CATALOG DESCRIPTION

This course focuses on the use of the nursing process to assist persons across the lifespan experiencing frequently seen complex healthcare needs. There will be an emphasis on increasing autonomy within an expanded scope of nursing practice. Clinical experience will occur in a variety of settings.

PREREQUISITES

BIO 140; SOC 101; NUR 112 or NUR 050

LEARNING GOALS

1. Critically analyze knowledge from the sciences and humanities for relevance to nursing practice.
2. Formulate a plan of care to meet the complex healthcare needs.
3. Use advanced therapeutic communications in meeting the complex needs of individuals and small groups.
4. Assume increased autonomy in identifying legal-ethical issues in nursing process.
5. Perform nursing skills independently with accuracy and efficiency.
6. Function as a client advocate.
7. Select activities that facilitate personal and professional growth.
8. Analyze practice of self and others in relation to caring behaviors.

FACULTY
1. Full-time
    a. Ruth Benfield
    b. Debbie Dalrymple
    c. Barbara Shaeffer
    d. Margaret Swisher
2. Part-time

CLINICAL AGENCIES

North Penn Hospital
Montgomery Hospital
Pottstown Memorial Medical Center
Norristown State Hospital
Varied Community Agencies

LEARNING ACTIVITIES

1. classroom activities
2. videotape with post discussion
3. selected readings
4. role-playing
5. computer assisted instruction
6. clinical experience with clients
7. clinicl-care conferences
8. outside agengies

GRADING
1. Tests (4)                 40%
2. Client care paper     20%
3. Fiinal exam              20%
4. Seminars                  20%
5. Clinical performance  S/U

ATTENDENCE
Students are expected to attend all classess, seminar and clinical

Students missing any exam are required to notify the instructor prior to 8:00 a.m. on the exam day (215-641-6471).  Arrangement to take a make-up exam are to be made with the N211 faculty within 24 hours of the original test time.  Failure to follow these instructions may result in a "0" grade for that test.  In accordance with departmental policy, students must maintain an average of 70% on tested material to pass the course.  Students desiring additional test review must request an appointment with a faculty member.

Clinical experience is evaluated each semester.  Grading is satisfactory or unsatisfactory.  In addition to performance in the clinical area,  the clinical grade includes laboratory practice assessment skills, and care plans.  An unsatisfactory clinical grade will result in a failure of the course.

As indicated in the Student Nurse's Handbook, cheating is not acceptable.  Any episodes of cheating will be dealth with according to college and departmental policy.

SEQUENCE OF TOPICS
 

Class	Seminar	Clinical PRE-CLINICAL DAY Safety: orientation and skills fair
Course orientation, role of the nurse and application of nursing process to clients with complex health care needs	Safety/protection from infection: Nursing care of the immuno-compromised client with a stigmatizing disease	Application of nursing process Safety/Protection from infection Psycho-social: Altered family processes  Role of the nurse: Member of the profession
Communications: nurse-client relations, group process, therapeutic milieu and family systems Cultural and spiritual needs of clients with complex health care needs	Nursing care of clients with alterations in mental health: Clients with developmentally related mental health needs	Spiritual and Psycho-social Considerations: Developmental, Cultural Psycho-Social: Altered growth and development Role of the Nurse: Communicator
Alterations in Mental Health: Levels of anxiety and anxiety disorders	Nursing care of clients with alterations in mental health: The client in crisis, abusive syndromes or rape	Psycho-social:  Anxiety Alterations in mental health: anxieties and crisis’s Role of the Nurse: Counselor
TEST 1 Alterations in Mental Health: Somatoform and psychophysiological disorders	Nursing care of clients with psychophysiologic disorders: The client with arrhythmias or a myocardial infarction	Psycho-social: Ineffective Denial Psychophysiological disorders Alterations in circulation Role of the Nurse: Comforter
Alterations in Oxygenation	Nursing care of clients with alterations in oxygenation:  Clients with respiratory distress disorders	Alterations in oxygenation Psycho-social: Powerlessness Role of the Nurse: Care Giver

