This is an archived copy of the 2013 Catalog. To access the most recent version of the catalog, please visit http://catalog.jccc.edu.

PN to RN Transition, A.A.S.

Overview
Courses

The LPN to RN bridge program provides those licensed practical nurses wanting to become registered nurses the opportunity to do so. Admission to the program is based on academic criteria.

All licensed practical nurses making application must have completed required general education courses before being accepted.

Following successful completion of the summer transition courses, students are admitted to the third semester of the program. At least 10 openings are available each year. Successful completion of the third and fourth semesters of the program allows the graduate to apply to take the national licensing examination for RNs. The application deadline is Jan. 15.

This program requires a professional liability insurance fee. Students will be notified via their JCCC student e-mail account if they are required to pay a $16 fee. The dollar amount for fees is subject to change.

Note: LPN to RN Transition Students must successfully complete NURS 136 and NURS 228 and NURS 230 before advanced standing credits for NURS 124 and NURS 126 will be granted.

(Major Code 235A; State CIP Code 51.1601)

Nursing

Associate of Applied Science Degree

Prerequisite: Prior to enrolling in NURS 228 and NURS 230

MATH 116	Intermediate Algebra* (or higher)	3
BIOL 144	Human Anatomy and Physiology	5
CHEM 122	Principles of Chemistry	5
ENGL 121	Composition I*	3
PSYC 130	Introduction to Psychology	3
PSYC 218	Human Development*	3
Communications Elective ^{^}		3
Total Hours		25

^	Communications Elective

Summer

NURS 136	LPN-RN Transition Course*	6
Total Hours		6

Note: NURS 136 is not added into the total program hours.

Third Semester

NURS 228	Nursing Care of the Childbearing Family*	5
NURS 230	Nursing Care of Children*	5
SOC 122	Introduction to Sociology	3
or SOC 125	Social Problems
BIOL 230	Microbiology*	3
Total Hours		16

Fourth Semester

NURS 232	Complex Patient Care Management*	9
Humanities Elective ^{^}		3
Health and/or Physical Education Elective ^{^^}		1
Total Hours		13

^	Humanities Elective
^^	Health and/or Physical Education Elective

Note: Total Program Hours include 18 hours APL for NURS 124/NURS 126

Total Program Hours: 72

Courses

NURS 124 Foundations of Nursing (9 Hours)

Prerequisites: Admission to the Nursing Program and current certification in Kansas as Certified Nursing Assistant (CNA) and Cardiopulmonary Resuscitation Certification (CPR) for Health Care Providers and CHEM 122 and MATH 116 or higher level MATH course and corequisite: BIOL 144 and PSYC 130

This course is the first in a sequence of five nursing courses. Students will acquire nursing knowledge and skills necessary to care for patients across the health care continuum. Students will use a critical thinking approach to apply fundamental principles of nursing to patient care. In the clinical component, students will apply theoretical content and therapeutic interventions to patients with health alterations. Course instruction will occur in the classroom, online, in the health resource center and healthcare agencies. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 4 hrs. lecture, 1 hr. lab, 15 hr. clinical/wk.

NURS 124H HON: Foundations of Nursing (1 Hour)

One-credit hour honors contract is available to qualified students who have an interest in a more thorough investigation of a topic related to this subject. An honors contract may incorporate research, a paper, or project and includes individual meetings with a faculty mentor. Student must be currently enrolled in the regular section of the courses or have completed it the previous semester. Contact the Honors Program Office, COM 201, for more information.

NURS 126 Nursing Care of the Adult: Health Alterations (9 Hours)

Prerequisites: BIOL 144 and PSYC 130 and NURS 124 and prerequisite or corequisite: PSYC 218 and corequisite: Communications elective 3 cr hrs.

This course is the second in a sequence of five nursing courses. Students will build on fundamental nursing knowledge and skills acquired in the first nursing course to care for adult patients across the health care continuum. The content will emphasize nursing care of older adults experiencing complex multi-system conditions. The content will also include nursing care for young, middle-aged, and older adults experiencing alterations in mental health. The student will use a critical thinking approach to apply concepts of adaptation, nursing process, therapeutic interactions, communication, and teaching/learning in the care of the culturally diverse patient. In the critical component, students will apply theoretical content and therapeutic nursing interventions to patients with acute and chronic health alterations. Course instruction will occur in the classroom, online, in the health resource center and health care agencies. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 4 hrs. lecture, 1 hr. lab, 15 hr. clinical/wk.

NURS 126H HON: Nursing Care of the Adult: Health Alterations (1 Hour)

NURS 136 LPN-RN Transition Course (6 Hours)

Prerequisites: Completion of LPN program, Current Cardiopulmonary Resuscitation Certificate (CPR) for Health Care Providers and CHEM 122 and MATH 116 or higher and either BIOL 144 or BIOL 140 and BIOL 225 and ENGL 121 and PSYC 130 and PSYC 218

This course is an introduction to the second year of the associate degree nurse (ADN) program for graduates of licensed practical nurse (LPN) programs. The content will emphasize nursing care for patients experiencing alterations in mental health and complex multi-system conditions. The student will use a critical thinking approach to apply concepts of adaptation, nursing process, therapeutic interactions, and teaching learning in the care of the patient. An in-depth examination of physical assessment and psychomotor/communication skills will prepare the student for transition to the associate degree nursing program. Course instruction will occur in the classroom, online, in the Healthcare Simulation Center, in the Health Resource Center, and health care agencies. Theory: 28 clock hours/week for 4 weeks; Clinical: 24 hours/week for 3 weeks.

NURS 228 Nursing Care of the Childbearing Family (5 Hours)

Prerequisites: ENGL 121 and PSYC 218 and NURS 126 and Prerequisite or Corequisites: BIOL 230 and NURS 230 and either SOC 122 or SOC 125

This course is the third or fourth in a sequence of five nursing courses. Students will acquire nursing knowledge and skills necessary to care for the childbearing family. Common alterations, stressors in the family, cultural sensitivity and the art of nursing will be emphasized during the antepartum, intrapartum, postpartum and newborn periods. Students will use principles of therapeutic communication, critical thinking, and teaching/learning to apply nursing process to both normal and high-risk mothers and newborns. In the clinical component, students will apply theoretical content and therapeutic nursing interventions with a caring approach to a culturally diverse population. Course instruction will occur in the classroom, online, in the health resource center and health care agencies. This course will be taken in the same semester with NURS 230, Nursing Care of Children. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 4 hrs. lecture, 1 hr. lab, 15 hrs. clinical/wk.

NURS 228H HON: Nursing Care of Childbearing Family (1 Hour)

NURS 230 Nursing Care of Children (5 Hours)

Prerequisites: ENGL 121 and PSYC 218 and NURS 126 and Prerequisite or Corequisites: BIOL 230 and NURS 228 and either SOC 122 or SOC 125

This course is the third or fourth in a sequence of five nursing courses. Students will acquire nursing knowledge skills necessary to care for infants through adolescents on a continuum of health and adaptation that may result in acute or chronic illness. Students will use principles of therapeutic communication, psychosocial concepts, growth and development, critical thinking, and organization to apply the nursing process to culturally diverse populations. In the clinical component, students will apply theoretical content and therapeutic nursing interventions to infants/children/adolescents with acute and/or chronic health alterations. Course instruction will occur in the classroom, online, in the health resource center and health care agencies. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 4 hrs. lecture, 1 hr. lab, 15 hrs. clinical/wk.

NURS 230H HON: Nursing Care of Children (1 Hour)

NURS 232 Complex Patient Care Management (9 Hours)

Prerequisites: NURS 228 and NURS 230

This course is the last in a sequence of five nursing courses that will enable students to care for patients experiencing complex multi-system health alterations across the health care continuum. Students will use a critical thinking approach to apply concepts of management to a group of patients in a health care setting. This course integrates knowledge and skills acquired in the previous four courses and facilitates student transition to professional nursing practice. In the clinical component, students will apply theoretical content and therapeutic nursing interventions to a group of patients/families with complex, acute and chronic health alterations. Course instruction will occur in the classroom, online, in the health resource center and health care agencies. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 4 hrs. lecture, 1 hr. lab, 15 hrs. clinical/wk.

NURS 232H HON: Complex Patient Care Management (1 Hour)

NURS 234 Registered Nurse Refresher (9 Hours)

Prerequisite: Current or previously licensed as a registered nurse. Corequisite: Current CPR certification for health care providers, professional liability insurance, health and dental records up-to-date, including current immunizations; personal health insurance.

The course will prepare the Registered Nurse (RN) to reenter the acute health care setting for employment after an absence from the patient care arena. The course has a general med-surg focus, and will review adult anatomy and physiology, pathophysiology, pharmacology, lab values and key issues related to patient care. The course includes classroom, lab, simulation, clinical and preceptorship experiences.

NURS 291 Independent Study (1-7 Hour)

Prerequisite: 2.0 GPA minimum and department approval

Independent study is a directed, structured learning experience offered as an extension of the regular curriculum. It is intended to allow individual students to broaden their comprehension of the principles of and competencies associated with the discipline or program. Its purpose is to supplement existing courses with individualized, in-depth learning experiences. Such learning experiences may be undertaken independent of the traditional classroom setting, but will be appropriately directed and supervised by regular instructional staff. Total contact hours vary based on the learning experience.

NURS 124

Title: Foundations of Nursing*
Number: NURS-124
Effective Term: Spring 2009
Course Type: Career
Credit Hours: 9
Contact Hours: 349
Lecture Hours: 115
Lab Hours: 58

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Upon successful completion of this course the student will
demonstrate responsibility for own learning and assumption of the nursing
role.

Identify the nurse’s professional role within the health care system.
Transition from certified nursing assistant to student registered nurse role.
Differentiate between therapeutic and non-therapeutic communication skills.
Utilize therapeutic communication skills.
Perform basic psychomotor skills accurately using standard precautions and principles of asepsis.
Collect data pertinent to the patient’s physical, cognitive, cultural, emotional, spiritual, and maturational status.
Assess the patient in a systematic manner.
Distinguish between normal and abnormal assessment findings.
Formulate beginning level nursing diagnoses based on patient data.
Use critical thinking when planning nursing care.
Plan basic nursing care for the patient with common alterations in health incorporating scientific principles of basic nutrition, elimination, oxygenation, gas exchange, and sensory/perceptual/motor function.
Implement basic nursing care for the patient in a safe, organized, timely manner according to the patient need.
Evaluate patient responses.
Convey information clearly, concisely, and accurately using appropriate terminology in oral, written, and/or computerized format.

*Note:  Specific Unit Objectives are outlined on the Guides to
Learning provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Introduction to the Profession of Nursing and Basic Patient Care
   A. Concepts of Professionalism
      1. Identify own learning needs and how to get focused.
      2. Apply the techniques to establish trust in therapeutic
nurse-patient relationships.
      3. Apply organizational skills to learning and patient care
situations.
      4. Apply active listening techniques in learning and patient care
situations.
   B. Professional Issues
      1. Discuss transition from CNA to RN role according to
responsibilities, knowledge base, and skills.
      2. Discuss effective interaction and collaboration with members of
the health care team.
      3. Discuss the historical development of the profession of nursing.
      4. Differentiate between the functions of professional, state,
national, and specialty organizations.
      5. Discuss the impact of select nursing theories and standards on
the practice of nursing.
      6. Differentiate between types of professional liability.
      7. Discuss the required elements for credible nursing
documentation.
      8. Discuss the healthcare delivery system.
   C. Critical Thinking and Study Skills
      1. Identify the skills and attitudes required for critical
thinking.
      2. Use critical thinking to solve problems in actual and simulated
situations.
      3. Use critical thinking and test-taking strategies to enhance
test-taking abilities.
   D. Wellness-Illness Continuum
      1. Discuss health, wellness, and well-being.
      2. Discuss the effect of illness and disease on the patient.
   E. Physical Assessment
      1. Identify normal and abnormal findings of a basic head to toe
physical assessment.
      2. Discuss the significance of physical assessment as a screening
tool.
      3. Perform and document findings of a basic physical assessment.
   F. Self-Concept, Readiness for Enhanced: Values, Ethics, Cultural
Diversity
      1. Differentiate between self-image and self-esteem.
      2. Discuss the concept of cultural identity and the implications for
safe nursing care.
      3. Examine humanistic values that help define patients and their
life journeys.
   G. Overview of the Nursing Process
      1. Discuss the importance of the nursing process as a model for
delivering quality nursing care.
      2. Discuss how the nursing process, critical thinking, the
problem-solving process, and decision-making are interrelated.
   H. Health-Seeking Behaviors:  Fundamentals of Homeostasis (Rest,
Activity, Hydration, Nutrition)
      1. Explain the rationale for adequate rest, activity, hydration, and
nutrition to maintain homeostasis and optimal functioning.
      2. Assess the health patterns of the patient and how they relate to
maintenance of homeostasis.
      3. Develop a teaching plan for promoting optimal rest, activity,
hydration, and nutrition.
      4. Differentiate isotonic, isometric, aerobic, and anaerobic
exercise.
      5. Discuss how the level of mobility influences self-esteem, body
image, protection/safety, and independence, as well as general physical
and mental health.
   I. Communication, Readiness for Enhanced: Therapeutic Communication
Skills
      1. Identify both verbal and nonverbal components of clear and
effective therapeutic communication.
      2. Discuss the impact of culture on communication style and the
expression of values.
      3. Identify methods of adapting to culturally determined
communication styles.
      4. Demonstrate use of therapeutic communication techniques.
      5. Utilize therapeutic communication techniques based on assessed
patient needs.
   J. Knowledge Deficit: Patient Teaching Concepts
      1. Discuss the importance of the teaching role of the nurse.
      2. Discuss useful teaching strategies for patients of different age
groups and cultures.
   K. Medical Terminology
      1. Define the meaning of common medical terminology.
      2. Use medical terminology appropriately in written documentation.
   L. Nutrition: Overview
      1. Identify the role of the different nutrients and foods.
      2. Discuss how nutrition choices affect health and disease.
      3. Evaluate a diet using the food guide pyramid.
   M. Drug Calculations
      1. Calculate drug dosages and infusion rates accurately using
appropriate conversion factors when indicated.

