nr226 fundamentals-patient care learning plan · pdf filetest plan’s client needs ca ......

NR226 FUNDAMENTALS-PATIENT CARE

NR226 Learning Plan.docx Revised 03/15/2016 BME 1

Learning Plan

PURPOSE This learning plan expands upon the key concepts identified for the course and guides faculty in teaching the prelicensure BSN curriculum in all locations. Each unit’s concepts

are linked (in the 3rd column) to the Chamberlain Care philosophical concepts that relate most prominently to that unit. The course content is further linked to the NCLEX-RN

Test Plan’s Client Needs Categories (in Orange-Brown font) from which NCLEX test items are derived. Readings and assignments contained within the newly aligned course

shells support learners mastery of this content and the course outcomes.

NCLEX TEST PLAN

These Client Needs Categories/Subcategories* of the NCLEX-RN Test Plan link to NR224 as annotated in the course content

outline below.

1. Safe and Effective Care Environment

o Management of Care

o Safety and Infection Control

2. Health Promotion and Maintenance

3. Psychosocial Integrity

4. Physiological Integrity

o Basic Care and Comfort

o Pharmacological and Parenteral Therapies

o Reduction of Risk Potential

o Physiological Adaptation

*There are five (5) Integrated Processes that are fundamental to the practice of nursing, and they are integrated throughout the

Client Needs categories and subcategories. They are Nursing Process, Caring, Communication & Documentation,

Teaching/Learning, and Culture & Spirituality.



CONTENT OUTLINE

Unit 1 The Nursing Process & Concept Mapping Chamberlain Care

Upon completion of this unit, the student will be able to do the following.

1. Identify nursing resources that reflect current evidence for best practices. (COs 4 and 8 NCLEX-1, 2)

2. Demonstrate use of all nursing process components in concept map development. (COs 6 and 8 NCLEX-1, 2, 3, 4, The Nursing Process)

3. Complete the medication calculation requirement for the course. (CO 7 NCLEX-4)

A. Course Overview (Physiological Integrity: Pharmacological and Parenteral Therapies)

a. Medication Administration Module i. Review

ii. Safe Medication Administration B. Clinical Reasoning and Decision Making (Safe and Effective Care Environment: Management of Care; Physiological Integrity: Reduction of Risk Potential)

a. Critical Thinking b. Clinical Reasoning c. Professional Nursing Decisions d. Delegation e. Professional Responsibility

C. Nursing Process (The Nursing Process) a. Review Steps b. Literature Use/ Evidence Based Practice

D. Concept Mapping a. Review Components b. Clinical expectations

1.

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Person-Centered: 1. Utilize components of the nursing process when planning nursing interventions for individual client care.

Experiential Learning

SIMCARE CENTER™/Lab Activities (Safe

and Effective Care Environment:

Management of Care; Health

Promotion and Maintenance; The

Nursing Process)

o Standardized Clinical Experience (SCE)—Jesus Garcia; Check with faculty for further information.

Unit 2 Pain & Professional Practice Chamberlain Care


1. Discuss the unique aspects of the professional nursing culture. (COs 5, 6, and 7 NCLEX-1)

A: Pain (Safe and Effective Care Environment: Management of Care; Health Promotion and Maintenance; Physiological Integrity: Basic Care & Comfort)

a .Defining pain b. Pain pathophysiology, etiology, manifestations. c. Pain theories d. Types of pain

i. Acute vs. Chronic

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Professional Identity Formation: 1. Recognize professional responsibility and the decision-making role when providing and planning nursing care



2. Differentiate between personal and professional values. (COs 5 and 6 NCLEX-1)

3. Identify the legal influences on safe, professional nursing practice. (COs 6 and 7 NCLEX-1, 4)

4. Assess an individual’s pain. (COs 1 and 3 NCLEX-1, 4, The Nursing Process)

5. Plan individualized dependent and independent interventions for safe pain management. (COs 1, 3, 4, 6, and 8 The Nursing Process)

