Nursing Syllabus

COURSE: NURS 125 3RD QUARTER, 1ST YEAR
NURSING III SYLLABUS –

THEORY
Meghan Gainer, RN, MSN, ONC

Pacific Union College
NURS 125
PAGE 1 OF 62
NURSING III – THEORY

Course Description
Nursing III reinforces and expands on concepts previously learned and introduces students to concepts
related to the individual (oxygenation, cellular regulation I, perfusion I). Students achieve student learning
outcomes by integrating knowledge, skills, and attitudes in classroom, laboratory, and clinical settings. 6
units - 3 theory units (30 clock hours) and 3 clinical units (90 clock hours).
Prerequisites: NURS 124, 212. Co-requisite: NURS 390.
Student Learning Outcomes
Upon completion of this course, nursing students will:

Professionalism
1. Collaborate with all members of the interdisciplinary team in providing care to two, medical-surgical
patients.
2. Demonstrate integrity in all interactions by functioning within the ethical, legal, and professional
guidelines for the nursing profession.
3. Demonstrate personal accountability through careful resource management by completing patient
care tasks and assignments on time.
4. Exhibit a spirit of inquiry by seeking answers to questions in both theory classes and clinical,
effectively using available resources to retrieve valid, reliable information.
Caring
5. Demonstrate compassion and respect for all individuals encountered in a manner that exemplifies
Christian values.
6. Address a client’s physical, mental, emotional, social, and spiritual needs in a holistic plan of care.
Critical thinking
7. Integrate knowledge and assessment data to inform clinical decision-making for assigned patients in
clinical as well as theory classes.
8. Employ tools of critical thinking, including the nursing process, in order to solve problems and
provide appropriate care.
Excellence in practice
9. Provide safe, quality interventions to assist the client toward optimum health.
10. Practice in a manner that is consistent with available evidence and guided by national standards.
11. Communicate with all those encountered in practice is clearly, appropriately, and with an attitude
that fosters continued effective communication.
12. Provide care in a manner that recognizes and respects the cultural differences among all those
encountered in the practice of nursing.
PAGE 2 OF 62
Teaching and learning

13. Assess, develop, implement, and evaluate a plan to meet the educational needs of assigned patients.
14. Effectively use traditional and emerging tools and technologies in the teaching and learning process.
Curricular Concepts
Concept Exemplars Skills
Biophysical
Cellular Regulation I Leukemia IV skills
Anemia
Thrombocytopenia
Oxygenation Acid-Base Balance Tracheostomy suctioning
Pneumonia
Asthma
Chronic Obstructive Pulmonary Disease
Perfusion I Dysrhythmias ECG interpretation
Hypertension
Peripheral Vascular Disease
About the Course

Faculty
Office/Phones: Meghan Gainer, MSN, RN, ONC DH 209, ext. 7623 (Office)
[email protected] (Email) best method
Office hours will be posted on the Canvas scheduler.

