Course Syllabus

Nursing 156: Pharmacology for Nurses III

Debi Ingraffia-Strong PhD-c, MSN, RN

Professor of Nursing

Fall 2017

Western Nevada CollegeNURS 156: Pharmacology in Nursing III ~ Fall 2017

Name: Pharmacology in Nursing III

Discipline: Nursing (NURS)

Credits: 1

Prerequisites: NURS 152, 153 and admission to the nursing program

I. Course Description

Provides a continuation of study of pharmacological principles and practices through in-depth application of principles of pharmacology, pharmacokinetics and pharmacodynamics. This course is designed to expand the nursing student’s knowledge of pharmacotherapeutics, which includes the cellular response level, for the clinical application within the context of the nursing process and prioritization of needs for patients across the lifespan. Selected drug classifications of pharmacological agents are examined and applied through case study application and analysis providing opportunity for development of the nursing competencies of clinical judgment, professional identity, use of evidence-based practice, and facilitation of a spirit of inquiry.

II. Course Objectives:

At the conclusion of the course the student will be able to:

1. Relate the foundational knowledge gained in previous pharmacology and nursing courses to case scenario application and analysis.

2. Apply the principles of pharmacology, including pharmacodynamics, pharmacokinetics and pharmacogenomics for a variety of patients across the lifespan.

3. Coordinate the use of pharmacologic and non-pharmacologic nursing interventions in the development of individualized care across the lifespan

4. Examine the relationship between pharmacologic agents and physiologic responses.

5. Identify potential adverse reactions of pharmacologic agents, including those caused by drug-drug, drug-diet and drug-disease interactions and nursing responsibility.

6. Critically apply selected case scenarios integrating pharmacologic considerations, principles of integrity, best practice standards, personal responsibility, ethical practice, safety, and caring.

7. Integrate research findings and evidence-based practice regarding the use of pharmacological agents for the management of common patient health problems, cost effectiveness, available resources, and best practice standards.

8. Describe legal, ethical, and regulatory issues related to medication administration.

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Nursing Program Student Learning Outcomes:

1. Incorporate principles from the bio/psycho/social sciences, mathematics, literacy and nursing in the provision of patient care.

2. Apply the nursing process in a caring manner to safely meet the holistic needs of patients across the lifespan

3. Utilize a broad range of communication skills to promote understanding4. Utilize a spirit of inquiry to integrate current evidence-based guidelines and

nursing science when making clinical practice decisions5. Apply concepts of caring, cultural sensitivity and respect for all persons6. Apply principles of teaching and learning to empower patients and families to

effectively manage healthcare7. Incorporate principles of collaboration and teamwork with patients, families and

the health care team to achieve patient centered care8. Provide and manage care that reflect the ethical values of nursing within

professional standards and legal parameters of the profession

Linkage of course to Institutional Student Learning Outcomes:

1. Identify, describe, and apply information, theories, methodologies and approaches from the sciences, social sciences, and humanities/arts.

2. Write effective projects, papers, and reports.3. Locate, evaluate, and appropriately use information from multiple resources to

complete projects, activities, and papers.4. Integrate knowledge and skills from the study of sciences, mathematics, social

sciences, and the humanities/arts to think critically about and develop solutions to contemporary and/or enduring problems.

5. Identify, describe, and apply information in the discipline or career area of their choice sufficient for further study and/or demonstrate competencies required to succeed in the workplace.

III. WEB Course Requirements

This course utilizes WNC online (Canvas) to provide handouts and communicate with students. Students will need to have the skills necessary to use the internet and a basic understanding of how to download and print documents from the internet. You should also know how to use a word processor that will save in an .rtf or .doc or html format to type and submit papers via the web. Tutorial link and frequently asked questions and answers regarding this online platform are available at http://www.wnc.edu/wnconline/

Canvas technical support for faculty and student is available 24/7 by phone or text chat (855-308-2493). Canvas help can be accessed by clicking on the help link at the top right of the canvas home page.

