Updated 9/5/08 NUR 105 dult Nursing Plan of Instrution Effetive ate: 2008 Version Number: 2008-1 OURSE ESRIPTION This ourse provides opportunities to develop ompetenies neessary to meet the needs of individuals throughout the lifespan in a safe, legal, and ethial manner using the nursing proess. Emphasis is plaed on providing are to individuals undergoing surgery, fluid and eletrolyte imbalane, and ommon alterations in respiratory, musuloskeletal, gastro-intestinal, ardiovasular, and endorine systems. Nutrition, pharmaology, ommuniation, ultural, and ommunity onepts are integrated. REIT HOURS Theory 5 redit hours Lab 1 redit hour linial 2 redit hours Total 8 redit hours Total ontat hours 14 NOTE: Theory redit hours are a 1:1 ontat to redit ratio. Lab redit is 3:1. linial redit is 3:1. The labama ommunity ollege System opyright 2008
PREREQUISITE OURSES NUR 102 Fundamentals of Nursing NUR 103 Health ssessment NUR 104 Introdution to Pharmaology NUR 106 Maternal and hild Nursing IO 201 Human natomy and Physiology I Math requirement O-REQUISITE OURSES NUR 106 Maternal and hild Nursing ENG 101 English omposition I IO 202 Human natomy and Physiology II SUMMRY OF HNGES: Module G removed referene to NG tubes from linial/lab Skills INSTRUTIONL GOLS ognitive - omprehend foundational knowledge of providing health are for adult lients. Performane - pply foundational knowledge of providing health are for adults. PROFESSIONL OMPETENIES/OJETIVES Unless otherwise indiated, evaluation of student s attainment of ognitive and performane objetives is based on knowledge and skills gained from this ourse. ompetenies speified for eah module may be set by ertifiation agenies, national and state odes, health are faility poliies, loally developed lab/linial assignments, or any ombination. Students are expeted to utilize relevant tehnology for lient are and doumentation. PROFESSIONL OMPETENIES Promote fluid and eletrolyte homeostasis. Promote aid-base homeostasis. Perform IV therapy. Obtain blood speimens. Provide perioperative are. Provide are for lients with respiratory system Provide are for lients with seleted ardiovasular system Provide are for lients with seleted endorine system Provide are for lients with seleted gastro-intestinal system Provide are for lients with musulo-skeletal system S opyright 2008 2
MOULE FLUI, ELETROLYTE, N I-SE HOMEOSTSIS PROFESSIONL OMPETENIES 1.0 Promote fluid and eletrolyte homeostasis. 2.0 Promote aid-base homeostasis. LERNING OJETIVES PERFORMNE OJETIVES Given various senarios and linial settings: 1.1 ssess a lient to determine fluid and eletrolyte homeostasis. 1.2 Use the nursing proess to promote fluid and eletrolyte homeostasis. Given various senarios and linial settings: 2.1 ssess a lient to determine aid-base homeostasis. 2.2 Use the nursing proess to promote aid-base homeostasis. 1.1.1 efine terms assoiated with fluid and eletrolyte homeostasis. 1.1.2 Explain the physiology of fluids and eletrolytes. 1.1.3 Explain how the body s regulators systemially maintain homeostasis. 1.1.4 Identify auses of fluid and eletrolyte imbalane. 1.1.5 Interpret linial manifestations to determine types of fluid and eletrolyte imbalane. 1.1.6 Identify treatment modalities for maintaining fluid and eletrolyte homeostasis. 1.1.7 Evaluate outomes of treatment modalities for maintaining fluid and eletrolyte homeostasis. 2.1.1 efine terms assoiated with aid-base homeostasis. 2.1.2 Explain the physiology of aids and bases. 2.1.3 Explain how the body s regulators systemially maintain homeostasis for aid-base. 2.1.4 Identify auses of aid-base imbalane. 2.1.5 Interpret linial manifestations to determine types of aid-base imbalane. 2.1.6 Identify treatment modalities for maintaining aid-base homeostasis. 2.1.7 Evaluate outomes of treatment modalities for maintaining aid-base homeostasis. LINIL/L SKILLS Use relevant tehnology for are and doumentation Interpret lab data Measure and alulate input and output data Obtain anthropometri measurements Obtain weights Perform appropriate assessments Interpret assessment findings KS Indiators S opyright 2008 3
