NURS 2158-48 S'17 Revised

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Harrison, Arkansas

NURSING 2158

SYLLABUS

Nursing Process I

LPN to RN Track
Spring 2017
Table of Contents
Calendar........................................................................................................................................................1-5
Course Title......................................................................................................................................................6
Course Number.................................................................................................................................................6
Course Description...........................................................................................................................................6
Credit Hours.....................................................................................................................................................6
Weekly Course Schedule..................................................................................................................................6
Location............................................................................................................................................................6
Course Instructors.............................................................................................................................................6
Prerequisite.......................................................................................................................................................6
Co-requisite......................................................................................................................................................6
Course Progression...........................................................................................................................................6
Course Outcomes/Objectives/Competencies................................................................................................7-8
Northark General Learning Outcomes.............................................................................................................8
Rationale...........................................................................................................................................................8
Required Textbooks.........................................................................................................................................8
Recommended/Supplemental/Suggested Books..............................................................................................9
Major Teaching-Learning Activities................................................................................................................9
Course Requirements.......................................................................................................................................9
Resources Needed for this Class......................................................................................................................9
Available on Campus Resources................................................................................................................9-10
Assistance available for this Course..............................................................................................................10
General Policies..............................................................................................................................................10
Withdrawal Policy..........................................................................................................................................10
Grading...........................................................................................................................................................10
Math Exam.....................................................................................................................................................10
Academic Assessment...............................................................................................................................10-11
Attendance......................................................................................................................................................11
Inclement Weather.........................................................................................................................................11
Make-up Exams..............................................................................................................................................11
Clinical Policies and Evaluation...............................................................................................................11-13
Academic Dishonesty.....................................................................................................................................13
Other Available Resources........................................................................................................................13-14
Student Responsibilities.................................................................................................................................14
ADA Statement..............................................................................................................................................15
Provision for Changing the Syllabus..............................................................................................................15
Syllabus Acknowledgement...........................................................................................................................15
How to be Successful in this Course..............................................................................................................16
Nursing Processes Units
Unit 1.........................................................................................................................................................18-21
Unit 2.........................................................................................................................................................22-25
Unit 3.........................................................................................................................................................26-28
Unit 4.........................................................................................................................................................29-31
Unit 5.........................................................................................................................................................32-36
Unit 6.........................................................................................................................................................37-39
Unit 7.........................................................................................................................................................40-41
Clinical Section
Clinical Improvement Form...........................................................................................................................43
Formative Evaluation Tool.......................................................................................................................44-45
Summative Evaluation Tool......................................................................................................................46-48
Head-to-Toe Assessment Form......................................................................................................................49
Critical Reasoning for Clinicals.....................................................................................................................50
Perioperative Clinical Written Assignment....................................................................................................51
Reflective Journaling......................................................................................................................................52
Musculoskeletal..............................................................................................................................................52
Respiratory Therapy.......................................................................................................................................53
Physical Therapy............................................................................................................................................53
Wound Care Clinical Rotation.......................................................................................................................54
GI Lab Written Assignment...........................................................................................................................55
Behavioral Health Assignment.......................................................................................................................56
Mental Health Nursing Assessment..........................................................................................................57-60
January 2017
Monday Tuesday Wednesday Thursday Friday
January 9 January 10 January 11 January 12 January 13
Classes Begin Unit 1 Unit 1 Test
Unit 1 Nursing Practice Unit 2
Nursing Practice 12:30-16:30 A106 Assessment
08:30-12:30 A106 M164 08:30-12:30

1230-16:30 Skills Fair


Lab A102
January 16 January 17 January 18 January 19 January 20
Holiday 08:30-15:00 Unit 2
Assessment and Health
Environmental Safety Maintenance/Promotio
Skills Lab n
A102 M164 08:30-12:30
January 23 January 24 January 25 January 26 January 27
08:30-16:30 Skills 08:30-16:30 Skills Unit 2 Test
Validation Validation Unit 3
A102 A102 Fluid & Electrolytes
M164 08:30-12:30

January 30 January 31
Assessment Validation Assessment Validation
12:30-16:30 12:30-16:30
HESC HESC

1
February 2017
Monday Tuesday Wednesday Thursday Friday
February 1 February 2 February 3
Unit 3
Shock & Emergency
care
M164 08:30-12:30

February 6 February 7 February 8 February 9 February 10


10:00 ATI Critical 10:00 ATI Critical Unit 3 Test
Thinking Exam Thinking Exam Unit 4
Room TBA Room TBA Respiratory
12:30-15:00 12:30-15:00 M164 08:30-12:30
Simulation A102 Simulation A102
February 13 February 14 February 15 February 16 February 17
Unit 4 Cox Branson NARMC Orientation
Respiratory Orientation 09:00
Room TBA Conference Room C
08:30-15:00 (3rd floor)

February 20 February 21 February 22 February 23 February 24


Unit 4 Test
Unit 5
Clinical 12o Respiratory Make up clinical Perioperative
Skills/Simulation Simulation M164 08:30-12:30

February 27 February 28

Clinical 8o Clinical 8o

March 2017
Monday Tuesday Wednesday Thursday Friday
2
March 1 March 2 March 3
  Calculations Exam 1
Unit 5
Endocrine
M164 08:30-12:30

March 6 March 7 March 8 March 9 March 10


Unit 5
Clinical 12o Endocrine
M164 08:30-12:30

March 13 March 14 March 15 March 16 March 17


Unit 5 Test
Clinical 8o Clinical 8o Unit 6
Cardiac
M164 08:30-12:30

March 20 March 21 March 22 March 23 March 24


Spring Break Spring Break Spring Break Spring Break Spring Break
         

March 27 March 28 March 29 March 30 March 31


Unit 6
Clinical 12o Cardiac
M164 08:30-12:30

April 2017
Monday Tuesday Wednesday Thursday Friday
3
April 3 April 4 April 5 April 6 April 7
Unit 6
o o
Clinical 8 Clinical 8 Cardiac
M164 08:30-12:30

April 10 April 11 April 12 April 13 April 14


Unit 6 Test
Clinical 12o Unit 7
Mental Health
M164 08:30-12:30
Calculation Exam 2
April 17 April 18 April 19 April 20 April 21
Unit 7
Clinical 8o Clinical 8o Mental Health
M164 08:30-12:30

April 24 April 25 April 26 April 27 April 28


Unit 7 Test
Clinical 12o Final Review
Make up Clinical M164 0830-1230
Simulation

May 2017
Monday Tuesday Wednesday Thursday Friday
May 1 May 2 May 3 May 4 May 5
o
Clinical 8 Final Exam—
Comprehensive
M164 08:30

4
5
Department of Registered Nursing

Course Title: Nursing Process I


Course Number: NURS 2158
Course Description: Nursing Process I introduces the LPN to basic concepts, attitudes, knowledge,
and skills of the registered nurse, thereby facilitating the role transition from
licensed practical nurse to registered nurse. The philosophy, conceptual
framework, and objectives of the Northark’s Nursing Department are introduced,
utilizing an integrated approach and building upon the foundation of fundamental
nursing knowledge. The concepts of human flourishing, nursing judgment, spirit
of inquiry and professional identity are used to guide learning outcomes for the
course. Clinical laboratory experience is in the nursing laboratory and in health
agencies, providing the student opportunities to develop nursing skills by giving
direct patient care.

Credit Hours: Eight semester credit hours


4 hours of theory/week Thursday 8:30-12:30
4 hour credit for clinical (12 hours of clinical/week)
Weekly Course Clinical is on Mondays and Tuesdays. Days and times vary for specialty
Schedule: rotations.
Location: Class is on Thursdays in M164.

Course Instructors: Jacquline Cheek MSN, RN


Fax—870-391-3354 Office: M175
Hours:
Monday: In Clinical or by appointment
Tuesday: In Clinical or by appointment
Wednesday: 8:00-4:00
Thursday: 8:00-4:00 between & after class
Friday: By appointment only
Phone: 870-391-3235
E-Mail: [email protected]

Kim McGowan MSN, RN


Office M177
Hours:
Monday: In clinical or by appointment only
Tuesday: In clinical or by appointment only
Wednesday: 8:00-3:30
Thursday: 8:00-3:30 between and after class
Friday: By appointment only
Phone: 870-391-3528
E-Mail: [email protected]

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Prerequisite: Acceptance into LPN-RN Program. MAT 1011 and 1012 or 1123 or higher,
ENGL 1013, PSYC 2003, BIO 2214, CIS 1103
Co-requisite: NURS 1011, ***BIOL 2224, ***PSYC 2103 (*** Pre or Co-requisite of NURS
2158)
Course Progression: Upon successful completion of NUR 2158 and NUR 1011, the student may
progress to NUR 2167 and NUR 2021.
Course Student Learning Outcomes Core Competencies
Outcomes/Objectives/ Human Flourishing Communication
Competencies: Patient Centered Care
Cultural Diversity

Nursing Judgment Safety/Quality Improvement


Evidence Based Practice
Managing Care
Collaboration/Teamwork

Spirit of Inquiry Clinical Decision Making


Clinical Reasoning

Professional Identity Professional Behavior


Legal/Ethical
Teaching/Learning
Informatics
Human Flourishing
1. Recognize basic principles of growth and development in caring for
clients of all ages that promote human flourishing. Measured by
evaluation, discussion, case studies, lab simulations, clinical practicum,
concept maps, and exams
2. Identify the role of the nurse as a patient advocate. Measured by case
studies, lab simulations, clinical experiences, and exams.
3. Use basic communication techniques to facilitate effective interactions
with peers, faculty, clients, and health personnel. Measured by observed
communication patterns between individuals, clinical practicum and
evaluation, and exams.
4. Apply to nursing interventions those cultural, social, spiritual and
historical influences which affect the client in all phases of life. (Man,
Nursing, Caring Intervention) Measured by clinical practicum and
evaluation, and written exams/quizzes.

Nursing Judgment
5. Relate the nursing process to provision of safe, comprehensive, and
holistic nursing care to clients at any stage of wellness or illness across
the lifespan. Measured by concept map for selected populations of clients,
lab simulations, and written exams.
6. Demonstrate the ability to safely meet the needs of adult and pediatric
clients in various health care settings by using clinical reasoning.
Measured by lab simulation, clinical practicum, exams.
7. Demonstrate professional behavior by being responsible and accountable

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for the ethical and legal aspects of nursing care provided to patients,
families, and communities. Measured by exam, written assignments, and
clinical practice.

Professional Identity
8. Discuss the role, scope, and practice of the Associate Degree Nurse as
defined by the Northark School of Nursing, its philosophy, conceptual
framework, subconcepts, and competency statement. Measured by
simulations and exams.
9. Identify teaching-learning principles. Measured by locating a teaching
tool for use in the clinical setting and lab simulations.
10. Describe the nurses' role in specific treatment methods designed for health
promotion, maintenance and restoration of health for individuals, families,
and communities. Measured by exams, concept maps, lab simulations
and clinical.

Spirit of Inquiry
11. Using evidence based practice, plan appropriate nursing intervention to
assist the client and family to adapt physiologically, psychologically, and
socially to the stressors which occur across the life span. Measured by
concept maps, exams, lab simulations and clinical.
12. Apply clinical decision making skills when managing care of patients and
families. Measured by case study and clinical practice.

Northark General The learning outcomes of general education will be common to all students
Learning Outcomes: regardless of major. When students have completed the general education
component of their studies, they should be able to:
1. Apply critical thinking and problem solving skills across disciplines.
2. Apply life skills in areas such as teamwork, interpersonal relationships,
ethics, and study habits.
3. Communicate clearly in written or oral formats.
4. Use technology appropriate for learning.
5. Discuss issues of a diverse global society.
6. Demonstrate math and/or statistical skills.

