Medical Surgical 1 01 - Lecture notes 1,2,3 PDF

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COURSE TITLE

MEDICAL-SURGICAL NURSING 1 SYLLABUS

COURSE DESCRIPTION:

This course is designed to give the student a basic understanding of the concepts of MedicalSurgical Nursing including the definition and etiology of diseases/disorders, methods of diagnosis, signs and symptoms, treatment and nursing care, including aspects of pharmacology and nutrition. Emphasis is placed on the nursing process. The course is organized by functioning systems and is arranged so that the presentation of the systems advances from simple to complex. Introduction to Mental Health will be part of Medical-Surgical Nursing 1.

TEACHING METHODS:

Lecture, Handouts, Group discussions, Visual Aids, ATI Lab skills – Virtual Clinical Simulation

COURSE OBJECTIVES:

Upon successful completion of this course, the student should be able to: 1. Compare and contrast normal anatomy and physiology functions with that of a pathological nature. 2. Integrate knowledge in the areas of nursing skills, nutrition, and pharmacology, to medical and surgical conditions and states of mental health. 3. Discuss general principles of first aid for major and minor emergencies with the rationale for care rendered. 4. Formulate a plan of holistic care for patients with medical-surgical conditions, based on the nursing process. 5. Correlate legal/ethical considerations to the plan of care for clients with medical-surgical and mental health conditions. 6. Identify the rights and responsibilities of the client, nurse, family and other health providers related to medical-surgical conditions and mental health conditions. 7. Identify concepts of disease transmission as it relates to the nurse's responsibilities while assisting to determine the client's need. 8. Describe how the dynamics of the nurse/client relationship affects/influences the formulation of client goals and a plan of care for various medical-surgical conditions and/or various states of mental health. 9. State how the nurse incorporates the fundamental principles of health restoration/promotion into identifying client goals and assisting in the formulation of a plan of care. 10. Explain how the nurse caring for clients with medical-surgical conditions assists in the implementation of a plan of care with other members of the health care team. 11. Identify how age/culture/situational variables relate to the implementation of the plan of care for clients with Medical-Surgical conditions 12. Discuss the concepts of personality development 13. List and define the well know personality deviations know to occur throughout the life span.

CLINICAL OBJECTIVES

Upon completion of this course, the student should be able to: i. ii. iii. iv. v. vi. vii. viii.

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Provide care for multiple patients within the professional nursing role. Provide care for multiple patients of all ages with a caring attitude and an understanding of the patient's cultural beliefs and practices. Apply the four (4) steps of the nursing process which includes assessment, planning, implementation, and evaluation in a patient care setting. Deliver care to patients utilizing professional standards in nursing practice. Utilize confidentiality in communication both verbally and in writing Demonstrate the ability to care for patients from different cultures, with the understanding that here are complementary and alternative therapies available. Deliver care within the legal and ethical guidelines. Deliver patient care with knowledge of the common characteristics, concepts, and processes related to transmission of communicable diseases, including risk factors and preventive health practices.

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Utilize nursing skills to deliver competent, safe patient care. Apply concepts of nutrition, pharmacology, and nursing skills into the disease processes that may affect patients.

CLOCK HOURS

280 CLOCK HOURS (100 Lecture/30 Lab/150 Clinical)

OUTSIDE WORK & HOURS

ATI Practice/Skilled Modules - 35 Hours

PREREQUISITES REQUIRED

Foundations of Nursing, Fundamentals of Nursing, Anatomy and Physiology I-II

INSTRUCTIONAL RESOURCES

Foundations and Adult Health Nursing, Cooper & Gosnell, 7th Edition ATI - Pharmacology for Nursing, Edition 10.0 ATI - Mental Health Nursing, Edition 10.0 ATI - Adult Medical Surgical Nursing, Edition 10.0 The Human Body in Health and Illness, Herlihy, Barbara, 5th Edition, Saunders, 2011 ATI Website Elsevier Website Computer Required Calculator Drug book or Medication Cards

MAXIMUM STUDENT/ INSTRUCTOR RATIO:

40:1

METHOD OF EVALUATION:

10 Quizzes ATI ATI Remediation 35 Hours (Mandatory)* 9 Exams Final Exam

5% 10% 5% 60% 20%

GRADING SCALES INCLUDING COMPLETION REQUIREMENTS Letter Grade

A B C F

Percentage

GPA

NOTE:

100-92 91-84 83-78 77-Below

4.00 3.00 2.00 0

May round up to move Letter Grade from “C” to “B”, “B” to “A”. May NOT round up any grade less than a 77.5.

