SCHOOL OF NURSING

COURSE OUTLINE

Course Title: Adult Health Nursing II Catalog No.: NR40

Credits: 8 Lecture & Clinical

Revised 6/06, 12/06

 PAGE

TABLE OF CONTENTS 1
Course description 2
Prerequisites/co-requisites; purpose; time allotment; & credit hours 2
Program's conceptual framework 2
Core component's definitions 3
Progression of core components 4 -6
Program objectives 7
NR40Course objectives 8
Topical outline 9
Methods of teaching 10
Required assignments 10
Methods of evaluation 10
Academic integrity 11
Student Responsibility for Safe Clinical Practice 12
Clinical Skills Policy 13
Guidelines for Student Written Report of Clinical Incident 14
Resulting in Clinical Warning or Failed Clinical Day
Report of Failed Clinical Day 15
Required textbooks 16-17
Attendance policy 18
Nursing Management of Clients with Stressors that Require Home Care 19-20
Nursing Management of Clients with Stressors that affect Cardiac and Peripheral 21-22
Function
Nursing Management of Clients with Stressors that affect Respiratory Function 23-24
Nursing Management of Clients with Stressors that affect Hematological Function 25-26
Nursing Management of Clients with Stressors that affect Musculoskeletal Function 27-28
Nursing Management of Clients with Stressors that affect Endocrine Function 29-30
Nursing Management of Clients with Stressors that affect Gastrointestinal/ 31-33
Hepatobiliary Function
Nursing Management of Clients with Stressors that affect Male & Female Organ 34-35
Reproductive Function
Nursing Management of Clients with Stressors that affect Urinary & Renal Function 36-37
Nursing Management of Clients with Stressors that affect Neurological Function 38-40
Nursing Management of Clients with Stressors Resulting from Burns, Disaster & 41-43
Shock States

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COURSE DESCRIPTION: NR40 – NURSING II
Nursing process is utilized in the study of adult health, incorporating responses and adaptation to stress
continued from NR 33. Adaptation and stress management is promoted for adults who manifest their stress
in acute and chronic physical illnesses and clients with multiple health problems. Experiences to integrate
nursing theory and skills include clinical experiences in health settings.

PRE-REQUISITE:
NR24 or NR 33/NR36

CO-REQUISITE:
BY 44 & PC 60

PURPOSE:
To assist the student to explore the effects of stress on human needs and the related nursing implications.
Emphasis will be placed on utilizing the nursing process to assist individuals with acute and chronic
conditions to re-establish a state of homeostasis and relative level of wellness. Preventative and
rehabilitative factors will be integrated throughout each unit. Related nutritional, pharmacological,
psychological and cultural/spiritual aspects will be considered. Community agencies will be utilized to
correlate theory and practice. Application of management skills will be developed in the clinical area.

TIME ALLOTMENT:
Lecture__________5 hours weekly
Clinical__________9 hours weekly

CREDIT ALLOCATION: 8 Credits

PROGRAM’S CONCEPTUAL FRAMEWORK

The nursing program reflects a clear organized structure, which is derived from the Nursing Philosophy.
The framework for curriculum development emphasizes stress and adaptation, wellness, caring and the
Nursing Process. The faculty believes that all human beings have patterns, which contribute to health,
quality of life, and achievement of human potential. Patterns focus on client-environment interactions, age-
developmental norms, and cultural realities as they relate to stress and adaptation.

Nursing facilitates interdisciplinary collaboration with clients for health promotion, maintenance, restoration
or attainment of a dignified death. The nursing process allows for the systematic early identification and
treatment of actual and potential stressors. Unresolved dysfunctional patters may increase susceptibility to
stressors. As adaptations diminish, assistance may be needed by the individual to obtain an optimal level of
health. The goal of nursing is to facilitate client adaptations to life stressors. The nursing faculty believes
that caring assists clients to adapt to stressors to achieve positive outcomes.

The following core components are integrated into the nursing curriculum: professional behavior,
communication, assessment, clinical decision-making, caring interventions, teaching and learning,
collaboration and managing care.

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CORE COMPONENTS TO BE INTEGRATED THROUGHOUT EACH UNIT

Professional Behaviors: adhering to standards of professional practice; being accountable for one’s actions;
practicing nursing within legal, ethical, and regulatory frameworks; having concern for others; valuing the
profession of nursing; and participating in ongoing professional development.

Communication: a goal directed interactive process through which there is an exchange of information that
may occur verbally, non-verbally, in writing, or through information technology.

Assessment: the holistic collection, analysis, and synthesis of relevant data from all of the client’s
functional health patterns for the purpose of appraising the client’s health status.

Clinical Decision Making: the systematic analysis and integration of knowledge and information to
identify dysfunctional health patterns and stressors in order to formulate clinical judgments and implement
therapeutic nursing interventions to assist the client toward a positive outcome. Evidence based practice
directs the modification of client care as indicated by the evaluation of outcomes.

Caring Interventions: the “being with” and “doing for” that assist clients to adapt to stressors to achieve
positive outcomes; insuring the care provided is culturally and spiritually sensitive to the needs of a diverse
population.

Teaching and Learning: the process of transmitting information to clients, significant others and members
of the healthcare team in order to assist clients and families to facilitate adaptations to stressors; promote
and maintain health; expand knowledge and change behavior.

Collaboration: working with other members of the healthcare team in a variety of healthcare settings in
order to achieve positive outcomes.

Managing Care: working efficiently and effectively with and through others and utilizing resources to meet
client needs and support organizational objectives.

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 PROGRESSION OF CORE COMPONENTS IN THE NURSING PROGRAM
Professional Behavior
Level I  Identify the standards of care for basic nursing process, and demonstrate accountability
for nursing care given.
 Identify resources for life long learning.
 Begin to correlate and identify consequences of ethical, legal and regulatory aspects of
professional nursing practice.
 Recognize the necessity for and maintenance of client confidentiality.
 Initiate proactive involvement to facilitate empowerment for the nursing profession.
 Report errors of omission/commission in a timely manner.
 Demonstrate non-judgmental/culturally sensitive behaviors.
▪ Maintain appropriate professional boundaries in the nurse-client relationship.
Level II  Adhere to standards of professional practice.
 Demonstrate accountability for personal actions and delegated actions.
 Practice nursing within legal, ethical and regulatory frameworks.
 Utilize and incorporate resources for life long learning.
▪ Demonstrate leadership in the nursing role.
Communication
Level I  Apply basic techniques of therapeutic communication when interacting with a client.
 Demonstrate beginning ability in documenting client status in nursing notes and care
plans.
 Demonstrate beginning skills in oral presentations to a group of fellow students.
 Identify and use information technology to access current nursing literature.
 Communicate therapeutically with significant others as well as clients and members of
the health care team.
 Demonstrate increasing ability to communicate relevant, accurate, and complete
information verbally and in written documentation
 Utilize appropriate verbal and non-verbal communication techniques to interact with
individual and groups of clients with impaired communication abilities.
▪ Utilize effective communication techniques when interacting with peers and members of
the health care team.
Level II  Identify similarities and differences on a position and support their position with current
nursing literature.
 Apply advanced techniques of therapeutic communication with clients, significant others
and members of the health care team.
 Employ group dynamic strategies when communicating with team members.
 Demonstrate increasing ability to communicate relevant, accurate and complete
information for groups of clients verbally and in written documentation.

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Assessment
Level I  Assess clients' health status to identify stressors that interfere with adaptation.
 Assess human responses to stress
 Identify strengths, resources and health care needs of a community.
 Complete a health history including a physical, cognitive, psychosocial and functional
assessment.
 Assess the client's response to actual and potential health problems.
 Assess the client's response to interventions.
▪ Assess personal stress and adaptation.
Level II  Analyze health status of acutely ill clients/groups of clients with multiple health
problems.
 Demonstrate advanced skill in completing a health history.
 Integrate prior knowledge in assessing the effects of stressors on clients, families and
communities.
 Prioritize responses to actual or potential health problems and to nursing interventions.
Clinical Decision Making
Level I  Identify evidence-based practice as the foundation for nursing decisions.
 Utilize nursing process as the basis for clinical decisions.
 Maintain accurate and safe care.
 Integrate prior knowledge and begin to question personal assumptions.
 Develop critical thinking and problem solving techniques as the foundation for
appropriate clinical decision making.
 Develop diagnoses and plan care that focuses on health promotion, wellness and
restoration.
 Modify client care as indicated by evaluation of outcomes.
Level II  Analyze dysfunctional health patterns and stressors of the individual, family and the
community.
 Utilize evidence-based practice in order to formulate clinical decisions.
Caring Interventions
Level I  Demonstrate caring behavior towards clients, significant other(s), peers, and other
members of the health team recognizing cultural and spiritual diversity.
 Provide safe nursing care in all settings.
 Perform nursing skills competently.
 Identify community resources to support clients in the promotion and maintenance of
health.
 Support the client and significant other when making healthcare and end-of-life
decisions.
 Provide individualized interventions that include self-esteem enhancement, anxiety
reduction, and coping enhancement.
Level II  Perform effective and preventative nursing measures to facilitate health promotion and
maintenance in clients and groups.
 Synthesize understanding of cultural and spiritual differences and developmental needs
when caring for individual and family in order to provide sensitive, holistic nursing care.