Rationale: The LPN is socialized into the role of the registered nurse through a focus on the
nursing process, expansion of skills, and application of critical thinking. Clinical
laboratory experience in the on-campus nursing lab and in affiliated health care
agencies provides students the opportunity to develop professional nursing skills
during the transition to an expanded role.

Required Textbooks: 1. Student Planner/Handbook/Calendar-May use calendar in your syllabus.


2. Drug Handbook (Student's choice) - No older than 2 years.
3. Ignatavicius, M. and Workman, L. (2016) Medical-Surgical Nursing: Patient-
Centered Collaborative Care, 8 th ed., St. Louis, MO: Elsevier-Saunders.
978-1-4557-7255-1
4. Evolve Elsevier Adaptive Quizzes.
5. Fitzpatrick. (2011). Maxi-Learn. WH Boyce Publishing. 0-9842536-1-0
6. Ball, J., Dains, J., Flynn, J., Solomom, B., Stewart, R. (2015). Seidel’s physical
examination handbook 8th ed., St. Louis, MO: Saunders-Elsevier. 978-0-
8
323-16953-0
7. Syllabus for Nursing 2158—Nursing Processes I

Recommended/ 1. Silvestri, L. (2017). Saunders Comprehensive Review for NCLEX-RN


Supplemental/ Examination, 7th ed., Saunders. 978-0-3233-9136-8
Suggested Books 2. Giangrasso, A. & Shrimpton, D. (2012). Dosage Calculations: A multi-
method approach. 13th ed., New York: Pearson. 978-0-13-801430-8
3. Ackley, B. and Ladwig, G. (2017). Nursing Diagnosis Handbook, 11th ed.,
Philadelphia, PA: Mosby. 978-0-323-32224-9

Major Teaching- Teacher: Lecture Student: Discussion


Learning Activities: Discussion Small group conferences
Demonstrations Role Playing
Audiovisual presentation Independent study guides
Classroom assessment techniques Skills lab/Simulation
Online assignments Computer assisted instruction

Course Requirements: 1. The student is expected to attend class, laboratory sessions, and clinical.
2. The student is expected to be prepared for classroom, laboratory activities,
and clinical.
3. The student is expected to complete all written assignments as directed by
the instructor.
4. The student is required to complete independent study activities.
5. The student is expected to meet all course outcomes.
6. The student is to write examinations on designated dates.

Resources Needed for 1. Personal computer - The student is expected to have access to a computer
This Class with these system requirements. If you have any problems with your computer,
i.e., computer crashes, internet goes down, or etc., it is your responsibility to
have a backup plan.
2. Email Account—A Northark email account was issued to you
automatically when you enrolled in your classes. To access your email,
navigate to Northark’s Web site at www.northark.edu. On the Students tab, you
should see a link Student Email. You may also access your email from
web.mail.northark.edu. Your email address will be your
[email protected]

Available on Campus 1. Computers:


Resources (i.) JPH Business building – Computers are available in rooms B206, 207, 208,
209, & 302. (See schedule on the wall beside Mary Bausch’s office on the 2nd
floor)
(ii.) Libraries – There are computers available for all Northark students on the
north and south campuses.
North Campus: Monday – Friday, 7:30 am – 4:30 pm
South Campus: Monday – Thursday, 7:30 am – 9:00 pm
Friday: 7:30 am – 5:00 pm
Saturday: 8 am – 5 pm

2. Writing Lab – South Campus room Resources on the north and south
campus including the library, computer labs, and the Learning Assistance
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Center (math & science tutors, writing lab, testing center)

Assistance available for If you are having any issues in your course, the first person you should contact is
this course your instructor.  If you need technical assistance for logon issues, contact Brenda
Freitas (Northark IT department) at [email protected] or 870.391.3275.

General Policies: All general policies in the Registered Nursing Program Handbook and the
Northark Student Handbook are adhered to in this course. Review the Registered
Nursing Program Handbook for this course. See the course coordinator or your
clinical instructor if you have any questions.

Withdrawal Policy: It is the responsibility of faculty members to advise their classes, in writing, of
their attendance and make up policies. It is the student’s responsibility to discuss
any absences and the possibility of make-up work with the instructor as soon as
possible. Students are expected to attend all class meetings and officially
withdraw from courses they are no longer attending. Faculty will not drop a
student from the course.

Grading: The course grade is determined as follows:


Unit Examination 70%
Final 20%
Homework 10%
Clinical Component is Pass/Fail
The homework grade is added ONLY after the student has achieved a 79% or
above on all examinations.
If a student has less than a passing average (79%) on unit tests and the final, the
student will not progress in the program. Please meet with the instructor if you do
not achieve a 79% or above following the third examination.
Students must pass the clinical component of the course in order to progress in
the program. If the student fails the clinical component, the theory grade drops to
a "D" and the student cannot progress.

Grading Scale:
A 91-100
B 84-90
C 79-83
D 70-78
F 69 & below

Math Exam: A mandatory math exam will be administered this semester. This exam is
excluded from the residual course contents and examinations. A score of 90%
must be achieved in order to continue with the nursing program. The exam may
be taken 3 times. See RN Handbook.

Academic Assessment: Various methods are used to evaluate student academic achievement. These
methods include, but are not limited to:
1. Written assignments
2. Evolve assignments
3. Clinical skills lab and simulation
4. ATI computerized exams
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Standardized exams will be employed to:
1. Assess individual student's critical thinking skills and nursing knowledge
to predict success on NCLEX.
2. Assist faculty in evaluating program content and identifying gaps in
curriculum.
3. Assess program outcomes and foster planning.

Attendance: Students are expected to attend all class meetings. Missing more than 15% of
scheduled class meetings constitutes excessive absence and you may be dropped
from the class. Students must see the instructor and explain tardiness. Only in
extreme circumstances will tardiness be excused.
Clinical days scheduled “on campus” are designed for clinical experience and
guidelines for clinical absence are applicable.

Inclement Weather: In the event the college is closed during inclement weather, the nursing program
may choose to have online content to minimize lost class/clinical time. You will
be expected to check portal for assignments during inclement weather and submit
any assignments when due.

Make-up Exams: 1. All exams should be taken at the scheduled time.


2. The student MUST personally notify the instructor prior to the exam if the
student is unable to take the exam at the scheduled time. A missed exam
is considered a class absence.
3. Students may make-up one test only per semester at the instructor's
discretion.
4. Missed exams must be taken within 3 days from original examination
date.
5. Failure to comply with the stated requirements omits the privilege of
taking a make-up exam. A zero will be given for the test not taken.
6. Students are expected to remain in their seat during exams.
Students needing to use the bathroom, get a drink or other activities must
hold their hand up and be recognized and permission granted by the
faculty in the room at the time the exam is being given prior to leaving the
room or the exam will be picked up and a zero will be given.

Clinical Policies and See RN Program Handbook for complete information regarding clinical policies
Evaluation: and evaluations.

Satisfactory completion of Nursing Processes I (NURS 2158) is determined by:


S = Satisfactory
Students meet minimum requirements for the course clinical outcomes.
N = Needs Improvement
Students did not meet minimum requirements for 1 or more core competency
for that program outcome. If an N is received, then the student and instructor
are expected to:
1. Discuss the issue during the clinical rotation.
2. The instructor will document the discussion on the clinical formative
evaluation tool.
3. The instructor will fill out the clinical warning form.
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4. The student will formulate a remediation plan to be presented to the
clinical instructor and course coordinator. (If applicable).
5. If after remediation, the student receives another NI, the process will
be repeated once more.

If the student receives 3 N’s in the same program outcome category, such as
Human Flourishing, on separate occasions during a course clinical rotation then
they will receive a U for that clinical rotation and will be dismissed from the
program.

U = Unsatisfactory
Student did not demonstrate essential skills for patient safety, professional
behavior etc. as stated in the RN Handbook. If the student participates in any
of the reasons for dismissal as listed in the RN Handbook they will receive a
U on the clinical formative evaluation tool.

Students are allowed 3 attempts to pass a clinical skill in the simulation lab. If the
student is not successful, a remediation plan will be discussed and implemented
between the instructor and the student. If the student does not pass the skill on the
3rd attempt, they will fail that skill and not be eligible to continue in the nursing
program.

Clinical Experience:
Concurrent clinical experience is provided in appropriate clinical settings.
Specific hours and locations for clinical assignment will be announced in class.

The type of clinical assignments may vary by institution and specific unit because
of variations in hospital policy and procedures and patient populations. The level
of clinical assignment will vary according to the needs and abilities of each
student.

Students are responsible for maintaining standards of care and competencies


achieved in prior semesters. Students are required to be prepared and adapt to
variations in the patient care assignment.

Students will be oriented to their assigned clinical site by the clinical instructor.
Expectations for clinical performance and written clinical assignments will be
included in the orientation.

Skills Lab:
Students must successfully pass the clinical skills test to continue in the program.
The student will be given 3 opportunities to pass the skill. If 3 attempts are made
and the skill is NOT successfully demonstrated, the student will fail the clinical
portion of the program.

Clinical Absence:
Absence from clinical requires that the student notify appropriate persons.
Clinical instructors will describe the procedure for specific clinical sites. Make
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up clinical experiences will be done during the assigned time at the end of the
semester (during final exam week). Maximum of 12 clinical hours may be made
up per semester. Any absences in excess of 12 hours will result in dismissal from
the program. (See attendance policy in the RN Program Handbook).

Academic Dishonesty: North Arkansas College's commitment to academic achievement is supported by


a strict but fair policy to protect academic integrity.
Academic fraud and dishonesty are defined as follows:

Cheating: Intentionally using or attempting to use unauthorized materials,


information, or study aids in any academic exercise.
Test
Tampering: Intentionally gaining access to restricted test booklets, banks,
questions, or answers before a test is given; or tampering with
questions or answers after a test is taken.

Plagiarism: Intentionally or knowingly representing the words and ideas of


another as one's own in any academic exercise.
Facilitating
Academic
Dishonesty: Intentionally or knowingly helping or attempting to help another
commit an act of academic dishonesty.
This policy regards academic fraud and dishonesty as disciplinary offenses
requiring disciplinary actions. Any student who engages in such offenses (as
here defined), will be subject to one or more courses of action as determined by
the instructor, and in some cases the Division Chairperson or Program Director,
the Vice President of Instruction, and Institutional Standards and Appeals
Committee as well.

