Nurs 2229: Nursing Care of Adult Ii

NURS 2229: NURSING CARE OF ADULT II Fall 2015

SYLLABUS

NURS2229_Fall2015 [1] Oklahoma State University Institute of Technology Face to Face Syllabus Fall 2015

NURS 2229 Nursing Care of Adults II Focuses on the provision of advanced care for adult clients in complex settings. The student demonstrates an internalization of the nursing process in the coordination of care for individuals and groups of clients. In the roles of provider and manager of care the student provides the opportunity to practice accountability for their own nursing judgments and actions. The clinical component utilizes theory from NURS 2229. Selected clinical experiences provide management and critical care opportunities for the student to apply concepts, principles, and skills acquired in related theory classes. Theory and campus laboratory skills/simulation enable the student to provide management and critical care for adult clients in complex settings.

Type of course Theory and Practicum Credit Hours 5 ½ credits hours Theory = 5 ½ hours weekly ½ credit hour skill lab = 1 hour weekly 3 credit hours clinical = 9 hours weekly Class Length Full Semester Meeting Time: Wednesday 1130-1400, Thursday 0900-1200 Clinical and simulation lab hours as assigned Pre-requisite: Fundamentals of Nursing NURS 1128 Dosage Calculation NURS 1322 (or equivalent, received approval) Nursing Care of Families NURS 1229 Nursing Care Adult I NURS2129 Co-requisite: NURS 2222 Nursing Capstone Seminar Instructor: Chrissi Martin MS, MBA, RN Phone: 918-293-4789 Office: AHS #106 E-mail:[email protected] Contact: My preferred method of contact is email. Please allow 24-48 hours to return your correspondence during the normal work week. Office Hours: Thursday 1300-1500 CST Friday 0900-1200 CST

Division Name: School of Nursing and Health Sciences Division’s Main Phone: 918-293-5339

2 Required Text: Text: Lewis, Dirksen, Heitkemper, Bucher, Camera. (2011). Medical Surgical Nursing Assessment and Management of clinical problems (9th Ed.) St. Louis, Mo Elsevier, E-text ISBN 97803232261869 Recommended Text: Silvestri, Linda A. (2014). Saunders comprehensive review for the NCLEX-RN Examination (6thEd.). St. Louis, MO: Elsevier. ISBN 9781455727551

Reference: Students are expected to utilize current (published in the last 5 years) nursing texts/resources including but not limited to: drug handbook; lab/diagnostic test handbook; medical dictionary; nursing diagnosis manual; Kaplan review book Materials: iPad2, Note-taking materials; email and internet access Uniform/Tools: OSU scrubs and assessment tools. Estimated Cost for Materials: approximate $150

Upon completion of the course, students should:

STUDENT LEARNING COURSE ASSESSMENT OF OUTCOMES OBJECTIVES COMPETENCY Patient-centered care—graduate Provide patient centered care by Major exams, simulation recognizes the patient as the source performing evidence based nursing lab performance of control and full partner in interventions, including teaching, evaluation form, providing compassionate and that are appropriate for diverse practicum written coordinated care based on respect patient populations with multiple assignments, clinical for the patients’ preferences, values and complex healthcare needs. evaluation form, & Kaplan and needs. Integrated Tests Teamwork and collaboration— Contribute to the ethical decision graduate functions effectively making process within boundaries within nursing and inter- as a contributing member of the professional teams, fostering open healthcare team. communication, mutual respect and shared decision-making to achieve quality patient care. Evidence based practice— Participate in research team graduate integrates best current activities using interpreted evidence with clinical expertise nursing research findings to and patient/family preferences improve patient care and patient and values for delivery of optimal safety. health care.

NURS2229_Fall2015 [3] Quality improvement—graduate uses Utilize research from quality data to identify errors and hazards in improvement studies to improve care and monitor the outcomes of care patient care and safety. processes and uses improvement methods to design and test changes to continuously improve the quality and safety of health care systems. Informatics – graduate uses Evaluate ways in which future information and technology to technology might improve patient communicate, manage knowledge, care and safety. mitigate error and support decision making. *Aspects of the competency assessments may be used in the university’s assessment of student learning and/or assessments for Oklahoma Board of Nursing and National League for Nursing Accrediting Commission, Inc.

COURSE ACTIVITIES In this course students will:  Prepare for class by completing assigned readings and activities and turn in assigned Kaplan test prior to class  Participate in class discussion and activities  Work in groups to develop and refine concepts  Participate in group and individual presentations  Develop, implement, and evaluate nursing plans of care  Participate in all assigned practicum experiences  Complete all independent assignments

EVALUATION

Grade will be comprised of major exams; passing requires a 75% exam average or better AND a satisfactory clinical grade. GRADES WILL NOT BE ROUNDED.

Exam 1: Neurology 100 Exam 2: Endocrine 100 Exam 3: Musculoskeletal & Integumentary 100 Exam 4: Trauma and Disaster/ICU 100 Exam 5: Hematology/ Immunity 100 Total Points 500

*The student’s grade average for exams will be used in the university’s assessment of student learning. A 75% average or higher receives a Pass rating. This Pass/Fail rating is independent

4 of the student’s course grade. Please refer to the “ Gradebook” for accurate grades and not the progress grade listed in D2L.

Exam grades will be posted in D2L no later than 2 business days following the exam. Any adjustments made to test items following the exam review and student comment opportunity will be posted prior to the following exam. No grades will be released via e-mail, phone or personal other personal correspondence.

Successful completion of Nurse Practicum (pass/fail) as specified below. Simulation lab-satisfactory performance (pass/fail) Practicum written assignments: passing average of 75% or better 1 case study 100 points 1 Leadership paper 100 points 11 clinical papers 1100 points Community project 100 points

Total points available 1400 points

Clinical--Must receive a satisfactory clinical performance grade to pass (See clinical evaluation form).

AUTHORIZED TOOLS Students may use any/all course materials, including books and notes, while completing in class assignments. All written assignments are to be completed independently unless directed otherwise (e.g. group projects); no collaboration with classmates is permitted and any instance of such will be considered academic dishonesty. This does not apply to major examinations given throughout the course. Refer to the Nursing Student Handbook under Testing for guidelines.

TESTING Major examinations are scheduled in the course syllabus and will be announced at least one week in advance. It is not reasonable to expect that examinations be rescheduled except in the case of an EMERGENCY absence, e.g. death in the immediate family or significant illness of the student. In case of an EMERGENCY absence, the student must notify the instructor prior to the test time, and the instructor reserves the right to give an alternate examination. Failure to make arrangements (within 24 hours) for a make-up test will result in a grade of “zero” recorded for the examination missed. If an exam is rescheduled for a non-emergency absence, 5 percentage points per calendar day will be deducted from the student’s test score. Bring appropriate documentation (e.g., doctor’s statement, obituary) to avoid losing points. Refer to the Nursing Student Handbook under Testing for additional guidelines. Students in NURS2229 Are allotted 75 seconds per exam question.

NURSING STUDENT HANDBOOK The Nursing Student Handbook is provided to all nursing students through D2L on the Content page. It is the student’s responsibility to be familiar with the policies within the handbook. If you have questions concerning the handbook or you are unable to access the handbook contact

NURS2229_Fall2015 [5] your instructor.

KAPLAN INTEGRATED TESTING PROGRAM In order to aid in the progression and success of our students, while lowering our program’s attrition rate and strengthening the NCLEX-RN pass rate, OSU Institute of Technology Nursing Program has implemented Kaplan Integrated Testing Program for nursing schools. Kaplan Integrated Testing Program is comprised of a series of secure online tests designed to evaluate the knowledge of students in a basic nursing curriculum leading to RN licensure. The results enable nursing faculty to identify students with knowledge deficits in specific content areas, so that early interventions can be implemented in order to positively influence student outcomes. Kaplan Integrated Tests will be given in appropriate semesters as outlined in the student handbook. Students should be aware that their ability to pass the NCLEX-RN is strengthened by their ability to pass each series of test. Scores will be reviewed on an individual basis and counseling will be provided as necessary.

In order to better prepare students for the Integrated Tests students will be required to complete the Focused Review Tests applicable to the Integrated Test. In order to receive credit for completion of the Focused Review Tests the student must score at least 65% correct and remediate for 60 seconds on all questions. Students will not be allowed to complete the Integrated Test until the assigned Focus Review Tests and remediation are completed.

Focused Review Test given this semester

1. Neurology 2. Endocrinology 3. Musculoskeletal/ Integumentary 4. Fluid and Electrolytes 5. Burns 6. Management

Students not completing the exam and any required remediation as assigned will receive an “I” for incomplete until the assignment has been submitted and approved.

Students that are not successful on the nurse assessment test will remediate the exam and re-take the nurse assessment test until the 55th percentile ranking is achieved. An alternate exam format will be scheduled for second and third attempts. The third exam if needed and able to schedule – time allowing - will be scheduled the last week of the semester. If it can’t be scheduled the last week due to previous time commitments, it will be scheduled the following Monday, after the end of the semester at 10:00 a.m. Individual examinations will not be scheduled. Students that are not successful on the nurse assessment test will receive an “I” in the course until the student achieves a 55th percentile ranking on the nurse assessment test and remediation occurs. Students will receive an “I” until all assigned remediation is completed and turned in.

