UNIVERSITY OF RHODE ISLAND COLLEGE OF NURSING Nursing 323 Medical-Surgical Nursing

SB 9/8/17 Fall UNIVERSITY OF RHODE ISLAND COLLEGE OF NURSING Nursing 323 Medical-Surgical Nursing FACULTY: Sandra Basley MSN, RN-BC OFFICE HOURS: Monday 9:15 am to 10:15 am White Hall Room 129 Tuesday 12:00 pm to 1:00 pm 401-874-5708 Friday 9:15 am to 10:15 am Email: Via Sakai only Other times available by appointment Elaine Vealey-Amato PhD, RN OFICE HOURS: 9am 10:30 am on days prior to teaching Email: Ryanv@uri.edu or by appointment Britni Turano (Grad Assistant) TUTORING: Tuesday, Wednesday, and Thursday Email: Via Sakai only 9am 11 am, room 210 COURSE DESCRIPTION Concepts of medical-surgical nursing with emphasis on nursing strategies, and utilizing levels of prevention in the management of adults with acute and chronic illness, including the impact of illness on their families. (LEC 6) PREREQUISITE: NUR 213, 233, 234, 253; Concurrent with NUR 243 COURSE OVERVIEW/GOAL This is a web-enhanced course designed to meet the changing learning needs of today's nursing student in acute care settings. It focuses on therapeutic nursing strategies and interventions used to restore health to individuals who are experiencing acute and/or complex health problems across the life continuum. Previous health and physical assessment knowledge as well as therapeutic communication principles are utilized to analyze deviations from health with attention to implications for the individual and family. METHODS OF INSTRUCTION Lecture, discussion, response ware (TopHat), POD CASTs, required readings, case studies, HESI case studies, group activities, audiovisual resources, homework, and adaptive quizzing (reaching a mastery level of intermediate is required) Textbook and/or laptops (or other internet accessible devices) will be needed for class activities. Quizzes through Sherpath or on Sakai are taken prior to each class. Exams (on examsoft) - multiple choice, true/false, matching, short answer and HESI Fundamental Exam 1

Class preparation is mandatory. It is a course expectation that you will spend 2 to 3 hours studying outside of class for each hour of class time. That means for each of our classes, you should expect to spend 5.5 to 8.25 hours of studying. Approximately 2 to 3 of these hours may be spent in preparation for class. Class assignments will be included in Sherpath or posted on Sakai. REQUIRED TEXTBOOKS: Sherpath for Medical-Surgical Nursing (Lewis Version) 10 th Edition, 36-month subscription. Includes: Sherpath resources, electronic adaptive quizzing, and E-book (Black and White version of text book available for purchase in book store if you want a hard copy of the book) Vallerand, A.H. & Sanoski, C.A. (2015). (15 th edition) Davis s drug guide for nurses. Philadelphia: F.A. Davis Company. (or any other nursing drug guide published within the last 2 years) REQUIRED TEXTBOOK ALREADY PURCHASED: Potter, P.A., Perry, A.G., Stockert, P.A., & Hall, A.M. (). Fundamentals of nursing (9 th edition). St. Louis, Missouri: Evolve (Mosby). Electronic Resource Elsevier Adaptive Quizzing for Potter & Perry Burchum, J.R. & Rosenthal, L.D. (2016). Lehne s Pharmacology for nursing care (9 th edition). St. Louis: Elsevier Ackley, B.J. & Ladwig, G.B. (2014). Nursing diagnosis handbook (10 th edition). St. Louis:, Missouri: Elsevier (Mosby) Pickar, G.D. & Abernethy, A.P. (2013). Dosage calculations (9 th edition). Clifton Park, NY: Delmar Cengage Learning Medical dictionary Manual of laboratory and diagnostic tests HIGHLY RECOMMENDED: Cadenhead Colgrove, K. (). Med-Surg success (3 rd edition). Philadelphia: F.A. Davis Co Silvestri, L.A. (). Saunders comprehensive review for the NCLEX-RN examination (7 th edition). St. Louis, Missouri: Elsevier (Mosby) 2