Other Available Northark’s Jenzabar Portal is like a “digital commons”, or a student and staff
Resources: center on the web. This new portal connects students to instructors, counselors,
and staff with a single point of access. You will be able to find your classes,
connect to BlackBoard, and find groups that you are involved in, like Honors,
PBL, Rodeo or other clubs. With one login and password, you have 24/7 access
to your campus e-mail, calendars, chat rooms or on-line exams. Without any
other login, you can see your Campus Connect services. You can customize your
home page as well!
SMARTHINKING is a web-based tutoring system that connects students to
qualified e-instructors (on-line tutors) anytime, from any internet connection.
This service supplements on-campus courses, distance-education courses and the
Northark Learning Assistance Center. This service is FREE to currently enrolled
students. Find the link to SMARTHINKING on the Northark Web page, student
tab. When you click on this link, instructions for starting your own account are
provided. This is a service purchased by the Title III grant.
Atomic Learning provides web-based software training for more than 100
applications that students and educators use every day. The web-site has short,
easy-to-understand tutorial movies and resources that can be used like a help-
desk for computer questions. This is a FREE service to students and staff (it even
answers questions about i-Pods!). Go to: http://highed.atomiclearning.com.
Northark students should type in:
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Username: northark
Login: pioneers.
Learn about your personal preference for taking in new information, and how you
can study differently to get the most out of your education. Students who take this
assessment find out how they prefer to learn, how teachers may prefer to teach,
and how to meet in the middle! Students can maximize their time and success in
school by following some time tested strategies for “Studying Without Tears
(SWOT)”.
 Personal computer – The student is expected to have access to a computer
with these system requirements. If you have any problems with your
computer, i.e., computer crashes, internet goes down, or etc., it is your
responsibility to have a backup plan.
 E-Mail Account – A Northark e-mail account was issued to you
automatically when you enrolled in your classes. To access your e-mail,
navigate to Northark’s Web site at www.northark.edu. On the Students
tab, you should see a link to Student E-mail. You may also access your e-
mail from web.mail.northark.edu. Your email address will be your
[email protected]
 Available On-Campus Resources
o Computers:
 JPH business Building – Computers are available in rooms B206,
207, 208, 209 & 302. (See schedule on the wall beside Mary
Bausch’s Office on the 2nd Floor.
 Libraries – There are computers available for all Northark students
on the north and south campuses.
 North Campus: Monday-Friday, 7:30 a.m.–4:30 p.m.
 South Campus: Monday-Thursday, 7:30 a.m.-9:00 p.m.;
Friday, 7:30 a.m.-5:00 p.m.; Saturday, 8:00 a.m.-5:00 p.m.
 South Campus Library houses the Testing Center. Call George
Laking at 391-3533 for hours.
o Learning Commons has computers/printers, tutors and writing help.
Assistance Available for the Course – If you are having any issues in your on-line
course, the first person you should contact is your instructor by e-mail. If you
need technical assistance for log-on issues, contact Brenda Freitas (Northark IT
Department) at [email protected] or 870-391-3275.

Student As a student at North Arkansas College, you share the responsibility for your
Responsibilities: success. The only way you can benefit from the many opportunities offered to
you by the college is by doing your part.

As a student, you are responsible to:

1. Read the college catalog and all materials you receive during registration.
These materials tell you what the college expects from you.
2. Read the syllabus for each class. The syllabus tells you what the course
expectations are and how you can plan ahead.
3. Attend all class meetings. Something important to learning happens during
every class period. If you must miss a class meeting, talk to the instructor
in advance about what you should do.

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4. Be on time. If you come in after class has started, you disrupt the entire
class.
5. Never interrupt another class to talk to the instructor or a student in that
class.
6. Be prepared for class. Complete reading assignments and other homework
before class so that you can understand the lecture and participate in
discussion. Always have pen/pencil, paper, and other specific tools for
class.
7. Learn to take good notes. Write down ideas rather than word-for-word
statements by the instructor.
8. Allow time to use all the resources available to you at the college. Visit
your instructor during office hours for help with material or assignments
you do not understand; use the library; use the free tutors, tapes, computers,
and other resources in Learning Assistance Center.
9. Treat others with respect. Part of the college experience is being exposed to
people with ideas, values, and backgrounds different from yours. Listen to
others and evaluate ideas on their own merit.
10. Be able to identify course and clinical objectives. (These are found in the
syllabus).

ADA Statement: North Arkansas College complies with Section 504 of the Rehabilitation Act of
1973 and the Americans with Disabilities Act of 1990. Students with disabilities
who need special accommodations should make their requests in the following
way: (1) talk to the instructor after class or during office hours about their
disability or special need related to classroom work; and/or (2) contact Special
Services in Room M154H and ask to speak to Kim Brecklein.

Provision for changing Changes made to the syllabus will be posted on portal and/or announced in class.
the Syllabus:

Syllabus The syllabus acknowledgement must be returned via file exchange by the 10th day
Acknowledgement: of the semester.

How to be Successful in this Course! 

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Start Out Strong:
a. read assignments (before class)
b. help your classmates (they need you)
c. work together (you need your peers)
d. enjoy the good times (there will be many)
e. eat right (feed those brain cells)
f. get plenty of sleep (when you can)
g. prioritize (for NOW school comes first)
h. set limits (you can't be ALL to everyone)
i. think and plan ahead (don't forget the nursing process)
j. participate in class (it helps everyone)
k. get to know your instructors (they are people too)
l. take responsibility for your own behavior (remember professional accountability)

don’t

DON'T:

a. let peers negative attitude pull you down (find new friends)
b. whine (it only wastes time, it never cures)
c. complain (if you find yourself and others just say stop)
d. get behind (you will be playing catch up all semester)
e. feel your instructors could care less (we care more than you know)
f. ask questions in class to hear yourself speak (it will not make you popular)
g. huddle in small groups and criticize your instructor

Remember:

a. You're the one who chose to come here. No one made you (if they did, ask yourself "Is nursing
what I really want to do?" There are people, this minute, who would give anything to be in your
chair today (value what you have and cherish it.)
b. We cannot make you learn, you're the only one that can do that (we can only teach).
c. All instructors have to teach to the majority and their learning style.
d. We are always there to assist the individual who has special needs.
e. Northark has an excellent pass rate on NCLEX-RN (your instructors and our program are among
the best in the state).

16
Nursing Processes
Units

17
NURSING 2158
UNIT 1 -- Overview of Nursing, the Nursing Process, Therapeutic Communication, and Concepts of Professional Nursing Practice
Course Outcomes: 2, 3, 4, 5, 7, 8, 9, 10
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
Upon completion of this unit, the student I. Overview of Nursing Classroom:
should be able to: A. Nurse Practice Act Review the Nurse Practice Act by accessing
1. Discuss how the Nurse Practice Act B. QSEN Core Competencies the Arkansas State Board of Nursing web page
guides Nurses' Scope of Practice. C. ANA Code of Ethics for Nurses at: http://www.arsbn.arkansas.gov/Pages/
default.aspx
2. Identify the Quality and Safety II. Therapeutic Communication
Education for Nurses (QSEN) Core Review the six QSEN competencies by
Competencies. III. Nursing Process accessing the web page at:
http://qsen.org/competencies/pre-licensure-
3. Explain how the QSEN Core IV. Concepts of Professional Nursing ksas/
Competencies are integrated into Practice
nursing practice. A. HIPAA Review the Code of Ethics for Nurses with
B. Client Advocacy Interpretive Statements by accessing the web
4. Examine the role of ethics in nursing. C. Client Education page at:
D. Client Rights http://nursingworld.org/DocumentVault/Ethics-
5. Explain how the Code of Ethics for E. Cultural Diversity 1/Code-of-Ethics-for-Nurses.html
Nurses guides nursing practice. F. Delegation
G. Informatics and Nursing Review and complete ATI Video Case Studies:
6. Discuss key legal/ethical issues in H. Priority Setting Therapeutic Communication
nursing. I. Teamwork and Collaboration
J. Safety Review and complete ATI Video Case Studies:
7. Describe the relevance of a therapeutic K. Health Care Quality Nursing Process
nurse-client relationship. L. Evidence-Based Practice
M. Critical Thinking Review HIPAA by accessing the web page at:
8. Identify and discuss essential N. Professionalism https://www.hhs.gov/hipaa/for-
conditions for a therapeutic nurse-client professionals/index.html
relationship to occur.
Review and complete ATI Video Case Studies:
9. Distinguish between therapeutic and HIPAA
non-therapeutic communication
techniques. Review and complete ATI Video Case Studies:
Client Advocacy
10. Demonstrate therapeutic
18
communication techniques. Review and complete ATI Video Case Studies:
Client Education
11. Discuss the five steps of the nursing
process. Review and complete ATI Video Case Studies:
Client Rights
12. Explain the benefits of using the
nursing process. Review and complete ATI Video Case Studies:
Cultural Diversity
13. Demonstrate an accurate application of
the nursing process. Review and complete ATI Video Case Studies:
Delegation
14. Explain the importance of ensuring
client confidentiality and the Health Review and complete ATI Video Case Studies:
Insurance Portability and Informatics and Nursing
Accountability Act.
Review and complete ATI Video Case Studies:
15. Examine the nurse's role as an Priority Setting
advocate.
Review and complete ATI Video Case Studies:
16. Discuss the importance of client Teamwork and Collaboration
education.
Review Health Care Quality by accessing the
17. Demonstrate an effective client web page: http://www.ahrq.gov/
education session.
Homework:
18. Describe the rights and responsibilities Review:
of the patient/client as a consumer and ATI RN Community Health Nursing
recipient of health care. ATI Nursing Leadership and
Management:
19. Identify key components of cultural Chapters 1-3
assessments for self and patients. Chapter 4-pg. 53
ATI Fundamentals of Nursing:
20. Differentiate the terms delegation, Chapters 1-8
supervision, and accountability. Chapter 16
Chapter 32-35
21. Explain the process of delegation. Cherry/Jacob:
Chapters 1-3, 6, 8, 10, 14, 18-22
19
22. List the principles guiding the process Ignatavicius/Workman:
of delegation. Chapters 1, 5
Complete:
23. Discuss the importance of Informatics ATI Tutorial: ATI Plan-Student Orientation
with regards to nursing practice and ATI Practice Assessment: Self-Assessment
quality health care. Inventory Web
ATI Tutorial: NurseLogic 2.0
24. Explain the importance of priority ATI Skills Modules 2.0: HIPAA
setting in nursing practice. Evolve Adaptive Quizzing: QSEN
Competency
25. Identify members of the health care Evolve Adaptive Quizzing: Nursing Process
team who collaborate to provide care to Evolve Adaptive Quizzing: Integrated Process
clients in acute care and community Evolve Adaptive Quizzing: Concept (HESI)
settings. Advocacy/Ethical/Legal Issues
Evolve Adaptive Quizzing: Concept (HESI)
26. Discuss the importance of a culture of Clinical Decision-Making/Clinical
safety in nursing practice. Judgment
Evolve Adaptive Quizzing: Concept (HESI)
27. Discuss the importance of ensuring Collaboration/Managing Care
patients/clients receive quality health Evolve Adaptive Quizzing: Concept (HESI)
care. Collaboration/Managing Care-Care
Coordination
28. Explain the importance of Evolve Adaptive Quizzing: Concept (HESI)
professionalism in nursing practice. Collaboration/Managing Care-Leadership
Evolve Adaptive Quizzing: Concept (HESI)
29. Discuss the importance of providing Communication
Evidence-Based Practice care in Evolve Adaptive Quizzing: Concept (HESI)
nursing practice. Cultural/Spiritual
Evolve Adaptive Quizzing: Concept (HESI)
30. Describe the nurse's use of critical Evidence-Base Practice/Evidence
thinking in providing care to clients. Evolve Adaptive Quizzing: Concept (HESI)
Informatics/Technology
31. Determine five critical thinking Evolve Adaptive Quizzing: Concept (HESI)
characteristics you, as a nurse, want to Nursing Interventions
acquire or improve. Evolve Adaptive Quizzing: Concept (HESI)
Professional Behaviors/Professionalism
32. Correlate knowledge, skills, caring, and
20
critical thinking with the nursing Evolve Adaptive Quizzing: Concept (HESI)
process and quality of care. Quality Improvement/Health Care Quality
Evolve Adaptive Quizzing: Concept (HESI)
Teaching and Learning/Patient Education
Evolve Adaptive Quizzing: Content Area
Fundamentals of Nursing-Issues in
Nursing
Evolve Adaptive Quizzing: Content Area
Fundamentals of Nursing-Nursing
Sciences