II. Assessment and Prevention of Health Alterations 
   A. Prioritized Assessment
      1. Discuss criteria for determining assessment priorities in the
clinical setting.
   B. Mental Assessment
      1. Accurately conduct the assessment of affective, cognitive,
interpersonal, and behavioral function.
      2. Organize assessment findings into professionally accepted
categories.
      3. Apply physical and mental assessment principles/techniques to
simulated situations.
   C. Neuro-Physiology
      1. Identify selected physiological responses related to
neurotransmitter activity.
      2. Identify specific foods related to neurotransmitter activities.
   D. Neurovascular Assessment
      1. Identify data that indicates the need for a neurovascular
assessment.
      2. Identify normal and abnormal findings of a neurovascular
assessment.
   E. Managing Patient Behaviors
      1. Utilize behavior management techniques with patients who express
anger or are noncompliant.
   F. Alteration in Comfort: Pain, Nausea, Immobility, and Skin
      1. Discuss the rationale for pain as the 5th vital sign.
      2. Discuss barriers to effective pain management and strategies
being implemented to improve pain management.
      3. Identify basic caring approaches to the management of altered
comfort.
      4. Discuss the classification, actions, side effects, and
implications of common analgesics.
   G. Risk for Infection: Nosocomial Infections and Protective
Precautions
      1. Describe nursing measures to break the chain of infection.
      2. Analyze cases in order to identify measures that prevent
nosocomial infections.
      3. Compare and contrast standard precautions with disease specific
protective precautions.
      4. Demonstrate proper dressing change technique using principles of
asepsis.
   H. Risk for Injury: Medical-Surgical Asepsis
      1. Distinguish between medical and surgical asepsis.
      2. Plan actions to maintain asepsis in the clinical setting using
case analysis.
      3. Demonstrate medical and surgical aseptic techniques.
      4. Identify appropriate barrier precautions for a variety of
simulated situations.
      5. Demonstrate proper application and removal of barrier
devices/materials.
      6. Don sterile gloves accurately and proficiently.
   I. The Nurse-Patient Relationship
      1. Maintain a professional boundary in the nurse/patient
relationship.
      2. Identify the impact of one’s self-concept in relationships.
      3. Implement activities to establish trust in patient care
situations.
      4. Apply appropriate therapeutic techniques to each phase of the
nurse-patient relationship.
   J. Ineffective Coping: Stress/Anxiety Management and Cognitive
Therapies
      1. Utilize techniques to lower the impact of stress.
      2. Apply progressive relaxation techniques accurately for self and
patients.
      3. Differentiate between positive and negative coping strategies in
health and illness.
      4. Apply appropriate cognitive approaches for anxiety reduction.
   K. Anxiety: Crisis Intervention
      1. Identify the components of a crisis and appropriate
interventions.
   L. Therapeutic Regimen Management: Antianxiety Agents
      1. Discuss the actions, side effects, and nursing implications for
common antianxiety medications.
   M. Affective Alterations
      1. Assess mood ranging from normal grief response to major
depression.
      2. Identify behavioral responses to mood alterations.
      3. Select and implement appropriate interventions for patients with
mood disorders.
      4. Identify the actions, side effects, and nursing implications for
common antidepressants.
   N. Risk for Ineffective Protection: Immunity and Hypersensitivity
      1. Describe how disease, vaccines, toxoids, and immunoglobulins
provide immunity.
      2. Discuss the process of hypersensitivity.
   O. Professional Role: Patient Advocacy
      1. Define advocacy.
      2. Discuss the eight dimensions of patient centered care.
      3. Apply principles of critical thinking, active listening, and
professional boundaries to the analysis of patient advocacy cases.
   P. Risk for Injury: Environmental Safety
      1. Identify safety risk factors in the health care environment.
      2. Identify fire alarm safety procedures in clinical agencies.
      3. Discuss principles of electrical, chemical, and biological safety
in the health care environment.
      4. Discuss safety concepts for heat and cold applications.
      5. Discuss safety concepts for applying restraints.
      6. Identify safety hazards in a patient care environment.
   Q. Impaired Immobility
      1. Discuss the effects that immobility imposes on different body
systems.
      2. Assess activity-exercise pattern, activity tolerance, and
potential problems related to impaired mobility.
      3. Identify interventions to promote optimal mobility.
   R. Nutrition: Carbohydrates, Proteins and Lipids
      1. Identify the structure and function of carbohydrates, proteins
and lipids.
      2. Discuss the dietary intake of carbohydrates, proteins, lipids,
and their effects on the body.

III. Basic Concepts of Nursing Care
   A. Therapeutic Regimen Management: Pharmacology Overview
      1. Discuss pharmacodynamics and therapeutics in patients receiving
medication therapy.
   B. Therapeutic Regimen Management: Medication Administration
      1. Demonstrate ability to accurately prepare and administer oral,
ophthalmic, otic, inhaled, topical, rectal, subcutaneous, tubal,
intramuscular and intravenous medications.
      2. Identify critical components of safe and effective medication
administration.
      3. Demonstrate essential steps in safely administering medications.
   C. Fluid Balance: Basic Concepts of Fluids and Electrolytes
      1. Differentiate between normal and abnormal fluid gains and
losses.
      2. Explain the mechanisms that regulate fluid and electrolyte
balance.
   D. Fluid Balance: IV Fluid Administration
      1. Discuss rationale for various IV therapy modalities and the
relevant nursing care for proper administration of IV fluids.
      2. Calculate intravenous infusion rates accurately.
      3. Demonstrate essential steps in safely administering intravenous
fluids and medications.
   E. Management of the Therapeutic Regimen: Nutritional Assessment
      1. Identify patients at risk for nutrition problems.
      2. Discuss methods of obtaining a nutrition history and assessment
of dietary intake.
   F. Nutrition: Readiness for Enhanced
      1. Examine the problems associated with excessive and deficient body
weight.
      2. Identify strategies toward solving the problem of obesity and
maintaining ideal body weight.
      3. Discuss body mass index, central obesity, and causes/risk factors
of obesity.
   G. Imbalanced Nutrition: Less than Body Requirements:  Specialized
Nutritional Support
      1. Determine the appropriate specialized nutritional intervention
based on the patient’s ability to ingest and digest nutrients.
      2. Explain standard guidelines to administer enteral and parenteral
nutrition safely.
      3. Demonstrate tubal feedings and medication administration per
nasogastric and percutaneous epigastric gastrostomy.
   H. Alterations in Nutrition - Eating Disorders
      1. Differentiate between anorexia and bulimia nervosa.
      2. Explain the relationship between eating disorders and self-esteem
needs.
      3. Implement care to increase self-esteem.
   I. Therapeutic Regimen Management: Antibiotics
      1. Discuss the classification, action, side effects, and nursing
implications of antibiotic therapy.
   J. Impaired Skin and Tissue Integrity: Common Alterations in the
Integument
      1. Explain the process of skin breakdown and the related etiology.
      2. Compare the stages of wounds I through IV.
      3. Identify patients at risk for skin breakdown.
      4. Discuss interventions that can reduce or eliminate the
development of skin breakdown.
      5. Describe the wound healing process including factors that impact
the process and wound care treatment.
      6. Apply wound management principles to eliminating etiologic
factors and providing local and systemic support.
      7. Select the appropriate dressings for wounds based on wound
characteristics/staging.
   K. Alterations in Urinary Elimination: Urinary Incontinence, Retention,
Enuresis and Urinary Tract Infection
      1. Identify common urinary abnormalities.
      2. Analyze cases in order to plan interventions for patients with
common alterations in urinary function.
      3. Describe prevention and management for patients with urinary
incontinence, retention, enuresis, and urinary tract infections.
      4. Describe diagnostic studies to detect urinary abnormalities.
      5. Insert an indwelling urinary catheter utilizing aseptic
technique.
   L. Alterations in Bowel Function: Constipation/Diarrhea
      1. Describe common alterations in the gastrointestinal system.
      2. Discuss the medical and/or surgical treatment of common
alterations in the gastrointestinal system.
   M. Nursing Process: Planning Nursing Care
      1. Develop a plan of care using the nursing process and clinical
scenarios.
   N. Risk for Injury: Over-the-Counter Drugs
      1. Develop a teaching plan that identifies information essential for
safe drug therapy in patients using complementary therapies and
over-the-counter drugs.

IV. Nursing Care of the Patient Experiencing Common Alterations in Health:
Part I
   A. Alterations in Bowel Function: Occult Blood, Hemorrhoids,
Gastrointestinal Bleedings, Gastro-Esophageal Reflux Disease (GERD), Bowel
Obstruction, Peritonitis, Diverticulitis, Hiatal Hernia, and Colon Cancer
      1. Describe common alterations in the gastrointestinal system.
      2. Discuss the medical and/or surgical treatment of common
alterations in the gastrointestinal system.
      3. Describe the interventions and patient teaching required for
common alterations in gastrointestinal system.
      4. Differentiate between continent and incontinent ostomy procedures
according to patient characteristics, disease etiology, dietary needs,
medication regimen, bowel or bladder effluent, pouching and irrigation
needs, personal hygiene, and daily activity.
      5. Apply an ostomy appliance using appropriate skin barrier
principles.
      6. Discuss the actions, side-effects, and implications for commonly
prescribed gastrointestinal medications.
   B. Therapeutic Regimen Management: Pre and Post Care following
Diagnostic Procedures
      1. Discuss care to meet the physical, educational, and emotional
needs of patients undergoing diagnostic procedures.
      2. Describe assessments to be conducted in the pre and post
procedural phases.
   C. Therapeutic Regiment Management: Postoperative Care
      1. Identify expected outcomes for the preoperative and postoperative
phases.
      2. Explain rationale for interventions in the pre and postoperative
phases.
      3. Demonstrate nasogastric tube placement and suction for
decompressions of the stomach.
   D. Alterations in Potassium and Sodium Balance
      1. Explain the relationship between sodium and water and how that
impacts management of fluid and electrolyte imbalances.
      2. Select appropriate interventions and activities for common
potassium and sodium imbalances.
   E. Health Seeking Behaviors: Skin Cancer Screening
      1. Identify differences between benign and potentially cancerous
skin lesions.
      2. Discuss a teaching plan that addresses essential aspects of skin
cancer prevention.
   F. Discharge Planning
      1. Discuss the importance of early discharge planning and the
nurse’s role in teaching and communicating discharge information.
      2. Discuss interpersonal strategies that facilitate collaboration
during the discharge process.
   G. Nutrition: Vitamins
      1. Differentiate between water and fat soluble vitamins and food
sources.
      2. Describe roles of fat and water soluble vitamins and
manifestations of deficiency or toxicity.

V. Nursing Care of the Patient Experiencing Common Alterations in Health:
Part II
   A. Impaired Gas Exchange: Pneumonia, Atelectasis, Reactive Airway
Disease, and Pulmonary Embolism
      1. Explain the pathophysiology of and interventions for common
alterations in oxygenation: e.g., pneumonia, aelectasis, reactive airway,
pulmonary embolism.
      2. Discuss management of individuals experiencing alterations in
oxygenation.
      3. Demonstrate proper use of inhalation therapy devices and oxygen
therapy.
      4. Identify the classification, therapeutic effects, side effects,
precautions, and interventions for commonly prescribed respiratory
medications.
   B. Alteration in Safety and Cognition: Seizure Disorders
      1. Explain the pathophysiology of seizures.
      2. Discuss management of individuals with seizures including seizure
precautions, and interventions during a seizure.
   C. Anticonvulsants
      1. Identify mechanisms of action of select anticonvulsants.
      2. Discuss the different uses of anticonvulsants in the clinical
setting (e.g. seizures, pain, dysrhythmias, mood stabilization, headaches,
anger).
   D. Managing the Therapeutic Regimen: Introduction to Diabetes, Insulin
Administration
      1. Discuss pathophysiology of diabetes mellitus.
      2. Describe nursing management of individuals with diabetes
mellitus.
      3. Compare the action, onset, and peak of different types of insulin
and antidiabetic agents.
   E. Ineffective Tissue Perfusion: Impaired circulation
      1. Discuss the pathophysiology of hypertension (HTN), coronary 
artery disease (CAD), angina pectoris, peripheral vascular disease (PVD),
and pulmonary embolism (PE).
      2. Differentiate between the signs/symptoms of common arterial and
venous disorders and the appropriate care.
   F. Managing the Therapeutic Regimen: Drugs Affecting the Cardiovascular
System
      1. Identify uses, side effects, adverse reactions, nursing
implications of drug therapy related to hypertension and CAD, angina
pectoris, PVD, and PE.
      2.Identify the categories of antihypertensive drugs and the
stepped-care approach to management of hypertension.
   G. Health Seeking Behaviors: Cardiac Screening and Prevention
      1. Describe care for patients undergoing common screening and
diagnostic procedures.
   H. Risk for Infection: Infectious Diseases
      1. Identify new and reemerging infectious diseases in the US.   
      2. Discuss why nurses need to be aware of new and emerging
infectious diseases.
      3. Analyze cases in order to identify actions that prevent the
transmission of resistant microorganisms.
   I. Risk for Infection: Sexually Transmitted Diseases
      1. Identify preventive, secondary, and tertiary measures for common
sexually transmitted disease (STD).
   J. Nutrition: Water and Minerals
      1. Describe the role of water in the body and the signs of
deficiency/toxicity for the major minerals: e.g., sodium, chloride,
potassium, calcium, magnesium, phosphorus, iodine, iron.

