SRJC Course Outlines

7/1/2022 10:41:18 AMNR 75.1D Course Outline as of Fall 2020

Changed Course
CATALOG INFORMATION

Discipline and Nbr:  NR 75.1DTitle:  ADV MEDSURG NRSG  
Full Title:  Advanced Medical Surgical Nursing
Last Reviewed:2/3/2020

UnitsCourse Hours per Week Nbr of WeeksCourse Hours Total
Maximum9.00Lecture Scheduled4.5017.5 max.Lecture Scheduled78.75
Minimum9.00Lab Scheduled017.5 min.Lab Scheduled0
 Contact DHR13.50 Contact DHR236.25
 Contact Total18.00 Contact Total315.00
 
 Non-contact DHR0 Non-contact DHR Total0

 Total Out of Class Hours:  157.50Total Student Learning Hours: 472.50 

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:  NR 75D

Catalog Description:
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Advanced concepts related to providing safe care and meeting the complex needs of the acutely ill adult medical-surgical patient. Concepts related to professionalism, a preceptorship experience, and advanced nursing skill practice in a variety of clinical settings gives students an opportunity to make the transition from student to professional nurse.

Prerequisites/Corequisites:
Course Completion of NR 75.1C AND NR 75.2C; OR Course Completion of NR 75C


Recommended Preparation:

Limits on Enrollment:
Admission to Program. The healthcare facilities in which students are clinically placed require that the students must comply with all of the following before they are allowed onsite: Currency on all immunizations including annual flu shots; currency on annual tuberculosis clearance; a negative background check, a negative urine drug screen, and possess a current American Heart Association Certified Healthcare Provider CPR/BLS card.

Schedule of Classes Information
Description: Untitled document
Advanced concepts related to providing safe care and meeting the complex needs of the acutely ill adult medical-surgical patient. Concepts related to professionalism, a preceptorship experience, and advanced nursing skill practice in a variety of clinical settings gives students an opportunity to make the transition from student to professional nurse.
(Grade Only)

Prerequisites:Course Completion of NR 75.1C AND NR 75.2C; OR Course Completion of NR 75C
Recommended:
Limits on Enrollment:Admission to Program. The healthcare facilities in which students are clinically placed require that the students must comply with all of the following before they are allowed onsite: Currency on all immunizations including annual flu shots; currency on annual tuberculosis clearance; a negative background check, a negative urine drug screen, and possess a current American Heart Association Certified Healthcare Provider CPR/BLS card.
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:TransferableEffective:Fall 1981Inactive:
 
UC Transfer:Effective:Inactive:
 
C-ID:

Certificate/Major Applicable: Both Certificate and Major Applicable



COURSE CONTENT

Student Learning Outcomes:
Upon completion of the course, students will be able to:
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1. Function as an entry-level professional registered nurse within the legal/ethical guidelines established by the Nurse Practice Act, and demonstrate the professional behaviors of responsibility, accountability, caring, and advocacy.
2. Demonstrate leadership through team leading and delegation of tasks to nursing care team members, while assuming responsibility for the tasks delegated.
3. Contribute to the interprofessional patient care team's shared decision-making process.
4. Integrate evidence-based knowledge with quality measures to deliver safe care to patients with multiple co-morbidities.
5. Qualify to take the National Council of State Boards of Nursing Examination (NCLEX-RN).
 

Objectives: Untitled document
I. Theoretical Outcomes and Objectives
    A. Theoretical Application for Professional Growth
         1. Analyze patient needs using the nursing process.
         2. Select nursing interventions using critical thinking strategies applied to theoretical
              patient scenarios.
         3. Incorporate leadership and research principles into nursing practice by integrating best
              current evidence.
         4. Evaluate health care delivery systems and the ethical and legal roles of professional
              nursing within these systems.
         5. Provide patient teaching and health resources to promote optimum health.
         6. Solve conflict management issues using theoretical scenarios and leadership principles
         7. Formulate a plan for professional growth using the Readiness for Practice Theory during
              preceptorship.
         8. Understanding the rationale for acknowledgement of medical orders.
    B. Theoretical Content Application for Clinical Objectives in a Nursing Practice Scenario:
         1. Plan for safety needs of more complex patients,  patients with multi-system disorders,
              and patients with special vulnerabilities.
         2. Integrate the knowledge of health care needs into the nursing care of patients with
              problems related to altered:
              a. Neurological status
              b. Respiratory function
              c. Immune and endocrine function
              d. Mobility
              e. Cellular growth
         3. Plan home care with patient, family, and health care team.
         4. Utilize principles of time management and organization to effectively deliver nursing
              care to a group of patients.
         5. Utilize professional communication in the nursing care of acutely ill patients.
         6. Demonstrate competency by integrating into nursing practice scientific, physiological
              and psychosocial concepts:
              a. Neurological assessment
              b. Tracheostomy care and advanced airway management
              c. Performing venipuncture and intravenous access
        