MOULE OUTLINE Fluid and eletrolyte homeostasis Funtions of fluids and eletrolytes Transports o tive o Passive Regulators isturbanes in fluid and eletrolyte balane auses of imbalane lterations o ehydration o Fluid volume exess o Hyper/Hypo eletrolyte disturbanes Nursing Proess id-base homeostasis lood gases Regulators id-base alterations auses of imbalane Respiratory aidosis/alkalosis Metaboli aidosis/alkalosis Nursing proess S opyright 2008 4
MOULE VENIPUNTURE N INTRVENOUS (IV) THERPY PROFESSIONL OMPETENIES 1.0 Perform venipunture and IV therapy. PERFORMNE OJETIVES Use the nursing proess to: 1.1 Perform venipunture. 1.2 Initiate intravenous therapy. 1.3 Maintain intravenous therapy. 2.0 Obtain blood speimens. Use the nursing proess to: 2.1 ollet blood speimens. 2.2 Handle blood speimens aording to poliy and protool. LERNING OJETIVES 1.1.1 efine terms assoiated with IV Therapy. 1.1.2 esribe key points of the Nurse Pratie t onerning intravenous therapy. 1.1.3 Explain guidelines and ageny poliies for intravenous therapy. 1.1.4 Explain seleted onepts of ethis and patient s rights related to intravenous therapy. 1.1.5 ifferentiate between the registered and pratial nurse s responsibilities for intravenous therapy. 1.1.6 Explain the registered and pratial nurse s responsibilities in administration of blood, blood produts, and volume expanders. 1.1.7 Interpret dotor s orders for intravenous therapy. 1.1.8 Explain the anatomial and physiologial onsiderations assoiated with intravenous therapy. 1.1.9 Explain rationale for the seletion of intravenous solutions. 1.1.10 esribe the purpose of equipment and supplies for intravenous therapy. 1.1.11 Selet appropriate equipment and supplies for speified intravenous therapy. 1.1.12 esribe the proess of preparing a patient for intravenous therapy. 1.1.13 esribe the proess of preparing the equipment for performing intravenous therapy. 1.1.14 alulate IV flow rates. 1.1.15 esribe the proess of starting the intravenous therapy. 1.2.1 esribe the proess of managing intravenous therapy inluding IV piggybak and saline flush. 1.3.1 Identify expeted outomes of treatment modalities for IV Therapy. 1.3.2 Use ritial thinking to prioritize management of are for lients reeiving seleted IV Therapy. 2.1.1 Identify equipment and tehniques for olleting blood speimens. 2.1.2 Selet the appropriate olor olletion tube for an ordered diagnosti test based on organizational protool. 2.1.3 esribe the proess of preparing a patient for olleting blood speimens. 2.1.4 Explain the proess for obtaining blood speimens. 2.2.1 Explain guidelines and/or ageny poliies for handling blood speimens. 2.2.2 Explain the proedures for handling and disposing of speimen gathering materials. KS Indiators a S opyright 2008 5
MOULE LERNING OJETIVES (ontinued) LINIL/L SKILLS Use relevant tehnology are and doumentation Perform venipuntures Manage IV therapy inluding IVPs and flush oument Obtain blood speimens Handle and dispose of IV therapy and blood speimen materials MOULE OUTLINE Roles and responsibilities Legal and ethial guidelines o Nurse Pratie t o guidelines o Handling medial waste o geny poliies o Ethis and patient s rights Interpreting dotor s orders Terminology and & P review Types and use of intravenous solutions Equipment and supplies Pumps and ontrollers Tubing and filters IV needles and atheters riteria for hoosing the appropriate equipment alulating flow rates Patient physial and psyhologial preparation for IV therapy Venipunture proess Tehniques Seuring the IV site ressings and labeling Flow rate problems IV ompliations and problems Loal Systemi Monitoring and maintenane of the IV oumentation Site are Patient eduation IV mediations ontinuous Intermittent lood, blood produts, and volume expanders Registered nurse responsibilities Pratial nurse responsibilities Transfusion reations Nursing proess S opyright 2008 6