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Teaching and Learning
Level I  Identify the role of the nurse as a teacher and develop awareness of the principles of
effective teaching and learning.
 Apply teaching and learning concepts to assist clients and groups in managing wellness
and/or self-management of illness.
 Evaluate the progress of the client/significant other toward achievement of identified
learning outcomes.
▪ Advocate health promotion.
Level II  Develop teaching plans to assist individuals and groups to promote health and manage
acute and chronic health problems.
 Identify learning needs of the individual and family and modify interventions according
to developmental level.
▪ Utilize teaching and learning concepts in leadership/management in assigned setting.
Collaboration
Level I  Identify roles of members of the health care team.
 Utilize multiple resources available for the individual and family within the community.
 Establish partnerships with clients and collaborate with the nursing team to achieve client
outcomes.
▪ Work cooperatively with others to achieve client outcomes.
Level II  Collaborate with peers and multidisciplinary team members to deliver cost effective,
quality care to individuals, families and communities.
 Convey mutual respect, trust, support and utilization of each discipline's role and
contributions to health care.
Managing Care
Level I  Describe the qualities of effective leaders.
 Utilize self-assessment to begin to develop leadership skills.
 Identify the relationship between power and leadership and management.
 Describe the role of the nurse in cost containment and implement-nursing strategies to
provide cost effective care.
 Demonstrate ability to prioritize client needs.
 Identify leadership/management skills necessary in planning and implementing client
care.
 Utilize team-building strategies.
 Describe principles of successfully motivating others.
 Identify key concepts underlying effective delegation.
▪ Identify and implement strategies of behavior change
Level II  Apply principles of effective motivation.
 Utilize key concepts underlying effective delegation.
 Demonstrate leadership management skills when working with the multidisciplinary
health team members to deliver care to groups of clients.
 Apply strategies of change theory with the health care team.
 Employ techniques that can be used in evaluating the work of others.
 Utilize conflict resolution skills.
 Assess visionary skills and identify a plan to become more innovative.

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PROGRAM OBJECTIVES

1. Exhibit ethical behavior in all professional activities.

2. Identify stressors and promote adaptation in clinical care.
3. Integrate advances in knowledge from all sciences and humanities in the care of clients.
4. Assume responsibility for health promotion by assisting the client in learning self- management
skills that provide and promote their health and serve as role models and resource for health
information and education.
5. Practice relationship-centered care with interdisciplinary teams that address the needs and concerns
of culturally and spiritually diverse individuals, families and communities.
6. Utilizes critical thinking to provide evidence-based clinical practice that assists clients in health
promotion, achievement of human potential, illness adaptation and preparation for death.
7. Assist in the delivery of primary care in diverse community-based settings.
8. Function as a client advocate on the interdisciplinary health care team.
9. Use communication and information technology effectively and appropriately.
10. Utilize leadership management skills in collaboration with the interdisciplinary health care team to
manage resources effectively and efficiently to deliver quality client care.
11. Introduce students to financial resources and constraints impacting delivery of health care services to
various populations.
12. Empower clients and communities to learn self-management skills.
13. Use established outcome criteria to measure effectiveness of care.
14. Demonstrate social responsibilities through participation in service activities.
15. Assume responsibility for self-improvement and use resources for life-long learning for self and
others.
16. Practice nursing within the legal parameters of the NY State Nurse Practice Act in diverse settings.
17. Advocate for public policy that promotes and protects the health care system.

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 NR40 COURSE OBJECTIVES:
PROFESSIONAL BEHAVIORS
1. Demonstrate accountability for own ethical behavior and for delegated actions.
2. Apply advances in knowledge from the sciences and humanities in the care of clients.
3. Practice within the framework of the New York State Practice Act and the American Nurse’s Association
Code of Ethics.
4. Assume responsibility for self-improvement and use resources for life-long learning for self and others.
5. Develop an awareness of information technologies that impact on the delivery of health care.
6. Promote and assure the individual’s rights in a defined health care setting.
COMMUNICATION
7. Advocate for clients and families by effectively communicating with members of the multidisciplinary
health team.

ASSESSMENT
8. Integrate prior knowledge to analyze and prioritize individual and community needs, to promote health
and manage acute and chronic health problems.
9. Demonstrate advanced skills in completing a health history.
CLINICAL DECISION MAKING
10. Utilize critical thinking and evidence based practice to analyze clients, families and community stressors
and response to stressors in order to support clinical decision-making.
11. Utilize information technology to meet care needs and to assist clients to use self-management skills.
12. Use evidence based outcome criteria to measure effectiveness of care in the acute and chronically ill adult
client with multiple health problems.
CARING INTERVENTIONS
13. Demonstrate empathy and caring with the ability to apply and reflect on one’s own application of the
principles of interpersonal communications with clients, families, peers and other health team members in
a diverse population.
14. Promote adaptation to the effects of stressors on acute and chronically ill clients with multiple health
problems.
TEACHING AND LEARNING
15. Integrate prior knowledge to identify, analyze and prioritize individual and community needs in order to
develop teaching plans to assist clients, families and communities to promote health and manage acute
and chronic health problems.
16. Demonstrate leadership management skills when working with the multidisciplinary health team to deliver
care to groups of clients.
COLLABORATION
17. Identify the social responsibilities of meeting the needs of acute and chronically ill clients with multiple
health problems and the community services available to them.
18. Collaborate with peers and other multidisciplinary team members to deliver cost effective quality care to
individuals, groups and communities.
19. Develop an interdisciplinary plan of care that conveys mutual respect, trust and support.
MANAGING CARE
20. Demonstrate leadership management skills when working with the multidisciplinary health team to
deliver care to groups of clients.
Revised 4/04, 8/04

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TOPICAL COURSE OUTLINE

Nursing Management of Clients with Stressors that require Home Care

Nursing Management of Clients with Stressors that affect Cardiac and Peripheral Function

Nursing Management of Clients with Stressors that affect Respiratory Function

Nursing Management of Clients with Stressors that affect Hematological Function

Nursing Management of Clients with Stressors that affect Musculoskeletal Function

Nursing Management of Clients with Stressors that affect Endocrine Function

Nursing Management of Clients with Stressors that affect Gastrointestinal and Hepatobiliary Function

Nursing Management of Clients with Stressors that affect Urinary and Renal Function

Nursing Management of Clients with Stressors that affect Male and Female Reproductive Organ Function

Nursing Management of Clients with Stressors that affect Neurological Function

Nursing Management of Clients with Stressors resulting from Disasters (Includes Burns and Shock States)

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STUDENTS ARE RESPONSIBLE TO REFER TO AND ADHERE TO THE POLICIES AS
WRITTEN IN THE COLLEGE CATALOG AND THE NURSING STUDENT HANDBOOK

TEACHING METHODS & TOOLS:

1. Lecture & discussion, case study analysis

2. Library resources
3. Audio-visual aids, videos, interactive software
4. Pre and Post Conference, internet resources
5. Clinical experiences, assignments
6. Alternative clinical experience (ACE) Day
7. Independent lab practice
8. Reading assignments

REQUIRED ASSIGNMENTS:

Written assignments will include:

Nursing Care Plan (1)/ or Care Map of the Acutely III Adult Client (See Clinical Folder)
Community Teaching Group project/or Change Project (See Clinical Folder)
Home Care Assignment and Community Agency Assignment / or Discharge Plan Paper (See
Clinical Folder)
Medication Administration Project for a Group of Clients (I) (See Clinical Folder)

EVALUATION METHODS

The evaluation is based on clinical performance, and written assignments. Each student will receive a mid-
term and final evaluation consisting of a written report and a personal interview by the instructor. Clinical
Evaluation Form attached.

1 .Unit exams (4) 90%

2. Assessment Technologies Institute (ATI) 10% (Adult medical surgical & Pharmacology Exams)
3. Evaluation of clinical performance Pass/Fail
4. Written assignments Pass/Fail

Examinations
Four multiple-choice examinations of approximately 50 questions each will account for 90% of the grade.
Each examination will cover the material presented prior to the exam. Questions will be primarily client
situations, using critical thinking skills and similar to questions that will be on the NCLEX.
As a component of the course, students will complete the ATI Mastery Series for 10% of the grade. The
Mastery Series will include Medical Surgical and Pharmacology exams which will be comprehensive and
will help prepare for and predict performance on the NCLEX.
An excellent way to review for the examinations is to complete the computer software programs, as well as
doing the “reflective thinking” and “critical thinking” activities in the textbooks.

All students who receive a score less than 75 on an examination MUST make an appointment to review
their status, study habits and the examination with the faculty within one week following the examination.
At this time, a study contract to work toward improved performance in the course will be initiated with the
student. If the student does not adhere to these guidelines, a statement will be placed in his/her file by the
faculty. After 2 exam failures students will be referred to the Academic Chair for counseling.