II. Professional Clinical Practice Objectives in Advanced Medical Surgical Nursing and
    Preceptorship
    A. Assess patient for physical manifestations of pathophysiological processes and identify
         patient self-care deficits.
    B. Use information technology to document findings, manage communication, share
         knowledge, mitigate error, and support decision making that improves patient outcomes.
    C. Initiate and/or maintain a current nursing care plan for assigned patients.
    D. Integrate the best current evidence based practice in clinical health care delivery.
    E. Implement and evaluate patient and family teaching in a variety of clinical settings.
    F. Use the nursing process and critical thinking to provide safe and effective patient care in a
         variety of practice settings.
    G. Demonstrate delegation and conflict resolution skills.
    H. Actively participate in quality improvement activities.
    I. Promote physical health and wellness by providing care and comfort, reducing patient risk
         potential, and managing health alterations.
    J. Collaborate effectively with other member of the multidisciplinary healthcare team.
    K. Collaborate with patients and families to provide compassionate and coordinated
         care-based on their preferences, values and needs.
    L. Function as an entry level RN within guidelines of the Nurse Practice Act and develop a
         professional growth plan in preceptorship.

Topics and Scope
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I. Theory
    A. Neurological Assessment of the Patient with Neurological Impairment*
    B. Nursing Care of the Patient with Neurological Disease
         1. Basic nursing assessment and specific care consideration for patients with neurological
              diseases, includes comfort and pain management
         2. Seizures
         3. Amyotrophic Lateral Sclerosis (ALS)
         4. Guillain Barre Syndrome (GBS)
         5. Multiple Sclerosis (MS)
         6. Myasthenia Gravis (MG)
    C. Nursing Care of the Patient with Auto-Immune Disease
         1. Basic nursing assessment and specific care consideration for patients with auto-immune
              diseases, includes comfort and pain management
         2. Human immunodeficiency virus (HIV) care and complications
         3. Acquired immunodeficiency syndrome (AIDS) care and complications
         4. Lupus care and complications
         5. Lyme disease care and complications
    D. Nursing Care of the Patient with Respiratory Failure
          1. Basic nursing assessment and specific care consideration for patients with respiratory
              failure, includes comfort and pain management
         2. Signs, symptoms, treatment and supportive therapies
         3. Acute respiratory distress syndrome (ARDS) care and complications
         4. Tracheostomy care and complications*
         5. Ventilator care and complications
    E. Nursing Care of the Patient with a Spinal Cord Injury
         1. Basic nursing assessment and specific care consideration for patients with a spinal cord
              injury, includes comfort and pain management
         2. Risks and prevention
         3. Signs, symptoms, treatment and supportive therapies
    F. Nursing Care of the Patient with Burns
         1. Basic nursing assessment and specific care consideration for patients with burns,
              includes comfort and pain management
         2. Risks and prevention
         3. Signs, symptoms, treatment and supportive therapies
    G. Nursing Care of the Patient with Endocrine Impairment
         1. Basic nursing assessment and specific care consideration for patients with endocrine
              impairment, includes comfort and pain management
         2. Signs, symptoms, treatment and supportive therapies
         3. Thyroid disorders care and complications
         4. Addison's Disease care and complications
         5. Cushing's Syndrome care and complications
    H. Nursing Care of the Patient with Cancer II
         1. Advanced nursing assessment and specific care consideration for patients with cancer,
             includes comfort and pain management
         2. Signs, symptoms and complications
         3. Treatment and supportive therapies: Chemotherapy, radiation and immuno-therapies
    I. Nursing Care of the Patient with Alterations in Cardiac Perfusion
         1. Basic nursing assessment and specific care consideration for patients with alterations in
              cardiac perfusion, includes comfort and pain management
         2. Signs, symptoms, complications, treatment and supportive therapies
    J. Nursing Care of the Patient with Alterations in Tissue Perfusion
          1. Basic nursing assessment and specific care consideration for patients with alterations in
              tissue perfusion, includes comfort and pain management
         2. Signs, symptoms, complications, treatment and supportive therapies