Method of Evaluation and Competencies:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or Projects
5. Proficiency exams

Grade levels are determined by the nursing faculty and announced at the
beginning of the course. Letter grades are assigned on the following
basis:
     Percent
  A = 89.5% to 100%
  B = 79.5% to 89.4%
  C = 77.5% to 79.4%
  D = 69.5% to 77.4%
  F = < 69.4%
      
Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course.
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives. The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily. Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook. This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required. These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines.
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:

1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to and from clinical settings.
Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

If you are a student with a disability, and if you will be requesting accommodations, it is your responsibility to contact Access Services. Access Services will recommend any appropriate accommodations to your professor and his/her director. The professor and director will identify for you which accommodations will be arranged.

JCCC provides a range of services to allow persons with disabilities to participate in educational programs and activities. If you desire support services, contact the office of Access Services for Students With Disabilities (913) 469-8500, ext. 3521 or TDD (913) 469-3885. The Access Services office is located in the Success Center on the second floor of the Student Center.

NURS 124H

No information found.

NURS 126

Title: Nursing Care of the Adult: Health Alterations*
Number: NURS-126
Effective Term: Spring 2009
Course Type: Career
Credit Hours: 9
Contact Hours: 321.5
Lecture Hours: 88.5
Lab Hours: 41

Description:

Prerequisites: BIOL 144 and PSYC 130 and NURS 124 and prerequisite or corequisite: PSYC 218 and corequisite: Communications elective 3 cr hrs.

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Fees: Students will be assessed fees for national competency exams and
liability insurance.  These fees will be collected each semester as part of
the tuition and fee structure and are non refundable.

Demonstrate responsibility for own learning and assumption of the nursing role.
Demonstrate principles of safety in the health care environment.
Utilize therapeutic communication skills in the health care environment with sensitivity to culturally diverse patients.
Perform psychomotor skills accurately using standard precautions and principles of asepsis.
Utilize a variety of resources for data collection.
Perform accurate physical, psychosocial, sociocultural, and spiritual assessments for patients with acute alterations in health.
Discuss common health problems of the older adult and the physiological changes that occur with those alterations.
Describe cognitive, emotional, and physiological changes that occur in common mental illnesses.
Select nursing diagnoses that reflect the condition and priority need of the patient.
Utilize critical thinking and nursing knowledge to plan nursing care.
Plan nursing care for the patient with complex multisystem alterations in health, incorporating scientific principles of nutrition, pathophysiology, and pharmacology.
Evaluate response of the patient to nursing care using specific, measurable outcomes.
Convey information clearly, concisely, and accurately using appropriate terminology in oral, written, and/or computerized format.

NOTE: Specific Unit Objectives are outlined on the Guides to Learning
provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Professional Issues: Role, Advocacy, Delegation, and Conflict
Management
   A. The role of the nurse
      1. Discuss the role of the nurse within the structure of the health
care team.
      2. Identify members of the health care team to collaborate with when
providing comprehensive care.
   B. Patient care advocacy
      1. Describe how the nurse collaborates with the health care team in
acting as a patient advocate.
   C. Delegation of care
      1. Discuss effective methods of delegating patient care to other
health care workers.
   D. Conflict management
      1. Discuss effective ways to manage conflict in the health care
setting.  
 
II. Nursing Assessment and Management of the Older Adult
   A. Growth and development:  Physical and psychosocial assessment of the
older adult
      1. Discuss techniques and approaches to performing a physical and
psychosocial assessment of an older adult.
      2. Differentiate abnormal assessment findings from those normal
age-related changes.
   B. Pharmacotherapeutics with older adults
      1. Discuss age related variables that effect drug therapy in older
adults with multisystem health alterations.
      2. Discuss drugs commonly used with older adults.
   C. Ethical, moral, sociocultural, and financial issues of older adults
      1. Discuss care related to ethical/moral, sociocultural/financial
issues of the older adults.
      2. Discuss collaboration with members of health care team.

III. Nursing Assessment and Management of the Older Adult with Alterations
in Cardiac Output and Tissue Perfusion
   A. Decreased cardiac output: Myocardial infarction
      1. Describe pathophysiology of decreased cardiac output/excess fluid
volume/ineffective transport and exchange of oxygen, carbon dioxide,
nutrients, waste products, and fluid and electrolytes.
      2. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management for the patient
experiencing a myocardial infarction and related basic arrhythmias.
      3. Discuss teaching and discharge planning for the patient
experiencing myocardial infarction/basic arrhythmias related to
activity/rest, medication, nutrition, and sexual activity.
   B. Fluid volume excess: Congestive heart failure (CHF) and pulmonary
edema
      1. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/nursing management for the patient experiencing
congestive heart failure and pulmonary edema.
      2. Discuss teaching and discharge planning for the patient
experiencing congestive heart failure and pulmonary edema related to
activity/rest, medication, and nutrition.
   C. Ineffective tissue perfusion: Diabetic neuropathic ulcers
       1. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management for the patient
experiencing amputation due to insufficient arterial blood flow to the
extremity.
       2. Discuss teaching and discharge planning related to pain,
immobility, skin integrity, and grieving related to loss of limb. 
 
IV. Nursing Assessment and Management of the Older Adult with Impaired Gas
Exchange and Impaired Spontaneous Ventilation
   A. Impaired gas exchange: Chronic obstructive pulmonary disease (COPD)
      1. Describe the pathophysiology of COPD.
      2. Discuss signs and symptoms, diagnosis, pharmacological therapy,
and the medical/nursing management of the patient with COPD.
      3. Discuss teaching and discharge planning for the patient with COPD
related to activity/rest, medication, and nutrition.
   B. Impaired spontaneous ventilation: Sleep apnea
      1. Describe the pathophysiology of the patient with obstructive
apnea.
      2. Discuss the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management of the patient with
obstructive apnea.
      3. Discuss teaching plan of the patient with obstructive apnea
related to relaxation, nutrition, weight loss, medication, and medical
management.

V. Nursing Assessment and Management of the Adult with Altered Cognitive
and Neurologic Function 
   A. Therapeutic regimen management: The nurse-patient relationship
      1. Identify the components of the nurse-patient relationship.
      2. Discuss the scope of professional boundaries.
      3. Demonstrate professional boundaries in the nurse-patient
relationship.
      4. Discuss the impact of one’s self-concept in relationships.
      5. Implement nursing activities to establish trust, encourage
interaction, promote collegiality and set appropriate limits.      
      6. Implement verbal and nonverbal therapeutic communication skills
that promote effective communication in the mental health setting.
      7. Select and implement therapeutic communication techniques based
on identified patient needs.
      8. Demonstrate appropriate methods of adapting therapeutic
communication skills to cultural differences.
   B. Nursing assessment and management of patients with psychiatric
disorders: Individual therapy
      1. Identify the nurse as a counselor in one to one interactions.
      2. Define and identify types of crisis.
      3. Assess adaptive and maladaptive behavioral responses to crisis
situations.
      4. Discuss modalities of crisis intervention.
      5. Plan interventions for patients in crisis.
      6. Develop an education plan for patients.
   C. Nursing assessment and management of patients with psychiatric
disorders: Group therapy
      1. Define and identify types of groups.
      2. Identify curative factors related to group therapy.
      3. Assess the therapeutic process of a group.
      4. Plan activities for a support group.
      5. Evaluate the effectiveness of a support group.
   D. Therapeutic regimen management: Diagnostic tests/neuro-endocrine
connection 
      1. Describe the findings of commonly used brain imaging techniques.
      2. Differentiate categories of electroencephalogram.
      3. Describe the relationship between selected blood chemistry
findings and mood and behavior.
      4. Identify the nurse’s role in preparation for procedures and
collecting specimens.
   E. Personal disturbance: Bipolar Affective Disorder
      1. Define Bipolar Affective Disorder.
      2. Describe the alterations in affect, speech, perception, and
interactions exhibited by a patient experiencing mania.
      3. Discuss the significance of Milieu Management regarding the care
of a patient experiencing mania vs. the patient who is depressed.
      4. Develop a plan and prioritize the interventions for a patient
experiencing mania.
      5. Evaluate the effectiveness of intervention based on patient
behavioral responses.
   F. Therapeutic regimen management: Mood-stabilizing medications
      1. Describe the action, side effects, signs of toxicity, and nursing
implications for mood- stabilizing medications.
      2. Develop patient teaching strategies for the patient receiving
mood-stabilizing medications.
   G. Altered thought processes: Psychosis
      1. Differentiate schizophrenia and type I and type II subtypes of
schizophrenia.
      2. Describe the subjective and objective symptoms of schizophrenia.
      3. Prioritize interventions and milieu management strategies for
patients with altered cognition.
   H. Therapeutic regimen management: Antipsychotic medications
      1. Describe the actions, side effects, signs of toxicity, and
nursing implications for classic and atypical antipsychotic medications.
      2. Identify early signs of life threatening and irreversible side
effects of antipsychotic medications.
      3. Plan teaching strategies for the patient on antipsychotic
medications.
   I. Therapeutic regimen management: Antidyskinetic medications
      1. Discuss the use of antidyskinetic medications with antipsychotic
medications.
      2. Describe the action, side effects, signs of toxicity, and nursing
implications for antidyskinetic medications.
   J. Degenerative Neurological Function: Altered Memory and Mobility
      1. Describe the pathophysiology of neurological degeneration in
Alzheimer’s and Parkinson’s disease.
      2. Implement nursing care designed to support function, maintain
self-esteem, and decrease risk of injury.
      3. Discuss related medical and surgical treatment options and
related nursing care.
      4. Discuss the implications of long term degenerative illness on the
family.

VI. Nursing Assessment and Management of the Older Adult with Alterations
in Elimination and Metabolism
   A. Alteration in fluid and electrolytes
      1. Explain the concepts related to fluid volume overload and fluid
volume deficit.
      2. Describe the management of hyponatremia, hypernatremia,
hypokalemia, and hyperkalemia.
   B. Imbalanced Nutrition: Less than Body Requirements
      1. Compare the older adult’s nutritional needs to the requirements
of a younger healthy adult.  
      2. Discuss diet therapy for specific needs of the older adult: e.g.,
changes in sodium, potassium, cholesterol, protein, fat, calcium, and
vitamins.
      3. Describe assessment and management of the older adult’s
nutritional diet consideration: e.g., dysphagia, tube feedings, and
medication interactions.
      4. Discuss the assessment and management of the older adult with
iron deficiency, folic acid deficiency and pernicious anemia.
   C. Therapeutic regimen management: Endocrine changes
      1. Discuss the pathophysiology of Diabetes Mellitus and the
chronic,
long-term complications with the older adult: e.g., renal disease,
neuropathies, retinal changes, gastroparesis, and peripheral circulation.
      2. Discuss the administration of hypoglycemic medications, diet, and
nursing interventions to manage alterations in blood glucose levels.
      3. Discuss the care and pharmacology related to alterations in
metabolism with the older adult: e.g., thyroid, adrenal.
      4. Describe the physiological changes and pharmacology of
corticosteroids as they relate to the stress response in the older adult.
   D. Risk for infection: Immune response
      1. Describe the physiological response of the older adult’s immune
system to infections.
      2. Describe the assessment and management of the older adult with an
infection: e.g., tuberculosis.
   E. Impaired urinary elimination
      1. Describe assessment and management of care for the older adult
with chronic renal failure.
      2. Discuss the assessment and management of care of the older adult
with changes in elimination: e.g., urinary retention, renal stones, Benign
Prostatic Hypertrophy (BPH).
   F. Potential complication of cancer
      1. Discuss the assessment and management of care for the older adult
with breast and uterine cancer.
      2. Discuss the assessment and management of care for the older adult
with prostate/testicular cancer.