A student's cumulative grades are calculated and recorded at the midpoint of each course. The grade results will be used to evaluate the student's academic progress and completion program objectives. Progress reports are available to students and/or sponsors at these periods. Students may request a program report at any time during the program session. A student must complete each course with a grade of 78% or better to progress to the next course. ATI Testing The ATI test grade is incorporated into the course as 10% of the final course grade. The ATI grade that the student scores places them into one of the four (4) different levels described below:

1. Level 3 – Scores meeting the Proficiency Level 3 standard may be considered to exceed most expectations for performance in this content area.

2. Level 2 – Scores meeting the Proficiency Level 2 standard may be considered to exceed minimum expectations for performance in this content area.

3. Level 1 – Scores meeting the Proficiency Level 1 standard may be considered to meet the absolute minimum expectations for performance in this content area.

4. Below Level 1 – Scores below the Proficiency Level standard can be considered below minimum expectations and may be indicative of significant risk in this content area. Revised 01/06/2019 EK MEW

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The final ATI test score for each course will be reflective of the individual level of proficiency that the student attains for the particular course being evaluated. The ATI score will be determined by the format set forth in policy as noted in the Vocational Nursing Student Handbook under ATI (Assessment Technologies Institute). ATI Retake Remediation Requirement Reference your current Vocational Nursing Student Handbook Policy Only students receiving a Below Level 1, are given one opportunity for retake. Student retake will be scheduled by the ATI Coordinator within one week of exam to allow for remediation and proctored retake review. Remediation consists of creating and completing review hours for the focused review associated to the PN Proctored Assessment for the Content Series tested. Students requiring a retake of a Proctored Content Mastery Assessment must complete 14 hours of remediation. A printed copy of the hours will be required as documentation of completion, and will be the students pass for the scheduled retake. If the student does not complete the required remediation hours, they will be out of compliance with program requirements, and will be withdrawn from the program for failure of academic course completion. An individual result of Level 2 must be attained on the retest and will be scored as follows: a Proficiency Level 2 or above on the second attempt will receive 78% documented for that exam. If a level 2 is not attained the student will not pass the course and will be withdrawn from the Vocational Nursing Program. ATI Remediation 35 Hours (Mandatory)* Student remediation hours will be calculated based ONLY on the correlated ATI modules and practice tests for the current course. Remediation hours greater than 3 consecutive hours, will be evaluated by the instructor or ATI Coordinator for scores reflective of the individual Content Course Mastery level of proficiency. If the student does not complete the required remediation hours, they will be out of compliance with program requirements, and will be withdrawn from the program for failure of academic course completion of ATI Proctored examination. * Rationale: This will maintain the integrity of all hours earned, and decrease the opportunity of false accumulation of content hours on focused assessments or course module completion, by letting time run without true remediation. Noted improvement on grades will solidify true content remediation. Students should reference to ATI Recommended Cut Scores for the course content being reviewed. Testing Test dates and content will be provided to the students at the beginning of the course by the instructor. A course schedule calendar with the material to be covered and the dates of the exams will be provided. If the student must miss an exam, they must notify the faculty that they will not be present for the exam and schedule a date for the make-up exam within 72 hours of the date of the exam; test will be different from exam given, regardless of it being excused or unexcused absence. This will maintain the integrity of all exams and decrease the opportunity of cheating. Tests will be taken from test bank, previous tests or test questions written by instructor using knowledge gained from reading, lecture, videos, presentations and handouts. Make-up Tests Occasionally a student will miss a test that is scheduled for a class. The student should contact his/her instructor to arrange the make-up test. See testing for further clarification. Quizzes May be given if instructor feels a need to determine if students are grasping information or are not prepared for class with reading preparation. Essay May be assigned to assess student’s ability to organize thoughts and writing ability. Clinicals/Lab The clinical portion of this course will be evaluated with the Clinical Evaluation Tool and the student must maintain an 85% at midterm and at the end of the course. Students with less than 85% at the mid-term evaluation will be required to formulate a plan of action to correct the deficiencies. If the student is already on a probationary status from a previous clinical evaluation, a score of less than 85% at mid-term will constitute grounds for termination from the program. Case studies in Evolve will constitute replacement