6. Evaluate an individual’s response to pain management interventions. (COs 1 and 4 NCLEX-1, 4, The Nursing Process)

ii. Physiologic vs. neuropathic iii. Others (breakthrough, psychogenic, phantom, central pain,

etc.) e. Factors/barriers influencing pain assessment

and management i. Myths/misconceptions

ii. Developmental iii. Environmental iv. Ethnic/Cultural

f. Pain response i. Physiological ii. Behavioral

B. Nursing Process: Pain (The Nursing Process) a. Assessment

i. Classification and categorizing pain ii. Quantifying and qualifying pain

1.Subjective data a. Pain history

b. Pain scales 2. Objective data

a. Observable manifestations

b. Diagnostic tests c. Sedation scales b. Nursing Diagnoses Examples

i. Acute left ankle pain related to inflammation ii. Chronic left shoulder pain related to

osteoarthritis

c. Planning i. Outcome identification

1. Reduction of pain as stated by individual stated goal within one(1) hour of intervention

2. Improved mobility according to

Holistic Health: 1. Identify pharmacology and non-pharmacology comfort measures use to provide comfort care and pain management.






Nursing Process)




individual stated goal

ii. Priorities i. Sequence of intervention

1. World Health Organization(WHO) Three –Step

Approach for managing pain 2. Impact of pain on sleep, activity

ii. Rationale iii. Anticipation of risks or complications iii. Delegation

1. Nursing assistive personnel (NAP) roles 2. Professional nurse role

a. Responsibilities associated with delegation

d. Interventions i. Independent Nursing Interventions

a. Agency for healthcare Research and Quality(AHRQ) recommendations for non- pharmacologic interventions b. Non-pharmacologic interventions

ii. Comfort measures c. Safe and effective care environment d. Person Centered education

A. Professional Nursing Culture (Safe and Effective Care Environment: Management of Care)

a. Attributes of a professional b. Professional Practice

i. American Nurses’ Association (ANA) 1. Definition of Nursing 2. Code of Ethics



3. Standards of Practice 4. Social Policy Statements

ii. Specialty Organizations i. Responsibilities

ii. Value System iii. Accountability

v. Confidentiality 1. HIPAA 2. Social Media 3. Responsibility for one’s actions 4. Reporting of errors/events

vi. Communication 1. Interdisciplinary 2. Individual 3. Delegation

4. Documentation c. Legal Influences

i. Types of Laws 1. Statutory

a. Civil b. Criminal

2. Nurse Practice Laws ii. National Council of State Boards of Nursing

1. State Boards of Nursing iii. Informed Consent

iv. Advanced Directives v. Restraints vi. Good Samaritan Laws vii. Patient Bill of Rights viii. Self determination

Unit 3 Sleep, Rest, & the Older Adult Chamberlain Care




1. Apply the nursing process to an individual with sleep pattern disturbance. (COs 1, 2, 3, 4, 6, and 8 The Nursing Process)

2. Explain therapies used in the collaborative care of individuals with sleep disorders. (COs 1, 4, and

8 NCLEX-1, 2, 4) 3. Discuss theories related

to the stages of adult development. (COs 1 and 8 NCLEX-3)

4. Apply the nursing process to the care of the older adult. (COs 1, 3, 4, and 8 NCLEX-1, The Nursing Process)

5. Adapt teaching strategies to accommodate common physiological, psychosocial, and cognitive changes related to the older adult. (COs 1 and 6 NCLEX-1, 2, 3, 4)

A. Sleep and Rest (Safe and Effective Care Environment: Management of Care; Health Promotion and Maintenance; Physiological Integrity: Basic Care & Comfort, Physiological Adaptations, Reduction of Risk Potential)

a. Physiology of sleep b. Functions of sleep c. Sleep/wake patterns and rituals

i. Stages ii. Cycles

d. Normal sleep requirements e. Factors/barriers affecting sleep patterns f. Common sleep/rest problems/disorders

B. Nursing Process: Sleep and Rest (The Nursing Process)

a. Assessment i. Quantifying and qualifying sleep

1. Subjective data a. Sleep history (obtained from individual and partner) b. Sleep assessment scales

2. Objective data ii. Outcome identification

1. Improved sleep pattern by second night of hospitalization 2. Achievement of adequate sleep within one week of intervention 3. Others

ii. Priorities iv. Sequence of interventions v. Rationale vi. Anticipation of risks or complications vii. Delegation

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Person-Centered: 1. Apply age-appropriate nursing considerations and interventions when providing care for the older adult.