Integrated test given this semester are 1. Kaplan Management- less than 55th percentile requires remediation

6 2. Kaplan Diagnostic -less than 55 percent requires remediation (this exam does not give a percentile ranking) 3. Kaplan Nurse assessment test- less than 55th percentile ranking requires remediation and re-take the exam. Instructor will provide the student with the percentile ranking of the nurse assessment test 4. Kaplan Predictor – No remediation required 5. Kaplan Critical Thinking 2- No remediation required 6. Kaplan Medical Surgical Comprehensive - less than 55th percentile requires remediation 7. Kaplan Trainer 1, Trainer 2, Trainer 3, Trainer 4, and Trainer 5, -less than 55 percent requires remediation (this exam does not give a percentile ranking) 8. Complete a minimum of 365 Q-bank test questions by 12/07/15 9. Students performing well on the integrated tests may receive points based on their percentile score. Points will be based off of percentile ranking and will be awarded only after successfully averaging a 75% or better on unit exams and clinical. Students with a minimum examination average less than 75% will not receive extra credit points. Points will be awarded as follows: A total of 1-3 % points will be added according to the student’s average percentile ranking score 55-65 percentile = 1 point 66-80 percentile = 2 points 81-100 percentile = 3 points If multiple tests are given during the semester the points will be averaged. For example: If 3 tests are given and the test scores are in the 59, 70, and 84 percentile the student will receive points based on 1+2+3=6 divided by 3 = 2 % points

UNIVERSITY & COURSE EXPECTATIONS As a student of OSUIT, I understand that it is my responsibility to read, abide by and maintain a copy of the syllabi for this course. Syllabi are also available on the OSUIT website.

As a student of OSUIT, I understand that excerpts of portions of my work may be utilized for institutional assessment purposes. The purpose of institutional assessment is for verification of student learning and program improvement. I recognize that every effort will be made to keep this information confidential.

AMERICANS WITH DISABILITIES ACT (ADA) According to the Americans with Disabilities Act, each student with a disability is responsible for notifying the University of his/her disability and requesting accommodations. If you think you have a qualified disability and need special accommodations, you should notify the instructor and request verification of eligibility for accommodations from the Office of Academic Accommodations/LASSO Center. Please advise the instructor of your disability as soon as possible, and contact The LASSO Center, located in the Noble Center for Advancing Technology – NCAT, top floor, and 918-293-4855 to ensure timely implementation of appropriate accommodations. Faculty have an obligation to respond when they receive official notice of a disability but are under no obligation to provide retroactive accommodations. To receive services, you must submit appropriate documentation and complete an intake process

NURS2229_Fall2015 [7] during which the existence of a qualified disability is verified and reasonable accommodations are identified. (Fall 2013)

ACADEMIC DISHONESTY Academic dishonesty or misconduct is neither condoned nor tolerated at OSUIT. Any student found guilty of academic dishonesty or misconduct shall be subject to disciplinary action. Academic dishonesty and/or misconduct includes, but is not limited to, the following actions: (1) Plagiarism: the representation of previously written, published, or creative work as one’s own; (2) Unauthorized collaboration on projects; (3) Cheating on examinations; (4) Unauthorized advance access to exams; (5) Fraudulent alteration of academic materials; (6) Knowing cooperation with another person in an academically dishonest undertaking. Students are required to actively protect their work against misuse by others. For details, refer to The OSUIT Student Handbook (Student Rights and Responsibilities Governing Student Behavior) available online at http://www.osuit.edu/academics/forms/student_rights_responsibility.pdf.

ATTENDANCE POLICY FOR NURSING See Nursing Student Handbook policies for Attendance Theory & Lab and, Clinical Attendance.

COURSE CONTENT EXAM 1: Neurology

Required Learning Activities: Read chapters in Lewis text 56, 57, 58, 59, 61 Practice Questions for the NCLEX Examination Kaplan Review Test Neurology Class attendance and participation Complete the online tutorial for each chapter http://www.evolve.elsevier.com/

Learning Outcomes: Chapter 56 At the conclusion of this chapter the learner will:

 Differentiate between the functions of neurons and glial cells.  Explain the anatomic location and functions of the cerebrum, brainstem, cerebellum, spinal cord, peripheral nerves, and cerebrospinal fluid.  Identify the major arteries supplying the brain.  Describe the functions of the 12 cranial nerves.  Compare the functions of the two divisions of the autonomic nervous system.  Link the age-related changes in the neurologic system to the differences in assessment findings.  Select significant subjective and objective data related to the nervous system that should be obtained from a patient.  Select appropriate techniques to use in the physical assessment of the nervous system.  Differentiate normal from abnormal findings of a physical assessment of the nervous system.

8  Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the nervous system.

Chapter 57 At the conclusion of this chapter the learner will:

 Explain the physiologic mechanisms that maintain normal intracranial pressure.  Describe the common etiologies, clinical manifestations, and collaborative care of the patient with increased intracranial pressure.  Describe the collaborative and nursing management of the patient with increased intracranial pressure.  Differentiate types of head injury by mechanism of injury and clinical manifestations.  Describe the collaborative care and nursing management of the patient with a head injury.  Compare the types, clinical manifestations, and collaborative care of patients with brain tumors.  Discuss the nursing management of the patient with a brain tumor.  Describe the nursing management of the patient undergoing cranial surgery.  Differentiate among the primary causes, collaborative care, and nursing management of brain abscess, meningitis, and encephalitis.

Chapter 58 At the conclusion of this chapter the learner will:  Describe the incidence of and risk factors for stroke.

 Explain mechanisms that affect cerebral blood flow.  Compare and contrast the etiology and pathophysiology of ischemic and hemorrhagic strokes.  Correlate the clinical manifestations of stroke with the underlying pathophysiology.  Identify diagnostic studies performed for patients with strokes.  Differentiate among the collaborative care, drug therapy, and surgical therapy for patients with ischemic strokes and hemorrhagic strokes.  Describe the acute nursing management of a patient with a stroke.  Describe the rehabilitative nursing management of a patient with a stroke.  Explain the psychosocial impact of a stroke on the patient, caregiver, and family.

 Compare and contrast the etiology, clinical manifestations, collaborative care, and nursing management of tension-type, migraine, and cluster headaches.

NURS2229_Fall2015 [9]  Differentiate the etiology, clinical manifestations, diagnostic studies, collaborative care, and nursing management of seizure disorders, multiple sclerosis, Parkinson’s disease, and myasthenia gravis.  Describe the clinical manifestations and nursing and collaborative management of restless legs syndrome, amyotrophic lateral sclerosis, and Huntington’s disease.  Explain the potential impact of chronic neurologic disease on physical and psychological well-being.  Outline the major goals of treatment for the patient with a chronic, progressive neurologic disease.

 Explain the etiology, clinical manifestations, collaborative care, and nursing management of trigeminal neuralgia and Bells palsy.  Explain the etiology, clinical manifestations, collaborative care, and nursing management of Guillain-Barr syndrome, botulism, tetanus, and neurosyphilis.  Describe the classification of spinal cord injuries and associated clinical manifestations.  Describe the clinical manifestations, collaborative care, and nursing management of neurogenic and spinal shock.  Relate the clinical manifestations of spinal cord injury to the level of disruption and rehabilitation potential.  Describe the nursing management of the major physical and psychological problems of the patient with a spinal cord injury.  Describe the effects of spinal cord injury on the older adult population.  Explain the types, clinical manifestations, collaborative care, and nursing management of spinal cord tumors.

EXAM 2: Endocrine

Required Learning Activities: Read chapters 48, 49, 50 Practice Questions for the NCLEX Examination Kaplan Review Test Neurology Class attendance and participation Complete the online tutorial for each chapter http://www.evolve.elsevier.com/

10  Describe the common characteristics and functions of hormones.  Identify the locations of the endocrine glands.  Describe the functions of hormones secreted by the pituitary, thyroid, parathyroid, and adrenal glands and the pancreas.  Describe the locations and roles of hormone receptors.  Select the significant subjective and objective assessment data related to the endocrine system that should be obtained from a patient.  Link age-related changes in the endocrine system to differences in assessment findings.  Differentiate normal from common abnormal findings of a physical assessment of the endocrine system.  Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the endocrine system.

 Describe the pathophysiology and clinical manifestations of diabetes mellitus.  Differentiate between type 1 and type 2 diabetes mellitus.  Describe the collaborative care of the patient with diabetes mellitus.  Describe the role of nutrition and exercise in the management of diabetes mellitus.  Discuss the nursing management of a patient with newly diagnosed diabetes mellitus.  Describe the nursing management of the patient with diabetes mellitus in the ambulatory and home care settings.  Relate the pathophysiology of acute and chronic complications of diabetes mellitus to the clinical manifestations.  Explain the collaborative care and nursing management of the patient with acute and chronic complications of diabetes mellitus.

