NS1p1 Theory and Clinical Workbook FALL 13 07-12-13 - CLee

MOORPARK COLLEGE
HEALTH SCIENCES DEPARTMENT
BEGINNING NURSING SCIENCE

NS 1 part 1
Theory and Clinical
Workbook
FALL 2013
Christina Lee RN, MSN
Moorpark College Associate Degree Nursing

Organizing Framework
Manager of Care
Delegation
Collaboration
Management/Leadership
Collegiality
Continuity of Care
Technology
Member Within NursingDiscipline

Values: Caring, Integrity,
Ethical Practices, Diversity,
Education, Service, Quality
Ethical/Legal Considerations
Nursing Standards of Practice
Self-Evaluation
Professional Behavior
Community Based Nursing
Practice in Diverse Settings
Teaching/Life-Long Learning
Peer Review/Governance
Critical Competencies
Safety, Technical Skills

Nursing Process
Communication
Organization/Prioritization
Responsibility/Accountability
Proficient
Practitioner
Beginner
Student
Provider of Care
Critical Thinking
Nutrition
Relationship Centered
Client Advocacy
Caring
Confidentiality
Self-Care Concepts
Pharmacology
Bio-Psycho-Socio-Cultural-Spiritual-Client Needs Throughout Life Cycle

Family
Health
Preventive
Nursing Assessment
Community
Client
Nursing Measures
Empower Toward Self-Care
Increase Health, Adaptation, Death/Dying
Illness
Restorative
FALL 13
NS1P1 THEORY WORKBOOK
Table of Contents
Organizing Framework
Course Description, Outcomes, Objectives
Required Text and Media
Grading System, Advancement Policy
Volunteer Requirement
Student Resources
Students with Disabilities
Resolution of Students Problems
Instructor Contact
Absences, Smoking, Academic Integrity
ATI, Surveys
Course Calendar
Module 1: Foundations of Nursing
Module 2: Legal/Ethical Issues, Nursing Process
Module 3: Integumentary/Musculoskeletal
Module 4: Gastrointestinal System
Module 5: Genitourinary System
Module 6: Respiratory System
Module 7: Cardiovascular System
Module 8: Neurological System
Appendix A: Final Group Project Rubric
Powerpoint slides Module 1-8
NS1P1 CLINICAL WORKBOOK
Course Description, Objectives, Outcomes
Required Texts and Media
Grading Criteria
Unsafe Practice (UPA), Late Assignments, Absences
Math Homework
Week 1-2 information
Week 1-2 Clinical Skills Checklist
Module 1 Info and Required Reading
Module 1 Worksheets
Week 1 and Module 1 Grading Sheets, part 1 and 2
Module 2 Legal/Ethical: Info & Required Reading
Module 2 Worksheet
Week 2 and Module 2 Grading Sheets, part 1 and 2
Hospital Orientation Info
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2
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9-10
10-11
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27-30
30-32
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Hospital Orientation Grading Sheet

Module 3 Skin/Musculoskeletal: Info & Required Reading
Module 3 Worksheet
Module 3 Grading Sheet
Module 4 GI: Info and Required Reading
Module 4 Worksheets
Module 5 GU: Info and Required reading
Module 5 Worksheet
Module 6 Respiratory: Info and Required reading
Module 6 Worksheet
Module 7 Cardiovascular: Info & Required Reading
Module 7 Worksheet
Module 8 Neuro: Info and Required Reading
APPENDIX B
48
49-50
51
52
53
54-55
56
57
58
59
61-62
62
63
65-66
67
68
69
70
71
Plagiarism /Advance Directive Assignment

Reflective Journaling Assignment
Video Project & Grading Rubric
Erikson Psycho-Social Development Chart
Orems Self Care Theory
NS1 p1 Nursing Care Study: Guidelines
Nursing Care Study: Grading Rubric
Nursing Care Study: Client Assessment Form
Medical Record Request Form
Medication Proficiency Pre-test for NS1p2
Stress Management Tips
National Patient Safety Goals
Intake and Output Guide
Maslows Hierarchy of Needs
NS1 Head to Toe Physical Assessment check list
Suggested Clinical Organization Tools
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75
76-77
78
79
80-82
83-84
85-89
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97-98
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Nursing Science 1 Part 1

I. Number of Course: NS1 Part 1 NS: M01
II. Hours: 4 hours of lecture each Monday x 8 weeks
III. Catalog Description of Course:
Part 1: Provides the theoretical concepts of patient-centered, evidence-based fundamental
nursing care of adult and geriatric patients using the nursing process related to health
promotion and self-care deviations in common and emerging healthcare settings. Presents the
foundations of nursing practice and the nursing process, legal and ethical frameworks,
diversity, head-to-toe assessment and documentation addressing all body systems for the adult
and geriatric client, theoretical concepts of skills associated with activites of daily living,
maintenance of a safe environment, and growth and nutrition.
IV. Prerequisites: Admission to Nursing Program and completion of Nursing Program
prerequisites
Co-requisite: Nursing Science 1L Part 1.
Recommended concurrent enrollment: Nursing Science 11
V. Course Outcomes: Students who complete NS1 will acquire the knowledge and theoretical
concepts of the five critical competencies of safety/technical skills, nursing process,
communication, responsibility/accountability, and organization/prioritization skills. These
competencies are essential to the function of the registered nurse in the direct care of patients with
common, acute, and chronic disorders/conditions in the adult/geriatric population in common and
emerging healthcare settings. The focus is on foundations of nursing practice and the nursing
process, the legal framework for nursing practice, cultural and spiritual diversity, comprehensive
head-to-toe physical assessment and documentation addressing all body systems for the adult and
geriatric client, theoretical concepts of skills associated with activities of daily living, maintenance
of a safe environment, growth and nutrition, concepts of care pertaining to medication
administration, the perioperative period, comfort, pain, diabetes mellitus, and care of patients with
basic health-deviations of the cardiovascular system and health-deviations of the musculoskeletal
system.
VI. Course Objectives: Upon successful completion of the semester-long NS M01 course, the
student will be able to:
1. Safety/Technical Skills:
- describe caring, safe, technically competent patient-centered fundamental and beginning
medical-surgical primary nursing care for patients with common, acute and chronic health
and self-care needs of adult and geriatrics in common and emerging healthcare settings.
- focus on comprehensive head-to-toe physical assessment and documentation addressing all
body systems for the adult and geriatric client, activities of daily living, growth and nutrition,
and medication administration.
2. Critical Thinking and Clinical Reasoning:
- discuss implementation of fundamental and beginning medical-surgical clinical decision
making with assistance, utilizing the nursing process applied to diverse adult and geriatric
individuals and support systems and communities.
- focus on the foundations of nursing practice and the nursing process, cultural/spiritual
diversity, the perioperative period, comfort and pain, diabetes mellitus, and care of patients
with basic health-deviations of the cardiovascular system and health-deviations of the
musculoskeletal system.
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3. Communication:
- identify patient-centered and interdisciplinary relationships characterized by caring and
inclusive communications utilizing confidentiality through principles of verbal, nonverbal,
and electronic communication systems in common and emerging healthcare settings.
- focus on the legal framework for nursing practice, cultural and spiritual diversity,
documentation addressing all body systems for the adult and geriatric client, and maintenance
of a safe environment.
4. Responsibility and Accountability:
- discuss ethical and legal standards of nursing practice.
- focus on the foundations and the legal framework of nursing practice.
5. Organization and Prioritization:
- identify advanced beginner skills in providing care for a group of patients with defined
health deviations interacting with interdisciplinary health care team members in a collegial
manner with assistance.
VII. Level I Terminal Objectives: The following are the Level I Critical Competencies of the
Moorpark College ADN program:
A.
Provider of Care
Demonstrate caring and implement the nursing process by providing competent nursing care to
individuals across the life span and across a variety of clinical settings, who require assistance to
maintain or restore their optimum states of health and self-care or support to die with dignity.
Critical Competency #1 Safety/Technical Skills

1.0 Nursing Science 1 students will provide caring, competent primary nursing care to 1-2
clients with common, acute and chronic health and self-care needs across the life span and
practice settings, including preventive, acute, rehabilitation and ambulatory.
1.1 Comprehend and demonstrate basic methods of maintaining clients universal requisites,
comfort and safety. Demonstrate effective use of technology and standardized practices,
including the National Patient Safety Goals that support safety and quality (QSEN).
1.2 Correctly indicate and begin to apply principles of administration and monitoring of
prescribed medical regimens and nursing procedures with direct supervision.
1.3 Recall and demonstrate accurate preparation and administration of meds (Oral, buccal,
sublingual, enteral, rectal, vaginal, nasal, inhaled, topical, transdermal, intradermal, SQ, IM,
otic, ophthalmic.) and monitor maintenance IV therapy with direct supervision, in a
reasonable time frame, with accurate math skills, knowledge of client, medications, and
correct administration technique.
1.4 Recognize inconsistencies in prescribed nursing and medical regimen and knows when to
seek assistance.
1.5 Distinguish and begin to apply when to act as the client advocate in incorporating the client
in decisions regarding plan of care.
Critical Competency #2: Critical Thinking and Clinical Reasoning

2.0 Implement clinical decision making with assistance, utilizing the nursing process applied to
diverse individuals and support systems.
2.1 Assessment
1. Systematically collect data, eliciting patients values, cultural preference, and needs
(QSEN).
2. Identify information to contribute to a data base.
2.2 Diagnosis
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1. Recognize actual or potential self care demands/deficits

2. Comprehend client data to select a Nursing Diagnosis on the basis of beginning
analysis and interpretation of data.
2.3 Planning
1. Indicate client centered goals. Demonstrate shared decision-making in setting goals
based on patients values and evidenced base practice (QSEN).
2. Use rudimentary application of assessment information to establish priorities
3. Explain and prepare an individualized Care Plan with interventions that follow
established nursing protocols and criteria for evaluation.
2.4 Implementation
Wholly/Partially Compensatory Nursing Actions
1. Practices standard precautions.
2. Select implementation of plan of care according to priority goals and begin to
recognize the need to adjust priorities as changes occur.
3. With moderate direction, initiate nursing interventions in response to clients selfcare needs and/or deficits to maintain physical and emotional comfort (QSEN).
4. Provide patient-centered care with sensitivity and respect for the diversity of human
experience (QSEN).
2.5 Use current technology to enhance client care.
Educative/Supportive Nursing Actions
1. Assess for an environment conducive to restoration and maintenance of clients
ability to meet self-care requirements.
2. Teach health care to individual and groups.
a. Identify evident situations in which clients need information or support to
maintain or regain health.
b. Implement an appropriate teaching plan specific to the clients level of
development, knowledge, culture, and learning needs.
c. Support/reinforce teaching of health care professionals.
d. Perform rudimentary evaluation of effectiveness of client learning.
e. Provide for continuing care and express how to support the clients right to die
with dignity.
3. Evaluation
a. Recognize the effects of nursing interventions on the status of the client.
b. With moderate supervision, participate with client, significant others and team
members in evaluating clients progress toward goals.
c. With moderate guidance, revise plan as needed.
Critical Competency #3: Communication

3.0 Provide relationships characterized by caring and inclusive communications.
3.1 Maintain confidentiality.
3.2 Utilize principles of verbal/non-verbal communication to assess self, client and support
system with assistance.
3.3 Express appropriate communication skills to communicate with clients of all developmental
ages, support systems, and interdisciplinary team members.
3.4 Establish functional relationship and promote effective relationships. Recognize boundaries
of therapeutic relationship, with clarifications of students role and accountabilities under
conditions of potential overlap in team member functioning (QSEN).
1. Distinguish and demonstrate caring, nonjudgmental and sensitive behavior in
providing care and interpersonal relationships with moderate assistance
2. Promote psychological safety in interpersonal relationships with moderate assistance
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3.5
3. Practice implementation of timely and effective conflict resolution with assistance.

Effectively communicate and document client behaviors and response to interventions and
plan of care.
B. Manager of Care
Demonstrate advanced beginner skills in providing care for a group of clients with defined
health deviations
Critical Competency #4: Responsibility and Accountability

4.0 Practice within the ethical and legal framework of nursing.
4.1 Demonstrates caring, integrity, ethical practice, diversity, education, community service, and
quality of care.
1. Recall principle of ethics to begin to recognize, explore and seek assistance related to
ethical dilemmas in practice.
4.2 Foster advanced beginner standards of nursing practice.
1. Participate in peer review and governance through observation and discussion.
4.3 Demonstrate professional behavior through appropriate attendance, appropriate
grooming/uniform dress, and without alcohol or substance abuse.
C.
Member within the discipline of nursing

Demonstrates ethical standards of nursing practice
Critical Competency #5: Organization and Prioritization

5.1 Establish priorities for 1 2 clients common, low to moderate acuity needs; adapts
priorities to changing situations
5.2 Organizes and effectively manages 1- 2 clients with common, low to moderate acuity needs in
a timely manner
5.3 Interact with interdisciplinary health care team members in a collegial manner with
assistance.
1. With assistance, interface appropriately with other resources to provide continuity of
care.
2. Identify channels of communication to begin to utilize them to accomplish goals
related to care delivery.
3. Collaborate with team members when situation encountered is beyond the students
knowledge and experience.
VIII. Workplace Preparation: The course will address the following SCANS competency areas:
1. Resources: the students will
Have access to faculty, textbook, library, technical-skills lab, acute and ambulatory care settings and other
college students. The students will demonstrate ability to set goals for nursing care and to allocate time to
complete those goals. They will plan and allocate resources through understanding structure and function
in cost effective methods of clinical practice.
2. Interpersonal: the students will
Be required to communicate with faculty, peers, clients, and other health care professionals. The students
will work in groups in problem-solving scenarios.
3. Information: the students will
Use computers and a variety of information resources to learn or review skills which prepares them to
assess, organize, analyze, evaluate, and communicate information, including documenting and creating a
plan of care.
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4. Systems: the students will

Demonstrate understanding of organizational, social, and informatics systems within a healthcare setting.
They will analyze systems to identify root causes of failures and areas for improvement.
5. Technology: the students will
Work with a variety of technologies within a healthcare setting, including electronic medical records,
computers, point-of-care testing equipment, and biomedical machinery. They will maintain equipment
properly, identify malfunctions and remove the item from service.
The course also addresses the SCANS skills and personal qualities:
1. Basic Skills: the students will
Review, learn and perform the procedures listed on skills checklist. They will read policy and procedures,
write, perform arithmetic and medication calculations, and effectively communicate patient information
amongst the interdisciplinary team.
2. Thinking Skills: the students will
Demonstrate critical thinking in formulating and carrying out a plan of care by thinking creatively,
knowing how to seek information, making decisions based on evidence, solving potential or actual selfcare problems, and utilizing clinical reasoning.
3. Personal Qualities: the students will
Utilize the Nursing Professional Code of Ethics while interacting with others. They will demonstrate
responsibility, accountability, cultural sensitivity, respect others and develop individual responsibility,
self-management, self-awareness, and integrity.
IX. Required Texts:

A. Available for purchase at Moorpark College Bookstore:
1.
2.
3.
4.
5.
Beginning Nursing Science: NS1 Theory & Clinical Workbook Fall 2013
Moorpark College Department of Nursing Student Handbook Fall 2013
Moorpark College ADN Clinical Portfolio Fall 2013
Clinical Nursing Skills Checklist
Moorpark College Nursing Program Daily Journal form
B. Available at Moorpark College bookstores or suppliers:

6. Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., Camera, I.M. (2011). Medicalsurgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, MO:
Mosby.
7. Study guide for Med-Surg Nursing Textbook Lewis & Heitkemper (2011)
8. Altman, G.B. (2009). Fundamental & advanced nursing skills (3rd ed). Clifton Park, NY:
Delmar.
9. Ellis, J & Hartley, C. (2008). Nursing in Today's World (9th ed). Philadelphia, PA: Lippincott
Williams, & Wilkins.
10. Buchholz, S. (2011). Henkes med-math, dosage calculation, preparation, and administration
(7th ed.). Philadelphia, PA: Lippincott Williams, & Wilkins.
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11. Jarvis, C. (2011). Pocket companion: Physical examination & health assessment (6th ed.). St.
Louis, MO: Saunders.
12. Doenges, M., Moorhouse, M.F. & Murr, A.C. (2010) Nurses pocket guide: Diagnoses,
interventions and rationales (10th ed.). Philadelphia, PA: F.A.Davis. (Or any nursing
diagnosis/care planning book of your choice)
13. California Nursing Practice Act. Read On-line version at
http://www.rn.ca.gov/regulations/bpc.shtml#2725
14. Professional Guide to Laboratory &Diagnostic Tests, and Nursing Drug Guide
* For Drug handbook and Diagnostic tests: Electronic PDA version for nurses is available.
To download these programs you need to have a smart phone or other PDA. Some sites are:
Pepid.com. skyscape.com, www.unboundmedicine.com. Free sites are available such as
Nursingcenter.com, Medline.com, and epocrates.com.
C. Recommended Texts:
1. All in One Care Planning Resources. Latest edition, Swearingen-Elsevier.
2. Fundamental of Success: Test taking strategies. Latest edition Davis.
D. Other required materials:

1. Computer access for D2L and E-mail address (Computers are available in the library for
students without access, e-mail address will be provided upon request).
2. Scantron forms 882-E for all exams.
3. A simple, 4-function basic calculator (No graphing, scientific, or other advanced functions)
E. Nursing Skills Lab (NS11) Each student is encouraged (not required) to concurrently register
for NS 11. This is an instructor/staff-assisted, independent study, in the skills lab. The lab time
will be earned by practicing technical skills as well as critical thinking and test taking skills.
X. Grading System
90 100% = A
80 89% = B
74.5 79% = C
74.4 % or below = F Non-Mastery
A. Exams: There will be two 100 point exams and two 50 point exams based on the NCLEX-RN
format. This followed by the cumulative final, worth 100 points.
There will be a Medication Proficiency Exam given during NS1 Part Two. This will be graded
on a Pass/Fail basis; a score of 90% or better is required for passing this exam and continuing
with the theory and clinical experience of the nursing program. Students will have three
opportunities to pass the exam.
B. Assignments and Projects There will be a Final Group project worth 10 points. Refer to the
course calendar for due date.
C. Quizzes, Bonus Points, and Extra Credit Points Theory course quizzes and extra credit
points are at the discretion of the instructor for participation in class, on-line discussion, or on
exams.
Bonus points are earned whether the student is passing the exam or the course or not.
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Extra Credit Points: A student who meets the performance standard set for designated classroom
activities may earn extra credit points. These extra credit points are added to the total points
earned in the class ONLY if the student has already achieved 74.5% or better in the course.
IX. ADVANCEMENT POLICY: NS1 student must master the course with greater than or equal to
74.5% in both Part 1 and Part 2. The student must master both clinical and theory in NS1p1 to progress to
NS1p2. The final grade for NS 1 will be the average of combined percentage of Part 1 and Part 2.
X. VOLUNTEER REQUIREMENT: Moorpark College nursing students are MANDATED to
contribute at least 5 hours to approved volunteer activities while in the nursing program. All activities
listed on the volunteer activity board in the skills lab are pre-approved and qualify for this requirement.
Please provide a copy of your volunteer activity to your NS4p2 instructor for your student file.
There is extra credit available for volunteering during the nursing program; one hour generally is equal to
one extra credit point. There is a maximum of 10 extra credit volunteer points possible (NS1 is limited to
5 extra credits) that can be added toward your final theory grade each semester. Extra credit points will
not be added to failing grades.
XI. Student Resources