Care-Focused: 1. Identify barriers affecting normal sleep patterns. 2. Utilize appropriate nursing interventions when providing care for individuals with altered sleep patterns.






Nursing Process)






C. Interventions (The Nursing Process) 1. Independent Nursing Interventions

a. Non-pharmacologic interventions b. Safe and effective care environment c. Person Centered education

2. Dependent Nursing Interventions a. Pharmacologic b. Non-pharmacologic clinical therapies (e.g. BiPaP/CPAP

3. Collaborative interventions a. Report of nursing assistive personnel(NAP) of vital signs and sleep status b. Communication with HCP response to dependent nursing interventions c. Complementary/Alternative therapies d. Evaluation

D. Health Perception and Management: Older Adult (Safe and Effective Care Environment: Management of Care; Health Promotion and Maintenance; Physiological Integrity: Basic Care & Comfort, Physiological Adaptations)

a. Developmental stage: Older Adult defined b. Theories of Aging c. Myths/Misconceptions /Stereotypes d. Concerns of the older adult e. Differentiation of 3Ds: Delirium, Dementia, Depression f. Legal/ethical issues related to care of the older adult

E. Nursing Process: Older Adult (The Nursing Process)



a. Assessment i. Subjective data

1. Geriatric assessment (from individual and sometimes family member or caretaker) 2. Recognizing acute illness 3. Fall assessment

ii. Objective data 1. Physiological, cognitive, and psychosocial 2. Diagnostic tests 3. Physical assessment

b. Nursing Diagnoses Examples i. Risk of falls related to decreased balance ii. Risk for medication toxicity related to cognitive impairment c. Planning iii. Outcome identification iv. Anticipation of risks or complications v. Delegation


a. Responsibilities associated with delegation b. Interventions

3. Independent Nursing Interventions

a. Non-pharmacologic interventions b. Therapeutic communication c. Safe and effective care environment d. Person Centered education



4. Dependent Nursing Interventions

a. Pharmacologic

5. Collaborative interventions a. Interdisciplinary providers (e.g. social workers, spiritual care providers, physical/occupational therapists, home care assistants, community resources for older adults, etc)

F. Evaluation (The Nursing Process)

1. Outcome evaluation a. Outcome achievement b. Modification of plan

2. Documentation

Unit 4 Fluid & Electrolytes

Chamberlain Care


1. Apply the nursing process

to an individual with fluid

and electrolyte

imbalances. (COs 1, 3, 4,

and 8 NCLEX-1, The

Nursing Process)

2. Discuss alterations in

health resulting from fluid

and electrolyte

A. Fluid and Electrolytes (Physiological Integrity: Basic Care & Comfort, Physiological Adaptations, Pharmacological & Parenteral Therapies)

a. Review physiology of fluid and electrolyte balance b. Regulating fluids

i. Sources of intake ii. Routes of output iii. Value ranges for fluids

c. Regulating electrolytes i. Balance of electrolytes ii. Functions of electrolytes iii. Value ranges for electrolytes

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Care-focused: 1. Identify risks for fluid and electrolyte imbalance when assessing and providing care for an individual across the lifespan.




imbalances. (CO 4 NCLEX-

1, 4) 3. Practice intravenous (IV)

skills in an experiential learning environment. (COs 1, 2, and 7 NCLEX-1, 4)

d.Factors affecting fluid and electrolyte balance

B. Assessment of Fluid & Electrolytes (The Nursing Process) a. Assessment

i. Quantifying and qualifying 1. Subjective data

a. Nursing history 2. Objective data

a. Physical assessment b. Clinical measurements

i. Weight ii. Vital signs iii. Intake/output iv. IV site

b. Diagnostics/lab i. Serum electrolytes ii. CBC iii. BUN iv. Urine Specific gravity

c. Nursing Diagnoses Examples i. Fluid Volume deficit related to vomiting and diarrhea ii. Water and sodium loss related excessive exercise

d. Planning i. Outcome identification

1. Return to normal hydration within 48 hours of intervention 2. Relate the need to replace essential fluids and electrolytes during and after exercise

ii. Priorities iii. Sequence of interventions xiv. Rationale iv. Anticipation of risks or complications v. Delegation





Nursing Process)


o Standardized Clinical Experience (SCE)—David Montanari; Check with faculty for further information.