 Explain the pathophysiology, clinical manifestations, collaborative care, and nursing management of the patient with an imbalance of hormones produced by the anterior pituitary gland.  Describe the pathophysiology, clinical manifestations, collaborative care, and nursing management of the patient with an imbalance of hormones produced by the posterior pituitary gland.  Explain the pathophysiology, clinical manifestations, collaborative care, and nursing management of the patient with thyroid dysfunction.

NURS2229_Fall2015 [11]  Describe the pathophysiology, clinical manifestations, collaborative care, and nursing management of the patient with an imbalance of the hormone produced by the parathyroid glands.  Identify the pathophysiology, clinical manifestations, collaborative care, and nursing management of the patient with an imbalance of hormones produced by the adrenal cortex.  Describe the pathophysiology, clinical manifestations, collaborative care, and nursing management of the patient with an excess of hormones produced by the adrenal medulla.  List the side effects of corticosteroid therapy.  Describe common nursing assessments, interventions, rationales, and expected outcomes related to patient teaching for management of chronic endocrine problems.

EXAM 3: Musculoskeletal & Integumentary

Required Learning Activities: Read chapters 62, 63, 64, 65, 23, 24, 25 Practice Questions for the NCLEX Examination Kaplan Review Test Neurology Class attendance and participation Complete the online tutorial for each chapter http://www.evolve.elsevier.com/

Learning Outcomes Chapter 62 At the conclusion of this chapter the learner will:

 Describe the gross anatomic and microscopic composition of bone.  Explain the classification system for joints and movements at synovial joints.  Compare and contrast the types and structure of muscle tissue.  Describe the functions of cartilage, muscles, ligaments, tendons, fascia, and bursae.  Link age-related changes in the musculoskeletal system to the differences in assessment findings.  Select significant subjective and objective data related to the musculoskeletal system that should be obtained from a patient.  Select appropriate techniques to use in the physical assessment of the musculoskeletal system.  Differentiate normal from abnormal findings of a physical assessment of the musculoskeletal system.  Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the musculoskeletal system.

12  Differentiate among the etiology, pathophysiology, clinical manifestations, and collaborative care of soft tissue injuries, including strains, sprains, dislocations, subluxations, bursitis, repetitive strain injury, carpal tunnel syndrome, and injuries to the rotator cuff, meniscus, and anterior cruciate ligament.  Relate the sequential events involved in fracture healing.  Compare closed reduction, cast immobilization, open reduction, and traction regarding purpose, complications, and nursing management.  Evaluate the neurovascular assessment of an injured extremity.  Explain common complications associated with a fracture and fracture healing.  Describe the collaborative care and nursing management of patients with various kinds of fractures.  Describe the indications for and the collaborative care and nursing management of the patient with an amputation.  Describe the types of joint replacement surgery for arthritis and connective tissue disorders.  Prioritize the preoperative and postoperative management of the patient having joint replacement surgery.

 Describe the pathophysiology, clinical manifestations, collaborative care, and nursing management of osteomyelitis.  Differentiate among the types, pathophysiology, clinical manifestations, and collaborative care of bone cancer.  Differentiate between the causes and characteristics of acute and chronic low back pain.  Explain the conservative and surgical therapy of intervertebral disc damage.  Describe the postoperative nursing management of a patient who has undergone vertebral disc surgery.  Specify the etiology and nursing management of common foot disorders.  Describe the etiology, pathophysiology, clinical manifestations, and collaborative and nursing management of osteomalacia, osteoporosis, and Paget’s disease.

 Compare and contrast the sequence of events leading to joint destruction in osteoarthritis and rheumatoid arthritis.

NURS2229_Fall2015 [13]  Detail the clinical manifestations, collaborative care, and nursing management of osteoarthritis and rheumatoid arthritis.  Describe the pathophysiology, clinical manifestations, and collaborative care of gout, Lyme disease, and septic arthritis.  Summarize the pathophysiology, clinical manifestations, collaborative care, and nursing management of ankylosing spondylitis, psoriatic arthritis, and reactive arthritis.  Differentiate the pathophysiology, clinical manifestations, collaborative care, and nursing management of systemic lupus erythematosus, scleroderma, polymyositis, dermatomyositis, and Sjogren’s syndrome.  Explain the drug therapy and related nursing management associated with arthritis and connective tissue diseases.  Compare and contrast the possible etiologies, clinical manifestations, and collaborative and nursing management of fibromyalgia and chronic fatigue syndrome.

 Describe the structures and functions of the integumentary system.  Link the age-related changes in the integumentary system to differences in assessment findings.  Select the significant subjective and objective data related to the integumentary system that should be obtained from a patient.  Describe specific assessments to be made during the physical examination of the skin and the appendages.  Compare and contrast the critical components for describing primary and secondary lesions.  Select appropriate techniques to use in the physical assessment of the integumentary system.  Specify the structural and assessment differences in light- and dark-skinned individuals.  Differentiate normal from common abnormal findings of a physical assessment of the integumentary system.  Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the integumentary system.

 Specify health promotion practices related to the integumentary system.  Explain the etiology, clinical manifestations, and nursing and collaborative management of common acute dermatologic problems.  Summarize the psychological and physiologic effects of chronic dermatologic conditions.  Explain the etiology, clinical manifestations, and nursing and collaborative management of malignant dermatologic disorders.  Explain the etiology, clinical manifestations, and nursing and collaborative management of bacterial, viral, and fungal infections of the integument.

14  Describe the etiology, clinical manifestations, and nursing and collaborative management of infestations and insect bites.  Explain the etiology, clinical manifestations, and nursing and collaborative management of allergic dermatologic disorders.  Explain the etiology, clinical manifestations, and nursing and collaborative management related to benign dermatologic disorders.  Distinguish the dermatologic manifestations of common systemic diseases.  Explain the indications and nursing management related to common cosmetic procedures and skin grafts.

 Relate the causes of and prevention strategies for burn injuries.  Differentiate between partial-thickness and full-thickness burns.  Apply the tools used to determine the severity of burns.  Compare the pathophysiology, clinical manifestations, complications, and collaborative management throughout the three burn phases.  Compare the fluid and electrolyte shifts during the emergent and acute burn phases.  Differentiate the nutritional needs of the burn patient throughout the three burn phases.  Compare the various burn wound care techniques and surgical options for partial- thickness versus full-thickness burn wounds.  Prioritize nursing interventions in the management of the physiologic and psychosocial needs of the burn patient.  Examine the various physiologic and psychosocial aspects of burn rehabilitation.  Design a plan of care to prepare the burn patient and caregiver for discharge.

Exam 4: Trauma and Disaster/ ICU

Required Learning Activities: Read chapters 66, 67, 68, 69 Practice Questions for the NCLEX Examination Kaplan Review Test Neurology Class attendance and participation Complete the online tutorial for each chapter http://www.evolve.elsevier.com/

 Differentiate the various certification opportunities for critical care nurses.

NURS2229_Fall2015 [15]  Select appropriate nursing interventions to manage common problems and needs of critically ill patients.  Develop strategies to manage issues related to caregivers of critically ill patients.  Apply the principles of hemodynamic monitoring to the collaborative care and nursing management of patients receiving this intervention.  Differentiate the purpose of, indications for, and function of circulatory assist devices and related collaborative care and nursing management.  Differentiate the indications for and modes of mechanical ventilation.  Select appropriate nursing interventions related to the care of an intubated patient.  Relate the principles of mechanical ventilation to the collaborative care and nursing management of patients receiving this intervention.

 Relate the pathophysiology to the clinical manifestations of the different types of shock: Cardiogenic, hypovolemic, distributive, and obstructive.  Compare the effects of shock, systemic inflammatory response syndrome, and multiple organ dysfunction syndrome on the major body systems.  Compare the collaborative care, drug therapy, and nursing management of patients experiencing different types of shock.  Describe the nursing management of a patient experiencing multiple organ dysfunction syndrome.

 Compare the pathophysiologic mechanisms and clinical manifestations that result in hypoxemic and hypercapnic respiratory failure.  Differentiate between the nursing and collaborative management of the patient with hypoxemic or hypercapnic respiratory failure.  Relate the pathophysiologic mechanisms and the clinical manifestations associated with acute lung injury and acute respiratory distress syndrome (ARDS).  Select appropriate nursing and collaborative management strategies for the patient with ARDS.  Prioritize measures to prevent or reverse complications that may result from acute respiratory failure or ARDS.

16  Apply the steps in triage, the primary survey, and the secondary survey to a patient experiencing a medical, surgical, or traumatic emergency.  Relate the pathophysiology to the assessment and collaborative care of select environmental emergencies (e.g., hyperthermia, hypothermia, submersion injury, bites).  Relate the pathophysiology to the assessment and collaborative care of select toxicological emergencies.  Select appropriate nursing interventions for victims of violence.  Differentiate among the responsibilities of health care providers, the community, and select federal agencies in emergency and mass casualty incident preparedness.

Exam 5: Hematology/Immunity

Required Learning Activities: Read chapters 30, 31, 12, 14, 15 Practice Questions for the NCLEX Examination Kaplan Review Test Neurology Class attendance and participation Complete the online tutorial for each chapter http://www.evolve.elsevier.com/

 Describe the structures and functions of the hematologic system.  Differentiate among the different types of blood cells and their functions.  Explain the process of hemostasis.  Link the age-related changes in the hematologic system to differences in findings of hematologic studies.  Select the significant subjective and objective assessment data related to the hematologic system that should be obtained from a patient.  Describe the components of a physical assessment of the hematologic system.  Differentiate normal from common abnormal findings of a physical assessment of the hematologic system.  Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the hematologic system.