Course Meeting Times and Locations
Classes meet in Davidian Hall Room 110 (DH 110) on M and W from 0930 – 1045.
Clinical labs are held at St. Helena Hospital. Clinical labs meet on either M, T, or Th from 1430 to 2230.
Course Resources
Required resources
1. NURS 125 Syllabus.
2. North Carolina Concept-Based Learning. (2014). Nursing: A concept-based approach to
learning, volumes 1-3 (2nd ed.). Upper Saddle River, NJ: Pearson.
3. Huff, J. (2017). ECG workout: Exercises in arrhythmia interpretation (7th ed.). Philadelphia, PA:
Lippincott, Williams, & Wilkins.
4. Giangrasso, A. P. & Shrimpton, D. M. (2013). Dosage calculations: A multi-method approach.
Upper Saddle River, NJ: Pearson.
5. ATI RN Adult Medical Surgical Nursing Review Module Edition 10.0.
6. Clicker by Turning Technologies, available at the bookstore.
PAGE 3 OF 62
Recommended resources:
7. Adams, M., Holland, L., & Urban, C. (2014). Pharmacology for nurses (4th ed.). Upper Saddle
River, NJ: Pearson Prentice Hall.
8. Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nursing diagnosis manual: Planning,
individualizing, and documenting client care (5th ed.). Philadelphia, PA: F. A. Davis Company.
9. Kee, J. L. (2014). Laboratory and diagnostic tests with nursing implications (9th ed.). Upper
Saddle River, NJ: Pearson.
Learning Methods
Class and lab will be composed of lecture, discussion (in-class and/or CANVAS), assigned readings from
textbooks or journal articles, individual/group activities, audio-visual aids, written assignments,
demonstration, return demonstration, and/or simulation.
This course is intended to promote critical thinking by active learning. Students are expected to take
responsibility for their own learning and the instructor’s role is that of a facilitator. Students are
responsible for all assigned materials, completing assignments on time, participating fully in course
activities, and communicating learning needs to the instructor. Course information and updates will be
provided on Canvas.
Students are also responsible for their classmates’ learning. Treating others with respect and dignity is
imperative if the student desires to pass this course. Failing to treat others with respect and dignity will be
grounds for failure in this course. Fostering a spirit of acceptance and respect will not only promote an
atmosphere for learning, it is also practice for how the student will treat future patients and colleagues.
Evaluation of Learning
Each nursing course is composed of theory and lab requirements. It is necessary to pass both theory and
lab to successfully complete the course. This syllabus discusses evaluation of the theory portion. All
grades will be posted on Canvas.
1. Assignments & Quizzes (15%)
Assignments will consist of class preparation activities, in-class activities, case studies, ATI practice
assessments, and/or simulation. ATI practice assessments and targeted medical-surgical assessments
are due periodically throughout the quarter. The ATI Practice assessments and targeted assessments
must be passed at a level of 90% or higher to receive credit.
There are various written assignments due throughout the quarter. These assignments may include
journal reports, in-class presentations and other assigned homework. Assignments submitted late
without an approved extension will be subject to a 10% deduction per day for up to 3 days.
Assignments more than 3 days late will receive no credit unless arrangements have been made with
the instructor prior to the assignment due date. All assignments must be completed to satisfactorily
complete the course.
Quizzes may be given in each class, on Canvas, and/or through My Nursing Lab and will cover the
assigned material. Please arrive on time so that you have ample time to finish quizzes that may be
given at the beginning of class. No missed quiz, excused or unexcused, can be made up. The lowest
quiz score will be dropped at the end of the quarter. If at least 95% of the class completes the Course
Survey at the end of the quarter by Thursday at noon of finals week, an additional quiz score will be
dropped.
PAGE 4 OF 62
2. Group Project (5%)

