Nursing Care of the Adult Client II •
The second of three medical/surgical courses focusing on acute and chronic health dysfunctions. Students gain clinical experience in acute-care settings. Course consists of two components: NURS 102X and 102Z. Prerequisite: NURS 101X and 101Z.
After completing this class, students should be able to:
- Continue to implement the five phases of the nursing process as a systematic approach to individualizing client care.
- Collects pertinent data by assessing one or two clients using the Advanced Assessment Data Collection Guide.
- Collects pertinent data from other sources:
- client's record
- family members
- health team members
- Identifies changes in assessment data that deviate from the client's baseline health status
- Validates abnormal data.
- Organizes assessment data according to Maslow's basic needs
Nursing diagnosis Begins to identify pertinent nursing diagnoses and their etiologies. Provides client-specific defining characteristics applicable to the nursing diagnosis. Planning and Outcomes Begins to prioritize nursing diagnoses. Begins to collaborate with client and/or family members to formulate expected outcomes that are: pertinent and related to nursing diagnoses realistic and measurable with critical times client focused, incorporating the family, sociocultural background and spiritual beliefs Begins to select appropriate nursing actions that address nursing diagnoses of the adult client in a medical-surgical setting. Provides rationale for medications and therapeutic interventions Incorporates the agency's plan of care Implementation Performs selected nursing actions specific to expected outcomes (with occasional cuing). Examples include, but are not limited to: suctioning - oral, nasal or tracheal monitoring chest drainage wound care - simple, complex administering nasogastric tube feedings tracheostomy care Involves family in nursing actions when appropriate. Provides for the physical safety of client in the acute care setting. Documents relevant care provided. Evaluation Identifies client progress as related to expected outcomes (with occasional cuing). Modifies the plan of care to best meet the needs of the hospitalized client (with occasional cuing). Continue to demonstrate cognitive, psychomotor, and affective skills to ensure safe practice. Identifies rationales for nursing actions and other therapeutic measures, incorporating knowledge of relevant pathophysiology, diagnostic procedures, etc. Performs psychomotor skills learned in Nursing 100 and Nursing 101 safely. With no cuing of N100 skills With minimal cuing of N101 skills With occasional cuing of N102 skills; examples include but are not limited to: suctioning - oral, nasal or tracheal monitoring chest drainage wound care - simple, complex administering nasogastric tube feedings tracheostomy care Applies principles of medical and surgical asepsis Performs skills on time Performs skills in a reasonable amount of time Demonstrates organizational skills Demonstrates dexterity Adapts performance to meet needs of client and/or situation Administers parenteral and non-parenteral medications safelyand in a timely manner. States action, contraindications, effects and nursing considerations for prescribed medications. Calculates medication and intravenous doses correctly Uses effective communication techniques with clients, families, instructor, peers and health care team. Develops oral presentation skills: Reports clear, concise and relevant data to staff, instructor, and peers Presents an oral nursing care plan to clinical peers and instructor during post-conference As a manager of care, the student will Collaborate as a health team member when providing care for a client in the medical-surgical setting. Cares for clients with dysfunction or disease in the following areas: Musculoskeletal dysfunction Arthritic and connective tissue disorders Respiratory dysfunction Cardiovascular dysfunction Peripheral vascular dysfunction Hypertension Visual and/or auditory dysfunction Cancer Demonstrates organizational skill in the management of care. Begins to prioritize nursing care for 2 clients in the medical-surgical setting Completes care for the assigned clients Practice in a cost-effective manner: Organizes care to conserve time, energy and resources Validates the use of supplies and equipment to minimize waste Assume the role of peer resource person (PRP): Listens to shift report and obtains additional current data from staff/instructor for group of clients assigned to peers Gives verbal support to peers and answers questions with instructor support Assists with selection of peer assignment as needed with instructor's input Schedules help from instructor for peers Assists peers with instructor approved procedures Monitors client care for group of assigned clients Seeks and schedules additional learning experiences for self and peers Ensures documentation is complete Ensures peers have reported to appropriate staff As a Member within the Discipline of Nursing, the student will: Practice within the ethical and legal framework of nursing Follows established school policies as outlined in the College and Program Student Handbooks. Follows established agency policies and procedures Documents care as given with occasional cuing using agency format meeting legal standards clearly and concisely in a timely manner legibly with correct grammar and spelling Reports pertinent data promptly to appropriate staff and instructor. Respects and supports the rights of the client's: Privacy Confidentiality Right to refuse care Begins to act as a representative of the adult client's needs and concerns when necessary (advocacy). Practices with knowledge of nurse's ethical and/or legal role and responsibilities related to issues presented during previous courses. Continue to exhibit professional accountability Prepares for N102 clinical assignment using appropriateresources. Seeks assistance when clinical situation is beyond knowledge and experience. Seeks opportunities in the clinical settings to enhance learning and pursue professional growth. Follows established lines of communication within the assigned clinical setting. Demonstrates reliability in completing client/clinical assignments. Evaluates own performance accurately: Accepts responsibilities for own decisions, behaviors, and actions while in clinical settings Accepts feedback and makes appropriate changes in behavior Identifies own strengths and areas for growth in adult health care settings Definitions of cuing: No cuing: student will perform independently with no intervention by instructor. Minimal cuing: instructor will provide no more than 2 prompts. Occasional cuing: instructor will provide no more than 4 prompts.