12/26/2024 7:23:52 PM	NR 75B Course Outline as of Fall 2015	Changed Course
CATALOG INFORMATION
Discipline and Nbr:  NR 75B	Title:  NRSG CARE MED-SURG,PSYCH
Full Title:  Nursing Care of Medical-Surgical and Psychiatric Clients
Last Reviewed:2/9/2015

Units		Course Hours per Week			Nbr of Weeks	Course Hours Total
Maximum	12.00	Lecture Scheduled	6.00		17.5 max.	Lecture Scheduled	105.00
Minimum	12.00	Lab Scheduled	0		17.5 min.	Lab Scheduled	0
		Contact DHR	18.00			Contact DHR	315.00
		Contact Total	24.00			Contact Total	420.00
		Non-contact DHR	0			Non-contact DHR Total	0

Total Out of Class Hours:  210.00

Total Student Learning Hours: 630.00

Title 5 Category:  AA Degree Applicable
Grading:  Grade Only
Repeatability:  42 - One Repeat if Grade was D, F, NC, or NP
Also Listed As: 
Formerly: 

Catalog Description:

Concepts and nursing practice in the care of medical/surgical patients and patients with chronic illness including psychiatric and substance abuse patients, are presented.  The emphasis is on acute medical/surgical patients both inpatient and outpatient management of patients with chronic illness relevant to adolescent and adult patients.  Knowledge and skills acquired in lecture-discussion and in simulation and skills laboratories are applied in medical-surgical, psychiatric and outpatient care settings.

Prerequisites/Corequisites:
Course Completion of NR 75.1A

Recommended Preparation:

Limits on Enrollment:

Schedule of Classes Information
Description:

Concepts and nursing practice in the care of medical/surgical patients and patients with chronic illness including psychiatric and substance abuse patients, are presented.  The emphasis is on acute medical/surgical patients both inpatient and outpatient management of patients with chronic illness relevant to adolescent and adult patients.  Knowledge and skills acquired in lecture-discussion and in simulation and skills laboratories are applied in medical-surgical, psychiatric and outpatient care settings.

(Grade Only)
Prerequisites:Course Completion of NR 75.1A
Recommended:
Limits on Enrollment:
Transfer Credit:CSU;
Repeatability:42 - One Repeat if Grade was D, F, NC, or NP

ARTICULATION, MAJOR, and CERTIFICATION INFORMATION

Associate Degree:		Effective:		Inactive:
Area:
CSU GE:	Transfer Area			Effective:	Inactive:
IGETC:	Transfer Area			Effective:	Inactive:
CSU Transfer:	Transferable	Effective:	Fall 1981	Inactive:	Fall 2020
UC Transfer:		Effective:		Inactive:
C-ID:

Certificate/Major Applicable: Both Certificate and Major Applicable

COURSE CONTENT

Student Learning Outcomes:
At the conclusion of this course, the student should be able to:

1.  Apply the nursing process to provide for safe nursing care for psychiatric patients and acutely ill medical-surgical patients.

2.  Devise and implement teaching plans that are individualized to meet patient's needs and abilities to participate in their care processes.

3.  Apply evidence-based medical-surgical concepts to clinical practice at the beginning acute care level.

4.  Apply evidence-based psychiatric theoretical concepts to clinical practice.

5.  Collaborate with patients, families, and members of the interdisciplinary care team to prioritize patient care need and promote optimal wellness.

 

Objectives:

Upon completion of this course students will be able to:

1. Analyze a patient's medical record in 15 minutes or less, at a level sufficient to begin providing safe and appropriate care.

2. Identify  patients' care needs based on the pathophysiology of their admitting diagnoses and comorbid conditions.

3. In collaboration with patients and families, prioritize care needs and develop plans for addressing them.

4. In collaboration with patients and families, set measurable goals for patients' health outcomes, and evaluate their attainment.

5. Create and implement teaching plans that are congruent with patients' motivation levels, cognitive and physical abilities and goals.

6. Describe the pathophysiology and behavioral patterns of selected psychiatric illnesses and substance abuse disorders that interfere with patients' ability to meet their own needs.

7. Use problem solving and facilitative communication skills to conduct interviews with mentally ill patients.

8. Describe community resources that may be utilized to meet patients' needs.

9. Describe use of psychotropic agents for psychopathology

10.Perform selected nursing skills competently and appropriately, consistent with  theoretical  knowledge base, agency policy, state law and cultural considerations.