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for nursing care plans for the course. The course final average must be at least 78 or better to pass. Clinical Attendance Attendance to clinical is critical. This is the opportunity for the student to learn and practice skills in the skills lab and then apply them later in patient care. All time spent in the skills lab and receiving instruction is considered clinical time. Any student missing a clinical day must call in to the instructor prior to the scheduled clinical so arrangements can be made for their patient assignment to be taken care of. Class Attendance Refer to Vocational Nursing Orientation Handbook, Attendance Policy. COURSE OUTLINE: 41 42 43 44 45 46 47

Care of the Surgical Patient Care of the patient with an Integumentary Disorder Care of the patient with a Musculoskeletal Disorder Care of the patient with a Gastrointestinal Disorder Care of Patient with Gallbladder, Liver, Biliary Tact, or Exocrine Pancreatic Disorder Care of the Patient with a Blood or Lymphatic Disorder Care of the Patient with Cardiovascular or Peripheral Vascular Disorder

MENTAL HEALTH NURSING 33 34 35

Concepts of Mental Health Care of a Patient with Psychiatric Disorder Care of a Patient with Addictive Personality

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Chapter 41: Care of the Surgical Patient Unit Objectives Student Assignments Identify the purposes of surgery. Foundations and Distinguish among elective, urgent, and emergency surgery. Adult Health Explain the concept of perioperative nursing. Discuss the factors that influence an individual’s ability to Nursing, Cooper & tolerate surgery. Gosnell, 7th EditionDiscuss the considerations for the older adult surgical pt. Chapter 41 Describe the perioperative checklist. Explain the importance of informed consent for surgery. ATI Content Mastery Explain the procedure for turning, deep breathing, Series PN- Med/ coughing, and leg exercises for postoperative patients. Surg Nursing, 10th Differentiate among general, regional, and local anesthesia. Edition Ch. 84 Explain conscious sedation. Pg 599-604 Describe the roles of the circulating nurse and the scrub nurse during surgery. Ch. 85 Discuss the initial nursing assessment and management Pg 605-610 immediately after transfer from the post anesthesia unit. Identify the rationale for nursing interventions designed to prevent postoperative complications. List the assessment data for the surgical patient. Identify the information needed for the postoperative patient in preparation for discharge. Discuss the nursing process as it pertains to the surgical pt. Chapter 42: Care of the patient with a Integumentary Disorders Unit Objectives Student Assignments Discuss the primary functions of the integumentary system. Describe the differences between the epidermis and Foundations and dermis. Adult Health Nursing, Cooper & Discuss the functions of the three major glands located in Gosnell, 7th Editionthe skin. Chapter 44 Discuss the general assessment of the skin. Discuss the viral disorders of the skin. Discuss the bacterial, fungal, and inflammatory disorders of ATI Content Mastery Series PN- Med/ the skin. Surg Nursing, 10th Identify the parasitic disorders of the skin. Describe the common tumors of the skin. Edition Identify the disorders associated with the appendages of Ch. 65 the skin. Pg 443-447 Ch. 67 State the pathophysiology involved in a burn injury. Pg 449-456 Identify the methods used to classify the extent of a burn injury. Discuss the stages of burn care with appropriate nursing interventions. Discuss how to use the nursing process in caring for patients with skin disorders. Identify general nursing interventions for the patient with a skin disorder.