TEST

UNIT 2 Health Promotion/Psychosocial & Physiological Integrity


Topic: Health Assessment/Data Collection
Nursing 2158 Course Outcomes: 2, 4, 5, 6, 8, 9, 10
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
21
Upon completion of this unit, the student I. Clinical Interviewing: The Health History Review: Seidel’s Physical
should be able to: A. The Purpose of a Health History Examination Handbook –
1. The role of the nurse Chapters 1-3, 5-12, 14, 18-20, 22, 25.
1. Describe the purposes of a health 2. Establishment of rapport
history. 3. Assessment and diagnosis of Review: ATI Fundamentals for
problems Nursing –
2. Describe the role of the registered 4. Phases of the health history Chapters 26-31.
nurse in obtaining the patient's health a. Interview phase
history. b. Documentation phase Review: Physical Assessment Video.
c. Ethical considerations in data
3. Differentiate between two types of collection Review: PowerPoints (PPTs)
assessment- (complete, problem B. Preparation for the Interview
focused). 1. The Environment Homework:
2. The Introductions ATI: Skills Module –
4. Explain ethical considerations 3. Note Taking During the Physical Assessment-Adult.
necessary for protection of the Interview Vital Signs.
patient's rights related to data collected C. Technique for Conducting the
for health assessment. Interview Online:
1. Types of questions Assessment Learning Quiz
5. Organize the environment to increase 2. Validation of Information Nursing Assessment Quiz
physical and psychological comfort. 3. Focusing/Refocusing
4. Nonverbal Communication Classroom Activity:
6. Evaluate the use of silence in the 5. Cultural Variations Practice Assessment.
interview. 6. Listening Document Assessment.
7. Providing Support
7. Identify methods to validate D. Common Errors in Interviewing Skills Lab/Simulation –
information obtained in the interview. E. Components of the Nursing Health Practice physical assessment skills.
History Document head-to-toe assessment.
8. Discuss common errors in 1. Client Profile
interviewing. 2. Developmental History
3. Health Perception/Health
9. Conduct a health history interview. Management Patterns
II. Physical Assessment
10. Describe the steps of an integrated A. Purpose of the Examination
physical examination. 1. Subjective Information
2. Objective Information
11. Plan safety measures in preparation B. Conducting an Integrated Physical
22
for conducting a physical examination. Exam
C. Preparation for the exam
12. Apply the four assessment techniques D. Technique for the exam
used in the physical examination. 1. Percussion
2. Palpation
13. Demonstrate light and deep palpation. 3. Auscultation
4. Special maneuvers and positions
14. Interpret auscultated sounds as normal E. General Inspection
or abnormal. F. Assessment of body morphology and
gait
15. Contrast the use of the diaphragm and 1. Normal body types
the bell of the acoustic stethoscope. 2. Symmetry
3. Posture
16. Explain the importance of the initial 4. Gait
inspection in the assessment process. 5. Techniques
G. Assessment of general appearance
17. Document findings from the physical H. Assessment of vital signs
examination in an efficient, logical, I. Teaching Self-Assessment
complete format. J. Documentation
1. Concise and comprehensive
18. Discuss variations in assessment III. Assessment of Systems
findings for the adult and geriatric A. Normal Findings
client. 1. Skin, hair, and nails
2. Lymphatic system
19. Identify normal vs. abnormal 3. Head and Neck
assessment findings in the adult and 4. EENT
geriatric client. 5. Chest and Lungs
6. Heart and blood vessels
20. Demonstrate a head-to-toe assessment 7. Abdomen
in the simulation lab on a fellow 8. Musculoskeletal system
classmate including vital signs. 9. Neurologic system

UNIT 2 UNIT 2 Health Maintenance/Promotion


Topic: Pain, Stress, Grief, Loss, Coping
NURS 2158 Course Outcomes 2, 3, 4, 5, 6, 7, 8, 9, 10
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
Upon completion of this unit, the student I. Enhancing Coping Strategies Review: ATI Fundamentals For
23
should be able to: A. Adaptive coping strategies Nursing- Chapters 33, 36, 41, 42
1. Describe the General Adaptation B. Nursing interventions
Syndrome as a theory of adaptation to 1. Promoting healthy lifestyle Review: ATI RN Mental Health
biological stress. 2. Teaching relaxation techniques Nursing-
3. Recommending support and Chapter 4, 27
2. Describe the influence of social therapy groups
support on coping with stress. 4. Enhancing social support Review: Iggy –
II. End-of-Life Care Chapter 3, 7
3. Explain measures that are useful for A. Ethics
reduction of stress. B. Durable Power of Attorney Review: PowerPoints
C. Patient-Centered Collaborative Care
4. Define chronic conditions. 1. Assessment Homework:
2. Pain Management ATI: Skills Module –
5. Apply the nursing process to the care 3. Weakness Management Pain Management
of the patient with chronic conditions. 4. Dyspnea Management
5. Restlessness Management Adaptive Quizzing:
6. Use safe patient handling practices 6. Psychosocial Management Unit 2: Pain, Stress, Grief, Loss,
based on current evidence to prevent D. Grief, Mourning and Bereavement Coping
self-injury. III. Nursing Care of the Client in Pain
A. Pain: The Fifth Vital Sign Classroom Activity:
7. Compare the settings where palliative 1. Acute pain Case Studies –
care and end-of-life care are provided. 2. Chronic pain Worksheets –
3. Cancer-related pain Concept Mapping –
8. Identify barriers to improving care at 4. Harmful effects of pain across the Group Work –
the end of life. lifespan
B. Theoretical Bases for pain ATI: Video Case Study –
9. Explain the purpose of advance 1. Pain transmission Anxiety
directives. 2. Attitudes and practices related to Pain Management
pain Palliative and Hospice Care
10. Differentiate cultural differences with 3. Addiction, pseudo addiction, Hand off
end-of-life care. tolerance and physical
dependence
11. Discuss the ethical and legal C. Assessment of pain
obligations of the nurse regarding end- 1. History
of-life care. 2. Physical assessment
3. Psychosocial assessment
12. Differentiate between acute pain and D. Interventions
24
chronic pain. 1. Drug therapy
2. Non-pharmacologic interventions
13. Describe and explain at least four non- 3. Home care
medical techniques that might be used 4. Self-Management
for pain control. Compare the 5. Health care resources
application in acute versus home
setting.

14. Assess variables that affect the client's


response to pain across the lifespan
including cultural considerations.

15. Demonstrate use of appropriate pain


measurement instruments.

16. Apply the nursing process as a


framework to care for clients in pain.

17. Explain the differences between


opioid dependency, tolerance, and
addiction.

25
NURSING 2158
UNIT 3 -- Fluid and Electrolyte Imbalances, Shock, Trauma, and Disaster Preparedness
Course Outcomes: 1, 2, 3, 4, 5, 6, 8, 9, 10, 12
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
Upon completion of this unit, the student I. Overview Classroom:
should be able to: Review and complete ATI Video Case Studies:
1. Differentiate between intracellular and II. Intracellular Fluid (ICF) Fluid Volume
extracellular fluid and movement
between the two. III. Extracellular Fluid (ECF) Review and complete ATI Video Case Studies:
Survival Potential
2. Differentiate between osmosis, IV. Osmosis
diffusion, filtration, and active A. Isotonic Review Safe Injection Practices to Prevent
transport. B. Hypotonic Transmission of Infections to Patients by
C. Hypertonic accessing the Centers for Disease Control
3. Differentiate types of solutions D. Colloid and Prevention (CDC) web page at:
(isotonic, hypotonic, hypertonic, http://www.cdc.gov/injectionsafety/
colloid). V. Diffusion IP07_standardPrecaution.html

4. Specify the etiology, clinical VI. Filtration Review and complete ATI Video Case Studies:
manifestations, diagnosis, management, Titrating Continuous IV Medications
and nursing interventions for fluid VII. Active Transport
imbalances. Review the disaster response plan of North
VIII. Fluid Imbalances Arkansas College.
5. Specify the etiology, clinical A. Dehydration
manifestations, diagnosis, management, B. Fluid Overload Homework:
and nursing interventions for electrolyte Review:
imbalances. IX. Electrolyte Imbalances ATI Fundamentals of Nursing:
A. Sodium Chapter 15
6. Identify best practice measures to 1. Hypernatremia Chapter 49
administer IV medications and prevent 2. Hyponatremia Chapter 57
medication errors. B. Potassium Chapter 58
1. Hyperkalemia ATI RN Adult Medical Surgical Nursing:
7. State usual sites for adult and infant IVs 2. Hypokalemia Chapter 2
and give rationale for their use. C. Calcium Chapter 37
1. Hypercalcemia Chapters 43-44
8. Demonstrate safe insertion of an IV 2. Hypocalcemia Ignatavicius/Workman:
catheter using the equipment correctly. Chapters 8-11, 13, 37
26
D. Phosphorus Guidelines for the Prevention of Intravascular
9. Describe nursing measures used for 1. Hyperphosphoremia Catheter-Related Infections, 2011 by
prevention of complications of IV fluid 2. Hypophosphoremia accessing the CDC web page at:
therapy. E. Magnesium http://www.cdc.gov/hicpac/pdf/guidelines/
1. Hypermagnesemia bsi-guidelines-2011.pdf
10. Prepare and administer IV medications. 2. Hypomagnesemia Complete:
F. Chloride ATI Skills Modules 2.0: IV Therapy
11. Calculate dosages and flow rates. 1. Hyperchloremia ATI Skills Modules 2.0: Central Venous
2. Hypochloremia Access Devices
12. Demonstrate care of various types of ATI Practice Assessment: Targeted Medical-
central venous infusion lines. X. Overview of IV Therapy Surgical 2013: Fluid, Electrolyte, and
Acid-Base
13. Teach maintenance and care of long- XI. Types of Infusion Therapy Evolve Adaptive Quizzing: Concept (HESI)
term central lines. A. Vascular Access Devices Cellular Regulation
1. Peripheral IV Therapy Evolve Adaptive Quizzing: Concept (HESI)
14. Identify nursing care associated in intra- 2. Mid-Line Catheters Fluids and Electrolytes
arterial, intraperitoneal, subcutaneous, 3. Central Venous IV Therapy Evolve Adaptive Quizzing: Concept (Giddens)
intraosseous, and intraspinal infusion a. PICC Cellular Regulation
therapy. b. CVC Evolve Adaptive Quizzing: Concept (Giddens)
1. Non-tunneled Fluid and Electrolytes
15. Define shock and its underlying 2. Tunneled Evolve Adaptive Quizzing: Client Needs
pathophysiology. 3. Implanted Ports Physiological Adaptation
B. Hemodialysis Catheters
16. Compare clinical findings of the C. Insulin Systems Lab Simulation: IV Therapy/Fluid &
compensatory and progressive stage of D. Administration sets Electrolyte/Shock/Trauma/Disaster Drill
shock. E. Rate Controlling Infusion utilizing SBAR and interprofessional
Devices communication
17. Compare the risk factors, causes, and F. Nursing Care for Patients
manifestations of different types of Receiving IV Therapy Case Studies
shock. G. Complications of IV Therapy Concept Maps
H. Alternative Sites for Infusion TEST
18. Describe the actions, side effects, and
nursing implications of drug therapy for XII. Shock
shock. A. Hypovolemic Shock
B. Septic Shock
19. Coordinate the nursing care for the
patients experiencing any stage of
27
shock. XIII. Concepts of Emergency Care and
Disaster Preparedness
20. Describe emergency care as a A. Care Environment
collaborative holistic approach that B. Safety Considerations
includes the patient and his C. Scope of Emergency Nursing
family/significant others. D. Emergency Nursing Principles
E. Trauma Nursing Principles
21. Discuss priority emergency measures F. Trauma
instituted for any patient with an G. Environmental Injuries
emergency condition. 1. Heat Stroke
2. Injected Poisons
22. Compare the emergency management 3. Lightening Injuries
of patient with swallowed, inhaled, and 4. Cold-related Injuries
injected poisons and food poisoning. 5. Drowning
H. Role of Nursing in Disaster
23. Describe the components of an Response Plans
emergency preparedness and response 1. Emergency Preparedness
plan.