NURS2229_Fall2015 [17]  Describe the general clinical manifestations and complications of anemia.  Differentiate the etiologies, clinical manifestations, diagnostic findings, and nursing and collaborative management of iron deficiency, megaloblastic and aplastic anemia’s, and anemia of chronic disease.  Explain the nursing management of anemia secondary to blood loss.  Describe the pathophysiology, clinical manifestations, and nursing and collaborative management of anemia caused by increased erythrocyte destruction, including sickle cell disease and acquired hemolytic anemias.  Describe the pathophysiology and nursing and collaborative management of polycythemia.  Explain the pathophysiology, clinical manifestations, and nursing and collaborative management of various types of thrombocytopenia.  Describe the types, clinical manifestations, diagnostic findings, and nursing and collaborative management of hemophilia and von Willebrand disease.  Explain the pathophysiology, diagnostic findings, and nursing and collaborative management of disseminated intravascular coagulation.  Describe the etiology, clinical manifestations, and nursing and collaborative management of neutropenia.  Describe the pathophysiology, clinical manifestations, and nursing and collaborative management of myelodysplastic syndrome.  Compare and contrast the major types of leukemia regarding distinguishing clinical and laboratory findings.  Explain the nursing and collaborative management of acute and chronic leukemia’s.  Compare Hodgkin’s lymphoma and non-Hodgkin’s lymphomas in terms of clinical manifestations, staging, and nursing and collaborative management.  Describe the pathophysiology, clinical manifestations, and nursing and collaborative management of multiple myeloma.  Describe the spleen disorders and related collaborative care.  Describe the nursing management of the patient receiving transfusions of blood and blood components.

 Describe the inflammatory response, including vascular and cellular responses and exudate formation.  Explain local and systemic manifestations of inflammation and their physiologic bases.  Describe the drug therapy, nutrition therapy, and nursing management of inflammation.  Differentiate among healing by primary, secondary, and tertiary intention.  Describe the factors that delay wound healing and common complications of wound healing.  Describe the nursing and collaborative management of wound healing.  Explain the etiology and clinical manifestations of pressure ulcers.

18  Apply a patient risk assessment for pressure ulcers to measures used to prevent the development of pressure ulcers.  Discuss nursing and collaborative management of a patient with pressure ulcers.

 Describe the functions and components of the immune system.  Compare and contrast humoral and cell-mediated immunity, including lymphocytes involved, types of reactions, and effects on antigens.  Characterize the five types of immunoglobulins.  Differentiate among the four types of hypersensitivity reactions in terms of immunologic mechanisms and resulting alterations.  Identify the clinical manifestations and emergency management of a systemic anaphylactic reaction.  Describe the assessment and collaborative care of a patient with chronic allergies.  Explain the relationship between the human leukocyte antigen system and certain diseases.  Describe the etiologic factors, clinical manifestations, and treatment modalities of autoimmune diseases.  Describe the etiologic factors and categories of immunodeficiency disorders.  Differentiate among the types of rejections following transplantation.  Identify the types and side effects of immunosuppressive therapy. Chapter 15 At the conclusion of this chapter the learner will:

 Evaluate the impact of emerging and reemerging infections on health care.  Identify ways to decrease the development of resistance to antibiotics.  Explain the ways the human immunodeficiency virus (HIV) is transmitted and the factors that affect transmission.  Describe the pathophysiology of HIV infection.  Chart the spectrum of untreated HIV infection.  Identify the diagnostic criteria for acquired immunodeficiency syndrome (AIDS).  Describe methods used to test for HIV infection.  Discuss the collaborative management of HIV infection.  Summarize the characteristics of opportunistic diseases associated with AIDS.  Describe the potential complications associated with long-term treatment of HIV infection.  Compare and contrast HIV prevention methods.  Describe the nursing management of HIV-infected patients and HIV at-risk patients

NURS2229_Fall2015 [19] OSUIT NURSING PROGRAM NURS 2229 NURSING CARE OF ADULTS II PRACTICUM HOURS

Hospital Orientation(s) 9 hours Hospital Experience 11 weeks x 9 hrs. 99 hours Community Project 9 hours Leadership 9 hours Total 126 hours

Clinicals-Must receive a satisfactory clinical performance grade of 2.0 or greater to pass (See clinical evaluation form).

EXPECTED LEARNER OUTCOMES/OBJECTIVES: At the conclusion of the course and after faculty evaluation, the student will be able to: 1. Demonstrate competent nursing care of clients experiencing stressors in a medical/surgical/ICU setting. 2. Expand application of the nursing process as it relates to the health care needs of the medical/surgical/ICU client. 3. Manage care for clients in a medical/surgical/ICU setting. 4. Accept accountability for own nursing judgments and actions and the impact they have on the systems of care and safety of patients in a medical-surgical setting/Intensive care setting. 5. Examine areas of needed personal/professional growth.

EVALUATION: Clinical grades are based on clinical performance and written/oral assignments. Failure to make a satisfactory grade in either clinical performance or written/oral assignments will result in an

20 unsatisfactory clinical grade. A satisfactory clinical grade is necessary for successful completion of the course.

The clinical performance grade is based on weekly evaluations using the "Clinical Evaluation Form" (provided within course materials). The student receives 0-2 points on each behavior s/he has performed that day according to observations by the instructor, and a pass or fail for unobserved clinical experiences.

In order to pass NURS 2229 Practicum, the student must:  Student must pass the dosage calculation test with a 90% or better within 2 attempts, and  Earn a satisfactory clinical performance grade, and  Earn a total average grade of 75% all written assignments, and  Earn at least an 84% on a case study. If a student does not score at least 84% s/he will be given the opportunity to complete an additional case study to demonstrate competency, and must earn an average grade of at least 84%. Case study is due 1 week after clinical date. Case studies later than 7 days will not be accepted and a zero will be given for the case study grade.  All clinical paperwork is due within 24 hours of clinical (except a case study) experience and posted to drop box. Failure to complete the assigned paperwork and post to drop box will result in a zero for that clinical grade

Once a student has passed the theory course with a 75% passing Test average - only then will points be added for clinical paperwork to your final average grade. Points will be added accordingly: Clinical Paperwork averaging between 92 – 100% = 3 points added Clinical paperwork averaging between 84 – 91% = 2 points added Clinical paperwork averaging between 75 – 83% = 1 point Example: Your test averages equal 83%, your clinical paperwork average 93% - three points will be added to your 83% to give you 86% and you will have a B for the semester. Another Example your test average is 90% (B), your homework average is 76% (C) - one point is added to your 90% to now give you 91% you continue to have a B for the semester. Final example – you have a 74.9% test average you have failed the course you will not receive any homework points. A student must pass the exams with a 75% average to pass the course and receive clinical paperwork points– no scores are rounded up.

SUMMARY OF WRITTEN & ORAL ASSIGNMENTS

WRITTEN/ORAL DUE DATE POINT VALUE GRADING ASSIGNMENTS TIME During clinical 100 points each Graded on site. Daily Work x 11 experience posted/returned to student by next clinical day (approximately 1

NURS2229_Fall2015 [21] week) Case Studies x1 Due 1 week after 100 points each Grade scheduled clinical posted/returned to student within 2 weeks of receipt. As assigned 100 points Within 1 week of Community Project discussion close date for each unit As Assigned 100 points Grade Leadership Contact Jodi, posted/returned to Shawnna, Jamie, student within 2 Kathryn or Robin for weeks of receipt. this rotation. As assigned by Chrissi

WRITTEN ASSIGNMENT GUIDELINES Format  Each assignment must be typed in black ink.  Correct spelling and grammar are essential.  Assignments will only be accepted electronically. Please name the file with your last name, first initial and the date of the clinical. E.g. MartinC_01-06-15  Students are required to turn in written work each week. Taking a zero is not acceptable; students must turn in written work every week of clinical for the instructor to evaluate clinical performance. Student will receive an “I” for the semester until all clinical paperwork has been turned in. References:  A minimum of two (2) current (< 5 years old) professional references must be used for each paper.  Medical dictionaries and encyclopedias may not be utilized as one of the two required reference, but may be used as supplemental references.  All information taken from a reference must be cited within the text, as well as included in the Reference Sheet. References should be formatted to current APA guidelines. Note:  Case study must be turned in on or before week 11 of clinical.  Clinical attendance is mandatory. Any student missing a clinical will be assigned a clinical make-up by the instructor of record and it will include an additional case study worth 100 points for the missed clinical week.  Feedback will be given at the clinical site by the instructor. Instructor feedback will be on clinical paperwork when submitted to Dropbox. Grading will be completed after the student post clinical assignment to Dropbox.

