Description:

The second of three medical/surgical courses focusing on acute and chronic health dysfunctions. Students gain clinical experience in acute-care settings. Course consists of two components: NURS 102X and 102Z. Prerequisite: Acceptance into program and NURS 101X and 101Z.

Outcomes:

After completing this class, students should be able to:

• Continue to implement the five phases of the nursing process as a systematic approach to individualizing client care.
• Assessment
• Collects pertinent data by assessing one or two clients using the Advanced Assessment Data Collection Guide.
• Collects pertinent data from other sources:
• client’s record
• family members
• health team members
• Identifies changes in assessment data that deviate from the client’s baseline health status
• Validates abnormal data.
• Organizes assessment data according to Maslow’s basic needs
• Nursing diagnosis
• Begins to identify pertinent nursing diagnoses and their etiologies.
• Provides client-specific defining characteristics applicable to the nursing diagnosis.
• Planning and Outcomes
• Begins to prioritize nursing diagnoses.
• Begins to collaborate with client and/or family members to formulate expected outcomes that are:
• pertinent and related to nursing diagnoses
• realistic and measurable with critical times
• client focused, incorporating the family, sociocultural background and spiritual beliefs
• Begins to select appropriate nursing actions that address nursing diagnoses of the adult client in a medical-surgical setting.
• Provides rationale for medications and therapeutic interventions
• Incorporates the agency’s plan of care
• Implementation
• Performs selected nursing actions specific to expected outcomes (with occasional cuing). Examples include, but are not limited to:
• suctioning - oral, nasal or tracheal
• monitoring chest drainage
• wound care - simple, complex
• administering nasogastric tube feedings
• tracheostomy care
• Involves family in nursing actions when appropriate.
• Provides for the physical safety of client in the acute care setting.
• Documents relevant care provided.
• Evaluation
• Identifies client progress as related to expected outcomes (with occasional cuing).
• Modifies the plan of care to best meet the needs of the hospitalized client (with occasional cuing).
• Continue to demonstrate cognitive, psychomotor, and affective skills to ensure safe practice.
• Identifies rationales for nursing actions and other therapeutic measures, incorporating knowledge of relevant pathophysiology, diagnostic procedures, etc.
• Performs psychomotor skills learned in Nursing 100 and Nursing 101 safely.
• With no cuing of N100 skills
• With minimal cuing of N101 skills
• With occasional cuing of N102 skills; examples include but are not limited to:
• suctioning - oral, nasal or tracheal
• monitoring chest drainage
• wound care - simple, complex
• administering nasogastric tube feedings
• tracheostomy care
• Applies principles of medical and surgical asepsis
• Performs skills on time
• Performs skills in a reasonable amount of time
• Demonstrates organizational skills
• Demonstrates dexterity
• Adapts performance to meet needs of client and/or situation
• Administers parenteral and non-parenteral medications safelyand in a timely manner.
• States action, contraindications, effects and nursing considerations for prescribed medications.
• Calculates medication and intravenous doses correctly
• Uses effective communication techniques with clients, families, instructor, peers and health care team.
• Develops oral presentation skills:
• Reports clear, concise and relevant data to staff, instructor, and peers
• Presents an oral nursing care plan to clinical peers and instructor during post-conference
• As a manager of care, the student will
• Collaborate as a health team member when providing care for a client in the medical-surgical setting. Cares for clients with dysfunction or disease in the following areas:
• Musculoskeletal dysfunction
• Arthritic and connective tissue disorders
• Respiratory dysfunction
• Cardiovascular dysfunction
• Peripheral vascular dysfunction
• Hypertension
• Visual and/or auditory dysfunction
• Cancer
• Demonstrates organizational skill in the management of care.
• Begins to prioritize nursing care for 2 clients in the medical-surgical setting
• Completes care for the assigned clients
• Practice in a cost-effective manner:
• Organizes care to conserve time, energy and resources
• Validates the use of supplies and equipment to minimize waste
• Assume the role of peer resource person (PRP):
• Listens to shift report and obtains additional current data from staff/instructor for group of clients assigned to peers
• Gives verbal support to peers and answers questions with instructor support
• Assists with selection of peer assignment as needed with instructor’s input
• Schedules help from instructor for peers
• Assists peers with instructor approved procedures
• Monitors client care for group of assigned clients
• Seeks and schedules additional learning experiences for self and peers
• Ensures documentation is complete
• Ensures peers have reported to appropriate staff
• As a Member within the Discipline of Nursing, the student will:
• Practice within the ethical and legal framework of nursing
• Follows established school policies as outlined in the College and Program Student Handbooks.
• Follows established agency policies and procedures
• Documents care as given with occasional cuing
• using agency format
• meeting legal standards
• clearly and concisely
• in a timely manner
• legibly with correct grammar and spelling
• Reports pertinent data promptly to appropriate staff and instructor.
• Respects and supports the rights of the client’s:
• Privacy
• Confidentiality
• Right to refuse care
• Begins to act as a representative of the adult client’s needs and concerns when necessary (advocacy).
• Practices with knowledge of nurse’s ethical and/or legal role and responsibilities related to issues presented during previous courses.
• Continue to exhibit professional accountability
• Prepares for N102 clinical assignment using appropriateresources.
• Seeks assistance when clinical situation is beyond knowledge and experience.
• Seeks opportunities in the clinical settings to enhance learning and pursue professional growth.
• Follows established lines of communication within the assigned clinical setting.
• Demonstrates reliability in completing client/clinical assignments.
• Evaluates own performance accurately:
• Accepts responsibilities for own decisions, behaviors, and actions while in clinical settings
• Accepts feedback and makes appropriate changes in behavior
• Identifies own strengths and areas for growth in adult health care settings
• Definitions of cuing:
• No cuing: student will perform independently with no intervention by instructor.
• Minimal cuing: instructor will provide no more than 2 prompts.
• Occasional cuing: instructor will provide no more than 4 prompts.