NURS 124

Description:

This course is the first in a sequence of five nursing courses. Students will acquire nursing knowledge and skills necessary to care for patients across the health care continuum. Students will use a critical thinking approach to apply fundamental principles of nursing to patient care. In the clinical component, students will apply theoretical content and therapeutic interventions to patients with health alterations. Course instruction will occur in the classroom, online, in the health resource center and healthcare agencies. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Payment of the liability insurance fee is made through Shop JCCC at http://www.jccc.edu/shop-jccc/index.html. 4 hrs. lecture, 1 hr. lab, 15 hr. clinical/wk. Note: An honors contract is available. Contact the Honors Program Office, COM 201, for more information.

Associated Costs: These are additional (out-of-pocket) expense considerations that students should expect in addition to the course tuition, fees, and textbooks. $540 to 565.

Prerequisites:

Prerequisites: Admission to the Nursing Program and current certification in Kansas as Certified Nursing Assistant (CNA) and Cardiopulmonary Resuscitation Certification (CPR) for Health Care Providers and CHEM 122 and MATH 116 or higher level MATH course and corequisite: BIOL 144 and PSYC 130

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives:

Upon successful completion of this course the student will
demonstrate responsibility for own learning and assumption of the nursing
role.

Upon successful completion of this course, the student should be able to:

  1. Identify the nurse’s professional role within the health care system.
  2. Transition from certified nursing assistant to student registered nurse role.
  3. Differentiate between therapeutic and non-therapeutic communication skills.
  4. Utilize therapeutic communication skills.
  5. Perform basic psychomotor skills accurately using standard precautions and principles of asepsis.
  6. Collect data pertinent to the patient’s physical, cognitive, cultural, emotional, spiritual, and maturational status.
  7. Assess the patient in a systematic manner.
  8. Distinguish between normal and abnormal assessment findings.
  9. Formulate beginning level nursing diagnoses based on patient data.
  10. Use critical thinking when planning nursing care.
  11. Plan basic nursing care for the patient with common alterations in health incorporating scientific principles of basic nutrition, elimination, oxygenation, gas exchange, and sensory/perceptual/motor function.
  12. Implement basic nursing care for the patient in a safe, organized, timely manner according to the patient need.
  13. Evaluate patient responses.
  14. Convey information clearly, concisely, and accurately using appropriate terminology in oral, written, and/or computerized format. 

