Los Angeles Harbor College Course Outline s4

LOS ANGELES HARBOR COLLEGE COURSE OUTLINE

Associate Degree Applicable Course TOP CODE: 1203.00

Non Associate Degree Applicable Course NEW Course ADDITION of a District Course Revision/Update Date: 09/01/05 Distributive Learning Curr. Committee Date: 09/24/05

1. DEPARTMENT/DISCIPLINE: Nursing

2. SUBJECT: Registered Nursing SUBJECT CODE: 669

3. COURSE TITLE: Nursing Process & Practice in the Care of the Adult Client III COURSE NUMBER/LETTER: 347

4. HOURS PER WEEK: Lecture 1.67 hrs. Lab 4.5 hrs. Discussion hrs

Other: (Specify) total hrs/wk 6.17 UNITS: 3

5. REPEATABILITY: None RPT1 RPT2 RPT3

6. PREREQUISITE AND/OR CO-REQUISITE: Completion of all program prerequisites, non-nursing courses and all preceding nursing courses with a grade of “C” or better. LVN Advanced Placement: As above AND completion of required 2nd and 3rd semester nursing courses and cognates, and Sociology 1 or Anthropology 102 with grades of “C” or better. “LVN 30- unit Option”: Admission to nursing program and completion of Nursing 339 with a grade of “C” or better. Concurrent enrollment in Nursing 343 and 347 is required. Enrollment in Nursing 318 is highly recommended.

7. COURSE CATALOG DESCRIPTION: (Please limit to 50 words) This modularized course provides theoretical knowledge correlated with clinical experience in the care of complex adult medical-surgical clients with cardio-pulmonary and multi-system insufficiencies. The Roy Adaptation Model and Nursing Process are used to plan and implement care. Clinical experiences utilize critical care and telemetry units. Theory content from previous nursing courses and required cognates are synthesized.

8. COURSE CLASSIFICATION / ARTICULATION: Course Articulation Classification Requested Approved/Date/Signature: Acceptable for Credit, University of California ______Acceptable for Credit, California State Universities ______Baccalaureate ______Occupational ______Pre-college level, prerequisite and/or Developmental

9. TEXTBOOKS: (List all publications that students are required to use, plus any recommended college level readings) (Also required for courses offered in a Distributive Learning format in order to be transferable.) Author: Ignatavicius, Workman, Mishler Title: Medical-Surgical Nursing Across the Health Care Continuum

Publisher: W.B. Saunders Company Edition/Year: 6th, 2005

Author: Springhouse Corporation Title: ECG Interpretation Made Incredibly Easy

Publisher: Springhouse Edition/Year: Latest

Other Readings:

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 1 of 9 10. MATERIALS & SUPPLIES: (List materials and supplies that are REQUIRED for this course. For Distributive Learning courses: Students are required to have a personal E-mail address & Internet access through a private provider.) COLLEGE PROVIDED: Assigned videotapes, computer programs available in Nursing Learning Lab

STUDENT PROVIDED: Scantrons, Nursing 345 modules, specified clinical forms

Not Applicable

11. COURSE ENTRY SKILLS, OBJECTIVES / EXIT SKILLS: A. ENTRY SKILLS: [Minimum of Five (5)] State performance skills and behaviors in specific and measurable terms. THE STUDENT IS ABLE TO: (1) Demonstrate a comprehensive theory base of normal physiologic and psychosocial changes in the client/patient in the acute care, home health care, extended care settings. (2) Complete an accurate head-to-toe assessment of the client, review of pertinent data. (3) Perform basic interviewing for nursing history and psychosocial assessment for clients with acute and chronic health problems. (4) Integrate theoretical knowledge in formulating and applying the Nursing Process based on the Roy Adaptation Model, including assessment, planning, implementation, and evaluation in relation to delivering care to two adult clients. (5) Collaborate and participate with other health care team members in meeting client needs. Include client/family/significant other in goal setting and planning. (6) Utilize knowledge, skills, and established protocols to provide a safe environment conducive to optimal restoration and maintenance of client’s basic needs. (7) Work in a variety of settings: Acute care, home health or extended care setting.