A. D2L: Desire2Learn Login
1. Login to MyVCCCD.
2. Click the My Courses icon
in the upper right corner of the screen.
3. Click on the name of the course you wish to enter. If the course uses Desire2Learn, you will be
directed to Desire2Learn.
Desire 2 Learn: There are multiple resources on our class Desire 2 Learn homepage. Class
announcements and e-mails will be delivered through Desire 2 Learn. You are responsible to
check this site often for updates. Web-based review (such as a chat room) may occur the week
before the scheduled exams. Chat time will be determined through discussion between the
instructor and class. Chats will be archived for accessibility to those who will be unable to take
part.
B. Peer Tutoring: Free Peer tutoring by senior nursing students is available in class during the
Monday lunch hour and by appointment as needed. Contact nursing professor Dalila Sankaran
([email protected]) or view the class D2L page for more information.
C. Remediation: If a student does not pass an exam, (s) he will receive a progress report and are
required to turn in documentation of completing the assigned Nurse Logic tutorial in ATI. The
progress report encourages student to contact peer tutors, faculty, and the learning center for
assistance in academic coursework.
D. Writing Center and Learning Center: The Moorpark College has a Writing Center
located in the Library for assistance in writing skills. Students are encouraged to call 378-1400 X
1696 for information. The Learning Center, Math Center, and Writing Center, located in Library
322, will provide tutorial services and supplemental instruction based on course goals. When
using these tutorial services, students need to state their instructors name for tracking and
reporting purposes. Students will also need to provide their student ID numbers when receiving
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tutorial services. For further information call The Learning Center (805) 378-1556 or the
Writing Center (805) 378-1400 ext 1696.
XII.
Students with Disabilities: Students with disabilities, whether physical, learning, or

psychological, who believe that they may need accommodations in this class, are encouraged to
contact the ACCESS office as soon as possible to ensure that such accommodations are
implemented in a timely fashion. Authorization from the ACCESS office, based on verification of
disability, is required before any accommodation can be made. The phone number for ACCESS
is (805) 378-1461. ACCESS is located in the first floor of the LMC building. If you have a
documented disability, you must provide your instructor with the verification paperwork on the
first day of class.
XIII.
Policy on Internet posting of assignments

Any nursing course assignments including photographs, videos, and group projects, associated
with Moorpark College may only be posted on the internet with the prior written consent of the
faculty and participants. You are prohibited from sharing information regarding patients,
clinical site experiences, or other HIPAA protected information verbally, in writing or on the
internet, including social networking websites.
XIV.
Resolution to student problems. Nursing students are encouraged to seek assistance and
clarification from the instructor. Do resolve conflict at the lowest level possible following the
nursing department structure's Chain of Command. See Moorpark College Online Student
Handbook at: Moorparkcollege.edu and Nursing Student's Handbooks for a list of your rights
and responsibilities.
A. Clinical Instructor: Your instructor's first initial, then last name @vcccd.edu
B. Theory Instructor: Christina Lee, RN, MSN e-mail: [email protected]
C. Assistant to the Coordinator: Dalila Sankaran, RN, MSN e-mail: [email protected]
D. Health Sciences Coordinator: Carol Higashida, RN, MSN, CNS [email protected]
E. Dean of Life and Health Sciences: Kim Hoffmans, RN, Ed.D [email protected]
IV. Instructor Information: Christina Lee, RN, MSN
Office Location: HSC 125 (Enter through the HS department office)

Phone: (805) 378-1400 x 1829
Cell phone: (818) 383 6794 emergencies only
Email: [email protected] (preferred)
Desire 2 Learn
Office Hours Second 8 Weeks Part II (excluding holidays): Must make appointments
Monday
Tuesday
Wednesday
Thursday
Friday
1145 1245
1500 1600 if no
faculty meeting
XV. Excused absences and Make-up exams:

Only students with an excused absence may make-up an exam with the approval of the instructor.
Student must notify the instructor prior to the absence, and give required documentation of proof
that the absence met the Moorpark College excused absence criteria (i.e. medical, legal, religious,
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see Moorpark College student handbook). Attendance is crucial to the successful learning of class
materials. In an 8 weeks course, students missing more than 1/9th of class hours (example: 3.5
hours lecture and 2 clinical days) may be dropped from the course regardless of grade.
XVI. Moorpark College Smoking Policy

In the interest of the health and welfare of students, employees and the public, smoking is not
permitted anywhere on the Moorpark College Campus, except in designated smoking areas in the
parking lots. The Student Health Center can help with smoking cessation.
XVII. Academic Integrity

Plagiarism and other types of unprofessional or unethical conduct will be strictly addressed
according to the Moorpark College Student Policy as well as the Moorpark College Student
Nurses Handbook. Student will receive a score of 0 for the assignment or exam in question.
XVIII. Dropping class

It remains the responsibility of the student to drop courses via the Moorpark College website or in
person at the administration office by the appropriate deadline.
XIX. Required ATI assessments

There will be a mandatory non-graded on-line ATI cumulative practice assessment exam to be
taken near the end of NS 1 Part 2. These tests are required every 8 weeks thereafter during the
nursing program. The student is required to score at or above 75% on the NS1 NS2 tests prior
to NS3 part II, and on the NS3 NS4 tests prior to graduation. This is designed to prepare the
student for the NCLEX-RN exam following completion of the program.
An incomplete for NS M01 will be issued to students that do not submit results of the mandatory
online ATI practice assessment when required during NS1 part 2. An incomplete in NS M01
means the student is not allowed to progress in the nursing program until the incomplete is
resolved as described in the Moorpark College Catalog.
XX. Surveys
At the end of every 8 weeks class students are required to complete an surveys of the theory
course, clinical instructor, and clinical site. The data collected during these course evaluations
are very important in analyzing the effectiveness of the nursing program and seeing where
adjustments and improvements need to be made.
Course evaluations are completed in two forms; on a campus-generated scantron, and using the
internet. For the online surveys (same D2L link and password), print out the signature page, sign
and print your name and turn in to the theory instructor. Students that do not turn in evidence
of completing the online course evaluations will be issued an Incomplete at the end of the
semester.
An incomplete in a nursing course means the student is not allowed to progress in the nursing
program until the incomplete is resolved as described in the Moorpark College Catalog. Failure
to resolve the Incomplete in a timely manner may cause the student to not be able to start the next
course in the nursing program, and would need to apply to return to the nursing program as an
advanced placement student. Admission as an advanced placement student is not guaranteed.
XXI. Caveat
The enclosed schedule and procedures are subject to change in the event of extenuating
circumstances. Every effort will be made to inform the student in advance of any anticipated
changes as they arise.
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NS 1 PART 1 CLASS CALENDAR

Schedule subject to change due to unforeseen circumstances
Date
Theory
Exams
8/14/ 2013
HS 103
Week 1
Week 2
Week 3
8/19
8/26
09/02
09-12 Orientation
12-1 Lunch
2-4: ATI Critical
Thinking testing
Module 1&2: Intro
to Nursing, Legal/
Ethical, Nsg
Process, ADLs
Turn in Entrance
survey signature
page to Christina
FALL 2013
Skills Lab/Clin
Assignments due in
addition to Module
assignments
All groups in Skills Lab

both days.
Bring Clinical portfolio

and copies of health
records, CPR, MC
registration
ADLs and Module 1
Module 3
Skin/Musculoskeletal. Safety,
Body Mechanics
Module 4 GI
HOLIDAY
LABOR DAY
No theory class
All groups in Skills Lab

both days.
ADLs and Module 2
Plagiarism and
Advanced Directive
assignment due
Tuesday = Hospital
Orientation for all
clinicals. Times TBA
on D2L. Full uniform
with MC photo ID.
Module 3
Skin/Musculoskeletal
Module 4 GI
Week 4
09/09
Module 4 GI
Module 5 GU
Exam 1: 09-10
Modules 1 & 2
Week 5
09/16
Module 5 GU
Module 6 Resp
EXAM 2: 9-10
Mod 3&4
Week 6
09/23
Module 6 Resp
Module 7 Cardio
Week 7
09/30
Module 7 Cardio
Module 8 Neuro
EXAM 3A:
09-9:45 Mod 5&6
Module 8 Neuro
Week 8
10/07
Exam 3B
09-9:45 Mod 7&8
Week 9
10/14
Module 8 Neuro
Class presentations
10-1450
Final Exam 09-11
Skills Review
3/20 Clinical Evals,
times TBA
NS1p2 starts
01-03 pm
Cumulative Final
Mod 1-8
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Module 5 GU
Mid Term Eval. Grades
Module 6, 7 Resp and

Cardio
Care Plan due 2nd day

of clinical
Turn in survey
signature pages to
theory instructor
MODULE 1 Foundations of Nursing

I. Introduction:
This module introduces concepts necessary to provide the student with the foundations for
nursing practice. The focus is on the emergence of nursing as a profession, nursing theories with an
emphasis on the Orem Self-Care Model, communication skills, patient teaching, head-to-toe assessment
of the older adult patient, and review of Ericksons stages of development.
II. Required reading
Basic Concepts, Critical Thinking, Health Education
Medical Surgical Textbook (Lewis): Chapter 1, 2, 3, 4
Foundations of Nursing Practice
Nursing In Today's World (Ellis): Chapter 4 p.146-165
Orems theory: See Appendix A in this workbook p. 24
Assessment:
Physical Assessment pocket companion (Jarvis): Chapters 1,2,3,4
III. Required Audiovisuals (Will be viewed on Skills Lab day)
Your Legal Duty: Reporting Elder and Dependent Adult Abuse, HIPPA
Recommended Audiovisuals: (Available in the Skills Lab)
Code Grey
Restraints: The last resort
Tuberculosis: Prevention and practices for health care workers
Website: ATI Nurse Logic, BRN and ANA (see class Web links on our homepage)
IV. Learning Objectives: Mastery of content will enable the student to:
1. Describe briefly the history of nursing and what lead to its emergence as a profession.
2. Describe the contributions of Florence Nightingale and Dorothy Orems Theory
3. Discuss the definition of nursing according to the American Nurses Association.
4. Describe the techniques for assisting with Activities of Daily Living, keeping the patient safe and
comfortable.
5. Apply Erickson's developmental theories to varied client populations.
6. Define the role of client advocate as it related to nursing.
7. Discuss the role that caring plays in building a nurse-patient relationship.
8. Identify cultural sensitive nursing assessment and interventions
9. Describe basic elements of therapeutic communication techniques
10. Describe teaching implications related to adult learning principles
11. Identify physical, psychological, and socio-cultural characteristics that affect client care and teaching.
12. Describe strategies that facilitate elderly adult's learning abilities
13. Describe the five steps of the nursing process and give examples of behavior performed by the nurse
in each step.
14. Describe the key part of a Nursing Diagnosis using NANDA (North American Nursing Diagnoses
Association) approved list.
15. Develop nursing diagnoses for selected case studies and write measurable goals.
16. Describe the purpose of the National Patient Safety Goals, SBAR, QSEN, NLNAC, BRN and Health
Care Reform
17. Apply concepts of evidenced based practice to nursing.
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MODULE 2: Legal/Ethical Issues, and the Nursing Process

I. Introduction
This module presents application of the nursing process to the nursing care of adult clients with
self-care deficits. The development of nursing diagnoses and nursing process, planning, nursing
interventions, and evaluations will be the focus of this module. Emphasis will be on the development of
critical thinking skills. In addition, focus will be placed on legal and ethical issues of nursing care of the
older adult, including clinical etiquette and advanced directives and the patient advocate role of the nurse
as well as end of life care.
II. Required Reading
Medical-Surgical Textbook (Lewis): Chapter 5, 11, Appendix B p 1793
Nursing in Today's World: Chapter 8: p 292-303, 306-325 and Chapter 9: p 335-348,
California Nursing Practice Act. On-line version at http://www.rn/ca/gov.
III. Required Audiovisuals. Required AV will be viewed during NS1p1 Skills Lab Class
The Nursing Process and Critical Thinking
Head to Toe Assessment
Infection Control
Recommended Audiovisuals: (Available in the Skills Lab)
Transcultural Perspectives in Nursing," "Therapeutic Communication," ATI,
Websites: http://nursingworld.org/ethics/chcode.htm, QSEN.org, JointCommission.org, NLN.org
IV. Learning Objectives: Mastery of content will enable the student to:
1. Describe the basic focus of the domain of Nursing
2. Describe how safety, quality, and evidence-based practice can be improved using the Quality and
Safety Education for Nurses (QSEN) competencies, the National League of Nursing (NLN) and The Joint
Commission standards.
3. Apply professional standards to the student in a nursing program.
4. Discuss RN nursing licensure process in California and reasons for license revocation.
5. Identify nursing students liability in the clinical setting, and ethical responsibilities outside the clinical
setting.
6. Define veracity, autonomy, fidelity, justice, beneficence, and non-malficence.
7. Define Torts, Negligence, Malpractice, Informed Consent, and Confidentiality.
8. Identify nursing legal responsibilities as defined in practice acts and standards of care.
9. Cite the nurses role and responsibilities in the signing of informed consents, witnessing wills and
advanced directives.
10. Describe strategies for successfully communicating with a person who speaks a foreign language that
the nurse does not understand.
11. Identify physiologic aspect of culture and ethnicity that may affect a person's health
12. Define ethical conduct for nurses as defined by the American Nurses Association.
13. Identify the nurses role in the nursing process when helping clients with hygiene, activities of daily
living, impaired mobility, illness, loss, grief, or death.
14. Explain the purpose, components, and techniques related to a patient history and physical
examination.
15. Accurately assess vital signs, pain, and identify normal and abnormal parameters.
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MODULE 3: Integumentary/Musculoskeletal System

I. Introduction
This module presents theoretical nursing concepts and assessment skills needed to care for
clients with self-care deficits related to the integumentary and musculoskeletal systems. There will be a
focus on the old adult, medical and surgical asepsis, and environmental safety, in various environments.
There will also be an emphasis on physiology of movement and factors that affect body alignment and
mobility and alterations in these systems in the form of ulcers. This module will also include a review of
basic infection control and isolation precautions.
Medical-Surgical Textbook (Lewis): Chapter 13,23, 62, & Fractures: p. 1596-1602, Infection in
Older Adults: p. 240-241,
Physical Assessment Jarvis: Chapters 5 & 15
III. Required Audiovisuals
Video: Nursing Management of Wounds
Recommended Videos in the Skills Lab: Patient Movement Safety Device Application,
Preventing falls in the Geriatric Client
Recommended web site: ATI skills module, www.ahrq.gov, www.cdc.gov,
www.niams.nih.gov, CDC guidelines: http://evolve.elsevier.com/Lewis/med-surg-E-table 15-7.
IV. Learning Objectives: Mastery of content in this module will enable the student to:
Integumentary:
1. Define key terms and nursing diagnosis in the textbook chapter (bold lettering).
2. Describe Standard Precautions and principles of Infection Control.
3. Recall the structures and functions of the skin, variations of age and culture.
4. Describe the elements to be included in the assessment of the hair, skin and nails
5. Identify and describe primary and secondary skin lesions and their pattern and distribution
6. Discuss the nursing assessment of skin integrity and wound healing.
7. Describe the differences among wounds healing by primary, secondary, and tertiary intention.
8. Describe factors that promote wound healing.
9. Describe factors that delay wound healing, and common complications of wound healing.
10. Discuss the incidence, prevalence, types, stages and risk factors for pressure ulcers.
11. Identify nursing interventions indicated for the patient with a pressure ulcer
12. Discuss common skin tests and procedures used in diagnosing skin and related disorders.
Musculoskeletal
1. Describe the basic structure and function of the musculoskeletal system.
2. Discuss the techniques of musculoskeletal physical assessment.
3. Discuss the technique of assessing muscle strengths, joint range of motion.
4. Identify changes in physiological and psychosocial function associated with mobility and immobility.
5. Formulate nursing diagnoses and care plans for impaired body alignment and mobility.
6. Describe essential techniques when helping a client to move up in bed, reposition a client, assisting a
client to a sitting position, and transferring a client from a bed to a chair or from a bed to a stretcher.
7. Describe active/passive range of motion.
8. Describe essential techniques when helping a client to safely use crutches, walker, w/c.
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9. Review the purpose and techniques of applying warm and cold compresses.
10. Discuss how to assess for Deep Vein Thrombosis; and how to prevent and treat this complication of
immobility and trauma.
11. Recall content and concepts presented in previous prerequisite courses (Anatomy & Physiology and
Microbiology) and identify the following terms:
macule
excoriation
pallor
nosocomial
exudate
papule
scar
ecchymosis
exogenous
paresis
nodule
keloid
petechiae
sanguineous
paralysis
wheal
fissure
vitiligo
purulent
cachexic
vesicle
turgor
edema
antiseptic
contact isolation
pustule
erythema
alopecia
antibacterial
contracture
ulcer
cyanosis
lesion
serous
abduction/adduct
crust
flushing
serosanguinous
jaundice
flexion/extension
kyphosis
joint
flaccid
crepitus
circumduction
scoliosis
ligament
rotation
supination
pronation
lordosis
tendon
paresthesia
inversion
eversion
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MODULE 4: Gastrointestinal System

Introduction GI
This module presents a basic review of the anatomy and physiology of the gastrointestinal
system. The focus is on how to perform a systematic physical assessment of this system. The basic
techniques of examination will be discussed. There will also be discussion of the self-care deficits related
to maintenance of nutrition and bowel elimination. This module will also address assessment of adult
clients with alterations in nutrition.
II. Required Reading:
Medical-Surgical Textbook (Lewis): Chapters 39, 40
Physical Assess (Jarvis): Chapters 14 & 19
"Bates visual guide for Physical Exam: Abdomen"
"Enteral Therapy: Nursing Implications"
Recommended Audiovisuals: Nasogastric/Enteral feeding/Salem Sump, Review GI system and
skills on ATI
Web resources: www.gastro.org, digestive.niddk.nih.gov
IV. Learning Objectives. Mastery of this content will enable the student to:
1. Define key terms and nursing diagnosis.
2. Describe clients who are at risk for nutritional deficits.
3. Describe the procedure for initiating and maintaining tube feedings.
4. Describe the methods to avoid complications of tube feedings.
5. Describe the methods to avoid complications of parenteral nutrition.
6. Identify the organs and function of the gastrointestinal system, including the alimentary canal and
accessory.
7. Discuss important health history components that provide information about GI system status.
8. Describe the appropriate techniques used in an abdominal assessment on an adult and elderly client.
9. Differentiate between normal and abnormal findings detected on physical assessment of the GI system.
10. Describe the physiologic, socio-cultural and psychological factors affecting nutrition and elimination.
11. Cite measures that may help to stimulate appetite in the hospitalized client.
12. Describe the following diets and the population of clients served: regular , clear, soft, renal,
dysphagia, 2gm sodium & low fat, and carbohydrate consistent.
13. Cite nursing measures which promote regular bowel habits.
14. Discuss various nursing measures related to the care of the ostomy patient.
15. Describe the purpose, significance of results, and nursing responsibilities related to common
diagnostic studies of the GI system.
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MODULE 5: Genitourinary System