*Note:  Specific Unit Objectives are outlined on the Guides to
Learning provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Introduction to the Profession of Nursing and Basic Patient Care
   A. Concepts of Professionalism
      1. Identify own learning needs and how to get focused.
      2. Apply the techniques to establish trust in therapeutic
nurse-patient relationships.
      3. Apply organizational skills to learning and patient care
situations.
      4. Apply active listening techniques in learning and patient care
situations.
   B. Professional Issues
      1. Discuss transition from CNA to RN role according to
responsibilities, knowledge base, and skills.
      2. Discuss effective interaction and collaboration with members of
the health care team.
      3. Discuss the historical development of the profession of nursing.
      4. Differentiate between the functions of professional, state,
national, and specialty organizations.
      5. Discuss the impact of select nursing theories and standards on
the practice of nursing.
      6. Differentiate between types of professional liability.
      7. Discuss the required elements for credible nursing
documentation.
      8. Discuss the healthcare delivery system.
   C. Critical Thinking and Study Skills
      1. Identify the skills and attitudes required for critical
thinking.
      2. Use critical thinking to solve problems in actual and simulated
situations.
      3. Use critical thinking and test-taking strategies to enhance
test-taking abilities.
   D. Wellness-Illness Continuum
      1. Discuss health, wellness, and well-being.
      2. Discuss the effect of illness and disease on the patient.
   E. Physical Assessment
      1. Identify normal and abnormal findings of a basic head to toe
physical assessment.
      2. Discuss the significance of physical assessment as a screening
tool.
      3. Perform and document findings of a basic physical assessment.
   F. Self-Concept, Readiness for Enhanced: Values, Ethics, Cultural
Diversity
      1. Differentiate between self-image and self-esteem.
      2. Discuss the concept of cultural identity and the implications for
safe nursing care.
      3. Examine humanistic values that help define patients and their
life journeys.
   G. Overview of the Nursing Process
      1. Discuss the importance of the nursing process as a model for
delivering quality nursing care.
      2. Discuss how the nursing process, critical thinking, the
problem-solving process, and decision-making are interrelated.
   H. Health-Seeking Behaviors:  Fundamentals of Homeostasis (Rest,
Activity, Hydration, Nutrition)
      1. Explain the rationale for adequate rest, activity, hydration, and
nutrition to maintain homeostasis and optimal functioning.
      2. Assess the health patterns of the patient and how they relate to
maintenance of homeostasis.
      3. Develop a teaching plan for promoting optimal rest, activity,
hydration, and nutrition.
      4. Differentiate isotonic, isometric, aerobic, and anaerobic
exercise.
      5. Discuss how the level of mobility influences self-esteem, body
image, protection/safety, and independence, as well as general physical
and mental health.
   I. Communication, Readiness for Enhanced: Therapeutic Communication
Skills
      1. Identify both verbal and nonverbal components of clear and
effective therapeutic communication.
      2. Discuss the impact of culture on communication style and the
expression of values.
      3. Identify methods of adapting to culturally determined
communication styles.
      4. Demonstrate use of therapeutic communication techniques.
      5. Utilize therapeutic communication techniques based on assessed
patient needs.
   J. Knowledge Deficit: Patient Teaching Concepts
      1. Discuss the importance of the teaching role of the nurse.
      2. Discuss useful teaching strategies for patients of different age
groups and cultures.
   K. Medical Terminology
      1. Define the meaning of common medical terminology.
      2. Use medical terminology appropriately in written documentation.
   L. Nutrition: Overview
      1. Identify the role of the different nutrients and foods.
      2. Discuss how nutrition choices affect health and disease.
      3. Evaluate a diet using the food guide pyramid.
   M. Drug Calculations
      1. Calculate drug dosages and infusion rates accurately using
appropriate conversion factors when indicated.

II. Assessment and Prevention of Health Alterations 
   A. Prioritized Assessment
      1. Discuss criteria for determining assessment priorities in the
clinical setting.
   B. Mental Assessment
      1. Accurately conduct the assessment of affective, cognitive,
interpersonal, and behavioral function.
      2. Organize assessment findings into professionally accepted
categories.
      3. Apply physical and mental assessment principles/techniques to
simulated situations.
   C. Neuro-Physiology
      1. Identify selected physiological responses related to
neurotransmitter activity.
      2. Identify specific foods related to neurotransmitter activities.
   D. Neurovascular Assessment
      1. Identify data that indicates the need for a neurovascular
assessment.
      2. Identify normal and abnormal findings of a neurovascular
assessment.
   E. Managing Patient Behaviors
      1. Utilize behavior management techniques with patients who express
anger or are noncompliant.
   F. Alteration in Comfort: Pain, Nausea, Immobility, and Skin
      1. Discuss the rationale for pain as the 5th vital sign.
      2. Discuss barriers to effective pain management and strategies
being implemented to improve pain management.
      3. Identify basic caring approaches to the management of altered
comfort.
      4. Discuss the classification, actions, side effects, and
implications of common analgesics.
   G. Risk for Infection: Nosocomial Infections and Protective
Precautions
      1. Describe nursing measures to break the chain of infection.
      2. Analyze cases in order to identify measures that prevent
nosocomial infections.
      3. Compare and contrast standard precautions with disease specific
protective precautions.
      4. Demonstrate proper dressing change technique using principles of
asepsis.
   H. Risk for Injury: Medical-Surgical Asepsis
      1. Distinguish between medical and surgical asepsis.
      2. Plan actions to maintain asepsis in the clinical setting using
case analysis.
      3. Demonstrate medical and surgical aseptic techniques.
      4. Identify appropriate barrier precautions for a variety of
simulated situations.
      5. Demonstrate proper application and removal of barrier
devices/materials.
      6. Don sterile gloves accurately and proficiently.
   I. The Nurse-Patient Relationship
      1. Maintain a professional boundary in the nurse/patient
relationship.
      2. Identify the impact of one’s self-concept in relationships.
      3. Implement activities to establish trust in patient care
situations.
      4. Apply appropriate therapeutic techniques to each phase of the
nurse-patient relationship.
   J. Ineffective Coping: Stress/Anxiety Management and Cognitive
Therapies
      1. Utilize techniques to lower the impact of stress.
      2. Apply progressive relaxation techniques accurately for self and
patients.
      3. Differentiate between positive and negative coping strategies in
health and illness.
      4. Apply appropriate cognitive approaches for anxiety reduction.
   K. Anxiety: Crisis Intervention
      1. Identify the components of a crisis and appropriate
interventions.
   L. Therapeutic Regimen Management: Antianxiety Agents
      1. Discuss the actions, side effects, and nursing implications for
common antianxiety medications.
   M. Affective Alterations
      1. Assess mood ranging from normal grief response to major
depression.
      2. Identify behavioral responses to mood alterations.
      3. Select and implement appropriate interventions for patients with
mood disorders.
      4. Identify the actions, side effects, and nursing implications for
common antidepressants.
   N. Risk for Ineffective Protection: Immunity and Hypersensitivity
      1. Describe how disease, vaccines, toxoids, and immunoglobulins
provide immunity.
      2. Discuss the process of hypersensitivity.
   O. Professional Role: Patient Advocacy
      1. Define advocacy.
      2. Discuss the eight dimensions of patient centered care.
      3. Apply principles of critical thinking, active listening, and
professional boundaries to the analysis of patient advocacy cases.
   P. Risk for Injury: Environmental Safety
      1. Identify safety risk factors in the health care environment.
      2. Identify fire alarm safety procedures in clinical agencies.
      3. Discuss principles of electrical, chemical, and biological safety
in the health care environment.
      4. Discuss safety concepts for heat and cold applications.
      5. Discuss safety concepts for applying restraints.
      6. Identify safety hazards in a patient care environment.
   Q. Impaired Immobility
      1. Discuss the effects that immobility imposes on different body
systems.
      2. Assess activity-exercise pattern, activity tolerance, and
potential problems related to impaired mobility.
      3. Identify interventions to promote optimal mobility.
   R. Nutrition: Carbohydrates, Proteins and Lipids
      1. Identify the structure and function of carbohydrates, proteins
and lipids.
      2. Discuss the dietary intake of carbohydrates, proteins, lipids,
and their effects on the body.