24. Provide support to the person and/or


family in coping with life changes
resulting from a disaster.

NURSING 2158
UNIT 4 -- Respiratory Function (Oxygenation)
28
Course Outcomes: 3, 4, 6, 7, 8, 9, 10, 11
OBJECTICVES/OUTCOM ES CONTENT LEARNER ACTIVITIES
Upon completion of this unit, the student I. Assessment of Respiratory Function Review: Iggy –
should be able to: A. Physiologic overview Concept Overview P 492-493
B. Assessment of patients with Chapters 27-32
1. Relate the pathophysiology of pulmonary disease
oxygenation to the respiratory 1. History Review: ATI RN Adult Med-Surg –
history/physical assessment. 2. Physical assessment Chapters 17-26
3. Cultural considerations
2. Compare the various procedures used 4. Aging adult considerations Review: PowerPoints
for diagnostic assessment of respiratory C. Diagnostic assessment of respiratory
function. functions Homework:
1. Noninvasive methods Online:
3. Anticipate nursing actions necessary to 2. Invasive methods Respiratory Quiz
support clients undergoing diagnostic II. Management of Clients requiring oxygen
procedures for respiratory health Delivery Systems ATI Skills Module –
problems. A. Low Flow versus High Flow Airway Management
1. Types Closed-Chest Drainage
4. Plan the nursing management for 2. Safety Oxygen Therapy
patients receiving oxygen therapy, 3. Client Education Specimen Collection: Sputum
intermittent positive pressure breathing, B. Non-Invasive Positive Pressure  accepted practice
mini-nebulizer therapy, incentive Ventilation  step by step viewing, nose
spirometry, chest physiotherapy and 1. BiPAP culture and throat culture
breathing retraining. 2. CPAP  practice challenge #2
C. Tracheostomy
5. Analyze the differences in nursing care 1. Operative Care: Before, During ATI Practice Assessments –
for a patient with an endotracheal tube & After Targeted Medical-Surgical 2013:
and for a patient with a tracheostomy. 2. Tracheostomy Tubes Respiratory
3. Preventing Tissue Damage
6. Recognize aspects of care that can be 4. Air Warming and Humidification Adaptive Quizzing –
delegated on clients who have 5. Suctioning Unit 4: Respiratory
endotracheal tube and who have 6. Tracheostomy Care
tracheostomy. 7. Bronchial/Oral Care Classroom Activity:
8. Ensuring Nutrition Case Studies –
7. Assess and plan nursing care of patients 9. Maintaining Communication Worksheets –
with noninfectious problems of the 10. Supporting Psychosocial Needs Concept Mapping –
upper and lower respiratory tract. & Self-Image
29
11. Weaning Group Work –
8. Discuss risk factors for developing 12. Subcutaneous Emphysema
chronic obstructive pulmonary disease III. Care of Patients with Noninfectious ATI Video Case Study –
(COPD) and the impact to communities Upper Respiratory Problems Oxygenation
related to smoking. A. Obstructive Sleep Apnea Metered Dose Inhaler
B. Epistaxis
9. Develop culturally-sensitive teaching C. Fracture/Repair of Nose Respiratory Simulation
plans for clients with COPD needing IV. Care of Patients with Noninfectious
smoking cessation. Lower Respiratory Problems
A. Chronic Airflow Limitation
10. Compare the various pulmonary 1. Asthma
infections regarding causes, clinical 2. COPD
manifestations, nursing management, B. Cystic Fibrosis
complications, and prevention. C. Pulmonary Hypertension
D. Interstitial Pulmonary Diseases
11. Describe the role of the nurse in E. Lung Cancer
detection and management of V. Care of Patients with Infectious
pulmonary tuberculosis. Respiratory Problems
A. Disorders of the Nose and Sinuses
12. Relate pleurisy, pleural effusion, and 1. Rhinitis
empyema to pulmonary infection. 2. Sinusitis
B. Disorders of the Oral Pharynx and
13. Describe risk factors, prevention, and Tonsils
management of pulmonary embolism. 1. Pharyngitis
2. Tonsillitis
14. Assess the respiratory status of patients C. Disorders of the Larynx and Lungs
who develop sudden-onset respiratory 1. Influenza
difficulty or acute confusion. 2. Pneumonia
3. Pulmonary Tuberculosis
15. Use laboratory data and clinical 4. Lung Abscess
manifestations to evaluate the adequacy 5. Pulmonary Empyema
of gas exchange with oxygenation and 6. Pertussis
ventilatory interventions. VI. Care of Critically Ill Patients with
Respiratory Problems
16. Prioritize care for the patient A. Pulmonary Embolism
experiencing a serious or critical B. Acute Respiratory Failure
respiratory disorder or event. C. Acute Respiratory Distress Syndrome
30
(ARDS)
17. Compare the complications of chest D. Chest Trauma
trauma and their clinical manifestations 1. Pulmonary Contusion
and nursing management. 2. Rib Fracture
3. Flail Chest
18. Examine collaboration efforts with 4. Pneumothorax
other health care providers in the 5. Tension Pneumothorax
specialized care of patients who are 6. Hemothorax
mechanically ventilated, including the E. The Patient Requiring Intubation and
need for communication systems. Ventilation
1. Endotracheal Intubation
19. Explain the principles of chest drainage 2. Mechanical Ventilation
and demonstrate the nursing
responsibilities related to the care of the
patient with water seal drainage.

31
NURSING 2158
UNIT 5 -- Perioperative Concepts, Responses to Altered Endocrine Function
Course Outcomes: 2, 3, 4, 5, 6, 7, 6, 9, 10
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
Upon completion of this unit, the student I. Overview Classroom:
will be able to: A. Surgical Settings Review and complete ATI Video Case
1. Identify legal and ethical considerations Studies: Type I Diabetes Mellitus
related to informed consent. II. Patient-Centered Collaborative Care Homework:
A. Preoperative Assessment Review:
2. Summarize factors included in the 1. History ATI RN Adult Medical Surgical Nursing
preoperative assessment to identify 2. Physical Assessment Chapters 76-83, 94-96
surgical risk factors. 3. Psychosocial Assessment Ignatavicius/Workman:
4. Laboratory and Imaging Chapters 14-16, 61-64
3. Describe preoperative nursing Assessment Complete:
measures that decrease risk for B. Pre-operative Planning and ATI Skills Modules 2.0: Diabetes
infection and other postoperative Implementation Management
complications. 1. Patient Teaching ATI Practice Assessment: Targeted
2. Informed Consent Medical-Surgical 2013: Endocrine
4. Develop a preoperative teaching plan 3. Minimizing Anxiety ATI Practice Assessment: Targeted
designed to promote the patients' 4. Pre-operative patient Medical-Surgical 2013:
recovery from anesthesia and surgery. Preparation Perioperative
Evolve Adaptive Quizzing: Content
5. Describe the immediate preoperative III. Intraoperative Overview Area, Medical-Surgical Nursing,
preparation of the patient. A. Members of the Surgical Team Endocrine System
B. Preparation of Surgical Suite and Evolve Adaptive Quizzing: Client Needs
6. Describe the principles and basic Team Safety Safety and Infection Control
guidelines of surgical asepsis. C. Anesthesia Evolve Adaptive Quizzing: Client Needs
1. Stages of Anesthesia Pharmacological and Parenteral
7. Identify adverse effects of surgery and 2. Types of Anesthesia Therapies
anesthesia. 3. Complications of Anesthesia Evolve Adaptive Quizzing: Mastery,
Content Area, Medical-Surgical
8. Compare the various types of IV. Intraoperative Patient-Centered Nursing, Endocrine System
anesthesia with regard to uses, Collaborative Care Evolve Adaptive Quizzing: Mastery,
advantages, disadvantages, and nursing A. Intra-operative Assessment Client Needs, Safety and Infection
responsibilities. B. Planning and Implementation Control
1. Preventing Injury &
9. Identify the surgical risk factors related Complications
32
to age-specific populations; list nursing V. Postoperative Overview Case Studies
interventions to reduce those risks. Concept Maps
VI. Postoperative Patient-Centered EXAM
10. Describe the interdisciplinary approach Collaborative Care
to the care of the patient during A. Postoperative Assessment
surgery. 1. Respiratory System
2. Cardiovascular System
11. Describe the responsibilities of the 3. Urinary System
post- anesthesia care unit nurse in the 4. Gastrointestinal System
prevention of immediate postoperative 5. Integumentary System
complications. 6. Pain Assessment
B. Psychosocial Assessment
12. Discuss postoperative education for C. Laboratory Assessment
patients and family members after D. Planning and Implementation
surgery. 1. Preventing Hypoxemia
2. Preventing Infection
13. Identify common postoperative 3. Managing Pain
discomforts, complications and their E. Community-Based Care
management. 1. Teaching for Self-
Management
14. Describe the gerontologic and pediatric
considerations related to postoperative VII. Anatomy and Physiology Review
management of patients.
VIII. Assessment Methods
15. Demonstrate sterile dressing technique.
IX. Disorders of the Anterior Pituitary
16. Collaborate with health care team Gland
members to perform emergency care A. Hypopituitarism
procedures for surgical wound B. Hyperpituitarism
dehiscence or wound evisceration.
X. Disorders of the Posterior Pituitary
17. Specify the functions and hormones Gland
secreted by each of the endocrine A. Diabetes Insipidus
glands. B. Syndrome of Inappropriate
Antidiuretic Hormone
18. Identify the diagnostic tests used to
determine altered adrenal function of
33
each of the endocrine glands. XI. Disorders of the Adrenal Gland
A. Adrenal Gland Hypofunction
19. Evaluate the influence of culture and B. Adrenal Gland Hyperfunction
genetics on endocrine disorders.
XII. Thyroid Disorders
20. Compare hyperparathyroidism and A. Hyperthyroidism
hypoparathyroidism: their causes, B. Hypothyroidism
manifestations, management and C. Thyroiditis
nursing interventions. D. Thyroid Cancer

21. Compare Addison's Disease and XIII. Parathyroid Disorders


Cushing's Syndrome: causes, clinical A. Hyperparathyroidism
manifestations and management. B. Hypoparathyroidism

22. Use the nursing process as a XIV. Diabetes Mellitus


framework for care of the patient with
Cushing's Syndrome.

23. Compare hypothyroidism and


hyperthyroidism: their cause, clinical
manifestations, management and
nursing interventions.

24. Describe conditions amenable to


thyroidectomy and the nursing needs
of patient's afterward.

25. Differentiate between type 1 and type


2 diabetes.

26. Describe etiologic factors associated


with diabetes.

27. Relate the clinical manifestation of


diabetes to the associated
pathophysiologic alterations.

34
28. Identify the diagnostic and clinical
significance of blood glucose tests.

29. Explain the dietary modifications used


for management of people with
diabetes.

30. Describe the relationship between diet,


exercise and medication (i.e. insulin or
oral hypoglycemic agents) for people
with diabetes.

