Nursing Care of the Adult Client I •
The first of three medical/surgical courses focusing on acute and chronic health dysfunctions in the adult client. Students gain clinical experience in acute-care settings. Course consists of two components: 101X and 101Z. 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.
- 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 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