III. Basic Concepts of Nursing Care
   A. Therapeutic Regimen Management: Pharmacology Overview
      1. Discuss pharmacodynamics and therapeutics in patients receiving
medication therapy.
   B. Therapeutic Regimen Management: Medication Administration
      1. Demonstrate ability to accurately prepare and administer oral,
ophthalmic, otic, inhaled, topical, rectal, subcutaneous, tubal,
intramuscular and intravenous medications.
      2. Identify critical components of safe and effective medication
administration.
      3. Demonstrate essential steps in safely administering medications.
   C. Fluid Balance: Basic Concepts of Fluids and Electrolytes
      1. Differentiate between normal and abnormal fluid gains and
losses.
      2. Explain the mechanisms that regulate fluid and electrolyte
balance.
   D. Fluid Balance: IV Fluid Administration
      1. Discuss rationale for various IV therapy modalities and the
relevant nursing care for proper administration of IV fluids.
      2. Calculate intravenous infusion rates accurately.
      3. Demonstrate essential steps in safely administering intravenous
fluids and medications.
   E. Management of the Therapeutic Regimen: Nutritional Assessment
      1. Identify patients at risk for nutrition problems.
      2. Discuss methods of obtaining a nutrition history and assessment
of dietary intake.
   F. Nutrition: Readiness for Enhanced
      1. Examine the problems associated with excessive and deficient body
weight.
      2. Identify strategies toward solving the problem of obesity and
maintaining ideal body weight.
      3. Discuss body mass index, central obesity, and causes/risk factors
of obesity.
   G. Imbalanced Nutrition: Less than Body Requirements:  Specialized
Nutritional Support
      1. Determine the appropriate specialized nutritional intervention
based on the patient’s ability to ingest and digest nutrients.
      2. Explain standard guidelines to administer enteral and parenteral
nutrition safely.
      3. Demonstrate tubal feedings and medication administration per
nasogastric and percutaneous epigastric gastrostomy.
   H. Alterations in Nutrition - Eating Disorders
      1. Differentiate between anorexia and bulimia nervosa.
      2. Explain the relationship between eating disorders and self-esteem
needs.
      3. Implement care to increase self-esteem.
   I. Therapeutic Regimen Management: Antibiotics
      1. Discuss the classification, action, side effects, and nursing
implications of antibiotic therapy.
   J. Impaired Skin and Tissue Integrity: Common Alterations in the
Integument
      1. Explain the process of skin breakdown and the related etiology.
      2. Compare the stages of wounds I through IV.
      3. Identify patients at risk for skin breakdown.
      4. Discuss interventions that can reduce or eliminate the
development of skin breakdown.
      5. Describe the wound healing process including factors that impact
the process and wound care treatment.
      6. Apply wound management principles to eliminating etiologic
factors and providing local and systemic support.
      7. Select the appropriate dressings for wounds based on wound
characteristics/staging.
   K. Alterations in Urinary Elimination: Urinary Incontinence, Retention,
Enuresis and Urinary Tract Infection
      1. Identify common urinary abnormalities.
      2. Analyze cases in order to plan interventions for patients with
common alterations in urinary function.
      3. Describe prevention and management for patients with urinary
incontinence, retention, enuresis, and urinary tract infections.
      4. Describe diagnostic studies to detect urinary abnormalities.
      5. Insert an indwelling urinary catheter utilizing aseptic
technique.
   L. Alterations in Bowel Function: Constipation/Diarrhea
      1. Describe common alterations in the gastrointestinal system.
      2. Discuss the medical and/or surgical treatment of common
alterations in the gastrointestinal system.
   M. Nursing Process: Planning Nursing Care
      1. Develop a plan of care using the nursing process and clinical
scenarios.
   N. Risk for Injury: Over-the-Counter Drugs
      1. Develop a teaching plan that identifies information essential for
safe drug therapy in patients using complementary therapies and
over-the-counter drugs.

