NRSR 0024. Advanced Medical Surgical and Maternal-Newborn Nursing

Units: 11
Prerequisite: Completion of NRSR 23 with grade of "C" or better
Hours: 396 (99 lecture, 297 laboratory)
Theory and correlated clinical practice related to the application of the nursing process based on Roy's Adaptation Model for multiple adult and geriatric clients with complex health problems experiencing acute illness. Students learn to promote adaptation for the maternal-newborn clients experiencing illness/stressors. Students further develop skills and apply theory introduced in previous semesters 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)

NRSR 0024 - Advanced Medical Surgical and Maternal-Newborn Nursing

http://catalog.sierracollege.edu/course-outlines/nrsr-0024/

Catalog Description Prerequisite: Completion of NRSR 23 with grade of "C" or better Hours: 396 (99 lecture, 297 laboratory) Description: Theory and correlated clinical practice related to the application of the nursing process based on Roy's Adaptation Model for multiple adult and geriatric clients with complex health problems experiencing acute illness. Students learn to promote adaptation for the maternal-newborn clients experiencing illness/stressors. Students further develop skills and apply theory introduced in previous semesters 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: Utilize the nursing process based on Roy’s Adaptation model to provide prioritization of direct and indirect care to multiple adult clients with complex health problems and life threatening illnesses and/or maternal/newborn clients with common and/or remedial health problems/stressors. CSLO #2: Utilize therapeutic communication (writing/verbal) skills to interact effectively with clients having complex and life-threatening illnesses, their families, and maternal/infant clients and families with common and/or remedial health problems/stressor; also utilize direct communication with nursing staff. CSLO #3: Identify the learning needs of clients with complex illnesses/stressors and of their families; and use the principles of teaching to plan, implement and evaluate goal-directed teaching plans. CSLO #4: Describe how to advocate for clients and collaborate with members of the health care team while coordinating and managing care for multiple clients with complex and life-threatening illnesses and maternal/infant clients with common and/or remedial health problems/stressors, in an acute care setting. CSLO #5: Explain legal and ethical practices related to the rights and protection of clients with complex and life threatening illnesses and maternal/newborn clients and accept responsibility and accountability for the care required in performing all nursing care (and medication administration). Effective Term Fall 2020 Course Type Credit - Degree-applicable Contact Hours 396 Outside of Class Hours 198 Total Student Learning Hours 594 Course Objectives Lecture Objectives: 1. Advocate for clients and collaborate with members of the health care team while coordinating and managing care for multiple clients (4-5) with complex and life-threatening illnesses in the acute care and maternal/infant settings. 2. Apply the nursing process to multiple clients (4-5) with complex health problems and maternal/newborn clients with remedial health problems/stressors. 3. Analyze the learning needs of adults with complex health problems and maternal/infant clients with remedial health problems and stressors to develop a teaching plan using principles of teaching, planning, implementing and evaluation. 4. Demonstrate effective legal and ethical principles related to adult and maternal/newborn care. Skills Laboratory, Clinical Laboratory Objectives: 1. Utilize the nursing process to provide direct and indirect prioritization of care to multiple (4-5) adult and maternal/infant clients. 2. Employ therapeutic communication (writing/verbal) skills to interact effectively with multiple (4-5) adult and maternal/infant clients and their families in the clinical setting. 3. Manage all aspect of intravenous therapy to include intravenous push medications. 4. Perform critical care calculations of titrated medications. General Education Information Approved College Associate Degree GE Applicability AA/AS - Multicultural Studies 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 Classroom Discussions Example: Through classroom discussions, students will describe the etiology, pathophysiology, clinical manifestations, treatment, and collaborative management for hepatitis, cirrhosis, and associated complications. 1. Discuss the standard of care for a G1P0 female with gestational diabetes. State the dietary considerations, exercise requirements and frequency of blood glucose monitoring. Students will be evaluated based on their knowledge and involvement within the discussion. Objective Examinations Example: Students will be given an objective examination. Standard grading will be used. Example Questions: 1. A patient has a normal cardiac rhythm strip, except that the PR interval is 0.34 seconds. The appropriate intervention by the nurse is to a. notify the physician. b. administer atropine per protocol. c. prepare the patient for temporary pacemaker insertion. d. document the finding and continue to monitor the patient. 2. A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. The nurse's initial response would be to: a. prepare the woman for imminent birth b. notify the woman's primary health care provider c. document the characteristics of the fluid d. assess the fetal heart rate and pattern. Projects Example: 1. All students are required to investigate the latest evidence-based care on a subject of their choosing and write a 2 page paper defending the rationales for that plan of care. Grading will be based on a rubric. 2. All students will submit a cover letter and resume that will be used for job searches post-graduation. Graded for completion. 3. Weekly care plans are required when the students are in the acute care hospital. The care plan demonstrates the student's ability to use the nursing process to problem solve and plan care of actual clients. Skill Demonstrations Example: Students will demonstrate competency in performing basic and advanced skills before caring for clients in the acute care hospital. Grading will be based on industry standards. Example skills: 1. IV Push medication administration; skill checked off during first skills lab day. 2. Fetal heart tone assessment; skill checked off during the OB skills lab day. Repeatable No Methods of Instruction Laboratory Lecture/Discussion Distance Learning Lab: Instructor will present case studies on arterial blood gas interpretation and then lead the students in an interactive discussion. Students use the Human Patient Simulator to apply concepts of the birthing process. Instructor provides "hands on" guidance with simulated birthing process. Lecture: Instructor will lecture on the topic of normal childbirth and then lead the students in a discussion. 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 Students will follow weekly content from assigned reading in required and recommended textbooks and professional journals. Examples: 1. From the text, read chapter on shock and hemodynamic monitoring and be prepared to discuss in class. 2. From the text, read chapter on Intrapartum Assessment and Interventions and create a list of questions to discuss in class. Writing, Problem Solving or Performance 1. Case studies are assigned as individual or group work to help the student learn complex concepts, nursing interventions and to foster critical thinking. Part of lecture/online time is used for discussion of case studies. 2. Weekly nursing care plans are required when the student is caring for multi-patients with complex health problems and maternal/infant clients in the clinical setting, demonstrating the students ability to critically think through situations, problem solve and plan care for clients in the clinical setting. Other (Term projects, research papers, portfolios, etc.) Students are required to complete an obstetric teaching plan on a postpartum patient. Students are required to complete one comprehensive nursing care plan in each area of advanced medical-surgical and maternal newborn. The care plan includes a cultural assessment of a client in the clinical area. Required Materials Medical-Surgical Nursing: A Clinical Approach Author: Lewis, Bucher, Heitkemper & Harding Publisher: Elsevier Publication Date: 2017 Text Edition: 10th Classic Textbook?: OER Link: OER: Maternal Child Nursing Care Author: Perry,S.,Hockenberry, M., Lowdermilk, D., Wilson,D.,Alden, K., Cashion, M.C. 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. Books required and suggested for previous semesters NRSR 21, NRSR 22, NRSR 23. Optional reference books as determined by faculty.

Nursing, Registered

http://catalog.sierracollege.edu/departments/nursing-registered/

Students completing the Registered Nursing Program earn an AS or AA degree in Registered Nursing. In order to receive complete and accurate information concerning the nursing programs, students are urged to first read the information on the Sierra College website carefully and then seek further information or clarification from the nursing department or counseling staff as necessary.