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Final Grading
Final grading in the course will be determined by averaging results on four unit examinations and results of
ATI testing.. There will be one comprehensive makeup exam administered at the end of the semester for
one missed exam. If two unit exams are missed only one makeup exam may be taken. A grade of zero will
be given for the second missed unit exam.

Students must pass theory with a minimum grade of C, and have satisfactory performance in the clinical
component to pass NR 40.

DOSAGE CALCULATION TEST:

Students must obtain a minimum score of 80% on the dosage calculation test to remain in the course.
The test may be repeated only 1 time, for a total of 2 attempts within the first two weeks of the course.

Academic Integrity

Nursing students will be held accountable to the Suffolk County Community College Nursing Program
Code of Honor in all phases of the program: classroom, college laboratory and all clinic settings. (Refer to
Nursing Student Handbook, Policy on Academic Integrity)

11
 SUFFOLK COUNTY COMMUNITY COLLEGE

School of Nursing
STUDENT RESPONSIBILITY FOR SAFE CLINICAL PRACTICE

Guidelines In Determining Student Clinical Grade

The clinical component of each nursing course provides nursing students with the opportunity to apply
nursing principles in a practice setting. This is an essential skill for every competent practitioner of nursing.
The four overriding criteria for a satisfactory passing grade in the clinical area are:

1. Using the steps of the nursing process for scientific problem solving.
2. Maintaining medical and surgical asepsis.
3. Maintaining physical safety.
4. Maintaining psychological safety.
The critical behavior for evaluating student performance is the student’s ability to make clinical decisions
for safe patient care. Such decision making reflects the ability of nursing students to apply nursing
principles in a variety of situations. Meeting these criteria constitutes competent performance and a
satisfactory passing grade.
When a student jeopardizes patient care by violating one of these principles, it shall constitute a
failure for that clinical day.* A student fails a course when repeated failures occur. The specific
standard for failure in each course is:
1. NR20 Three (3) failed clinical days. 5. NR46 Two (2) failed clinical days.
2. NR24 Two (2) failed clinical days. 6. NR48 Two (2) failed clinical days.
3. NR33 Two (2) failed clinical days. 7. NR40 Two (2) failed clinical days.
4. NR36 Two (2) failed clinical days.
*Please note that a failed clinical evaluation will constitute a failed clinical day.
Student’s responsibilities in this situation include:
1. Taking responsibility for one’s own actions.
2. Identify own error. Ask for assistance.
3. Develop and utilize strategies to assist in clinical decision making.
4. Please refer to document entitled "Guidelines for student written report for student
incident resulting in student warning or failed clinical day".
Faculty responsibilities in this situation include:
1. Counseling the student.
2. Providing a written notification regarding the failure.
3. Provide recommendations for corrective action.

12
 SUFFOLK COUNTY COMMUNITY COLLEGE
School of Nursing

Clinical Skills Policy

Students are responsible for all skills taught throughout the

program. Students are responsible to independently practice in the
nursing lab during their out-of-class time in order to gain skill
proficiency.
Students can make an appointment with the Professional Assistant
in the nursing lab for additional practice.

SUFFOLK COUNTY COMMUNITY COLLEGE

School of Nursing

13
 GUIDELINES FOR STUDENT WRITTEN REPORT OF CLINICAL INCIDENT
RESULTING IN CLINICAL WARNING OR FAILED CLINICAL DAY

Explanation
This is an additional assignment that is given when the faculty identifies student decisions and/or actions
that fail to meet the course objectives or standards of nursing practice during a given clinical class. The
assignment is made in the spirit of student-centered learning and continued professional development. It
provides a framework that assists the student to analyze clinical events, to consult the nursing literature, and
to plan future nursing goals for themselves that are in keeping with professional standards.
Instructions to Faculty
The student’s written report should be submitted on the clinical day following the critical incident. The
faculty must discuss the critical incident with the student before making this assignment. The completion of
the written assignment provides tangible evidence of the student’s perspective regarding the incident.
Further discussion with the student or further action may/may not be necessary depending upon the insight
demonstrated in the written report as well as the student’s subsequent clinical practice.
Instructions to Students
1. Provide a written report of the critical incident to the clinical instructor.
2. The report is due on the next clinical day following the critical incident.
3. The report should consist of your answers to three basic questions.

A. What happened?
Describe the details of the incident.
What were your nursing actions? What was the patient’s response? What were the
actual and the potential consequences for the patient? Include any and all details you
deem pertinent.

B. What should have happened?

Based upon your meeting with your clinical instructor after the incident, and based
upon the research you have done since the incident, what should have happened in
this clinical circumstances?

C. What Nursing Practices will you implement in the future to prevent the
recurrence of similar incidents?

4. The report should include a bibliography of at least one pertinent nursing reference.

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 SCHOOL OF NURSING
STUDENT RESPONSIBILITY FOR SAFE CLINICAL PRACTICE
REPORT OF FAILED CLINICAL DAY
Learning Activities

1. Utilize the nursing practice lab to simulate:

a. Practice independently to become familiar with:

b. Arrange an appointment with a nursing faculty member for supervised practice of this skill.

c. Demonstrate competency in __________________________________ in clinical area.

2. View video tapes on the following topics:

And/or complete the following Computer Assisted Instructional (CAI) programs:

3. Discuss the principles of the above video tapes/CAI with assigned clinical instructor.

4. Review text material on the following topics:

5. Apply this knowledge and these skills in the clinical setting.

CONCLUSION: Student must successfully complete all the recommendations of this learning guide in order to progress in the
Nursing program. The student agrees to provide the faculty with a written summary of the specified learning activities he/she has
completed by _____________________. (date)

Student Signature:________________________________________ Date_________________

Student Comments:

Faculty Signature:________________________________________ Date__________________

Faculty Comments:

Note: The clinical faculty member is responsible to distribute three copies of this report as follows:
Student, Clinical Faculty and student file by way of the Course Coordinator and the Academic Chair/Assistant Chair

FFL/ds Rev 5/06

15
REQUIRED TEXTBOOKS:

1) Ignatavicius, D. & Workman, L. (2006). Medical surgical nursing: Critical thinking for

collaborative care. (5th ed.). Philadelphia: Saunders. *(single volume: 0-7216-0446-3; double

volume: 0-7216-0671-7)

2) Ignatavicius, D. (2006). Virtual clinical excursions 3.0 to accompany Medical-Surgical Nursing. (5th

ed.). Philadelphia: Saunders. *(1-4160-0103-4)

3) Winningham, M. & Preusser, B. (2005). Critical thinking in medical-surgical settings: A case study

approach. (3rd ed.) St. Louis: Mosby. *(0-323-02566-8)

4) Ackley, B. & Ladwig, G. (2006). Nursing diagnosis handbook: A guide to planning care. (7th ed.).

St. Louis: Mosby. *(0-323-03664-3) (Grant Campus)

5) Carpenito-Moyet, L. (2005). Nursing diagnosis: application to clinical practice (11th ed.). New

York: Lippincott-Raven. * (0-7817-6131-X) (Ammerman campus)

6) Deglin, J., & Valleran, A. (2005). Davis drug guide for nurses (9th ed.). Philadelphia: FA Davis.

*(0-8036-1152-8)

7) Ellis, J., & Hartley, C. (2005). Managing and coordinating nursing care. (4th ed.). New York:

Lippincott-Raven. *(0–7817-41068)

8) Pickar, G. (2004). Dosage calculations (7th ed.). New York: Delmar. *(0–7668–6286-0)

9) Smith, S., Duell, D., & Martin, B. (2004). Clinical nursing skills-basic to advanced skills (6th ed.).

(6th ed.) New Jersey: Prentice Hall. * (013-049371-6)

16
RECOMMENDED TEXTBOOKS

1) Lilley, L., Harrington, S., & Snyder, J. (2005). Pharmacology and the nursing process. (4th ed.).

New York: Mosby. *(0-323024084)

2) Dudek, S. (2006). Nutrition essentials for nursing practice (5th ed.). New York: Lippincott-Raven.

*(0-7817–5382)

3) Fishbach, J. (2005). Nurses quick reference to common laboratory & diagnostic tests (4th ed.).

Philadelphia: Lippincott. *( 0-78174185)

4) Ignatavicius, D., Snyder, J. & Kerby, L. (2006). Critical thinking study guide for medical surgical

nursing. (5th ed.). Philadelphia: Saunders. *(0-7216-06148)

5) Thomas, C. (2005). Taber’s medical dictionary (20th ed.). Philadelphia: F.A. Davis. *(0–8036–

1207-9)

17
 SUFFOLK COUNTY COMMUNITY COLLEGE
Nursing Program

ATTENDANCE POLICY
(Please refer to college policy on attendance)

Applicable to all nursing courses:

1. Students must be able to meet ALL of the course objectives in the Course Outline and on the
Performance Evaluation Form in order to pass each nursing course.
2. Students are expected to attend ALL nursing classes in order to meet all objectives of the course. Pre
and post conferences are an integral aspect of the clinical experience and students are required to
participate in this experience.
3. Students are expected to be ready to begin all nursing classes at the appointed time and to remain in
class until class is ended.

