3/13/2025 11:30:40 PM	NR 75C Course Outline as of Fall 2001	Changed Course
CATALOG INFORMATION
Discipline and Nbr:  NR 75C	Title:  CARE/ACUTELY ILL
Full Title:  Nursing Care of the Acutely Ill Patient
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:  00 - Two Repeats if Grade was D, F, NC, or NP
Also Listed As: 
Formerly: 

Catalog Description:

This course continues to focus on the development of concepts applicable to the care of the more complex adult medical-surgical client.  In addition, a new focus on the pediatric client is included.  Application of Orem's Self-Care Deficit Model is incorporated throughout this course. Emphasis is placed on the student's ability to use critical thinking skills, identify relationships among concepts, and incorporate both into the nursing process in multiple clinical settings.  Professional growth is encouraged by incorporating selected concepts in theoretical scenarios and in the clinical setting for more complex skills.

Prerequisites/Corequisites:
Enrollment in Associate Degree Nursing program; completion of NR 75B or NR74A with a grade of "C" or better.

Recommended Preparation:

Limits on Enrollment:

Schedule of Classes Information
Description:

This course continues to focus on the development of concepts applicable to the care of the more complex adult medical-surgical client.  In addition, a new focus on the pediatric client is included.

(Grade Only)
Prerequisites:Enrollment in Associate Degree Nursing program; completion of NR 75B or NR74A with a grade of "C" or better.
Recommended:
Limits on Enrollment:
Transfer Credit:CSU;
Repeatability:00 - Two Repeats 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: Certificate Applicable Course

COURSE CONTENT

Outcomes and Objectives:
At the conclusion of this course, the student should be able to:

This course is one of a series in which it is essential that students

demonstrate continued ability to meet previously achieved objectives to

ensure client safety.  The parameters for meeting the course objectives

are outlined in the course syllabus.

I.  Theoretical Outcomes and Objectives

   A.  Theoretical Application for Professional Growth

       At the completion of this course, the student working with adult

       medical-surgical and pediatric clients, will be able to:

       1. Evaluate the use of critical thinking in nursing practices as

          it relates to the pediatric and adult medical-surgical patient

       2. Analyze patient needs across the life span using the nursing

          process

       3. Incorporate professional, legal, and ethical dimensions as a

          basis for decision making and delegation

       4. Design and implement a plan of care that incorporates time

          management and organizational strategies

       5. Through nursing practice scenarios, integrate knowledge of

          health deviation states and self-care requisites (Orem's Self-

          Care Deficit Model) into the nursing care of clients across the

          age span, in acute care and community-based care, with problems

          related to altered:

          a. fluid and electrolyte balance

          b. oxygenation and perfusion requirements

          c. regulation processes

          d. nutrition and elimination

          e. perioperative care needs

II. Professional Clinical Practice Based on Theoretical Concepts

   A.  Professional Growth Objectives

   At the completion of the course, the student will practice

   professional nursing by demonstrating the ability to:

       1.  Apply critical thinking concepts to develop and implement

           nursing care by incorporating in-depth information

           gathered through a systematic nursing assessment

       2.  Incorporate physiological, developmental, psychological, and

           adaptive potential concepts into the development of a nursing

           care plan.

       3.  Incorporate the findings from laboratory, physical,

           psychological and communication pattern assessments into the

           development and implementation of a nursing care plan.

       4.  Develop appropriate nursing diagnoses and interventions.

       5.  Perform selected nursing skills incorporating

           scientific, physiological and psychological concepts in a

           simulated skills laboratory.

       6.  Articulate the scientific rationale for selected nursing and

           medical interventions.

       7.  Evaluate to determine if expected outcomes were achieved.

       8.  Develop nursing care plans that include the concepts of:

           a. normal and abnormal child growth and development

           b. children with problems related to:

              1) oxygenation and nutrition

              2) blood production and circulation

              3) genitourinary function

              4) cerebral function

              5) endocrine function

              6) integumentary function

              7) mobility

           c. adult medical-surgical clients with problems related to:

              1) fluid and electrolytes

              2) oxygenation

              3) regulation

              4) nutrition

              5) perioperative care

              6) self-care in home setting

   B.  Clinical Practice Objectives

       When assigned a client in the clinical setting, the student will

       practice professional nursing incorporating Orem's Self-Care

       Deficit Model into the nursing process by demonstrating the

       ability to:

       1.  Use the nursing process as a basis for providing nursing care

           to the pediatric and the adult medical-surgical client.

       2.  Modify a nursing care plan to reflect a client's impaired

           ability to adapt to illness, injury, disability, loss, or

           grieving.

       3.  Refine verbal and written communication skills to reflect:

           a. Client teaching in a wide variety of clinical settings

           b. Interaction with more members of the health care team

       4.  Incorporate characteristics of developmental stages of the

           pediatric and adult client in the development and

           implementation of a nursing care plan.

       5.  Explain the theoretical basis underlying all aspects of the

           nursing process as applied to each assigned client.

       6.  Incorporate into the writing and implementation of a nursing

           care plan significant theoretical concepts that apply to the

           pediatric and the adult medical-surgical client.

       7.  Differentiate practices that protect the client from

           environmental and psychological hazards from those that place

           the client in danger.