Unit 5 Altered Bowel Elimination Chamberlain Care


1. Apply the nursing process to individuals with altered bowel elimination. (COs 1, 2, 4, 6, 7, and 8 The Nursing Process)

2. Discuss health conditions requiring bowel diversion surgery. (CO 8 NCLEX-1, 4)

A. Bowel Diversion Surgeries (Safe and Effective Care Environment: Management of Care; Health Promotion and Maintenance; Physiological Integrity: Basic Care & Comfort, Reduction of Risk Potential)

a. Conditions Requiring Ostomy Surgery i. Cancer ii. Inflammatory Bowel Disease iii. Trauma iv. Others

b. Temporary vs permanent ostomies i. Ileostomy

1. Continent Ileostomy 2. Ileoanal Pouch

ii. Colostomy 1. Loop 2. Double-Barrel 3. End

c. Assessment (The Nursing Process) i. History

1. Elimination Patterns 2. Nutrition-Metabolic Patterns 3. Cognitive-Perceptual Patterns: Pain 4. Coping /Stress Tolerance Pattern

b. Support system 5. Other Health Patterns

ii. Physical Exam 1. Elimination Pattern

a. Abdominal Girth

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Holistic Health: 1. Apply stress-reduction techniques when providing care for individuals experiencing altered bowel elimination.

Person-Centered: 1. Recognize risk factors associated with altered bowel elimination for individuals across the lifespan.






Nursing Process)


o Standardized Clinical Experience (SCE)—David Montanari; Check with faculty for further information.



b. Bowel Sounds 2. Nutrition-Metabolic Pattern

a. Fluid & Electrolyte Imbalance

3. Other Health Patterns iii. Lab and Diagnostic Tests

1. Blood a. CBC b. Electrolytes c. Bilirubin d. Amylase e. Alkaline phosphatase f. CEA g. Others

2. Fecal Occult Blood 3. Radiologic

a. UGI b. Barium Swallow & Enema c. Endoscopies d. Ultrasound e. Others

4. Nursing Care d. Nursing Diagnoses (The Nursing Process)

i. Body image disturbance r/t bowel diversion surgery ii. Risk for fluid volume deficit r/t inadequate intake iii. Others

e. Planning (The Nursing Process) i. Outcome Identification

1. Individual will demonstrate self-care for stoma within 5 days. 2. Person will demonstrate no signs of dehydration within 48 hours of surgery.



3. Others ii. Priorities iii. Delegation

f. Implementation of Interventions (The Nursing Process)

i. Independent Nursing Interventions 1. Preparation for surgery

a. Education of person and others

2. Postoperative care a. Assessment b. Fluid Intake

i. Oral and Intravenous c. Diet d. Activity e. Comfort Measures f. Safe & Effective Care

B. Environment (Safe and Effective Care Environment: Management of Care)

i. Privacy Issues ii. Stoma care iii. Communication iv. Infection prevention ii. Dependent Nursing Interventions

1. Preparation for surgery a. Pharmacological

i. Anitinfectives ii. Preoperative medications

b. Bowel cleansing c. Diet d. Education

2. Postoperative a. Pharmacological

i. IV Fluids ii. Analgesics



iii. Antiinfectives iv. Others

b. Stoma care i. Surrounding skin ii. Output iii. Appliances

c. Potential complications d. Psychosocial Care e. Preparation for home management

i. Collaborative Interventions

Unit 6 Perioperative Nursing Chamberlain Care


1. Apply the nursing process to each phase of an individual’s perioperative experience. (COs 1, 2, and 4 The Nursing Process)