DAILY WORK GUIDELINES AND GRADING CRITERIA

22 Daily work provides a way for the student to summarize patient information, assessment and care provided each day, as well as demonstrates knowledge of the nursing process as it pertains to his/her patient. This work will be typed on provided forms and include at a minimum:  Assessment focused on abnormal and diagnosis specific data  Nursing notes summarizing care provided that shift  Summary of laboratory data and ordered treatments  List of medications patient is taking including order details along with the reason for the medication  Recommendations for discharge including placement, further care needed, education, equipment, etc.  Nursing care plan with a priority diagnosis following OSUIT guidelines

If a student is assigned to an observation experience, e.g. surgery, s/he will submit an assignment following the guidelines and objectives as assigned.

Each daily assignment is worth 100 points which will be assigned according to the posted rubric.

CASE STUDY GUIDELINES & GRADING CRITERIA

A case study provides a comprehensive patient situation for you to review and critique. It should present a complete picture of your patient and the clinical situation. Writing a case study will help you to apply concepts and theories to clinical situations, identify actual and potential problems, propose varied approaches for solving them, weigh different decisions possible, and arrive at judgments as to the effectiveness of interventions.

All students are required to submit one typed case study this semester. One week after the clinical experience students must turn in all completed paper work including individualized pathophysiology paper, head to toe narrative assessment, laboratory tests form, medication worksheets, narrative documentation, medical treatments and diagnostic tests form, care plan, reference sheet, and case study evaluation form. Case study will include two (2) nursing diagnoses as instructed below.

Each case study will be evaluated using the “Case Study Evaluation Form.” Make sure to turn in a copy of the evaluation form with your case study to avoid losing points. Case studies must be typed, use appropriate terminology, correct spelling and grammar, and follow other specified requirements listed in the case study evaluation form (Rubric). Points will be deducted for not following all directions. Students must achieve an 84% or higher on the case study. If a student does not achieve an 84% or higher on the first case study they will be required to complete a second case study. If a second case study is required the student will receive a weekly grade for the first case study submitted.

* It is recommended that you schedule an appointment with your clinical instructor to discuss your plans for the paper.

CLINICAL PAPERWORK SUBMISSION PROCEDURE

NURS2229_Fall2015 [23] All paperwork is to be submitted electronically to the appropriate dropbox folder on D2L. At no time will emailed or printed assignments be accepted. Graded paperwork will be returned to the corresponding dropbox on D2L and will be accessible via the “feedback” mechanism.

Please refer to the Nursing Student Handbook for other relevant Clinical Policies.

Adult 2 Course Outline Topic Assignment Due Date Schedule Wednesday/Week 1 Simulation Lab SCI Group 1 0800-0900 9/2/15 0800-1100 Lab Group 2 0900-1000 Group 3 1000-1100 1130-1400 WELCOME- Syllabus Dosage Calculation Exam Orientation At 1130 Thursday/ Week Lecture Neurology Please do Kaplan Focus 9/3/15 1 Chapter 56 and 57 Review over neurology and 0900-1200 turn into me at beginning of class. This is mandatory to attend class. Read All Chapters before class. Friday/Week 1 Clinical Orientation / This counts as a clinical Day 9/4/15 0900-1600 Complete Syllabus Please post 3 learning Orientation objectives in dropbox that Complete lecture on you would like to learn at chapter 56 and 57 clinical this semester for this Amanda Pape Kaplan Rep clinical day assignment. at 1330 Wednesday/Week 2 Lecture Neurology 9/9/15 1130-1400 class Chapters 58,59 Thursday/Week 2 Simulation Lab Stroke Group 1 0800-0900 9/10/15 0800-1100 Lab Lecture Neurology Group 2 0900-1000 1200-1500 Chapters 61 Group 3 1000-1100 Wednesday/Week 3 Simulation Lab TBI Group 1 0800-0900 9/16/15 0800-1100 Lab Exam 1 Group 2 0900-1000 1130-1400 class Group 3 1000-1100 Thursday/Week 3 Lecture Endocrine Chapter Please do Kaplan Focus 9/17/15

24 0900-1200 48 Review over Endocrine and turn into me at beginning of class. This is mandatory to attend class. Read All Chapters before class. Wednesday/Week 4 Simulation Lab DM type 1 Group 1 0800-0900 9/23/15 0800-1100 Lab Lecture Endocrine Chapter Group 2 0900-1000 1130-1400 class 49 Group 3 1000-1100 Thursday/Week 4 Lecture Endocrine Chapter 9/24/15 0900-1200 50 Wednesday/Week 5 Simulation Lab DKA Group 1 0800-0900 9/30/15 0800-1100 Lab Exam 2 Group 2 0900-1000 1130-1400 class Group 3 1000-1100

Thursday/Week 5 Lecture Integumentary Please do Kaplan Focus 10/1/15 0900-1200 Chapter 23,24,25 Review over Musculoskeletal and fluid and electrolyte and turn into me at beginning of class. This is mandatory to attend class. Read All Chapters before class. Capstone topic due- please email me with group and topic Wednesday/Week 6 Simulation Lab Burn Group 1 0800-0900 10/7/15 0800-1100 Lab Lecture Integumentary Group 2 0900-1000 1130-1400 class Chapter 62,63 Group 3 1000-1100 Thursday/Week 6 Lecture Integumentary and 10/8/15 0900-1200 Musculoskeletal Chapter 64,65 Wednesday/Week 7 Simulation Lab Group 1 0800-0900 10/14/15 0800-1100 Lab Compartment Syndrome Group 2 0900-1000 1130-1400 class Exam 3 Group 3 1000-1100 Thursday/Week 7 Lecture ER Please do Kaplan Focus 10/15/15 0900-1200 /Trauma/Disaster/ICU Review over Respiratory 2 Chapters 66 and Cardiac 2 and turn into me at beginning of class. This is mandatory to attend class. Read All Chapters before class. Wednesday/Week 8 Simulation Lab ARDS Group 1 0800-0900 10/21/15 0800-1100 Lab Lecture ER Group 2 0900-1000 1130-1400 class /Trauma/Disaster Group 3 1000-1100 Chapters/ ICU 67,68

NURS2229_Fall2015 [25] Thursday/Week 8 Lecture ER 10/22/15 0900-1200 /Trauma/Disaster Chapters/ ICU 69 Wednesday/Week 9 Simulation Lab Sepsis Group 1 0800-0900 10/28/15 0800-1100 Lab Group 2 0900-1000 1130-1400 class Exam 4 Group 3 1000-1100 Thursday/Week 9 Hematology/Immunity Please do Kaplan Focus 10/29/15 0900-1200 Chapter 30,31 Review over Hematology- Immunity turn into me at beginning of class. This is mandatory to attend class. Read All Chapters before class. Wednesday/Week 10 Simulation Lab Anemia Group 1 0800-0900 11/4/15 0800-1100 Lab w/blood transfusion Group 2 0900-1000 1130-1400 class Lecture Chapter 12,14 Group 3 1000-1100 Thursday/Week 10 Lecture 11/5/15 0900-1200 Hematology/Immunity Chapter15 Tuesday/Week 11 OBN Clinical-wear Mandatory trip to OBN 11/10/15 Clinical to OBN nursing uniform Meet at the school at 0530, Meet at the school at 0530. will return at approximately This is a mandatory 4:30 p.m. clinical. Wednesday/Week 11 Simulation Lab Code 11/11/15 0800-1100 Lab Blue, Hematology 1130-1400 class Exam 5 Thursday/Week 11 Kaplan Testing Trainer 1, Mandatory remediation if 11/12/15 Take at Home on 2 and 3 less than 55% on trainer 1, 2 a PC (iPad will and 3. Post remediation (if not work) needed) to clinical dropbox by 11/18/15 @ 0800 Wednesday/Week 12 Kaplan Diagnostic Mandatory remediation if less 11/18/15 0800-1100 Lab Kaplan Critical Thinking 2 than 55% on Diagnostic not 1130-1400 class Testing critical thinking. Post Lab hour utilized remediation (if needed) to clinical dropbox by 11/19/15 @ 0800 Thursday/Week 12 Kaplan med - surg comp Mandatory remediation on 11/19/15 0900-1200 in class. Kaplan management and med-surg Management Testing comp if less than 55%. Post remediation (if needed) to clinical dropbox by 11/30/15 @ 0800 Wednesday/Week 13 Nurse Assessment Test Mandatory remediation if less 12/2/15 0800-1100 Lab Take Trainer 4 at home than 55% on NAT test. Post

26 1130-1400 class tonight and post remediation (if needed) to Lab hour utilized remediation to dropbox clinical dropbox by 12/4/15 NAT 2nd attempt 12/4/15 @ 0800 @ 0900 Thursday/Week 13 Kaplan Predictor 12/3/15 0900-1200 Take Trainer 5 at home tonight and post remediation to dropbox Monday –Thursday Mandatory Kaplan Live Pinning practice at 1130 in 12/7/15 week 14 Review Monday through Covelle Hall on 12/10/15 12/10/15 0900-1600 Thursday 0900-1600 Week 14 Pinning and Graduation 12/11/15  NCLEX = RN!!!! Congratulations! 