The first week of class the students will be divided into groups. This project will be divided into two
parts: a group paper and a brief group presentation. Topics will be assigned and the group will present
their topic on the appropriate class date. The students will present either a real case study addressing
the assigned topic or may make up a case study, using the knowledge gained from readings and the
literature. The purpose of this project is to enhance learning and retention of the information while
giving the student a supportive and nurturing environment to practice their teaching and professional
communication skills. Please refer to the Class 20 page for more information regarding the project
details.
3. Exams (75%)
There will be three unit exams and one final exam, equally weighted. The three unit exams will be
over each concept that will be covered this quarter, Cellular Regulation, Oxygenation, and Perfusion.
The final will be comprehensive and include the new dosage and calculation that will be covered at
the end of the quarter.
Exams will start promptly at 9:30 am. Students are expected to be on time for the exam. Once an
examination has started, the student is discouraged from leaving the classroom to minimize disruption
to classmates. Please make sure to use the restroom and/or get a drink before the exam starts. As a
courtesy to fellow classmates, once a student has completed an examination and leaves the room, the
student will not return to the classroom until testing is finished. If you are sick and cannot take an
examination, arrangements must be made PRIOR to the examination date and time. Failure to notify
faculty may result in a zero score for that examination. Please refer to the testing policies in the ASN
Student Handbook for more information.
Students are encouraged to review their exam after each exam, especially if the student scored less
than a 75%. It is the student’s responsibility to contact the instructor for exam review. Review of an
exam must be done before the next exam is taken. For example, if Exam I has not been reviewed
before Exam II is taken, Exam I may not be reviewed any longer.
4. ATI (5%)
There is one proctored ATI exam given during the quarter, RN Fundamentals 2016. The ATI
assessment process accounts for 5% of the overall course grade. See the section on ATI
Testing for further detail. The complete ATI policy can be found on the AS Support site on
Canvas as well as in the ASN Student Handbook.
Department Policies
Department of Nursing Grading Scale and Policy
94% - 100% = A 70% - 74% = C-
90% - 93% = A- 67% - 69% = D+
87% - 89% = B+ 64% - 66% = D
84% - 86% = B 60% - 63% = D-
80% - 83% = B- Below 60% = F
77% - 79% = C+
75% - 76% = C
A minimum grade of “C” is required to pass all nursing courses. Within each nursing course, exams make
up a minimum of 75% of the course grade. To pass a course, students must:
PAGE 5 OF 62
• Attain a cumulative average of 75% or better on exams. (If a student does not meet the
required 75% exam average, the grade corresponding to the exam average is entered as the
final course grade.)
• Achieve a satisfactory final summative clinical performance evaluation (in clinical/lab
courses). Clinical performance is evaluated in terms of pass or fail. If a student does not
receive a satisfactory final clinical performance evaluation, a grade of “F” is entered as the
final course grade.
• Satisfactorily complete all assigned work.
• Achieve a minimum of 75% of the total course points.
Any student who receives a grade of a C- or lower will be dropped from the nursing program and, if he or
she wishes to return, must reapply for admission. Admission is based both on the merits of the student
and on a space-available basis. A student repeating a course must repeat both the theory and clinical
components of the course.
ATI Testing
Students will complete a Content Mastery Proctored Assessment as a requirement of this class and the
program. The ATI assessment process includes three parts.
1. Preparation: The student will prepare for the Proctored Assessment by completing an online
practice test at least one week before the assessment date and obtaining a score of 90% or better
on the practice test (online practice tests may be taken only once each 48 hours).
• Attain a 90% on the online practice test (the test may only be taken once every 48 hours.)
• Complete a focused review for the missed topics.
2. Assessment: The student will complete the Proctored Assessment.
3. Remediation: The student will review the assessment results and complete remediation. All
aspects of remediation must be completed by the end of final exams week. Remediation is
required for students completing the original assessment at Proficiency Level 1 or Below.
• Access second online practice assessment and achieve 90% (the test may only be taken once
every 24 hours)
• Complete a Focused Review on topics missed (30 minutes to 4 hours, depending on
proficiency level on Proctored Assessment)
• Complete the ATI exploratory questions for all missed topics.
• If the original exam was completed at Proficiency Level 1 or Below, retake the Proctored
Exam and achieve an improved proficiency level. Two exam retake times are scheduled
during the week of final exams. Schedule the retake on the Scheduler tab on the Canvas
Calendar for the AS Support site.
The total points achieved by completing all three parts of the ATI assessment (preparation, assessment,
and remediation) will count for 5% of your course grade according to the following grid.
Below
Proficiency Level on Proctored Assessment Level 1 Level 1 Level 2 Level 3
Evidence of Preparation for Assessment * 2 2 2 2
Achievement Level on Proctored Exam 2 3 5 6
Evidence of Specified Remediation ** 2 2 2 2
Total Points awarded 6 7 9 10
PAGE 6 OF 62
A complete description of required remediation is found in the Student Handbook and on the ADN
Nursing Program Support site on Canvas.
Dosage and Calculation Competency Evaluation