I. Introduction
This module presents a basic review of the anatomy and physiology of the genitourinary system.
The focus is on how to perform a systematic physical assessment of this system. The basic techniques of
examination will be discussed. There will be an emphasis on the self-care deficits related to maintenance
of bladder elimination.
II. Required Reading:
Medical-Surgical Textbook (Lewis): Chapter 45, & Urinary incontinence and catheters
p. 1151-1154
Physical Assessment (Jarvis): Chapters 17 & 18
III. Required Audiovisuals:
"Urethral Catherization: Fluid Balance assessment, maintenance, intervention"
"Basic Clinical Skills: Urethral Catherization"
Web resources: www.niddk.nih.gov, www.nafac.org, www.auanet.org, ATItesting.com review
GU system and nursing skills. ATI: review GU related skills.
Reference: Lewis: Appendix C, Lab values p. 1795-1802
IV. Learning Objectives. Mastery of this content will enable the student to:
1. Define key terms and nursing diagnosis.
2. Describe the anatomic location and functions of the kidneys, ureters, bladder, and urethra.
3. Discuss the main functions of the kidneys and their basic functional units.
4. Describe the techniques of assessment of the genitourinary system: Inspection, Palpation, Percussion,
and Auscultation.
5. Describe normal vs. abnormal assessment findings.
6. Explain the process of urinary catheterization and how to prevent complications.
7. Identify self-care needs of the patient with alterations in the urinary system.
8. Describe normal urine characteristics: amount, color, clarity, specific gravity.
9. Cite nursing measures to promote normal voiding habits
10. Describe the diagnostic studies used to determine upper and lower urinary tract function and nursing
implications
11. Describe alterations in the genitourinary system associated with normal aging
12. Differentiate among the different type of urinary incontinence and nursing interventions required.
13. Describe the signs and symptoms and causative factors of electrolyte imbalance
14. Cite nursing assessment and interventions for Alteration in Fluid volume
15. Describe nursing interventions for Fluid volume deficits and Fluid volume excess
16. Describe nursing responsibility for: Intake/Output, collecting a clean catch urine specimen, sterile
urine specimen, 24 hour urine creatinine clearance, continuous bladder irrigation, and interpreting a
normal urinalysis.
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Module 6: Respiratory System

I. Introduction
This module presents a basic review of the anatomy and physiology of the respiratory system as a
basis for the discussion of nursing assessment of the respiratory system. Gerontologic differences in
assessment findings related to changes of aging are discussed.
Medical-Surgical Textbook (Lewis): Chapter 26, pages 567-568, Table 26-7, 26-10.
Respiratory Therapy p. 1752- 1754
Physical Assessment: Chapter 11
Bates Visual Guide to Physical Examination: Thorax and Lungs
Respiratory Signs & Symptoms

Web Resources: Recommended sites for Heart & Lung sounds: www.med.ucla.edu/wilkes/intro
Heart and Lung sounds audio also available in Skills Lab.
ATI review respiratory assessment and related skills.
VI. Learning Objectives: Master of content in this module will enable the student to:
1. Identify key terms and nursing diagnosis
2. Identify the structures and functions of the upper and lower respiratory tract.
3. Identify anatomical processes involved in ventilation, perfusion, and exchange of respiratory gases.
4. Describe the process that initiates and controls inspiration and expiration.
5. Identify variations in respiratory patterns.
6. Discuss the method for lung assessment and auscultation of lung sounds.
7. Describe the different modalities for providing supplemental oxygen.
8. Identify nursing diagnoses related to alteration in respiratory status.
9. Describe the impact of a clients level of health, age, lifestyle, and environment on tissue oxygenation.
10. Identify and describe clinical outcomes of hyperventilation, hypoventilation, and hypoxemia.
11. Identify nursing care interventions in the primary care, acute care, and restorative and continuing care
settings that promote oxygenation.
12. Describe the purpose, significance of results, and nursing responsibilities related to common
respiratory diagnostic tests and thoracentesis.
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MODULE 7: Cardiovascular System

I. Introduction
This module presents a basic review of anatomy and physiology of the cardiovascular system.
The focus is on the essential components of the physical assessment of this system. There will be an
emphasis on the self-care deficits related to maintenance of perfusion and circulation. Focus will be on
the nursing care of the older adult with cardiovascular self-care deficits.
Medical-Surgical Textbook (Lewis): Chapter 32, Chap 34: p 761-766, 810-811
Jarvis: Chapters 12 & 13
"Coronary Artery Disease and Angina Pectoris
"Bates Visual Guide to Physical Exam: Neck Vessels and Heart" DVD
Bates Visual Guide to Physical Exam Vol 5: Peripheral Vascular System" DVD
Web site: www.med.ucla.edu/wilkes/intro, www.americanheart.org, www.nia.nih.gov.
ATI pertaining to cardiovascular system assessment.
IV. Learning Objectives. Mastery of content in this module will enable the student to:
1. Recall the structure and function of the cardiopulmonary system.
2. Identify anatomical processes of cardiac output, myocardial blood flow, and coronary artery
circulation.
3. Diagram the electrical conduction system of the heart.
4. Define pre-load, contractility, afterload and how it affects cardiac output
5. Define blood pressure and the mechanisms involved in its regulation
6. Define postural (orthostatic) hypotension.
7. Describe auscultatory findings of the cardiovascular system.
8. Describe the impact of a clients level of health, age, lifestyle, and environment on tissue oxygenation.
9. Describe Metabolic Syndrome as a risk factor for cardiovascular disease
10. Describe nursing measures to promote cardiovascular health
11. Identify and describe assessment findings as a result of disturbances in conduction, altered cardiac
output, and impaired tissue perfusion.
12. Discuss the clinical indications, patient preparation, and other related nursing implications for
common tests and procedures used to assess cardiovascular function and diagnose cardiovascular
diseases.
13. Identify nursing diagnoses related to alteration in cardiovascular status.
14. Discuss the laboratory tests to assess cardiovascular status, lipid profiles, troponin, CK enzymes, Creactive protein, hemoglobin and hematocrit.
15. Describe the basic pathophysiology and signs and symptoms of hypertension, angina, and congestive
heart failure.
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Module 8: Neurological System

I. Introduction
This module presents a basic review of the anatomy and physiology of the neurological system.
The focus is on the systematic physical assessment of the neurological system. Focus will be on the basic
human needs of sleep as well as the nursing care of clients with sensory alterations, stress, and Pain. The
effects of aging will be presented as it applies to abnormalities in this system. The nursing process is
emphasized in meeting the self-care deficits.
Medical Surgical (Lewis) Chapter 9, 10: p134-136, Chapter 56, and p. 1434: table 57-5
Physical Assessment: Jarvis Chapter 16
III. Required Audiovisuals:
Neurologic Signs and Symptoms
Respiratory Suctioning part 1: Introduction & the upper airway
Recommended Audiovisual: Chronic Pain Assessment
Web Resources: www.braintrauma.org., www.epilepsyfoundation.org.
IV. Learning Objectives: Master of content in this module will enable the student to:
1. Define key terms, nursing diagnosis.
2. Describe the structures and functions of the central and peripheral nervous system
3. Discuss normal physical findings in a young and middle-age adult compared with an older adult.
4. Compare the functions of the sympathetic and parasympathetic nervous system
5. Identify the function of each of the 12 cranial nerves and describe one assessment technique for each.
6. Cite interview questions that provide information about the status of the clients nervous system,
mental status, and level of consciousness.
7. Describe nursing responsibilities related to common neurological diagnostic tests.
8. Describe the Glasgow Coma score
9. Describe three tests of cerebellar function.
10. Compare the characteristics of rest and sleep for adult and older clients.
11. List nursing interventions helpful in the treatment of insomnia and related lifestyle changes necessary
in order to carry out those interventions.
12. Discuss ways to maintain a safe environment for clients with sensory deficits.
13. Identify nursing diagnoses related to neurological deficits.
14. Assess pain.
14. Discuss methods for the evaluation of stress and sleep.
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Appendix A
FINAL GROUP PROJECT GRADING RUBRIC
Your final project for this class is a group research project. Your group of 6-7 students will select a topic
from the list provided. The group will research the topic and prepare a 10 minutes presentation to the
class sharing what you have learned on the final week of class. Each member is not only solely
responsible for these areas, but also fairly divides up the work. Everyone needs to speak during the
presentation.
Circle your topic
Topic: National Patient Safety Goals, QSEN, Preventing Malpractice,
Documentation, Nutrition, Infection Control
Give Rubric and hands out to Instructor at start of Presentation. Bring a memory stick to
class prior to the presentation.
Maximum
score
Presentation: Present your findings in a brief 10 minutes report to the class. Give the
class a good overview of what you have learned and it is your opportunity to share your
knowledge with your classmates. Your group will be graded on delivery and
completeness of information.
Visual: Accompany your presentation with 2 original piece of artwork that will serve as
a visual aid to your presentation. This can be your choice of a collage of images, a
PowerPoint (max 5 slides), artifacts etc.
4 points
4 points
2 points
Write Up/Hands out: E-mail to the students and instructor a 2-3 pages summary of
your topic by the Saturday before the presentation. Keep it thorough but brief, just the
basic "crib sheet" on the topic to help students review for the final. Cite your
references.
If a student failed to participate in the preparation of this assignment, the group will turn
in a confidential note to the instructor. ATTENTION: Students who do not participate
in the preparation of this assignment or who have an unexcused absence on the
presentation day will receive a ZERO for the FINAL PROJECT.
Group Members: 1. ________________
2. _________________3._____
4._______________5.__________________6.________________7._______________
- 24 -
Group
score
PowerPoint
Slides
Slides current as of 06/30/13.
These Power Point slides are subject to change in

arrangement and with possible alteration of the content
prior to the scheduled lecture date.
You must expect to need to take notes during lecture.
- 25 -
Moorpark College
Beginning Nursing Science
NS1 Part I
Clinical
Christina Lee RN, MSN

Fall 2013
- 26 -
NS1L Part 1
I.
Number of Course: NS1L Part 1
NS M01L
II. Hours: 14 hours clinical laboratory weekly for 8 weeks.

III. Description Title: Beginning Nursing Science Laboratory
IV. Catalog Description of Course:
Part 1: Applies fundamental, patient-centered, evidence-based nursing care to simulated patients in

the skills lab setting and one selected adult/geriatric patient in extended, rehabilitation, or acute care
settings using the nursing process related to health promotion and self-care deviations. The focuses is
on practice and demonstration of communication, physical assessment, activity of daily living,
identification of actual and potential health deviations, and documentation of the nursing process.
V. Prerequisites: Admission to Moorpark College ADN Program.
VI.
Course Objectives: Measured by Point System in Clinical Portfolio.
Safety/Technical Skills:
- provide caring, safe, technically competent fundamental and beginning medical-surgical patientcentered primary nursing care to 1-2 patients with common, acute and chronic health and selfcare needs of adult and geriatrics in common and emerging healthcare settings.
- assist the patient with activities of daily living, provide safe medication administration and IV
maintenance, and identify actual and potential health deviations.
Critical Thinking and Clinical Reasoning:
- implement fundamental and beginning medical-surgical clinical decision making with
assistance, utilizing the nursing process applied to diverse adult and geriatric individuals and
support systems.
- develop a plan of care for diabetes mellitus, basic health deviations of the cardiovascular
system, and health deviations of the musculoskeletal system.
- provide patient centered care during the perioperative period including pain management.
Communication:
- identify patient-centered and interdisciplinary relationships characterized by caring and
inclusive communications utilizing confidentiality through principles of verbal, nonverbal, and
electronic communication systems in common and emerging healthcare settings.
Responsibility and Accountability:
- demonstrate ethical and legal standards of nursing practice.
Organization and Prioritization:
- demonstrate advanced beginner skills in providing care for a group of patients with defined
health deviations interacting with interdisciplinary health care team members in a collegial
manner with assistance.
VII. Level I Terminal Objectives: The following are the Level I Critical Competencies of the
Moorpark College ADN program:
A.
Provider of Care
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Demonstrate caring and implement the nursing process by providing competent nursing care to
individuals across the life span and across a variety of clinical settings, who require assistance to
maintain or restore their optimum states of health and self-care or support to die with dignity.
Critical Competency #1 Safety/Technical Skills

1.0 Nursing Science 1 students will provide caring, competent primary nursing care to 1-2
clients with common, acute and chronic health and self-care needs across the life span and
practice settings, including preventive, acute, rehabilitation and ambulatory.
1.1 Comprehend and demonstrate basic methods of maintaining clients universal requisites,
comfort and safety. Demonstrate effective use of technology and standardized practices,
including the National Patient Safety Goals that support safety and quality (QSEN).
1.2 Correctly indicate and begin to apply principles of administration and monitoring of
prescribed medical regimens and nursing procedures with direct supervision.
1.3 Recall and demonstrate accurate preparation and administration of meds (Oral, buccal,
sublingual, enteral, rectal, vaginal, nasal, inhaled, topical, transdermal, intradermal, SQ, IM,
otic, ophthalmic.) and monitor maintenance IV therapy with direct supervision, in a
reasonable time frame, with accurate math skills, knowledge of client, medications, and
correct administration technique.
1.4 Recognize inconsistencies in prescribed nursing and medical regimen and knows when to
seek assistance.
1.5 Distinguish and begin to apply when to act as the client advocate in incorporating the client
in decisions regarding plan of care.
Critical Competency #2: Critical Thinking and Clinical Reasoning

2.0 Implement clinical decision making with assistance, utilizing the nursing process applied to
diverse individuals and support systems.
2.1 Assessment
3. Systematically collect data, eliciting patients values, cultural preference, and needs
(QSEN).
4. Identify information to contribute to a data base.
2.2 Diagnosis
3. Recognize actual or potential self care demands/deficits
4. Comprehend client data to select a Nursing Diagnosis on the basis of beginning
analysis and interpretation of data.
2.3 Planning
4. Indicate client centered goals. Demonstrate shared decision-making in setting goals
based on patients values and evidenced base practice (QSEN).
5. Use rudimentary application of assessment information to establish priorities
6. Explain and prepare an individualized Care Plan with interventions that follow
established nursing protocols and criteria for evaluation.
2.4 Implementation
Wholly/Partially Compensatory Nursing Actions
5. Practices standard precautions.
6. Select implementation of plan of care according to priority goals and begin to
recognize the need to adjust priorities as changes occur.
7. With moderate direction, initiate nursing interventions in response to clients selfcare needs and/or deficits to maintain physical and emotional comfort (QSEN).
8. Provide patient-centered care with sensitivity and respect for the diversity of human
experience (QSEN).
2.6 Use current technology to enhance client care.
Educative/Supportive Nursing Actions
- 28 -
4. Assess for an environment conducive to restoration and maintenance of clients

ability to meet self-care requirements.
5. Teach health care to individual and groups.
f. Identify evident situations in which clients need information or support to
maintain or regain health.
g. Implement an appropriate teaching plan specific to the clients level of
development, knowledge, culture, and learning needs.
h. Support/reinforce teaching of health care professionals.
i. Perform rudimentary evaluation of effectiveness of client learning.
j. Provide for continuing care and express how to support the clients right to die
with dignity.
6. Evaluation
d. Recognize the effects of nursing interventions on the status of the client.
e. With moderate supervision, participate with client, significant others and team
members in evaluating clients progress toward goals.
f. With moderate guidance, revise plan as needed.
Critical Competency #3: Communication

3.0 Provide relationships characterized by caring and inclusive communications.
3.1 Maintain confidentiality.
3.2 Utilize principles of verbal/non-verbal communication to assess self, client and support
system with assistance.
3.3 Express appropriate communication skills to communicate with clients of all developmental
ages, support systems, and interdisciplinary team members.
3.4 Establish functional relationship and promote effective relationships. Recognize boundaries
of therapeutic relationship, with clarifications of students role and accountabilities under
conditions of potential overlap in team member functioning (QSEN).
4. Distinguish and demonstrate caring, nonjudgmental and sensitive behavior in
providing care and interpersonal relationships with moderate assistance
5. Promote psychological safety in interpersonal relationships with moderate assistance
6. Practice implementation of timely and effective conflict resolution with assistance.
3.5 Effectively communicate and document client behaviors and response to interventions and
plan of care.
D. Manager of Care
Demonstrate advanced beginner skills in providing care for a group of clients with defined
health deviations
Critical Competency #4: Responsibility and Accountability

4.0 Practice within the ethical and legal framework of nursing.
4.1 Demonstrates caring, integrity, ethical practice, diversity, education, community service, and
quality of care.
1. Recall principle of ethics to begin to recognize, explore and seek assistance related to
ethical dilemmas in practice.
4.2 Foster advanced beginner standards of nursing practice.
1. Participate in peer review and governance through observation and discussion.
4.3 Demonstrate professional behavior through appropriate attendance, appropriate
grooming/uniform dress, and without alcohol or substance abuse.
E.
Member within the discipline of nursing

Demonstrates ethical standards of nursing practice
- 29 -
Critical Competency #5: Organization and Prioritization

5.1 Establish priorities for 1 2 clients common, low to moderate acuity needs; adapts
priorities to changing situations
5.2 Organizes and effectively manages 1- 2 clients with common, low to moderate acuity needs in
a timely manner
5.3 Interact with interdisciplinary health care team members in a collegial manner with
assistance.
1. With assistance, interface appropriately with other resources to provide continuity of
care.
2. Identify channels of communication to begin to utilize them to accomplish goals
related to care delivery.
3. Collaborate with team members when situation encountered is beyond the students
knowledge and experience.
VIII. Workplace Preparation: The course will address the following SCANS competency areas:
A. Resources: the students will have access to faculty, textbook, library, technical-skills lab, acute
and ambulatory care settings and other college students. The students will demonstrate ability to set
goals for nursing care and to allocate time to complete those goals. They will plan and allocate
resources through understanding structure and function in cost effective methods of clinical practice.
B. Interpersonal: the students will be required to communicate with faculty, peers, clients, and
other health care professionals. The students will work in groups in problem-solving scenarios.
C. Information: the students will use computers and a variety of information resources to learn or
review skills which prepares them to assess, organize, analyze, evaluate, and communicate
information, including documenting and creating a plan of care.
D. Systems: the students will demonstrate understanding of organizational, social, and informatics
systems within a healthcare setting. They will analyze systems to identify root causes of failures and
areas for improvement.
F. Technology: the students will work with a variety of technologies within a healthcare setting,
including electronic medical records, computers, point-of-care testing equipment, and biomedical
machinery. They will maintain equipment properly, identify malfunctions and remove the item from
service.
The course also addresses the SCANS skills and personal qualities:
A. Basic Skills: the students will review, learn and perform the procedures listed on skills checklist.
They will read policy and procedures, write, perform arithmetic and medication calculations, and
effectively communicate patient information amongst the interdisciplinary team.
B. Thinking Skills: the students will demonstrate critical thinking in formulating and carrying out a
plan of care by thinking creatively, knowing how to seek information, making decisions based on
evidence, solving potential or actual self-care problems, and utilizing clinical reasoning.
C. Personal Qualities: the students will utilize the Nursing Professional Code of Ethics while
interacting with others. They will demonstrate responsibility and accountability. Respect others and
develop individual responsibility, self-management, self-esteem, and integrity.
IX.
Instructional Media:
A. Available for purchase at Moorpark College Bookstore:
- 30 -
1.
2.
3.
4.
5.
Beginning Nursing Science: NS1 Theory & Clinical Workbook Fall 2013
Moorpark College Department of Nursing Student Handbook Fall 2013
Moorpark College ADN Clinical Portfolio Fall 2013
Clinical Nursing Skills Checklist
Moorpark College Nursing Program Daily Journal form
B. Available at Moorpark College bookstores or suppliers:

6. Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., Camera, I.M. (2011). Medicalsurgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, MO:
Mosby.
7. Study guide for Med-Surg Nursing Textbook Lewis & Heitkemper (2011)
8. Altman, G.B. (2009). Fundamental & advanced nursing skills (3rd ed). Clifton Park, NY:
Delmar.
9. Ellis, J & Hartley, C. (2008). Nursing in Today's World (9th ed). Philadelphia, PA: Lippincott
Williams, & Wilkins.
10. Buchholz, S. (2011). Henkes med-math, dosage calculation, preparation, and administration
(7th ed.). Philadelphia, PA: Lippincott Williams, & Wilkins.
11. Jarvis, C. (2011) Pocket companion: Physical examination & health assessment (6th ed.). St.
Louis, MO: Saunders.
12. Doenges, M., Moorhouse, M.F. & Murr, A.C. (2010) Nurses pocket guide: Diagnoses,
interventions and rationales (10th ed.). Philadelphia, PA: F.A.Davis. (Or any nursing
diagnosis/care planning book of your choice)
13. California Nursing Practice Act. Read On-line version at
http://www.rn.ca.gov/regulations/bpc.shtml#2725
14. Professional Guide to Laboratory &Diagnostic Tests, and Nursing Drug Guide
* For Drug handbook and Diagnostic tests: Electronic PDA version for nurses is available.
To download these programs you need to have a smart phone or other PDA. Some sites are:
Pepid.com. skyscape.com, www.unboundmedicine.com. Free sites are available such as
Nursingcenter.com, Medline.com, and epocrates.com.
F.
Recommended Texts:
1. All in One Care Planning Resources. Latest edition, Swearingen-Elsevier.
2. Fundamental of Success: Test taking strategies. Latest edition Davis.
G. Other required materials:

1. Computer access for D2L and E-mail address (Computers are available in the library for
students without access, e-mail address will be provided upon request).
2. Others: As specified and assigned
a) Audio-visual aids: videos available.
b) Reading assignments in professional magazines.
c) Computer assisted instructions (CAI) as available.
- 31 -
d) All students will be required to participate for a video assignment. Bring a blank
DVD. A video recorder will be available for use in the skills lab, or the student may
bring his or her own recorder.
e) Nurse Pack: Paid for with your registration fees. Distributed in the skills lab.
f) A stethoscope, preferably a dual-headed one.
g) Watch with a second hand
h) Moorpark College nursing student uniform and Student photo ID badge
i) A plastic folder to submit your clinical portfolio, skills checklist, and all completed
assignments to your instructor every Hospital day at post conference.
H. Nursing Skills Lab (NS11)
Each student is strongly encouraged (not required) to register for NS 11 concurrently. This is an
instructor-assisted independent study in the skills lab. The lab time will be used for practicing
technical skills as well as critical thinking and test taking skills.
Clinical Grading Criteria for NS1 part 1
X.
90 - 100% = A
80 - 89% = B
75 - 79% = C
<74.5% = F Non Mastery
A student must master (>74.5% GPA) for each of the five critical elements following the final grade in
NS1L Part I to meet the course objectives and continue in the program. In addition, mastery (>74.5%) of
NS1L Part II is also required. Concurrent grade of >74.5% in Nursing Science 1 Part 1 Theory and
subsequently in Part II is required to progress to the next nursing level.
I.
Technical Skills
A.
Procedures and participation in skills lab 20 points possible per Skills Lab day
II. Critical Thinking/Clinical Reasoning:
A. Application of the Nursing Process: Students can receive points/process for each scheduled
day of patient care. Students will be assigned to a patient each Hospital clinical day.
1. Assessment
10 points possible per hospital day
2. Planning
3. Implementation
4. Evaluation
B. Nursing Care Study - 100 points See rubric and guidelines in Appendix.
C. Plagiarism/Advanced Directive Assignment - 40 points See guidelines in Appendix
D. Video Project- 25 points See rubric and guidelines in Appendix.
III. Communication:
A. Documentation
1. The student can earn 10 points per Hospital clinical day for complete and accurate
documentation.
B. Interpersonal Relations
1. The student can earn 10 points per hospital clinical day for preparing and conducting
a complete and concise report of the patients status to the staff nurse.
a. Provide accurate and complete information.
b. Communicate in a professional and respectful manner.
c. Maintain patient confidentiality
d. Report in an organized manner.
- 32 -
2.
Daily Journal
a. The student can earn 10 points per hospital clinical day for maintaining,
completing, and handing in the journal thoroughly, neatly, and on time.
b. Failure to turn in the daily journal on time results in a loss of 2 points per
late clinical day from the earned score.
IV. Responsibility and Accountability:

A. Self-Direction and Nursing Judgment
1. The student can earn 10 points per Hospital clinical day for the following behaviors:
a. No absences or tardies.
b. Meets all Moorpark college Nursing Program and hospital policies
ensuring safe and ethical conduct

Demonstrates ethical, professional behavior and assumes responsibility
for own actions.
d. Demonstrates good judgment regarding patient safety, staff safety, and
personal safety.
e. Turn in all required assignments, clinical portfolio on time.
c.
V. Organization and Prioritization:

A. Manage Patient Assignment
1. The student can 10 earn points for each day of patient care for organizational skills.
Points will be reduced for the following behaviors:

a. Plan, organizes, and manage total patient care for 1 - 2 clients with
selected self-care deficits with direct supervision.
b. Demonstrate prioritization of individual patient needs.
c. Complete client care assignment and journal on time.
VI. Performance Improvement Report (PIR) and Unsafe Practice Act (UPA)
A. Each student should read the complete descriptions of Performance Improvement/Unsafe

Practice (UPA) included in the clinical portfolio before entering the clinical area.
B. A UPA will be given to any student whose nursing behavior (knowledge, skills, & attitude)
may cause harm to a client and it has been identified as such by the clinical instructor.
1% grade reduction will occur for each UPA. For repetitive incidents occurring in the
same critical element, an increasing reduction of 2%, then 3%, then 5% will be
incurred.
C. Some examples of UPA are: Leaving the patient in a bed on high position, failure to
maintain confidentiality, patient abandonment, not notifying instructor and staff nurse of a
change in the patient's condition or abnormal vital signs, horse-playing, not following safety
procedures in transferring, medications, infection control etc.
VII. Late Assignments
Deduction of 2 points per day for the Daily Journal. For the Nursing Care Plan: 5% per day
deduction will be incurred. Any assignment turned in after 5 days will not be accepted and
will be given a ZERO
VIII. Absences
The Board of Registered Nursing requires students to have certain amounts of clinical during
their nursing education. Refer to the Student Handbook for details regarding clinical absences.
IX. Self-Evaluation:
- 33 -
It is the students responsibility to self evaluate and fill in the grade sheet in the clinical portfolio
for each clinical day. There are numbers listed in the first column indicating the maximum
number of points possible. Daily clinical points are based on the scale listed on the grading sheet,
which is based off of Patricia Benners Novice to Expert theory. The instructor may alter the
points that the student has self-assigned if deemed necessary. The instructors score is the
official grade.
X. Clinical Evaluation Day:
All students will be scheduled for evaluations on the mandatory clinical evaluation day. If the
student must miss his/her evaluation due to an approved excuse with documentation, then the
evaluation may be rescheduled after the evaluation day.
XI. Dropping a class:
When it is necessary to drop from a class at Moorpark College, it is the responsibility of the
student to drop the class via the Moorpark College website or in person at the Registration office.
Math Homework
Text: Henkes Medication Math, 7th ed.
Pages
Learning Activities
Evaluation
Chapter 2: Metric
Topic
Page 46
Self Review
Chapter 4: Calculation of
Oral Medications
liquids
p. 108
Do Proficiency
Test 1 p. 46
Do Proficiency
Test 3 p. 108
Do Self-Test 1 p. 138
IV drip rates
Chapter 8: Dosage based on
mg/kg
p. 131 - 138
199 209,
NS1 part 2 Med Proficiency

pre-test
296 - 304
Medication Calculation Rounding Rules: See D2L Homepage
- 34 -
Turn in to instructor
with GU module
Turn in to Instructor
with Resp/Cardio
module
Turn in with Neuro
module
Week 1 - 2: Basic Skills and Introduction to Nursing

I. Introduction:
Assisting in or performing activities of daily living is a critical role of the registered nurse. Skills
pertaining to hygiene, nutrition, elimination, safety, infection control, activity, and comfort will be
introduced, practiced, and evaluated prior to entering the clinical area to provide patient care.
Professionalism, responsibility, and preparation for clinical will be discussed and evaluated.
II. Learning Activities:
The student is responsible for:

1. Successfully logging on to Desire 2 Learn (D2)
2. Completing the Nursing Student Entrance Survey on our class D2L page homepage. Go
to the link. Password is: health. Submit the signed signature page to your lecture instructor.
3. Viewing the instructor-selected basic skills videos from the Skills Lab library
4. Practicing the prescribed basic skills to competency.
5. Turning in all required certificates, physical, immunizations, and other clearances to the
health sciences office.
6. Participating in review of clinical portfolio and discussion of self-evaluation and Progress
Appraisal Reports
7. Bringing the clinical portfolio and this workbook to all skills lab/clinical days.
III. Clinical Performance Objectives:
1. Provide caring, safe, technically competent fundamental patient-centered primary nursing

care to 1-2 patients with common, acute and chronic health and self-care needs of simulated
adult and geriatric patients in common and emerging healthcare settings.
2. Assist the patient with activities of daily living, and identify actual and potential health
deviations.
3. Demonstrates entry-level practice by accurate completion of the competency checklist.
4. Demonstrates grooming within the standards for the Moorpark College Associate Degree
Nursing Program.
5. Demonstrates professional behavior by arriving on time, treating the professor and peers with
courtesy, handling skills lab equipment appropriately, and adheres to the code of ethical
conduct outlined in the MCADN student handbook.
6. Accountable and Responsible for documents.
- 35 -
Week 1 and 2: Clinical Skills Checklist, Entry Level Competencies

Student and a partner will learn, practice, and perform all of these tasks in the first 2 weeks of clinical in the skills
lab. Five skills will then be randomly chosen by your clinical instructor in a scenario typical of your clinical day.
You and your partners performance will be graded on a pass/fail basis. Failure will require remediation and
successful retest within 1 clinical week or will result in 0 points for week 1 and week 2 implementation area.
Read Altman
Nursing Skills
3rd ed
Chapter 1:
Physical
Assessment
to Intake
/Output
Chapter 2:
Safety and
Infection
Control
Chapter 3:
Client Care
and Comfort
Chapter 4:
Basic Care
Skill
Pages
General Assessment/General Survey
3-6
Measure and record vital signs: T, HR, B/P,

RR, Pulse Ox, pain
Manual blood pressure
29-43,52,58,
Weighing the patient
p. 67
Measuring Intake/Output
p. 64
Proper Body Mechanics, Safe Lifting and

Transferring
Apply restraints
143, 153,
Handwashing and Hand hygiene
173
Isolation procedures: Gown, gloves, mask
179
Disposal of soiled linen, contaminated items
186
Emergency Airway Management
213
The effective communication Process
263-266
Provide Passive Range Of Motion
516
Therapeutic Massage
286
Applying Cold Treatment
320
Make an unoccupied bed
337
Make an occupied bed
345
Turning and Positioning a Client
352
Assist with bed pan/urinal
369
Assisting with Feeding
376
Bathing a Client in Bed
383
Oral Care
391
Shaving a client
433
Provide incontinence care, adult brief
402
Assisting from Bed to Wheelchair
457
Assist to ambulate with cane, crutches, walker
153-160
Assisting from bed to walking, using gait belt
464
Using a Hydraulic Lift+weight
471
- 36 -
58
161
Pass
Need
Improvement
Comments
NS1L Part 1 Module 1: The Foundation of Nursing Practice

Introduction:
This module is designed to assist the student in the application of the nursing process and the
performance of the nursing health history. There will be a major focus on the interviewing process,
communication techniques, and sensitivity to the diverse cultural and spiritual backgrounds of the clients.
Nursing Process will be practiced and Introduction to physical assessment and documentation.
I.

A. The student is responsible for:
1. Reading Prior to Lab

a. Del Mar Fundamental Nursing Skills: Read skills chapter 1-4
b. Jarvis Chapter 1 through end of 4
2. Viewing the videos during clinical lab:
a. HIPPA
b. Your Legal Duty: Reporting Elder and Dependent Abuse
Recommended videos: Putting it all together
Transcultural Perspectives in Nursing: Communication part II
3.
4.
5.
6.
Participating in Student Interview Activity on a fellow student.

Participate in demonstration of cursory head to toe evaluation of a client.
Being prepared for class with readings and materials.
Participate in Documentation of subjective and objective information activity

Recall that nursing theory provides the basis for nursing systems and activity. Your clinical grade is
based on your performance in 5 critical areas of nursing practice. These areas are:
Communication
Technical Skills Critical
Responsibility
Organization
Thinking/Cli
&Accountability
&Prioritization
nical
Reasoning
With this in mind, when the student is assigned either an adult or geriatric patient he/she will:
1. Adhere to the professional conduct and etiquette identified in the MC ADN Student Handbook.
2. Identify problems he/she has in talking with patients.
4. Address patients and other personnel with the correct title and/or name.
5. Utilize correct principles of interviewing.
6. Interact in a one-to-one relationship and/or in a group setting effectively.
7. Begin to identify and report patient communication to the appropriate team member.
8. Identify and utilize effective verbal, nonverbal and written modes of communication in clinical setting.
9. Use appropriate communication when relating to a patient with communication barrier.
10. Demonstrate awareness of the importance of the family as a source of information and care
11. Demonstrate knowledge of communication patterns between cultural and ethnic groups
12. Recognize communication blocks based upon cultural misconceptions.
- 37 -
Module 1, Interviewing Assignment

Name: _____________________________________
I interviewed: ________________________________
1. What influenced you to choose nursing as a career?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
2. What do you want to learn in this
class:________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
3. What were your thoughts and feelings when you were accepted into this nursing program?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
4. Are you working now, in what occupation, and how many hours a week?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
5. How are you planning on managing your studies, family and work responsibilities while in the
program? Give at least 3 ways
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
6. List 3 weaknesses and how will you address them to ensure your success in this program?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
7. List 3 strengths that you will bring to this program? (ex: language, work history, life experience,
support system)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
Reference: Spector, R. Cultural Diversity in Health and Illness
TURN THIS IN TO INSTRUCTOR on Day 2 of the week
- 38 -
Module 1 Head to Toe Assessment SAMPLE ASSESSMENT FORM

Name:
NORMAL
Neuro: Alert and oriented X4
(To person, place, time, event).
Pupils equal, round, reactive to
Light (perrl).
Active Range of
Motion (ROM) of all extremities.
No paresthesia
Pain:
____Yes
____No
Sleep: Problems
___Yes
___No
Psych-Social
Behavior appropriate to situation.
Cooperative. Responds
appropriately to all questions. No
delusions, mood disturbances, no
hallucinations. No suicidal
ideation.
Cultural/Spiritual
__No problems or requests
__Advance Directives on file
Integumentary
Skin color uniform. Smooth, soft,
warm, dry, intact. Turgor WNL.
Mucus membrane moist. No odor.
___All parameters WNL
Musculo-Skeletal
Absence of joint swelling and
tenderness. Muscle strengths 5/5
bilaterally. Full ROM all joints. No
weakness. No deformity, gait
steady. No numbness or tingling.
Respiratory regular, unlabored.
Breath sounds clear and equal
bilaterally. Respiration 12-24 per
minutes. Sputum clear. Pulse
Oxymeter >90%
Normal
Cardiovascular: Regular radial
pulse. Capillary Refill Time (CRT)
<3 secs. Peripheral pulses palpable.
VARIANCE
Instructor:
NURSING DIAGNOSES
Disoriented: to
_____P erson
_____Place
_____Time
_____ Event
Sensory Motor Impairment:
__Alteration in thought processes

__Pain
__Risk for injury
__Sleep pattern disturbance
__Anxiety
Location:
Description:
Intensity (1-10):
Duration;
Better: Worse:
Disturbance
___Pain
___Acute
___Chronic
Affect:
___Social isolation
___Knowledge deficit
___Alteration in Coping
___Other
Family Issues
___Sleep pattern disturbance
Requests or special
considerations:
___Needs info on Advance
Directive
___Communication
___Spiritual Distress
Appearance:
__Impaired skin integrity

__Infection
__Other:
Condition:
Immobile:
Deformity:
Breath Sounds:
___Alt in mobility
___Activity intolerance
___Risk for injury
___Other
___Ineffective breathing pattern
___Other
Cough:
Rhythm:
Edema:
- 39 -
___Activity Intolerance
___Pain
No edema. No calf tenderness (or

Negative Homan's sign).
Gastro-Intestinal
Ate >75% meal. Reported good
appetite. Denies N/V. Abdomen
soft, non-distended, non-tender.
Bowel sounds active all quadrants.
Bowel movements within own
normal pattern and consistency.
Last BM:
Genito-Urinary
Voids without dysuria. Urine clear
amber. No distension. Continent of
urine
Reproductive/Sexuality
Female: No vaginal bleeding,
itching, discharge, or legion. . No
complaints of sexual dysfunction.
Pulses:
Homan's:
___Other
Bowel Sounds:
___Alteration in elimination
___Diarrhea
___Constipation
___Incontinence
Abdomen:
Tubes:
__Alteration in Nutrition
___More than ___Less than
Urine:
Appliances:
Discharge:
Unusual Bleeding/Pain
Male: No prostate problems, penile

bleeding, lesions, or discharge. No
complaints of sexual dysfunction.
- 40 -
___Alteration in elimination
___Retention
___Incontinence
___Pain
___Infection
Skills Lab NS1 p1
Week 1 GRADING SHEET, part 1 of 2
Basic Skills: Physical Assessment and Safety

Name: ________________________________ Date: _____________________
Students will self-evaluate based on these Grading key percentages:
100% of points = Excellent,
80% of points = Proficient,
60% of points = Competent,

40% of points = Advanced Beginner,
10% of points = Novice,

0% of points = Absent
The instructor will review and change the points as necessary to reflect the students performance. The
instructors points are the final points that will be entered into the clinical portfolio.
Skills Lab points
Possible Points
Student
Points
Comment
Assessment
All required paperwork on file in the health
sciences office and copies included in clinical
portfolio (CPR, Fire card, physical,
immunizations etc., MC photo ID). Attach
copies to back cover of the clinical portfolio
Planning
Demonstrates proficiency in computer skills
by logging on D2L and introducing self to
class in Discussion section.
10
*Grading sheets will be

completed by the student
and turn in with the
clinical portfolio on the
2nd day of clinical each
week.
10
Has read the required reading.

