RNRS 195: Beginning Medical/Surgical Nursing II

• Consistently utilize verbal and written communication in English while practicing in the clinical environment.
• Recognize and practice culturally sensitive communication and respect for all members of the health care team, including peers, instructors, patients, and including those with different linguistic or other abilities, as well as those with different cultural backgrounds.
• Demonstrate an understanding of ethical issues that will enhance their capacity for making sound decisions about the health care environment as part of a patient’s rights.
• Demonstrate knowledge of the legal and ethical framework established for the Medical-Surgical health care settings by consistently practicing within the scope of practice set forth by the state of California’s Nurse Practice Act during clinical interactions with patients and health care staff.
• Design and implement teaching plans using principles of learning/teaching to meet the holistic and complex physical and psycho-social needs of patients with Medical-Surgical alterations in wellness.
• Operate as a collaborative member of the nursing team by formulating nursing care plans for those patients assigned to the student with moderate guidance from an instructor or facility staff.

1. Altered Senses: Pain - Intermediate knowledge of pain and pain management
   1. Briefly review physical and psychologic effects of unrelieved pain. 
   2. Subjective & objective data obtained during comprehensive pain assessment, and evaluate the influence of the patient's beliefs and attitude about pain. 
   3. Multidisciplinary pain management and the nurses role.
   4. Describe pharmacological and non-pharmacological interventions for pain.
   5. Utilize the Citrus College ADN Framework in caring for a patient with pain alterations.
2. Upper Respiratory - Intermediate knowledge of alterations in the upper respiratory system
   1. Describe the etiology and pathophysiology of various upper respiratory system alterations.  
   2. Clinical manifestation, diagnostic studies, and nursing management of a patient with upper respiratory disorders. 
   3. Utilize the Citrus College ADN Framework in caring for a patient with upper respiratory disorders.  
3. Cardiovascular - Intermediate knowledge of alterations in the cardiovascular system 
   1. Describe the pathophysiology associated with acute and chronic cardiovascular system disorders.
   2. Describe the clinical manifestations and complications of various cardiovascular disorders. 
   3. Describe the collaborative care for patients with various cardiovascular disorders, including but not limited to, prevention, medications, nutrition, lifestyle modifications. 
   4. Describe the mechanisms involved in the regulation of blood pressure. 
   5. Describe the indications for cardiac transplantation and the nursing management of patients undergoing cardiac transplantation.
   6. Utilize the Citrus College ADN Framework in caring for a patient with cardiovascular system disorders.
4. Hematological - Intermediate knowledge of alterations in the hematological system
   1. Explain the etiology and pathophysiology of various types of hematological disorders.
   2. Describe the clinical manifestations of various types of hematological disorders.
   3. Describe the collaborative care of patients with various hematological disorders. 
   4. Utilize the Citrus College ADN Framework in caring for a patient with hematological disorders. 
5. Immune System - Intermediate knowledge of alterations in the immune system
   1. Describe the functions and components of the immune system.
   2. Describe etiologic factors and categories of immunodeficiency disorders.
   3. Describe the clinical manifestations and treatment modalities of autoimmune disorders. 
   4. Compare and contrast humoral and cell-mediated immunity.
   5. Identify various types of Immunoglobins and their characteristics.
   6. Describe the various types of organ transplants and the complications associated with the immune system following transplantation.
   7. Utilize the Citrus College ADN Framework in caring for a patient with immune system disorders.
6. Nervous System - Intermediate knowledge of alterations in the nervous system 
   1. Describe the etiology of various chronic neurologic disorders. 
   2. Compare and contrast various types of headaches. 
   3. Describe the clinical manifestations associated with various neurological disorders.
   4. Describe normal and abnormal neurological assessment findings.
   5. Describe the collaborative care of the patient with various neurological disorders, outlining major goals of treatment.  
   6. Explain the potential impact of chronic neurological disorders on physical and psychological well-being.
   7. Utilize the Citrus College ADN Framework in caring for a patient with nervous system disorders.  
7. Musculoskeletal - Intermediate knowledge of alterations in the musculoskeletal system
   1. Describe the etiology and pathophysiology of multiple musculoskeletal disorders.
   2. Describe the clinical manifestations and diagnostic testing associated with  various musculoskeletal disorders. 
   3. Describe normal physical assessment of the musculoskeletal system.
   4. Describe neurovascular assessment of an injured extremity.
   5. Describe the collaborative care of the patient who has a musculoskeletal disorder, including, but not limited to, medications, surgical interventions.
   6. Utilize the Citrus College ADN Framework in caring for a patient with musculoskeletal system disorders. 
8. Fluid and Electrolytes - Intermediate knowledge of alterations with fluid and electrolytes
   1. Describe the composition of the major body fluid compartments.
   2. Define the processes involved in the regulation of water and electrolytes between the body fluid compartments. 
   3. Describe the etiology, clinical manifestations, and collaborative care of the various disorders involving fluid and electrolytes. 
   4. Identify the processes involved in maintaining acid-base balance.
   5. Compare and contrast commonly used IV solutions related to their components, characteristics, and indications for use.
   6. Identify and discuss specific laboratory data and their implications as they relate to assessment and evaluation of fluid and electrolyte status.
   7. Utilize the Citrus College ADN Framework in caring for a patient with fluid and electrolyte disorders. 
9. Upper Gastrointestinal System - Intermediate knowledge of alterations in the upper gastrointestinal system
   1. Describe the etiology and pathophysiology of various upper gastrointestinal disorders. 
   2. Describe the clinical manifestations associated with various upper gastrointestinal disorders. 
   3. Describe diagnostic testing associated with various upper gastrointestinal disorders. 
   4. Describe the collaborative care of the patient with various upper gastrointestinal disorders, including but not limited to, medications, nutrition, surgical intervention. 
   5. Compare and contrast between acute and chronic upper gastrointestinal disorders. 
   6. Utilize the Citrus College ADN Framework in caring for a patient with upper gastrointestinal disorders. 
10. Renal and Urologic - Intermediate knowledge of alterations of the renal and urologic system 
    1. Describe the pathophysiology, etiology of multiple renal and urologic disorders.
    2. Explain the clinical manifestations associated with various renal and urologic disorders. 
    3. Identify urinary diagnostic tests and procedures and differentiate among various catheters used in the renal and urologic system.
    4. Describe the collaborative care of a patient with various renal and urologic disorders. 
    5. Explain postoperative care and expected outcomes for a patient following surgery of the renal and urologic system.   
    6. Utilize the Citrus College ADN Framework in caring for a patient with renal and urologic system disorders.
11. Endocrine - Intermediate knowledge of alterations in the endocrine system 
    1. Review and describe the endocrine system.
    2. Identify the pathophysiology of various endocrine system disorders, including, but not limited to, diabetes mellitus.
    3. Explain the clinical manifestations of acute and chronic complications of endocrine system disorders, including, but not limited to, diabetes mellitus.
    4. Describe the collaborative care of the patient with endocrine system disorders. 
    5. Utilize the Citrus College ADN Framework in caring for the patient with endocrine system disorders.
12. Perioperative Care - Intermediate knowledge of perioperative care
    1. Identify the common purposes and settings of surgery.  
    2. Describe the various types and classifications of surgical procedures.
    3. Identify the various phases of surgery and the nurse’s role during each phase.
    4. Explain the purpose of informed consent. 
    5. Describe the purpose and components of a pre-operative, post-operative assessment.
    6. Discuss the basic principles of aseptic technique used in the operating room.
    7. Explain the potential complications associated with patients in the post-anesthesia care unit. 
    8. Describe the management of the patient after transfer from the post-anesthesia unit to the general care unit. 
    9. Identify the information needed in order to prepare the patient for discharge post-operative. 
    10. Utilize the Citrus College ADN Framework in caring for a patient in the perioperative phase. 
13. Integumentary - Intermediate knowledge of alterations in the integumentary system
    1. Explain the etiology, clinical manifestations, and nursing and collaborative management of common acute dematologic problems. 
    2. Describe health promotion practices related to the integumentary system. 
    3. Utilize the Citrus College ADN Framework in caring for a patient with integumentary system disorders. 