(8) Demonstrate technical competency in performing basic physical assessment, administering medications by all routes (excluding direct IV push), insertion of peripheral intravenous catheters, monitoring blood transfusions and intravenous therapy, care of stomas, bladder irrigations, insertion and care of nasogastric tubes, care and treatment of feeding tubes, wounds, tracheostomies and decubiti care and prevention. (9) Establish and maintain communication with individual clients, families, and health team members; evaluate and modify personal communication. (10) Assess verbal and nonverbal communication of clients and families. (11) Communicate and record assessments, nursing care plans, nursing actions, evaluation and discharge plan according to established protocols. (12) Identify situations in which clients and families need information and support to promote, maintain and restore faith. (13) Develop short-term teaching plans specific to client’s level of development and cognitive ability, and which are based on short-term goals for the individual client. (14) Participate in the evaluation of client learning and the modification of teaching plans.

B. OBJECTIVES / EXIT SKILLS: [Minimum of five (5)] State performance behaviors and skills in specific and measurable terms. These skills become the entry skills for the next course. As a result of completing this course, THE STUDENT WILL BE ABLE TO:

(1) Assemble past and present learning to develop an advanced theory base related to cardiopulmonary physiologic principles and alterations; oxygenation and acid-base status; and shock states. (2) Integrate the nursing process and Roy Adaptation Model in caring for clients with complex oxygenation and multisystem needs: Assessment: a. Demonstrate advanced physical assessment techniques for the cardiovascular and respiratory systems. b. Incorporate advanced assessment data, i.e., hemodynamic monitoring, EKG analysis, ABG analysis into data base. c.Differentiate between adaptive and ineffective behaviors in the client with complex multisystem needs. d. Select common stimuli contributing to ineffective behaviors in the client with complex multisystem needs. Nursing Diagnosis: Rank major client problems based on analysis of assessment data and demonstrate the ability to prioritize problems and formulate specific goals for the client with complex multisystem needs.

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 2 of 9 Intervention: a. Formulate a plan of care for identified client problems, utilizing theoretical data base. b. Plan realistic short term goals in collaboration with the client, family, and health care team. c. Provide care to client requiring artificial airways, mechanical ventilation, EKG monitoring, ABG monitoring, hemodynamic monitoring, chest tubes, pacemakers, and vasoactive medications based on theoretical concepts. Evaluation: Evaluate nursing interventions and adjust plan of care as needed.

(3) Adapt concepts of teaching/learning process in developing an educational plan for the acutely ill client with multisystem needs. (4) Synthesize and apply knowledge and understanding of cultural diversity as it relates to caring for the acutely/critically ill client with multisystem needs. (5) Discuss legal/ethical issues as they relate to the acutely/critically ill client with multisystem needs, to include Advance Directives, Do-Not-Resuscitate (DNR) status, end-of-life care, and organ/tissue donation. (6) Demonstrate critical thinking abilities in classroom and clinical settings in assessing, planning, implementing, and evaluating care for the client with complex multisystem needs. (7) Demonstrate the ability to safely integrate therapeutic interventions for the acutely/critically ill client requiring: a. advanced cardiovascular and respiratory system assessments. b. Vasoactive and intravenous push medications (with RN supervision) c. Hemodynamic monitoring (with RN supervision) d. Artificial airway/mechanical ventilation (with RN supervision) e. EKG monitoring, pacemakers f. ABG monitoring and analysis g. Chest tubes (8) Assess the need for, implement, and evaluate pain management techniques/medications for an acutely/critically ill client. (9) Synthesize therapeutic communication concepts and demonstrate the ability to establish therapeutic communication with an acutely/critically ill client and family/significant other. (10) Integrate information technology into data research and charting at designated facility. Validate information obtained by Internet sources.

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 3 of 9 12. SCANS Competencies (Must be listed with all Vocational Education courses.) Indicate the SCANS competencies developed in this course:

Resources (Identifies, organizes, and allocates resources.) Time Money Material and Facilities Human Resources

Information (Acquires and uses information.) Acquires/Evaluates Organizes/Maintains Interprets/Communicates Uses Computers

Technology (Works with a variety of technologies.) Selects Applies to tasks Maintains and troubleshoots equipment

Thinking Skills Creative Thinking Decision Making Problem Solving Symbolic Thinking Application of learning techniques Reasoning

Interpersonal (Works with others.) Serves as team member Teaches others Serves clients/customers Exercises Leadership Negotiates Works with diversity

Systems (Understands complex inter-relationships.) Understands systems Monitors/corrects systems Improves/designs systems

Fundamentals Reading Writing Mathematics Listening Speaking

Personal Qualities Responsibility Self-Esteem Sociability Self- Management Integrity

13. INSTRUCTIONAL METHODOLOGY: (Recommended types of writing assignments, demonstrated use of symbol systems or ability to apply skills learned in the course) (For Distributed Learning courses: Description of “asynchronous interactivity”, i.e. ability to receive instruction at a different time than class is offered.)

