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NRSR 0022 - Medical Surgical I and Pediatric Nursing

http://catalog.sierracollege.edu/course-outlines/nrsr-0022/

Catalog Description DESCRIPTION IS HERE: Prerequisite: Completion or equivalent of NRSR 21 with grade of "C" or better as determined by Dean/department chair Hours: 387 (104 lecture, 283 laboratory) Description: Theory and correlated clinical practice related to utilizing the nursing process based on Roy's Adaptation Model to promote adaptation by adult and pediatric clients and their families experiencing common and/or remedial illnesses/stressors. Students further develop skills and apply theory introduced in NRSR 21 in varied and more complex settings, and gain additional theory and skills related to new clinical areas and levels of responsibility. (letter grade only) (CSU) Units 11 Lecture-Discussion 104 Laboratory 283 By Arrangement Contact Hours 387 Outside of Class Hours Course Student Learning Outcomes Explain and utilize the nursing process based on Roy's Adaptation Model to provide direct total patient care to stable and noncritical adult and/or pediatric patients with common and/or remedial health problems/stressors. During the care planning process, describe and consider sociocultural and economic influences on the care of adult and pediatric patients experiencing illness or procedure. Explain how to communicate and confer appropriately with all patients and members of the healthcare team. Demonstrate effective intershift communication and patient responsibility hand-off. Identify the learning needs of clients with common or remedial illnesses/stressors and those of their families. Apply basic teaching principles to convey information concerning daily health practices and treatment regimens. Perform as a member of the nursing team while caring for adult and pediatric patients with stable or noncritical illnesses. Outline how to manage total patient care and appropriate level of care planning for either two adults or two pediatric patients concurrently who are experiencing illness or procedure. Administer intravenous fluids and intravenous medications with the exception of intravenous push medications. Course Content Outline 1. Review of Roy's Adaptation Model, utilization of the nursing process, concept maps and care planning for the adult patient 2. Fluid and Electrolytes, intravenous therapy, electrolyte imbalances, assessment and intervention 3. Care of the Pediatric Client: Pediatric health promotion, growth and development in children, child's reaction to hospitalization, nursing process, legal, ethical, and cultural influences specific to the pediatric patient, pediatric variation in assessment, pain management, medication administration, intravenous fluids 4. Antibiotic therapy 5. Leadership: Review of nursing care delivery models, assigning, delegating and supervising client care 6. Review of California Nurse Practice Act, scope of practice, critical thinking in nursing and problem solving. 7. Care of the Surgical Patient: Pre-operative/pre-procedural assessment and preparation for surgery, care of the surgical patient, prophylactic antibiotic therapy management, post-operative complications (Infection/MRSA, fat emboli, compartment syndrome, DVT, and PE) 9.Diabetes mellitus types 1 and 2, insulin management, acute and chronic complications of diabetes, pediatric diabetes 9. Pediatric Metabolic Disorders: Growth hormone deficiency, precocious puberty, congenital hypothyroidism, PKU, diabetes 10.Care of the patient with gastrointestinal disorders: Obesity and bariatric surgery management, cholecystitis and cholelithiasis, bowel obstruction (adult and pediatric), pediatric anatomical disorders, infant colic, GERD, pediatric diarrhea, inflammatory bowel disease (colitis and Crohn's Disease), ostomies, diverticulitis, esophagitis, hernias, ulcers, appendicitis 11. Care of the client with musculoskeletal disorders: Surgical interventions, joint replacement, fractures, sprains, strains, and dislocations; pediatric congenital musculoskeletal disorders, juvenile rheumatoid arthritis 12. Care of the patient with respiratory disorders: Asthma, COPD, acute and chronic bronchitis, tracheostomy, pneumonia, tuberculosis, pediatric asthma, cystic fibrosis, bronchiolitis 13. Care of the adult patient with hypertension 14. Care of the child with congenital heart disorders 15. Chronic illness and/or disability in the pediatric client 16. Child abuse reporting, home care issues and challenges, end-of-life, mandatory reports of abuse and neglect 17. Care of the anemic adult and pediatric patient 89. Care of the child with neurosensory disorders: Seizure disorder, hydrocephalus, spina bifida, meningitis 19. Care of the child with genitourinary disorders: Obstruction, hypospadia, nephrotic syndrome, and enuresis 20. Care of the adult patient with dermatological disorders 21. Care of the pediatric with patient with skin and infectious disorders: Shigella, parasites, diaper dermatitis, impetigo 22. Care of the adult patient with peripheral arterial and venous disease Nursing skills learned and validated in this course: 1. Effective inter-shift communication 2. Dosage calculation of IV fluids and medications, intravenous fluid management, intravenous medication administration and pediatric intravenous management 3. Suture/staple removal 4. TPN, PPN, ostomy care, nasogastric tube insertion, management, and removal 5. Crutch walking and use of walkers, application and maintenance of orthopedic devices (traction, splints, ACE wraps, braces, casts, slings, abductor wedge, CPM) 6. Inhaled medications, tracheostomy care, tracheostomy suctioning, oropharengeal and naso-tracheal suctioning 7. Transfusion and administration of blood products 8. Pediatric: Assessment, medication administration, dosage calculation, intravenous management, and urinary catheterization Course Objectives Course Objectives Lecture Objectives: 1. Explain and utilize the nursing process based on Roy's Adaptation Model to plan direct total care to stable and noncritical adult and/or pediatric clients with common and/or remedial health problems/stressors; describe and consider sociocultural and economic influences on the care of adult and pediatric clients experiencing common illnesses or procedures. 