Under supervision by clinical instructors, the student nurse will perform the following skills in a clinical setting (or simulated lab situation using low and high fidelity manikins) on adult clients who are experiencing complex but not critical alterations in wellness involving multiple systems:

1. Cluster assessment cues into relevant groups of identifying criteria and formulate individualized nursing diagnoses.
2. Prioritize nursing diagnoses and individual interventions to be carried out by the health care team.
3. Administer IV therapy demonstrating correct critical thinking regarding pharmacologic interventions.
4. Consistently complete appropriate computer or paper documentation required per school and clinical facility, for care rendered to assigned clients in a timely manner.
5. Relation of essential nursing values to attitudes, personal qualities and professional behaviors.
6. Description of ways the California Nurse Practice Act, standards of care, agency policies, and procedures affect the scope of RN practice.
7. Incorporation of beginning concepts of fiscal responsibility in planning and implementing patient care.
8. Application of past learning and current nursing theories and principles in utilizing the nursing process in care of the non-critical, moderately complex adult medical-surgical patient.
9. Utilization of critical thinking in predicting patient care needs as related to safety and nursing interventions for specific patient populations.
10. Adaptation to changing patient and environmental conditions that influence time management, delegation, and prioritization of patient care.
11. Collaboration with the health care team in providing formal and informal health care teaching, health promotion, illness prevention and restorative care to medical-surgical patients and families.
12. Provision of end-of-life care for medical-surgical patients and providing support for their families.
13. Employment of appropriate verbal and written communication in English, as well as non-verbal and interpersonal communication skills to implement and evaluate nursing care.