IV. Nursing Care of the Patient Experiencing Common Alterations in Health:
Part I
   A. Alterations in Bowel Function: Occult Blood, Hemorrhoids,
Gastrointestinal Bleedings, Gastro-Esophageal Reflux Disease (GERD), Bowel
Obstruction, Peritonitis, Diverticulitis, Hiatal Hernia, and Colon Cancer
      1. Describe common alterations in the gastrointestinal system.
      2. Discuss the medical and/or surgical treatment of common
alterations in the gastrointestinal system.
      3. Describe the interventions and patient teaching required for
common alterations in gastrointestinal system.
      4. Differentiate between continent and incontinent ostomy procedures
according to patient characteristics, disease etiology, dietary needs,
medication regimen, bowel or bladder effluent, pouching and irrigation
needs, personal hygiene, and daily activity.
      5. Apply an ostomy appliance using appropriate skin barrier
principles.
      6. Discuss the actions, side-effects, and implications for commonly
prescribed gastrointestinal medications.
   B. Therapeutic Regimen Management: Pre and Post Care following
Diagnostic Procedures
      1. Discuss care to meet the physical, educational, and emotional
needs of patients undergoing diagnostic procedures.
      2. Describe assessments to be conducted in the pre and post
procedural phases.
   C. Therapeutic Regiment Management: Postoperative Care
      1. Identify expected outcomes for the preoperative and postoperative
phases.
      2. Explain rationale for interventions in the pre and postoperative
phases.
      3. Demonstrate nasogastric tube placement and suction for
decompressions of the stomach.
   D. Alterations in Potassium and Sodium Balance
      1. Explain the relationship between sodium and water and how that
impacts management of fluid and electrolyte imbalances.
      2. Select appropriate interventions and activities for common
potassium and sodium imbalances.
   E. Health Seeking Behaviors: Skin Cancer Screening
      1. Identify differences between benign and potentially cancerous
skin lesions.
      2. Discuss a teaching plan that addresses essential aspects of skin
cancer prevention.
   F. Discharge Planning
      1. Discuss the importance of early discharge planning and the
nurse’s role in teaching and communicating discharge information.
      2. Discuss interpersonal strategies that facilitate collaboration
during the discharge process.
   G. Nutrition: Vitamins
      1. Differentiate between water and fat soluble vitamins and food
sources.
      2. Describe roles of fat and water soluble vitamins and
manifestations of deficiency or toxicity.