VII. Nursing Assessment and Management of the Adult with Alterations in
Behavior
   A. Post-Trauma Syndrome
      1. Identify common behavioral responses to prolonged stress and
unresolved fear as it relates to Post Traumatic Stress Syndrome (PTSD).
      2. Compare and contrast physiological and cognitive responses to
profound emotional stress.       
      3. Identify the curative effects of Cognitive Therapy.
      4. Utilize cognitive approaches to reduce the effects of stress.
      5. Differentiate the components of a therapeutic milieu for patients
with PTSD.
      6. Evaluate the effectiveness of interventions based on behavioral
responses.
   B. Therapeutic regimen management: Antianxiety medications
      1. Describe the actions, side effects, signs of toxicity, and
nursing implications for antianxiety medications.
      2. Discuss the potential hazards of dependence on medication to
resolve feelings.
      3. Implement patient teaching strategies for medication therapy.
   C. Ineffective Coping: Psychoactive Substance Abuse
      1. Differentiate substance abuse, dependence, and addiction.
      2. Discuss substances that are highly addictive.
      3. Differentiate between Central Nervous System (CNS) depressants
and stimulants.
      4. Differentiate between signs of life threatening overdose and
withdrawal.
      5. Discuss signs of alcohol toxicity.
      6. Explain the use and effects of narcotic antagonists.
      7. Utilize interventions for the patient who has manipulative
behavior.
      8. Develop a patient care approach that demonstrates respect and
sets limits to inappropriate behavior.
      9. Evaluate the effectiveness of care based on patient behavior.
      10. Discuss the effect of prolonged substance abuse on family
members.
      11. Discuss community-based treatment and support for patients
involved with substance abuse.
   D. Personality Development and Disorder
      1. Identify the characteristics of healthy personality traits.
      2. Differentiate behaviors related to the three personality
clusters.
      3. Identify characteristics of disorders in personality.
      4. Implement nursing care for patients demonstrating manipulative,
withdrawn, aggressive, and self harming behaviors.
      5. Implement nursing care designed to promote a stronger sense of
self-esteem.   

VIII. Nursing Assessment and Management of the Older Adult with
Alterations in Structural and Sensory Processes
   A. Risk for impaired mobility: Alterations in the musculoskeletal
system
      1. Describe alterations in musculoskeletal structure which may lead
to inflammatory and/or degenerative changes.
      2. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management for the older adult
experiencing inflammatory conditions: e.g., Rheumatoid arthritis, Gout,
and degenerative conditions such as Osteoarthritis, Osteoporosis,
Ankylosing spondylosis.
      3. Describe the physiologic responses to immobility.
      4. Compare and contrast the care of patients with joint
replacements, as it relates to the pathophysiology/etiology, signs and
symptoms, and therapeutic management.
      5. Differentiate between acute and chronic pain as it relates to
mobility.
      6. Discuss pharmacologic and nonpharmacologic therapies that can be
used for older adults with pain.
   B. Therapeutic regimen management:  Blood administration
      1. Discuss management of the patient receiving a blood transfusion.
      2. Demonstrate proper technique for blood administration.
   C. Ineffective protection: Alterations in the integumentary system
      1. Identify normal age-related skin changes.
      2. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management of the older adult
experiencing skin alterations: e.g., Psoriasis, Herpes zoster, Actinic
keratosis.
   D. Disturbed sensory perception: Alterations in vision/hearing
      1. Compare normal, age-related sensory changes to abnormal
age-related sensory changes.
      2. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management of older adults with
vision and hearing alterations.

Method of Evaluation and Competencies:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or projects
5. Proficiency exams

Percent
  A = 89.5% to 100%
  B = 79.5% to  89.4%
  C = 77.5% to  79.4%
  D = 69.5% to  77.4%
  F = < 69.4%

Grade levels are determined by the nursing faculty and announced at the
beginning of the course.  Letter grades are assigned on the following
basis:
      
Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course. 
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives.  The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily.  Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook.  This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required.  These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines. 
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:
1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to and from clinical settings.
Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

NURS 126H

No information found.

NURS 136

Title: LPN-RN Transition Course*
Number: NURS-136
Effective Term: Spring 2009
Course Type: Career
Credit Hours: 6
Contact Hours: 199
Lecture Hours: 112
Lab Hours: 15

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Students will be assessed fees for national competency exams and
liability insurance.  These fees will be collected each semester as part
of the tuition and fee structure and are non-refundable.

Demonstrate responsibility for own learning and assumption of the nursing role.
Discuss the philosophy, objectives and expected outcomes of the Registered Nurse (RN) Program.
Demonstrate principles of safety in the health care environment.
Utilize therapeutic communication techniques in the health care environment with sensitivity to culturally diverse patients.
Perform psychomotor skills accurately using standard precautions and principles of asepsis.
Utilize a variety of resources for data collection.
Perform accurate physical, psychosocial, sociocultural, and spiritual assessments for patients with alterations in health.
Describe cognitive, emotional, and physiological changes that occur in common mental illnesses.
Select nursing diagnoses that reflects the condition and priority need of the patient.
Utilize critical thinking and nursing knowledge to plan nursing care.
Plan nursing care for the patient with complex multi-system alterations in health incorporating scientific principles of nutrition, pathophysiology, and pharmacology.
Evaluate response of the patient to nursing care using specific, measurable outcomes.
Convey information clearly, concisely, and accurately using appropriate terminology in oral, written, and/or computerized format.

NOTE: Specific Unit Objectives are outlined on the Guides to Learning
provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Transition From LPN to RN Role
   A. Test-taking strategies
      1. Use critical thinking and test-taking strategies to enhance
test-taking abilities.
   B. Professional issues
      1. Discuss transition from LPN to RN role related to standards of
clinical nursing practice.
   C. Therapeutic regimen management: The nurse-patient relationship
      1. Collaborate with other members of the health care team using a
professional communication style.
      2. Apply the appropriate therapeutic communication techniques based
on identified patient need in the mental health setting.
      3. Demonstrate methods for adapting to culturally determined
communication styles.

II. The Nursing Process
   A. Therapeutic regimen management: Overview of the nursing process
      1. Discuss the importance of the nursing process as a model for
delivering quality nursing care.
      2. Compare and contrast the nursing process, critical thinking,
problem solving, and decision-making models.
      3. Plan care of the patient using the nursing process.
   B. Physical assessment
      1. Discuss normal and abnormal data using head to toe approach to
physical assessment.
      2. Perform physical assessments accurately and professionally.
   C. Mental assessment
      1. Assess the affective, cognitive, interpersonal, and behavioral
function of the patient.
      2. Organize assessment findings to support appropriate nursing
diagnosis.
      3. Apply physical and mental assessment principles/techniques to
simulated situations.
   D. Altered Thought Processes:  Neurovascular Assessment
      1. Identify data that indicates the need for a neurovascular
assessment.
      2. Identify the normal and abnormal findings of a neurovascular
assessment.

III. Nursing Care of the Patient Experiencing Common Alterations in
Health: Part I
   A. Nutrition: Readiness for enhanced
      1. Discuss how nutrition choices affect health and disease.
      2. Evaluate a diet using the recommended daily requirements.
      3. Discuss nursing interventions to promote optimal nutrition.
      4. Discuss the effect of specific foods on neurotransmitters. 
      5. Discuss common drug-diet interactions. 
   B. Therapeutic regimen management: Nutritional assessment across the
lifespan
      1. Identify patients at risk for nutritional problems.
      2. Discuss methods for obtaining a nutrition history.
   C. Imbalance nutrition: Less than body requirements:  specialized
nutritional support: e.g., enteral and parenteral
      1. Determine the appropriate specialized nutritional intervention
based on patients ability to ingest and digest nutrients.
      2. Explain standard guidelines to follow in the delivery of enteral
and parenteral nutrition.
      3. Demonstrate tubal medication administration per nasogastric tube
and percutaneous gastrostomy.
   D. Fluid balance: Basic concepts of fluids and electrolytes
      1. Differentiate between normal and abnormal fluid gains and
losses.
      2. Explain the mechanisms that regulate fluid and electrolyte
balance.
   E. Risk for imbalances fluid volume: Intravenous fluid (IV)
administration 
      1. Administer intravenous fluids (IV) and medications accurately.
      2. Discuss rationale for various IV therapy modalities and the
relevant nursing care for proper administration of IV fluids.
      3. Calculate intravenous infusion rates accurately.
      4. Demonstrate essential steps in safely administering intravenous
fluids and medications.
      5. Demonstrate changing sterile dressing, inserting a foley
catheter, and performing phlebotomy.
   F. Imbalanced fluid volume: Alterations in potassium and sodium
balance
      1. Explain the relationship between sodium and water and how that
impacts management of fluid and electrolyte imbalances.
      2. Select appropriate interventions for common potassium and sodium
imbalances.
   G. Decreased cardiac output: Myocardial infarction
      1. Describe pathophysiology of decreased cardiac output/excess fluid
volume/ineffective transport and exchange of oxygen, carbon dioxide,
nutrients, waste products, and fluid and electrolytes.
      2. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management for the patient
experiencing a myocardial infarction and related basic arrhythmias.
      3. Discuss teaching and discharge planning for the patient
experiencing myocardial infarction/basic arrhythmias related to
activity/rest, medication, nutrition, and sexual activity.
   H. Fluid volume excess: Congestive Heart Failure (CHF) and Pulmonary
Edema
      1. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/nursing management for the patient experiencing
congestive heart failure and pulmonary edema.
      2. Discuss teaching and discharge planning for the patient
experiencing congestive heart failure and pulmonary edema related to
activity/rest, medication and nutrition.
   I. Ineffective tissue perfusion: Diabetic neuropathic ulcers
      1. Describe the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management for the patient
experiencing amputation due to insufficient arterial blood flow to the
extremity.
      2. Discuss teaching and discharge planning related to pain,
immobility, skin integrity, and grieving related to loss of limb.  
   J. Impaired gas exchange: Chronic Obstructive Pulmonary Disease (COPD)
      1. Describe the pathophysiology of COPD.
      2. Discuss signs and symptoms, diagnosis, pharmacological therapy,
and the medical/nursing management of the patient with COPD.
      3. Discuss teaching and discharge planning for the patient with COPD
related to activity/rest, medication, and nutrition.
   K. Impaired spontaneous ventilation: Sleep apnea
      1. Describe the pathophysiology of the individual with obstructive
apnea.
      2. Discuss the signs and symptoms, diagnosis, pharmacological
therapy, and medical/surgical/nursing management of the patient with
obstructive apnea.
      3. Discuss teaching plan of the patient with obstructive apnea
related to relaxation, nutrition, weight loss, medication, and medical
management.
   L. Therapeutic regimen management: Endocrine changes
      1. Discuss the pathophysiology of Diabetes Mellitus and the chronic,
long-term  complications with the older adult:  e.g., renal disease,
neuropathies, retinal changes, gastroparesis, and peripheral circulation.
      2. Discuss the administration of hypoglycemic medications, diet, and
nursing interventions to manage alterations in blood glucose levels.
      3. Discuss the care and pharmacology related to alterations in
metabolism with the older adult:  e.g., thyroid, adrenal.
      4. Describe the physiological changes and pharmacology of
corticosteroids as they relate to the stress response in the older adult.
   M. Risk for infection: Immune response
      1. Describe the physiological response of the older adult’s immune
system to infections.
      2. Describe the assessment and management of the older adult with an
infection:  e.g., Tuberculosis.
   N. Impaired urinary elimination
      1. Describe assessment and management of care for the older adult
with chronic renal failure.
      2. Discuss the assessment and management of care of the older adult
with changes in elimination:  e.g., urinary retention, renal stones,
Benign Prostatic Hypertrophy (BPH).

IV. Nursing Care of the Patient Experiencing Common Alterations in Health:
Part II
   A. Neuro-physiology:  Mind-body connection
      1. Identify selected physiological responses related to
neurotransmitter activity.
      2. Identify specific foods related to neurotransmitter activities.
   B. Ineffective coping: Stress management/anxiety management/crisis
intervention
      1. Utilize techniques to lower the impact of stress.
      2. Apply progressive relaxation techniques for self and patients.
      3. Identify the components of a crisis and appropriate
interventions.
   C. Therapeutic regimen management: Cognitive therapies
      1. Apply the appropriate cognitive approaches for anxiety
reduction.
   D. Therapeutic Regimen Management:  Antianxiety Agents
      1. Describe the action, side effects, sign of toxicity, and nursing
implications for antianxiety medications.
   E. Hopelessness/Risk for Suicide:  Affective Alterations
      1. Assess mood ranging from normal grief response to major
depression.
      2. Implement appropriate interventions for patients with mood
disorders.
      3. Identify behavioral responses to mood alterations.
   F. Therapeutic regimen management: Antidepressants
      1. Describe the actions, side effects, signs of toxicity, and
nursing implications for commonly prescribed antidepressant medications.