Brings this clinical workbook and clinical
portfolio to lab.
Implementation
Practice basic skills with a peer in class
20
Clinical Portfolio: Sign and date exhibits for

NS1 part 1
Clinical Portfolio: Write NS1p1 Goal for self.
With instruction, completes paperwork in
preparation for hospital orientation neatly,
accurately, and in black pen
Professionalism & Evaluation
Arrive on time, be prepared for class, stay on
task. Handles skills lab equipment
appropriately. Interacts with peers and
instructor in a respectful manner.
10
TOTAL
50
TURN THIS IN TO CLINICAL INSTRUCTOR on Day 2 of week 1
- 41 -
Turn this form in to

Clinical Instructor on 2nd
day of clinical this week,
with clinical portfolio
Skills Lab NS 1 Part I, Week 1 Grading Sheet, part 2 of 2

Module 1
Foundation of Nursing Practice
Name: ________________________________ Date: _____________________

There will be a total of 20 points possible for this portion of skills lab.
Students will self-evaluate and determine their graded based on, but not limited to, the following scale:
Grading key:
5 = Excellent, 4 = Proficient, 3 = Competent, 2 = Advanced Beginner, 1 = Novice, 0 = Absent
The instructor will review and change the points as necessary to reflect the students
performance. The instructors points are the final points that will be entered into the clinical
portfolio.
Skill
Assessment
Learning Activity 1:
Interviewing Assignment
Assignment is to be completed in
ink.
Planning
Has all necessary equipment and
brings Nurse Pack as necessary
Has read material prior to class
Implementation
Learning Activity 2: Participate in
Head to Toe assessment of another
student with instructor's assistance.

The student will arrive on time to
skills lab, prepared for class, assist
with clean up, and stay on task during
skills lab time.
TOTAL
Possible Points
Student
Points
20
- 42 -
Comment
Module 2: Legal and ethical issues and Nursing Process

I.
Introduction:
This module is designed to assist the student in the application of the nursing process for client health
problems and also for ethical decision-making. The focus is on the identification of subjective and
objective data, formulation of nursing diagnoses and development of expected outcomes and
appropriate interventions.

A. The student is responsible for: Required Reading
Delmar: Safety and Infection Control: Chapter 2: 2.1-2.6

and Ch 4 4.1-4.19, 4.24, Therapeutic Communication: Chapter 3, p. 263
Jarvis, Chapter 3
Viewing video/DVD
Nursing Process and Critical Thinking
"Head to Toe Assessment"
Infection Control
a. Recommended video: Code Gray.
Participate in discussion of the personal Advanced Directive Assessment
Participate in discussion of nursing diagnosis and Care Plan requirement
Participate in practicing nursing process with Care Plan
Participating in nursing process exercises and ethical discussions
based on your performance in 5 areas of nursing practice. These areas are:
Technical
Skills
Critical
Thinking/Clinical
Reasoning
Communication
Responsibility
&Accountability
Organization &
Prioritization
With this in mind, when the student is assigned either an adult or geriatric patient he/she will:
1. Demonstrate skill and understanding in the performance of the nursing process.
2. Demonstrate proficiency in conducting a nursing health history.
3. Follow the clinical policies outlined in the MC ADN Student Handbook.
3. Demonstrate the principles of the ethical base of nursing and the legal aspects of nursing when
providing care to clients in the clinical setting.
4. Identify subjective and objective client data.
5. Formulate a nursing diagnosis that is pertinent for assigned client.
6. Write goals or expected outcomes that are appropriate for assigned client.
7. Observe a patient who demonstrates anxious or stressed behavior and identify signs and symptoms of
anxiety-stress.
14. Interact therapeutically with a patient who demonstrates anxious behavior.
15. Identify the required information when conduction a nursing health history on a geriatric client.
16. Identify independent, dependent and interdependent nursing interventions for assigned client.
17. Conduct and complete an Elder Interview /Advanced Directive Assignment
- 43 -
Learning Activity for Skills Lab: Module 2

Case Study #1
Group Documentation Exercise
J.M. a 24-year-old male patient admitted to the orthopedic unit with a fractured Lt. femur following a
motorcycle accident. His vital signs are as follows: T-98.0, P- 102, R-24, BP- 140/80. He is grimacing,
tense, reports pain level of 9 out 10 left leg. He is alert and oriented to person, place, time and situation.
Skin is warm and dry, respirations even and unlabored, denies shortness of breath. His abdomen is soft
and non-distended. He has a 5x 4x 2 cm subcutaneous wound left arm and abrasions on his chest, arms
and legs. Full cast Left leg, toes Capillary Refill Time <3secs, pink, warm, with movement, denies
numbness or tingling. He receives Morphine IV 2mg every 4 hours for c/o pain. Dressing changes to left
arm wounds bid. His IV is D5 1/2 NS at 125cc hr to right arm, site without erythema. He told the nurse
that he is worried about the cost of treatment, as he does not have health insurance. He asks: "what's the
cast for?"
DOCUMENTATION EXERCISE:
For this exercise, your instructor will read to you a case study. On this sheet of paper you will document
as many subjective and objective pieces of information from the case study as possible. The class will
then take this information and build 3 nursing diagnoses: one physical, one psychosocial, and one
educational.
As a class: Choose a Physical Diagnoses., a Psycho-social Diagnoses, an Educational Diagnosis
1. What would be expected goals for this patient? Use this format: By time, patient will verb
{walk, say, eat etc} as evidenced by {walk 10 feet, said pain is <5 (0-10), 100%
2. What are some of the things nursing can do to address this problems?
3. How could we evaluate his response to these actions? Go back to the goal, was it met, not met,
how do you know?
Identify 3 priority nursing diagnoses: 1 physical, 1 psycho-social, 1 educational.
Physical Nursing Dx
Psych Social
Educational
Goal:
Goal:
Goal:
Interventions
Interventions
Interventions
Eval:
Eval
Eval
- 44 -
Skills Lab NS1 p1

Week 2 GRADING SHEET, part 1 of 2
Week 2: Basic Skills + Care & Comfort
Name: ________________________________ Date: _____________________
Students will self-evaluate based on this Grading key:
100% of points = Excellent,
80% of points = Proficient,
60% of points = Competent,

40% of points = Advanced Beginner,
10% of points = Novice,

0% of points = Absent
Skills Lab points
Possible Points
Assessment
Assess safety in environment
10
Student
Points
Comment
Pts cultural needs and preferences

Assess developmental level
Planning
Has read the required reading
10
Demonstrate competency in patient centered
care.
Brings this clinical workbook and clinical
portfolio to lab.
Implementation
Communicate and collaborate with peers
and simulated patient.
20
Perform skills accurately and safely

Follow infection control procedure
Turn in Plagiarism/Advance directive
assignment (grading of assignment is
separate)
Arrive on time, be prepared for class, stay on
task. Handles skills lab equipment
appropriately. Interacts with peers and
instructor in a respectful manner.
10
TOTAL
50

Clinical Instructor on
2nd clinical day of the
week, with clinical
portfolio
- 45 -
Skills Lab NS1 part 1 Week 2 GRADING SHEET part 2 of 2

Legal & Ethical issues & Nursing Process
Name: ________________________________ Date: _____________________
There will be a total of 20 points possible for this portion of the skills lab.
Students will self-evaluate and determine their graded based on the following scale:
5 = Excellent, 4 = Proficient, 3 = Competent, 2: Advanced Beginner, 1 = Novice, 0 = Absent
Skill
Possible Points
Assessment
Documentation Exercise
Planning
Student
Points
Comment
Has read material prior to class. Has

visited QSEN.org and list 6 core
competencies
Implementation
Participates in class discussion
regarding Standard of Care, QSEN,
Safety, and Communication.
Bring 1 nursing article about QSEN
to Post-Conference.
Signature pages of Student

Handbook
Skills lab, assist with clean up, and
stay on task during skills lab time.
TOTAL
20
TURN THIS IN TO INSTRUCTOR
Clinical instructor
will turn in the
plagiarism
assignment and
signature pages for
filing.
on Day 2 of week 2
- 46 -
Week 3: Hospital and Skills Lab Orientation

I. Introduction:
In accordance with Joint Commission policy, no student may provide nursing care or perform nursing
tasks in the facility setting without completion of orientation to the facility.
III. Learning Activities:

1. Viewing the videos: All videos will be viewed in Skills Lab clinical day
a. Your Legal Duty: Reporting Elder and Dependent Adult Abuse
b. HIPPA
c. Infection Control
2. Bring signed confidentiality forms and Electronic Medical record privacy forms to
orientation, if distributed by clinical instructor
3. Completion of Computer Orientation & HIPPA post-test requirements (a copy will remain in
the students college records)
3. Having all required certificates, physical, immunizations, drug screen, and background check
on file at the Health Sciences Office.
4. Having a copy of the above documents attached to back of the Clinical Portfolio and show to
your clinical instructor on Orientation Day.
5. Attending hospital and computer documentation orientation in full uniform with Moorpark
College Student Photo ID badge.
6. Participating in review of clinical portfolio, discussion of self-evaluation and Progress Reports
7. Participating in the orientation to and tour of the hospital.
8. Bringing the clinical portfolio and this workbook to the hospital orientation.
IV. Clinical Performance Objectives:
1. Demonstrates grooming and wear of uniform within the standards for the Moorpark College
Associate Degree Nursing Program.
2. Demonstrates professional behavior by arriving on time, treating the clients, hospital staff,
professor and students with courtesy, and adheres to the code of ethical conduct outlined in the
MCADN student handbook.
3. Accountable and Responsible for documents.
Skills Lab and Hospital Orientation:
I. Introduction: Orientation to the Skills Lab will be essential for optimum utilization of the equipment,
services, and media available to the student. This will include orientation to the required paperwork for
NS1L Part I, computers, and introduction to the skills lab.
II.
Learning Activities:
1. Arriving to class prepared, having read and bring the NS1 part 1 Workbook, Clinical Portfolio,
required texts, and the Nurse Pack.
2. Viewing of required videos will be done on Skills Lab day
3. Participating in discussion of Plagiarism/Advanced Directive assignment, Group Video, and
the Nursing Care Plan assignments.
4. Completion of Plagiarism/Advanced Directive assignment.

1. Accountable and Responsible for all required documents and materials.
2. Demonstrates professional behavior by arriving on time, treating the professor and students
with courtesy, and adheres to the code of ethical conduct outlined in the MCADN handbook.
3. Identify behaviors that warrant a Progress Performance Report/Unsafe Practice.
- 47 -
Skills Lab NS1 p1
Hospital Orientation GRADING SHEET

(20 pts possible)
Name: ________________________________ Date: _____________________

Students will self-evaluate based on this Grading key:
5= Excellent, 4 = Proficient, 3 = Competent, 2 =Advanced Beginner, 1 = Novice, 0 = Absent
Skills Lab points
Possible Points
Student
Points
Comment
Assessment
Wears full uniform with photo ID
Planning
Has read the NS1p1 Clinical workbook
module 1 and 2.
Brings Clinical Portfolio, with all required

paperwork still attached to back cover.
Brings black pen for signatures.
Implementation
With instruction, completes St. Johns or Los
Robles orientation forms and paperwork
accurately and neatly.
St. Johns: Complete the internet-based MCR

orientation (instructions will come from
clinical instructor)
The student will arrive on time, prepared for
orientation, remains focused on and engaged
with orientation.
TOTAL
20
on Day 2 of week 3
- 48 -

Clinical Instructor on
2nd clinical Day with
clinical portfolio.
NS1L Part 1 Module 3: Assessment of the Client with Self-Care Deficits

Related to Integumentary and Musculoskeletal Alterations
Introduction :
This module is designed to assist the student in the application of the nursing process to the client with
self/care deficits related to the integumentary and musculo-sketeletal systems. There will be a major
focus on assessments, nursing systems and education.
1. Reading:
a. Del Mar Chapter 2: Safety and Infection Control: 2.7-2-9.
Ch. 9 Skin Integrity and Wound Care: Skills 9.1 to 9.11
b. Jarvis, Chapter 5, 15 Assessment of the Musculoskeletal and
Integumentary Systems.
c. Math Homework See p. 33
2. Viewing the videos:
a. AJN Nursing Management of Wounds.
3. Bring a nursing research article about skin, musculosketal to share with class
3. Web resources: Review ATItesting.com
Review of Physical Systems McGill University Virtual Stethoscope:
http://sprojects.mmi.mcgill.ca/mvs/mvsteth.htm.
4. Performing assessments of the integumentary system
5. Donning and removing sterile gloves
6. Preparing a sterile field
7. Collecting a wound culture
8. Irrigating a wound
9. Changing a dry sterile dressing
10. Applying wet to dry dressings
11. Performing isolation precautions
12. Using standard precautions
13. Performing assessments of the musculoskeletal system
14. Document using a problem oriented charting method a wound and sterile wet to damp
dressing change.
15. Transferring of clients (review)
16. Actively participating in clinical conference discussions and activities
17. Participate in discussion of Problem Based Learning, medication math, video assignment.
Clinical Performance Objectives:

Communication
Technical
Nursing
Responsibility &
Organization &
Skills
Process
Accountability
Prioritization
- 49 -
With this in mind, when the student is assigned either an adult or geriatric patient with self-care deficits
related to skin and musculoskeletal system he/she will:
1. Demonstrate an understanding of the normal anatomy and physiology.
Assessments and rationale.
2. Perform a health history.
Relate the elements of an integumentary and musculoskeletal physical examination.
Distinguish the other systems that are especially important in a detailed integumentary and
musculoskeletal history.
3. Performance of a integumentary and musculoskeletal physical examination.
4. Interpret observations of patients with skin, musculoskeletal alterations.
5. Plan personalized nursing actions with patient experiencing skin, muscle and bone problems on short
and long term basis.
State nursing diagnosis.
Plan nursing actions and establish priorities in providing nursing care.
Identify nursing responsibilities in interventions.
Include client/family in setting goals.
Incorporate psychological, social adjustments.
Incorporate client/family teaching.
Incorporate rehabilitation team.
Develop individualized discharge plan.
6. Identify the risk factors of developing a pressure ulcer of assigned client using the Braden scale.
7. Observe the four stages of pressure ulcers on clients in the clinical facility.
8. Develop nursing diagnoses related to the development of a pressure ulcer on assigned client.
9. Perform nursing actions to prevent or minimize pressure ulcers in the assigned client.
10. Perform cleaning and dressing a wound.
11. Develop a teaching plan that addresses the needs of clients/family caregivers with altered skin
integrity.
12. Care for a client in isolation.
13. Practice safe hand washing/use of hand sanitizer gel in the clinical arena.
14. Identify the risk factors of altered mobility.
15. Develop nursing diagnoses related to altered mobility of assigned client.
16. Perform nursing actions to prevent falls of the assigned client.
17. Perform passive range of motion (ROM) on assigned client.
18. Perform ADL care, including oral care on assigned client.
IV. Daily Journal Requirement this week: Complete the following parts of the Daily Journal:
- Kardex and assessment sections,
- 1 physical nursing diagnosis and plan
- Columns 1, 5, 6 of the medication section on the back.
- 50 -
Case Study #2 : Skin Musculo/Skeletal

Your patient is a 84-year-old female client admitted to the hospital after a fall at home. She is now
recovering after an operation for a fracture left hip, an open reduction internal fixation (ORIF)
surgery. She has a history of dementia and is nonverbal. Her vital signs are as follows: T-99.9, P102, R-24, BP- 140/80, pulse oxymeter 92%, moaning. BMI 20.
Awake and oriented X 1, to name only. Skin warm and dry, with poor turgor. Stage 2 decubitus on
coccyx 2 cm x 3 cm x 1 cm, moderate amount green purulent drainage with foul odor. Respirations
even and unlabored. Abdomen is soft and non-distended. Fed 100% of pureed breakfast and lunch.
Last BM yesterday: large brown, soft formed. Foley Catheter draining amber cloudy urine, > 30
mL/hr. Dressing over left hip clean and dry. Muscle strength 5/5 upper extremities and 4/5 lower
extremeties bilaterally, toes pink, mobile with sensation. She receives IV of Normal Saline at
100cc/hour to her left wrist. IV site non-tender, without erythema.
Her husband visits and states that he "feels helpless, conflicted whether to request a DNR order for
his wife. He states Will DNR mean that she will not get good nursing care?
1.
2.
3.
b.
c.
d.
e.
f.
g.
h.
2 Gm sodium pureed diet

UA/ C&S
C&S decubitus then
Clean wound with NS, covered with duoderm Q 3 days.
IV NS @ 100cc/hr.
Air Flow mattress
Foley Catheter
I&O
Ancef 1 gm antibiotic IVPB q 8 hrs.
Morphine 1-2mg IVP q 1-2 hrs. prn pain
Labs are as follows:

a. WBC- elevated >10,000
b. BUN- elevated
c. Blood clotting- normal
1.
Identify 3 priority nursing diagnoses: 1 physical, 1 psycho-social, 1 educational
2.
Print out 1 nursing article about skin, musculoskeletal, decubitus, ORIF, focus on nursing
interventions. Use our class D2L web links to look for article. Bring the article to share with our
clinical class.
- 51 -
Skills Lab Nursing Science 1 Part I

Module 3: Integumentary and Musculoskeletal (20 Points)
Name: ________________________________ Date: _____________________
Students will self-evaluate and determine their graded based on this scale: Key 5 Excellent, 4 =
Proficient, 3: Competent, 2 = Advanced Beginner, 1 = Novice, 0 = Absent
Skill
Possible Points Student
Comment
Points
Assessment
Problem Based Learning; case studies 5
Planning
Implementation
Demonstrates skin/musculoskeletal
assessment skills accurately.
Document below using PIR problem

oriented recording of: a wound
description and sterile wet to damp
dressing change.

skills lab, assist with clean up, and
participates and stays on tasks.
TOTAL
P= Problem: Nursing Diagnoses

R/T________aeb:
Subjective Data
Objective Data
I= Nursing Interventions
R= patient's response to nursing
interventions.
20
P:_(Nursing Diagnoses R/T

aeb Subj and Obj. Data)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
I:_(Interventions)_____________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
__________________________________________________________________________________
R. (Patient's response to nurse's interventions)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
TURN THIS IN TO INSTRUCTOR on Day 2 of week 3
Daily Journal this week: Kardex and assessment sections, 1 physical nursing diagnosis and plan,
Columns 1, 5, 6 of the medication section on the back.
- 52 -

Related to Gastrointestinal Alterations
I.
Introduction:
self-care deficits related to the gastrointestinal system. There will be a major focus on physical
assessments, nursing systems and education.
1. Delmar Chapter 6 Nutrition and Elimination, pages: 701-728, 840- 858
2. Reading Jarvis, "Assessment of the Gastrointestinal System".
3. Viewing videos on:
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
a. Bates visual guide for Physical Exam: Abdomen

b. Enteral Therapy: nursing implications
Review ATI skills on GI system and ostomy care prior to class
Bring a nursing article about GI to share with class
Performing assessments of the gastrointestinal system
Inserting, checking placement, irrigating a Nasogastric (NG) Tube
Document a NG tube insertion practiced in class
Changing a Stoma Appliance on an ostomy
Administering a Cleansing Enema
Reviewing pericare.
Completing the Dietary Assessment on a fellow student.
Self Study Henke Math Calculation
Communication
Technical
Nursing
Responsibility
Organization
Skills
Process
Accountability
&Prioritization
related to gastrointestinal status he/she will:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Demonstrate an understanding of the normal anatomy and physiology.