Lab Groups Keah Allen RN, MSN 918-293-5331 Lab Group 1 Lab Group 2 Wednesday 0800-0900 Wednesday 0900-1000

Armstrong, Barbara Hunalp, Paula Arnold, William Kelch, Felicia Brillhart-Green, Cassandra Long, Kelsey Caldwell, Erin Martin, Lauren Casey, Elizabeth Minter, Alexis Chitseko, Robert Nestlerode, Meranda Gould, Rachel Rowlett, Michael Hickman, Elizabeth Sarant, Jessica Kyle Curry

Lab Group 3 Wednesday 1000-1100 Shaw, Taylor Stanton, Autumn

NURS2229_Fall2015 [27] Stevens, Michelle Thai, Lan Thoman, Paige Tuttle, Mary Vose, Cari

OSUIT NURSING PROGRAM ER Observation CLINICAL OBJECTIVES

Instructions for Leadership Rotation

 You will be following an RN in the emergency room.

 You will work a scheduled shift with the ER RN.

 This clinical cannot conflict with class or other scheduled clinicals.

 You will attend this clinical on the week scheduled on the clinical schedule.

 Your written assignment is due within 24 hours of your experience, to be posted in the weekly dropbox on D2L.

 If you have any issues, please call Chrissi immediately (918-269-9538)

Clinical Objectives

1. Attend a clinical as scheduled and observe an emergency room RN.

2. Identify the purpose of the RN in the emergency room.

3. Describe ways in which the information presented will affect your personal nursing practice.

28 4. Identify why a registered nurse is needed for patient care in the ER

Written Assignment Directions

1. A written description of your day—a journal of sorts including what you did and saw and how you felt about it. No more than one page is expected.

2. A short (at least 2, no more than 4 pages) paper addressing the rubric listed below.

3. This sheet, signed where indicated, by ER nurse verifying your attendance and participation in the day.

4. Your written assignment is due within 24 hours of your experience, to be posted in the weekly dropbox on D2L.

Student Name: ______Date: ______

I verify that the above named student did attend this home health observation experience and was appropriately participative and professional.

Preceptor signature: ______

GRADING CRITERIA AND RUBRIC FOE ER Points Possible (All or nothing) 1. Describe the role of the nurse in the ER. What is the primary purpose of the nurse 20 in the ER? 2. How does the ER nurse roles differ from nurses you have observed at the 15 bedside in the hospital on the floors? 3. Identify one thing you learned from your clinical with an ER nurse. 15 4. Identify one thing you intend to incorporate into your current care and future 15 practice as a registered nurse after learning more about the nurse’s role in the ER. 5. Describe your experience during the clinical (what you seen, how you felt). 15

NURS2229_Fall2015 [29] 6. Identify one topic that stood out to you and why, while learning about 15 emergency room nursing. 7. Do you feel this experience is beneficial for nursing students why or why not? 5 Would you recommend this rotation to other nursing students? TOTAL POINTS POSSIBLE 100

OSUIT NURSING PROGRAM Leadership Observation CLINICAL OBJECTIVES

Instructions for Leadership Rotation  You will be following an RN in a leadership position of your choice (Robin, Jodi, Jamie, Kathryn, Shawnna or an RN that is approved by Chrissi).  You will attend a clinical following the RN that you have chosen, you will work their scheduled shift with them.  This clinical cannot conflict with class or other scheduled clinicals.  You will attend this clinical on the week scheduled on the clinical schedule unless other arrangements have been made with Chrissi  Your written assignment is due within 24 hours of your experience, to be posted in the weekly dropbox on D2L.

30  If you have any issues, please call Chrissi immediately (918-269-9538)

Clinical Objectives 5. Attend a clinical as scheduled and observe a nurse leader.

6. Identify the purpose of the nurse leader

8. Identify where nurse leader services are needed and why. (i.e. Acute care, LTC)

9. Identify resources available to nurses and nurse leaders for patient education such as healthy people 2020 and national patient safety goals. Written Assignment Directions

7. This sheet, signed where indicated, by leadership nurse verifying your attendance and participation in the day.

Student Name: ______Date: ______

GRADING CRITERIA AND RUBRIC Points Possible LEADERSHIP (All or nothing) 1. Describe the role of the nurse Leader. What is the primary purpose of the nurse 10 leader? 2. How does leadership roles differ from nurses you have observed at the bedside 10 in the hospital? 3. Identify one thing you learned from your clinical with the nurse leader. 10

NURS2229_Fall2015 [31] 4. Identify one thing you intend to incorporate into your current care and future 10 practice as a registered nurse after learning more about leadership. 5. Describe your experience during the clinical (what you seen, how you felt). 10 6. Identify one topic that stood out to you and why, while learning about 10 leadership. 7. Describe Autocratic leadership. 10 Describe Bureaucratic leadership. Describe Democratic leadership or participative leadership. Describe Laissez-faire leadership. 8. Identify and describe the leadership style that you observed. 10 Identify and describe your leadership style. How do you differ from the leader that you observed? 9. Visit the web site Healthy people 2020 pick 2 topic areas and read the topic 10 information. Describe what you learned about these 2 topics and if you would include the information while doing patient education in the future and why you chose these 2 health related topics. https://www.healthypeople.gov/ 10. Identify the 2015 National patient safety goals for the hospital. 10 http://www.jointcommission.org/standards_information/npsgs.aspx TOTAL POINTS POSSIBLE 100

OSUIT NURSING PROGRAM Home Health Observation CLINICAL OBJECTIVES

Instructions for Home Health Rotation

 You will be observing an RN from Traditions Home Health, Morris office 918-733-2062. The Traditions contact person is Tamara Saddler RN her cell phone is (918) 759-4243 Please plan to arrive by 0900 am, at 511 West Ozark St., Morris OK 74445 or

32  You will be observing an RN from St. Francis located at 6600 S. Yale, Ste 200 Tulsa, OK. at the Warren Clinic Tower on the second floor, please arrive by 8:00am. Main Office Number is 918-488-6888. The St. Francis contact person is Tamara Wolfe RN her numbers are office 918-488-6885, cell 918-637-9305. (FYI you will be following the nurse in your personal vehicle)

 If you have any issues, please call Chrissi immediately (918-269-9538)

Clinical Objectives

 Describe the role of the primary nurse and compare it to the role of a bedside nurse in an inpatient setting.  Identify the primary purpose of the home health/hospice setting and describe the patient qualifications for this level of care.  Describe concerns that are unique to the home setting including, but not limited to: safety, legal, and ethical concerns.  Describe how medication is controlled, monitored and evaluated in the home care setting.  Describe the care planning done in the home care setting and compare it to what is seen in the inpatient setting.

3. This sheet, signed where indicated, by the home health/hospice nurse verifying your attendance and participation in the day.

5. Student Name: ______Date: ______

NURS2229_Fall2015 [33]

34 Points GRADING CRITERIA AND RUBRIC Possible (All or nothing) 1. Give a thorough description of what you observed. 10

2. Give a thorough description of your activities throughout the experience. 10

3. Give a thorough description of your impressions regarding the home care setting. 10

4. Give a thorough and accurate description of the role of the primary nurse and 15 compare it to the role of the bedside nurse in the inpatient setting.

5. Thoroughly and accurately identify the primary purpose of the health care setting 10 and describe patient qualifications for this level of care.

6. Give a thorough and accurate description of concerns (safety, legal, ethical) that are 10 unique to the home care setting.

7. Give a thorough and accurate description of how medications are controlled, 15 monitored and evaluated in the home care setting.

8. Give a thorough and accurate description of care planning in the home care setting 20 and compare it to what is seen in the inpatient setting.

Points Possible TOTAL 100

GUIDELINES FOR BOARD MEETING ATTENDANCE

NURS2229_Fall2015 [35] 1. Ensure you have reservations for your group prior to attending the meeting. Although Board meetings are open to the public, fire safety codes limit the number of persons that can be accommodated in the conference center. (This is done by the school).

2. Weapons prohibited pursuant to the Oklahoma Self-Defense Act. Okla. Stat. Tit. 21 §1277. It shall be unlawful for any person in possession of a valid handgun license issued pursuant to the provisions of the Oklahoma Self-Defense Act to carry any concealed or unconcealed handgun into any of the following places: Any structure, building, or office space which is owned or leased by a city, town, county, state, or federal governmental authority for the purpose of conducting business with the public; and any meeting of any state appointed officials.

3. All persons entering the area may be subject to a request to remove loose fitting or bulky clothing and a search of any personal belongings.

4. Students are to dress appropriately and should wear school uniforms/scrubs

5. Turn off cell phones and pagers prior to entering the meeting room.

6. Avoid disrupting the proceedings. If you are arriving late and the Board meeting has already begun, wait for the next break to enter the room and find your seats. Standing in the aisles, walkways, or the back of the meeting room is not allowed.

7. Smoking is not permitted in the hotel hallways or conference center and is restricted to designated areas only.

8. Participation in Board meetings is not permitted unless previously scheduled on the agenda, or an invitation to speak is extended by the Board.

9. It is not appropriate to make comments, applaud, laugh, or verbally respond to any Board decision while the Board is in session.

10. Do not interact or interfere with the Board as they exit and then reenter the conference center after voting to go into an Executive Session.