GRADING: Exams (5 exams, 10 % each) ------------------------- 50% Final Exam----------------------------------------------- 12% Quizzes -------------------------------------------------- 8% HESI Testing ------------------------------------------- 20% Homework and Class Participation ------------------ 10% *** A grade of 73 or higher must be earned in the course in order to progress in the nursing curriculum. **Students must pass the course with a 73% on quizzes, tests, and the final exam. Once this is accomplished, the homework and class participation grades will be calculated into the course grade. Students that have attended class and completed assignments will usually see an increase in their course grade when homework and class participation grades are included in the course grade calculation. However, students that have not attended class or completed assignments may see a decrease in their grade. If the grade falls below a 73%, this will be considered a course failure. HESI Policy pending. Once the policy is finalized, it will be distributed to students. GRADING SCALE: A 93 100 A- 90 92 B+ 87 89 B 83 86 B- 80 82 C+ 77-79 C 73 77 C- 70 72 D+ 67 69 D 60 66 F < 60 3

PROGRAM OUTCOMES / COURSE OBJECTIVES I. Knowledge and Inquiry: Demonstrates knowledge of concepts, theories, evidence-based practice and develops a sense of inquiry. 1. Discuss the impact of evidence based knowledge on health care. 2. Examine nursing research findings in relation to nursing strategies in caring for adult patients with acute and chronic illnesses II. Nursing Practice: Provides care to clients across the lifespan and in a variety of settings, and shows an ability to skillfully assess strengths and health needs, identify problems, formulate outcomes, design and implement interventions, and evaluate effectiveness 1. Critically analyze assessment data of adult clients with acute and chronic illnesses. 2. Identify appropriate, priority nursing diagnosis based on the client s response to acute and chronic illnesses, and the associated hospitalization. 3. Explain expected client outcomes in relation to nursing diagnosis. 4. Integrate medical and nursing diagnoses in defining nursing care needs of adult clients with acute and chronic illnesses. 5. Describe collaborative care needs and design nursing strategies in the care of adult clients with acute and chronic illnesses. 6. Discuss evaluative criteria for measurement of client outcomes. 7. Discuss psychosocial, spiritual, and cultural concerns in caring for adult clients and their families. III. Professionalism: Demonstrates ethical and professional behaviors, and engages in the process of lifelong learning. 1. Apply legal and ethical issues pertinent to nursing care of adult clients. IV: Leadership: Integrates leadership, quality improvement, and safety into the design, management, and coordination of care. 1. Discuss the multiple roles of the professional nurse. 2. Discuss advocacy as a leadership role in nursing. 3. Apply the criteria for safe and effective delegation of patient care. VI: Communication and Collaboration: Communicates effectively and interacts collaboratively with clients, health professionals, and other colleagues in the provision of comprehensive health services. 1. Describe effective communication strategies for collaborating with inter-disciplinary team members. 2. Effectively utilize SBAR communication techniques. 3. Identify potential communication barriers that exist among clients, family members, and health care providers. VII: Societal and Global: Demonstrates knowledge of the impact of societal and global issues on health and health care. 1. Describe the relevant social determinants that influence client care. 4