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IV. Disability Support ServicesAny student needing to request accommodations for a specific disability, counseling and/or testing support to please meet with the DSS coordinator (445-4459) at your earliest convenience to ensure timely and appropriate accommodations. The DSS office is located in Cedar building, Room 209.

V. Teaching-Learning StrategiesRequired reading, pathophysiology concept maps, lecture, pair-share activities, online discussion and activities, case study application, & audiovisual aids. Evolve resource modules.

VI. Credit Hour DesignationThis course has 15 contact hours, with 15 weekly lecture content & discussion activities.

VII. TextbooksRequired Texts:Lilley, L., Collins, S., Harrington, S., & Snyder, J. (2017) Pharmacology and the Nursing

Process, (8th edition) St. Louis: Mosby.

Manning L., & Zager, L (2014) Concepts Made Insanely Easy for Clinical Nursing. Duluth, GA: ICAN Publishing

Elsevier online resources

Recommended Texts:

Rayfield, S., & Manning, L. Pharmacology Made Insanely Easy (2013) (4th edition) GA: ICAN publishers.

Lilley, L., Collins, S., Harrington, S., & Snyder, J., (2017) Study Guide for Pharmacology and the Nursing Process, (8th edition) St. Louis: Mosby.

VIII. Methods of Evaluation

The student must pass all methods of evaluation with 75% cumulative accuracy. These methods include:

Examinations HESI Practice tests Weekly Case Studies/Quizzes Practice Tests Written assignments

IX. Grading SystemGrading of all exams, quizzes, and written assignments are calculated on a point basis. The letter grade is calculated from the number of points earned against the number of points possible. All exams are taken online in the WNC Computer lab (0800-0845 of the exam day) unless prior arrangements are made or sick call to faculty prior to exam.

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The student must pass the exams with a score of 209 points which is 75% or better to earn the extra points from the additional course assignments (refer to the WNC nursing student handbook). Any students caught cheating on an exam, quiz, or assignment will receive a 0. No exceptions. Refer to criteria for exam taking.Exam scores will be released at the completion of the exam in WNConline. If the exam is taken in written format, grades will be released by 5:00 pm Friday of the exam week. There will be no extra credit questions on exams!You have one week after grades are posted to further review the content of the exam. You are highly recommended to review your exams as all exams are cumulatively cumulative and build upon each other. Test review sessions may be scheduled during faculty office hours.

Any exam question, concern or debate regarding exam questions must be submitted via email to the appropriate faculty in APA format with rationale referenced per APA within one week of the exam for consideration.

Assignments submitted after the published due date will not be accepted. Exception to the policy could occur if a waiver is granted by the faculty prior to the due date due to a documented emergency situation. A grade of “0” will be entered for the late assignment, which may result in failure of the course.

See WNC Student Handbook for grading policy & final grade distribution.

Withdrawal Policy: The last day to drop a course with a “W” is October 26, 2017 otherwise the grade earned for the course will be recorded.

HESI Integrated testing: Week 1 requires completion of the HESI practice test for Pharmacology. This is used as a starting point for your integrated learning and to identify gaps in learning and a study plan. There is no end of semester HESI Integrated Exam.

HESI practice tests are available throughout the semester with rationale available for all questions. While there are no course “points” allocated for these, they are very helpful to enhance your student learning.

Course Point DistributionExam 1 (2 points per question) 60Exam 2 (2 points per question) 60Exam 3 (2 points per question) 60Final Cumulative (one point per question) 100Cumulative points from exams & quizzes must total 209~ equal to 75% in order for the additional points to count

280

Weekly case studies/quizzes (10 points each; lowest dropped) 90HESI Pharm Practice Test 10Drug Class NCLEX Study Guide 20Total Possible PointsCumulative points must total 298 in order to attain a grade of C or better and progress within the nursing program

400 possible total points

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Must attain 298 points (75%) in order to receive a passing grade of CSee WNC Student Handbook for grading policy, progression, & final grade distribution.