31. Develop a plan for teaching insulin


self-administration.

32. Recognize and be able to incorporate


cultural influences in the planning and
administration of care of the diabetic
patient.

33. Identify the role of oral antidiabetic


agents in diabetic therapy.

34. Describe management strategies for a


person with diabetes to use during
"sick days".

35. Describe the macrovascular


microvascular, and neuropathic
complication of diabetes and the self-
care behaviors important in their
prevention.

36. Identify the teaching aids and


community support groups available
for people with diabetes.

35
37. Apply the nursing process as a
framework for care of the patient with
diabetes.

NURSING 2158
UNIT 6 -- Cardiac (Perfusion) Concepts
Course Objectives: 2, 3, 4, 5, 6, 8, 9 and 10
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
36
Upon completion of this unit, the student I. Assessment of Cardiac Function Review: Iggy –
should be able to: A. Physiological Overview Chapters 33, 35, 36
1. Cardiac Physiology
1. Review the anatomy and physiology of 2. Circulatory Physiology Review: ATI RN Adult Medical
the cardiovascular system. B. Assessment Methods Surgical Nursing–
1. History Chapters 27,32, 33, 34, 35, 36, 38
2. Identify patients at risk for a. Modifiable/Nonmodifiable
cardiovascular (CV) problems. Risk Factors Review: ATI Nutrition for Nursing
b. Nutrition –
3. Perform a focused cardiac assessment. c. Self-management Page 67 Coronary heart disease
2. Physical Assessment Page 68 Coronary heart disease, &
4. Identify the clinical significance and a. Heart Sounds Hypertension
related nursing implications of the b. general appearance Page 69 Heart Failure
various tests, procedures, and labs used c. vital signs
for assessment of cardiac function. d. peripheral pulses and Review: PowerPoints
extremities
5. Identify community resources for C. Diagnostic Evaluation Homework:
patients with cardiac problems and their 1. Lab Tests (CKMB, Troponin, Adaptive Quizzing –
families. Myoglobin) Unit 6: Cardiac Perfusion
2. CXR and Fluoroscopy
6. Use the nursing process as a framework 3. EKG ATI Practice Assessments –
for the care of a patient with heart 4. Stress Tests Targeted Medical-Surgical 2013:
failure. 5. Ultra Sound Cardiovascular
6. Radio nucleotide Imaging
7. Develop a teaching plan for a patient 7. Angiography Classroom Activity:
with heart failure. II. Care of Patients with Cardiac Case Studies –
Problems Worksheets –
8. Review current evidence-based A. Heart Failure Concept Mapping –
published guidelines for the 1. Pulmonary Edema Group Work –
management of heart failure. B. Valvular Heart Disease
C. Inflammations and Infections ATI Video Case Study –
9. Relate the use of pharmacological 1. Infective Endocarditis Heart Failure
therapy to the management of heart 2. Pericarditis
failure. 3. Rheumatic Carditis
III. Care of Patients with Vascular
10. Describe emergency care of patients Problems
experiencing complications such as A. Arteriosclerosis/Atherosclerosis
37
cardiac tamponade or pulmonary B. Hypertension
edema. C. Peripheral Arterial Disease
D. Aneurysms
11. Contrast different types of valvular E. Aortic Dissection
disorders. F. Peripheral Venous Disease

12. Describe nursing care of patients Guide for Study –


undergoing surgical management of Know the important NURSING
valvular disease. information connected to each of the
following categories:
13. Differentiate between the different
cardiac inflammations and infections. Pathophysiology – a couple of sentences
in your own words.
14. Identify and assess for risk factors
associated with hypertension. Diagnostics – labs, US, X-ray etc.,
expected findings.
15. Define normal blood pressure and
categories of abnormal blood pressure. Assessment – focused.
Include age-related considerations.
Clinical manifestations – what do you
16. Use the nursing process as a framework expect the patient to look like? What may
for care of a patient with hypertension. happen if this progresses?

17. Describe immediate treatment for a Risk factors – history and physical info.
hypertensive crisis
Nursing interventions – what will you do
18. Identify risk factors for vascular about the assessment findings?
problems.
Medications – what are the most
19. Use the nursing process as a framework COMMON drugs or classes used and what
of care for a patient with peripheral are basic pieces of information the patient
vascular disorders or you should know.

20. Compare common assessment findings Complications – how does this progress?
present in patients with peripheral What will you look for?
arterial and peripheral venous disease.
Education – what will you teach your
38
patient: diet, medication information,
activity, self-management at home, etc.

NURSING 2158
UNIT 7: Mental Health Concepts
Course Objectives: 2, 3, 4, 5, 11, 12
OBJECTICVES/OUTCOMES CONTENT LEARNER ACTIVITIES
Upon completion of this unit, the student will I. Concepts of Mental Health Nursing Review: ATI RN Mental Health Nursing –
39
be Chapters 1, 2, 3, 5, 7, 8, 9, 10, 21, 22, 23, 24,
able to: A. Assessment 29, 30, 31, 32, 33,
B. Standardized Screening Tools
1. Examine barriers to treatment in the C. DSM-5 Review: PowerPoints
homeless and incarcerated population.
D. Therapeutic Strategies Homework:
2. Demonstrate therapeutic communication II. Legal and Ethical Issues  Adaptive Quizzing –
with clients experiencing mental illness A. Rights of Mental Health Clients  Unit 7 Mental Health
including therapeutic use of self. B. Ethical Principals  Unit 7 Foundations and Modes of Care
A. Types of Admissions 
3. Identify the roles of different health care B. Seclusion and Restraints ATI Learning System RN –
team members involved with patients with C. Tort Law Practice Tests –
mental health disorders. D. Documentation Mental Health 1
Mental Health 2
III. Effective Communication
4. Identify ethics and legalities related to
A. Levels of Communication Classroom Activity:
mental health care.
B. Nonverbal Communication Case Studies –
C. Therapeutic Communication Group Work –
5. Examine appropriate measures to ensure the
1. Components
safety of clients, self, and other members of
2. Nursing Process
healthcare team.
D. Skills and Techniques
6. Develop knowledge of nonpharmacological 1. Effective
therapies and plan care for implementation. 2. Noneffective
IV. Therapeutic and Safe Environment
7. Evaluate safety concerns when dealing with V. Traditional Nonpharmacological Therapies
patients with mental disorders. A. Psychoanalysis, Psychotherapy, and
Behavioral Therapies
8. Evaluate community resources both B. Group and Family Therapy
inpatient and outpatient settings related to C. Stress Management
clients suffering mental illnesses. D. Brain Stimulation Therapies
VI. Psychiatric Emergencies
9. Use the nursing process as a framework of A. Crisis Management
care for communicating with a mental B. Suicide Anger Management
health patient.
40
C. Family and Community Violence
10. Differentiate the method of communication D. Sexual Assault
during assessment with child, adolescent,
and older adults.
VII. Psychopharmacological Therapies
11. Compare the different methods of A. Antipsychotic Agents
nonpharmacological therapy. B. Anxiolytics
C. Antidepressants
12. Differentiate nursing care of patients D. Mood Stabilizers
dealing with psychiatric emergencies.
Know the following for each class of
drug listed above:
13. Use the nursing process as a framework for
 Mechanism of Action
care of patients experiencing psychiatric  Adverse Reactions
emergencies.  Common Side Effects
 Nursing Considerations
14. Relate the use of pharmacological therapy  Food, Drug, Herbal Interactions
to the management of psychiatric
emergencies.

41
Clinical Section

42
Registered Nursing Program
Clinical Improvement Form
Definitions & Procedures

S = Satisfactory

Students meet minimum requirements for the program outcomes.

N = Needs Improvement

Students did not meet minimum requirements for 1 or more core competency for that program
outcome. If an N is received, then the student and instructor are expected to:

1. Discuss the issue during the clinical rotation.


2. The instructor will document the discussion on the clinical formative evaluation tool.
3. The instructor will fill out the clinical warning form.
4. The student will formulate a simple remediation plan to be presented to the clinical instructor and
course coordinator. (if applicable)
5. If after remediation, the student receives another N, the process will be repeated once more.
6. If the student receives 3 N’s in the same program outcome category, such as Human Flourishing, on
separate occasions during a course clinical rotation then they will receive a U for that clinical rotation
and will be dismissed from the program.

U= Unsatisfactory (3 N’s)

Student did not demonstrate essential skills for patient safety, professional behavior, etc. as stated
on page 37 in the RN Handbook. If the student participates in any of the reasons for dismissal as listed
under “Unsafe Clinical Practice” if the RN Handbook they will receive a U on the clinical formative
evaluation tool.

43
Revised 4-12
North Arkansas College Semester____________________
10-24-12 Department of Nursing RN Program Course______________________
Formative Evaluation Tool
Student Name________________________________________ Clinical Rotation_______________________
S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not Applicable
Fill in Clinical Dates HERE
Communication
Uses effective therapeutic communication skills with patients,
health care team, faculty and others
Actively participates in pre/post conferences
Human Flourishing

Documents appropriately in either writing or in the electronic


health record
Patient Centered Care
Assess/plan for patient-family spiritual needs
Respects the individual’s personal spirituality
Assists the patient to meet their spiritual outcomes
Demonstrates compassion for others
Cultural Diversity
Respects & values diverse cultures
Provides culturally competent care
Safety/Quality Improvement
Uses standard precautions, hand hygiene and sterile technique
Administers medications using the 6 rights
Able to verbalize action, side effects, adverse reactions of
medications
Recognizes and intervenes for high risk patients
Provides for a safe environment for self, others and patients
Recognizes their role in a disaster preparedness
“Identifies” quality improvement measurements
Evidence Based Practice
rsing Judgment/Practice

Utilizes the nursing process to provide patient care


Uses correct assessment techniques
Identifies appropriate nursing diagnosis
Plans patient care using current trends in health care
Performs appropriate nursing interventions
Evaluates patient outcomes and revises care as needed
Managing Care
Prioritizes patient care
Provides timely patient care
Demonstrates organizational skills
Completes assignments on time
Collaboration/Teamwork
Identifies members of the health care team (lower level)
Compares the roles of the health care team (medium)
Plans patient care with the health care team (higher level)
Provides assistance to other health care team members
Functions as a team member by demonstrating cooperativeness
& displaying mutual respect

44
Fill in Clinical Dates HERE
Clinical Decision Making
Makes clinical judgments to ensure safe care
Uses evidence-based information to evaluate patient
Spirit of Inquiry

outcomes
Identifies problems, issues, and risks to promote health
and safety
Seeks out learning opportunities
Explores alternatives to achieve patient goals
Clinical Reasoning
Questions underlying assumptions
Offers new insight to improve quality of care
Professional Behaviors
Professional appearance (uniform and hygiene)
Preparedness (comes to clinical with stethoscope, name
tag, pen, etc)
Demonstrates positive attitude
Role model for others
Notifies clinical instructor of absence/tardiness per
policy
Does not show pattern of tardiness/absenteeism
Professional Identity

Accepts criticism and corrects mistakes willingly


Is self-motivated and directed
Complies with agency and program policy
Teaching and Learning
Utilizes evidence-based teaching interventions
Demonstrates mutual goal-setting
Identifies resources (physical, emotional, spiritual, etc.)
Promotes self-determination of patient and self
Informatics
Utilizes technology to provide safe patient care
Access appropriate resources to support positive patient
outcomes
Legal/Ethical
Practices with in the identified role of a student nurse
Maintains confidentiality (HIPAA)
Clinical Instructor Initial HERE
Instructor Comments:

Instructor
Signature:_________________________________________________Date:_____________________
Student Comments:

I acknowledge that I have read and understand the above clinical evaluation.
Student Signature:__________________________________________Date:____________________

45
Revised 10-12
North Arkansas College Semester____________________
10-24-12 Department of Nursing RN Program Course______________________
Summative Evaluation Tool
Student Name___________________________________________ Clinical Rotation_______________
S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not Applicable
S, Instructor Comments
N,
Communication
U,
NA

Uses effective therapeutic communication skills with patients,


health care team, faculty and others
Actively participates in pre/post conferences
Documents appropriately in either writing or in the electronic
Human Flourishing

health record

Patient Centered Care

Assess/plan for patient-family spiritual needs


Respects the individual’s personal spirituality
Assists the patient to meet their spiritual outcomes
Demonstrates compassion for others

Cultural Diversity

Respects & values diverse cultures


Provides culturally competent care
Nursing Judgment/Practice

Safety/Quality Improvement

Uses standard precautions, hand hygiene and sterile technique


Administers medications using the 6 rights
Able to verbalize action, side effects, adverse reactions of
medications
Recognizes and intervenes for high risk patients
Provides for a safe environment for self, others and patients
Recognizes their role in a disaster preparedness
“Identifies” quality improvement measurements

Evidence Based Practice

Utilizes the nursing process to provide patient care


Uses correct assessment techniques
Identifies appropriate nursing diagnosis
Plans patient care using current trends in heath care
Performs appropriate nursing interventions
Evaluates patient outcomes and revises care as needed

46
Managing Care

Prioritizes patient care


Provides timely patient care
Demonstrates organizational skills
Completes assignments on time

Collaboration/Teamwork

Identifies members of the health care team (lower level)


Compares the roles of the health care team (medium)
Plans patient care with the health care team (higher level)
Provides assistance to other health care team members
Functions as a team member by demonstrating cooperativeness
& displaying mutual respect
Clinical Decision Making

Makes clinical judgments to ensure safe care.


Uses evidence-based information to evaluate patient outcomes.
Spirit of Inquiry

Identifies problems, issues, and risks to promote health and


safety.
Seeks out learning opportunities
Explores alternatives to achieve patient goals

Clinical Reasoning

Questions underlying assumptions


Offers new insight to improve quality of care
Professional Identity

Professional Behaviors

Professional appearance (uniform and hygiene)


Preparedness (comes to clinical with stethoscope, name tag, pen,
etc)
Demonstrates positive attitude
Role model for others
Notifies clinical instructor of absence/tardiness per policy
Does not show pattern of tardiness/absenteeism
Accepts criticism and corrects mistakes willingly
Is self-motivated and directed
Complies with agency and program policy.

Teaching and Learning

Utilizes evidence-based teaching interventions

47
Demonstrates mutual goal-setting
Identifies resources (physical, emotional, spiritual, etc.)
Promotes self-determination of patient and self

Informatics

Utilizes technology to provide safe patient care


Access appropriate resources to support positive patient
outcomes

Legal/Ethical

Practices with in the identified role of a student nurse


Maintains confidentiality (HIPAA)

PASS FAIL
Student Comments:

I acknowledge that I have read and understand the above clinical evaluation.

Student Signature:___________________________________________________
Date:_____________________

Instructor Signature:__________________________________________________
Date:_____________________

48
NORTHARK HEAD-TO-TOE ASSESSMENT

Date: Sex: M / F Age: Admitting Diagnosis: Diet / I & O:

Fluids/Rate: IV site/Gauge Vital Signs: Drains/Tubes (NG, Blood Sugar:


etc)

General Inspection Neurological / Mental


Skin: ☐ Intact ☐ Dry/Warm ☐ Pink ☐ Cyanotic ☐ Icteric LOC: ☐Awake ☐Alert ☐ Not alert
☐ Cool/Clammy ☐ Diaphoretic ☐Lesions ☐ Oriented to: ☐Person ☐Place ☐Time ☐Situation
Petechiae
Head: ☐Symmetrical ☐Asymmetrical ☐ Masses Mental Status: ☐Calm ☐Anxious ☐Fearful
☐ Non-tender ☐Tender ☐Neck supple ☐ Full ROM ☐ Depressed ☐Other:
____________________________
Hair: ☐Evenly distributed ☐Shiny luster ☐ Dry scalp Pupils: Left: ☐Equal ☐Reactive ☒mm ________
☐Balding ☐ Scalp Lesions Right ☐Equal ☐Reactive ☐mm________
Eyes: ☐Symmetrical ☐Asymmetrical ☐ Drainage ☐Blind Speech:☐Clear ☐Aphasic☐Slurred
☐ No Drainage ☐Edema/lid tag/redness ☐Appropriate☐Inappropriate
☐glasses/contacts
Ears: ☐Symmetrical ☐Asymmetrical ☐ Otorrhea Gait: ☐Shuffling ☐Steady ☐Non-ambulatory
☐ Lesions/redness/tenderness/edema ☐Hearing Aids
(L,R,B)
Nose: ☐Symmetrical ☐Nares Patent ☐ Rhinorrhea Head: ☐Symmetrical ☐Asymmetrical ☐ Masses
☐ Obstruction: ____ R nare ____L nare ☐ Non-tender ☐Tender ☐Neck supple ☐ Full ROM
Mouth: ☐Lips moist ☐Lips dry/cracked ☐ Sores/bleeding
☐ Mucous dry ☐Teeth missing ☐Dentures ☐Gums Pain Scale (circle): 0 1 2 3 4 5 6 7 8 9 10
pink/intact
☐Right-handed ☐Left-handed ☐Unable to assess Description: ☐No pain ☐Sharp ☐Pressure ☐Dull
PAIN
☐Ache ☐Burning ☐Chronic ☐Acute
IV Site: ☐Asymptomatic☐Tenderness Location:
☐Discoloration☐Localized Edema

Cardiovascular Respiratory
Pulses: Rate: ____ ☐Right Radial ☐Left Radial ☐ Apical Breath Sounds: ☐Clear ☐Crackles ☐ Rhonchi ☐
☐Right Pedal ☐ Left Pedal ☐Right Carotid ☐Left Carotid Diminished
☐Bruits (carotids) Right OR Left ☐Inspiratory Wheezes ☐Expiratory Wheeze
Amplitude____ (1+ weak, 2+ strong , 3+bounding) Location: ☐RUL ☐RML ☐RLL
☐LUL ☐LLL
Rhythm: ☐Regular ☐Irregular Cough: ☐No cough ☐Productive ☐Non-productive ☐Frequent
☐Occas.
Capillary Refill: ☐ Less than 3 sec ☐More than 3 sec Sputum: Color: ______________ Consistency:
______________________
Skin Turgor: ☐Elastic ☐Tenting ☐Clubbing Oxygen: ☐Yes ☐No Rate:_________ Delivery: __________
Edema: ☐ No Edema ☐Edema Location: __________________ ☐Nasal Cannula (NC) ☐Non-rebreather (NRB) ☐High
☐Pitting Edema:☐2+ ☐3+ ☐4+ ☐Nonpitting (brawny) flow NC
☐Vent ☐Veni-mask ☐CPAP
☐Bi-Pap

Gastrointestinal Genitourinary/Renal (GU)


Abdomen: ☐ Non-tender ☐ Tender ☐Distended ☐Flat Voids:☐BRP ☐Catheter Size: ________FR
☐Soft ☐Firm ☐Ascites Bladder: ☐Distended ☐Non-distended
Bowel Sounds: ☐Active ☐Inactive ☐Hypoactive ☐Hyperactive Urine: ☐Clear ☐Yellow ☐Amber ☐Other:
Quadrants: ________________________________ __________________
☐Continent ☐Incontinent
Tube: ☐NGT: : ☐G-Tube
☐Suction ☐Clamped ☐Intermittent ☐Gravity ☐Continuous Psychosocial-Cultural
Residual: _______ml ☐Placement checked
Living Arrangement: ☐Alone ☐With spouse ☐With
Formula: ______________________ Rate: _____________
children
☐Nursing Home ☐Assisted Living ☐Homeless
☐Rehab
Stoma: ☐Colostomy ☐Ileostomy☐Pink ☐Red ☐Blue/Black49 Cultural Concerns:
LBM: ________ ☐Soft ☐Formed ☐Hard ☐Loose ☐Bloody Spiritual Concerns:
☐ Brown ☐Continent ☐Incontinent ☐Other: ____________ Occupation/Retired:
Erickson’s Stage:
General Concerns:
CRITICAL REASONING FOR CLINICALS

Patient Age_________ Allergies___________________________________________________________

Date of Patient Admit/Surg _____________________________________ M/F__________


Primary medical diagnosis and brief pathophysiology:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Lab/Diagnostics:
Lab: H & H______________________ WBC_____ K+_____ N+_____ Glucose_____
BUN____________
PT,, PTT, INR ______ RBC______ Blood Cultures______ MIC (S/R)________________________
Cardiac Markers (troponin, CKMB)_____ BNP_____ D-Dimer_____ Creatinine________________
Urinalysis_______________ Ketones_______ Urine Cultures___________ Myoglobin__________
Phenytoin____________ Digoxin_______ Lipase______ Amylase_____ Occult stool___________
H-pylori__________ Liver Enzymes__________ ABGs___________________________________
(try to determine if your patient was alkalotic or acidotic, why is this important?)_________________
HDL__________ LDL__________
*Add other lab values specific to your patient ______________________________________________
_____________________________________________________________________________________
Which ones will you continue to monitor R/T medical dx or meds?________________________________
Compare to previous draws or collections? Note any change.____________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Radiology (C-T scans, films, MRI, Ultrasound)? Why were these done? What were the results and how
were they used to diagnose or determine treatment?
_______________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_ Any PRNs? Just list and note if patient has needed them.
______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Equipment? Vent, Monitors, Drains, Wound Vac, Foley, Bi-Pap, Pumps, Central Lines, defibrillators,
pacemakers, stimulators, implants, prostheses or reconstructive hardware; Treatments? Respiratory
treatments; GI procedures; stress tests, etc.

50
Perioperative Clinical Written Assignment
Objectives: Upon completion, completing the assigned reading, and observation in the perioperative area, the
student will be able to:
1. Utilize the nursing process to plan care for the perioperative patient.
2. List priority areas to be included in the instruction of a preoperative patient.
3. Describe the roles of nurses and other members of the operating room team.
4. Identify types of anesthesia and rationales for use in a variety of surgeries.
5. State priority postoperative interventions for selected patients.
6. Describe changes in physiological status which occur as patients recover from anesthesia.
Answer the below:
1. Preoperative Phase:
a. Describe your first interaction with your assigned patient.
b. What was the patient’s response to having a student nurse with them?
c. If the response was positive, what do you think aided this? If negative, what could have been done
differently?
d. Discuss your patient’s thoughts and feelings in response to having surgery. Include verbal and non-
verbal observations..
e. Explain what pre-operative teaching was done prior to the patient being taken to the operating room.
What was the patient’s response to this teaching?
f. Describe the role of the preoperative nurse.  Describe your overall view of the patient’s
preoperative phase.
2. Intraoperative Phase:
a. How was the patient greeted upon entering the operating room?
b. What special preparations were done prior to surgery beginning and why?
c. Discuss the Time-Out process and its purpose. Must cite reference in the text.
d. Discuss the interactions of the OR team.
e. Discuss the role of the intraoperative nurse.
f. Discuss how you feel the patient was treated during surgery.
3. PACU Phase:
a. Discuss unique aspects of the PACU environment.
b. Discuss the role of the PACU nurse.
c. Discuss SBAR technique and its purpose. Must cite reference in the text.
d. Describe the nurse-to-nurse report when the patient was transferred into PACU. Was it
comprehensive? How did it align or differ from SBAR technique?
e. Was the information shared during report appropriate? If not why? Post-operative Care:
f. Describe the nurse-to-nurse report when the patient was transferred onto the postoperative floor.
Was it comprehensive? How did it align or differ from SBAR technique?
g. Was the information shared during report appropriate? If not why?
h. Discuss how the electronic system used for medication administration impacts patient safety. How
does it address the 10 rights of medication administration?
i. Discuss the role of the postoperative nurse.
4. Evaluation of Surgical Follow Through:
a. Research and find one Evidence Based Practice article related to the perioperative process. Read
and explain the similarities/differences you noticed during your experience.