MOULE PERIOPERTIVE RE STUENT PERFORMNE PROFESSIONL OMPETENIES OJETIVES 1.0 Provide perioperative are. 1.1 Given linial situations use the nursing proess to provide perioperative are. 1.2 evelop a nursing are plan to provide perioperative are. 1.3 Evaluate the effetiveness of perioperative are. LERNING OJETIVES 1.1.1 efine terms assoiated with perioperative are. 1.1.2 Explain the nurse s role within perioperative settings. 1.1.3 Explain the elements of informed onsent. 1.1.4 Explain nursing proess for perioperative are. 1.1.5 Explain preoperative are. 1.1.6 Explain intraoperative are. 1.1.7 Explain postoperative are. 1.1.8 esribe tehniques for aute pain management. 1.1.9 Use ritial thinking to prioritize management of are. LINIL/L SKILLS Use relevant tehnology for are and doumentation omplete the preoperative heklist Prep lients for surgery Surgial gowning and gloving Surgial srubbing Maintain a sterile field Post anesthesia reovery are and doumentation Sterile and lean dressing Wound assessment Pain management Thromboembolyti evie (TE) Sequential ompression evies (S s) Inentive Spirometry Turn-ough-and deep breath (T) ommon drainage devies KS Indiators S opyright 2008 7
MOULE OUTLINE Nurses role within perioperative settings Informed onsent Pre-operative Legal onsiderations Types of surgery Risk fators iagnosti tests and exams omplete preoperative heklist Prep for surgery Nursing proess Intraoperative Surgial Gowning and gloving Surgial srub Holding area Operative area o Maintaining a sterile field o Safety o Types of nesthesia o Malignant hyperthermia Post-operative ompliations Wound lassifiation and healing Reovery area o Post anesthesia reovery Nursing proess Pain management o Epidurals o Patient ontrolled nalgesia (P s) Shok Pharmaology S opyright 2008 8
MOULE RESPIRTORY SYSTEM LTERTIONS PROFESSIONL OMPETENIES 1.0 are for lients with respiratory system PERFORMNE OJETIVES 1.1 ssess a lient for seleted respiratory system 1.2 evelop a nursing are plan to provide are for a lient with seleted respiratory system 1.3 Implement a nursing are plan to provide are for a lient with seleted respiratory system 1.4 Evaluate the effetiveness of interventions for a lient with respiratory system LERNING OJETIVES 1.1.1 Explain the anatomy and physiology of respiratory system. 1.1.2 efine terms assoiated with the respiratory system. 1.1.3 esribe diagnosti tests for respiratory system 1.1.4 esribe upper respiratory system 1.1.5 esribe lower respiratory system 1.1.6 esribe respiratory failure for adult lients. 1.1.7 Interpret linial manifestations to determine neessary are for respiratory system 1.2.1 esribe the proess of traheotomy are, sutioning, and hest physiotherapy. 1.2.2 esribe the pharmaologial agents for respiratory system 1.2.3 esribe nutritional onsiderations for treating respiratory system 1.3.1 esribe the proess for implementing a nursing are plan to treat respiratory system 1.4.1 Identify expeted outomes of treatment modalities for respiratory system 1.4.2 Use ritial thinking to prioritize management of are. LINIL/L SKILLS Use of relevant tehnology for lient are and doumentation Trah are and sutioning hest physiotherapy Respiratory assessment Metered-dose inhalers (MI) Nebulizers Maintaining Oxygenation Peak flow monitor Pulse oximetry mbu bag Responding to odes KS Indiators S opyright 2008 9
MOULE OUTLINE Terminology and & P review iagnosti tests lterations Upper o ute o hroni Lower o ute o hroni Respiratory Failure o dult Respiratory isorder Syndrome (RS) Traheotomy are and sutioning hest physiotherapy Nursing proess Pharmaologial agents Nutritional onsiderations S opyright 2008 10
