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NURS 101Z Nursing Care of the Adult Client I Clinical • 5 Cr.


Clinical component for NURS 101X. Students gain experience in health agencies correlating with and implementing nursing theory. Prerequisite: NURS 100X and 100Z.


After completing this class, students should be able to:

  • Continues to implement the five phases of the nursing process as a systematic approach to provide nursing care for the adult.
    • Assessment
      • Collects pertinent data by assessing one or two clients using the Assessment Data Collection Guide.
      • Collects pertinent data from other sources:
        • client’s record
        • family members
        • health team members
      • Identifies changes in assessment data.
      • Validates abnormal change in data.
      • Organizes assessment data according to Maslow's basic needs.
  • Nursing Diagnosis
    • Begins to identify pertinent nursing diagnoses and their etiologies for the client:
      • experiencing pain
      • undergoing surgery
      • undergoing gynecologic surgery
      • with commonly occurring genitourinary, gastrointestinal, renal, pancreatic, liver, and biliary dysfunctions
      • who has a fluid, electrolyte or acid-base imbalance
      • who has diabetes mellitus
    • Provides client-specific defining characteristics applicable to the nursing diagnoses
  • Planning and 4. Outcomes
    • Begins to prioritize nursing diagnoses.
    • Begins to collaborate with client and/or family members to formulate expected outcomes that are:
      • pertinent and related to nursing diagnoses
      • realistic and measurable with critical times
      • client-focused incorporating the family, sociocultural background, and spiritual beliefs
    • Begins to select appropriate nursing actions that address nursing diagnoses of the adult client in a medical-surgical setting.
    • Provides rationale for medications and therapeutic interventions.
    • Incorporates the agency's plan of care.
  • Implementation
    • Performs selected nursing actions specific to expected outcomes (with occasional cuing)*. For example, postoperatively when the client returns to his room:
      • positions client sidelying and assesses level of consciousness
      • monitors and records vital signs q 15 min. X 1 hr., then q 30 min. X 2 hr. then q.1.h. X 4, then q.4.h. if stable
      • assesses skin color and condition
      • provides for warmth
      • checks wound dressings and drainage systems to rule out hemorrhage and ensure patency and functioning of the latter
      • maintains correct I.V. infusion at correct rate
      • provides safe environment
      • assesses comfort level and when client last received analgesic
      • informs client of place and progress and reorients to environment.
        • Involves family in nursing actions when appropriate.
        • Provides for physical safety of the client.
        • Documents relevant care provided.
      • Evaluation
        • Identifies client progress as related to expected outcomes (with occasional cuing*)
        • Modifies plan of care to best meet the needs of the hospitalized adult (with occasional cuing*)
    • Continues to demonstrate cognitive, psychomotor, and affective skills to ensure safe and effective practice.
      • Identifies rationales for nursing actions and other therapeutic measures incorporating knowledge of relevant pathophysiology.
      • Performs psychomotor skills learned in Nursing 100 safely with minimal cuing* and Nursing 101 safely with occasional cuing*.
        • Applies principles of medical and surgical asepsis.
        • Performs skills on time.
        • Performs in a reasonable amount of time.
        • Demonstrates organizational skill.
        • Continues to improve dexterity.
        • Begins to adapt performance to meet needs of client and/or situation.
      • Administers parenteral and non-parenteral medications safely and in a timely manner
        • States indications, action, contraindications, effects, and nursing considerations for prescribed medications.
      • Uses effective communication techniques with clients, families, instructor, peers, and health care team:
        • Recognizes a therapeutic relationship between student and client.
        • Modifies environment to enhance nurse-client interaction.
        • Participates in and supports constructive interaction with peers and instructor in the clinical setting and during conferences.
      • Develops oral presentation skills by reporting clear, concise and relevant data to staff and instructor.
  • As a Manager of care the student:
    • Begins to collaborate as a health team member when providing nursing care in the medical-surgical setting.
    • Begins to demonstrate organizational skill in the management of care.
      • Begins to prioritize nursing care for a client in the medical-surgical setting
        • Completes care for assigned clients
    • Practices in a cost-effective manner:
      • Organizes care to conserve time, energy and resources.
      • Validates the use of supplies and equipment to minimize waste.
  • As a Member within the Discipline of Nursing, the student:
    • Continues to practice within the ethical and legal framework of nursing
      • Follows established policies as outlined in the College and Nursing Program Student Handbooks.
      • Follows established agency policies and procedures.
      • Documents nursing care given with occasional cuing*
        • using the agency format
        • meeting legal standards
        • clearly and concisely
        • in a timely manner
        • legibly with correct grammar and spelling.
      • Reports pertinent data promptly to appropriate staff and instructor.
      • Respects and supports the rights of the clients for privacy, confidentiality, and the right to refuse care.
      • Begins to act as a representative of the adult client's needs and concerns when necessary. (Advocacy)
      • Practices with knowledge of nurse's ethical and/or legal role/responsibility related to issues presented during previous courses.
        • Continues to exhibit professional accountability
      • Prepares for clinical assignment using appropriate resources.
      • Seeks assistance when the clinical situation is beyond knowledge and experience.
      • Seeks opportunities in the various clinical settings to enhance learning and pursue professional growth.
      • Follows established lines of communication within the assigned clinical setting.
      • Demonstrates reliability in completing client/clinical assignments.
      • Evaluates own performance accurately.
        • Accepts responsibility for own decisions/behaviors/actions while in clinical setting.
        • Accepts feedback and makes appropriate changes in behavior.
        • Identifies own strengths and areas for growth in adult health care settings.
      • Definitions of cuing:
        • No cuing: student will perform independently with no intervention by instructor.
        • Minimal cuing: instructor will provide no more than 2 prompts.
        • Occasional cuing: instructor will provide no more than 4 prompts



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Bellevue College
3000 Landerholm Circle SE Bellevue, WA 98007-6484 U.S.A.
Work: (425) 564-1000