A. WRITTEN ASSIGNMENTS Req. Opt. Req. Opt. Essay(s) Journals Term Paper(s) Homework Report(s) E-mail/Bulletin Boards Summaries & Analyses Internet/Chat Rooms Other (Weekly clinical write-up & evaluation)

B. SYMBOL SYSTEMS Req. Opt. Req. Opt. Req. Opt. Logic Computation Art Projects Music Interpretations Drafting/Graphics Proofs Applications Other ( )

C. SKILLS Req. Opt. Req. Opt. Req. Opt. Verbal Analytical Laboratory Written Physical Computer Other ( )

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 4 of 9 14. APPROPRIATE OUTSIDE ASSIGNMENTS Req. Opt. Req. Opt. Field Trips Readings Lectures Research Projects Meetings Computer Projects Skill Practice Library Work Special Films and TV Programs Other ( )

15. CRITICAL THINKING ASSIGNMENTS Req. Opt. Req. Opt. Problem Solving Translation Class Research Syntheses Analyses Interpretations Comparing and Contrasting Comprehension of Subject Matter Evaluating Significance Creating/Formulating Ideas Setting Up Proofs Other ( )

16. INSTRUCTIONAL MODES Req. Opt. Req. Opt. Lecture Term Project Lecture/Discussion Oral Drills Lecture/Laboratory Work Experience Laboratory Computer Interactive Assignments Demonstration Guided Discussion Written Assignments Discussion/Seminar Reading Assignments Independent/Directed Study Mediated TV One-on-one Conference TV/Audio Visual Digitized/Modem Guest Speakers ISDN/CODEC (Videoconference) Small Group Experience Internet Access Field Experience E-mail Address Other ( )

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 5 of 9 17. COURSE CONTENT (Please outline by topics or activities and include time schedule or week)

Time Allocated(in hours) Topic or Activity Lec Tutorial Clinical 8 hrs. 2 hrs. 13.5 hrs Introduction to course Medication test (may take up to 3 times for90% competency) Module I: Advanced Care Concepts- CV/pulm A&P, advanced physical assessment, diagnostic tests, hemodynamics, artificial airways, ventilators, chest tubes vasoactive medications, advanced medication calculations Module I examination

8 hrs 2 hrs. 27.0 hrs. Module II: Care of Client with Dysrhythmias: electrophysiology, lead systems, graph paper, EKG complex. Systematic approach to EKG analysis in lead II. Identify, discuss etiologies, clinical significance, treatment, and nursing interventions for sinus, atrial, junctional, ventricular rhythms, and for 1st degree AV block. Pacemakers, AICD. Module II examination

7 hrs. 2 hrs. 13.5 hrs. Module III: Care of Clients with Complex Cardiovascular Dysfunction/Shock: pulmonary edema, valvular heart disease,cardiomyopathy hypertensive crisis, aortic aneurysms, myocardial infarction. Hypovolemic, cardio-genic, distributive shock states. Ethical issues in nursing Test Module III/Ethics assignment due

7 hrs. 2 hrs. 13.5 hrs. Module IV: Care of Clients with Oxygenation and Acid-Base Disruptions: Acid-base concepts and analysis, COPD, pulmonary embolus, ARF, ARDS, TB, lung cancer, pulmonary trauma. Module IV examination Review for final examination

2 hrs. 13.5 hrs. FINAL EXAMINIATION Clinical Evaluation Conference with each student. Course and instructor evaluation and final grade.

Note: The Carnegie Rule and Title 5 section 55002 sets forth the minimum standards which require: 1 hour lecture with 2 hours homework = 1 unit Lecture also includes discussion and/or demonstration 2 hours of lab with homework = 1 unit 3 hours of lab without homework = 1 unit. laboratory includes activity and/or studio hours. State number of hours (111) for activities.

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 6 of 9 18. EVALUATION METHODS (Multiple measures, which are consistent with the course objectives, content and scope, must be used to determine student’s final grade. Student performance will be evaluated by essay unless problem solving or skill demonstration is more appropriate.)