    K. Nursing Care of the Patient with Increased Intracranial Pressure
          1. Basic nursing assessment and specific care consideration for patients with increased
              intracranial pressure, includes comfort and pain management
         2. Signs, symptoms, complications, treatment and supportive therapies
         3. Head trauma
    L. Nursing Care of the Patient with Gastrointestinal Bleeding and Liver Failure
         1. Basic nursing assessment and specific care consideration for patients with
              gastrointestinal bleeding and liver failure, includes comfort and pain management
         2. Signs, symptoms, complications, treatment and supportive therapies
         3. Risk factors and prevention
     M. Nursing Care of the Trauma Patient in the Critical Care Environment
          1. Basic nursing assessment and specific care consideration for patients experiencing
              trauma, includes comfort and pain management
         2. Signs, symptoms, complications, treatment and supportive therapies
         3. Risk factors and prevention
         4. Care management in the emergency department (ED) and intensive care unit (ICU)
    N. Palliative Care and End of Life Treatment
         1. Basic nursing assessment and specific care consideration for patients receiving palliative
              care and end of life treatment, includes comfort and pain management
         2.  Complications, treatment and supportive therapies
    O. Alternative and Complimentary Therapies
         1. Basic nursing assessment and specific care consideration for patients receiving
              alternative and complimentary therapies, includes comfort and pain management.
         2.  Complications, treatment and supportive therapies
    P. Introduction to nursing research methods and evidence-based practice application to
         clinical care
    Q. Legal Aspects of Nursing Practice - accountability and liability
     R. Healthcare Delivery Systems - admission, discharge and case management  
     S. Homecare and Community-Based Nursing Practice
         1. Vulnerable community populations and care needs identification
         2. Nursing assessment and care of the home care patient
         3. Community health prevention, education and early interventions
    T. Cultural and Ethnic Nursing - assessment and specific care consideration for patients in
         need of cultural and ethnic nursing, includes comfort and pain management
    U. Spiritual Nursing - assessment and specific care consideration for patients in need of
         spiritual nursing, includes comfort and pain management
    V. Advanced Professionalism in Nursing
          1. Quality Improvement
         2. Leadership and management
         3. Resume writing and job interview strategies
    W. Nurse Practice Act
         1. State Registered Nurse (RN) licensure regulations
         2. RN Intervention Program
         3. Supervision and delegation of unlicensed assistive personnel (UAP)
    X. Nursing Behavioral Objectives and Conflict Resolution
         1. Behavioral objective development and implementation
         2. Conflict resolution strategies and application
    Y. Orientation to Preceptorship:  Preparation for formal preceptorship assignment
         1. Preceptee identification of clinical strengths and areas for improvement
          2. Preceptor assignment process
         3. Clinical objective development to achieve success in preceptorship
 
*These items are introduced in lecture, and the related skills are performed in the lab
 
II. Skills
    A. All Skills Review of ADN first, second and third semester medical-surgical skills topics
    B. Neurological Assessment
    C. Advanced airway management and tracheostomy care
 
III. Clinical
    A. Clinical application of advanced medical-surgical nursing practice in the acute care
         hospital setting: Standard care and pharmacotherapy
    B. Quality improvement, evidence-based practice and informatics application in the care of the
         acute care adult population
    C. Preceptorship:  Novice to entry-level nurse transition experience

Assignments:
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Lecture-Related Assignments:
1. Reading 70-250 pages per week.
2. Unit and standardized exams: 5-7 per semester. Minimum cumulative score of 75% on four
    unit exams to continue in the nursing program.
 
Lab-Related Assignments:
1. Reading prior to nursing skills demonstration15-50 pages per skill.
2. Completion of media review prior to each skills lab (1 -2 hours per lab).
3. Practice skills performance in simulated lab.
4. Completion of skills lab quizzes; 1 per skill (ungraded).
5. Demonstrate competency in 2 formal skill check-offs within 3 attempts related to skill
    lab topic: Rubric graded Pass/fail. Failure of skills competency results in dismissal from the
    nursing program.
 