A pattern of lateness, leaving class early and/or absence in lecture, laboratory or the clinical setting will
negatively affect your grade.
4. Absence and lateness will be reviewed by a faculty committee. Appropriate action will be taken by the
committee as to the status of the student in the course. Excessive absence or lateness may lead to
failure in the course.
5. In the rare event of an extreme emergency that requires the student to be late or absent, students will be
expected to notify the clinical agency. Call at least one hour prior to the beginning of the clinical
experience.
a. Leave your message, being sure to state:
- your name and phone number
- your school
- the hospital unit to which you are assigned
- the clinical instructor's name
b. Obtain the name of the person taking the message, when possible.
6. In the rare event of an extreme emergency that requires the student to be late or absent for a lecture or
college laboratory class, students will be expected to notify the faculty. Call at least one hour prior to
the beginning of class.
a. Leave your message, being sure to state:
- your name and phone number
- the reason for your absence or lateness
7. Students who are absent or late for Clinical, lecture, or college laboratory classes are expected to provide
a written explanation to the faculty immediately. This communication should be in the form of a neat
and professionally written memorandum that will be placed in the student’s file at the college.

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NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT REQUIRE HOME CARE
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the Client and his
environment
2. Assesses the client’s level of
knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients in the Home
Care Setting
PLANNING
1. Proposes alternate nursing
measures to assist the client
in adapting to changes in
levels of physical and
psychological functioning in
the home care setting
2. Plans nursing measures that
allow for prevention/or early
detection of complications
3. Formulates a teaching plan
for a home care client
IMPLEMENTATION
1. Implements measures to
promote optimal client
functioning in the home care
setting
2. Promotes adaptation by
manipulating the environment
to maintain optimal level of
independence
COURSE CONTENT
ASSESSMENT
1. Utilizing the nursing process
to identify client needs
Stressors affecting care in the 2. Arrange for home care visit.
home
3. Safety issues in the home
environment
4. Identify family and other
support systems
Describe the role of the nurse
in home care
DIAGNOSIS
Risk for Injury
Impaired Home Maintenance R/T
Impaired Cognitive, Emotional or
Psychomotor Functioning
Impaired Home Maintenance R/T
Inadequate Support Systems
Care Giver Role Strain
PLANNING
1. Formulates nursing diagnosis
based on assessment data
2. Determines expected
outcomes for individual
clients and families
IMPLEMENTATION
1. Adaptations to maximize
functioning in the home care
setting
2. Maintaining a safe therapeutic
environment.
3. Applying principles of
asepsis.
4. Importance of
interdisciplinary team
functions.
19
CORRELATED LEARNINGS
ASSESSMENT
1. Review client records prior to
visit.
3. Home Care visit to assess
client and environment.
4. Collaborate with Home Care
Nurse to complete forms for
planning and reimbursement.
DIAGNOSIS
Analyze Data and Formulate
Diagnoses
PLANNING
1. Assists RN to coordinate and
delegate nursing home health
aide, physical therapy and
other services delivered to the
client.
2. Participates in developing a
teaching plan
IMPLEMENTATION
1. Assist the nurse to organize
client care
2. Participate in direct client care
3. Implements a plan of care
Incorporate the client’s values
and preferences in medical
decision making and goal
setting.
4. Contribute to health teaching
with client and or family
BEHAVIORAL OBJECTIVES
EVALUATION
1. Evaluates the effectiveness of
nursing action designed to:
a. maintain current level of
functioning
b. prevent complications
c. improve level of
functioning
2. Evaluates clients response
to drug, diet and activity
regimen
3. Evaluates the effectiveness
of client teaching
COURSE CONTENT
5. Effective communication
strategies for dealing with the
client and care givers in the
home.
EVALUATION
1. Outcome criteria for:
a. Self-care in the home
b. Home maintenance
20
CORRELATED LEARNINGS
members
6. Assist the nurse to coordinate
discharge planning.
EVALUATION
1. Reports and records
significant changes in client
status
2. Evaluates progress based on
outcome criteria for an
individual client in the home
setting
3. Evaluates the effectiveness of
teaching
4. Illustrate with examples how
home care objectives were
met.
5. Summarize a journal article
related to home care nursing.
NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT CARDIAC AND
PERIPHERAL FUNCTION
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the client’s
circulatory status.
a. Assesses the effects of
alterations in circulation on
physical and psychological 3. Effect of stressors:
adaptation
b. Assesses client’s level of
knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Cardiovascular and Peripheral
Dysfunction.
PLANNING
1. Proposes alternate nursing
measures to assist the client
in adapting to changes in
levels of physical and
psychological functioning.
2. Plans nursing measures that
allow for prevention/or early
detection of complications
3. Formulates a teaching plan for
a client within alteration in
circulatory function
COURSE CONTENT
ASSESSMENT
1. Stressors affecting circulation 1. Performs a circulatory
a. Internal/External
2. Assessment criteria for
alteration in circulation
a. Angina and Myocardial
Infarction
b. Life-threatening
dysrythmias
c. CHF, pulmonary edema
d. Pulmonary and systemic
emboli
e. Peripheral vascular disease
f. Aneurysm
DIAGNOSIS
Common Nursing Diagnoses for
these disorders include:
Impaired Gas Exchange
Decreased Cardiac Output
Ineffective Tissue Perfusion
Activity Intolerance
Ineffective Therapeutic
Management
PC Dysrythmias
PLANNING
1. Formulates nursing diagnosis
based on assessment data
2. Determines expected
outcomes for individual
clients
21
CORRELATED LEARNINGS
ASSESSMENT
assessment
2. Diagnostic tests:
CBC, cardiac isoenzymes,
troponin, APTT, prothrombin
time, INR, homocystine
levels, BNP, C Reactive
Protein, EKG, chest X-ray,
cardiac catheterization, CVP,
radionuclide studies,
arteriograms, venograms
3. Analyzes information from
cardiac assessment and
diagnostic tests
4. Formulates, revises or
concurs with nursing
diagnosis
DIAGNOSIS
Analyze Data and Formulate
Diagnoses
PLANNING
1. Plans nursing care for a client
with an alteration in
circulatory function
2. Participates in developing a
teaching plan for a client with
impaired circulatory function
3. Incorporates homecare needs
as indicated.
BEHAVIORAL OBJECTIVES
IMPLEMENTATION
1. Implements measures to
promote optimal client
functioning in an individual
with a circulatory deficit
2. Initiates appropriate actions
for persons experiencing a
cardiac related emergency
3. Promotes adaptation by
manipulating the environment
to maintain optimal level of
independence
EVALUATION
1. Evaluates the effectiveness
of nursing action designed to:
b. maintain current level of
functioning
b. prevent complication
c. improve level of
functioning
2. Evaluates clients response
to drug, diet and activity
regimen
3. Evaluates the effectiveness
of client teaching for a
client with a circulatory
deficit
COURSE CONTENT CORRELATED LEARNINGS
IMPLEMENTATION IMPLEMENTATION
1. Adaptations to maximize 1. Implements a plan of care for
function a client with circulatory
a. Emergency treatment problems. Implements a
b. TEDS teaching plan for a client with
c. Diet therapy a circulatory problem
d. Drug therapy 2. Implements the following
2. Surgery skills:
a. Revascularization a. Apical and radial pulses
b. Angioplasty b. Peripheral vascular
c. Valve replacement assessment
d. Transplantation
3. Teaching Needs for Self-
Care:
a. Drug/diet therapy
b. Planned exercises
c. Stress reduction
d. Foot Care
e. Weight control
f. Community agencies
g. Rehabilitation program
EVALUATION EVALUATION
2. Outcome criteria for: 1. Reports and records
a. Cardiovascular significant changes in
adaptation cardiovascular status
b. Self-care 2. Evaluates progress based on
outcome criteria for an
individual client with a
circulatory dysfunction
3. Evaluates the effectiveness of
teaching for a client with a
circulatory deficit
22
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT RESPIRATORY
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the client's
respiratory status for
presence of stressors that
precipitate respiratory
dysfunction
2. Assess the effects of
alterations in respiration on
physical and psychological
adaptation
3. Assesses client’s level of
knowledge
FUNCTION
COURSE CONTENT CORRELATED LEARNINGS
ASSESSMENT ASSESSMENT
1. Stressors affecting 1. Performs a respiratory
respiratory status assessment
2. Assesses for alterations in: 2. Diagnostic Tests:
Rate and character of Lung Scan
respirations; pain; X-rays
characteristics of Bronchoscopy
breathing; skin color; Thoracentesis
hemoptysis Biopsy
3. Effects of stressors Blood Gases
a. Cancer of the lung Pulmonary Function Tests
b. Respiratory Failure and Sputum Analysis
ARDS 3. Formulates, revises, or
c. Chest Trauma- concurs with nursing
Pneumothorax, diagnosis
Hemothorax
d. Pulmonary Embolism

