RNRS 191: Introduction to Medical/Surgical Nursing I

• Demonstrate proper use of computing skills through appropriate computer documentation at the clinical sites.
• Apply an understanding of basic legal and ethical behaviors to the care of assigned patients.
• Consistently utilize verbal, non-verbal, and written communication in English with the purpose of assisting patients to promote, maintain, or restore physical, psycho-social, and spiritual well-being.
• Utilize bio-psycho-social concepts and theories along with principles of critical thinking to plan, implement and evaluate care of medical-surgical patients.
• Demonstrate critical thinking by utilizing the nursing process as it applies to patient care for the purpose of making appropriate decisions based on the patient’s assessment data.
• Demonstrate caring behaviors to patients, families and the health care team members by use of communication, both verbal and non-verbal, including touch therapy, while perform care during clinical assignments.
• Describe nursing actions which result in the safe administration of medications to patients.

1. PAIN: Nursing management - An introduction to pain and pain management 
   1. Definition of pain.
   2. Mechanisms of pain perception.
   3. Classifications of pain.
   4. Methods of pain assessment.
   5. Classification of medications used for pain and pain management.
   6. Ethical and legal issues related to pain and pain management.
   7. Nursing and collaborative management of pain.
   8. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with pain.
2. CANCER : Nursing management - An introduction to cancer
   1. Biology and development of cancer.
   2. Common carcinogens.
   3. Anatomic classifications of tumors.
   4. Seven warning signs of cancer.
   5. Collaborative care of patients undergoing surgery and radiation therapy for cancer.
   6. Classification of medications used to treat and manage cancer.  
   7. Utilize the Citrus College ADN Framework in caring for a patient with cancer.
3. INTEGUMENTARY: Nursing Management - An introduction of alterations in the integumentary system
   1. Structures and functions of the integumentary system.
   2. Environmental hazards that can lead to integumentary problems.
   3. Health promotion measures to prevent integumentary problems.
   4. Classification of medications used to treat and manage integumentary problems. 
   5. Techniques used in the physical assessment of the integumentary system.
   6. Etiology, clinical manifestations, nursing and collaborative management of, but not limited to, skin infections, skin infestations, and dermatitis.
   7. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with integumentary problems.
4. UPPER RESPIRATORY: Nursing Management - An introduction of alterations in upper respiratory system
   1. Structures and functions of the respiratory system.
   2. Objective and subjective data related to upper airway problems.
   3. Clinical manifestations and nursing management of various upper respiratory disorders. 
   4. Classification of medications used to treat and manage upper respiratory disorders. 
   5. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with upper respiratory problems.
5. LOWER RESPIRATORY: Nursing Management - An introduction of alterations in the lower respiratory system
   1. Description and pathophysiology of lower respiratory problems.
   2. Types and classifications of lower respiratory problems.
   3. Etiology, pathophysiology, clinical manifestations, and collaborative care of the patient with obstructive pulmonary diseases.
   4. Clinical manifestations and nursing management of lower respiratory problems.
   5. Classification of medications used to treat and manage lower respiratory problems. 
   6. Pathogenesis, clinical manifestations, and nursing management of a patient with lower respiratory problems.
   7. Utilize the Citrus College ADN Conceptual Framework used in caring for a patient with lower respiratory problems.
6. Hematologic: Nursing management - An introduction of alterations of the hematologic system
   1. Structure and functions of the hematologic system.
   2. Normal lab values for, but not limited to, erythrocytes, hemoglobin, and hematocrit.
   3. General manifestations and complications of hematologic disorders.
   4. Classification of medications used to treat and manage hematologic problems. 
   5. Etiologies, clinical manifestations, diagnostic findings and nursing management of hematologic disorders.
   6. Utilize the Citrus College ADN Conceptual Framework used in caring for a patient with hematologic disorders.
7. CARDIOVASCULAR: Nursing Assessment - An introduction of alterations of the cardiovascular system 
   1. Anatomy and physiology of the cardiovascular system.
   2. Review of the pulmonary and systemic circulation.
   3. Subjective and objective assessment data related to the cardiovascular system.
   4. Normal and abnormal physical assessment findings of the cardiovascular system.
   5. Classification of medications used to treat and manage cardiovascular problems. 
   6. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with cardiovascular disorders.
8. NUTRITION: Nursing Management - An introduction of alterations with nutrition
   1. Common etiologic factors, clinical manifestations, and management of malnutrition.
   2. Common etiologic factors, clinical manifestations, and management of obesity.
   3. Indications, complications, and nursing management related to the use of enteral nutrition.
   4. Indications, complications, and nursing management related to the use of parenteral nutrition.
   5. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with nutritional problems.
9. LOWER GASTROINTESTINAL: Nursing Management - An introduction to alterations of the lower gastrointestinal system
   1. Collaborative care and nursing management of the patient with lower GI problems.
   2. Anatomy and functions of the liver.
   3. Etiology, pathophysiology, clinical manifestations, and nursing management of the patient with liver disorders.
   4. Classification of medications used to treat and manage liver disorders.
   5. Anatomic and physiologic changes and nursing management of the patient with a lower gastrointestinal disorder. 
   6. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with lower gastrointestinal problems.
10. RENAL and UROLOGIC: Nursing Management - An introduction to alterations of the genitourinary system 
    1. Anatomic location and functions of the genitourinary system.
    2. Pathophysiology, clinical manifestations, and nursing management of infectious and inflammatory conditions of the genitourinary system.
    3. Classification of medications used to treat and manage genitourinary problems. 
    4. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with renal/urologic problems.
11. ENDOCRINE: Nursing Assessment - An introduction to alterations of the endocrine system
    1. Common characteristics and functions of hormones.
    2. Major endocrine glands and hormones.
    3. Difference between negative and positive feedback in regulation of hormone secretion.
    4. Normal and abnormal findings of a physical assessment of the endocrine system.
    5. Purpose and significance of results of diagnostic studies of the endocrine system.
    6. Classification of medications used to treat and manage endocrine problems. 
    7. Utilize the Citrus College ADN Conceptual Framework in caring for a patient with endocrine disorders.
12. NERVOUS SYSTEM: Nursing Assessment - An introduction to alterations of the nervous system
    1. Structures and functions of the nervous system.
    2. Etiology and pathophysiology of ischemic and hemorrhagic stroke.
    3. Neurological assessment and physical assessment of a patient with a nervous system disorder.
    4. Clinical manifestations, diagnostic studies, and rehabilitative nursing management of a patient with nervous system disorders.
    5. Classification of medications used to treat and manage neurological problems. 
    6. Utilize the Citrus College ADN Framework in caring for a patient with nervous system disorders.
13. MUSCULOSKELETAL: Nursing Management - An introduction to alterations of the musculoskeletal system
    1. Etiology, pathophysiology, clinical manifestations, and nursing care of soft tissue injuries.
    2. Complications associated with fractures and fracture healing.
    3. Postoperative management of a patient with musculoskeletal disorders. 
    4. Classification of medications used to treat and manage musculoskeletal problems. 
    5. Utilize the Citrus College ADN Conceptual Framework in the care of a patient with a musculoskeletal disorders. 