V. Nursing Care of the Patient Experiencing Common Alterations in Health:
Part II
   A. Impaired Gas Exchange: Pneumonia, Atelectasis, Reactive Airway
Disease, and Pulmonary Embolism
      1. Explain the pathophysiology of and interventions for common
alterations in oxygenation: e.g., pneumonia, aelectasis, reactive airway,
pulmonary embolism.
      2. Discuss management of individuals experiencing alterations in
oxygenation.
      3. Demonstrate proper use of inhalation therapy devices and oxygen
therapy.
      4. Identify the classification, therapeutic effects, side effects,
precautions, and interventions for commonly prescribed respiratory
medications.
   B. Alteration in Safety and Cognition: Seizure Disorders
      1. Explain the pathophysiology of seizures.
      2. Discuss management of individuals with seizures including seizure
precautions, and interventions during a seizure.
   C. Anticonvulsants
      1. Identify mechanisms of action of select anticonvulsants.
      2. Discuss the different uses of anticonvulsants in the clinical
setting (e.g. seizures, pain, dysrhythmias, mood stabilization, headaches,
anger).
   D. Managing the Therapeutic Regimen: Introduction to Diabetes, Insulin
Administration
      1. Discuss pathophysiology of diabetes mellitus.
      2. Describe nursing management of individuals with diabetes
mellitus.
      3. Compare the action, onset, and peak of different types of insulin
and antidiabetic agents.
   E. Ineffective Tissue Perfusion: Impaired circulation
      1. Discuss the pathophysiology of hypertension (HTN), coronary 
artery disease (CAD), angina pectoris, peripheral vascular disease (PVD),
and pulmonary embolism (PE).
      2. Differentiate between the signs/symptoms of common arterial and
venous disorders and the appropriate care.
   F. Managing the Therapeutic Regimen: Drugs Affecting the Cardiovascular
System
      1. Identify uses, side effects, adverse reactions, nursing
implications of drug therapy related to hypertension and CAD, angina
pectoris, PVD, and PE.
      2.Identify the categories of antihypertensive drugs and the
stepped-care approach to management of hypertension.
   G. Health Seeking Behaviors: Cardiac Screening and Prevention
      1. Describe care for patients undergoing common screening and
diagnostic procedures.
   H. Risk for Infection: Infectious Diseases
      1. Identify new and reemerging infectious diseases in the US.   
      2. Discuss why nurses need to be aware of new and emerging
infectious diseases.
      3. Analyze cases in order to identify actions that prevent the
transmission of resistant microorganisms.
   I. Risk for Infection: Sexually Transmitted Diseases
      1. Identify preventive, secondary, and tertiary measures for common
sexually transmitted disease (STD).
   J. Nutrition: Water and Minerals
      1. Describe the role of water in the body and the signs of
deficiency/toxicity for the major minerals: e.g., sodium, chloride,
potassium, calcium, magnesium, phosphorus, iodine, iron.

Method of Evaluation and Competencies:

Evaluation of student mastery of course competencies will be accomplished using the following methods:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or Projects
5. Proficiency exams

Grade levels are determined by the nursing faculty and announced at the
beginning of the course. Letter grades are assigned on the following
basis:
     Percent
  A = 89.5% to 100%
  B = 79.5% to 89.4%
  C = 77.5% to 79.4%
  D = 69.5% to 77.4%
  F = < 69.4%
      
Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course.
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives. The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily. Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook. This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required. These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines.
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:

1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

  1. Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
  2. Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
  3. Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
  4. Students are expected to provide their own transportation to and from clinical settings.
  5. Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
  6. Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
  7. Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies. 

Student Responsibilities:

Disabilities:

If you are a student with a disability, and if you will be requesting accommodations, it is your responsibility to contact Access Services. Access Services will recommend any appropriate accommodations to your professor and his/her director. The professor and director will identify for you which accommodations will be arranged.

JCCC provides a range of services to allow persons with disabilities to participate in educational programs and activities. If you desire support services, contact the office of Access Services for Students With Disabilities (913) 469-8500, ext. 3521 or TDD (913) 469-3885. The Access Services office is located in the Success Center on the second floor of the Student Center.