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Course Number:  NUR 142

Course Title: Care of Acutely Ill Patients and Developing Families I
Credit Hours: 12
Lecture Hours: 60
Lecture/Lab Hours: 0
Lab Hours: 180
Special Fee: none

Course Description

Focuses on the care of individual patients with health problems related to the respiratory, cardiovascular, fluid & electrolytes, endocrine, musculoskeletal, and neurological systems. Incorporates the nursing role in providing care to patients across the lifespan. Includes the second skills laboratory section in the Nursing sequence.

Intended Outcomes for the Course

  1. Utilize critical thinking skills and understanding of nursing process to develop holistic, individualized plans of care for patients with pain, endocrine, respiratory, cardiovascular, musculoskeletal, integumentary disorders, and women’s health needs across the life span.
  2. Identify health-related community-based resources supporting individuals across the lifespan.
  3. Utilize therapeutic communication skills with individual patients and families, while providing health education and health promotion.
  4. Collaborate with members of the health care team during planning, implementation and evaluation of the plan of care for assigned patients.
  5. Distinguish personal ethics that might conflict with professional ethics as delineated by the American Nurses Association in the Code of Ethics for Nurses
  6. Evaluate and apply strategies and communication techniques that promote effective delegation.

Course Activities and Design

  1. Lecture
  2. Skills practice lab with patient scenario simulation
  3. Clinical
  4. Reflective journaling
  5. Assignments
  6. Community Based Project

Outcome Assessment Strategies

  1. Satisfactory completion of electronic patient care planning tool (75% or above complete in all categories)
  2. Multiple choice, short answer, and essay questions that require integration, application, and critical examination of material covered in class
  3. Weekly and final clinical performance evaluation
  4. Written assignments designed to stimulate critical thinking related to clinical experiences.
  5. Oral presentation resulting from group research, analysis, and critical evaluation.
  6. Written journals designed to promote integration of clinical outcomes with personal reflection and clinical experience.
  7. Skills practice lab formative and summative performance evaluation
  8. Completion of drug dose math exam at 90% or above.
  9. Completion of ATI comprehensive student assessment program (Skill modules; practice and proctored exams).

Course Content (Themes, Concepts, Issues and Skills)

  1. Alterations in Patterns of Health: Nursing care of patients having surgery.
  2. Pathophysiology and Patterns of Health:
    • Nursing care of patients in pain
    • Nursing: care of patients with altered fluid, electrolyte and acid-base balance
  3. Conceptual Foundations of Nursing:
    • Nursing research and evidenced- based care
    • Patient education and health promotion
  4. Psychosocial Nursing Tools: Communication and the clinical interview
  5. Foundations of Practice—Legal and ethical guidelines for safe practice
  6. Response to Altered Endocrine Function:
    • Nursing care of patients with Diabetes Mellitus-Part I
    • Nursing care of patients with Endocrine disorders: Thyroid and parathyroid disorders
  7. Response to Altered Respiratory Function:
    • Nursing care of patients with gas exchange disorders- Part I: The patient with chronic obstructive disease.
  8. Pulmonary Diseases
    • Nursing care of patients with ventilation disorders-Part I: Infectious pulmonary disease; Tuberculosis
  9. Response to Altered Cardiovascular Function:
    • Nursing care of patients with coronary disease
    • Nursing care of patients with vascular and lymphatic disorders: hypertension and peripheral vascular disease
  10. Response to Altered Musculoskeletal Function:
    • Nursing care of patients with musculoskeletal trauma: Fractures and surgical stabilization;
    • Nursing care of patients with musculoskeletal disorders: Arthritis & joint replacement
  11. Response to Altered Integumentary Structure and Function:
    • Nursing care of patients with integumentary disorders
  12. Pregnancy:
    • Fetal development and genetics
    • Maternal adaptation and nursing management during pregnancy
  13. Childbearing at Risk:
    • Nursing management of pregnancy at risk; pregnancy related complications
    • Understanding the application of nursing process in developing individualized plans for patient care.
    • Foundation for practice; documentation and communication in the health care team: patient medical record
  14. Introduction to Pharmacology and drug dose calculations.

Skills

  1. Enteral feedings via nasogastric, gastrostomy, and nasoduodenal tubes
  2. Sterile gowning, gloving and field preparation.
  3. Assessment of acute and chronic wounds and pressure ulcers
  4. Clean and sterile dressing changes
  5. Preparation and changing of intravenous bags and tubing
  6. Administration of primary and secondary intravenous infusions
  7. Conversion of peripheral intravenous infusions to intermittent device
  8. Saline flush via a peripheral intermittent venous access devices
  9. Urinary catheterization
  10. Electronic Health Record documentation

Computation

Hours: 40
Course Outcomes:

  • Provide basic nursing care for patients using facts and principles from physical, biological, social, and behavioral sciences.
  • Follow standard safety and infection control measures to perform nursing skills correctly in the skills practice laboratory.