V. Nursing Care of the Patient Experiencing Common Alterations in Health:
Part III
   A. Nursing assessment and management of patients with psychiatric
disorders: Individual therapy
      1. Identify the nurse as a counselor in one to one interactions.
      2. Identify types of crisis and interventions.
   B. Nursing assessment and management of patients with psychiatric
disorders: Group therapy
      1. Identify types of groups.
      2. Identify curative factors related to group therapy.
   C. Personal identity disturbance: Bipolar affective disorder
      1. Define Bipolar Affective Disorder.
      2. Describe the alterations in affect, speech, perception, and
interactions exhibited by a person experiencing mania.
      3. Discuss the significance of Milieu Management regarding the care
of a patient experiencing mania vs. the patient who is depressed.
      4. Develop a plan of care prioritizing interventions for a patient
experiencing mania.
      5. Evaluate the effectiveness of interventions based on patient
behavioral responses.
   D. Therapeutic regimen management: Mood-stabilizing medications
      1. Describe the action, side effects, signs of toxicity, and nursing
implications for mood-stabilizing medications.
      2. Discuss the use of anticonvulsant medications as mood-stabilizing
agents.
      3. Identify specific lab studies for mood-stabilizing medications.
      4. Develop patient teaching strategies for patient receiving
mood-stabilizing medications.
   E. Altered thought processes: Psychosis
      1. Differentiate schizophrenia and Type I and Type II subtypes of
schizophrenia.
      2. Describe the subjective and objective symptoms of schizophrenia.
      3. Prioritize interventions and milieu management strategies for
patients with altered cognition.
   F. Therapeutic regimen management: Antipsychotic medications 
      1. Describe the actions, side effects, signs of toxicity, and
nursing implications for classic and atypical antipsychotic mediations.
      2. Identify early signs of life threatening and irreversible side
effects of antipsychotic medications.
      3. Plan teaching strategies for the patient on antipsychotic
medications.
   G. Therapeutic regimen management: Antidyskinetic medications
      1. Discuss the use of antidyskinetic medications with antipsychotic
medications.
      2. Describe the actions, side effects, and signs of toxicity, and
nursing implications for antidyskinetic medications.

VI. Nursing Care of the Patient Experiencing Alterations in Behavior
   A. Post traumatic syndrome
      1. Identify common behavioral responses to prolonged stress and
unresolved fear as it relates to Post Traumatic Stress Disorder (PTSD).
      2. Compare and contrast physiological and cognitive responses to
profound emotional stress.
      3. Identify the curative effects of Cognitive Therapy.
      4. Utilize cognitive approaches to reduce the effects of stress.
      5. Differentiate the components of a therapeutic milieu for patients
with PTSD.
      6. Evaluate the effectiveness of nursing interventions based on
behavioral responses.
   B. Ineffective coping: Psychoactive substance abuse
      1. Differentiate substance abuse, dependence and addiction.
      2. Identify substances that are highly addictive.
      3. Differentiate between Central Nervous System (CNS) depressants
and stimulants.
      4. Differentiate between signs of life threatening overdose and
withdrawal.
      5. Identify signs of alcohol toxicity.
      6. Explain the use and effects of narcotic antagonists.
      7. Utilize interventions for the patient who has manipulative
behavior.
      8. Develop a patient care approach that demonstrates respect and
sets limits to inappropriate behavior.
      9. Evaluate the effectiveness of care based on patient behavior.
     10. Identify the effect of prolonged substance abuse on family
members.
     11. Identify community-based treatment and support for patients
involved with substance abuse.

Method of Evaluation and Competencies:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or Projects
5. Proficiency exams

Percent
  A = 89.5% to 100%
  B = 79.5% to  89.4%
  C = 77.5% to  79.4%
  D = 69.5% to  77.4%
  F = < 69.4%

Grade levels are determined by the nursing faculty and announced at the
beginning of the course. Letter grades are assigned on the following
basis:

Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course. 
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives.  The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily.  Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook.  This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required.  These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines. 
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:

1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to and from clinical settings.
Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

NURS 228

Title: Nursing Care of the Childbearing Family*
Number: NURS-228
Effective Term: Spring 2009
Course Type: Career
Credit Hours: 5
Contact Hours: 156
Lecture Hours: 65
Lab Hours: 16

Description:

Prerequisites: ENGL 121 and PSYC 218 and NURS 126 and Prerequisite or Corequisites: BIOL 230 and NURS 230 and either SOC 122 or SOC 125

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

FEES: Students will be assessed fees for national competency exams and
liability insurance.  These fees will be collected each semester as part of
the tuition and fee structure and are non-refundable.

Independently assume responsibility for own learning and the professional nursing role.
Describe the basic standards of care in maternal-newborn nursing.
Demonstrate therapeutic communication skills with culturally diverse childbearing families.
Perform psychomotor skills accurately using standard precautions and principles of asepsis.
Utilize a variety of resources for data collection including ongoing assessments, medical chart review, as well as collaboration with the health care team.
Perform accurate physical, psychological, sociocultural and spiritual assessments with the childbearing family in the following areas: Antepartum, Intrapartum, Postpartum, and Newborn.
Describe normal maternal and newborn conditions.
Describe common high-risk maternal and newborn complications.
Select nursing diagnoses that reflect the condition and priority needs of the childbearing family.
Plan nursing care specific to the childbearing family utilizing critical thinking and nursing concepts.
Implement safe, effective and caring interventions based on priority needs of the childbearing family.
Implement teaching with the childbearing family based on identified need.
Promote effective parenting skills through family education in collaboration with the health care team.
Assess the childbearing family at risk for domestic violence.
Evaluate the care of the childbearing family using specific, measurable outcomes.
Communicate pertinent observations and patient response to nursing care accurately.

NOTE: Specific Unit Objectives are outlined on the Guides to Learning
provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Foundations of Reproduction, Fertility, Maternity Nursing and Care
of the Antepartum Patient
   A. Professional issues: Maternal newborn nursing
      1. Review basic standards of care.
      2. Discuss ethical and legal issues in maternal newborn nursing.
      3. Discuss the role of the nurse as patient/family advocate.
      4. Demonstrate collaboration with the health team.
   B. Preconception health
      1. Discuss health status prior to conception.
      2. Describe the various reasons for infertility and the modalities
employed to restore fertility.
      3. Discuss genetic issues related to pregnancy.
   C. Reproductive decision
      1. List the means of conception prevention and family planning.
      2. Describe the pathology of abortion and the nursing care
required.
      3. Discuss options of infant relinquishment, abortion, and the
legal/ethical issues encountered.
   D. Care of the antepartum family
      1. Describe the physiological changes of pregnancy and implications
for nursing care.
      2. Discuss benefits of breastfeeding.
      3. Discuss maternal and fetal nutritional needs during pregnancy.
      4. Describe developmental stage, emotional and role changes that
occur during pregnancy for the childbearing family.
      5. Describe cultural assessments and the modifications in care that
may be required.
      6. Discuss the rationale for antepartum testing and diagnostics.
      7. Discuss the rationale for fetal monitoring and surveillance.
      8. Identify complications that may occur in the Antepartum phase of
pregnancy.

II. Care of the Family During the Birth Experience
   A. Care of the intrapartum family
      1. Discuss various childbirth preparation methods.
      2. Discuss developmental, cultural, and psychosocial influences in
labor and delivery.
      3. Describe the stages of labor and the implications for nursing
care.
         a. Identify types of nonpharmacologic and pharmacologic
strategies utilized during the     childbearing process.
         b. Compare the typical signs of non-reassuring fetal heart rate
patterns with reassuring            patterns.
         c. Identify basic standards of care in labor and delivery in the
patient care areas.
      4. Describe complementary therapies utilized during the birth
experience.
      5. Identify complications in the labor/delivery setting and
implications for nursing care for the following types of deliveries:
Induction, Vacuum extractor, Forceps, and Cesarean delivery.
   B. Care of the postpartum family
      1. Describe each of the physiological and psychosocial changes which
occur during the   puerperium.
      2. Discuss the influence of culture during the postpartum period.
      3. Prioritize actions to facilitate effective breast and/or
bottle-feeding.
      4. Prioritize care to assist with parent-infant attachment, sibling
adjustment, and grandparent adaptation.
      5. Describe complications and role changes that may occur during the
postpartum period.
      6. Prioritize care to postpartum patients based on standards of
care.
   C. Care of the newborn
      1. Describe the physiologic and behavioral adaptations of the normal
newborn.
      2. Recognize deviations from normal physiologic findings during
assessment of the newborn.
      3. Discuss the implications of jaundice in the neonate.
      4. Distinguish characteristics of a normal, physiologic event of
hyperbilirubinemia from a hematologic crisis.
      5. Identify priority interventions to promote optimum newborn
nutrition and feeding.
      6. Implement standards of care with well newborns.

III. Care of the High Risk Pregnant Patient
   A. Complications of pregnancy
      1. Discuss predisposing factors, pathophysiology, signs, symptoms,
diagnosis, medical treatment, and nursing care of patients at risk for
pregnancy complications: Preeclampsia, Eclampsia, Disseminating
Intravascular Coagulation, Premature labor, Incompetent cervix, and
medical disorders e.g., Diabetes, Cardiac, Anemia, and Substance abuse.

IV. Care of the High Risk Infant
   A. Newborn complications
      1. Discuss predisposing factors, pathophysiology, signs, symptoms,
diagnosis, medical treatment, and nursing treatment of the premature
infant.
      2. Identify common newborn complications, signs, symptoms,
diagnosis, medical treatment, and nursing care of infants: e.g., Sepsis,
Transient tachypnea of the newborn, and Jaundice.
      3. Describe the treatment and priority care needed for infants born
with withdrawal secondary to intrauterine exposure to substance abuse.
   B. Care for the family experiencing neonatal loss
      1. Describe interventions to meet the needs of childbearing families
experiencing grief.

V. Psychosocial Stressors in the Family
   A. Violence against women/family
      1. Assess for signs of abuse in high risk families.
      2. Evaluate resources available to families experiencing abuse.
      3. Discuss the role of advocate with high-risk families.

Method of Evaluation and Competencies:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or Projects
5. Proficiency exams

Percent
  A = 89.5% to 100%
  B = 79.5% to  89.4%
  C = 77.5% to  79.4%
  D = 69.5% to  77.4%
  F = < 69.4%

Grade levels are determined by the nursing faculty and announced at the
beginning of the course.  Letter grades are assigned on the following
basis:
      
Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course. 
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives.  The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily.  Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook.  This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required.  These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines. 
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:

1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to and from clinical settings.
Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

NURS 228H

No information found.

NURS 230

Title: Nursing Care of Children*
Number: NURS-230
Effective Term: Spring 2009
Course Type: Career
Credit Hours: 5
Contact Hours: 152
Lecture Hours: 41.5
Lab Hours: 14.5

Description:

Prerequisites: ENGL 121 and PSYC 218 and NURS 126 and Prerequisite or Corequisites: BIOL 230 and NURS 228 and either SOC 122 or SOC 125

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

FEES: Students will be assessed fees for national competency exams and
liability insurance.  These fees will be collected each semester as part of
the tuition and fee structure and are non-refundable.

Independently assume responsibility for own learning and assumption of the professional nursing role.
Demonstrate therapeutic communication skills with pediatric patients and families experiencing acute or chronic illness.
Perform psychomotor skills accurately using standard precautions and principles of asepsis in a variety of situations.
Collect data systematically regarding the child’s physical, psychological, maturational, spiritual, and sociocultural status.
Perform accurate physical, psychological, maturational, sociocultural, and spiritual assessments on the pediatric patient and their family system.
Prioritize nursing diagnoses that reflect the needs of the pediatric patient and family.
Plan individualized patient/family care based on knowledge of growth and development, critical thinking, and nursing concepts.
Develop creative nursing care approaches to common pediatric health problems based on the patient and family adaptation to illness.
Implement safe, effective, and caring interventions on priority needs of the pediatric patient and family.
Assume the role of a patient and family advocate.
Evaluate the response of the pediatric patient/family to nursing care using specific, measurable outcomes.
Communicate pertinent observations and patient responses to nursing care accurately.

NOTE: Specific Unit Objectives are outlined on the Guides to Learning
provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Overview of Nursing of Children:  Concepts of Normal Growth and
Development, Health Promotion, Assessment, Safety and Communications.
   A. Professional issues
      1. Review basic standards of care in pediatric nursing.
      2. Discuss ethical and legal issues in nursing care of children.
      3. Discuss the role of the nurse as patient and family advocate.
      4. Demonstrate collaboration with the health team.
   B. Review of growth and development
      1. Discuss the age-related stages of physical, cognitive, and
psychosocial development.
      2. Discuss the interventions related to the care of the child with
failure to thrive.
   C. Therapeutic communication with children and families
      1. Discuss the complexity of the communication process with
pediatric patients.
      2. Utilize strategies and techniques for effective communication.
      3. Utilize therapeutic communication techniques in the health care
environment with sensitivity to culturally diverse children and families.
   D. Health promotion and safety
      1. Review milestones of growth and development for infants to
adolescents.
      2. Discuss rationale for safe/accurate medication administration.
      3. Review concepts of wellness/prevention guidelines of
immunizations, childhood illnesses as it relates to stages of growth and
development.
      4. Discuss the difference in techniques used when assessing
pediatric patients versus adults.
      5. Identify normal and abnormal assessment data while completing a
pediatric assessment.