Perform a health history.
Relate the elements of a gastrointestinal physical examination.
Distinguish the other systems that are especially important in a detailed gastrointestinal history.
Performance of a gastrointestinal physical examination.
Make, document and interpret observations of patients with nutritional and elimination alterations.
Plans personalize nursing actions with patients experiencing nutritional and elimination problems on
short and long term basis.
Care for a patient with enteral nutrition.
Develop nursing diagnoses related to nutritional problems on assigned patient.
Develop nursing diagnoses related to bowel elimination problems on assigned patient.
Daily Journal this week: Same as before, PLUS 1 psychosocial nursing diagnosis and plan, 1
educational nursing diagnosis and plan, and columns 1-6 of the med section on the back.
- 53 -
Module 4
GI Case Studies
1. J.C. is an 80 year-old male Rehab client with a diagnosis of Alzheimer's, dehydration, and
constipation. Client is ambulatory and attempts to wander off the Unit. He becomes combative and calls
out when restrained and left in his room. He drinks fluids well when encouraged by the staff, but only eats
when his son is visiting. His abdomen is distended with hypoactive bowel sounds. His last bowel
movement was 3 days ago. He lost 2 lbs in 1 week.
1. What are his primary system problems?
2. What are some of the things nursing can do to address these problems?
3. What would be expected goals for this client?
4. How could we evaluate his response to these actions?
2. Mrs. Klotz has just been admitted to the hospital with severe abdominal distention. A flat plate x-ray of
the abdomen shows a possible small bowel obstruction. A Nasogastric tube has been ordered for
abdominal decompression. Mrs. Klotz is NPO except ice chips. This NG tube will be connected to low
intermediate suction to facilitate empting of the stomach.
1. How will you determine which nostril to place the NG tube in?
2. What will be your first intervention if you cannot place the NG in the nostril you have
chosen?
3. What will be your next step if you are unable to place the NG tube in either nostril?
4. After placement you cannot hear air bubbles over the gastric region, what will be your
intervention?
After placing the NG tube it drains well and 400cc of green liquid is obtained. After 3 more hours no
more fluid is evident in the suction canister. Mrs. Klotz is complaining of worsening nausea.
5. What intervention is appropriate for Mrs. Klotz at this time?
6. Write one physical nursing diagnosis for Mrs. Klotz.
- 54 -
NS1 Part 1 Module 4: Dietary Assessment

Interview each other
A. 24 hour recall of diet
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
B. Does your present intake differ from your usual intake? If yes, what is the reason?
_________________________________________________________________________________
___________________________________________________________________________
C. Do you have any food allergies or intolerance?
I.
_________________________________________________________________________________
________________________________________________________________________
Who does the food shopping?
_________________________________________________________________________________
_________________________________________________________________________________
Who prepares the meals?
_________________________________________________________________________________
____________________________________________________________________________
Do you have adequate food storage space and preparation equipment?
________________________________________________________________________
Do you now or have you in the past, followed a modified diet prescribe by a healthcare provider?
_________________________________________________________________________________
_________________________________________________________________________________
Do you now or have you in the past used a fad diet, health foods or self-prescribed supplements?
_________________________________________________________________________________
______________________________________________________________________
Have you had a fever in the past week? ______________________________________
J.
How much alcohol do you drink a week, what type? ______________________________________
D.
E.
F.
G.
H.
K. Is your food budget adequate?________________________________________________________

L. What is your BMI? _______
Your ideal?________________________________________
M. Have you had recent unintentional weight loss or gain greater than 10% of weight? ______________
N. Have you recently had any of the following abnormal lab tests?
Low hemoglobin and hematocrit

Decrease in lymphocyte count
Serum albumin less than 3.5 g/dl
Elevated or decreased cholesterol level
- 55 -

Module 4: Gastrointestinal (20 points possible)
Name: ________________________________ Date: _____________________
5 = Excellent, 4 = Proficient, 3:Competent, 2: Advanced Beginner, 1 = Novice, 0 = Absent
Skill
Possible Points
Assessment
Problem Based Learning/case study
Self-Review of Henke Ch. 2.

Planning
Has all necessary equipment and brings
Nurse Pack as necessary
Has read all materials prior to class
Bring a nursing article about GI to
share with class
Implementation
Demonstrates skills accurately
Student Points
Comment
Document using the PIR or SOAP

below of a Nasogastric Tube
insertion.
The student will arrive on time to skills
lab, come prepared for class, assist
skills lab time.
Math homework
TOTAL
20
NG insertion Documentation:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Daily Journal this week: Same as before, PLUS 1 psychosocial nursing diagnosis and plan, 1
educational nursing diagnosis and plan, and columns 1-6 of the med section on the back.
- 56 -

Related to Genitourinary Alterations
II. Introduction:
self-care deficits related to the genitourinary system. There will be a major focus on physical
assessments, nursing systems and education.
B. The student is responsible for reading:
1. Del Mar Chapter 6: Nutrition and Elimination: pages 751-795,

2. Jarvis, "Assessment of the Genitourinary System".
3. Henkes Medication Math
4. Bring an article about GU to share with classmate
5. Viewing videos on: "Basic Clinical Skills: Urethral Catherization"
6. Review ATI skills r/t GU system prior to class
7. Performing assessments of the genitourinary system
8. Catheterizing the Female Urinary Bladder
9. Catheterizing the Male Urinary Bladder
10. Document a Indwelling Urinary Catheter insertion (Foley).
11. Irrigating the Catheter Using the Closed System
12. Review the techniques for obtaining a clean catch urine specimen, a sterile culture &
sensitivity urine specimen
13. Differentiate between condom, straight catheter, Foley catheter and Continuous
Bladder Irrigation.
14. Complete an Intake and Output documentation in the clinical setting.
IV. Clinical Performance Objectives:
Technical Skills
Nursing Process
Communication
Responsibility
Accountability
Organization &
Prioritization
related to genitourinary status he/she will:
Relate the elements of a genitourinary physical examination.
Distinguish the other systems that are especially important in a detailed genitourinary history.
6. Performance of a genitourinary physical examination.
7. Care for an indwelling catheter
8. Monitor intake and output
Daily Journal this week: Same as before, PLUS the entire med section on the back.
- 57 -
Case Study #5
Module 5: Urinary Problem
You are the nurse assigned to a 74 year old female patient in the emergency room who is admitted with
urosepsis. Her vital signs: 164/90, 98, 24, 100.8 U/A result: WBC +40, Spec. grav 1.032. pH 7.0, C&S:
E. Coli, MRSA. She has an order for the placement of a Foley catheter. She is restless and irritable.
1. What will you tell the patient about the procedure?
2. List what supplies you will need for this procedure.
It is a busy day in the ER and you attempt to catheterize this patient on your own. On the first attempt you
are unable to visualize the urinary meatus and make an attempt since you have some idea where it is.
No urine is obtained from the catheter.
3. Explain why this attempt was unsuccessful.
4. Were any standards of care breeched during this attempt?
5. What is your next action?

You are successful on your second attempt and allow the family to enter the room. The daughter sits
closely to the bed and places the urinary bag on the bed to avoid bumping it.
6. What is your first action?
7. What teaching will you give the family?
8. Describe how you will obtain a urine specimen from the patient at this time.

- 58 -

Module 5: Genitourinary (20)
Name: ________________________________ Date: _____________________
There will be a total of 20 points possible for this skills lab.
Skill
Possible Points
Student
Points
Comment
Assessment:
GU assessment on simulated patient
Turn in Math homework:

Proficiency Test 3, page 108
Bring an article about GU to share
with classmates at post conference.
Planning
Implementation
Document PIR below: a
Foley Catheter insertion
Straight Cath insertion
Sterile urine specimen
skills lab, prepared for class, assist
skills lab time
Turn in Case study
TOTAL
20
Documentation:
P___________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
I___________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
R___________________________________________________________________________________
_____________________________________________________________________________________
Daily Journal this week: Same as before, PLUS the entire med section on the back.
- 59 -
Page Left blank
- 60 -
NS1L Part 1 Module 6 Assessment of the Client with Self-Care Deficits

Related to Respiratory System
I.
Introduction:
self-care deficits related to the respiratory and cardiovascular systems. There will be a major focus on the
timely performance of physical assessments, nursing systems and education for this system.
1.
2.
Reading Del Mar, chap 7, Oxygenation: p. 867-888, p. 969, 983.

Reading Jarvis, "Assessment of the Respiratory System" and Assessment of the
Cardiovascular System.
3.
Viewing the videos:

a. " Techniques of Physical Diagnosis: Part 4: The thorax and the lungs"
b. Bring a nursing journal article about the Resp. system, assessment, disease etc.
5. Review respiratory system assessment and care in ATItesting.com prior to class.

Listening to the "Lung Sounds Simulator".
6. Obtaining the equipment necessary to perform the assessment (stethoscope, watch with a
second hand)
7. Performing a health history specifically focused on the respiratory and cardiovascular
systems.
8. Performing a physical assessment on a client
9. Documenting the results of the performed physical assessment
10. Assessing Respiratory Rate, and ABCs of assessment
11. Using a Pulse Oximeter
12. Administering Oxygen by Nasal Cannula
13. Administering Oxygen by Mask
14. Perform oral suctioning and document
B. Web resources: McGill University Virtual Stethoscope:
http://sprojects.mmi.mcgill.ca/mvs/mvsteth.htm. ATItesting.com
II. Clinical Performance Objectives:
Communication
Technical
Nursing
Responsibility
Organization &
Skills
Process
Accountability
Prioritization
related to respiratory and cardiovascular status he/she will:
Relate the elements of a respiratory/cardiovascular physical examination.
Distinguish the other systems that are especially important in a detailed
respiratory/cardiovascular history.
1.
- 61 -
3.
4.
5.
6.
7.
8.
9.
10.
Performance of a respiratory and cardiovascular physical examination.

Make, document and interpret observations of patients with oxygenation or perfusion alterations.
Plan personalizes nursing actions with patients experiencing oxygenation problems on short and long
term basis.
Include patient/family in setting goals.
Incorporate psychological and social adjustments.
Incorporate patient/family teaching.
Incorporate the rehabilitation team.
Develop an individualized discharge plan.
Recognize normal and abnormal lung sounds.
Begin to differentiate the following lung sounds: Crackles, Rhonchi, Wheezes, Pleural friction rub
Develop nursing diagnoses related to alterations in respiratory status.
Inspect, palpate and auscultate the heart, jugular veins, pulses and extremities.
Develop nursing diagnoses related to alterations in respiratory status.
Daily Journal this week: Entire front and back, including the lab section.
Case Study #6: Respiratory problem

E.T. is an 82 year-old female patient admitted with pneumonia to the Med/Surg unit. She is on oxygen at
4L/min via Nasal Cannula. She is short of breath with activities and with eating. She has an IV with NS at
60cc/hour. She gets antibiotics every 6 hours via IV. She has a history of depression and complains that,
no one ever comes to visit me. She has a history of hypertension and her current vitals are as follows:
BP 140/80, P-98, R-24, and T-99.6F.
1. List 2 Nursing diagnosis priority problems for this patient.
2. What would be expected goals for this patient?
3. What are some of the things nursing can do to address these problems?
4. How could we evaluate her response? What data should we seek?
- 62 -

Module 6 Respiratory (20 pts)
Name: ________________________________ Date: _____________________
5 = Excellent, 4 = Proficient, 3 = Competent, 2 = Advanced Beginner, 1 = Novice, 0 = absent
Skill
Possible
Points
Assessment: Problem Based Learning

Case study
Student Points
Comment
Planning
Has all necessary equipment and brings
Nurse Pack as necessary
Has read material prior to class.
Bring a research nursing journal article
about Resp. problem to share with class
Implementation
Document a respiratory assessment using

the PIR or SOAP format.
Turn in Math homework: Self-Test 1 p.
138
The student will arrive on time prepared,
to skills lab, assist with clean up, and stay
on task during skills lab time. Participates
in class
20
TOTAL
Respiratory Assessment and Suctioning Documentation:

P.___________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
I.___________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
R.___________________________________________________________________________________
______________________________________________________________________________
Daily Journal this week: Entire front and back, including the lab section.
- 63 -
Page Left blank
- 64 -
NS1L Part 1 Module 7 Assessment of the Client with Self-Care Deficits

Related to Cardiovascular System
II. Introduction:
self-care deficits related to the cardiovascular systems. There will be a major focus on the timely
performance of physical assessments, nursing responsibilities and education for this system.

1.
2.
3.
4.
Reading Del Mar p. 220, 1043, 1417

Reading Jarvis, Assessment of the Cardiovascular System.
Math: Read Henkes Medication math. Do med exercises
Viewing the DVDs: Bates Visual Guide to Physical Examination: Neck Vessels and
Heart Bates Visual Guide to Physical Exam Vol 5: Peripheral Vascular System"
5. Bring a nursing research article about cardiac assessment, problem to share
6. Having the equipment necessary to perform the assessment (stethoscope, watch with a
second hand)
7. Performing a health history specifically focused on the cardiovascular systems.
8. Performing a physical assessment on a client
9. Documenting the results of the performed physical assessment
10. Assessing Heart rate, heart sounds, blood pressure, and peripheral pulses
11. Assessing for edema, Jugular Venous Distension (JVD)
12. Assessing the Apical Pulse Rate
13. Locating the areas on the precordium to auscultate S1 and S2
14. Reviewing the technique for CPR
B. Web Resources: www.unmc.edu/library/reference/medimage.html,
www.merck.com/mrkshared/mmanual/sections.jsp, ATItesting.com: Review cardiac
assessment, CPR, and nursing care prior to class.
Technical
Skills
Nursing
Process
Communication
Responsibility
Accountability
Organization &
Prioritization
related to respiratory and cardiovascular status he/she will:
Relate the elements of a respiratory/cardiovascular physical examination.
Distinguish the other systems that are especially important in a detailed cardiovascular history.
3. Performance of a cardiovascular physical examination.
4. Make, document and interpret observations of patients with perfusion alterations.
1.
- 65 -
5.
6.
7.
8.
9.
10.
11.
Plan individualized nursing actions with patients experiencing cardiovascular problems on short and
long term basis.
Recognize normal and abnormal heart sounds.
Develop nursing diagnoses related to alterations in cardiovascular status.
Inspect, palpate and auscultate the heart, jugular veins, pulses and extremities.
Identify S1 and S2 heart sounds upon auscultation of the point of maximum impulse (PMI).
Develop nursing diagnoses related to alterations in cardiovascular status.
Hosp: Complete the Daily Journal FRONT PAGE AND MEDICATION & LAB SECTIONS
Module 7: Cardiovascular: Learning Activity

Perform the steps of CPR on a mannequin, 1 person and 2 person
- 66 -
Module 7: Cardiovascular: CASE STUDY Learning Activity

Your patient is a 65-year-old male client admitted to the hospital with chest pain and shortness of
breath. He has a history of hypertension but does not take his antihypertensive medication regularly.
His vital signs are: B/P 156/94, HR 56 irregular, Respiration 24, T: 99.6.
Awake and oriented X4, anxious about chest pain. Skin pink,warm and dry, with good turgor. C/O
chest pain 6/10 relieved by Nitroglyceryn 1 pill to 2/10. Pulses 4+, irregular, EKG sinus rhythm with
occasional PVCs. Respirations even and unlabored, but c/o short of breath. Lung sounds diminished
at bases with crackles. Pulse oxymeter= 92% on 2 L of 02. Abdomen is soft and non-distended,
hypoactive bowel sounds all quadrants. Ate 30% of meal. Last BM yesterday: hard bown pellets.
Voiding amber cloudy urine, > 30 mL/hr. Muscle strength 5/5 all extremeties. Strenght equal
bilaterally, toes pink, mobile with sensation. He receives IV D51/2 at 75mL/hour to his left wrist.
IV site non-tender, without erythema. Pedal edema 2+. Negative Homan signs. His wife visits and
states that client has been under much stress; financial worry due to recent retirement.
a.
b.
c.
d.
e.
f.
2 Gm NA, low fat diet

IV D5 @ 75 mL/hr.
02 @ 2 L via n/c
NTG .04mg 1 prn chest pain, may repeat q 5 min. x 3
I & O.
Morphine 1-2mg IVP q 1-2 hrs. prn pain
Labs are as follows:

WBC- 6,700
CBC & Electrolytes WNL
Troponin elevated
Identify 2 priority nursing diagnoses: 1 physical, 1 psycho-social
Physical Nursing Dx
Psych Social
Goal:
Goal:
Interventions
Interventions
Eval:
Eval
- 67 -
Blood clotting- normal

Module 7 Cardiovascular
Name: ________________________________ Date: _____________________
There are a total of 20 points possible for this skills lab..
Skill
Possible Points
Student
Points
Comment
Assessment
Problem Based Learning
Case study
Bring a nursing research article about
Cardiac assessment, problem to share
with class
Planning
Has read material prior to class Has all
necessary equipment and brings Nurse
Pack as necessary
Implementation
Document a Cardiovascular
assessment below using Narrative
charting.
Do CPR on a mannequin
The student will arrive on time
prepared to skills lab, assist with clean
up, and stay on task during skills lab
time. Participates in class
Turn in NS1p2 Math pretest.
TOTAL
20
Document assessment of the cardiovascular system of a peer:

_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
- 68 -
Skills Lab Nursing Science 1 Part I Module 8

Assessment of the Client with Self-Care Deficits Related to Neurological Alterations
I.
Introduction: This module is designed to assist the student in the application of the nursing
process to the client with self-care deficits related to the neurologic system., visual and auditory
deficits. There will be a major focus on physical assessment, nursing systems and education.

