cardizem)
verapamil (Calan)

digoxin (Lanoxin)
Anticoagulants

heparin & lovenox
warfarin (Coumadin)
5. Identify the most common nursing diagnoses utilized in patients with
cardiac disorders / Lewis Med-Surg Text, Chapter 32 (p. 739-760)
Bring the following books with you to class:

Davis’s Drug Guide
Nurse’s Pocket Guide: Diagnoses, prioritized interventions, & rationales

Utilize your NCLEX-PN review book to review all the cardiovascular medications that we will be covering in the 4 cardiac lectures.
Chapter 51 begins on page 729, and the practice questions begin on page 739.
Davis’s Drug Guide is also a good resource.
Cardiac I Class # 2
Topic / Objective / Assignments/Comments
Coronary Artery Disease (CAD)
Health promotion
Teaching
Medications
Nursing Process / 1. Describe the pathophysiology and clinical manifestations of coronary artery disease and lipoprotein disorders
2. Discuss health promotion measures for the client at risk for coronary artery disease:
3. Develop a teaching plan for a client with coronary artery disease or lipoprotein disorder(s)
4. Differentiate between angina pectoris and myocardial infarction.
5. Describe the nursing management of the patient following a myocardial infarction. Include psychosocial needs of the client.
6. Identify the actions, side effects, and nursing implications for the following medications:

Platelet Aggregation Inhibitors

aspirin
plavix

Lipid Lowering Agents

atorvastatin (Lipitor)
lovastatin (Mevacor)
simvastatin (Zocor)

Nitrates--Nitroglycerin
Angiotensin-Converting Enzyme Inhibitors

captopril (Capoten)
enalapril (Vasotec)

Morphine
Fibrinolytics

Activase
Retavase
7. Develop a nursing care plan for a client with coronary artery disease / Lewis Med-Surg Text, Chapter 34 (p. 784-819)
Assignment:
RISKO Paper: Due at beginning of cardiac class # 2, before start of lecture.
See attached handout for the RISKO Paper criteria and for the RISKO form.

Pre-Class Assignment For Cardiac Lecture # 3: RISKO Paper

(Total Points Possible = 3 points)

Complete an American Heart Association “RISKO” form using your own data as much as possible. The RISKO form is attached.

If you do not know your cholesterol and HDL numbers and are unable to have it done, your instructor will provide you with some numbers.
For this paper, you will be your own “client”.

2.(Lifestyle) Describe your “clients” current lifestyle with regard to:

Stressors
Typical daily diet
Typical exercise (or lack of it) program

(RISKO Interpretation) Interpret the RISKO profile, using the guidelines of “What Your Score Means” for your

“client.”

(Recommendations) Develop a lifestyle plan for your “client”. Include specific recommendations you would make for this “client” with regard to identified risk factors. Include areas of:

Stress Management
Diet
Exercise

**On your paper, please use the following headings:

Lifestyle
RISKO Interpretation
Recommendations/ Lifestyle Plan

**Grading will be based on how well the above three aspects are discussed. Length of paper is 2-4 pages, single spaced. Hint: If paper is less than 2 pages, it probably does not reflect good critical thinking. If paper is more than 4 pages, it