X. Written AssignmentsRefer to the student handbook for policies on legibility, completion of written assignments, and grading policies. APA format will be used for all references and citations.Students are expected to abide by the WNC Code of Student Conduct in all of their classes http://www.wnc.edu/policymanual/3-4-4.htm Plagiarism is a particularly serious violation, as outlined in the WNC policy manual, Academic Integrity section of code #3-4-5. It will not be tolerated!Assignments submitted after the published due date will not be accepted. Exception to the policy could occur if a waiver is granted by the faculty prior to the due date due to a documented emergency situation. A grade of “0” will be entered for the late assignment, which may result in failure of the course.

Drug Class NCLEX Study Guide: Working individually, each student will develop a study guide incorporating the National Council of State Boards of Nursing (NCSBN) recommendations for medication administration specific to the students chosen drug classification (see attached). Drug classifications will be randomly drawn on the first day of class. Aspects that must be included are: mechanism of action and common generic medications within the chosen drug class. As a study guide you want to include pertinent information relevant practice considerations, safety, patient teaching, best practice guidelines, etc. Be creative. You may include images, visual aids, etc. Formatting should be creative and created in Microsoft word, publisher, or ppt. Please include a title page per APA formatting and a reference page with references used within the study guide. Each study guide will be submitted to the drop box in WNC online (Canvas) by midnight of the assigned content /lecture day prior to class. Each of the study guides will be available to every student to use as a study guide for NCLEX preparation. Grading rubric attached.

Online assignments and participation in discussions:This is web-enhanced course. Active participation on WNC online is required. Please check WNC online daily for new postings, announcements, etc.

Evolve Case Studies & Adaptive Quizzing (EAQ):

Each weekly RN Case Study is assigned through Evolve to be completed prior to class.  These are case studies and quiz questions that are linked to the weekly course content.  If not completed prior to class no credit will be awarded.  Students must be present in class in order to attain case study/quiz

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points with the exception of weeks 2 & 3).  The lowest quiz score during the semester will be dropped. EAQ’s from the previous pharmacology courses (NURS 152 & NURS 153) are available for further learning. Challenge yourself seek to meet level three mastery.The access code for EAQ is: Elsevier Adaptive Quizzing COURSE ID: 156570_dingraffiastrong_1001 Elsevier Adaptive Quizzing for Pharmacology and the Nursing Process, 8thEdition - SP'18 Grads

XII. Student ResponsibilityThe student is responsible for knowing and following the policies and procedures of the college and the nursing program that define appropriate student. The student is responsible for prompt communication with the instructor for any student concern or information needed to be successful in NURS 156The student is responsible for acquiring the necessary technology skills needed to access WNC online for unit objectives, assignments and handouts, testing and communicate between the instructor and other students.The student is encouraged to request accommodations for a specific disability. The student needs to notify the instructor of appropriate accommodations. The student needs to coordinate the accommodations with Susan Trist (the DSS coordinator: phone 445-4459) located in Cedar, Room 209 as soon as possible to ensure timely and appropriate accommodations.Student absences will be acknowledged by each faculty member to determine if there is an ongoing problem. Absences will be dealt with on a one to one basis between the student and the instructor and the Director of Allied Health.

Tobacco PolicyWNC is continuing efforts to support a healthy and safe campus. Starting August 14th, 2017, WNC is officially a tobacco free campus. We are excited to be joining over 1700 tobacco free campuses across the United States. As of now, the use of tobacco and vapor products are prohibited on all WNC property, including inside buildings, and all outdoor areas. Tobacco and smoke free includes all tobacco products. SMOKING means inhaling, exhaling, burning, or carrying any liquid or heated cigar, cigarette, or pipe, or any other lighted or heated tobacco or plant product intended for inhalation, including hookahs and marijuana, whether natural or synthetic, in any manner or in any form. ‘Smoking’ also includes the use of an electronic smoking device which creates an aerosol or vapor, in any manner or in any form. Support and commitment from our students allow us to continue our efforts for a healthy campus. We thank you for your dedication to a tobacco free WNC. 