1. Reading Del Mar, Ch. 3 Client Care and Comfort 279-327. Jarvis: Ch. 16
2. Math: Complete NS1p2 Medication Pretest
3. Viewing Videos: Neurologic Signs and Symptoms
4. Bring a nursing research article about Neuro assessment, dz, or interventions
5. Review neuro assessment and nursing skills ATItesting.com
6. Performing assessment of the neurologic system.
7. Performing assessments of the 12 cranial nerves.
8. Practice assessment of major tendon reflexes
9. Perform motor and sensory assessment
10. Perform assessment of Cortical sensation: Define: stereognosis, graphesthesia, 2
point discrimination
11. Perform assessment of Cerebellar function: Coordination, Rhomberg test, Gait
12. Assess pain.
Recall that nursing theory provides the basis for nursing systems and activity. Your clinical grade is based on
your performance in 5 areas of nursing practice. These areas are:
Communication
Technical
Nursing
Responsibility
Organization &
Skills
Process
Accountability
Prioritization
With this in mind, when the student is assigned an adult or geriatric patient with self-care deficits related to
neurologic status he/she will:
Relate the elements of a neurologic physical examination.
Distinguish the other systems that are especially important in a detailed neurologic history.
3. Performance of a neurologic physical examination.
4. Make, document and interpret observations of patients with alterations in neurologic status.
5. Plan personalized nursing actions with patient experiencing neurological problems on short and log term
basis.
6. Intervene appropriately with clients experiencing rest or sleep disturbances.
7. Develop nursing diagnoses related to alterations in rest or sleep on assigned client.
8. Provide appropriate nursing intervention to the client experiencing pain.
9. Develop nursing diagnoses related to pain on assigned client.
10. Conduct a Head to Toe Assessment on assigned client and complete the assessment form.
11. Daily Journal this week: Entire front and back
- 69 -
Module 8: Neurological System (20 pts)

Name: ________________________________ Date: _____________________
5 = Excellent, 4 = Proficient, 3 = Competent, 2= Advanced Beginner, 1 Novice, 0 = Absent
Skill
Possible Points
Assessment
Subjective and Objective Data of a
Neurological Assessment
Student Points
Comment
Bring a nursing journal article about

Neuro assessment, dz., nursing
interventions.
Turn in Math: NS1 part 2 Med
Proficiency pre-test (in Appendix)
Planning
Implementation
Document a Neurological exam of a

peer using Narrative charting
The student will arrive on time,
prepared to skills lab, assist with clean
up, and stay on task during skills lab
time. Participates in class
TOTAL
20
Document a neuro exam of a peer:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
______________________________________________________________________________
Turn this in to your instructor
Daily Journal this week: Entire front and back
- 70 -
Appendix
B
- 71 -
Plagiarism / Advance Directive Assignment (40 points)

Turn the following two assignments in together. Attach a single copy of the Plagiarism / Advanced
Directive grading rubric to the back.
Plagiarism Assignment (25)

Type the answers to the following questions, using complete sentences and double-line spacing.
The body of the paper should be approximately 1 page. In APA format, include a title page,
running head, page numbers, in-text citations (where necessary) and reference page. Attach a
copy of the Plagiarism Assignment grading rubric form, and the signed Plagiarism Statement.
1. Define and describe plagiarism. Use at least 2 references in your answer (websites are
acceptable).
2. Give at least 3 examples of plagiarism as it applies to a students, and how to avoid them.
3. Describe where a student can get help with referencing, APA format, and writing skills
at Moorpark College.
Advanced Directive Assignment (15)
1. Print the sample Advanced Health Care Directive from the NS1 part 1 D2L webpage.
Complete the sample Advanced Directive for yourself. For this assignment, do not have
the document notarized by a Notary Public unless you want the Advanced Directive to be
official. If not having the form notarized it is ok to write MOCK/UNOFFICIAL on each
page, to signify that this is not an official document. If you already have an official
Advanced Directive you may attach a copy of it instead of the form, and obscure
information you find too personal for your clinical instructor to see when he or she is
grading your assignment.
The sample Advanced Health Care Directive form may also be found here:
http://ag.ca.gov/consumers/pdf/AHCDS1.pdf
2. Talk with your family (parents/spouse, children, etc) about this assignment and get their
feelings about the Advanced Directive.
3. Write a reflection paper about this assignment. Had you thought of completing an
Advanced Directive prior to this assignment? Why or why not? Include reactions of
parents/spouse, children, etc. and your feelings about the assignment. Use APA formatting
(12 point font, double-line spaced, 1 inch margins, title page, running head, page numbers).
4. Attach a copy of your completed sample Advanced Directive and the Advanced Directive
grading rubric to your paper.
- 72 -
Plagiarism Assignment Statement

Student: Copy of this form, sign it, and include with your
Plagiarism/Advanced Directive Assignment
I have researched the issue of Plagiarism as it applies to the student, and completed the required
plagiarism assignment. I understand that plagiarism can result in reprimand from Moorpark
College. I understand that plagiarism will also result in loss of points for the paper or
assignment, possibly leading to failure and dismissal from the Moorpark College Nursing
Program.
Signed___________________________________________Date:_________________________
Print Name:_____________________________________
Semester:_____________________
INSTRUCTOR:
Detach this form and submit it to the health sciences department for filing.
- 73 -
Plagiarism / Advanced Directive Assignment Grading Rubric

Possible
Points
Plagiarism Assignment
Points Earned & Comments
1. Defines and describes plagiarism. Uses at least 2
references in answer (websites are acceptable).

2. Gives at least 3 examples of plagiarism as it applies to
a students, and how to avoid them.

3. Describes where a student can get help with
referencing, APA format, and writing skills at MC.

4. APA-formatted reference page.
5
4
5. Paper is in APA format (12 point Times New Roman
font, double-line spaced, 1 inch margins, title page,

running head, page numbers. Body of paper is
approximately 1 page.
6. Grading rubric and Plagiarism Statement are attached.
Plagiarism Statement is signed in black ink.
Total
25
Feedback:
Possible
Points
Advanced Directive Assignment

1. One-page reflection paper. Includes reflection on
the following:
Had you thought of completing an Advanced Directive
prior to this assignment? Why or why not? Include
reactions of parents/spouse, children, etc. and your feelings
about the assignment.
10
2. Copy of completed Advanced Directive is attached
(mock or official is acceptable). Uses black ink.
3. Paper is in APA format (12 point Times New Roman
font, double-line spaced, 1 inch margins, title page,

running head, page numbers).
4. Grading rubric is attached
2
1
Total
Feedback:
- 74 -
15
Points Earned & Comments
Reflective Journaling Assignment

Keep a diary, 4 entries per 8-week rotation, 8 total for the semester.
Bring to clinical evaluation
Each student, throughout their MPC Nursing Program experience, will keep a journal provided in the
nurse pak. It will be a place of private, and at times structured, self-reflection. It will be viewed only by
the clinical instructor to validate entries, it will not be read unless by student's request. Adhere to all
confidentiality, use only patient's initial.
OBJECTIVES: Skills Acquired and Benefits of Journaling
To increase self awareness and the ability to analyze ones own feelings
To develop new, or alternative perspectives on relationships, interactions and events
To personalize the educational and clinical experience, and what is being learned
To foster the establishment of linkages between theory, research, and experiences
Reflective Journaling using the LIFE Model

L: Learning: What did you Learn/experience today?
I: Ideas: How were you able to use past learning, or new ideas in this experience?
F: Feelings how did you feel about your experience?
E: Excited: What did you get excited about?
*Adapted from information from material of Vanderbilt University, 1996; Nursing, 1998.
Instructions for Keeping a Journal

Date each entry
Write more than a few sentences in each entry
Write regularly, as often as you would like, minimum of 4 times during NS1p1 clinical rotation.
Nursing Course Reflective Journal *
* Date each entry and write in ink.

1. Identify a situation/experience that generated some interest or concern. Describe it in a short
paragraph.
2. Provide the details of the situation/experience. Include your reactions, thoughts and feelings.
3. Analyze the meaning of this experience to you. Were you satisfied with your response and with
that of others?
4. Discuss how this situation/experience was significant to your clinical practice and self-awareness.
What lessons were learned, or insights gained? Were your attitudes, values, behaviors or skills
changed by this experience? How?
- 75 -
Video Project (25 points)

Assignment: Short video displaying student demonstration of 1 of 5 technical clinical skills.
Grade: 25 points possible for each member in a 3-4 members group.
Use the nursing process of Assessment, Planning, Implementation and Evaluation in your video
assignment. You may include interviews of students and individual comments, suggestions or insights.
Patient education and preparation is to be an important part of the demonstration of this skill.
Write, direct and perform in a class video. Each student must appear in a 10 min. maximum time
allotted) which demonstrates one of the following 5 skills:
1. Male/Female Indwelling urinary catheterization: include insertion, discontinuing.

2. Insertion of an NG tube for gastric decompression OR for enteral feeding. Include insertion,
discontinuing .
3. Sterile wet-to-damp dressing change.
4. Head to Toe Physical Assessment
Turn in assignment to the clinical instructor 1 week after the skills was taught in Skills Lab.
Include:
1. DVD or flash drive to your clinical instructor the week following the module, which introduces
the chosen skill.
2. Video Scoring Rubric
3. Confidential Evaluation of student's participation
Each student will turn in a confidential evaluation of all the other students participation and input
into the project.
Students who fail to participate in researching, planning, communicating, and participating
professionally as team members and to share the work fairly will receive a 10 points deduction in their
scores.
Due Date: ______________________
- 76 -
Video Assignment Grading Rubric (25 points)

Turn this form in with your Video Assignment
5 Excellent: follow all steps accurately, provide rationales and teaching, incorporates good
communication skills, excellent quality of sound and video.
4 Proficient: follows steps accurately, good use of communication.
3 Advanced beginner: few minor errors; correct self.
2 Novice: few errors did not self correct; incorrect sequencing of procedures, average video quality.
1 Unsatisfactory: Many errors, infection control many violations, poor quality video and sound.
0 Unsafe: did not follow procedural steps, major errors (including errors in universal precautions) that
could harm patients, did not turn in video, and did not participate in team.
Physical assessment: up to 5 pts
Assess patient, environment,
comfort level, rationale for
procedures.
_____ points
Preparation: up to 5
Assembled all needed equipments
Practice infection control
Explain procedure to patient
_____ points
Communication: up to 5
Utilized therapeutic verbal and non-verbal communication
(Open- ended questions, empathetic tone of voice, listening)
Use of professional ethics, non-malfeasance, beneficence, fidelity
______points
Implementation: up to 5
Provide for privacy and patient comfort
Systematic sequencing of technical skills utilizing proper infection
Control procedures.
(Use Delmar Skills book, videos as resources, state reference at
End of video)
______points
Evaluation and Teamwork: up to 5

Demonstrates shared responsibility and teamwork
All students participates in video. Show creativity.
Video and sound quality clear and easy to follow
Evaluation of patient post procedure
_____ points
Grade:
________points
Name of Group members________________________________________________

Date:____________________
Comments___________________________________________________________________
_____________________________________________________________________________
TURN IN TO INSTRUCTOR
- 77 -
Erikson's Psychosocial Stages Summary Chart

Erikson's Stages of Psychosocial Development
Erik Erikson described development that occurs throughout the lifespan.
Stage
Basic Conflict Important

Events
Outcome
Infancy (birth
to 18 months)
Trust vs.
Mistrust
Feeding
Children develop a sense of trust when caregivers

provide reliabilty, care, and affection. A lack of this
will lead to mistrust.
Early
Childhood (2
to 3 years)
Autonomy vs.
Shame and
Doubt
Toilet
Training
Children need to develop a sense of personal control

over physical skills and a sense of independence.
Success leads to feelings of autonomy, failure results
in feelings of shame and doubt.
Exploration
Children need to begin asserting control and power

over the environment. Success in this stage leads to
a sense of purpose. Children who try to exert too
much power experience disapproval, resulting in a
sense of guilt.
School
Children need to cope with new social and academic

demands. Success leads to a sense of competence,
while failure results in feelings of inferiority.
Social
Relationships
Teens need to develop a sense of self and personal

identity. Success leads to an ability to stay true to
yourself, while failure leads to role confusion and a
weak sense of self.
Preschool (3 to Initiative vs.

Guilt
5 years)
School Age (6
to 11 years)
Industry vs.
Inferiority
Identity vs.
Adolescence
(12 to 18 years) Role
Confusion
Yound
Adulthood (19
to 40 years)
Intimacy vs.
Isolation
Relationships
Young adults need to form intimate, loving

relationships with other people. Success leads to
strong relationships, while failure results in
loneliness and isolation.
Middle
Adulthood (40
to 65 years)
Generativity
vs. Stagnation
Work and
Parenthood
Adults need to create or nurture things that will

outlast them, often by having children or creating a
positive change that benefits other people. Success
leads to feelings of usefulness and accomplishment,
while failure results in shallow involvement in the
world.
Reflection on
Life
Older adults need to look back on life and feel a

sense of fulfillment. Success at this stage leads to
feelings of wisdom, while failure results in regret,
bitterness, and despair.
Maturity(65 to Ego Integrity

vs. Despair
death)
Reference: http://psychology.about.com Retrieved on 6/1/2011
- 78 -
OREM'S SELF-CARE THEORY

Care Model: A Professional Nursing Practice Model
Person (client/patient) self-care deficits are the result of environmental situations. Nurses have
always recognized the rights of clients of all ages to be both informed and active participants in
care. Nursing models are client-centered. The goal of self-care is to empower our clients and
families. .
3 systems within professional nursing practice
Compensatory system: nurse provides total care
Partial compensatory system: nurse & patient share responsibility for care
Educative-development system: client has primary responsibility for personal health,
with nurse acting as a consultant
Self-care: "activities initiated or performed by an individual, family, or community to achieve,
maintain or promote maximum health" Self-care is a universal requirement for sustaining and
enhancing life and health. Competence in self-care determines quality of life and has an impact
on longevity. Nurses assist clients to achieve competence in self-care. Health education (an
example of a self-care service) informs, motivates and helps people adopt healthful life styles.
Self-care is ongoing and a competence which is in continual development.
Areas Applicable to Self-Care Theory

Direct Nursing Care (nurse has direct contact with client and/or family)
Providing care or teaching in the following areas:
Nutrition; Hygiene; Mobility; Medications; Behavior; maintaining health and/or enhancing health
with client/family; Exercise & physical fitness; Nutrition and weight control, stress management;
maintenance of social support systems, environmental control.
Examples of Self Care Nursing Interventions
Wholly Compensatory system: nurse provides total care, turning, feeding, keeping
patients airway open by suctioning, monitor vital signs, intake and output.
Partially compensatory system: nurse & patient share responsibility for care
Nurse assists patient out of wheel chair into bathroom, assists with ADLs.
Educative-development system: client has primary responsibility for personal health,
with nurse acting as a consultant. Patient and family teaching.
REFERENCES
Orem, D.E. (1991). Nursing: Concepts of practice (4th ed.). St. Louis, MO: Mosby-Year Book
Inc.
www.http://currentnursing.com/nursing_theory/self_care_deficit_theory.htm
- 79 -
NURSING CARE STUDY GUIDELINES for NS1 Part 1 ONLY

NS1 part 1 students are required to follow the following format in preparing the NS1 part 1
Nursing Care Study. The care study is to be typewritten and turned in on the date due. Each day
the Nursing Care Study is late without an acceptable excuse or prior excused arrangement with
the instructor, 5 percent of the total available points will be deducted from the total score earned.
20 page limit, not including title page, reference page, medication section.
1.
Assessment: A health history and physical assessment is to be included. Use the

"Client Assessment" sheet enclosed in the forms section of the syllabus. Include a
narrative summarization of critical physical information from "Client Assessment to
present a clear picture of your clients current status1 page max. (10 points)
Reason for hospitalization (Chief Complaint), admit date, and brought into
facility from
Detailed description of the chief complaint (Ex. Use PQRST pneumonic,
P=precipitation/palliating, Q=quality, R=region, S=severity, T=timing)
Allergies and reactions (meds/foods/others)
Past Medical History (chronic conditions and surgeries, include dates if
possible)
Prescriptions, OTC meds, conventional therapies, and alternative therapies
Family History
Physical Assessment (Head to Toe) with location, date and time obtained
2.
Cultural Assessment: Include a narrative summarization of critical cultural

information. Use the Cultural Assessment sheet enclosed in the forms section of the
syllabus. This section should contain information regarding the clients cultural and
ethnic affiliation, religious beliefs, developmental, psychosocial, and socioeconomic
status, language skills, and health related beliefs and practices. (10 points)
Cultural practices that impact the patients disease process or care
(determine if beneficial, neutral, or harmful)
Religious/spiritual practices that impact the patients disease process or
care (determine if beneficial, neutral, or harmful)
Eriksons Developmental stage
Family support systems, the identified care giver
Medical Insurance
Durable Power of Attorney for Health Care and the named agent
State how the nursing care would be adjusted based on the cultural
assessment
State how the changes made in the care benefit the patient
3.
Educational Assessment: Include a narrative summarization of critical educational

information obtained from your client assessment. This section should contain
information regarding client learning needs, learning barriers (motivation, sensory,
and physical) and knowledge base. (10 points)
Learning readiness of patient/caregiver (physically, psychologically, and
emotionally ready)
- 80 -
Learning style (auditory, visual, and/or tactile/kinesthetic learner) of

patient/caregiver. Learns best by verbal and written instruction or
demonstration
Barriers to learning
Learning needs identified
Based on the assessment, the teaching strategy/plan
4.
Pathophysiology: Compare and contrast the pathophysiology of your client's health

deviation as it relates to the literature. Include client specific information relating to
his or her diagnosis. (15 Points)
State how the patients disease process is similar to or different from what
is stated in the literature (integrate patient specific information)
Focus is the condition that brought the patient to the hospital for this
admission
Explain how the patients past medical history (chronic conditions) impact
the current disease process and the patients recovery process
5.
Medications and related nursing considerations: List the medications your client is
taking and their classification. Describe the nursing considerations and the
information you would teach to your client for each medication. (10 points)
Routine and PRN medications
Dosage, Route, and frequency
Save dosage range
Specific purpose for this patient
Pertinent data
Patient/family teaching
6.
List of Nursing Diagnosis (minimum of 6): List in order of importance your clients
diagnosis developed from your assessment problem list. (5 points)
You must have at least one physical, one psychosocial, and one educational
diagnosis
Number 1 diagnosis has the highest priority
See example on D2L for how to format sections 7 10.

7.
Select one educational, one psychosocial, and one physical diagnosis with support
data: Select the priority diagnoses from the above list. Include subjective and
objective data supporting the three chosen diagnoses. (5 points)
8.
Client Goals: List the physical, psychosocial, and educational goals you want your
patient to accomplish (long term and short term goals). Make sure goals are
measurable and realistic. (5 points)
9.
Nursing Intervention: Describe 6-7 nursing interventions for each of the 3 diagnoses.
(15 points)
Include scientific rationale for each intervention
Cite reference(s) for each rationale
Include Orems Nursing System (Wholly compensatory, partial
compensatory or Supportive/Educative) and why it applies to your
interventions (see attached examples)
- 81 -
10. Evaluation and Documentation: Evaluate your educational, psychosocial and

physical goals. (5 points)
Include a narrative nursing note documenting client goal obtainment or
unobtainment.
11. Neatness and References: A minimum of 3 references (other than the text) and one
current periodical is required. (10 points)
Use the APA guidelines available on the Moorpark College Writing Center website.
APA format is to include:
Typewritten, double spaced and spell checked
1 inch margins on top, bottom and sides
12pt Times New Roman font
Title page, citations and reference page (use hanging indention in
paragraph from format dropdown in Microsoft Word)
Daily journal for patient included
Client Assessment form completed and included
Cultural Assessment form completed and included
Copy of one current article from a professional periodical relating to your
Care Plan (preferably nursing).
NS1 Part 1 ONLY
- 82 -
NS1p1 NURSING CARE STUDY GRADING RUBRIC

Name:______________________________________
Date:_______________
Include a copy with your paper

Topic
Comments
Assessment:
Reason for hospitalization, date of admit, and entered
into facility from
Detailed chief complaint
Allergies/ reactions (meds/foods/other)
Points
/10
Past medical history

Home medications and therapies
Family history
Physical assessment (head to toe). Include client
assessment form.
Cultural assessment:
Cultural practices that impact disease process
Religious/spiritual practices that impact disease
process/care
Eriksons Developmental Stage
/10
Family support systems

Medical insurance
Durable Power of Attorney with named agent
Cultural, religious and/or spiritual adjustments in nursing
care that benefited the patient
Cultural Assessment worksheet.
Educational assessment:
Learning readiness of patient/caregiver (physically,
psychologically, and emotionally ready)
Learning style (auditory, visual, and/or tactile/kinesthetic
learner) of patient/caregiver. Learns best by verbal and
written instruction or demonstration
Barriers to learning
/10
Learning needs identified