MOULE E RIOVSULR SYSTEM LTERTIONS PROFESSIONL OMPETENIES E1.0 are for lients with seleted ardiovasular system PERFORMNE OJETIVES E1.1 ssess a lient to determine seleted ardiovasular system E1.2 evelop a nursing are plan to treat seleted ardiovasular system E1.3 Implement a nursing are plan to treat seleted ardiovasular system E1.4 Evaluate the effetive of interventions to treat seleted ardiovasular system LERNING OJETIVES E1.1.1 Explain the anatomy and physiology of ardiovasular system. E1.1.2 efine terms assoiated with the ardiovasular system E1.1.3 esribe diagnosti tests for seleted ardiovasular system alterations and ompliations. E1.1.4 esribe seleted ardiovasular system alterations and ompliations. E1.1.5 Interpret linial manifestations to determine seleted ardiovasular system alterations and ompliations. E1.2.1 esribe the pharmaologial agents for seleted ardiovasular system alterations and ompliations. E1.2.2 esribe nutritional onsiderations for treating seleted ardiovasular system alterations and ompliations. E1.2.3 esribe the nursing proess for providing are for seleted ardiovasular system alterations and ompliations. E1.3.1 esribe the proess for implementing a nursing are plan to treat seleted ardiovasular system E1.4.1 Identify expeted outomes of treatment modalities of seleted ardiovasular system alterations and ompliations. E1.4.2 Use ritial thinking to prioritize management of are. LINIL/L SKILLS Use of relevant tehnology for lient are and doumentation ardiovasular assessment irulation, movement, and sensation assessment (MS) Pulselessness Pallor/Temperature Pain Edema Paresthesia Paralysis Interpreting diagnosti data iagnosti and monitoring equipment pial pulse Thromboembolyti evie (TE) Sequential ompression evies (Ss) KS Indiators S opyright 2008 11
MOULE E OUTLINE Terminology and & P review iagnosti tests lterations and ompliations Hypertension Peripheral Vasular lterations (PV) o rterial and venus ulers nemia Hematologial Pulmonary embolus ongestive heart failure neurysms Nursing proess Pharmaologial agents Nutritional onsiderations S opyright 2008 12
MOULE F ENRORINE SYSTEM LTERTIONS PROFESSIONL OMPETENIES F1.0 are for lients with seleted endorine system PERFORMNE OJETIVES F1.1 ssess a lient to determine seleted endorine system F1.2 evelop a nursing are plan to treat seleted endorine system F1.3 Implement a nursing are plan to treat seleted endorine system F1.4 Evaluate the effetive of interventions to treat seleted endorine system LERNING OJETIVES F1.1.1 Explain the anatomy and physiology of endorine system. F1.1.2 efine terms assoiated with the endorine system F1.1.3 esribe diagnosti tests for seleted endorine system alterations and ompliations. F1.1.4 esribe seleted endorine system alterations and ompliations. F1.1.5 Interpret linial manifestations to determine seleted endorine system alterations and ompliations. F1.2.1 esribe the pharmaologial agents for seleted endorine system alterations and ompliations. F1.2.2 esribe nutritional onsiderations for treating seleted endorine system alterations and ompliations. F1.2.3 esribe the nursing proess for providing are for seleted endorine system alterations and ompliations. F1.3.1 esribe the proess for implementing a nursing are plan to treat seleted endorine system F1.4.1 Identify expeted outomes of treatment modalities of seleted endorine system alterations and ompliations. F1.4.2 Use ritial thinking to prioritize management of are. LINIL/L SKILLS Use of relevant tehnology for lient are and doumentation Endorine assessment Insulin administration Hypoglyemia management (gluagon) lood and urine gluose monitoring Sliding sale lient teahing for self-are, nutrition, and monitoring Interpreting diagnosti data KS Indiators S opyright 2008 13
MOULE F OUTLINE Terminology and & P review iagnosti tests iabetes Types ute and hroni ompliations Management o lood and urine gluose monitoring o Insulin and insulin pumps o Oral hypoglyemi agents o iet and exerise o Emergeny management o Self-are and monitoring Nursing proess Pharmaologial agents Nutritional onsiderations S opyright 2008 14