Safe nursing practice demands that nurses possess the ability to consistently demonstrate accuracy in
calculating medication dosages before going into the clinical setting. A Dosage & Calculation (D&C)
exam appropriate to course level will be given during the first week of each quarter for students in
quarters two through six of the AS Nursing Program. The D&C exam date and time will be posted on the
AS Support Site on Canvas. Practice exams for each course level are posted on the AS Support site on
Canvas for students to review their skills prior to testing.
If a student does not successfully pass the D&C competency exam (80% for first-year students, 90% for
second-year students), the student must complete an alternate version during one of the retake testing
times. A maximum of two retakes are permitted. Each retake must be taken on a different day. Failure to
pass the second retake results in an immediate failure of the course. Students must pass the D&C exam
prior to attending clinical, except for the Orientation clinical. Please refer to the ASN Student Handbook
for the complete Dosage & Calculation testing policy.
Academic Integrity
This course follows College guidelines for Academic Integrity (refer to the College Catalog). Academic
dishonesty is taken very seriously and may result in a failure to pass this course. All cases of academic
dishonesty will be referred to the Academic Dean.
Students with Disabilities
In compliance with the equal access laws, Pacific Union College makes reasonable accommodation for
qualified students with documented disabilities. Students may have a learning disability, a chronic illness,
or a physical or psychiatric disability that may impact his or her work for this class and for which he or
she may be eligible for accommodations. If you have a verified need for an academic accommodation or
materials in an alternate media (i.e., Braille, Large print, electronic text, etc.) per the Americans With
Disabilities Act or Section 504 of the Rehabilitation Act please contact your instructor as soon as
possible. To receive accommodations, a student needs to register with the disabilities coordinator at the
Teaching and Learning Center (707-965-7688). Please keep in mind that accommodations are not
retroactive, so it is best to register as early as possible. If a student suspects that he or she may have a
learning disability, but it is not yet diagnosed, the student should consider seeing the disabilities
coordinator for a screening appointment.
Course Policies
Attendance and Professional Behavior
On-time attendance at all classes and clinical experiences is expected. Students must be present for the
entire class or clinical period to receive any possible points unless prior arrangements are made with the
instructor. Missing a class or clinical to study for an exam will be considered an unexcused absence.
Refer to the ASN Student Handbook for the full Attendance policy. Missed exams may not be
rescheduled if advance notice is not provided. If a student knows that he or she will be absent, it is his or
her responsibility to make advanced arrangements for taking the exam. Any in-class activities missed
because of an absence may not be completed outside of class for credit. Absences which result from
short-term suspensions due to violations of the principles outlined in the Student Life Agreement will be
treated as unexcused absences, and significant academic penalties may apply as a result of such
unexcused absences.
PAGE 7 OF 62
Tutoring
Each student is allowed two hours per week per course of free tutoring through the Teaching & Learning
Center (TLC). Please contact them at: 965-7688 or [email protected].
Course Communication
PUC email addresses and/or Canvas announcements will be used for communication purposes. Students
are responsible for retrieving messages sent through the PUC email system or having email forwarded to
private email addresses. Students are also responsible for any announcements made on Canvas during the
course of the quarter.
Disclaimer
The instructor has the right to alter or adjust the syllabus as needed. Any exceptions to this syllabus are at
the instructor’s discretion.
PAGE 8 OF 62
Course Objectives
After completion of this course, students will be able to:
Concepts:
1. Identify interrelationships between cellular regulation, oxygenation, and perfusion as well
as between concepts learned in NURS 121 & 124. (SLO 4)
Assess:
2. Describe the clinical manifestations of alterations in cellular regulation, oxygenation, and
perfusion related to the pathophysiology of these alterations. (SLO 7, 8)
3. Identify the etiology and risk factors of alterations in cellular regulation, oxygenation and
perfusion. (SLO 7, 8)
4. Identify and describe appropriate diagnostic tools for identifying alterations to cellular
regulation, oxygenation, and perfusion. (SLO 7, 8)
Diagnose:
5. Formulate priority, 3-part nursing diagnoses for patients with alterations in cellular
regulation, oxygenation or perfusion and their families. (SLO 6, 8, 9; QSEN EBP-K)
6. Determine goals and expected outcomes for patient with alterations in cellular regulation,
oxygenation or perfusion. (SLO 8; QSEN EBP-S)
Plan/Implement:
7. Create care plans with evidence-based, culturally competent, holistic nursing
interventions for patients with alterations in cellular regulation, oxygenation, or perfusion
that incorporates both collaborative and independent nursing interventions. (SLO 1, 6, 9,
13, 14; QSEN PCC-S, TC-S, EBP-S)
8. Describe therapies used by interdisciplinary teams in the collaborative care of an
individual with alterations in cellular regulation, oxygenation, and perfusion. (SLO 1, 6,
8; QSEN TC-K)
Evaluate:
9. Evaluate expected outcomes for individuals with alterations in cellular regulation,
oxygenation or perfusion. (SLO 6, 8, 11; QSEN EBP-S)
PAGE 9 OF 62
PAGE 10 OF 62
Course Schedule*
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
April 2 3 4 5 6
Class 1: D&C Exam Class 2:

Orientation/Concept of Cellular 1100 - 1230 Leukemia
Regulation
Clinical #1: Orientation Clinical #1: Orientation Clinical #1: Orientation

1430 – 1800 1430 – 1800 1430 – 1800
SHH B-Level Computer Room SHH B-Level Computer Room SHH B-Level Computer Room
Trach Skills Trach Skills Trach Skills
1900 – 2230 1900 – 2230 1900 – 2230
DH Skills Lab DH Skills Lab DH Skills Lab
9 10 11 12 13
Class 3: Class 4:
Anemia/Thrombocytopenia Concept of Oxygenation
Clinical #2: IV Skills Lab Clinical #2: IV Skills Lab Clinical #2: IV Skills Lab
1430 – 2230 1430 – 2230 1430 – 2230
DH Skills Lab DH Skills Lab DH Skills Lab
16 17 18 19 20
Class 5: Class 6:
Exam I – Cellular Regulation Acid-Base Balance
Clinical #3: Patient Care Clinical #3: Patient Care Clinical #3: Patient Care
1430 – 2230 1430 – 2230 1430 – 2230
SHH SHH SHH
23 24 25 26 27
Class 7: Class 8:
ATI Proctored Exam Pneumonia
Library Computer Lab
Clinical #4: Patient Care Clinical #4: Patient Care Clinical #4: Patient Care Tracheostomy Skills Test
1430 – 2230 1430 – 2230 1430 – 2230 Due by 1300
SHH SHH SHH
30 May 1 2 3 4
Class 9: Class 10:

Asthma COPD
1430 – 2230 1430 – 2230 1430 – 2230
SHH SHH SHH
7 8 9 10 11
Class 11: Class 12:

Exam II - Oxygenation Concept of Perfusion
1430 – 2230 1430 – 2230 1430 – 2230
SHH SHH SHH
Midterm Evaluations Midterm Evaluations Midterm Evaluations
PAGE 11 OF 62
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

14 15 16 17 18
Class 13: Class 14:

Dysrhythmias I Dysrhythmias II
1430 – 2230 1430 – 2230 1430 – 2230
SHH SHH SHH
21 22 23 24 25
Class 15: Class 16:

Hypertension Peripheral Vascular Disease
1430 – 2230 1430 – 2230 1430 – 2230
SHH SHH SHH
28 29 30 31 June 1
NO CLASS : Class 17:

Exam III - Perfusion
MEMORIAL DAY
1430 – 2230 1430 – 2230 1430 – 2230
SHH SHH SHH
4 5 6 7 8
Class 18: Class 19:

D&C Class Presentations
Clinical #10: Sim Lab Clinical #10: Sim lab Clinical #10: Sim Lab
1430 – 2230 1430 – 2230 1430 – 2230
DH Sim Lab DH Sim Lab DH Sim Lab
Final Evals Final Evals Final Evals
11 12 13 14 15
SUMMER VACATION BEGINS

Final Exam 1200
0800 - 1000 |--------------------------------- -----------------------------------
*Please see course home page on Canvas for complete list of assignments and due dates.
PAGE 12 OF 62
Preparation Guidelines by Class