University and College of Nursing Policies and Requirements 1. All students must review STUDENT POLICIES AND REQUIREMENTS. All students must comply with each of these policies. See the CON website under student resources a. URI Student Handbook. http://web.uri.edu/studentconduct/university-student-handbook b. College of Nursing Academic and Health Policies. http://web.uri.edu/nursing/guidelines-and-policies/ c. APA Guidelines. https://owl.english.purdue.edu/owl/resource/560/01/ 2. Standards of Behavior and Professional Conduct: University Rules and Regulations Life in the academic community must be one of integrity, honesty, acceptance of responsibility, and a willingness to clearly and accurately represent oneself, one's work and activities. Failure to meet these standards must be treated as a failure to accept responsibility as a student and make one subject to separation from the community. Students must comply with all rules and regulations as written in URI Student Handbook and URI University Manual: http://www.uri.edu/facsen/manual_09.html. All students are responsible for reading and adhering to these policies and procedures. 3. Academic Honesty All submitted work must be your own. If you consult other sources (class readings, articles or books from the library, articles available through internet databases, or websites) these MUST be properly documented, or you will be charged with plagiarism and will receive an F for the paper. In some cases, this may result in a failure of the course as well. Any charge of academic dishonesty will go on your record in the Office of Student Life. Any good writer s handbook as well as reputable online resources will offer help on matters of plagiarism and instruct you on how to acknowledge source material. If you need more help understanding when to cite something or how to indicate your references, please refer to APA Publication Manual of Style. This can be located on the College of Nursing web page under Student Resources. 4. Academic Enhancement Center The work in this course is complex and intensive. To do the best you can, it s a good idea to visit the Academic Enhancement Center (AEC) in Roosevelt Hall. The AEC offers a comfortable environment in which to study alone or together, with or without a tutor. AEC tutors can assist with test taking skills, answer questions, clarify concepts, check understanding, and help you to study. You can make an appointment or walk during office hours -- Monday through Thursday from 9 am. to 9 pm, Friday from 9 am to 1 pm, and Sunday from 4 pm. to 8 pm. For a complete schedule - including when tutors are available specifically for this class - go to www.uri.edu/aec or call (401) 874-2367 or visit fourth floor of Roosevelt Hall. 5. Accommodations for Special Needs "Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 require the University of Rhode Island to provide academic adjustments or accommodations for students with documented disabilities. The student with a disability shall be responsible for self-identification to the Disability Services for Students in the Office of Student Life by providing appropriate documentation of disability, requesting accommodation in a timely manner, and following accommodations requested." It is the student s responsibility to make arrangements for any special needs and the instructor s responsibility to accommodate them with help from the Office of Disability Services for Students. Any student with a documented disability is encouraged to contact faculty as early in the semester as possible so that reasonable accommodations can be arranged. As part of this process, please contact Disability Services for Students Office at 330 Memorial Union, 401-874-2098. http://web.uri.edu/disability/aboutdss/ 5

6. The Writing Center The Writing Center is for all writers, all disciplines, at all levels, and all stages of writing. If an instructor suggests that you go to the Writing Center, it is not a punishment, and does not mean that you are a terrible writer. It means the instructor wants you to receive more individualized attention to your writing than s/he is able to provide, given the constraints of the class. It will only improve your grade. If possible, call ahead for an appointment (874-4690). Drop-in tutorials are often available. You may make repeat appointments, requesting the same tutor each time if you wish. http://events.uri.edu/group/writing_center 7. Religious Holidays University of Rhode Island allows students, on an individual basis, the opportunity to observe their traditional religious holidays. Students desiring to observe a holiday of special importance must provide written notification to each instructor prior to scheduled observance. 8. Academic Conduct Faculty, in the College of Nursing, believes that professional conduct is critical to the practice of nursing and fully supports the University policies. Breach of professionalism is a serious offense which will be dealt with firmly. The faculty reserves the right to require withdrawal from the College of Nursing (classroom and/or clinical) of any student who gives evidence academically and/or personally of inability to carry out safe, professional practice in nursing. Students who violate University policy prohibiting illegal use or possession of any controlled substance without a prescription may be dismissed from the College of Nursing and will be reported to the Office of Student Life, as indicated in the URI student handbook. 6

CLASS SCHEDULE Dates Content Readings and Assignments 9/8/17 Care of the Client in the Acute Care Setting Chapters 3 (p. 34-35), 5, 9, 14, 17, 18, 19, 20, 22, 23, 24, 25, 26 (p. 356-367), 27 Chapters 1 (p. 15-16), 2, 4, 5 Take Home Quiz (on sakai) 9/11/17 Safe and Effective Administration of Medications Ch. 32 9/15/17 Nursing Care of the Client with a Disturbance in Oxygenation Nursing assessment of respiratory dysfunction Diagnostic tests Nursing interventions: supportive care, oral suctioning, oxygen administration Ch. 41, pp. 877, 887, 891-906 Ch. 25 review structures and functions, assessment, and diagnostic tests of the respiratory system Ch. 28, p. 565-572 (respiratory management) Ch. 7, p. 96-98 9/18/17 Nursing Care of the Client with Respiratory Problems Ch. 41, p. 898-900 (chest tubes) Ch. 26, p. 482-483 Ch. 27, p. 499-506, 513-528, 529-531 Ch. 28, p. 560-601 9/22/17 Care of the Client with Fluid and Electrolyte Imbalances Ch. 42, p. 935-954 (excluding information on acid-base balance) Ch. 16, p. 270-285 Ch. 66, p. 1587-1589, 1597 (hypovolemic shock) 7