11. Discuss standard care for patients with selected illnesses, including pharmacologic therapies.

12. Describe the evidence for selected aspects of standard care, within and across diagnostic categories.

13. Document care in paper and electronic health records, consistent with care standards and agency policy.

14. Communicate therapeutically with acutely ill medical-surgical patients, with attention to developmental, cultural and spiritual needs.

15. Adapt communication strategies to meet needs and abilities of patients with mental illnesses.

16. Collaborate with members of the health care team to optimize patient care and to improve care outcomes.

Topics and Scope

I. Nursing care of the medical-surgical patient: Standard care and pharmacotherapy

   A.  Cardiovascular disorders

      1. Hypertension

      2. Coronary artery disease

      3. Intravenous fluid therapy and medications

      4. Heart failure

      5. Heart rhythms and dysrhythmias

      6. Shock

   B.  Acid-base balance

   C.  Diabetes complications

   D.  Respiratory infections

   E.  Orthopedic disorders

   F.  Gastrointestinal [GI] disorders

      1. Upper GI disorders

      2. Lower GI disorders

      3. Cancers of the GI tract

   G. Enteral and parenteral nutrition      

   H. Vision disorders

    I. Advanced pain management

II. Skill competencies

   A.  Ostomy management

   B.  Intravenous therapy: Primary and secondary infusions

   C.  Electrocardiography

      1. Obtaining the electrocardiogram

      2. Interpretation of major dysrhythmias

   D.  Nasogastric tube; insertion, maintenance and removal

   E.  Ambient breathing treatments

   F.  Intradermal injections and tuberculosis test interpretation

III. Nursing care of the psychiatric patient.

   A.  The role of the nurse in the psychiatric setting

   B.  Personality disorders

   C.  Self-destructive behaviors

   D.  Mood disorders

   E.  Thought disorders

   F.  Substance abuse

   G.  Dementia and delirium

   H.  Anxiety and somatoform disorders

   I.   Psychiatric disorders of childhood and adolescence

   J.  Victims of abuse and violence

IV. Communication and collaboration

   A. Collaboration with acute care patients

   B. Strategies for communicating with clients with mental illness

   C. Developmental, cultural and spiritual needs

V. Community resources and strategies for promoting wellness for the chronically ill patient

Assignments:

1. Reading assignments, 70-350 pages per week.

2. Clinical practice in acute care and psychiatric hospitals and community settings (two 8-9 hour days per week).

3. Skill practice and competency demonstration, 1-2 hours/week.

4. Preparation for clinical assignments by reviewing patients' charts; preparing database, pathophysiology form, researching medications and treatments, 3-4 hours/week.

5. Written nursing care plans,1 psychiatric and 2 medical-surgical.

6. Alcoholics Anonymous paper 1-2 pages.

7. Completion of clinical assessment tools, approximately 2 per week [medical-surgical component].

8. Viewing selected media prior to skills lab [1-2 hours per skill].

9. Present patient situations for discussion in clinical conferences (10-12).

10. 6-8 instructor-authored exams.

11. Comprehensive standardized exams.

12. Case studies (6-8).

Methods of Evaluation/Basis of Grade.

Writing: Assessment tools that demonstrate writing skill and/or require students to select, organize and explain ideas in writing.		Writing 10 - 20%
Paper, care plans, assessment tools.
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.		Problem Solving 15 - 30%
Clinical patient care, case studies, presenting patient situations in clinical conferences
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.		Skill Demonstrations 10 - 15%
Skills competency demonstrations
Exams: All forms of formal testing, other than skill performance exams.		Exams 40 - 60%
Instructor-prepared and standardized tests.
Other: Includes any assessment tools that do not logically fit into the above categories.		Other Category 0 - 0%
None

Representative Textbooks and Materials:

Varcarolis' Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, Halter, M., 2013, 7th Ed., St. Louis: Elsevier/Mosby

Medical-Surgical Nursing, Lewis, S.M., Heitkemper, M. M, & Dirksen, S.R.,  2013, 9th Ed., Chicago: Mosby/Elsevier

Mosby's Nursing Video Skills Student Online Version 4.0, Mosby Elsevier

Clinical Nursing Skills and Techniques, Perry, A., Potter, P. and Ostendorf, W., 2014,  8th Ed., Chicago: Elsevier/Mosby

Manual of IV Therapeutics, Phillips, L., 2014, 6th Ed., F.A. Davis

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