Class 1: Orientation & Introduction to Cellular Regulation
Upon completing this class, the student will be able to:
1. Identify the focus of this class as well as the concepts covered in Nursing III.
2. Describe three strategies to use that will help with success in Nursing III.
3. Summarize the physiology of the hematological system as it relates to cellular regulation.
(CO* 2)
4. Differentiate common assessment procedures used to examine cellular regulation in
adults. (CO 4)
5. Describe diagnostic tests along with their nursing implications to determine the
individual’s cellular regulation status. (CO 4)
6. Discuss commonly occurring alterations in cellular regulation and their related
treatments. (CO 2, 3, 8)
7. Examine the relationship between cellular regulation and other concepts/systems. (CO 1)
Preparation Guidelines:
1. Read the NURS 125 syllabus & complete the quiz on Canvas (due Friday of week 1).
2. Read Nursing: a concept-based approach to learning, pp. 29 – 41
3. Complete the ATI: Basic Concept Template (available on Canvas) (due at beginning of
class)
4. OPTIONAL:
o MyNursingLab: The Concept of Cellular Regulation
*CO – Class Objective
PAGE 13 OF 62
Class 2: Cellular Regulation – Leukemia

1. Describe the pathophysiology, etiology, and clinical manifestations of leukemia. (CO 2,
3)
2. Identify risk factors and prevention methods associated with leukemia. (CO 2, 3)
3. Summarize diagnostics and therapies used by interdisciplinary teams in the collaborative
care of an individual with leukemia. (CO 4, 8)
4. Formulate priority nursing diagnoses and appropriate outcomes for an individual with
leukemia. (CO 5, 6)
5. Plan evidence-based care for individuals with leukemia and their family members that
incorporates independent and collaborative nursing interventions. (CO 7)
6. Evaluate expected outcomes for an individual with leukemia. (CO 9)
1. Read Nursing: a concept-based approach to learning, pp. 92 – 104; ATI pp. 245-248
2. Complete the ATI: System Disorder Template (available on Canvas)
3. OPTIONAL:
o MyNursingLab: Leukemia
PAGE 14 OF 62
Class 3: Cellular Regulation – Anemia & Thrombocytopenia

1. Describe the pathophysiology, etiology, and clinical manifestations of anemia and
thrombocytopenia. (CO 2, 3)
2. Identify risk factors and prevention methods associated with anemia and
thrombocytopenia. (CO 2, 3)
care of an individual with anemia and/or thrombocytopenia. (CO 4, 8)
anemia and/or thrombocytopenia. (CO 5, 6)
5. Plan evidence-based care for individuals with anemia and/or thrombocytopenia and their
family members that incorporates independent and collaborative nursing interventions.
(CO 7)
6. Evaluate expected outcomes for an individual with anemia and/or thrombocytopenia.
(CO 9)
1. Read Nursing: a concept-based approach to learning, pp. 64 – 76; ATI pp. 253 – 258;
ATI pp. 259 – 263
2. Read Thrombocytopenia articles on Canvas in Files under Unit I, Thrombocytopenia
Articles
3. Complete the ATI: System Disorder Template (one for anemia & one for
thrombocytopenia)
4. OPTIONAL:
o MyNursingLab: Anemia
PAGE 15 OF 62
Class 4: Introduction to Oxygenation

1. Summarize the physiology of the respiratory system as it relates to oxygenation. (CO 2)
2. Differentiate common assessment procedures used to examine oxygenation in adults.
(CO 4)
individual’s oxygenation status. (CO 4)
4. Discuss commonly occurring alterations in oxygenation and their related treatments. (CO
2, 3, 8)
5. Examine the relationship between oxygenation and other concepts/systems. (CO 1)
1. Read Nursing: a concept-based approach to learning, pp. 953 – 974; ATI, pp. 97 – 102;
107 – 110
2. Complete the ATI: Basic Concept Template
3. ATI “Targeted Medical-Surgical 2016: Fluid, Electrolyte, and Acid-Base” at a level of
90% or higher. DUE Sunday, April 29 @ midnight.
4. ATI “Targeted Medical-Surgical 2016: Respiratory” due at a level of 90% of higher.
DUE Sunday, May 6 @ midnight.
5. OPTIONAL:
o MyNursingLab: The Concept of Oxygenation
Class 5: Cellular Regulation – Exam I
PAGE 16 OF 62
Class 6: Acid-Base Balance