For more information, please go to our website, www.wnc.edu/healthy-campus/Nevada Tobacco Quitline: 1-800-quitnow or online nevadatobaccoquitline.com 

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Classroom Community

It is important that each person that attends this class have all the opportunity possible to master this content. Every member of this class has the right to participate freely in the class activities without interruption or feeling insecure or insignificant. In order for this to occur, certain classroom conduct is expected. To following outlines behaviors that are expected of the students and instructors.

1. Each member of the community is important to that community as any other member.

2. Every member of the classroom community deserves the right to speak his or her own thoughts as long as those thoughts do not intentionally hurt another.

3. No member of the community has the right to interfere in the exercise of another member’s right to speak: when a member is speaking no one else should.

4. All members of the community are expected to attend class and become involved in the topic of the day. The benefit of coming to class is in networking with your peers and coming to a better understanding of the topics discussed. Your attendance at class benefits all.

5. Because time is limited and much content is covered it is important that the class begin at the appointed hour. Unless prior arrangements have been made, those who arrive late shall wait until the next classroom break to enter the classroom.

6. The only learning materials allowed in the classroom are those directly related to the activities of the class. All other materials, cell phone, PDA’s newspapers, magazines must be put away. Shut off all cell phones. No texting allowed during class times! Computers are allowed to take lecture notes, however no other online activities (such as Facebooking) is allowed during lecture!

7. Trust and respect are expected for everyone in the classroom. Talking with your neighbor and making unnecessary noise will not be tolerated.

8. Your syllabus can answer all your questions about exams and classroom lecture schedule. We will not answer questions such as “What is on the exam?” We will cover exam topics as appropriate. Listen carefully. Recording lecture content is allowed for your use only. These recordings are not to be posted to any internet source.

9. Web conduct: This is web-enhanced course. Active participation on WNC online is required. Please check WNC online daily for new postings, announcements, etc. WNC online is an excellent tool to communicate with the instructor and other students. Please be respectful and post questions and material that is related to the classroom activities. Any negative comments not related to classroom topics should be communicated elsewhere.

10. Examples of misconduct during testing follow. Any student engaging in such behavior will be dismissed and receive a “0” grade for the quiz/exam.

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Being late!Using electronic communications equipment such as pagers, cellphones, iPod’s or PDA’sGiving or receiving help during the quiz or examination or being suspected of doing soUsing prohibited aids, such as reference materials, websites, listening devices, or recordings.Sharing information about the test and test questions with any unauthorized person.

XIII. Instructor Contact Information

Debi Ingraffia-Strong PhDc, MSN, RN Office: Cedar 231Professor of Nursing Office phone: (775) 445-3334deborah.ingraffia@wnc.edu Cell phone: (775) 901-0612

Office hours are posted outside of office door and on the WNC website. Course faculty are available by appointment in office (Carson or Fallon) or online!Communication with faculty: Texting individual faculty is allowed for absences, late to class, and emergency notifications. Otherwise, please email questions, concerns, etc. directly to the faculty member.