Alteration in Mental Health: Schizophrenia	Nursing care of clients with altered mental health and fluid and electrolyte imbalance: The client with schizophrenia and water intoxication	Psycho-social:  Impaired thought processes  Alterations in fluid and electrolyte balance Role of the Nurse: Advocate
TEST 2 Alterations in Mental Health: Dissociative and Personality Disorders	Nursing care of clients with  alteration in mental health and infectious diseases: The client with borderline personality disorder and tuberculosis	Psycho-social: Ineffective Management of Therapeutic Regimen Safety/Protection form Infection Role of the Nurse: Teacher
Alteration in Mental Health: Mood Disorders	Nursing care of clients with  altered mental health: The client with a mood disorder	Psycho-social: Hopelessness Alterations in mental health Role of the Nurse: Manager
Alteration in Regulation and Sensation: Infectious Diseases and Neoplasms	Nursing care of clients with endocrine based impaired regulation and sensation: The client with pancreatic, thyroid or adrenal dysfunction	Psycho-social: Self esteem Disturbance Alterations in regulation and sensation Role of the Nurse: Discharge planner
TEST 3 Alterations in Circulation	Nursing care of clients with altered circulation: blood dyscrasias; surgeries	Psycho-social: Body Image Disturbance Altered Patterns of Sexuality Alterations in circulation Role of the Nurse: Researcher
Alteration in Urinary Elimination	Nursing care of clients with impaired urinary elimination and fluid and electrolyte imbalance: The client with renal failure	Psycho-social: Defensive coping Decisional conflict Alterations in urinary elimination Role of the Nurse: Decision Maker

Alteration in Mental Health: Substance Abuse	Nursing care of clients with alteration in nutrition and mental health: The client with eating disorders	Psycho-social: Ineffective Individual Coping Behaviors Alterations in Nutrition Role of the Nurse: Role model
Alteration in Nutrition: Pancreatic and Liver Dysfunction	Nursing care of clients with altered activity: The client with joint replacement or disfiguring surgery	Psycho-social: Fear Alterations in activity and rest and sleep Role of the Nurse: Rehabilitator
TEST 4 Alteration in Elimination: Bowel Guest speaker: Carol Jensen	Nursing care of clients with alteration in bowel elimination The client with bowel cancer	No Clinical

LEARNING MATERIALS
New:
1. Varcarolis, E. (1998).  Foundations of psychiatric-mental health nursing.(2nd Ed.). Philadelphia: W. B. Saunders.

Already purchesed:
2. Smeltzer, S. C. and Bare, B. G. (1996). Brunner and suddarth's textbook of medical-surgical nursing. Philadelphia: Lippincott.

3. Wilkinson, J. (1995). Nursing diagnosis & intervention pocket guide.(6th Ed.).Menlo Park, CA: Addison Wesley.

4. Fischbach, F. (1996). A manual of laboratory diagnostic tests. Philadelphia: Lippincott.

5. Ladewig, P.W. et al. (1994). Essentials of maternal-newborn nursing. Menlo Park, CA: Addison-Wesley.

6. Wong, D. (1997). Essentials of pediatric nursing. St. Louis: Mosby.

7. Deglin, J.H. and Vallerand, A.H. (1996). Drug Guide for Nurses. Philadelphia: Davis.

8. Olsen, J.L., Ablon, L.J., Giangrasso, A.P., and Siner-Weissman, H. (1995). Medical dosage calculations. Menlo Park, CA: Addison-Wesley.

9. Kozier, B., Erb, G., Blais, S., and Wilkinson, J. (1995). Fundamentals of nursing. Menlo Park, CA: Addison-Wesley.

Recommended:
10. Stanhope, M. and Knollmueller, R. (1996). Handbook of community and home health nursing.St. Louis:Mosby.
11. Townsend, M. (1997). Nursing diagnosis in psychiatric nursing. Philadelphia:F.A. Davis Company.

HOMEWORK LOAD

Greater than 20 hours per week (2-3 hours per week per credit) with independent lab time