Under supervision by clinical instructors, the student nurse will perform the following skills in a clinical setting (or simulated lab situation using computerized simulation manikins) on adult clients across the life span whom are experiencing complex but not critical alterations in wellness involving multiple systems:

1. Medication preparation and administration through the following routes:
   1. oral
   2. optic
   3. otic
   4. sublingual
   5. topical
   6. vaginal
   7. rectal
   8. inhalants
   9. through NGT/GT/JT
2. Parenteral Fluids:
   1. care of client with continuous IV fluid administration / saline lock or IV pump
   2. subcutaneous medications:
      1. administering insulin/anticoagulants
   3. intramuscular injections
   4. intradermal injections
3. Care of patient with nasogastric tube (NGT) / gastrostomy tube (GT) / jejunostomy (JT)
   1. insertion/removal / irrigation of a nasogastric tube (NGT)
   2. continuing care of a patient with intermittent NGT/GT/JT feeding
   3. assessment of NGT/GT placement / patency, and residual check
   4. assessment of JT placement and patency 
   5. administration of nutrition through a NGT, GT, and JT
4. Care of patient with integumentary system problems:
   1. wound drains and suction
   2. pressure ulcer assessment and care
5. Care of the patient with altered sensation: hearing, vision, smell, and touch
6. Care of the patient with tracheostomy
   1. suctioning: oral, nasopharyngeal, oropharyngeal, and tracheostomy
7. Care of patient with traction, fractures, and joint immobility
   1. log-rolling
   2. range-of-motion exercises
8. Insertion/removal of urinary catheter: straight, indwelling