Tip for success…

It is best to utilize multiple study methods to learn the medications you need to know to pass the NCLEX. You should be reading, listening, watching, discussing, practicing calculations, and teaching others. Studying in several different ways is important because:

We Learn . . .10% of what we read20% of what we hear30% of what we see50% of what we see and hear70% of what we discuss80% of what we experience95% of what we teach others.-William Glasser

Keep up the hard work!!! Prof DI-S

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XIV. Course Calendar ~ Outline of Topics & Readings

Week Content Covered ~ Lecture/Class Review Readings Lilley et al. Manning & Zager

Review NURS 152/153 Lecture Notes

Quizzes/Evolve Case

Studies

Assignments

Sem wk 1 8/31/17

Pharmacologic Principles Integration of Parenteral

Therapies, Fluid & Electrolyte Balance

Lilley et al. Chapter 1,2,3,4,5,6,7,8,9, 29Manning & Zager pp. 8-25

Case Study: FUN: Fluid

Balance

Complete HESI Pharm practice test

Sem wk 29/8/17

Pain & Inflammation Case Analysis

Lilley et al. Chapter 10,11Manning & Zager pp. 81-83Optional lecture attendance

Case Study: FUN: Pain

Review HESI practice test

Sem wk 39/15/17

Oxygenation Case Analysis

Lilley et al. Chapter 36,37Manning & Zager pp. 26-28 & 21-25Optional lecture attendance

Case Study: MS: COPD

with Pneumonia

NCLEX study guides: Oxygenation

Sem wk 49/21/17

Exam 1 Computer lab (0800 – 0845)

Sem wk 509/28/17

Perfusion Cardiac/Peripheral Case Analysis

Lilley et al. Chapter 22,23,24,25,27,28Manning & Zager pp. 29-32

Case Study: MS: PVD

with amputation

NCLEX study guides: Cardiac perfusion

Sem wk 610/5/17

Metabolism - Endocrine Case Analysis

Lilley et al. Chapter 30,31,32,33,34,35Manning & Zager pp. pp. 44-53

Case Study: MS: DMI

NCLEX study guides: Endocrine

Sem wk 710/12/17

Immune Case Analysis Lilley et al. Chapter 40, 47,48,49, 41Manning & Zager

Case Study: MS: TB

NCLEX study guides: Immune

Sem wk 810/19/17

Perfusion Renal Case Analysis

Lilley et al. Chapter 22, 24, 28Manning & Zager pp. 54-59

Case Study: MS: CKD

NCLEX study guides: Renal

Sem wk 910/26/17

Exam 2 Computer lab (0800 – 0845) Perfusion Shock Case

Analysis *At Home

Lilley et al. Chapter 18, 38, 39 Manning & Zager pp. 33-35*This is the make-up lecture for the Thanksgiving Holiday

Case Study: MS:

Colonoscopy bowel perf.

NCLEX study guides: Shock

Sem wk 1011/02/17

Thermoregulation & Intracranial Regulation Case Analysis

Lilley et al. Chapter 13,14,15,16,17,18,19,20,21Manning & Zager pp. 36-38 & pp. 84-87

Case Study: MS: Traumatic Brain Injury

NCLEX study guides: Neuro

Sem wk 1111/09/17

Exam 3 Computer lab (0800 – 0845)

Sem wk 1211/16/17

Biliary/Liver/GI Metabolism Case Analysis

Lilley et al. Chapter 27, 40, 49 (vaccines), 50-55 (GI portion)Manning & Zager pp. 39-43

Case Study:MS: Cirrhosis

NCLEX study guides: Biliary

Sem wk 1311/22/17

Thanksgiving HolidayClass make-up via lecture capture semester week 9

Sem wk 1411/30/17

Cellular Regulation Case Analysis

Lilley et al. Chapter 45,46, 54Manning & Zager pp. 63-67

Case Study: MS - Breast

Cancer

NCLEX study guides: Cellular Regulation

Sem wk 1512/7/17

Review Review None None

Finals Week

Final Exam – CumulativeTuesday 12-13-17 - Computer lab – 10:00-12:00 (TBA)

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Drug Class NCLEX Study Guide Assignment

Working individually, each student will develop a single page study guide incorporating the National Council of State Boards of Nursing (NCLEX) recommendations for medication administration specific to the students chosen drug classification (see attached). This will be available for each student to use as a study guide for NCLEX preparation. Aspects that must be included are: mechanism of action and common generic medications within the chosen drug class. As a study guide you want to include pertinent information relevant practice considerations, safety, patient teaching, best practice guidelines, etc. Be creative. You may include images, visual aids, etc. Formatting should be creative and created in Microsoft word, publisher, or ppt. APA formatting will be used for the title and reference pages. Each study guide will be submitted to the drop box in WNC online (Canvas) by midnight of the assigned content /lecture day prior to class. Grading rubric attached.