2. Identify how to confer appropriately with all members of the health care team and formulate effective intershift communication and patient responsibility hand-off. 3. Identify the learning needs of patients with specific illnesses presented in the course. 4. Outline concepts of interdisciplinary team interactions necessary when caring for adult and pediatric clients with stable or noncritical illnesses; discuss basic legal and ethical practices for caring for adults and children with remedial illnesses, diagnostic or therapeutic procedures. 5. Describe the process for safe administration of intravenous fluids and intravenous medications, with the exception of intravenous push medications; 6. Describe concepts of prioritization and organizational skills needed to successfully manage total patient care and appropriate level of care planning for either two adults or two pediatric clients concurrently who are experiencing illness or procedures. 7. Formulate personal learning needs and goals. Clinical Laboratory Objectives: 1. Write comprehensive patient care plans using Roy's adaptation model to guide patient care interventions in the clinical setting; demonstrate cultural sensitivity in care planning and when participating in direct patient care for adult and pediatric patients. 2. Share and transfer patient information throughout and at the end of the shift using the S-B-A-R format. 3. Use basic teaching principles to educate patients and families experiencing common disorders presented in the course. 4. Apply the concepts of ethical and legal professional practice in the development of patient care plans and when participating in direct patient care; perform as a member of the nursing team when caring for adult and pediatric patients with stable or noncritical illnesses. 5. Safely administer secondary intravenous medications in compliance with nursing procedure and in alignment with the nursing program's Safe Medication Administration Policy 6. Demonstrate adequate organizational and time management skills to manage total patient care and care planning for either two adult or pediatric patients. 7. Initiate a personal development plan to achieve self-identified learning needs and goals. Methods of Evaluation Objective Examinations Problem Solving Examinations Projects Skill Demonstrations Reading Assignments Reading assignments are regularly assigned from several adult and pediatric textbooks, current professional journals, pediatric professional association websites, government websites and consumer/client-oriented websites. Case studies assigned for lectures are to be completed before class and are used for discussion in the classroom. 1. Read the medical-surgical text chapter covering anatomy, physiology and treatment of the gas exchange and respiratory function system, "Preventing Readmissions in Patients With COPD." Complete the assigned case study.Be prepared to discuss in class. 2. Read the material discussed in the case study, "The Infant with CHF." Be prepared to discuss in class. Writing, Problem Solving or Performance 1. Weekly journal writing reflecting clinical laboratory experiences allows the student to explore options for handling clinical experiences, bridge the gap between theoretical and clinical knowledge, allow for expression of feelings, develop critical thinking, improve written communication skills, increase self-confidence, and validate assumptions and ideas. Examples of typical writing prompts: Identify one example of good leadership, delegation or management skills; note an observation of critical thinking; analyze problems encountered during the clinical week. 2. The Personal & Professional Growth in Nursing paper is a first-year capstone written assignment using weekly journal entries to analyze progression midway through the nursing program. 3. Required weekly nursing care plans demonstrate the student's ability to use the nursing process to problem-solve and plan care for clients in the clinical setting. 4. Required weekly written patient hand-off reports demonstrate effective intershift communication and patient responsibility hand-off. 5. Clinical case studies facilitate the student's mastery of content and stimulation of critical thinking. Case studies are completed individually or in small groups and independently or as part of a lecture discussion. Examples of Arthroscopy Case Study Questions: What risk factors for hip fracture did the patient exhibit? Why is the patient receiving both enoxaparin (Lovenox) and warfarin (Coumadin)? What is the difference between arthroplasty and open reduction and internal fixation (ORIF)? List four critical, potential postoperative problems for the patient, and explain why each is important. Other (Term projects, research papers, portfolios, etc.) Students are required to complete the Clinical Expert assignment, an exploratory, capstone project of the first year of the nursing program. Student groups present an overview of a clinical skill or operation of equipment or technology, develop written or kinesthetic learning materials and function as resources for their peers. Students must identify potential resources available at their clinical facility or in the healthcare/technology sectors in order to complete the assignment. Methods of Instruction Laboratory Lecture/Discussion Distance Learning Other materials and-or supplies required of students that contribute to the cost of the course. All required textbooks and reference books for NRSR 21 apply to this course. Books for dosage calculations, nursing care plans, drug reference, lab test reference, and medical dictionary, are also required and published in the course syllabus. Students must also purchase Kaplan practice tests for independent practice and preparation for clinical skills and review of theoretical course content. Supplies for skills and clinical laboratory are also required.