Learning Activities

ATI Pharmacology Tutorial- Pharmacology Made Easy -Pain & Inflammation

Learning Activities ATI Learning System PN Module & Practice Test -Medical-Surgical: Dermatological

Chapter 43: Care of the patient with a Musculoskeletal Disorder Revised 01/06/2019 EK MEW

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Unit Objectives List the five basic functions of the skeletal system. List the two divisions of the skeleton. Describe the location of major bones and muscles of the body. List the types of body movements. Describe three vital functions muscles perform when they contract. List diagnostic examinations for musculoskeletal function. Compare medical and nursing care for patients suffering from gouty arthritis, rheumatoid arthritis, and osteoarthritis. List at least four healthy lifestyle measures people can practice to reduce the risk of developing osteoporosis. Describe medical and nursing care for the patient undergoing a total hip or knee replacement. Discuss nursing interventions for a patient with a fractured hip after open reduction with internal fixation and bipolar hip prosthesis (hemiarthroplasty). Discuss the physiology of fracture healing (hematoma, granulation tissue, and callus formation). Describe the signs and symptoms of compartment syndrome. List nursing interventions for a fat embolism. List at least two types of skin and skeletal traction. Compare methods for assessing circulation, nerve damage, and infection in a patient who has a traumatic insult to the musculoskeletal system. List four nursing interventions for bone cancer. Describe the phenomenon of phantom pain. Define lordosis, scoliosis, and kyphosis.

Student Assignments Foundations and Adult Health Nursing, Cooper & Gosnell, 7th EditionChapter 43

ATI Learning System PN Module & Practice Test -Medical-Surgical: Musculoskeletal

ATI Content Mastery Series PN- Med/Surg Nursing, 10th Edition Unit 10 Ch. 59 Pg 399-402 Ch. 60 Pg 403-408 Ch. 61 Pg 409-413

ATI Pharmacology Tutorial- Pharmacology Made Easy

Chapter 44: Care of the patient with a Gastrointestinal Disorder Unit Objectives Student Assignments List in sequence each of the parts or segments of the Foundations and alimentary canal and identify the accessory organs of Adult Health digestion. Nursing, Cooper & Discuss the function of each digestive and accessory organ. Gosnell, 7th EditionDiscuss the laboratory and diagnostic examinations Chapter 44 associated with the gastrointestinal system. Identify nursing interventions associated with disorders of ATI Content Mastery the gastrointestinal tract Series PN- Med/ Explain the etiology and pathophysiology, clinical Surg Nursing, 10th manifestations, assessments, diagnostic tests, medicalEdition surgical management, and nursing interventions for the Unit 7 patient with disorders of the mouth, esophagus, stomach, Ch. 39-45 and intestines. Pg 261-313 Identify nursing interventions for preoperative and postoperative care of the patient who requires gastric surgery. Compare and contrast the inflammatory bowel diseases of ulcerative colitis and Crohn’s disease. Identify nursing interventions for the patient with a stoma for fecal diversion.

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Learning Activities

-The Musculoskeletal System

Learning Activities ATI Learning System PN Module & Practice Test -Medical-Surgical: Gastrointestinal ATI Pharmacology Tutorial- Pharmacology Made Easy -The Gastrointestinal System

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Discuss the etiology and pathophysiology, clinical manifestations, assessment, diagnostic tests, medical management, and nursing interventions for the patient with acute abdominal inflammations (appendicitis, diverticulitis, and peritonitis), for the patient with hernias, and for the patient with colorectal cancer. 10. Differentiate between mechanical and non-mechanical intestinal obstruction, including causes, medical management, and nursing interventions. 11. Explain the etiologies, medical management, and nursing interventions for the patient with fecal incontinence.

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Chapter 45: Care of the patient with a Gallbladder, Liver, Biliary Tract, Exocrine Pancreatic Disorder Unit Objectives Student Assignments Learning Activities Discuss nursing interventions for the diagnostic Foundations and examinations of patients with disorders of the gallbladder, Adult Health liver, biliary tract, and exocrine pancreas. Nursing, Cooper & Explain the etiology, pathophysiology, clinical Gosnell, 7th Editionmanifestations, assessment, diagnostic tests, medical management, and nursing interventions for the patient with Chapter 45 cirrhosis of the liver, carcinoma of the liver, hepatitis, liver ATI Content Mastery abscesses, cholecystitis, cholelithiasis, pancreatitis, and Series PN- Med/ cancer of the pancreas. Surg Nursing, 10th Discuss specific complications and teaching content for the Edition patient with cirrhosis of the liver. Unit 7 Define jaundice and describe signs and symptoms that may Ch. 46 occur with jaundice. S...