Content:

  • Students are required to complete self-study modules with regard to drug dose calculations and medication administration. Modules build on the prior course content and have more complex problems. The goal is for increased accuracy on independent and proctored exams.
  • Required Self-Study: Dosage Calculation and Skill Modules through ATI (Advanced Technologies Institute): including: Safe Dosage, Medication Administration (three different modules); Injectable Medications, Powdered Medications and Parenteral Medications and related case studies. 25 item exam with each module plus a proctored exam per term.
  • Dosage calculation and safe medication administration modules include online tutorials that are designed to support students in learning the basics of safe medication administration. These modules improve comprehension and critical-thinking math skills in relation to safely calculating medication dosages. Students practice clinical reasoning and problem-solving skills while working through in-depth and real-life case scenarios (that are drug dose in nature) at their own pace. In the clinical, skills lab and simulation environments, under the direct supervision of a nursing instructor the student puts into direct practice those elements that have been presented in the independent study modules.

Communication

Hours: 55
Course Outcomes:

  • Utilize critical thinking skills and understanding of nursing process to develop holistic, individualized plans of care for patients with pain, endocrine, respiratory, cardiovascular, musculoskeletal, integumentary disorders, and women’s health needs across the life span.
  • Identify health-related community-based resources supporting individuals across the lifespan.
  • Utilize therapeutic communication skills with individual patients and families, while providing health education and health promotion.
  • Collaborate with members of the health care team during planning, implementation and evaluation of the plan of care for assigned patients.
  • Evaluate and apply strategies and communication techniques that promote effective delegation.

Content:

  • Nursing care of Patients in pain: Discuss factors affecting individual responses to pain. Discuss interdisciplinary care for the patient in pain, including medications, surgery, and complementary medicine.
  • Nursing Research and evidence-based care: Discuss the role of evidence-based research in nursing. Discuss the value of evidence-based practice to the nursing profession and patient care delivery. Compare and contrast qualitative and quantitative studies, as they would apply to nursing or healthcare research.
  • Patient education and health promotion: describe individualized teaching methods and evaluation strategies for patients of different ages and abilities. Describe important qualities of a teaching–learning relationship. Describe why teams are essential in healthcare settings. Describe teambuilding processes and how they strengthen a team. Describe individualized teaching methods and evaluation strategies for patients of different ages or abilities. Discuss important assessment data used to individualize patient teaching. Discuss therapeutic techniques when doing the clinical interview in establishing data to set up a patient teaching plan. Utilize therapeutic verbal and non-verbal communication skills when interacting with patients and families and members of the interdisciplinary team. Participate in verbal collaboration about patient care with other members of the nursing care team regarding progress towards desired outcomes. Initiate appropriate and timely collaboration about individualized patient care with other members of the interdisciplinary team.

Activities:

  • Activities include classroom discussion, focused on how to effectively communicate with members of the team, the patient and their family members; team building related activities; communicating with members of a team to accomplish tasks related to patient care; learning to communicate effectively in order to maintain a safe environment for all involved and reading for meaning by learning to read critically so as to interrupt patient data appropriately. In the clinical, skills lab and simulation environments under the direct supervision of a nursing instructor the student puts into direct practice those elements that have been presented in the theory classroom setting.
  • Community Based Group Project: To provide the student with the opportunity to explore community agencies that are involved in health promotion activities for the individual and family. Students are required to interview the staff of a non-profit agency of their choice. They are given some direction with regard to data they need to gather and outcomes they are to accomplish. The second part of the assignment requires a presentation to first and second year nursing students and faculty regarding the agency.

Human Relations

Hours: 45
Course Outcomes:

  • Collaborate with members of the health care team during planning, implementation and evaluation of the plan of care for assigned patients.
  • Evaluate and apply strategies and communication techniques that promote effective delegation

Content:

  • Team Building: Describe why teams are essential in healthcare settings. Describe teambuilding processes and how they strengthen a team. Identify characteristics of a positive team member. Demonstrate sound judgment and effective interpersonal relationships while managing patients with medical surgical problems and functioning as an effective team member. Demonstrate evolving ability to manage patient care through effective interpersonal relationship with staff, peers patients and instructors.
  • Patient education, health promotion and becoming an effective team member: Describe why team members are essential in healthcare settings. Describe the teambuilding process and how they strengthen a team. Identify characteristics of a positive team member. Demonstrate cooperation and teamwork by providing support and assistance to others when requested. Understands the roles of delegator and delegatee; receives delegation from staff RN and follows through appropriately.

Activities:

  • Activities include classroom discussion, in-class case studies related to content area; team building activities in order to assist the student in understanding the role of human relations in patient care. Independent study includes video clips related to content area along with reading assignments. In the clinical, skills lab and simulation environments under the direct supervision of a nursing instructor the student puts into direct practice those elements that have been presented in the theory classroom setting.