II. Concepts in Caring for Children Experiencing Alterations in Health,
Part I
   A. Impaired physical mobility: Alterations in cognitive and
neurological function
      1. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, complications, and therapeutic management of
problems of impaired mobility: e.g., Neural tube defects, Scoliosis,
Cerebral Palsy, Hydrocephalus.
      2. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, complications, and therapeutic management of the
child with meningitis.
   B. Decreased cardiac output: Congenital anomalies, sickle cell disease,
hemophilia
      1. Discuss the nursing care, pathophysiology, etiology/risk factors,
signs and symptoms, and therapeutic management of the child with a cardiac
anomaly.
      2. Discuss the nursing care, pathophysiology, genetic pattern, signs
and symptoms, diagnostic evaluation, complications, and therapeutic
management of the child with sickle cell disease and hemophilia.
   C. Impaired gas exchange: Acute and chronic respiratory conditions
      1. Describe the pathophysiology, signs and symptoms, diagnostic
evaluation, and therapeutic management of chronic respiratory conditions:
e.g., Asthma and Cystic Fibrosis.
      2. Manage nursing care for prevention and acute exacerbations of
symptoms of asthma and status asthmaticus.
      3. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, complications, and therapeutic management of the
child with acute respiratory conditions: e.g., Respiratory Synctival Virus
(RSV), Epiglottitis, and Croup.

III. Caring for Children Experiencing Alternations in Health, Part II.
   A. Management of therapeutic regimen: Concepts of nutrition and
metabolism
      1. Discuss the various types and routes of infant feedings.
      2. Discuss the nursing care, pathophysiology, etiology/risk factors,
signs and symptoms, complications, and therapeutic management for the
patient with Type I Diabetes Mellitus.
      3. Discuss the nursing care of the patient experiencing diabetic
ketoacidosis.
   B. Ineffective feeding pattern:  Alteration in oral intake
      1. Discuss the nursing care, etiology/risk factors, complications,
and therapeutic management for the child born with a cleft lip and/or
palate.
   C. Risk for fluid volume deficit/electrolyte imbalance
      1. Discuss the nursing care, pathophysiology, etiology/risk factors,
diagnostic evaluation, complications, and therapeutic management of the
child with acute symptoms: e.g., gastroesophageal reflux, pyloric
stenosis, intussusception, tracheoesophageal fistula, anorectal
malformations, Hirschsprung’s Disease, and appendicitis.
      2. Compare and contrast the physiologic response of the pediatric
vs. adult patient experiencing a fluid and electrolyte imbalance.
      3. Discuss the nursing care, pathophysiology/etiology, and
therapeutic management   of child with a burn.
      4. Describe burn wound characteristics and therapeutic management.
   D. Impaired urinary elimination: Genitourinary alterations
      1. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, and therapeutic management of three types of
nephrotic syndrome.
      2. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, and therapeutic management of vesicoureteral
reflux.
   E. Impaired physical mobility: Musculoskeletal alterations
      1. Describe the different types of fractures and treatment including
casting, surgery, and traction therapy.
      2. Discuss nursing care of the child with a cast or traction
set-up.
      3. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, and therapeutic management: e.g., Juvenile
Rheumatoid Arthritis, Osteomyelitis, Legg-Calve-Perthes, Torticollis,
Slipped Femoral Capital Epiphysis, Club Feet, and Sports Injuries.
   F. Risk for Infection: Alterations in regulatory/defense mechanisms
      1. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, and therapeutic management of the child with
leukemia and lymphoma.
      2. Discuss the nursing care, pathophysiology, signs and symptoms,
diagnostic evaluation, and therapeutic management of nervous system
tumors, bone tumors, solid tumors, Wilm’s tumor, Rhabdomyosarcoma, and
Retinoblastoma.  
   G. Impaired parenting: Psychosocial alterations
      1. Describe the underlying societal and family issues of child
abuse.
      2. Recognize the physical emotional signs of abuse in the child:
e.g., Shaken baby syndrome and head injury.
   H. Potential compromised family coping:  Emotional disorders
      1. Apply nursing process to children and adolescents who have
emotional disorders: e.g., Autism, Attention-Deficit/Hyperactivity
Disorder, Depression/Suicide, Substance Abuse, and Loss/Grief.

Method of Evaluation and Competencies:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or projects
5. Proficiency exams

Percent
  A = 89.5% to 100%
  B = 79.5% to  89.4%
  C = 77.5% to  79.4%
  D = 69.5% to  77.4%
  F = < 69.4%

Grade levels are determined by the nursing faculty and announced at the
beginning of the course.  Letter grades are assigned on the following
basis:

Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course. 
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives.  The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily.  Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook.  This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required.  These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines. 
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:

1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to and from clinical settings.
Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

NURS 230H

No information found.

NURS 232

Title: Complex Patient Care Management*
Number: NURS-232
Effective Term: Spring 2009
Course Type: Career
Credit Hours: 9
Contact Hours: 343.5
Lecture Hours: 90.5
Lab Hours: 45

Description:

Prerequisites: NURS 228 and NURS 230

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

FEES: Students will be assessed fees for national competency exams and
liability insurance.  These fees will be collected each semester as part of
the tuition and fee structure and are non refundable.

Practice in an accountable and responsible manner within the framework of an associate degree nursing graduate managing care to a group of patients/families with complex health alterations.
Identify individual needs for transition to the nursing role and continued professional growth.
Develop a plan of care for patients with chronic and terminal health problems while considering ethical, legal, and moral issues.
Communicate therapeutically in patient care situations to address chronic behavior, complex emotions, and end-of-life conversations.
Perform psychomotor skills accurately to meet the needs of complex patient care situations.
Collect significant patient data systematically and proficiently in order to determine the physiological, psychological, sociocultural and spiritual needs of the patient.
Formulate accurate nursing diagnoses using sufficient critical data.
Plan nursing interventions for complex patient/family care needs using critical thinking and nursing knowledge.
Implement safe and effective care based on changing needs of the patient, family, group, and community needs.
Apply theories of organization and patient care management to care for a group of patients across health care settings.
Evaluate expected patient outcomes in collaboration with the health care team.
Communicate patient information as a member of the multidisciplinary team to improve patient care outcomes.

Note:  Specific Unit Objectives are outlined on the Guides to Learning
provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Professional Issues in Nursing/Nursing Management of Patients with
Altered Cardiac Perfusion and Defense Mechanisms
   A. Professional Issues:  Ethical decision-making and critical thinking
      1. Discuss the principles of critical thinking in nursing.
      2. Discuss nursing ethics and its relationship to common moral
frameworks.
      3. Discuss the nurse’s role in moral situations that arise in the
practice of nursing.
   B. Professional Issues: Health Care Delivery
      1. Discuss the impact of health care delivery systems.
   C. Professional Issues: Caseload Management
      1. Explore interactive and leadership styles among members of the
health care team.
      2. Define accountability in professional nursing practice.
   D. Professional Issues: Leadership/Delegation and Collaboration
      1. Describe the process and principles of
leadership/delegation/collaboration used by the registered nurse with
members of the health care team.
   E. Professional issues: Conflict management
      1. Describe the models of conflict resolution that can be used in
the health care environment to resolve conflict.
      2. Identify potential threats to and strategies for promoting
personal health and well being.
   F. Professional issues: Interviewing
      1. Discuss the formal interviewing process for a graduate nurse
position.
      2. Describe the key components of a resume`and how to communicate
personal and professional skills effectively.
   G. Professional Issues: Role Transition
      1. Discuss transition from student nurse to graduate nurse role.
   H. Decreased cardiac output: Cardiopulmonary resuscitation
      1. Perform basic skills of cardiac resuscitation.
   I. Decreased cardiac output: Cardiac dysrhythmias 
      1.Characterize common dysrhythmias in terms of rate, rhythm,
causation, manifestations, and treatment.
      2. Prioritize collaborative nursing activities for common cardiac
dysrhythmias.
      3. Differentiate between common dysrhythmias seen on
electrocardiogram (ECG) and patient signs/symptoms.
      4. Select appropriate antidysrhythmics for a variety of common
rhythm alterations.
      5. Demonstrate the proper application and use of an automatic
external defibrillator (AED).
   J. Management of the therapeutic regimen: Antidysrhythmic medication 
      1. Discuss medications used to treat common cardiac dysrhythmias.
   K. Decreased cardiac output: Pacemakers, cardioversion, defibrillation,
AED 
      1. Differentiate between defibrillation and cardioversion.
      2. Outline a teaching plan and safety issues for the patient with a
pacemaker or automatic internal cardiac defibrillator.
      3. Identify possible causes of pacemaker malfunctioning.

II. Nursing Management of Patients with Altered Oxygenation and Urinary
Elimination
   A. Risk for infection: Alterations in immune function, deficiency, and
autoimmunity
      1. Describe the structure and function of the immune system.
      2. Discuss immune system abnormalities that place patients at
increased risk for infections. 
      3. Differentiate between altered immune states:  autoimmunity,
primary and secondary immune deficiency. 
   B. Ineffective protection: Human Immunodeficiency Virus (HIV) Infection
and Acquired Immune Deficiency Syndrome (AIDS)
      1. Explain the impact of HIV on immunity. 
      2. Describe the sequence of events leading to immune deficiency from
HIV.
      3. Describe assessment and care of the patient with HIV infection
and/or AIDS. 
   C. Infection: Opportunistic infections in patients with immune
deficiency
      1. List common opportunistic infections occurring with HIV
infection.
      2. Describe care of patients with opportunistic infections.
   D. Management of therapeutic regimen: Antiretroviral therapy for
HIV/AIDS
      1. Discuss indications for the use of anti-retroviral medication.
      2. Describe care for patients receiving anti-retroviral medication.
   E. Risk for ineffective coping: Psychosocial, ethical and legal
implications of HIV/AIDS
      1. Identify ethical and legal issues involved with management of
HIV/AIDS.
      2. Analyze cases to determine personal issues and biases that may
interfere with care provided to patients with HIV/AIDS.
   F. Decisional conflict/risk for spiritual distress - care versus cure
e.g., shifting focus to palliative care  
      1. Discuss ways of eliciting patient/family perspectives on the
extent of disease, goals, and results of treatment.
      2. Describe the transition to palliative care.
      3. Find common hopes with the terminally ill patient.
      4. Discuss cultural influences that impact care. 
   G. Death anxiety - conversations at the end-of-life: e.g., the patient
and family 
      1. Discuss empathic ways to communicate about end-of-life issues.
      2. State common fears of family during the dying process that can be
addressed through therapeutic communication.
      3. Review effective communication techniques for talking with
families managing anger and distrust.
   H. Ineffective breathing pattern: Acute Exacerbated Chronic Obstructive
Pulmonary Disease (COPD)
      1. Differentiate between pulmonary emphysema and other forms of
COPD.
   I. Impaired gas exchange: Acute exacerbated COPD
      1. Describe emphysema according to pathophysiology, gas exchange
dynamics, and clinical manifestations.
   J. Ineffective airway clearance: Acute exacerbated COPD
      1. Develop a plan of care for the COPD patient which includes airway
clearance, mobilization of secretions, controlled coughing techniques,
oxygenation, nutrition, rest/activity, and breathing exercises. 
   K. Impaired gas exchange: Acute Respiratory Distress Syndrome (ARDS)
      1. Compare the etiology and pathophysiology of ARDS with other forms
of respiratory dysfunction.
      2. Describe the clinical progression and complications of patients
with ARDS.
   L. Impaired spontaneous ventilation: (ARDS)
      1. Discuss management of patients with ARDS.  
   M. Impaired spontaneous ventilation: Mechanical ventilation
      1. Differentiate between the various modes of mechanical ventilator
support.
   N. Dysfunctional ventilatory weaning response: Mechanical ventilation
      1. Identify the essential components necessary for successfully
weaning a patient from mechanical ventilation.
   O. Impaired gas exchange: Alterations in respiratory acid-base balance
      1. Identify common causative and contributing factors to respiratory
acid-base imbalances.
      2. Select appropriate nursing activities to prevent and/or minimize
respiratory acidosis or alkalosis.
      3. Discuss the rationale for select medical interventions used to
treat respiratory acidosis or alkalosis.
      4. Explain how the respiratory and renal systems interact to
maintain acid-base balance.
      5. Support arterial blood gas interpretation with scientific
priniciples about oxygenation, gas exchange, and compensation.
      6. Describe care of the patient with an acid-base imbalance.
   P. Decisional conflict: Lung cancer 
      1. Identify the link between smoking and the development of lung
cancer.
      2. Describe the incidence of lung cancer according to cell type.
      3. Describe clinical manifestations and management of the patient
with lung cancer.
   Q. Ineffective Health Maintenance: Smoking Cessation 
      1. Explain how to successfully quit smoking according to current
recommended guidelines.
   R. Potential complications of chest surgery:  Thoracotomy/chest tubes
      1. Differentiate between partial and total lung resection surgery.
      2. Discuss management of the patient with lung resection.
      3. Identify precautions to be observed in the care of patients with
chest tubes and closed drainage system. 
   S. Ineffective Airway Clearance: Tracheostomy Care 
      1. Demonstrate the ability to perform tracheostomy care.
      2. Describe differences between various endotracheal and tracheal
tubes.
      3. Discuss principles and techniques of tracheostomy suctioning. 
      4. Implement tracheotomy and ventilator care.
   T. Excess fluid volume: Acute Renal Failure (ARF).
      1. Describe the etiologies and stages of acute renal failure.
      2. Discuss prevention, assessments, and care of patients during and
after acute renal  failure.
      3. Implement care for the patient with acute renal failure. 
      4. Describe pathophysiological changes that produce the clinical
manifestations of acute  renal failure.
      5. Plan interventions for patients with acute renal failure.
   U. Excess fluid volume: Chronic Renal Failure (CRF)
      1. Differentiate between acute and chronic renal failure. 
      2. Describe assessment and management of patients with chronic renal
failure. 
   V. Management of therapeutic regimen: Dialysis 
      1. Describe assessments and care of patients undergoing hemo or
peritoneal dialysis.
   W. Management of therapeutic regimen: Organ transplantation
      1. Describe the organ donation and procurement process.
      2. Describe care of the patient undergoing organ transplantation.