Teaching strategy/plan
Pathophysiology:
Compare/contrast the pathophysiology of the patients
disease process is to current literature (integrated patient
specific information)
Focus is on the condition that brought the patient to the
hospital for this admission
Past medical history and/or chronic conditions that
impact the current disease process and/or recovery
process
Reference material cited
- 83 -
/15
Medications/nursing considerations: list the routine and PRN

medications. Cite your reference material.
Routine and PRN medications
Dosage, Route, and frequency
Safe dosage range
Specific purpose for this patient
Pertinent data
Patient/family teaching
List of Nursing Diagnoses: Prioritize at least 6 nursing diagnoses
for your patient including at least one
Physical
Psychosocial Diagnosis
Educational Diagnosis
/10
/5
See example on D2L for how to format the Plan of Care section
Priority Nursing Diagnosis: select the priority physical,
psychosocial, and educational diagnosis, support with subjective
and objective data.
Physical Diagnosis Subjective/Objective Data
Psychosocial Diagnosis Subjective/Objective Data
Educational Diagnosis Subjective/Objective Data
Client Goals: list long and short terms goals that are measurable
and realistic.
Nursing Interventions: provide 6-7 interventions for each
diagnosis including
Scientific rationales for each intervention
Orems Nursing system for each intervention
Reference Material
Evaluation and documentation: include a narrative nursing note
documenting client goal obtainment or unobtainment
APA format, neatness, current article: follows APA format
Typewritten, double spaced, 1 inch margins, and spell
checked
12pt Times New Roman font
Cover page, citations and reference page (use hanging
indention)
Daily journal for patient included
Client Assessment form completed and included
Copy of one current article from a professional periodical
relating to your Care Plan (preferably nursing).
Cultural Assessment form completed and included
/5
/5
/15
/5
/10
NS1 part 1 ONLY. Revised 06/2013 from 10/2012 faculty decision
TOTAL:
- 84 -
/100
cLIENT ASSESSMENT FOR NURSING CARE PLAN

Date:
Day of Hospitalization:
Chief Complaint:
Communication
Barriers:
MEDICAL HISORY: Hospitalizations/Surgeries

Dat Reason:
e:
PAST MEDICAL HISTORY

Neuro disease
Remarks
Heart disease
Respiratory disease
DATA BASE:
Male
Female
Age:
Resp:
Temp:
Ht: _____
% _____
Pulse:
Wt: _____
% _____
BP:
Head
Circum:_
% _____
Pacemaker
Yes
No
:
Dentures:
Yes
No
Hearing
Yes
No
Aid:
Deaf:
Yes
No
Glasses:
Yes
No
Blind:
Yes
No
NUTRITIONAL HISTORY:
Current
Diet:
Appetite:
Good Fair
Poor
Food:
Likes:
Dislikes
:
Swallowing
Yes
No
Difficulty:
Feed self
Needs assistance
Liver disease
GU disease
Diabetes
GI disease
Bleeding problems
Cancer
TB
HTN
CVA
ALLERGIES: Medication/Food/Other
Reaction
PREVIOUS MEDICATIONS: Prescription/Nonprescription

Na
Dose/Frequency:
me:
- 85 -
PSYCHOSOCIAL HISTORY:
Alcohol
Yes
No
Caffeine
Tobacco
Recreational drugs
Amount:
Yes
Amount:
Yes
Amount:
Yes
Type:
Amount:
No
No
No
_______
History of abuse
PAIN ASSESSMENT
SCALE: 0-10 (zero refers to no pain; 10 refers to severe pain)
Describe the pain:
CULTURAL/DEVELOPMENTAL
Marital
Status
Number of
children
Occupation
Educational level
Country of
birth
Language(s)
spoken
Religion
Developmental
stage
Special
customs
NEUROVASCULAR/MUSCULOSKELETAL/SKIN INTEGRITY
Pupils
PERL
Alert
Other:
Anxious
Speech:
Gait:
Clear
Other:
Steady
Slurred
Unsteady
Confused
Lethargic
Angry
Depressed
Other:
Unable to
ambulate
Skin:
Color:
Skin
Firm Fragile
Dehydrated
turgor:
Decubitus: (description, stage, location, size):
RESPIRATORY
- 86 -
Oriented to:
Person
Place
Time
ROM: Full
Limited (specify below)
Respiratory
pattern:
Breath
sounds:
Cough: None
Thoraci
c chest:
Barrel
Regular
Irregular
Labored
Productive Non-productive
Scoliosis Kyphosis
CARDIOVASCULAR
Cardiac Regular Irregular
rhythm:
Telemetry reading:
Shallow
Equal
Pacemaker:
Yes
No
Type:
_____
Yes
No
Describe:
_________
Retractions
Major
pulses:
Edema:
Strong
1+
Weak
Absent
Murmur:
2+
3+
4+
Location:
Chest
pain:
Yes
No
Describe: _____
GASTROINTESTINAL
Bowel
Normal
Hypoactive
sounds: Hyperactive
Abdom Soft
Tender
Firm
en:
Elimina Diarrhea
Constipation
tion:
Wounds/drains/dressings/tubes/o
stomy
GENITOURINARY
Urine:
Clear Cloudy
Dysuria Oliguria Anuria
Incontin Yes
No
ent
Bladder trained
REPRODUCTIVE
Gravida ______
Date of
LMP
Method of birth
control:
Breasts: Soft
Absent
Distended
Catheter type:
Nocturia
Date
inserted
Hematuria
Para _____ AB ____________

Menstrual pattern/problems:
Menopausal Yes
No
Yes
No
Monthly self breast exam

Filling
Last BM
Engorged
___________________
Lochia
Sexual concerns:
- 87 -
Cultural Assessment
Client Initials
Medical Diagnosis
Client Cultural Information
Ethnic Group/Affiliation
Country of Birth
Age
Length of time in U.S.
City/State where client
With what *cultural group(s) does client affiliate?
(e.g. Hispanic, Polish, Navajo, or combination)
What is client's reported **racial affiliation?
(e.g. Black, White, Native American, Asian, etc...)
*"Culture is the set of beliefs and life practices followed by a group of individuals and passed
down from generation to generation, (p.89)"
**"Race denotes a system for classifying humans by physical characteristics, (p.89)"
D'Amico,. D. et. al., (1995). Health Assessment in Nursing, esley.
Religion
What is client's religious affiliation? _________________________
What are client's religious beliefs and practices during health and illness?
What are (if any) the healing rituals or practices that your client performs?
What is the role of significant religious representative(s) during your client's health
and illness (e.g. Priest)?
Nutrition
Preferred client foods?
Client foods disliked/prohibited?
Client's preferred meal times?
Foods that might be brought in by family?
How do religious beliefs influence client's diet?
Socioeconomic
Who composes the client's social network family/friends?
What are the roles of the individuals listed above during client's health and illness?
Who does the client lives with?
How do the members of the client's social network participate in the nursing care?
Who is the major person(s) making decisions regarding client's treatments?
Who is the principal wage earner in the client's family?
What is the occupation of the principal wage earner and client
Communication
What language does your client feel most comfortable speaking/reading?
- 88 -
What other languages does your client speak or read?

Who is available as an interpreter if your client needs one?
Is it easier for your client to learn information by reading/explanation/demonstration?
Health-Related Beliefs and Practices
What is your client's belief as to the cause of his/her illness?
What does your client believe promotes health?
What is the chief problem that this illness has caused?
What is your client's greatest fear/concern about this illness?
Who determines if your client is ill and needs treatment?
Who decides when your client is no longer sick?
How does your client perceive hospital personnel?
How does your client feel about health care providers who are not of the same cultural
background?
What daily routines would your client like to continue while in the hospital?
What are your client's desired results following this hospitalization?
What does your client believe will help maintain their wellness following this hospitalization?
1. What did the information gathered on the cultural assessment tell you about this
client/familys cultural beliefs, health care beliefs and views of the care they are receiving?
2. How would you adjust your nursing care based on the information gathered on the cultural
assessment?
3. In what way or how would these changes in care help the client?
Instructor:____________________________________
- 89 -
Moorpark College Nursing Department

MEDICAL RECORD REQUEST
Date:___________________
To:_________________________________
Dear Medical Record Personnel:
The Moorpark College nursing students are in the process of writing a Nursing Care Plan as a
mandatory assignment this semester. The patient this student, _________________________, has
selected has been discharged and their records have been sent to the medical records department.
This letter is to request that the medical records on ______________ (pt. Initials optional) with
Medical Record #___________________ , made available to the above named Moorpark College
Nursing Student.
In addition to having authorized access to private healthcare information as a nursing student
participating in the care of patients within your facility, this student has attended required HIPPA
training sessions, has signed confidentiality and privacy statements, and has had training
regarding the legal aspects of respecting patient medical records and rights. This student has been
informed to allow 48 hours for the processing of this request and will call prior to arrival. If you
have any questions, please feel free to page me at______________________.
Thank you for your time, and I appreciate your assistance.

Sincerely,
____________________________
Moorpark College Nursing Faculty
Student's Name: _______________________

Student's Phone #_______________________
- 90 -
Medication Proficiency Pretest for NS1 P2

1. Which of the following associations is incorrect?
a. 2 tsp = 10 ml
b. 2 cups = 16 ounces
c. 1 quart = 1000 ml
d. 2 ounces = 50 ml
2. Mr. L is to have one drop of a solution instilled the right eye bid. The nurse demonstrates
correct med administration technique when doing all of the following except:
a. Instills one drop of medication into the right eye
b. Drops the medication onto the lower conjunctival sac.
c. Asks the individual to look straight ahead when instilling the medication.
d. Uses clean technique to administer the medication twice daily.
3. Mrs. P. is to receive Ampicillin 250 mg po BID. This means that she should receive the
medication:
a. After meals twice a day
c. By mouth three times a day
b. By mouth twice a day
d. Twice a day when needed
4. Order: Gentamicin 60 mg. On hand is Gentamicin 80 mg/2cc.
Give:
5. Order: Aspirin gr V. On hand is Aspirin 300mg/tab.

Give:
6. Order: IV D5W to infuse at 125ml/hr. IV drip factor is 10 gtts/ml. How may drops per
minute will you infuse?
7. Order: IV D5 .2% NS with 20 meq kcl/Liter to infuse at 80 cc/hr. How many drops per
minute will you infuse? Drip factor is 15 gtts/ml.
8. Pt. weighs 112 lbs. Order: Amoxicillin 750 mg po q 6 hrs. The safe dose is 20-50
mg/kg/day. Is this a safe dose for this patient? If not, what is the safe dose for this
patient?
9. Order: Digoxin 0.25 mg po qday. The medication is supplied 50 mcg/1cc. How much
medication will you administer?
Key 1. d 2. c 3. b 4. 1.5 ml 5. 1 tab 6. 21 gtt/min 7. 20 gtt/min

is too much. Safe dose = 254.5 636.3 mg per dose. 9. 5 ml
- 91 -
8. No, not safe, order
Ten Minutes a Day to Reduced Stress and Better Health

The "Relaxation Response" has helped many people to overcome debilitating stress.
STRESS MANAGEMENT
If you have ten free minutes a day, you can reduce stress, improve insomnia, lessen anxiety and
depression, and decrease your chances of developing cardiovascular disease. Sound too good to
be true? Dr. Benson's 1975 book The Relaxation Response, reissued in 2000, has become the
definitive work on the mind/body connection and the effects of stress on our physical well being.
The Relaxation Response is the opposite of the "adrenaline rush" we associate with stress and
anxiety. Physiologically, our bodies respond to perceived threatening situations with an increased
release of the hormones epinephrine and norepinephrine, leading to increased heart rate,
increased blood pressure, accelerated breathing rate and increased blood flow to the muscles.
Because these reactions prepare our bodies to flee the situation or to fight, this reaction has been
termed the "fight-or-flight" response.
To elicit the relaxation response technique : repeat a word, sound, phrase, etc. while sitting
quietly with eyes closed. Intruding thoughts are dismissed by passively returning to the repetition.
This should be practiced for 10-20 minutes a day in a quiet environment free of distractions. A
seated position is recommended to avoid falling asleep, and you may open your eyes to check the
time but do not set an alarm. Don't feel discouraged in the beginning if it is difficult to banish
intruding thoughts or worries; this technique requires practice. With consistency and time the
relaxation response will occur effortlessly and smoothly.
Quick Progressive Muscle Relaxation
Tighten the muscles in your toes. Hold for a count of 10. Relax and enjoy the sensation of
release from tension.

Flex the muscles in your feet. Hold for a count of 10. Relax.
Move slowly up through your body- legs, abdomen, back, and neck, face- contracting and
relaxing muscles as you go. Breathe deeply and slowly.

Get in a comfortable position. Minimally tighten your right fist so that you feel only the
smallest amount of tension. Hold it at this level. continue to breathe... Now relax...
Raise your shoulders to your ears minimally. Let go and relax. Feel the relaxation sinking
through the body... Minimally tighten the stomach. Minimally tighten the feet, calves, and
thighs... Let go and relax
Now minimally tense every muscle in your body so that you just feel the minimum tension...
jaws... eyes... shoulders... arms... chest... back... legs... stomach... Let your whole body relax.
Feel a wave of calmness as you stop tensing. Now, with your eyes closed, take a deep breath
and hold it. Note all the minimum tensions... Exhale and feel the relaxation and
calmness developing... Note the feeling of heaviness.
Other stress management techniques are: Talk to a friend, keep a reflective
journal, get adequate sleep and nutrition, exercise, yoga, meditation, time
management, problem solve, assertiveness, humor, music, art, hobbies, pet.
Ask the dumb questions. They're easier to deal with than dumb mistakes....
- 92 -
Insert National Patient safety goals
- 93 -
Insert Intake and output guide
- 94 -
Maslows Hierarchy of Basic Human needs

Mnemonic: Perfect Nurses Save Lives by Effective Care Always
http://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs
- 95 -
Insert PHYSICAL EXAM GUIDE
- 96 -
CLINICAL ORGANIZATION TOOLS Sample 1

Shift: 0630-1430
Immobile patient: Turn q 2 hrs
Incontinent care q 2
IV site check Q1hr
Heels off bed/pad bony prominences.
NPO Patient: Oral Care q 2 hrs

Tube Feeding patient: Check Residual q4 hrs
G-Tube care/cleaning q shift
New NG/GT syringe q 24
0630
0730
0800
09
10
Arrive in
Lobby of
Hosp.
Meet
patient
Turn all
immobile
patient
Daily Care
AM Care,
Bath,
Make bed
Check
chart,
Kardex, emar
Listen to
change of
shift
report
Obtain
VS, pulse
oxy, pain
level
Assess
patient,
check all
tubes
Pass
breakfast
tray
Turn
patient,
oral care
Review
History
and
Physical
Review
last 24
hours
Doctor's
orders,
Lab
Review
Vital
Signs
sheet
Offer or
perform
AM care,
toileting
Organize
room
Chart
Vital
signs in
Graphics
Feed
patient if
needed.
Begin
completio
n of
Nursing
Journal
Give VS
to nurse
Notify
abnorma
l VS
Documen
t in
computer
: VS,
I/O, ADL
Student
Self Care
Eat
breakfast
Placemen
t check
and
Residual
check to
NG, GT
feeding
pt.
Oral Care
to all
NPO
patient
Bath and
straighten
linens.
11
12
13
14
Turn patient,
oral care
Turn
patient,
oral care
Placement
check and
Residual
check to NG,
GT
feeding pt.
Make sure
patient is
comfortabl
e and
clean
Pick up trays.
Record %
Offer
toileting
Incontinent
care
Offer
toileting
Incontinent
care
Offer
toileting.
Incontinen
t care
Pick up
trays.
Record
%
Assist
patient
OOB,
ambulation
Pass lunch
tray
Feed pt prn
Ensure
room
neatness
Nursing
dx, chart
in
journal
Record
I&O
VS for
patient on q4
hr VS and
record
FC=
IV credit=
NG/GT=
I&0
Take a
15 min
break.
Finish
journa
l
Give report to Post

nurse. Go to
Confe
Lunch
rence
- 97 -
CLINICAL ORGANIZATION TOOLS Sample 2

Time
0615
0630
0730
0800
0900
1000
1130
1200
1300
Task
Arrive for patient assignment
Obtain e-Kardex
Check e-MAR
Get verbal report from nurse
Review History & Physical
Review last 24 hour labs/diagnostic imaging results
Review graphic sheets
Begin completion of journal
Look up meds
Meet patient
Obtain vital signs
Offer toileting
Perform a.m. care
Organize room
Assess patient
Obtain blood sugar, if indicated
Chart vital signs (chart by 0800)
Give vital signs to nurse
Meds
Turn immobile patient
Pass breakfast trays
Oral care to NPO patients
Residual check for gastric feeding patient
Look up meds
Chart assessment (chart by 0930)
Chart patient notes
Meds
Pick up trays
Record I&O
Continue with journal completion
Daily care
Turn immobile patients
Offer toileting
ROM for immobile patients
Offer ambulation
Chart patient notes
Accuchecks
Chart vital signs (chart by 1200)
Meds
Pass lunch tray
Turn immobile patients
Offer toileting
Residual check for gastric feeding patients
Closing note/patient notes
Chart ADLs
Give report to nurse
Shred hospital documents that were printed, if any
- 98 -
Shift 0630-1330
Immobile Patients
- Turn Q2 hours
- ROM once shift
- Heels off bed/pad bony
prominences
NPO Patients
- Oral care Q2hours
Tube feeding patients
- Residual check Q4 hours
- G-tube care/cleaning Q shift
- New graduated container and
syringe Q am

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MOORPARK COLLEGE

HEALTH SCIENCES DEPARTMENT

BEGINNING NURSING SCIENCE

Moorpark College Associate Degree Nursing

Member Within NursingDiscipline

Safety, Technical Skills

Bio-Psycho-Socio-Cultural-Spiritual-Client Needs Throughout Life Cycle

Hospital Orientation Grading Sheet

Plagiarism /Advance Directive Assignment

Nursing Science 1 Part 1

Critical Competency #1 Safety/Technical Skills

Critical Competency #2: Critical Thinking and Clinical Reasoning

1. Recognize actual or potential self care demands/deficits

Critical Competency #3: Communication

3. Practice implementation of timely and effective conflict resolution with assistance.

Critical Competency #4: Responsibility and Accountability

Member within the discipline of nursing

Critical Competency #5: Organization and Prioritization

4. Systems: the students will

IX. Required Texts:

B. Available at Moorpark College bookstores or suppliers:

D. Other required materials:

XI. Student Resources

Students with Disabilities: Students with disabilities, whether physical, learning, or

Policy on Internet posting of assignments

IV. Instructor Information: Christina Lee, RN, MSN

Office Location: HSC 125 (Enter through the HS department office)

XV. Excused absences and Make-up exams:

XVI. Moorpark College Smoking Policy

XVII. Academic Integrity

XVIII. Dropping class

XIX. Required ATI assessments

NS 1 PART 1 CLASS CALENDAR

All groups in Skills Lab

Bring Clinical portfolio

ADLs and Module 1

All groups in Skills Lab

Mid Term Eval. Grades

Module 6, 7 Resp and

Care Plan due 2nd day

MODULE 1 Foundations of Nursing

MODULE 2: Legal/Ethical Issues, and the Nursing Process

MODULE 3: Integumentary/Musculoskeletal System

MODULE 4: Gastrointestinal System

MODULE 5: Genitourinary System

Module 6: Respiratory System

Respiratory Signs & Symptoms

MODULE 7: Cardiovascular System

Module 8: Neurological System

Group Members: 1. ________________

These Power Point slides are subject to change in

You must expect to need to take notes during lecture.

Christina Lee RN, MSN

Number of Course: NS1L Part 1

II. Hours: 14 hours clinical laboratory weekly for 8 weeks.

Part 1: Applies fundamental, patient-centered, evidence-based nursing care to simulated patients in

Course Objectives: Measured by Point System in Clinical Portfolio.

Critical Competency #1 Safety/Technical Skills

Name: ____________ Date: _