2. Discuss psychological care for individuals and families during the perioperative experience. (COs 1 and 3 NCLEX-3)

3. Identify an individual’s perioperative educational needs. (COs 6, 7, and 8 NCLEX-1, 2, 3, 4, The Nursing Process)

A. Overview (Safe and Effective Care Environment: Management of Care; Health Promotion and Maintenance; Physiological Integrity: Basic Care & Comfort, Physiological Adaptations; Reduction of Risk Potential)

a. Association of Operating Room Nurses (AORN) b. Scope of Practice c. Standards of Practice

B. Surgical Phases (Physiological Integrity: Basic Care & Comfort, Physiological Adaptations, Reduction of Risk Potential)

a. Preoperative Phase (The Nursing Process) i. Definition

ii. Nursing Roles iii. Therapeutic Communication iv. Assessment

1. Comprehensive Assessment 2. Identification of Risk Factors 3. Lab and Diagnostics 4. Gender, Culture, and Age Considerations

v. Diagnosis 1. Fear r/t upcoming surgery

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Holistic Health: 1. Apply stress-reduction techniques when providing perioperative nursing care.

Professional Identity Formation: 1. Recognize the nursing scope of practice with perioperative nursing.






Nursing Process)

o Standardized Clinical Experience

(SCE)—Jesus Garcia; Check with

faculty for further information.



4. Identify the implication of age on the perioperative experience. (COs 4 and 8 NCLEX-1, 3, 4)

2. Knowledge deficit r/t preparations for surgery 3. Others 4. Priorities

vi. Outcome Identification 1. Person will verbalize source of fear 2. Individual will ask questions about instructions that are unclear. 3. Others

vii. Implementation of Therapeutic Interventions

1. Safe and Effective Care Environment

a. Informed Consent b. Interdisciplinary Team c. Preoperative Evidence Based Practices

2. Safety & Infection Control

a. Preoperative Education b. Hygiene and Infection c. Preoperative

d. Wrong Surgery/Site Precautions

3. Psychological Integrity a.Fears, Anxiety, Needs

i. Pain Management

b. Individual and Family Support

viii. Evaluation and Documentation b. Intraoperative Phase (The Nursing Process)

i. Nursing Roles


(SCE)—David Montanari; Check

with faculty for further

information.



ii. Assessment 1. Individual Identification 2. Surgery/Site Identification 3. Allergies 4. Aging considerations

iii. Diagnoses 1.Risk for injury r/t positioning 2.Risk for fluid volume deficit r/t volume loss 3.Others

iv. Implementation of Therapeutic Interventions

1. Safe Environment a.Anesthesia b.Positioning c.Body Temperature d.Right to Withdraw Consent e.Materials Counting

2. Infection Control a.Surgical Scrub b.Individual Site Preparation c.Environmental Controls

3. Psychological Integrity a.Support through anesthesia and procedure.

4. Physiological Integrity a.Monitoring devices b.DVT risk reduction

i. Sequential Compression Devices



v. Evaluation and Documentation

c. Postoperative Phase i. Post-anesthesia Care Unit (PACU)

1. Nursing Roles 2. Reporting and Hand-Off 3. Assessment

a. Post Anesthesia Recovery Score (PARS) b.Parameters for Assessment c.Complications d.Aging considerations

4. Diagnoses a. Anxiety b. Fear c. Others

5.Implementation of Therapeutic Interventions

a.Arousal and Emotional Support b. Comfort Measures c. Pain Management d. IV Fluids e. NG tube f. Indwelling Catheter g. Surgical wounds h. Transport to Nursing Unit

6.Evaluation and Documentation a. Observing and reporting of findings. b. Communication



ii. Nursing Unit Recovery (Safe and Effective Care Environment: Management of Care; Health Promotion and Maintenance; Physiological Integrity: Basic Care & Comfort, Physiological Adaptations; The Nursing Process)

1. Assessment a.Nutrition and Metabolism b.Elimination c.Cognitive Perceptual d.Activity and Exercise e.Coping and stress tolerance f.Aging considerations g.Complications

2. Diagnosis a.Knowledge deficit r/t home management b.Risk for fluid volume deficit r/t excess blood/fluid loss c.Others

3.Implementation of Safe & Effective Care Environment

a.Physiologic Integrity i. ABCs ii. Reduction of Risk for Complications iii. Comfort Measures



iv. Pain Management v. Fluid Balance vi. Skin Integrity vii. Activity Tolerance and Restrictions viii. Implications of physiological changes of age.