III: Nursing Management of Patients with Altered Cellular Proliferation
and Homeostasis
   A. Ineffective protection: Alterations in metabolic acid-base balance 
      1. Identify common causative and contributing factors to metabolic
acid-base imbalances.
      2. Select appropriate activities to prevent and/or minimize
metabolic acidosis or alkalosis.
      3. Discuss the rationale for select medical interventions used to
treat metabolic acidosis or alkalosis.
   B. Management of the therapeutic regimen: Diabetes Mellitus 
      1. Discuss the pathophysiology, complications, and management of
patients with diabetes mellitus.
      2. Discuss concepts of multi-organ failure as it relates to
diabetes.
   C. Ineffective protection:  Hypovolemic shock
      1. Discuss the underlying physiological defects occurring in shock
regardless of cause. 
      2. Differentiate between actual and relative hypovolemia.
      3. Describe care of patients during and following shock.
   D. Ineffective protection: Sepsis and septic shock
      1. Differentiate between septic and other forms of shock.
      2. Describe care of patients during and following septic shock.
   E. Risk for allergy response:  Hypersensitivity  
      1. Discuss immune alterations that lead to hypersensitivity.
      2. Describe the underlying physiological alterations that result in
anaphylactic shock.
      3. Describe prevention and care of patients experiencing
hypersensitivities and anaphylactic shock.
      4. Implement care for the patient with hypovolemic, septic, and
anaphylactic shock.
      5. Differentiate between the clinical manifestations of hypovolemic,
septic and anaphylactic shock.
      6. Plan interventions for the patient experiencing shock.
   F. Decreased cardiac output: Advanced Congestive Heart Failure (CHF)
and Cardiovascular Shock 
      1. Correlate the pathophysiology of right and left heart failure
with their clinical manifestations. 
      2. Select appropriate interventions to improve the quality of life
for patients with  advanced heart failure.
      3. Provide rationale for pharmacologic and nonpharmacologic
interventions used in   managing cardiogenic shock.
   G. Ineffective protection: Pathophysiology of the malignant process 
      1. Distinguish between the characteristics of benign and malignant
neoplasms.
      2. Explain the process of grading and staging abnormal
tissue/tumors.
      3. Formulate appropriate nursing diagnoses that address patient
responses to the malignant process.
   H. Hopelessness/powerlessness - Cancer diagnosis: e.g.,  psychological,
spiritual aspects of having cancer
      1. Identify personal biases about cancer and cancer treatment.  
      2. Collect data about family and cultural preferences for care.  
      3. Evaluate the effect of cultural differences on views, behaviors,
and rituals regarding  death and dying.
      4. Discuss specific approaches to patients/significant others
exhibiting emotional responses to a terminal illness.
   I. Managing the therapeutic regimen: Chemotherapy 
      1. Identify nursing diagnoses common to all patients receiving
chemotherapy.
      2. Identify activities to minimize chemotherapy side effects.
   J. Ineffective protection: Internal and external radiation 
      1. Identify interventions to minimize radiation side effects.
      2. Compare and contrast safety principles for use of internal versus
external radiation therapy.
   K. Chronic Pain: End-of-life care and symptom management 
      1. Identify common physical and psychological symptoms associated
with end-of-life processes. 
      2. Discuss interventions that can prevent or diminish symptoms and
improve quality of life prior to death.
   L. Family processes: Interrupted: Preparation and care at the time of
death
      1. Discuss the need for family rituals and memories at the time of
death.
      2. Describe post-mortem nursing care.
      3. Discuss ways in which nursing staff cope with loss and grief.
      4. Describe the multiple nursing roles to improve quality care at
the end-of-life.
      5. Discuss cost containment when providing quality care at the
end-of-life.
      6. Discuss phases of communication that occur with the patient,
family and interdisciplinary team throughout end-of-life care.    
      7. Discuss the role of nurses in advocating for the patients at the
end-of-life.

IV. Nursing Management of Patients with Altered Structural and Metabolic
Processes 
   A. Altered role performance: Collaborating with the health care team
      1. Identify principles of delegation as they apply to the health
care environment.
   B. Ineffective protection- Autoimmunity: e.g., Lupus Erythematosus and
Systemic Sclerosis 
      1. Describe underlying immune defects that occur with autoimmunity.
      2. Describe pathophysiological changes that produce symptoms in
patients with  Systemic Lupus Erythematosus and Systemic Sclerosis.
      3. Describe care of patients with System Lupus Erythematosus and
Systemic Sclerosis.
   C. Disturbed body image/ineffective protection: e.g., Multiple
Sclerosis (MS)
      1. Describe pathophysiological changes that produce symptoms in
patients with MS.
      2. Describe care of patients with MS.
   D. Ineffective protection: Gullian’ Barre Syndrome (GBS)
      1. Describe possible etiologies and pathophysiological changes that
produce symptoms in the person with GBS.
      2. Describe management of patients with GBS.
   E. Impaired gas exchange/Ineffective protection: Myasthenia Gravis
(MG)
      1. Describe pathophysiological changes that produce symptoms in
patients with MG.
      2. Describe management of patients with MG.
   F. Impaired gas exchange/Ineffective protection:  Amyotrophic Lateral
Sclerosis (ALS)
      1. Describe pathophysiological changes that produce symptoms in
patients with ALS. 
      2. Describe management of patients with ALS. 
   G. Disturbed body image/Impaired physical mobility: Spinal cord injury

      1. Distinguish between the signs/symptoms and care measures for the
patient with upper versus lower motor neuron lesion.
      2. Select appropriate interventions for patients in the acute and
chronic phase of spinal cord injury.
   H. Ineffective protection: Liver dysfunction: Cirrhosis and Hepatitis 
      1. Select appropriate nursing diagnoses for patients experiencing
altered metabolism secondary to liver disease.
      2. Select interventions that will assist the patient in adapting to
chronic liver dysfunction.
      3. Compare the incidence, risk factors, transmission, serologic
markers, prophylaxis, safety precautions, and care for patients with
Hepatitis A, B, or C.
   I. Risk for infection: New and reemerging infectious diseases
      1. Identify new and reemerging infectious diseases.
      2. Discuss care of patients with unusual and/or highly infectious
diseases. 
   J. Community coping: Bioterriorism 
      1. Discuss current chemical and biological threats to the United
States.
      2. Describe the role of the nurse in preparing for and during
biological warfare.  
   K. Professional issues: Role transition 
      1. Apply a theory of change to the transition from student to
graduate nurse/registered nurse.

Method of Evaluation and Competencies:

1. Exams
2. Clinical evaluation of application of theoretical concepts
3. Psychomotor/Communication skill proficiencies
4. Assignments and/or projects
5. Proficiency exams

Percent
  A = 89.5% to 100%
  B = 79.5% to  89.4%
  C = 77.5% to  79.4%
  D = 69.5% to  77.4%
  F = < 69.4%

Grade levels are determined by the nursing faculty and announced at the
beginning of the course.  Letter grades are assigned on the following
basis:

Clinical Evaluation:

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course.
Periodic assessment of progress throughout the semester provides the
student with a basis for identifying and meeting course objectives. The
measurement tools enhance student motivation by defining areas of
achievement and areas needing improvement to meet course objectives
satisfactorily. Clinical nursing progress is measured by attainment of
specific objectives as defined by the Clinical Nursing Progress Report
(CNPR) Handbook.  This evaluation may be done in either the clinical
setting or the Health Resource Center.

Proficiency skill check-offs are required.  These check-offs are a part of
the preparation for clinical, are evaluated according to established
criteria and require successful completion by established deadlines. 
Students who fail to demonstrate competency of these skills by deadlines
will be in clinical jeopardy as documented on the CNPR.

Promotion:

Promotion to other nursing courses is based on:

1. A total cumulative score of 77.5% or higher on exams, assignments
and/or projects.
2. Satisfactory completion of clinical objectives as outlined in the
Clinical Nursing Progress Report (CNPR).
3. Completion of proficiency exams.
4. Completion of assignments and/or projects.

Unless withdrawal is made prior to the college withdrawal deadline date,
students who do not receive a passing evaluation in the clinical will
receive a D for the final grade; students whose total exam points fall
below a C will receive the letter grade that corresponds with their final
total points (D or F).

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all nursing students. Contact with assigned patients may only occur while under the direct supervision of clinical faculty. Nursing students may not have any patient contact outside this structured educational setting.
Students entering the nursing program should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nursing students in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner. Please refer to the Health Policy for Health Programs in the Student Handbook.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to and from clinical settings.
Students must maintain current CPR affirmation throughout the program. Upon reaffirmation, the student must bring affirmation of CPR updates to the designated instructor.
Students will need basic word processing and Internet searching skills for the completion of some papers, exercises, and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

NURS 232H

No information found.

NURS 234

Title: Registered Nurse Refresher*
Number: NURS-234
Effective Term: Spring 2010
Course Type: Career
Credit Hours: 9
Contact Hours: 174
Lecture Hours: 63.5
Lab Hours: 50.5

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Fees includes insurance, supplies for lab skills, and use of human
patient simulator.

Practice in an accountable and responsible manner within the framework of the Registered Nurse, managing care of patients/families with complex health alterations.
Identify individual learning needs for transition to the acute health care setting and assumption of the Registered Nurse role.
Perform psychomotor skills accurately to meet the needs of complex patient care situations.
Communicate therapeutically in patient care situations to address patient/family needs.
Collect significant patient data systematically and proficiently to determine physiological, psychological, sociocultural and spiritual needs of the patient.
Develop a plan of care prioritizing nursing interventions to meet patient expected outcomes using critical thinking and nursing knowledge.
Implement safe and effective care based on changing needs of the patient.
Evaluate expected patient outcomes in collaboration with the health care team.
Communicate patient information as a member of the multidisciplinary team to improve patient care outcomes.

Specific unit objectives are outlined on the Guides to Learning
provided for each student at the beginning of each unit.

Content Outline and Competencies:

I. Professional Nursing Issues/Management of Patient Care 
   A. Professional issues: RN role assumption/standards of care
      1. Discuss the ANA standard of care and course competencies.
      2. Discuss the RN responsibilities within the health care system.
   B. Professional issues: risk management 
      1. Discuss the RN role to implement risk management standards. 
      2. Describe high risk patients and strategies to promote safety.
      3. Describe indications for transfer to long-term care facilities
after discharge.
      4. Describe different types of health care reimbursement to plan for
discharge.  
   C. Professional issues: leadership/delegation and collaboration
      1. Describe the process and principles of
leadership/delegation/collaboration to assume the role as a member of the
health care team.
   D. Professional issues: conflict management
      1. Describe the models of conflict resolution that can be used in
the health care environment to resolve conflict.
      2. Identify potential conflicts and strategies for promoting
personal health and management of stress.
   E. Professional issues: legal implications
      1. Describe the legal aspects of the nursing role and patient care
(i.e., consents, health care legislation, restraints, documentation and do
not resuscitate order).
      2. Discuss the Patient Bill of Rights document and implication for
nursing care.
      3. Discuss patient confidentiality while managing patient care. 
   F. Risk for injury: standards of care
      1. Discuss management of the patient environment to promote safety.
      2. Describe nursing interventions to prevent nosocomial infections
and disease specific protective precautions.
      3. Describe safe administrations of medications and intravenous
fluids to prevent errors.
      4. Evaluate pharmacodynamics and therapeutic responses for patients
receiving complex medication therapy.

II.  Nursing Management of Patients with Alterations in Gastrointestinal,
Endocrine and Vascular Response
   A. Alteration in comfort: pain/nausea
      1. Differentiate between acute and chronic pain management.
      2. Describe the pathophysiology of gastrointestinal function and
management of nausea prior to and after surgery.
   B. Nutrition: less than body requirements
      1. Differentiate between acute and chronic gastrointestinal
alterations.
      2. Describe the pathophysiology of intestinal obstruction.
   C. Fluid volume imbalance: risk for
      1. Describe the fluid needs and losses of a patient with a bowel
obstruction and/or a chronic inflammatory gastrointestinal process.
   D. Management of the therapeutic regime: ulcerative colitis
      1. Discuss the pathophysiology, complications and management of
patients with ulcerative colitis.
   E. Management of the therapeutic regimen: diabetes mellitus 
      1. Discuss the pathophysiology, complications and management of
patients with diabetes mellitus.
   F. Ineffective tissue perfusion: impaired circulation
      1. Discuss the pathophysiology of hypertension episodes and
management of blood pressure.
   G. Ineffective protection: hypovolemic shock
      1. Discuss the underlying physiological defects occurring in shock
regardless of cause.
   H. Psychosocial response
      1. Describe stress management in relation to health alterations and
lifestyle changes. 
      2. Describe the alterations in affect, speech, perception, and
interactions exhibited by a patient experiencing depression.      