Grading Rubric for Drug Class NCLEX Study Guide ~ 20 points possible

Area Never0

Seldom1

Occas.2

Mostly3

Always4

Mechanism of action clearly defined (at the cellular level)

Relevant practice considerations for administration: *refer to the NCSBN attachment *safety *patient teaching *best practice guidelines *nursing considerations *Common generic medications identified and comprehensive

Creativity of material presented

APA format* Title page* Reference page

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Concept Drug Classifications AssignedOxygenation Beta-2 agonists

Phosphodiesterase inhibitors (PDE4)Leukotriene inhibitorMast cell stabilizerAnticholinergics

Perfusion - Cardiac Cholinergic blockersAntiplatelets; AnticoagulantsThrombolyticsAce inhibitorsAngiotensin II receptor blockers Calcium Channel blockersBeta-blockersCentral Alpha-2 agonists

Metabolism Endocrine BiguanidesAmylin MimeticsSulfonylureasInsulin sensitizing GliptinsIncretin mimeticsMeglitinidesHyperglycemic agents

Immune Adrenocorticoid hormonesAntiretrovirals (6)AntimetabolitesInterferon

Perfusion Renal Blood forming agentsLoop/Thiazide/Potassium sparring diureticsMuscarinic antagonists Alpha-blockers5-alpha-reductase inhibitors

Perfusion Shock NitratesHuman B-type naturetic peptidesVasodilators – nitroprussideAlpha adrenergicsThrombolytic

Thermoregulation - Neuro Anticonvulsants Cholinergic agentsOsmotic diureticsDopaminergicsDopamine agonists

Metabolism - Biliary/Liver Laxatives (Lactulose)Prokinetic agents

Cellular Regulation Alkylating agentsSelective estrogen receptive modulators (SERMS)Miotic inhibitors

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NSCBN Attachment: Pharmacological and Parenteral Therapies

Pharmacological and Parenteral Therapies – the nurse provides care related to the administration of medications and parenteral therapies.

Pharmacological and Parenteral TherapiesRelated Activity Statements from the 2014 RN Practice Analysis: Linking the NCLEX-RN

Examination to Practice

Administer blood products and evaluate client responseAccess venous access devices, including tunneled, implanted and central linesPerform calculations needed for medication administrationEvaluate client response to medication (e.g., therapeutic effects, side effects, adversereactions)Educate client about medicationsPrepare and administer medications, using rights of medication administrationReview pertinent data prior to medication administration (e.g., contraindications, labresults, allergies, potential interactions)Participate in medication reconciliation processTitrate dosage of medication based on assessment and ordered parameters (e.g., givinginsulin according to blood glucose levels, titrating medication to maintain a specific blood pressure)Evaluate appropriateness and accuracy of medication order for clientMonitor intravenous infusion and maintain site (e.g., central, PICC, epidural and venousaccess devices)Administer pharmacological measures for pain managementAdminister controlled substances within regulatory guidelines (e.g., witness, waste)Administer parenteral nutrition and evaluate client response (e.g., TPN)Handle and maintain medication in a safe and controlled environment

Related content includes, but is not limited to:Adverse Effects/Contraindications/Side Effects/Interactions

Identify a contraindication to the administration of a medication to the client Identify actual and potential incompatibilities of prescribed client medications Identify symptoms/evidence of an allergic reaction (e.g., to medications) Assess the client for actual or potential side effects and adverse effects of medications