Clinical-Related Assignments:
1. Completion of the safe medication dosage calculation exam with a score of 95% or better by
    the third attempt. This assignment is not graded for purposes of this course, but failure to pass
    this assignment with a grade of 95% or better on the third attempt will result in a failed grade
    and dismissal from the nursing program.
2. Clinical advanced medical-surgical practice in acute care hospital settings (two 8 hour days
    per week for 8 weeks), continued application of critical thinking skills, including the use of
    evidence-based practice research. Students must meet minimum problem-solving skills and
    performance standards to pass this course. Provide safe care to 3-4 patients each clinical
    shift. Rubric graded Pass/Fail. Achieving a pass in clinical practice is required to remain in
    the nursing program.
3. Participation in case conferences for analysis of patient care situations in group setting each
    clinical shift.
4. Development of 1-3 nursing care plans based on assigned patient cases and promotion of
    quality patient outcomes.  Rubric graded:  Achieve score of 75% or better.
5. Development of 1-4 evidence-based practice research article critiques.  Rubric graded:
    Achieve score of 75% or better.
6. Completion of 6-10 critical thinking journals.  Rubric graded:  Achieve score of 75% or better.
7. Preparation and participation in a simulation lab scenario (ungraded).
8. Completion of required preceptorship hours.

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
5 - 15%
Critical thinking journals, nursing care plan(s), evidence-based research article critiques
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.Problem Solving
15 - 25%
Clinical patient care: pass/fail, case conferences and analyses, preceptorship required hours
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.Skill Demonstrations
5 - 10%
Skills performance competencies
Exams: All forms of formal testing, other than skill performance exams.Exams
50 - 60%
Unit and standardized exams
Other: Includes any assessment tools that do not logically fit into the above categories.Other Category
0 - 0%
None


Representative Textbooks and Materials:
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California regulations for RN practice: accessible via California Board of Registered Nursing Internet website
Davis's Drug Guide for Nurses. 16th ed. Vallerand, A.H. and Sanoski, C. A. 2018. F.A. Davis. 2018
Gerontological Nursing. 9th ed. Eliopoulos, C. Lippincott. 2018
Varcarolis' Foundations of Psychiatric Mental Health Nursing: A Clinical Approach. 8th ed. Halter, M. Saunders. 2018
Dimensional Analysis: Calculating Dosages Safely. 2nd ed. Horntvedt, T. F.A. Davis. 2019
Pocket Companion for Physical Examination and Health Assessment. 8th ed. Jarvis, C. Saunders. 2019
Pharmacology: A Patient-Centered Nursing Process Approach. 9th ed. McCuistion, L.E. and Dimaggio, K. and Winton, M.B. Elsevier. 2017
Medical-Surgical Nursing. 10th ed. Lewis, S. M. and Heitkemper, M. M. and Dirksen, S.R. Mosby/Elsevier. 2019
Pathophysiology: The Biologic Basis for Disease in Adults and Children. 6th ed. McCance and Huether. Mosby Purnell. 2013 (classic)
Swearingen's Manual of Medical Surgical Nursing Care. 7th ed. Monahan, F. Mosby. 2010 (classic)
Mosby's Nursing Video Skills Student Online Version. 4th ed. Mosby Elsevier. 2013 (classic)
Mosby's Manual of Diagnostic and Laboratory Tests. 6th ed. Pagana, K. and Pagana, T. Elsevier/Mosby. 2017
Clinical Nursing Skills and Techniques. 9th ed. Perry, A.G. and Potter, P.A. and Ostendorf, W. Elsevier/Mosby. 2017
Phillips Manual of IV Therapeutics. 7th ed. Gorski, L. F.A. Davis. 2018
Fundamentals of Nursing. 9th ed. Potter, P.A. and Perry, A.G. Mosby. 2016
Pearson Nursing Diagnosis Handbook. 11th ed. Wilkinson, J.M. Pearson. 2016
Leadership Roles and Management Functions in Nursing: Theory and Application. 9th ed. Marquis, B.L. and Huston, C.J. Lippincott Williams & Wilkins. 2017

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