III. Nursing Management of Patients with Altered Oxygenation, Peripheral
Vascular Function, Endocrine and Immune Response
   A. Risk for infection: alterations in immune function and deficiency
      1. Describe the structure and function of the immune system.
      2. Discuss immune system abnormalities that place patients at
increased risk for infections. 
      3. Differentiate between altered immune states:  autoimmunity,
primary and secondary immune deficiency.
   B. Impaired gas exchange: acute exacerbated Chronic Obstructive
Pulmonary Disease (COPD)
      1. Describe COPD according to pathophysiology, gas exchange dynamics
and clinical manifestations.
      2. Differentiate between COPD and other forms of chronic respiratory
alterations.
      3. Describe acute signs of respiratory distress and management.
   C. Ineffective airway clearance: acute exacerbated COPD
      1. Develop a plan of care for the COPD patient which includes airway
clearance, mobilization of secretions, controlled coughing techniques,
oxygenation, nutrition, rest/activity and breathing exercises. 
   D. Management of the therapeutic regimen: diabetes mellitus 
      1. Discuss the pathophysiology, complications and management of
patients with diabetes mellitus.
      2. Discuss concepts of multi-organ failure as it relates to
diabetes.
   E. Ineffective tissue perfusion: impaired circulation
      1. Discuss the pathophysiology of hypertension, coronary artery
disease and peripheral vascular disease.
      2. Describe the impact of cardiac and vascular changes in relation
to an altered arterial blood gas.
    F. Impaired mobility: rheumatoid arthritis
      1. Describe the pathophysiology and management of altered joint
function as related to an immune response.
   G. Psychosocial response  
      1. Differentiate between positive and negative coping strategies in
health/illness.
      2. Describe anxiety management techniques for patients with acute
and chronic illnesses.
      3. Describe factors that influence patient’s acceptance and
therapeutic management of the illness.

IV. Nursing Management of Patients with Altered Cardiac Perfusion and
Immune Dysfunction
   A. Decreased cardiac output: myocardial infarction
      1. Describe the pathophysiology of decreased cardiac output, excess
fluid volume, and ineffective transport and exchange of oxygen, nutrients,
waste products fluid and electrolytes.
      2. Describe the sign and symptoms, diagnosis, pharmacological
therapy and management of the patient experiencing myocardial infarction
and related basic arrythmias. 
      3. Discuss electrolyte imbalance and management of potential cardiac
dysrythmias.
   B. Ineffective protection: Human Immunodeficiency Virus (HIV) Infection
and Acquired Immune Deficiency Syndrome (AIDS)
      1. Explain the impact of HIV on immunity. 
      2. Describe the sequence of events leading to immune deficiency from
HIV.
      3. Describe assessment and care of the patient with HIV infection
and/or AIDS. 
   C. Risk for ineffective coping: psychosocial, ethical and legal
implications of HIV/AIDS
      1. Identify ethical and legal issues involved with management of
HIV/AIDS.
      2. Analyze cases to determine personal issues and biases that may
interfere with care provided to patients with HIV/AIDS.

V. Nursing Management of Patients with Altered Cardiac and Cerebral
Perfusion, Neurological Function and Musculoskeletal Function
   A. Fluid volume excess: Congestive Heart Failure (CHF) and Pulmonary
Edema
      1. Describe the signs and symptoms, diagnoses, pharmacological
therapy and management for the patient experiencing congestive heart
failure and pulmonary edema.
      2. Discuss the teaching needs related to activity/rest, medication
and nutrition.
      3. Correlate the pathophysiology of right and left heart failure
with clinical manifestations.
   B. Tissue perfusion: altered cerebral
      1. Discuss the pathophysiology, risk factors, signs and symptoms,
pharmacological therapy and management for the patient experiencing
cerebral vascular accident.
      2. Discuss management of impaired memory, communication patterns and
psychosocial needs of the patient.
   C. Alterations in potassium and sodium
      1. Discuss the relationship between sodium and water and management
of imbalances.
      2. Select appropriate interventions for the type of potassium and
sodium imbalance. 
      3. Discuss the implications of digoxin toxicity and electrolyte
imbalance.
   D. Physical mobility: impaired
      1. Describe the signs and symptoms, diagnosis, pharmacological
therapy and management for the patient experiencing inflammatory vs.
non-inflammatory degenerative musculoskeletal system.
      2. Differentiate the common motor and sensory impairments manifested
with altered cerebral perfusion.      
   E. Psychosocial response
      1. Discuss the impact of transition of independent living to long
term care facility for the older adult.
      2. Discuss the changes in family dynamics and roles when caring for
older adult.
      3. Describe the potential for anticipatory grief process with acute
health alterations.

VI. Nursing Management of Patients with Altered Renal Function, Altered
Blood Function and Infectious Hepatic Function
   A. Excess fluid volume: Chronic Renal Failure (CRF)
      1. Differentiate between acute and chronic renal failure. 
      2. Describe assessment and management of patients with CRF. 
   B. Management of therapeutic regimen: dialysis 
      1. Describe assessments and care of patients undergoing blood or
peritoneal dialysis.
   C. Activity intolerance: impaired
      1. Compare and contrast signs and symptoms and management of
different types of anemias and blood dyscrasias.
   D. Ineffective protection: liver dysfunction: Cirrhosis and Hepatitis 
     1. Select appropriate nursing diagnoses for patients experiencing
altered metabolism secondary to liver disease.
     2. Select interventions that will assist the patient in adapting to
chronic liver dysfunction.
     3. Compare the incidence, risk factors, transmission, serologic
markers, prophylaxis, safety precautions and care for patients with
Hepatitis A, B or C.
   E. Psychosocial response
      1. Discuss the potential for family violence and dysfunction with
stress from alterations in health.
 
VII. Nursing Management of Patients with Acute Blood Disorder, Acid-Base
Imbalance, Hypoxemia and Infectious Process
    A. Ineffective protection: alterations in metabolic acid-base balance

      1. Identify common factors of metabolic acid-base imbalances.
      2. Select interventions to prevent and/or minimize metabolic
acid-base imbalances.
      3. Discuss the rationale for selected interventions used to manage
metabolic acid-base imbalances.
   B. Risk for injury: Thrombocytopenia
      1. Describe the pathophysiology of altered blood products in
relation to the transport and exchange of oxygen, nutrients, immune
function, and fluid and electrolytes.
      2. Describe the sign and symptoms, diagnosis, pharmacological
therapy and management of the patient experiencing acute leukemia and
related complications.   
   C. Ineffective protection: Sepsis and Septic Shock 
      1. Differentiate between septic and other forms of shock.
      2. Describe care of patients during and following septic shock.
   D. Ineffective coping: substance abuse
      1. Discuss the pathophysiology and management of the patient with
alcohol dependence.
      2. Discuss signs of alcohol toxicity.
      3. Discuss the effect of prolonged substance abuse on patient
behavior and family members.
   E. Hopelessness/powerlessness 
      1. Discuss specific approaches to patients/significant others
exhibiting emotional responses to a newly diagnosed cancer.
      2. Describe the potential for anticipatory grief process with acute
health alterations.

VIII. Nursing Management of Patient with Altered Immune and Renal
Function, Infectious Process and Cardiovascular/Respiratory Compromise
   A. Ineffective protection: autoimmunity 
      1. Describe underlying immune defects that occur with autoimmunity.
      2. Describe physiologic changes that produce symptoms in patients
with systemic lupus erythematosus and systemic sclerosis.
      3. Describe care of patients with system lupus erythematosus. 
   B. Excess fluid volume: Acute Renal Failure (ARF)
      1. Describe the etiologies and stages of acute renal failure.
      2. Discuss prevention, assessments and care of patients during and
after ARF.
      3. Describe pathophysiological changes that produce the clinical
manifestations of ARF.      
   C. Impaired gas exchange: alterations in respiratory acid-base balance

      1. Identify common factors of respiratory acid-base imbalances.
      2. Select interventions to prevent and/or minimize respiratory
acid-base imbalances.
      3. Discuss the rationale for selected interventions used to manage
respiratory acid base imbalances.
      4. Describe how the respiratory and renal systems interact to
maintain acid-base balance.
      5. Support arterial blood gas interpretation with scientific
principles about oxygenation, gas exchange and compensation.   
   D. Risk for allergy response: hypersensitivity  
      1. Discuss immune alterations that lead to hypersensitivity.
      2. Describe the underlying physiological alterations that result in
anaphylactic shock.
      3. Describe prevention and care of patients experiencing
hypersensitivities and anaphylactic shock.
      4. Compare and contrast care for the patient with hypovolemic,
septic and anaphylactic shock.
   E. Psychosocial response
      1. Discuss the management of individual stress and implications for
health.
             
IX. Professional Issues/Management
   A. Altered role performance: collaborating with the health care team
      1. Identify principles of delegation as they apply to the health
care environment.
   B. Professional issues: role transition 
      1. Apply a theory of change to the transition for registered nurses
to enter the acute care setting.
   C. Decisional conflict/risk for spiritual distress - care versus cure,
e.g., shifting focus to palliative care  
      1. Discuss ways of eliciting patient/family perspectives on the
extent of disease, goals and results of treatment.
      2. Describe the transition to palliative care.
      3. Find common hopes with the terminally ill patient.
      4. Discuss cultural influences that impact care.
   D. Death anxiety - conversations at the end-of-life: e.g., the patient
and family 
      1. Discuss empathic ways to communicate about end-of-life issues.
      2. State common fears of family during the dying process that can be
addressed through therapeutic communication.
      3. Review effective communication techniques for talking with
families managing anger and distrust.
   E. Chronic pain: end-of-life care and symptom management 
      1. Identify common physical and psychological symptoms associated
with end-of-life processes.
      2. Discuss interventions that can prevent or diminish symptoms and
improve quality of  life prior to death.
   F. Family processes interrupted: preparation and care at the time of
death
      1. Discuss the need for family rituals and memories at the time of
death.
      2. Discuss ways in which nursing staff cope with loss and grief.  
      3. Describe the multiple nursing roles to improve quality care at
the end of life.
      4. Discuss phases of communication that occur with the patient,
family and interdisciplinary team throughout end-of-life care.
      5. Discuss the role of nurses in advocating for patients at the end
of life.

X. Independent Modules: Skills and Proficiencies
   A. Drug/intravenous  dose calculation proficiency exam
      1. Calculate complex drug and intravenous calculations accurately.
   B. Pharmacology proficiency exam
      1. Compare and contrast drug classifications in regards to action,
side effects and nursing interventions to manage patient symptoms.
   C. Psychomotor skills
      1. Perform the following skills safely and accurately using aseptic
technique with rationale to adapt skills to specific patient situations:
         a) Physical assessments
         b) Medication administration
         c) Intravenous access and administration of fluids by gravity or
with infusion pumps
         d) Infusions of total parenteral nutrition, blood products
         e) Dressing changes: sterile and clean technique
         f) Foley catheterizations
         g) Nasogastic tube placement 
         h) Gastrostomy tube feedings and medication administration
         i) Airway management
         j) Cardiac monitoring

Method of Evaluation and Competencies:

 1. Exams                           70-90% of grade
 2. Assignments and/or projects     10-30% of grade 
                                    ----------------
    Total:                           100%
      
The following will be graded Pass/Fail:         
 3. Clinical evaluation of application of theoretical concepts      
 4. Psychomotor/communication skill proficiencies
 5. Proficiency exams

The course is graded on a pass/fail basis. The passing grade will be a
cumulative grade of 80% for assignments and exams. The passing grade for
proficiency exams will be 100%.
      
Clinical Evaluation 

Clinical performance is graded on a pass/fail basis.  Clinical performance
must be satisfactory in order to receive a passing grade for the course.
Periodic assessment of progress throughout the course/preceptorship
provides the student with a basis for identifying and meeting course
objectives. This evaluation may be done in either the clinical setting or
the Health Resource Center.

Proficiency skill check-offs are required. These check-offs are a part of
the preparation for clinical, and require successful completion by
established deadlines. Students who fail to demonstrate competency of
these skills by deadlines will need to repeat those proficiency skill
check-offs.

Caveats:

Strict confidentiality of patient information is an unconditional expectation for all students. Contact with assigned patients may only occur while under the supervision of mentorship faculty.
Students must have on file prior to starting clinical/preceptorship a current physical exam, TB skin test, and additional vaccines as dictated by the clinical agency.
Students should be aware that they will be in close contact with other individuals having a variety of health problems in which the etiology (cause) may or may not be known. This exposure places nurses in the “high risk” category for health problems. Students in the program assume responsibility for their own health and care under all circumstances (pregnancy, orthopedic problems, infection, etc.). Course objectives and clinical assignments must be met in a satisfactory manner.
Clinical/field agencies and state certification application may require drug screening and a criminal background check. Additional requirements and/or disclosures may become necessary throughout the course of the program. Any non-compliance with these mandates may result in termination from the program. Any fees associated with these mandates will be the responsibility of the student.
Students are expected to provide their own transportation to class/clinical settings.
Students must maintain current CPR accreditation.
Students will need basic word processing and Internet searching skills for the completion of online assignments and projects.
Any form of academic dishonesty results in a zero grade for the exam, project or assignment. See college catalog under Student Code of Conduct for examples of cheating. The exam, project or assignment may not be made up, and college expulsion policy applies.

Student Responsibilites:

Disabilities:

NURS 291

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