1. Summarize the physiology of acid-base balance. (CO 2)
individual’s acid-base status. (CO 4)
3. Accurately interpret an arterial blood gas report. (CO 4)
4. Discuss commonly occurring alterations in acid-base balance and their related treatments.
(CO 2, 3, 8)
5. Formulate priority nursing diagnoses and appropriate outcomes for an individual with an
acid-base imbalance. (CO 5, 6)
6. Plan evidence-based care for individuals with an acid-base imbalance and their family
members that incorporates independent and collaborative nursing interventions. (CO 7)
7. Evaluate expected outcomes for an individual with an acid-base imbalance. (CO 9)
1. Read Nursing: a concept-based approach to learning, pp. 3-27; ATI pp. 281 – 285
3. OPTIONAL: ATI: System Disorder Template for each acid-base imbalance (2 points
extra credit available for each system disorder template completed)
4. OPTIONAL: MyNursingLab:
o The Concept of Acid-Base Balance
o Metabolic Acidosis
o Metabolic Alkalosis
o Respiratory Acidosis
o Respiratory Alkalosis
Class 7: ATI RN Fundamentals Proctored Exam – See Canvas under Assignments → ATI
PAGE 17 OF 62
Class 8: Oxygenation – Pneumonia

1. Describe the pathophysiology, etiology, and clinical manifestations of pneumonia. (CO 2,
3)
2. Identify risk factors and prevention methods associated with pneumonia. (CO 2, 3)
care of an individual with pneumonia. (CO 4, 8)
pneumonia. (CO 5, 6)
5. Plan evidence-based care for individuals with pneumonia and their family members that
6. Evaluate expected outcomes for an individual with pneumonia. (CO 9)
1. Read Nursing: a concept-based approach to learning, pp. 584 – 599; ATI pp. 120 – 122
2. Complete the ATI: System Disorder Template
3. OPTIONAL:
o MyNursingLab: Pneumonia
PAGE 18 OF 62
Class 9: Oxygenation – Asthma

1. Describe the pathophysiology, etiology, and clinical manifestations of asthma. (CO 2, 3)
2. Identify risk factors and prevention methods associated with asthma. (CO 2, 3)
care of an individual with asthma. (CO 4, 8)
asthma. (CO 5, 6)
5. Plan evidence-based care for individuals with asthma and their family members that
6. Evaluate expected outcomes for an individual with asthma. (CO 9)
3. OPTIONAL:
o MyNursingLab: Asthma
PAGE 19 OF 62
Class 10: Oxygenation – Chronic Obstructive Pulmonary Disease

1. Describe the pathophysiology, etiology, and clinical manifestations of COPD. (CO 2, 3)
2. Identify risk factors and prevention methods associated with COPD. (CO 2, 3)
care of an individual with COPD. (CO 4, 8)
COPD. (CO 5, 6)
5. Plan evidence-based care for individuals with COPD and their family members that
6. Evaluate expected outcomes for an individual with COPD. (CO 9)
1. Read Nursing: a concept-based approach to learning, pp. 1005 – 1018; ATI, pp. 129 –
134
3. OPTIONAL:
o MyNursingLab: COPD
Class 11: Oxygenation – Exam II
PAGE 20 OF 62
Class 12: Introduction to Perfusion

1. Summarize the physiology of the cardiovascular system as it relates to perfusion. (CO 2)
2. Differentiate common assessment procedures used to examine perfusion in adults. (CO 4)
individual’s perfusion status. (CO 4)
4. Discuss commonly occurring alterations in perfusion and their related treatments. (CO 2,
3, 8)
5. Examine the relationship between perfusion and other concepts/systems. (CO 1)
3. OPTIONAL:
o MyNursingLab: The Concept of Perfusion
PAGE 21 OF 62
Class 13: Perfusion – Dysrhythmias I