       8.  Demonstrate competency in the performance of nursing skills

           clustered in the following categories incorporating

           scientific, physiological and psychosocial principles:

           a. Medical-Surgical

              1) Enteral/Parenteral Feeding

              2) EKG monitoring and interpretation

              3) Chest tube and Drainage

              4) Stump dressings

              5) Advanced assessment of heart and lung sounds

              6) Intermediate IV therapy and central line dressing

                 changes

          b.  Pediatric

              1) Assessment

              2) Fluid and caloric maintenance

              3) Safety

              4) Use of respiratory equipment

              5) Medication administration

Topics and Scope

I. Pediatric Nursing

   1. Perspectives in the nursing care of the pediatric client

   2. Assessment of child and family

   3. Growth and development

      a. General concepts of growth and development

      b. Growth and development concepts of infant

      c. Growth and development concepts of toddler and preschooler

      d. Growth and development of school age child and adolescent

   4. Child and family with special needs

   5. Child with problems related to oxygenation and nutrition

   6. Child with problem related to blood production and circulation of

      blood

   7. Child with disturbance of regulating mechanisms

      a. Genitourinary dysfunction

      b. Endocrine and integumentary dysfunction

      c. Cerebral dysfunction

   8. Child with problems that interfere with physical mobility

   9. Skill competencies required:

      a. Pediatric assessment

      b. Fluid and caloric maintenance of the pediatric client

      c. Safety/equipment used for pediatric clients

      d. Respiratory care/equipment used for pediatric clients

      e. Medication administration for pediatric clients

II. Intermediate Medical - Surgical Nursing

   1. Fluid and electrolytes

      a. Pathophysiology of renal system

      b. Assessment - physical and interpreting laboratory/diagnostic

         studies

      c. Choosing and prioritizing appropriate nursing diagnoses for

         the client with renal dysfunction

      d. Planning, implementing and evaluating nursing care for the

         client with selected renal dysfunction

   2. Oxygenation

      a. Applying the nursing process to the care of the client with

         chest trauma

      b. Assessment of cardiac disorders related to altered cardiac

         structures and rhythms.

      c. Applying the nursing process to the care of the client with

         altered peripheral tissue perfusion.

      d. Applying the nursing process to the care of the client with

         chest trauma

      e. Applying the nursing process to the care of the client with

         gastrointestinal bleeding

   3. Regulation

      a. Nursing care of the client with abnormal cell growth

      b. Applying the nursing process to the assessment, diagnosis,

         planning, intervention, and evaluation of pain

      c. Nursing care of the client with various venous access

         devices

    d. Assessment, diagnosis, planning, intervention and evaluation of

       the client with pancreatitis and acid-base imbalances

   4. Nutrition

      a. Nursing care of the client with alterations in nutritional

         balance

      b. Application of the nursing process to the assessment,

         diagnosis, planning, implementation, and evaluation of the

         client undergoing nutritional therapy

    c. Application of the nursing process to clients with lower

   gastrointestinal tract diseases

   5. Home Care Nursing

      a. Comparing and contrasting the use of the nursing process in the

         home care setting versus the acute care setting

   6. Perioperative Clients

      a. Applying the nursing process to the perioperative client using

         domains of fluid and electrolyte balance, oxygen requirements,

         regulation process, and nutritional elimination

   7. Decision making and delegation

      a. Nursing decision making within legal and ethical policy

         guidelines

   8. Skills development required:

      a. Bladder irrigation

      b. Care and maintenance of chest tubes

      c. Electrocardiogram

      d. Advanced heart sound assessment

      e. Stump dressings

      f. Perioperative assessment skills

      g. Intermediate IV skills including central line dressing changes

Assignments:

1. Preparation for clinical assignments by reviewing patient's chart,

approximately 2-3 hours per week

2. Written Nursing Care Plans approximately 2-3/semester.  Includes data

collection, data analysis, assessment and development of plan for nursing

care with specific interventions and evaluation of effectiveness

3. Completion of an assessment tool on every client in preparation

for clinical using data base, medication sheet and pathophysiology form

4. Viewing selected videotapes in HLRC; 12-15 per semester

5. Viewing selected CAI program in HLRC; 8-12 per semester

6. Present patient situations for discussion in pre/post clinical

conferences, approximately 1 hour presentation per student per semester

7. Analysis of patient care situations in group setting, approximately

8-12 per semester

8. Reading assignments, 70-100 pages per week

9. Completion of a weekly critical thinking journal

10. Completion of up to 12 CD ROM modules with an accompanying 20-point

quiz

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 2 - 5%
Term papers, NCPs-Pass/Fail;growth & dev. paper
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.		Problem Solving 0 - 0%
None
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.		Skill Demonstrations 0 - 0%
None
Exams: All forms of formal testing, other than skill performance exams.		Exams 95 - 98%
Multiple choice
Other: Includes any assessment tools that do not logically fit into the above categories.		Other Category 0 - 0%
None

Representative Textbooks and Materials:

Delmar, Beginning to Advanced Nursing Skills (2000)

Lewis, S. Heitkemper, M., and Dirksen, S. (2000.)

   Medical - Surgical Nursing: Assessment of Clinical Problems.

   (5th ed.), New York: Mosby.

McCance, K., and Huether, S. (1997.),

   Pathophysiology: The Biologic Basis for Disease in Adults and Children

   (3rd ed.), New York: Mosby.

Wilkinson, J. (1995.), Nursing Diagnosis and Intervention Pocket Guide.

   (6th ed.), Menlo Park, CA: Addison - Wesley.

Whinningham, M., and Preusser, B. (1996.), Critical Thinking in Medical-

   Surgical Settings: A Case Study Approach. New York:  Mosby.

Wong, D., and Whaley, L. (1997.), Whaley and Wong's Essentials of

   Pediatric Nursing. (5th ed.), New York:  Mosby.

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