9/25/17 Math Test Acid-Base Imbalances Safe and Effective Administration of Intravenous Therapy Chapter 42 Ch. 16, p. 286-297 Ch. 39, p. 869-871 (parenteral nutrition) Ch. 30, p. 647-652 (blood transfusion) 9/29/17 Exam #1 Complete content on Safe and Effective Administration of Intravenous Therapy 10/2/17 Nursing Care of the Client with Cancer Ch. 8 Care of the cancer survivor Ch. 15 Ch. 29, p. 587-590 (components of blood) Ch. 30, p. 606-608 (S&S and care of patient with anemia), 622-626 (S&S of thrombocytopenia), 653-665 (S&S and care of the patient with thrombocytopenia), 632-634 (S&S and care of the patient with neutropenia) 10/6/17 Nursing Care of the Preoperative Client Wound Care 10/13/17 Nursing Care of the Client with Hypertension and Hyperlipidemia 10/16/17 Normal EKG Interpretation Analyzing Basic Cardiac Arrhythmias Ch. 48, 50 Ch. 11, 17, 19, Ch. 31 Review structures and functions, assessments, and diagnostic tests of the cardiovascular system Ch. 32 Ch. 33, p. 709-711 Ch. 35, p. 757-767, 768-775 (no heart blocks) 8

10/20/17 Exam #2 Nursing Care of the Client with Coronary Artery Disease and Acute Coronary Syndrome Ch. 33 Ch. 35, p. 775-777 10/23/17 Nursing Care of the Client with Heart Failure Nursing Care of the Client with an Aortic Aneurysm Ch. 34 Ch. 37, p. 802-808, 810-825 Nursing Care of the Client with Peripheral Vascular Disease 10/27/17 Nursing care of the Client with Endocrine Disorders Corticosteroid Use Ch. 47 Review structures and functions, assessment, and diagnostic test of endocrine system Ch. 49, p. 1159-1170,1171-1180 10/30/17 Nursing Care of the Client with Diabetes Ch. 48 11/3/17 Exam #3 End-of-Life Care Ch. 36 Ch. 37, p. 765-767 (carte after death) Ch. 9 11/6/17 Nursing care of the client with urinary disorders Chapter 46, pp. 1105-1106 (urinary diversions), 1119-1126 Ch. 44 Review structures and functions, assessment, and diagnostic tests of GU system Ch. 45, pp. 1033-1039, 1044-1049, 1052-1055, 1061-1066 9

11/10/17 Nursing Care of the Client with Men s health Issues Ch. 50 Review structures and functions, assessment, and diagnostic studies of male reproductive system Ch. 45, p. 1268-1282, 1285-1289 11/15/17 Nursing Care of Clients with Traumatic Injuries Ch. 61 Review structures and functions, assessment, and diagnostic tests of musculoskeletal system Ch. 62, p. 1468-1480,1481-1484 11/17/17 HESI Exam Nursing Care of the Client with Acute and Chronic Pain 11/20/17 Nursing Care of Clients with Degenerative Musculoskeletal Disorders 11/27/17 Exam #4 Nursing Care of the Client with Chronic Neurologic Disorders Nursing Care of the Client with Peripheral Nervous System Disorders Ch. 44 Ch. 8 Ch. 63, p. 1496-1499, 1502-1507, 1510-1514 Ch. 64, p. 1517-1535 Ch. 55 Review structures and function, assessment, and diagnostic tests of the nervous system Ch. 58, p. 1383-1395, 1395-1396 Ch. 60, p. 1439-1441 12/1/17 Nursing Care of the Client with a CVA / TIA Ch. 57 12/4/17 Nursing Care of the Client with Common Gastrointestinal Symptoms Ch. 45, 47 Ch. 38 Review structures and functions, assessment, and diagnostic studies of the GI system Ch. 41, p. 893-897, 921-925 Ch. 42, p. 929-933, 934-940, 943-944, 950-953 Ch. 43, p. 961-972, 974-975 (peritonitis), 954-957 (GI Bleed) 10

12/8/17 Nursing Care of Clients with Upper Gastrointestinal Disorders Nursing Care of Clients with Lower Gastrointestinal Disorders Lewis Ch. 41, p. 900-919 Ch. 42, p. 940-941, 944-950,954-964 Ch. 43, p. 1005-1010 (cholecystitis) 12/1//17 Exam #5 TBA Final Exam 11