Req. Opt. Req. Opt. Quizzes, Unit Tests, Midterms Essays Final Exam Term Papers, Projects and Reports Laboratory Reports Homework Assignments Observation Record of Student Oral Presentations Performance Questionnaires Class Participation Standardized Tests Written Compositions Other ( )

(For Distributive Learning courses: explain how testing will be accomplished, i.e., through U.S. mail, over E-mail, in on- campus testing center, at the LAC, or in designated classroom. When an in-person testing center or site is used, a picture ID will be required to verify student’s identity during testing or examination.)

19. COLLEGE LIBRARY MATERIALS ASSESSMENT:

The instructor and acquisitions librarian have evaluated the library materials relating to this course and noted relevant supporting materials and needs.

Acquisitions Librarian ______Date ______

The above signature does not denote approval or disapproval of this course. Signature is not required for routine course revisions, which do not have substantive changes.

20. DISTRIBUTIVE LEARNING COURSES: COLLEGE READINESS

The instructor has consulted with the LAN Administrator and Distance Education Coordinator regarding needed support related to this course. This support may include use of college facilities, assistance in preparation of materials to be sent over the ISDN lines in digitized format, and provision for intellectual property rights of the instructor.

LAN Administrator ______Date ______

Distance Education Coordinator ______Date ______

The above signatures do not denote approval or disapproval of this course. Signatures are not required for routine course revisions that do not have substantive changes.

_Wendy Hollis______09-14-05 ___Wendy Hollis______09-14-05__ Prepared by Date Division Chair Date

______Curriculum Committee Chair Date V. P. Academic Affairs Date

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 7 of 9 LOS ANGELES HARBOR COLLEGE STANDARDS AND CRITERIA FOR APPROVAL OF CREDIT COURSES

Name of Course: Nursing 345

Using the Official Course Outline, please determine whether or not the above listed credit course meets the following standards and criteria required in Title 5, Part VI of the California Administrative Code, and which has been designated as appropriate to the Associate Degree. Place a mark (X) in the appropriate box. For courses applicable for an Associate Degree all criteria must be met. For courses NOT applicable for an Associate Degree only criteria marked with an (*) must be met. RATING CRITERION NOT MET MET

* 1. Is recommended by the responsible college officials, and the academic senate or other appropriate faculty body as meeting the requirements of this subsection and has been approved by the local district governing board as a course meeting the needs of the students eligible for admission.

* 2. Is taught by a credentialed instructor in the discipline

* 3. Is offered as described in an outline in official college files. That outline shall specify the unit value, scope, objectives, content in terms of a specified body of knowledge, appropriate reading and writing assignments, outside of class assignments, instructional methodology, and methods of evaluation for determining whether the stated objectives have been met by students.

* 4. Is taught in accordance with a set of instructional objectives common to all students.

* 5a. Provides for measurement of student performance in terms of the stated course objectives and culminates in a formal recorded grade based upon uniform standards in accordance with Section 55758 of this part, which is permanently recorded as an evaluation of student performance.

5b. Bases grades on demonstrated proficiency in subject matter determined by multiple measurements for evaluation; and has examinations, including essays and/or, where appropriate, uses appropriate symbol systems and/or skills demonstrations by students.

* 6a. Grants units of credit based upon a specified relationship between the number of units assigned to the course and the number of lecture and/or laboratory hours or performance criteria specified in the course outline.

6b. Requires a minimum of three hours of work per week including class time for each unit of credit and prorated for short term, lab and activity courses.

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 8 of 9 RATING CRITERION NOT MET MET

7. Treats subject matter with the scope and intensity, which requires students to study independently outside of class time.

* 8.Requires, when appropriate, entrance skills and consequent prerequisites for the course before students are enrolled

9. Requires as a pre- or co-requisite to enrollment in other courses throughout the degree and certificate curricula, eligibility for enrollment in associate degree credit courses in English and/or mathematics when language and/or computational skills at the associate degree level are deemed by the college and/or district curriculum committee as necessary for success in such courses.

10. Requires the ability to think critically and to understand and apply concepts in order to participate in the course.

11. Requires learning skills and vocabulary appropriate for a college course.

12. Requires the use of college level educational materials.

* 13. Allows repeated enrollment only as permitted by provisions of Division 2 (commencing with Section 51000). Section 55781-55783 and 58161 of this part.

PLEASE INDICATE THE DEPARTMENT’S PLAN FOR IMPROVING ANY STANDARD NOT PRESENTLY MET.

COURSE NOT APPROVED FOR THE FOLLOWING REASON (S):

______DATE ______Curriculum Committee Chairperson

Form revised and approved LAHC Curriculum Committee 09/17/02 Page 9 of 9