MOULE G GSTROINTESTINL SYSTEM LTERTIONS PROFESSIONL OMPETENIES G1.0 are for lients with seleted gastrointestinal system PERFORMNE OJETIVES G1.1 ssess a lient to determine seleted gastrointestinal system G1.2 evelop a nursing are plan to treat seleted gastrointestinal system G1.3 Implement a nursing are plan to treat seleted gastrointestinal system G1.4 Evaluate the effetiveness of interventions to treat seleted gastrointestinal system G1.5 Manage gastri deompression. G1.6 Reinsert a seleted gastrostomy tube. KS Indiators LERNING OJETIVES G1.1.1 Explain the anatomy and physiology of gastrointestinal system. G1.1.2 efine terms assoiated with the gastrointestinal system G1.1.3 esribe diagnosti tests for seleted gastrointestinal system alterations and ompliations. G1.1.4 esribe seleted gastrointestinal system alterations and ompliations. G1.1.5 Interpret linial manifestations to determine seleted gastrointestinal system alterations and ompliations. G1.2.1 esribe the pharmaologial agents for seleted gastrointestinal system alterations and ompliations. G1.2.2 esribe nutritional onsiderations for treating seleted gastrointestinal system alterations and ompliations. G1.2.3 esribe the nursing proess for providing are for seleted gastrointestinal system alterations, ompliations, and surgial proedures. G1.3.1 esribe the proess for implementing a nursing are plan to treat seleted gastrointestinal system G1.4.1 Identify expeted outomes of treatment modalities of seleted gastrointestinal system alterations and ompliations. G1.4.2 Use ritial thinking to prioritize management of are. G1.5.1 Explain the proess of managing gastri deompression. G1.6.1 esribe the proess of reinserting a seleted gastrostomy tube. LINIL/L SKILLS Use of relevant tehnology for lient are and doumentation Gastrointestinal assessment Reinserting a gastrostomy tube Managing gastri deompression Interpreting diagnosti data S opyright 2008 15
MOULE G OUTLINE Terminology and & P review iagnosti tests Upper GI Infetious/inflammatory o Stomatitis o Ulers o Gastritis o Gastroesphageal Reflux isease (GER) Hiatal hernias Oral aner E oli, Salmonella, lostridium Nasogastri intubation Gastrostomy tube reinsertion and management Surgial proedures Gastretomy o Gastri deompression Gastri by-pass surgery Fratured mandible Nursing proess Pharmaologial agents Nutritional onsiderations S opyright 2008 16
MOULE H MUSULOSKELETL SYSTEM LTERTIONS PROFESSIONL OMPETENIES H1.0 are for lients with musuloskeletal system trauma and PERFORMNE OJETIVES Given linial situations: H1.1 ssess a lient to determine musuloskeletal system trauma and H1.2 evelop a nursing are plan to treat musuloskeletal system trauma and H1.3 Implement a nursing are plan to treat musuloskeletal system trauma and H1.4 Evaluate the effetiveness of interventions to treat musuloskeletal system trauma and LERNING OJETIVES H1.1.1 Explain the anatomy and physiology of musuloskeletal system. H1.1.2 efine terms assoiated with the musuloskeletal system H1.1.3 esribe diagnosti tests for musuloskeletal system trauma and H1.1.4 esribe seleted musuloskeletal system trauma and H1.1.5 Interpret linial manifestations to determine musuloskeletal system trauma and H1.2.1 esribe the pharmaologial agents for musuloskeletal system trauma and H1.2.2 esribe nutritional onsiderations for treating musuloskeletal system trauma and H1.2.3 esribe the nursing proess for providing are for musuloskeletal system alterations, ompliations, and surgial proedures. H1.3.1 esribe the proess for implementing a nursing are plan to treat musuloskeletal system trauma and H1.3.2 Explain the nursing proess for assisting lients with ast are and ompliations. H1.3.3 Identify tehniques for various ruth-walking methods. H1.3.4 Identify tehniques for various tration methods. H1.4.1 Identify expeted outomes of treatment modalities of musuloskeletal system trauma and H1.4.2 esribe tehniques for management of hroni pain. H1.4.3 Use ritial thinking to prioritize management of are. KS Indiators 2b 2b 2b 2b b b S opyright 2008 17
