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NRSR 0022 - Medical Surgical I and Pediatric Nursing

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

Catalog Description 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) Course Student Learning Outcomes CSLO #1: 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. CSLO #2: During the care planning process, describe and consider sociocultural and economic influences on the care of adult and pediatric patients experiencing illness or procedure. CSLO #3: Explain how to communicate and confer appropriately with all patients and members of the healthcare team. CSLO #4: Demonstrate effective intershift communication and patient responsibility hand-off. CSLO #5: Identify the learning needs of clients with common or remedial illnesses/stressors and those of their families. CSLO #6: Apply basic teaching principles to convey information concerning daily health practices and treatment regimens. CSLO #7: Perform as a member of the nursing team while caring for adult and pediatric patients with stable or noncritical illnesses. CSLO #8: 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. CSLO #9: Administer intravenous fluids and intravenous medications with the exception of intravenous push medications. Effective Term Fall 2020 Course Type Credit - Degree-applicable Contact Hours 387 Outside of Class Hours 208 Total Student Learning Hours 595 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. General Education Information Approved College Associate Degree GE Applicability CSU GE Applicability (Recommended-requires CSU approval) Cal-GETC Applicability (Recommended - Requires External Approval) IGETC Applicability (Recommended-requires CSU/UC approval) Articulation Information CSU Transferable Methods of Evaluation Objective Examinations Example: Weekly nursing care plans are required when students are assigned to the clinical laboratory. Completed nursing care plan assignments demonstrate the student's ability to utilize the nursing process, think critically and plan care for actual adult and pediatric clients. Students are required to demonstrate a basic level of competency in performing required skills that were presented in skills lab before participating in the hospital clinical laboratory setting. Students must also pass a dosage calculation exam before administering intravenous medications in the clinical laboratory. Sample test question, Medical-Surgical Nursing: All these medications are ordered at 0900 for a patient who has had a right-hip replacement the previous day and is scheduled to ambulate with the physical therapist for the first time at 0945. Which medication should be given first? a. Ceftriaxone (Rocephin) 500 mg intravenously, a cephalosporin antibiotic b. Oxycodone (Roxicodone) 5 mg orally, an opioid c. Enoxaparin (Lovenox) 30 mg subcutaneous, an anticoagulant d. Colace 100 mg orally, a stool softener Problem Solving Examinations Example: Sample test question, Dosage Calculation: 2.5 L D5NS to infuse in 24 hours. Drop factor: 10 gtt/mL. What is the hourly rate? ______ mL/hr Calculate the gravity flow rate: ______ gtt/min Projects Example: The student will complete a "Clinical Expert assignment." The student will choose a group partner. The students will choose a topic to teach the class regarding medical equipment or a medical procedure. The students will research using OVID and develop an outline, presentation, and handout to present to the class. Skill Demonstrations Example: Sample test question, Pediatrics: Bert is a 16-year-old who is admitted to the adolescent unit after an emergency appendectomy. He is in pain, and he has a NG tube in place which is draining light green fluid. There are three other teenagers in the room staring at him. What is your priority nursing intervention for Bert? a. Introduce him to the other young men and encourage interaction. b. Screen him from the other teenagers and administer a dose of pain medication. c. Tell the other boys to leave him alone and go to bed. d. Explain to the other boys what Bert has been going through. Repeatable No Methods of Instruction Laboratory Lecture/Discussion Distance Learning Lab: The student will formally interview a patient about the patient's surgery to gain insight into the surgical experience; the instructor will provide an assignment that includes specific prompts to elicit the patient's perceptions. In addition, the instructor will arrange a surgical observational experience at the clinical facility that includes the surgical preparation area, the operating room and the recovery room. The instructor will provide a written assignment for students to record and log their perioperative observations. Grading based upon correct or incorrect answer to questions. Laboratory Human Patient Simulator: Instructor will demonstrate how to administer intravenous piggyback medication followed by the students properly performing the administering of intravenous piggyback medication under supervision. Lecture: The instructor will present an overview of musculoskeletal disorders through lecture and class discussion. The student will complete a case study containing questions which will prompt the students to explore and analyze the care of patients with total hip replacement, total knee replacement, sprains, and fractures. Instructor will guide the students to correct answers Distance Learning Faculty will enter a question in the discussion board pertaining to the content covered of the disease process. The student will answer the question and respond to two other student replies. Faculty will provide constructive feed back to the initial student post. Typical Out of Class Assignments 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. Required Materials Brunner & Suddarth's textbook of Medical-Surgical Nursing Author: Hinkle & Cheever Publisher: Wolters Kluwer Publication Date: 2018 Text Edition: 14th Classic Textbook?: OER Link: OER: Fundamentals of Nursing: the art and science of person-centered nursing care Author: Taylor, Lynn, Bartlett Publisher: Wolters Kluwer Publication Date: 2019 Text Edition: 9th Classic Textbook?: OER Link: OER: Lehne's pharmacology for Nursing Care Author: Burchum, Rosenthal, Jones Publisher: Elsevier/Saunders Publication Date: 2018 Text Edition: 10th Classic Textbook?: OER Link: OER: Mosby's manual of diagnostic and laboratory tests Author: Pagana & Pagana Publisher: Mosby/Elsevier Publication Date: 2018 Text Edition: 6th Classic Textbook?: OER Link: OER: Maternal Child Nursing Care Author: Perry, Hockenberry, Lowdermilk, et al. Publisher: Elsevier Publication Date: 2017 Text Edition: 6th Classic Textbook?: OER Link: OER: 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.