11. Permit Board members to exit the room first during breaks.

12. Ensure trash, paper, cups etc.; have not been left behind for others to dispose of prior to making your departure.

Oklahoma Board of Nursing (OBN)

36 Adult II Objectives Clinical Objectives 1. Attend an OBN meeting as scheduled per your syllabus – mandatory.

2. Identify the purpose of the OBN.

4. Identify the purpose of the nurse practice act and how it will affect your personal nursing practice

Provide a written description of your experience that day answering the questions listed below. Please include your feelings that you experienced, case (if one was available) that stood out to you, and if you agreed or disagreed with the Board’s decision for the respondent.

Must be two pages in length, and please include the following: Due within 24 hours of attendance  List at least one thing you learned from your visit to the OBN  List at least one thing you intend to incorporate into your current care and future practice.  Define the Nurse Practice Act (NPA) and describe how the NPA will affect your practice as a registered nurse in the future.  Do you think it benefits student nurses to attend OBN meetings? Why or why not? GRADING CRITERIA AND RUBRIC Points Possible 1. Identify the purpose of the Oklahoma Board of Nursing. 20 2. Describe ways in which the information presented will affect your personal 15 nursing. 3. Identify the purpose of the nurse practice act and how it will affect your personal 15 nursing practice. 4. One thing you learned from your visit to the OBN. 15 5. One thing you intend to incorporate into your current care and future practice as 10 a Registered Nurse. 7. Your experience during the hearing (what you seen, how you felt). 10 9. One case that stood out to you and if you agreed or disagreed with the Board’s 10 decision for the respondent why or why not. 10. Do you think this activity benefits student nurses – why or why not? 5 TOTAL POINTS 100 POSSIBLE

NURS2229_Fall2015 [37] OSUIT Nursing Program CASE STUDY EVALUATION FORM (Rubric) NURS2229

Name: ______Date: ______

GRADING KEY U = The required content is either not present or is present in a form that does not demonstrate understanding of the patient situation and of the case study or care planning process that is appropriate for the student’s progression in the nursing program.

NI = The required content is present in the case study. The student demonstrates a beginning understanding and follows a logical line of reasoning concerning the patient situation and the care planning process that is appropriate for progression in the nursing program.

S = The required content is present in the case study and demonstrates understanding of the patient situation and of the case study or care planning process that is appropriate for the student’s progression in the nursing program.

**All sections must be present or the case study will not be accepted

INTRODUCTION U NI S 0 pts 1 pts 2 pts 1. Description of the patient and their demographics is clear, direct, and does not leave any questions. 2. Clear description of present medical problems and events leading to hospitalization. 3. Addresses growth and development stage according to Erikson’s, cultural issues, and spiritual issues. 4. Past medical history (as is relevant to current patient status) is identified, includes definition of pertinent diagnosis. 5. It is concise and no more than 2 pages. Subtotal /10 points

ASSESSMENT U NI S 0 pts 1 pts 2 pts 1. All systems (head to toe) and contents of assessment are addressed, including normal data 2. Abnormal data is fully addressed including reassessment and interventions as appropriate 3. A focused assessment in present for patient’s priority problems 4. Includes appropriate baseline data for comparison. 5. Findings support nursing diagnoses and patient’s medical problems are evident, easily identified and supported by medical/medication orders. 6. Written in concise format using proper medical terminology. 7. Includes pertinent psycho-social assessment addressing patient’s perception of current health status, mood/affect.

38 8. Information is factual, consistent with other packet information, comprehensive, and organized Subtotal /16 points

SUPPORTING DOCUMENTATION U NI S 0 pts 1 pts 2 pts 1. Medications a. All medications are listed including PRN, with dose, frequency, route, and reason this patient is taking medication identified b. Classification and dosage range is identified, including safe dose c. Assessment needed and implementation guidelines are identified for each medication. Evaluation of effects of meds is concise, complete, and relevant to the patient. Includes data related to potential adverse effects. 2. Laboratory: a. List all lab values, normal and abnormal (see example table) b. Reference values and trends are noted for all normal and abnormal lab values within 48 hours of the time care was provided. Additional abnormal data may be included to show trending as appropriate. (Abnormal values should be formatted in red) c. Interpretation of abnormal lab values is accurate and correlates with diagnosis, medication regime and assessment findings. d. Nursing interventions for abnormal lab data is appropriate to the patient and situation e. A summary statement is included, in student’s own words, that summarizes the abnormal findings and their relevance/connection to the patient’s situation 3. Treatments and other diagnostic testing: a. Identify why treatment is necessary, what it provides for the patient; b. Review both normal and abnormal results and their significance as it relates to the patient. Subtotal /20 points

PATHOPHYSIOLOGY U NI S 0 pts 1 pts 2 pts 1. Pathophysiology of one of the major medical diagnoses experienced during this admission and is written in the student’s own words. 2. Rationale for the student’s choice for discussion of this medical diagnosis is included and reflects student’s ability to prioritize and to be active in their own learning. 3. A complete description of the disease process, etiology, risk factors, medical treatments and common nursing interventions are provided for the diagnosis. 4. Each section is individualized to the patient comparing actual data and treatment plans with general recommendations for this diagnosis. 5. This section is concise (1- 2 pages in length). At least two (2) references are provided. The references should be valid, reliable, and appropriate.

NURS2229_Fall2015 [39] Subtotal /10 points

NURSING PLAN OF CARE #1 NURSING DIAGNOSIS U NI S 0 pts 1 pts 2 pts 1. This nursing diagnosis is stated according to the PES format, using a NANDA approved problem statement. NANDA defining characteristics and supporting assessment data are present to support the choice of nursing diagnosis and priority. The “related to” factor of the nursing diagnosis is NOT a medical diagnosis and reflects an etiology that can be addressed by virtue of the RN’s legal and ethical scope of practice. Actions necessary to modify the “related to” factor are realistic for this patient situation. 2. The student’s rationale for choosing the priority of this nursing diagnosis reflects a solid understanding of the patient’s care and situation. Supporting data for this decision is sufficient for decision making. Subtotal /4 points

EXPECTED GOAL AND OUTCOMES (SHORT TERM) U NI S 0 pts 1 pts 2 pts 1. An overall goal with three outcome indicators is established. The expected goals/outcomes are stated in measurable patient behavior and include a time frame for evaluation. 2. The expected goal/outcomes are realistic for the patient and relevant to the diagnosis. Subtotal /4 points

NURSING INTERVENTIONS U NI S 0 pts 1 pts 2 pts 1. Five individualized nursing interventions are documented for each nursing diagnosis. Each intervention should be designated as “done”, “observed”, or “planned”. One intervention should be a teaching intervention. Interventions are directed toward assisting the patient to achieve the expected outcome chosen for the nursing diagnosis. 2. Nursing interventions are individualized to the patient and are specific enough to direct care provided by other nurses or assistive personnel. Nursing interventions are within the RN’s scope of practice. Each interventions includes the following: a. Rationale: Each nursing intervention is accompanied by a scientific rationale that describes why the intervention is appropriate for the patient situation. There is an APA citation for each scientific rationale provided. The source of the scientific rationale directly related to the care of the particular patient. **at least one rational must come from an evidence

40 based practice journal article b. Implementation and Evaluation: Care that was given or planned is described along with an evaluation of the effectiveness of the intervention. The discussion of clearly identifies the student’s understanding of the RN role in provision of care. Subtotal /8 points

EVALUATION OF THE EXPECTED GOAL/OUTCOMES U NI S 0 pts 1 pts 2 pts Each expected outcome is evaluated as “met”, “partially met”, or “not met”. If “partially met” or “not met”, discussion of what changes in the plan of care, necessary to move the patient toward achievement of the expected outcome are clear and concise. This evaluation section should not exceed ½ page.

LONG-TERM GOAL U NI S 0 pts 1 pts 2 pts The long-term goal selected for the patient is appropriate and well developed. Documentation of the parameters that would be evaluated to assess attainment of the long-term goal are appropriate and measurable. This discussion is at least ½ page in length, but does not exceed 1 page. Subtotal /4 points

NURSING PLAN OF CARE #2 NURSING DIAGNOSIS U NI S 0 pts 1 pts 2 pts 1. This nursing diagnosis is stated according to the PES format, using a NANDA approved problem statement. NANDA defining characteristics and supporting assessment data are present to support the choice of nursing diagnosis. 2. The student’s rationale for choosing the priority of this nursing diagnosis reflects a solid understanding of the patient’s care and situation. Supporting data for this decision is sufficient for decision making. Subtotal /4 points EXPECTED GOAL AND OUTCOMES (SHORT TERM) U NI S 0 pts 1 pts 2 pts 3. An overall goal with three outcome indicators is established. The expected goals/outcomes are stated in measurable patient behavior and include a time frame for evaluation. 4. The expected goal/outcomes are realistic for the patient and relevant to the diagnosis. Subtotal /4 points

NURSING INTERVENTIONS U NI S 0 pts 1 pts 2 pts

NURS2229_Fall2015 [41] 1. Five individualized nursing interventions are documented for each nursing diagnosis. Each intervention should be designated as “done”, “observed”, or “planned”. One intervention should be a teaching intervention. Interventions are directed toward assisting the patient to achieve the expected outcome chosen for the nursing diagnosis. 2. Nursing interventions are individualized to the patient and are specific enough to direct care provided by other nurses or assistive personnel. Nursing interventions are within the RN’s scope of practice. Each interventions includes the following: a. Rationale: Each nursing intervention is accompanied by a scientific rationale that describes why the intervention is appropriate for the patient situation. There is an APA citation for each scientific rationale provided. The source of the scientific rationale directly related to the care of the particular patient. **at least one rational must come from an evidence based practice journal article b. Implementation and Evaluation: Care that was given or planned is described along with an evaluation of the effectiveness of the intervention. The discussion of clearly identifies the student’s understanding of the RN role in provision of care. Subtotal /8 points

EVALUATION OF THE EXPECTED GOAL/OUTCOMES U NI S 0 pts 1 pts 2 pts Each expected outcome is evaluated as “met”, “partially met”, or “not met”. If “partially met” or “not met”, discussion of what changes in the plan of care, necessary to move the patient toward achievement of the expected outcome are clear and concise. This evaluation section should not exceed ½ page.