LINIL/L SKILLS Use of relevant tehnology for lient are and doumentation Interpreting diagnosti data Musuloskeletal assessment ruth walking Tration management ast are hroni pain management rain management utologous transfusion management ontinuous Passive Motion Mahine (PM) MOULE H OUTLINE Terminology and & P review iagnosti tests Musulo-skeletal traumas Sprains Fratures o ast are and ompliations o Tration isloations mputations ruthes and other devies Inflammatory alterations Rheumatoid arthritis Osteomyelitus egenerative alterations Osteoporosis Osteoarthritis Gout Lyme disease Osteomylaia disease Surgial proedures Knee and hip arpal tunnel Spinal fusion Laminetomy is repair Nursing proess Pharmaologial agents Nutritional onsiderations hroni pain management S opyright 2008 18
Learning Objetives Table of speifiations The table below identifies the perentage of ognitive objetives for eah module. Instrutors should develop suffiient numbers of test items at the appropriate level of evaluation. Fats/ Nomenlature Priniples/ Proedures nalysis/ Operating Priniples Evaluation/ omplete Theory /a /b / /d Module 21% 50% - 29% Module 8% 17% 63% 12% Module 11% 11% 67% 11% Module 15% 31% 46% 8% Module E 18% 18% 55% 9% Module F 18% 18% 55% 9% Module G 15% 15% 62% 8% Module H 13% 27% 53% 7% S opyright 2008 19
Performane bility Knowledge of Skills Knowledge ffetive Knowledge, Skills, and ttitudes (KS) Indiators Value Key Word(s) efinition 4 Highly Performs ompeteny quikly and aurately. Instruts others how to do Profiient the ompeteny. 3 Profiient Performs all parts of the ompeteny. Needs only a spot hek of ompleted work. 2 Partially Profiient Performs most parts of the ompeteny. Needs help only on hardest parts. 1 Limited Profiieny Performs simple parts of the ompeteny. Needs to be told or shown how to do most of the ompeteny. d omplete Theory Predits, isolates, and resolves problems about the ompeteny. Operating Identifies why and when the ompeteny must be done and why eah step Priniples is needed. b Proedures etermines step-by-step proedures for doing the ompeteny. a Nomenlature Names parts, tools, and simple fats about the ompeteny. Evaluation Evaluates onditions and makes proper deisions about the subjet. nalysis nalyzes fats and priniples and draws onlusions about the subjet. Priniples Identifies relationship of basi fats and states general priniples about the subjet. Fats Identifies basi fats and terms about the subjet. *5 haraterization by Value *4 Organization ting onsistently with the new value Integrating a new value into one's general set of values, giving it some ranking among one's general priorities *3 Valuing Showing some definite involvement or ommitment *2 Responding Showing some new behaviors as a result of experiene *1 Reeiving eing aware of or attending to something in the environment lpha Sale Values - ny item with an upper ase letter (,,, ) by itself is taught as general information on a topi. This information may be related to the ompeteny or enompass multiple ompetenies. Examples might inlude mathematial omputations or knowledge of priniples suh as Ohm s Law. lower ase letter indiates a level of Knowledge of Skills." Individuals are taught information pertaining to performing a ompeteny. These may be indiated alone or in onjuntion with a numerial sale value. lower ase letter by itself indiates the individual is not required to perform the task-just know about the task. (Example: an state or explain proedures for doing a task). Numerial Sale Values - The numbers reflet the levels the individual will be able to perform a ompeteny. Number values are always aompanied by lower ase letters (i.e. 1a, 2b, 3...et.) in order to speify the level of knowledge of skills assoiated with the ompeteny. Example: n individual with a ompeteny with a sale indiator of 3b has reeived training of knowledge of skills whereby he or she an determine the orret proedures and perform with limited supervision; only requiring evaluation of the finished produt or proedure. sterisk items indiate desired affetive domain levels and are used to indiate the desired level for a given ompeteny. They may be used independently or with other indiators (i.e. 1a-*1, -*3). If used with another indiator, separate with a hyphen. NOTE: odes indiate terminal values. S opyright 2008 20