b. Psychological Integrity c. Health Promotion & Maintenance

i. Education and preparation for home care

Unit 7 The Grief Response Chamberlain Care


1. Apply the nursing process to the grief response. (COs 1, 2, 3, 4, and 8 The Nursing Process)

2. Differentiate between normal and pathologic manifestations of the grief

A. Coping and Stress Tolerance: Loss and Grief (Safe and Effective Care Environment: Management of Care, Psychosocial Integrity, Physiological Integrity: Basic Care & Comfort, Physiological Adaptations) a. Types of loss

b. Grief Responses c. Theories of grief/bereavement process/stages d. Factors affecting grief response(e.g. cognitive level and developmental, gender, age, culture, spiritual beliefs, etc) e. End-of-life decisions

B. Nursing Process: Loss and Grief (The Nursing Process)

Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Holistic Health: 1. Identify factors, such as culture and spiritual beliefs, affecting the grief response when providing care for individuals across the lifespan.

Extraordinary Nursing:



response. (COs 1 and 4 NCLEX-1, 3, 4)

a. Assessment i. Subjective data

1. Nursing history 2. Grief and loss assessment

ii. Objective data 1. Physical assessment

b. Nursing Diagnoses Examples

i. Grieving related to loss of right lower leg ii. Prolonged grieving related to denial of loss

c. Planning i. Outcome identification

1. Individual will participate in rehabilitative activities 2. Individual adjusts to actual loss

ii. Priorities iii. Delegation iv. Sequence of interventions . Rationale v. Anticipation of risks or complications

C. Delegation


a. Responsibilities associated with D. Independent Nursing Interventions

1.Non-pharmacologic interventions 2.Therapeutic communication

3. Safe and effective care environment 4. Person Centered education

1. Recognize the role of the nurse as a patient advocate when providing care for individuals across the lifespan.






Nursing Process)







information.



E. Dependent Nursing Interventions (The Nursing Process)

a. Pharmacologic 1. Non-pharmacologic clinical therapies

b. Collaborative interventions 1. Complementary therapies (e.g. music/art therapies) 2. Interdisciplinary providers (e.g. social workers, spiritual care providers, grief/loss support groups, etc)

F. Evaluation(The Nursing Process)

1. Outcome evaluation a Outcome achievement b. Modification of plan

2. Documentation

Unit 8 Wrap it Up

Chamberlain Care


1. Differentiate between the components and apply the principles of the nursing process in the learning laboratory setting using simulated patient care scenarios.

(PO 1 NCLEX-1, 2, 3, 4, The Nursing Process)

2.Apply the concepts of health promotion and illness prevention in

Review All Previous Content Chamberlain Care provides a framework for student learning by addressing the following concepts in this unit: Cultural Humility 1. Incorporate knowledge of individual cultural needs when providing care for clients across the lifespan.

Professional Identity Formation 1. Understand the role of the nurse when providing care for individuals across the lifespan.




the laboratory setting. (PO 2

NCLEX-1, 3, 4)

3.Demonstrate communication skills necessary for interaction with other health team members and for providing basic nursing care in a simulated environment. (PO 3

NCLEX-1, 2, 3)

4. Employ critical thinking skills in the simulated laboratory setting.

(PO 4 NCLEX-1, 2, 3, 4, The Nursing Process)

5.Assume responsibility and accountability for identifying own personal, educational, and

professional goals. (PO 5 NCLEX-1)

6. Explain and apply principles of legal, ethical, and professional standards in planning for and delivering patient care. (PO 6

NCLEX-1, 3)

7. Demonstrate beginning roles and responsibilities associated with professional nursing while planning for cost-effective basic nursing care to individuals and families. (PO 7

NCLEX-1)

8.Explain the rationale for selected nursing interventions based upon





Nursing Process)







information.

o Final Evaluation



current nursing literature. (PO 8

NCLEX-1, 4, The Nursing Process)

nr226 fundamentals-patient care learning plan · pdf filetest plan’s client needs ca ......

Documents