(e.g., prescribed, over-the-counter, herbal supplements, preexisting condition) Provide information to the client on common side effects/adverse effects/potential

interactions of medications and inform the client when to notify the primary health care provider

Notify the primary health care provider of side effects, adverse effects and contraindications of medications and parenteral therapy

Document side effects and adverse effects of medications and parenteral therapy Monitor for anticipated interactions among the client prescribed medications and fluids

(e.g., oral, IV, subcutaneous, IM, topical prescriptions)

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Evaluate and document the client’s response to actions taken to counteract side effects and adverse effects of medications and parenteral therapy

Blood and Blood Products Identify the client according to facility/agency policy prior to administration of red blood

cells/blood products (e.g., prescription for administration, correct type, correct client, cross matching complete, consent obtained)

Check the client for appropriate venous access for red blood cell/blood product administration (e.g., correct gauge needle, integrity of access site)

Document necessary information on the administration of red blood cells/blood products Administer blood products and evaluate client response*

Central Venous Access Devices Educate the client on the reason for and care of a venous access device Access venous access devices, including tunneled, implanted and central lines* Provide care for client with a central venous access device

Dosage Calculation Perform calculations needed for medication administration* Use clinical decision making/critical thinking when calculating dosages

Expected Actions/Outcomes Obtain information on a client’s prescribed medications (e.g., review formulary, consult

pharmacist) Use clinical decision making/critical thinking when addressing expected effects/outcomes

of medications (e.g., oral, intradermal, subcutaneous, IM, topical) Evaluate the client’s use of medications over time (e.g., prescription, over-the-counter,

home remedies) Evaluate client response to medication (e.g., therapeutic effects, side effects, adverse

reactions)*

Medication Administration Educate client about medications* Educate client on medication self-administration procedures Prepare and administer medications, using rights of medication administration* Review pertinent data prior to medication administration (e.g., contraindications, lab

results, allergies, potential interactions)* Mix medications from two vials when necessary Administer and document medications given by common routes (e.g., oral, topical) Administer and document medications given by parenteral routes (e.g., intravenous,

intramuscular, subcutaneous) Participate in medication reconciliation process* Titrate dosage of medication based on assessment and ordered parameters (e.g., giving

insulin according to blood glucose levels, titrating medication to maintain a specific blood pressure)*

Dispose of unused medications according to facility/agency policy Handle and maintain medication in a safe and controlled environment*

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Evaluate appropriateness and accuracy of medication order for client* (order/prescription)

Parenteral/Intravenous Therapies Identify appropriate veins that should be accessed for various therapies Educate client on the need for intermittent parenteral fluid therapy Apply knowledge and concepts of mathematics/nursing procedures/psychomotor skills

when caring for a client receiving intravenous and parenteral therapy Prepare the client for intravenous catheter insertion Monitor the use of an infusion pump (e.g., IV, patient-controlled analgesia device) Monitor intravenous infusion and maintain site (e.g., central, peripheral, epidural and

venous access devices)* Evaluate the client’s response to intermittent parenteral fluid therapy

Pharmacological Pain Management Assess client need for administration of a PRN pain medication (e.g., oral, topical,

subcutaneous, IM, IV) Administer and document pharmacological pain management appropriate for client age

and diagnoses (e.g., pregnancy, children, older adults) Administer pharmacological measures for pain management* Administer controlled substances within regulatory guidelines (e.g., witness, waste)* Evaluate and document the client’s use and response to pain medications

Total Parenteral Nutrition (TPN) Identify side effects/adverse events related to TPN and intervene as appropriate (e.g.,

hyperglycemia, fluid imbalance, infection) Educate client on the need for and use of TPN Apply knowledge of nursing procedures and psychomotor skills when caring for a client

receiving TPN Apply knowledge of client pathophysiology and mathematics to TPN interventions Administer parenteral nutrition and evaluate client response (e.g., TPN)*

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