LONG-TERM GOAL NI U S 1 0 pts 2 pts point The long-term goal selected for the patient is appropriate and well developed Subtotal /4 points

EVALUATION OF THE STUDENT’S EXPERIENCE WITH THE U NI S PATIENT 0 1 point 2 pts pts This discussion is insightful. This discussion is at least ½ page in length, but does not exceed 1 page. Subtotal /2 points

EVIDENCE BASED PRACTICE ARTICLES U NI S 0 pts 1 pts 2 pts

42 For each article cited, a review is present which includes a summary reflecting the student’s understanding of the information presented and a description of the article’s application to this patient. Subtotal /2 points

Overall Score /100 points

NURS2229_Fall2015 [43] FACULTY EVALUATION OF STUDENT'S CARE PLAN

SATISFACTORY UNSATISFACTORY*

Dates:  The case study must be submitted to the appropriate dropbox folder on D2L by the due date announced in class and posted on D2L  If a student does not achieve an 84% or higher on the first case study, they will be required to complete a second case study. If a second case study is required, the student will receive a weekly grade for the first case study submitted.

Late work:  Five (5) percentage points will be deducted for each calendar day the assignment is past due. Late points will be deducted when any part of the next calendar day elapses before receipt of the assignment given.

 Assignments submitted seven (7) calendar days late will not be graded and the student will receive a zero (0) for that assignment; however, assignments MUST be posted for student to receive credit for clinical time.

*Grades lower than 84% are considered unsatisfactory. An unsatisfactory case study result in a clinical faculty report and the student being placed on clinical probation. The student has one opportunity to do another case study, which is submitted to the instructor within 2 weeks of receipt of original grade. The student is responsible for contacting the instructor immediately for guidance regarding the new case study.

FACULTY SIGNATURE DATE

For grade <84%: I have reviewed this document with my clinical faculty and have had an opportunity to ask questions.

STUDENT SIGNATURE DATE

44 APA Help: https://owl.english.purdue.edu/owl/resource/560/01/

Formatting Examples:

Journal Summary—Required Formatting Name Date

Instructions: The purpose of an article citation is to cite nursing literature support for the nursing case study. Use correct grammar, spelling and punctuation.

REFERENCE CITATION Provide the full article citation in APA format

SUMMARY Provide a summary of the article including the purpose, research methods and results. This should be a paragraph in length, approximately ½ page.

NURSING IMPLICATIONS Identify how this article applies to your patient and what the implications of the research are to nursing practice. This should be a paragraph in length, approximately ½ page.

NURS2229_Fall2015 [45] Medications:

Medication Order Assessment Implementation Class needed Outcome/expected Dosage range outcome Adverse Effects

Azithromycin Assess for fever. Assess for Take on an empty stomach 500 mg PO daily for allergy. Monitor CBC one hour prior to eating or 2 community acquired specifically white blood hours after eating. Do not give pneumonia cell count. with medications containing potassium. Patient was on KCl infusion, monitor for S/S of Adverse Effects: side hyperkalemia. Class: Antibiotic effects including abdominal Outcome: WBC count went Normal Dosage Range: pain, nausea, vomiting, and from 27.2x103 uL 9x103 uL, 500 mg orally every day headache. indicating reduction of for 5-7 days presence of pathogen.

Vancomycin Assess CBC for white Administer over 60 1 g/250 mL NaCl IV blood cell count. Assess minutes. Dilute in D5W, q8h for lower for fever. LR, or NS. Maximum respiratory tract infusion rate 10 mg/min. infection Adverse Effects: Hypokalemia, GI upset Outcome: WBC count Class: Antibiotic went from 27.2x103 Normal Dose Range: uL9x103 uL, 2 g/day divided q6-12 h indicating reduction of presence of pathogen. Lab Values:

Lab Test Normal Date Probable Nursing Values Value Cause/Reason Intervention Obtained (Reference) (Reference) Blood Chemistry 7-7-15 7-8-15 List probable List nursing 135-145 134 135 cause/reason intervention  Na 3.5-5.0 4.5 4.6 for abnormal for abnormal  K+ 8.5-10.7 9.2 10.0 lab in this lab in this  Ca 7-20 11 16 section. Don’t section.  BUN 20-29 22 27 forget your Don’t forget  CO2 0.8-1.4 0.9 1.2 reference. your  Creatinine 101-111 99 101 reference.  Chloride

46 STUDENTS Group2 Tammie Baker RN 918-284-8713 Cell 918-269-9538 Chrissi 9/21/1 9/4/15 9/7/15 5 9/28/15 10/5/15 10/12/15 10/19/15 10/30/15 11/2/15 Holiday Nestlerode, STIC BOO Meranda "O" U 3Sp HHT STICU STICU CICU OBN Chitseko, Robert Holiday STIC BOO OBN "O" U Lead 3Sp CICU 3Sp STICU Sarant, Jessica "O" Holiday CICU CICU Lead STICU 3Sp BOO CICU OBN Shaw, Taylor "O" Holiday CICU 3Sp 3Sp Lead STICU BOO CICU OBN Stanton, Autumn "O" Holiday CICU STICU STICU STICU Lead BOO STICU OBN Stevens, Michelle "O" Holiday HHT STICU CICU CICU CICU BOO STICU OBN Thai, Lan "O" Holiday CICU STICU CICU 3Sp STICU BOO Lead OBN Thoman, Paige "O" Holiday Lead STICU STICU CICU HHT BOO STICU OBN Hunalp, Paula Holiday STIC BOO OBN "O" U HHT CICU 3Sp STICU CICU Vose, Cari Holiday STIC BOO OBN "O" U CICU STICU STICU CICU HHT Hickman, Elizabeth "O" Holiday 3Sp CICU STICU HHT CICU BOO 3Sp OBN Gould, Rachel "O" Holiday 3Sp CICU CICU CICU CICU BOO 3Sp OBN

Fall 2015 Clinical Schedule Chrissi Martin 918-269-9538 [email protected] 3 Specialty = 3S Lead = Leadership 3W STICU = 3W HH= Home Health St. Francis Monday 0800-1630 5 Specialty CICU = 5S OBN= OK Board of nursing

STUD ENTS Group 1 Chrissi Martin 9/7/14 RN, MS,M BA 918- 269- 1 9538 0 Cell / 3 91829 0 34789 / 1 Office 9/4/15 9/14/15 9/28/15 10/5/15 10/12/15 10/19/15 5 11/2/15

NURS2229_Fall2015 [47] Armstr Holiday ong, B Barbar O a "O" Lead 3Sp HHT STICU 3Sp O CICU OBN Arnold Holiday B OBN , O Willia O m "O" ER Lead 3Sp HHT 3Sp STICU Brillha Holiday B OBN rt- O Green, O Cassan dra "O" 3Sp ER Lead STICU STICU CICU Caldw Holiday B OBN ell, O Erin "O" 3Sp 3Sp ER Lead STICU O CICU Casey, Holiday B OBN Elizab O eth "O" STICU STICU STICU ER Lead O STICU Rowlet Holiday B OBN t, O Micha O el "O" STICU STICU CICU CICU ER STICU Brandi Holiday B OBN Radeb O augh "O" CICU STICU CICU 3Sp STICU O Lead Kyle Holiday B OBN Curry O "O" STICU STICU STICU CICU HHT O ER Tuttle, Holiday B OBN Mary O "O" CICU HHT CICU 3Sp STICU O CICU Kelch, Holiday B OBN Felicia O "O" CICU CICU STICU STICU CICU O HHT Long, Holiday B OBN Kelsey O "O" STICU CICU STICU CICU CICU O 3Sp Martin, Holiday B OBN Lauren O "O" CICU CICU CICU CICU CICU O 3Sp Minter, Holiday B Alexis O "O" HHT CICU 3Sp STICU CICU O Lead OBN Fall 2015 Clinical Schedule Chrissi Martin 918-269-9538 [email protected] 3 Specialty = 3S Lead = Leadership 3W STICU = 3W ER= Henryetta Medical Center Monday 0630-1500

48 5 Specialty CICU = 5S HHT= Home Health (Traditions) Monday 0800-1630 with Tamara Sadler RN OBN= OK Board of nursing

NURS2229_Fall2015 [49]