DIAGNOSIS DIAGNOSIS DIAGNOSIS

Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Respiratory Dysfunction
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include: Diagnoses
Impaired Gas Exchange
Acute Confusion RT hypoxia
Ineffective Airway Clearance
Ineffective Breathing Patterns
Impaired Verbal Communication

PLANNING PLANNING PLANNING

1. Proposes alternate nursing
care measures to assist the
client in adapting to changes
in physical and
psychological functioning
2. Formulates a teaching plan
for self-care for client with
respiratory dysfunction
3. Proposes alterations in
nursing care to prevent
respiratory infections
1. Formulates nursing diagnoses
based on assessment data
2. Determines expected
outcomes for individual
clients
1. Participates in developing a
teaching plan for a client with
respiratory problem
2. Plans nursing care for a client
with respiratory dysfunction
3. Reviews established
protocols for assisting with
respiratory procedures i.e.
Thoracentesis
4. Incorporates home care needs
as indicated

23
BEHAVIORAL OBJECTIVES
IMPLEMENTATION
1. Utilizes the nursing process
with minimal assistance to
maintain/improve the
client’s current status
COURSE CONTENT CORRELATED LEARNINGS
IMPLEMENTATION IMPLEMENTATION
1. Mechanical ventilation 1. Implements a plan of care for
2. Chest drainage client with respiratory
3. Suctioning problem
4. Diet management 2. Implements teaching plan for
5. Drug Management a client with a respiratory
6. Teaching needs for self-care problem
7. Surgery 3. Assists client with
a. Thoracotomy preventative or prescribed
b. Lobe resections and breathing exercises
pneumonectomy 4. Implements the following
skills:
a. endotracheal suctioning
b. maintain water seal
drainage system
c. Safety aspects for a
ventilated client

EVALUATION EVALUATION EVALUATION

1. Evaluates effectiveness of
respiratory therapy
2. Evaluates effectiveness of
nursing actions designed to:
a. maintain or improve
current level of
functioning
b. prevent complications
3. Evaluates the effectiveness
of client teaching with
respiratory problems
1. Outcome criteria for:
a. Respiratory adaptations
b. Self-care
1. Reports and records
significant changes in
respiratory status
2. Evaluates outcome criteria
for individual clients with
respiratory problem
3. Evaluates effectiveness of
client teaching for a client
with respiratory dysfunction

24
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assess the client’s
hematological status and
stressors that precipitate
hematological dysfunction
2. Assess the effects of
alterations in hematological
function
3. Assess laboratory findings for 3. Effects of stressors and client
client with blood dyscrasia
4. Assess client’s level of
knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Hematological Dysfunction
PLANNING
1. Identify outcomes for
prevention of illness and
adaptation of client with
hematological dysfunction
2. Develop a plan of care that
prioritizes nursing diagnoses
based upon subjective and
objective assessment.
3. Plan nursing interventions for
a client with anemia
HEMATOLOGICAL FUNCTION
COURSE CONTENT CORRELATED LEARNINGS
ASSESSMENT ASSESSMENT
1. Pathophysiology of 1. Assess stressors for client with
hematologic dysfunctions anemia, or bleeding
2. Assess circulatory changes: dysfunction.
vital signs, bleeding, blood 2. Reviews diagnostic tests:
count, color, diet, petechiae, CBC, sed rate, WBC with
infections, sensory changes in differential UA
extremities
adaptation:
Polycythemia vera
Chronic Myoocytic Leukemia
Chronic Lymphocytic
Leukemia
DIAGNOSIS DIAGNOSIS
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include: Diagnoses
Risk for Infection
Fatigue
Risk for Injury
Impaired Oral Mucous
Membranes
Imbalanced Nutrition
Anxiety
PLANNING PLANNING
1. Develops approaches to 1. Participates in developing a
nursing care based on teaching plan including
assessment of individual sensitivity to cultural and
status. spiritual diversity
2. Identify and prioritize nursing 2. Plans nursing care that
diagnoses enhances and/or maintains
3. Develop a plan of care that optimal functioning and
prioritizes nursing diagnoses quality of life.
based upon subjective and
objective assessment.
4. Determine client outcomes
appropriately and on an
individual basis.
5. Develop a plan of care based
on client’s variables including
personal, spiritual and cultural
diversity.
25
BEHAVIORAL OBJECTIVES
IMPLEMENTATION
1. Implements therapeutic
nursing interventions that
optimize adaptation for the
client with leukemia.
2. Discuss client’s role in
medical and surgical
management of blood
dysfunction.
3. Teach client about diagnostic
studies used to detect
hematological dysfunction.
4. Teach client basic principles
of effective nutrition
EVALUATION
1. Evaluate outcomes utilizing
outcome criteria developed in
the planning phase of care.
COURSE CONTENT
IMPLEMENTATION
1. Measure to increase adaptation
to stressors:
a. therapeutic nutrition
b. pharmacologic
management
c. oxygen therapy
d. blood transfusion
observation
e. activity exercises
f. positioning
g. bone marrow aspiration
h. chemotherapy
i. splenectomy
j. prevention of infection
k. biopsychosocial support
l. teaching measures to
include diet, medication,
safety, rest & exercise
EVALUATION
1. Outcome criteria for:
a. Hematological adaptation
b. Self-care
26
CORRELATED LEARNINGS
IMPLEMENTATION
1. Communicates ideas
effectively with clients and
other members of health care
team.
2. Demonstrates skill in:
a. application of cold and
warm compresses
b. therapeutic nutrition
c. management of bleeding
d. transfusions
e. observations with
chemotherapy and
radiation
3. Reviews protocols for bone
marrow aspiration and
splenectomy.
4. Provides supportive assistance
in dealing with stressors and
adaptation.
5. Carries out protective isolation
procedures.
6. Provides discharge planning
and community referrals.
EVALUATION
1. Evaluate client’s
understanding and adaptation
to nursing interventions.
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assess the client’s
musculoskeletal status and
stressors that precipitate
musculoskeletal dysfunction
2. Assess the effects of
alterations in musculoskeletal
dysfunction
3. Assess laboratory findings for
client with musculoskeletal
dysfunction
4. Assess client’s level of
knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
PLANNING
1. Proposes alterations in
nursing care to meet the needs
of the immobilized client and
to maintain optimal levels of 2. Determine expected
mobility.
2. Reorders nursing priorities in
accordance with changing
therapeutic response.
3. Formulates a teaching plan to
prepare the client with a
motor problem to function at
his maximal level of
independence
MUSCULOSKELETAL FUNCTION
COURSE CONTENT
ASSESSMENT
1. Stressors affecting mobility 1. Assesses problems of a client
2. Musculoskeletal assessment
3. Effects of stress on
musculoskeletal systems
a. Musculoskeletal trauma
b. Osteomyelitis,
Osteoporosis
c. Gout
d. Osteoarthritis
e. Rheumatoid arthritis
f. Systemic lupus
erythematosus
DIAGNOSIS
Common Nursing Diagnoses for
these disorders include:
Risk for Peripheral
Neurovascular dysfunction
Acute Pain
Chronic Pain
Disturbed Body Image
Impaired Physical Mobility
PC Compartment Syndrome
PC Thromboembolism
PC Delayed Healing or Non
Union
PLANNING
1. Formulates nursing
diagnoses based on
assessment data
outcomes for individual
clients
27
CORRELATED LEARNINGS
ASSESSMENT
with an alteration in mobility
2. Diagnostic tests
Arthrocentesis
Arthroscopy
Bone Scan, Tomogram
Calcium, Phosphorous,
Alkaline
Phosphatase
Uric Acid, Sed Rate
Serology tests associated
with joint disease
3. Formulates, revises or
concurs with nursing
diagnosis
DIAGNOSIS
Analyze Data and Formulate
Diagnoses
PLANNING
1. Plans nursing care for a client
with a musculoskeletal
problem
2. Reviews established
protocols for assisting a client
in a cast or in traction, or a
knee immobilizer
3. Develops a teaching plan for
use of ambulatory aids
BEHAVIORAL OBJECTIVES
IMPLEMENTATION
1. Manipulates the environment 1. Adaptation to Maximize
to protect the immobilized
client from further injury or
impairment
2. Selects appropriate First Aid
measures for emergency
treatment of musculoskeletal
injuries
3. Revises approaches to
nursing action in response to
increasing muscle spasm
4. Applies principles from the
natural sciences to maintain
traction apparatus
5. Manipulates the environment
to maintain a proper balance
between rest and activity in
inflammatory or
degenerative joint conditions
EVALUATION
1. Evaluates the effectiveness of
nursing care and rehabilitation
measures.
COURSE CONTENT
IMPLEMENTATION
Function
a. Cast care, pin care
b. Traction, types and
maintenance
c. Hot/cold application
d. Measures to prevent joint
degeneration
e. Diet/Drug management
f. First Aid and Positioning
with common fractures
2. Teaching Needs for Self-care
a. Diet and Drug therapy
b. Planned exercise
c. Safety measures for heat
treatments
d. Use of ambulatory aids
e. Home adaptations for
independence
f. Community agencies
3. Surgery
a. Total hip replacement,
knee replacement
b. Open reduction of
fractures
c. Amputations
EVALUATION
1. Outcome criteria for:
a. Motor-Safety adaptations
b. Self-care
28
CORRELATED LEARNINGS
IMPLEMENTATION
1. Implements a plan of care for
a client with a
Musculoskeletal problem i.e.
reinforcing physical therapy
program
2. Implements a teaching plan
for a client with a
musculoskeletal problem
3. Implements the following
skills:
a. Teach use of ambulatory
aids
b. Apply wet packs, splints,
braces
c. Maintain traction
d. Give cast care, pin care
e. Teach use of self-help
devices
4. Implements neurovascular
assessment
EVALUATION
1. Reports and records
significant changes in motor
function
2. Evaluates outcome criteria
for a client with a specific
motor problem
3. Evaluates the effectiveness of
an established plan of care
for a client with a
musculoskeletal problem
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT ENDOCRINE
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assess the client’s
regulatory status.
2. Assess factors that
precipitate regulatory
dysfunction
3. Assess alterations in the
client’s current ability to
cope with stress.
4. analyze laboratory findings
in clients with hormone
imbalances. States effects of
these findings on the plan of
nursing care.
5. Assess client’s level of
knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Endocrine Dysfunction
PLANNING
1. Proposes alterations in
nursing care to decrease
stress in individual clients
2. Plans nursing actions to
restore optimal level of
adaptation when a hormonal
deficiency or excess exists
3. Proposes nursing measures
that encourage prevention or
early detection of
complications in clients with
regulatory problems
4. Formulates a teaching plan
for self-care for a client who
has a regulatory problem or
has undergone endocrine
surgery
FUNCTION
COURSE CONTENT CORRELATED LEARNINGS
ASSESSMENT ASSESSMENT
1. Assess for: 1. Nursing history
a. Parameters of regulatory 2. Related diagnostic tests
function Formulates, revises or
b. Mechanisms concurs with nursing
c. External diagnoses, care map
2. Interference
a. Hyperfunction or
b. Hypofunction of endocrine
glands: pituitary, thyroid,
adrenals and parathyroid
DIAGNOSIS DIAGNOSIS
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include: Diagnoses
Disturbed Body Image
Sexual Dysfunction
Activity Intolerance
PC Fluid and Electrolyte
Imbalance
Decreased Cardiac Output
Disturbed Thought Processes
PLANNING PLANNING
1. Formulate nursing diagnoses 1. Participates in developing a
or care map based on teaching plan for a client with
assessment data a regulatory problem
2. Determine expected outcomes 2. Plans nursing care for a client
for individual clients with a regulatory problem
3. Incorporate homecare needs
as indicated
29
BEHAVIORAL OBJECTIVES
IMPLEMENTATION
1. Decrease external stressors
that interfere with the
client’s ability to cope with
deficiencies in regulatory
mechanisms.
2. Implements measures to
promote optimal client
functioning when a
hormonal deficiency/excess
exists.
3. Promotes adaptation by
encouraging optimal levels
of independence in clients
with regulatory problems.
4. Teaches comprehensive self
management to assist clients
adapting to endocrine
dysfunction.
COURSE CONTENT CORRELATED LEARNINGS
IMPLEMENTATION IMPLEMENTATION
1. Adaptations to achieve 1. Implements a plan of care for
homeostasis a client with a regulatory
a. Drugs problem.
*Hormone 2. Plans nursing care for a client
*Steroids with a regulatory problem.
b. Diet Therapy
c. Emergency Treatment
d. Fluid and electrolyte
balance
2. Teaching Needs for Self care
a. Stress Management
b. Manifestations of
hormone
deficiency/excess
c. Monitoring effects of
hormone therapy
d. Diet therapy
e. Situations requiring
professional interventions
f. Measures to prevent
infection and fatigue
g. Community Agencies
3. Surgery
a. Subtotal and Total
Thryoidectomy
b. Adrenalectomy
c. Parathyroidectomy
4. Irradiation therapy