51
Reflective Journaling

Writing –reflecting on the day’s clinical experience gives you opportunity to recall and possibly allow you to
recognize both your strengths and weaknesses. Are you able to appreciate another’s pain, concerns, fears-can
you face your own? Reflections help you to self-evaluate, develop your skill level, recognize your ability to
empathize, and show compassion (or maybe the need to improve).

Four journals are to be turned into the instructor during each clinical rotation (8 weeks). As you progress in
your training you should see a change in your ability to express your experiences and learn from them.

Some ideas to get you started:


 Describe an experience, observed behavior or perception of the experience during this clinical day.
 Express your feelings or maybe the feeling of others involved in the experience (e.g. staff, patient,
patient’s family)
 Do you feel inadequate or better prepared to make decisions, plan care, and evaluate patient care after
today’s encounter? What can you do to improve?
 Any skills you feel you need to improve or develop?

Musculoskeletal

1. How does the patient describe their discomfort? Is complaint muscle or skeletal related?

2. Does the injury/complaint affect the ability to perform ADLs? If so what are the deficits and what

interventions might you suggest to assist or alleviate the problem?

3. How is the patient being treated? What collaborative referrals are made?

4. What medications is the patient receiving? Will these decrease pain? Increase fall risk?

5. Was the patient using any assistive devices prior to injury/surgery? Will they be able to use them on

discharge?

6. What is a priority nursing diagnosis for this patient?

7. Complete the physical assessment with focus on musculoskeletal system.

8. Complete Teaching plan for a patient experiencing musculoskeletal problems.

52
1. Auscultate at least 3 client breath sounds using appropriate assessment techniques. Discuss and
document your findings with the R.T.
2. Review radiology films/reports of a patient for treatment of COPD/pneumonia, asthma, and/or flu.
What did you find? Any differences?
3. Observe at least one ventilator client. Notice settings. Answer below questions describing difference (if
ventilator was not observed, describe each statement and differences)
a. What classification of ventilator is being used (positive pressure, negative pressure)?
b. What is the ventilator mode (assist-control, intermittent, synchronized – see your med-surg text
book)?
c. What is the tidal volume set at, why is this important?
d. What is the FiO2 setting, why is this important?
e. What is the sensitivity setting, why is this important?
f. What is the sigh setting, why is this important?
g. What is the PEEP, why is this important?

1. Observe the R.T. administering pulmonary treatments (such as updrafts, use of incentive spirometers,
chest percussion). What were the common medications administered? What route are they being given
and why were they being given?
2. Observe the RT drawing ABG’s? What is the purpose of an ABG and what does it assess, describe?

3. What is/are the reason(s) for using a gait belt?

53
WOUND CARE -
CLINICAL ROTATION

Student Learning Outcomes:

1. Observe nursing process and describe therapeutic communication skills demonstrated by the wound care
nurse.
2. Identify and describe at least two methods for wound care.
3. Identify 3 different types of wounds and the interventions used for each type of wound.
4. Utilize best practice to assess a client’s wound status. Describe how this was done.
5. Relate 3 examples of wound healing to co-morbidities that the client may be experiencing (such as
diabetes or peripheral vascular disease).
6. Identify the services that wound care program provides to the community.
7. How is a patient accepted into the wound care program? Is a referral necessary?
8. Identify safety and infection control practices used during wound care. What PPE (personal protective
equipment) was used?
9. Discuss one patient visit. Include:
a. The assessment involve
b. nursing care provided
c. Education/instructions given to patient or caregiver, (d) documentation.
10. Discuss the nurses’ interdisciplinary collaboration with the healthcare team (i.e. physical therapist,
social worker, occupational therapist, dietitian, physician, etc)
11. Define osteomyelitis? How is it treated? What is the patho involved?
12. How does the Hyperbaric Chamber help with wound healing?

54
GI LAB WRITTEN ASSIGNMENT

1. What is an EGD? What is the purpose of this procedure? Describe the pre- and post-procedure nursing
care of a patient having this procedure.

2. Differentiate between proctoscopy, sigmoidoscopy and colonoscopy.

3. Identify pre- and post-procedure nursing measures in caring for the patient having a colonoscopy.

4. Describe the responsibilities of the RN in the GI lab and the skills needed to fulfill responsibilities.

55
BEHAVIORAL HEALTH ASSIGNMENT

Clinical Objectives
1. Demonstrate increasing competency in using therapeutic communication skills with psychiatric/mental
health clients.
2. Demonstrate the ability to observe and describe problematic behavior in a clinical setting.
3. Analyze clinical therapeutic modalities and their effectiveness with clients.
4. Demonstrate professional standards of moral, ethical, and legal conduct.
5. Assume accountability for personal and professional behaviors.
6. Demonstrate professionalism, including attention to appearance, demeanor, respect for self and others,
and attention to professional boundaries with patients and families as well as among caregivers.
7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient
preferences, and health literacy considerations to foster patient engagement in care.
8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care
of patients and promoting health across the lifespan.
9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.
10. Create and maintain a safe and effective therapeutic milieu that results in high quality patient outcomes.

ASSIGNMENT
 Using therapeutic communication complete Mental Health Nursing Assessment this will include
gathering information from the chart in addition to performing an abbreviated mental health assessment.
 Complete Maxi-learn cards for medications of that patient
 Complete Concept map

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Mental Health Nursing Assessment

Student’s Name: __________________________________ Date: ____________________________

I. Client Assessment
A. Client’s Demographic Data
Client’s initials: _____ Client’s Age: ____ Client location/room: ___________________
Admit date: ________ Gender: ________ Marital Status: _______ Children: ________
Career: ___________________ Last worked: ___________ Education: _____________
Cultural background: ________________________ Primary language: ______________
Spiritual belief/Religion: ___________________________________________________
Legal status: _____________ Privileges: _______________ Precautions: ____________
Living arrangements: ________________________ ADLs: _______________________
Family/community supports: ________________________________________________
Erikson’s developmental stage: ______________________________________________

B. DSM-IV-TR Admitting Diagnoses


Axis I- (Admitting psychiatric disorder(s)): ____________________________________
Axis II- (Personality disorder(s) or DD: _______________________________________
Axis III- (General medical diagnoses): ________________________________________
Axis IV- (Psychosocial/environmental factors): _________________________________
Axis V- (GAF Score):______________________________________________________

C. Psychopathology Leading to Current Admission


(Behavior, thought processes, dysfunction, crisis event, and past history or mental illness or
addictions)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________

D. Contributing History or Events (i.e., social, cultural, family, etc.)


______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________

E. Discharge Plan
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_______________________________________________________________________

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II. Mental Status Exam Flow Sheet
A. Identifying Data
Client initials: ____________ Living arrangements: ________________________
Gender: _________________ Religious preference: ________________________
Age: ____________________ Allergies: _________________________________
Race/Culture: _____________ Special diet: _______________________________
Occupation: _______________ Chief complaints: ___________________________
Significant Other: __________ Medical diagnoses: __________________________

B. General Description
1. Appearance
Grooming/dress: _________________ Hair color/texture: ______________
Hygiene: _______________________ Scars/tattoos: __________________
Posture: ________________________ Appears age?: __________________
Height/weight: ___________________ Level of eye contact: ____________
2. Motor activity
Tremors: ________________________ Rigidity: ______________________
Tics/movements: __________________ Gait: _________________________
Mannerisms: _____________________ Echopraxia: ___________________
Restlessness: _____________________ Psychomotor retardation: _________
Aggressiveness: ___________________ Range of motion: _______________
3. Speech patterns
Slow or rapid pattern: _______________ Volume: ______________________
Pressured speech: __________________ Speech impediment: _____________
Intonation: _______________________ Aphasia: ______________________
4. General attitude
Cooperative/uncooperative: ___________ Interest/apathy: _________________
Friendly/hostile/defensive: ____________ Guarded/suspicious: _____________

C. Emotions
1. Mood
Sad: ___________ Depressed: _____________ Despairing: ____________________
Irritable: ________ Anxious: ______________ Elated: _______________________
Euphoric: _______ Fearful: _______________ Guilty: _______________________
Labile: __________
2. Affect
Congruence with mood: ____________________________________________________
Constricted or blunted: _____________________________________________________
Flat: ____________________________________________________________________
Appropriate or inappropriate: ________________________________________________

D. Thought Processes
1. Form of thought
Flight of ideas: __________________________ Associative looseness: ______________
Circumstantiality: ________________________ Tangentiality: ____________________
Neologisms: ____________________________ Concrete thinking: ________________
Clang associations: _______________________ Word salad: _____________________
Perseveration: ___________________________ Able to concentrate: _______________
Echolalia: ______________________________ Mutism: _________________________
Poverty of Speech: _______________________ Attention span: ___________________
2. Content of thought
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Delusions: persecutory: __________ Grandiose: __________ Reference: _________
Control: _____________ Somatic: ____________ Nihilistic: _________
Suicidal/homicidal ideas: ___________________________________________________
Obsessions: _____________________________________________________________
Paranoia/suspiciousness: ___________________________________________________
Magical thinking: _________________________________________________________
Religiosity: ______________________________________________________________
Phobias: ________________________________________________________________
Poverty of content: ________________________________________________________

E. Perceptual Disturbances
Hallucinations: Auditory: __________________ Visual: ____________________
Tactile: ____________________ Olfactory: _________________
Gustatory: __________________
Illusions:
Depersonalization: ________________________________________________________
Derealization: ____________________________________________________________

F. Sensory and Cognitive Ability


Level of alertness/consciousness
Orientation: Memory:
Time: ____________________________ Recent: _____________________________
Place: ____________________________ Remote: ____________________________
Person: ___________________________ Confabulation: _______________________
Circumstances: _____________________ Capacity/abstract thought: ______________

G. Impulse Control
Ability to control impulses related to the following:
Aggression: ________________________ Guilt: ______________________________
Hostility: __________________________ Affection: ___________________________
Fear: ______________________________ Sexual feelings: ______________________

H. Judgment and Insight


Ability to solve problems
Ability to make decisions
Knowledge about self: awareness of limitations, awareness of consequences of actions,
awareness of illness
Adaptive/maladaptive use of coping strategies and ego defense mechanism

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Laboratory Data
Write normal value range, exact value for patient, and indicate if this is normal, high, or low.
Sodium White Blood Cells

Potassium Red Blood Cells

Chloride Hemoglobin

Glucose Hematocrit

Blood Urea Nitrogen Total Bilirubin

Creatinine AST

Calcium ALT

Magnesium Alkaline Phosphatase

Phosphorous Lithium/Depakote/Tegretol Level

Total Protein TSH

Albumin UA

Pre-Albumin Drug Toxicology

Cortisol Level

What information can you obtain from these lab values? Why is this information important for this
specific patient?

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