EVALUATION EVALUATION EVALUATION

1. Evaluates effectiveness of
hormone replacement
therapy
2. Evaluates effectiveness of
nursing actions designed to:
a. maintain or improve
current level of
functioning
b. prevent complications
3. Evaluates the effectiveness
of client teaching for a
client with a regulatory
problem
1. Outcome criteria for:
a. regulatory adaptations
b. self-care
1. Reports and records
significant changes in
regulatory status
2. Evaluates outcome criteria
for individual client with
regulatory problems
receiving hormone
replacement therapy
3. Uses established outcome
criteria to evaluate
effectiveness of client
teaching for a client with
endocrine dysfunction

30
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT
GASTROINTESTINAL/HEPATOBILIARY FUNCTION
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assess the client’s
gastrointestinal and
Hepatobiliary status and
stressors that precipitate
gastrointestinal or
Hepatobiliary dysfunction
2. Assess the effects of
alterations in gastrointestinal 1. Assesses for alteration in
or Hepatobiliary dysfunction
3. Assess laboratory findings
for client with
gastrointestinal or
Hepatobiliary dysfunction
4. Assess client’s level of
knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Gastrointestinal/Hepatobiliary
Dysfunction
COURSE CONTENT CORRELATED LEARNINGS
ASSESSMENT ASSESSMENT
1. Stressors effecting 1. Nursing history
Nutritional/Metabolic Patterns 2. Diagnostic tests: X-rays,
on G.I./Hepatobiliary sonogram, CBC and bleeding
functioning studies, electrolytes, serum
a. Internal enzymes
b. Genetic 3. Selects appropriate nursing
c. External diagnosis for a client with
gastrointestinal or
G.I./Hepatobiliary function Hepatobiliary dysfunction
in: weight, dietary patterns,
alcohol use, bowel habits,
pain, nausea, vomiting,
distension, anorexia, skin
turgor, jaundice, ascites
pruritis, bleeding, etc.
2. Effects of stressors:
a. Peptic ulcers
b. Inflammatory bowel
disease
c. Irritable Bowel
d. Appendicitis and
peritonitis
e. Intestinal obstruction
f. Hernias
g. Hepatitis and cirrhosis
h. Pancreatitis and
cholecystitis
i. Cancer
j. Morbid obesity
DIAGNOSIS DIAGNOSIS
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include: Diagnoses
Risk for Hemorrhage
Risk for Deficient Fluid Volume
Acute or Chronic Pain
Fluid and Electrolyte Imbalance
Imbalanced Nutrition
Ineffective Therapeutic Regimen
Management
Disturbed Body Image
Constipation
31
BEHAVIORAL OBJECTIVES
PLANNING
1. Proposes alternate nursing
measures to assist the client
in adapting to changes in
levels of physical and
psychological functioning.
2. Plans nursing measures that
allow for prevention and/or
early detection of
complications
3. Formulates a teaching plan
for a client having an
alteration in G.I or
Hepatobiliary function
IMPLEMENTATION
1. Selects nursing measures to
maintain or improve the
clients nutritional status
2. Discusses principles of diet
management for a client
with an alteration in G.I.
function
3. Teaches self-care
management to clients
with an ostomy promotes
adaptation by encouraging
appropriate levels of
independence
COURSE CONTENT
Diarrhea
Excess Fluid Volume
PC for Hemorrhage
PC Porto-Systemic
Encephalopathy
Acute Pain
Imbalanced Nutrition
Impaired Skin Integrity
PC Drug Toxicity
Disturbed Body Image
PC Fluid and electrolyte
Imbalance
PC Hyperglycemia
PLANNING
1. Formulates nursing
diagnoses based on
assessment data.
2. Determines expected
outcomes for individual
clients
IMPLEMENTATION
1. Adaptations to minimize
function:
a. Drug Therapy
b. Diet therapy
c. Colostomy and ileostomy
care
d. Care of esophageal,
nasogastric and intestinal
tubes, T-tubes
e. Measures to prevent
Hepatitis
f. Stress reduction
32
CORRELATED LEARNINGS
PLANNING
1. Plans nursing care for a client
with an alteration in G.I. or
Hepatobiliary function
2. Participates in developing a
teaching plan for a client with
an alteration in G.I. or
Hepatobiliary function
3. Incorporates homecare needs
as indicated
IMPLEMENTATION
1. Implements a plan of care for
a client with a
gastrointestinal/hepatobiliary
problem
2. Implements a teaching plan
for a client with an alteration
in G.I. function
3. Implements the following
skills:
a. Tube feedings
b. Ostomy care
c. Maintenance of
nasogastric tubes and G.I.
suction
BEHAVIORAL OBJECTIVES
2.
3.
EVALUATION
1. Evaluates the effectiveness
of nursing action designed
to:
a. Improve or maintain
current level of
functioning.
b. Prevent complications
2. Evaluates the effectiveness
of client teaching for a client
with an alteration in G.I. or
Hepatobiliary functioning
COURSE CONTENT CORRELATED LEARNINGS
Surgery:
a. Gastrectomy
b. Bariatric Surgery
c. Bowel resection,
colostomy, ileostomy
d. Appendectomy
e. Herniorraphy
f. Cholecystectomy
g. Shunt procedures
Teaching needs for self-care:
a. Drug/diet therapy
b. Ostomy care
c. Measures to decrease
stress
d. Community agencies
EVALUATION EVALUATION
1. Outcome criteria for: 1. Reports and records
a. Gastrointestinal or significant changes in fluid
Hepatobiliary adaptation and nutritional status
b. Self-care 2. Evaluates progress based on
outcome criteria for an
individual client with an
alteration in G.I.or
Hepatobiliary function
3. Evaluates the effectiveness of
client teaching for a client
with an alteration in G.I. or
Hepatobiliary function
33
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT MALE &
FEMALE ORGAN REPRODUCTIVE FUNCTION
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the client’s
reproductive organ status
2. Assesses sexual/reproductive
patterns in the presence of
stressors that precipitate
reproductive dysfunction
3. Assesses the efforts of
alterations in sexuality and 2. Assesses for alterations male
reproduction in physical and
psychological adaptation
4. Assesses the clients level of
knowledge related too
reproductive organ function
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with Male
and Female Reproductive
Dysfunction
PLANNING
1. Plans nursing care to assist
clients in dealing with
female sexual/reproductive
concerns
2. Proposes alternate nursing
care measures to assist
clients in adopting changes
in physical and
COURSE CONTENT
ASSESSMENT
1. Stressors affecting
sexual/reproductive states
a. Internal
b. Genetic i.e. family
history
c. External i.e. DES,
contraceptives
and female reproductive
organ function
Effects of stress:
Cervical cancer, uterine/
endometrial cancer
ovarian cancer
Hypertrophy of the
Prostrate
Prostate and Testicular
Cancer
DIAGNOSIS
Common Nursing Diagnoses for
these disorders include:
Body Image Disturbance
PC Hemorrhage
PC Metastasis
PC Urinary Incontinence
PC Sexual Dysfunction
Anticipatory Grieving
PLANNING
1. Formulates nursing diagnosis 1. Plans nursing care for a client
based on assessment data
2. Determines expected
outcomes for individual
clients
34
CORRELATED LEARNINGS
ASSESSMENT
1. Diagnostic tests
a. Gynecological exam
b. Pap Smear
c. MRI-CT of pelvis,
abdomen, bones
d. Cervical, endometrial,
vaginal biopsy
e. coloposcopy
f. D & C
g. cystoscopy
h. sigmoidoscopy
i. endoscopy
j. CA125 Antigen level
k. ultra sonography
l. PSA, Prostatic Alkaline
Phosphatase
m. Alfa-feto Protein
2. Analyzes alterations in male
and female sexual/
reproductive function
3. Selects appropriate Nursing
DX for client with
deterioration in male and
female sexual/reproduction
DIAGNOSIS
Analyze Data and Formulate
Diagnoses
PLANNING
with alterations in male or
female sexual/reproductive
function
2. Formulates a teaching plan
for the male and female client
with a sexual/reproductive
organ dysfunction
BEHAVIORAL OBJECTIVES
psychological functioning
3. Formulates a teaching plan
for prevention and
management in a client with
female sexual/reproductive
dysfunction
COURSE CONTENT CORRELATED LEARNINGS
3. Reviews established protocol
for clients receiving
chemotherapy, Radiation and
surgical interventions
3. Incorporates home care needs
as indicated

IMPLEMENTATION IMPLEMENTATION IMPLEMENTATION

1. Utilizes the nursing process 1. Adaptations to maintain
to maintain/improve the
clients current
sexual/reproductive status
2. Manipulates the environment
to manipulate alterations in
sexual/reproductive patterns
3. Teaches principles of
prevention and management
of cervical and uterine
cancer and management of
ovarian cancer
4. Instructs the client in self-
care following interventions
for cervical, uterine and
ovarian cancer
5. Discusses problems of
sexuality in clients who have
undergone prostrate surgery.
1. Implements a plan of care for
function a client with cervical, uterine
a. testosterone sparing or ovarian cancer
drugs 2. Implements a plan of care for
b. androgen deprivation a client experiencing
drugs hysterectomy or
c. Chemotherapy oophorectomy, or pelvic
d. Radiation therapy exenteration
e. Prevent complications of 3. Implements a teaching plan
therapy for a client with a
f. Relieve pain sexual/reproductive organ
dysfunction
4. Implements a plan of care for
a client with prostate or
testicular cancer
5. Implements the following
skills:
Care of continuous bladder
irrigation

EVALUATION EVALUATION EVALUATION

1. Evaluates the effectiveness
of nursing actions designed
to:
a. prevent complications
b. maintain or improve
current level of
functioning
Evaluates the effectiveness of
client teaching for a client
with female sexual/
reproductive dysfunction
1. Outcome Criteria for:
a. Adaptations in sexuality
and reproduction
b. Adaptations to body
image
c. Self care
1. Reports and records
significant changes in
sexual/reproductive patterns
2. Develops outcome criteria for
a client with a female
sexual/reproductive problem
3. Evaluates effectiveness of
teaching for clients with
male or female sexual/
reproductive problems

35
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT URINARY AND
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the client’s
genitourinary status.
2. Assesses elimination/sexual
reproductive patterns for
presence of stressors that
precipitate genitourinary
dysfunction.
3. Assess the effects of
alterations in genitourinary
function on physical and
psychological adaptation.
4. Assesses the client’s level of
knowledge
RENAL FUNCTION
COURSE CONTENT CORRELATED LEARNINGS
ASSESSMENT ASSESSMENT
1. Stressors effecting 1. Diagnostic tests
elimination Blood chemistry
a. Internal Clearance studies
b. Genetic Concentration and Dilution
c. External studies
2. Assesses for alterations in: Bacteriologic studies
Pattern of micturation, Radiologic studies
characteristics of urine, Angiogram
pain, gastro-intestinal Cystoscopy
symptoms, fluid balance, Needle biopsy
vital signs, emotional 2. Analyzes alterations in
changes, level of elimination
consciousness, Sexual 3. Selects appropriate nursing
dysfunction. diagnosis for a client with an
Effects of stress: alteration in elimination
a. Urinary tract infections
b. Glomerulonephritis
c. Renal calculi
d. Renal failure
e. Dialysis
f. Transplantation

DIAGNOSIS DIAGNOSIS DIAGNOSIS

Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Urinary and Renal Dysfunction
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include Diagnoses
Acute Pain
PC Fluid and Electrolyte
Imbalances
PC Septic Shock
Activity Intolerance
Imbalanced Nutrition
Disturbed Thought Process
PC Metabolic Acidosis

PLANNING PLANNING PLANNING

1. Plans nursing care to assist
clients in dealing with
elimination concerns
2. Proposes alternate nursing
care measures to assist
clients in adapting to
changes in physical and
psychological functioning
1. Formulate nursing diagnosis
based on assessment data
2. Determines expected
outcomes for individual
Clients
1. Plans nursing care for a client
with alterations in urinary
elimination
2. Formulates a plan for
teaching for the client with an
elimination impairment
3. Reviews established protocol
for clients receiving chemo

36
BEHAVIORAL OBJECTIVES
3. Formulates a teaching plan
for prevention and
management in a client with
elimination dysfunction
IMPLEMENTATION
1. Utilizes the nursing process
to maintain/improve the
client’s current elimination
status
2. Manipulates the
environment to prevent
alterations in elimination
3. Teaches principles of
prevention and management
to the client with a urinary
tract infection or renal
calculi
4. Instructs the client in self-
care following urinary
diversion
EVALUATION
1. Evaluates the effectiveness
of nursing actions designed
to:
a. prevent complications
b. maintain or improve
current level of
functioning
2. Evaluates the effectiveness
of client teaching for a client
with elimination
sexual/patterns
COURSE CONTENT CORRELATED LEARNINGS
and peritoneal dialysis
4. Incorporates homecare needs
as indicated
IMPLEMENTATION IMPLEMENTATION
1. Adaptations to maintain 1. Implements a plan of care
function: for a client in renal failure
a. Maintenance of fluid 2. Implements a plan of care
balance for a client having urinary
b. Drug therapy: tract surgery or prostrate
antibiotics surgery
urinary antiseptics 3. Implements a teaching plan
electrolyte & vitamin for a client with an
replacement elimination problem
diuretics 4. Implements the following
immunosuppressants skills:
c. Maintain and prevent a. Participation in care of
complications of venous client undergoing
access devices dialysis
d. Diet therapy b. Urinary diversion care
EVALUATION EVALUATION
1. Outcome criteria for: 1. Reports and records
Adaptations in significant changes in
elimination and sexuality elimination
2. Develops outcome criteria
for a client with a
sexual/elimination problem
3. Evaluates effectiveness of
teaching for clients with
sexual elimination
problems
37
NURSING MANAGEMENT OF CLIENTS WITH STRESSORS THAT AFFECT NEUROLOGICAL
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the client’s
Neurological status
2. Assesses cognitive-
perceptual patterns for
presence of stressors that 1. Assesses for alterations in
precipitate neurological
dysfunction.
3. Assesses the effects of
alterations in neurological
function on physical and
psychological adaptation
4. Assesses the client’s level
of knowledge
DIAGNOSIS
Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Neurologic Dysfunction
FUNCTION
COURSE CONTENT CORRELATED LEARNINGS
ASSESSMENT ASSESSMENT
Stressors effecting cognitive- 1. Nursing history
perceptual : 2. Diagnostic Tests:
a. Internal X-rays/Cat scan, MRI, MRA
b. External Brain scan
Cerebral Angiography
neurological status i.e.: level EEG
of consciousness, pupillary Lumbar Puncture
response, vital signs, motor Electromyograph, Nuclear
and sensory functions, Magnetic Resonance
mental status, speech, Positron Emission
headache, vomiting, Tomography
incontinence 3. Analyzes the neurological
2. Effects of stressors Assessment- Glasgow Coma
a. Increasing intracranial Scale
pressure 4. Selects appropriate nursing
b. Altered level of diagnosis for a client with a
consciousness neurological problem
c. Neurological trauma:
head injury, spinal cord
injury, ruptured
intervertebral disc
d. Cerebrovascular accident
e. Degenerative Neurologic
Disorders: Parkinson’s
Disease, Myasthenia
Gravis, Huntington’s
Disease, Multiple
Sclerosis, ALS, Gullian
Barre
f. Neurologic Tumors
DIAGNOSIS DIAGNOSIS
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include: Diagnoses
Chronic Confusion
Risk for Injury
Compromised Family Coping
Impaired verbal Communication
Disturbed Sensory Perception
Unilateral Neglect
Impaired Swallowing
38
BEHAVIORAL OBJECTIVES
PLANNING
1. Proposes alternate nursing
care measures to assist the
client in adapting to changes
in physical and
psychological functioning
2. Plans nursing care to prevent
complications of immobility
3. Formulates a teaching plan
to assist the client with a
neurological deficit to
perform A.D.L. with
maximal independent
functioning
IMPLEMENTATION
1. Utilizes the nursing process 1. Adaptations to maximize
to maintain/improve the
client’s current neurological
functioning
2. Manipulates the environment
to prevent complications of
immobility
3. Implements care for the
unconscious client
4. Teaches principles of
adaptation in A.D.L. to the
client with a neurological
deficit
Utilizes supportive devices
effectively to maintain
correct alignment in the
client with alterations in
neurological functioning
COURSE CONTENT
PC Aspiration
PC Seizures
Impaired Physical Mobility
Total Urinary Incontinence
Bowel Incontinence
PC Increased Intracranial
Pressure
Ineffective Airway Clearance
Sexual Dysfunction
PC Autonomic Dysreflexia
Self Care Deficit
Powerlessness
PLANNING
1. Formulates nursing
diagnoses based on
assessment data
2. Determines expected
outcomes for individual
clients
IMPLEMENTATION
function
a. Positioning and use of
supportive devices
b. Range of motion and
other exercises
c. Use of ambulatory aids
d. Bowel and bladder
training
e. Inducing hypothermia
f. Halo Cast
g. Diet/Drug therapy
h. Support of psychological
adaptation to long-term
problems
i. Emergency management
of head and spine
j. Injuries and CVA
39
CORRELATED LEARNINGS
PLANNING
1. Formulates a plan for the care
of a client with a neurological
deficit
2. Plans nursing care for a client
who is unconscious
3. Plans nursing care that
enables a client to
maintain/restore or improve
levels of
physical/psychological
functioning
IMPLEMENTATION
1. Implements a teaching plan
for a client with a
neurological problem
2. Implements a plan of care for
a client with a change in level
of physical and/or
psychological functioning
3. Assists client with exercise
positioning, ambulatory
4. Implements the following:
a. Neurological assessment
b. Correct use of ambulatory
aids
BEHAVIORAL OBJECTIVES
EVALUATION
1. Evaluates effectiveness of
nursing actions designed to:
a. Maintain current level
of functioning
b. Prevent complications
improve level of
functioning
c. Evaluates effectiveness
of client teaching for
a client with
neurological problem
COURSE CONTENT CORRELATED LEARNINGS
2. Cranial and Spinal Surgery
a. Craniotomy
b. Laminectomy
c. Microdiscectomy
EVALUATION EVALUATION
1. Outcome criteria for: 1. Reports and records
a. Neurological adaptation significant changes in
b. Self-care neurological functioning
2. Evaluates progress based on
outcome criteria for a client
with a neurological problem
3. Evaluates effectiveness of
client- teaching for client
with neurological problems
40
 NURSING MANAGEMENT OF CLIENTS WITH STRESSORS RESULTING FROM BURNS,
BEHAVIORAL OBJECTIVES
ASSESSMENT
1. Assesses the client’s status
in response to stressors as a
result of burn injuries, shock
states and disasters.
2. Assesses airway, respiratory, 2. Assesses for alterations in:
circulatory, elimination and
metabolic status.
3. Assesses the client for risk
factors implicated in burn
injuries, shock states and
disasters
4. Assesses the burn area
various methods
5. Assesses the impact of
physical and emotional
stress on clients
experiencing burns, shock
states and disasters
6. Assess for epidemiological
clustering of disaster events
7. Assesses client’s level of
knowledge related to burns,
shock states and disasters
DISASTER AND SHOCK STATES
COURSE CONTENT
ASSESSMENT
1. Stressors effecting the
recovery of clients
experiencing burns, shock
states and disasters
vital signs, intake and output,
pain, lab values, burn areas
CORRELATED LEARNINGS
ASSESSMENT
1. Diagnostic tests
CBC
BS
UA
ABG’S
BUN, Creatinine
Electrolytes
Culture &Sensitivity
2. Assesses fluid replacement
Requirements to prevent and
treat shock states and
disasters
3. Formulates appropriate
nursing diagnosis for a client
experiencing burns, shock
states and disasters

DIAGNOSIS DIAGNOSIS DIAGNOSIS

Formulate nursing diagnoses
based on a biopsychosocial
assessment of clients with
Burns/Shock States/Disasters
Common Nursing Diagnoses for Analyze Data and Formulate
these disorders include: Diagnoses
Fluid and Electrolyte Imbalance
Acute Pain
Deficient Fluid Volume
Decreased Cardiac Output
Ineffective Tissue Perfusion
Ineffective Breathing Pattern
Ineffective Thermoregulation
Risk for Infection Transmission
Coping Ineffective Community
Risk for Post Trauma Syndrome
Powerlessness
Social Isolation
Spiritual Distress

41
BEHAVIORAL OBJECTIVES
PLANNING
1. Proposes alternate nursing
care to assist the client in
adapting to changes in
physical and psychological 2.
functioning
2. Plans nursing actions:
a. to preserve joint mobility
b. to prevent spread of
infection
c. for early detection of
shock and fluid overload
3. Formulates a teaching plan to
prepare the client with burns
or injuries from shock states
or disasters to function at
maximal level of
independence
IMPLEMENTATION
1. Implements a plan of care
for a client with burn
injuries, shock states and
disasters
2. Promotes adaptation by
encouraging optimal
levels of independence
3. Selects measures to
promote and
maintain client’s
nutritional status
COURSE CONTENT
PLANNING
1. Formulates nursing
diagnoses based on
assessment data
Determines expected
outcomes for individual
clients and groups
IMPLEMENTATION
1. Provides measures to prevent
and treat complications of
burns, shock states and
disasters
2. Adaptation to maintain
function:
a. positioning
b. ROM
c. physical therapy
3. Airway maintenance and O2
administration
4. Pain Management
5. Fluid resuscitation to prevent
and treat shock states, burns
and disasters
6. Surgical Interventions
a. Debridement
b. Tissue Grafting
7. Wound care, Sterile
dressings
8. Therapeutic Communication
9. Drug/Diet Therapy
10. Rehabilitation Program
42
CORRELATED LEARNINGS
PLANNING
1. Plans nursing care for a
client/group experiencing
burns, shock states and
disasters
2. Reviews established practices
for wound care of various
types of burns
3. Reviews established practices
for care of clients in shock
states and disasters
4. Develops a teaching plan for
self care
IMPLEMENTATION
1. Implements a plan of care for
a client with burn injuries,
shock states and disasters
2. Implements the following
skills:
a. triage methodology
b. wound care
c. fluid resuscitation
d. system assessment
e. pain control
f. therapeutic
communication
BEHAVIORAL OBJECTIVES
EVALUATION
1. Evaluates effectiveness of
nursing actions designed to:
a. Prevent complications
b. Improve level of
functioning
c. Determine effectiveness of
client teaching
Disk#7Price
COURSE CONTENT CORRELATED LEARNINGS
EVALUATION EVALUATION
1. Outcome criteria for: 1. Reports and records
a. self care significant changes
b. coping strategies 2. Evaluates progress based on
c. response to treatment outcome criteria
3. Evaluates effectiveness of
client teaching
43