1. Describe the pathophysiology, etiology, and clinical manifestations of sinus and atrial
dysrhythmias. (CO 2, 3)
2. Identify risk factors and prevention methods associated with sinus and atrial
3. Correctly identify sinus and atrial dysrhythmias and summarize therapies used by
interdisciplinary teams in the collaborative care of an individual with sinus and atrial
dysthymias. (CO 4, 8)
5. Plan evidence-based care for individuals with dysrhythmias and their family members
that incorporates independent and collaborative nursing interventions. (CO 7)
6. Evaluate expected outcomes for an individual with dysrhythmias. (CO 9)
1. Read ECG Workout:
a. Ch. 5 pp. 32 – 41
b. Ch. 6 pp. 44 – 47 (read through “Sinus Bradycardia”)
c. Ch. 7 pp. 85, 88 – 102 (skip “Wandering Atrial Pacemaker”)
d. Complete assigned problems on Canvas, “Dysrhythmias, Part 1”
2. Read Nursing: a concept-based approach to learning, pp. 1194 – 1197 beginning with
“Nursing Process”
PAGE 22 OF 62
Class 14: Perfusion – Dysrhythmias II

1. Describe the pathophysiology, etiology, and clinical manifestations of ventricular
dysrhythmias and/or paced rhythms. (CO 2, 3)
2. Identify risk factors and prevention methods associated with ventricular dysrhythmias
and/or paced rhythms. (CO 2, 3)
3. Correctly identify ventricular dysrhythmias and/or paced rhythms and summarize
therapies used by interdisciplinary teams in the collaborative care of an individual with
ventricular dysrhythmias and/or paced rhythms. (CO 4, 8)
5. Plan evidence-based care for individuals with dysrhythmias and their family members
that incorporates independent and collaborative nursing interventions. (CO 7)
6. Evaluate expected outcomes for an individual with dysrhythmias. (CO 9)
1. Read ECG Workout:
a. Ch. 9 pp. 196 – 210 (skip sections on Bundle-Branch Blocks, Idioventricular and
Accelerated Idioventricular rhythms)
b. Ch. 10 pp. 254 – 268
c. Complete assigned problems on Canvas, “Dysrhythmias, Part 2”
2. Read ATI pp. 172, 175 – 180
3. Review Nursing: a concept-based approach to learning, pp. 1194 – 1197 beginning with
“Nursing Process”
PAGE 23 OF 62
Class 15: Perfusion – Hypertension

1. Describe the pathophysiology, etiology, and clinical manifestations of hypertension. (CO
2, 3)
2. Identify risk factors and prevention methods associated with hypertension. (CO 2, 3)
care of an individual with hypertension. (CO 4, 8)
hypertension. (CO 5, 6)
5. Plan evidence-based care for individuals with hypertension and their family members that
6. Evaluate expected outcomes for an individual with hypertension. (CO 9)
3. OPTIONAL: MyNursingLab: Hypertension
o Pretest
o Review
o Remember
o Apply
PAGE 24 OF 62
Class 16: Perfusion – Peripheral Vascular Disease

1. Describe the pathophysiology, etiology, and clinical manifestations of PVD. (CO 2, 3)
2. Identify risk factors and prevention methods associated with PVD. (CO 2, 3)
care of an individual with PVD. (CO 4, 8)
PVD. (CO 5, 6)
5. Plan evidence-based care for individuals with PVD and their family members that
6. Evaluate expected outcomes for an individual with PVD. (CO 9)
3. OPTIONAL: MyNursingLab: Peripheral Vascular Disease
o Pretest
o Review
o Remember
o Apply
Class 17: Perfusion – Exam III
PAGE 25 OF 62
Class 18: Dosage and Calculation – Advanced IV Drip Rates

1. Convert from dosage rates (drug/time) to IV rates (volume/time).
2. Convert from IV rates (volume/time) to dosage rates (drug/time).
3. Calculate infusion rates when medication must be added to the intravenous piggyback
(IVPB) bag.
4. Calculate infusion rates based on the weight of a patient.
5. Calculate flow rates for IV push medications.
6. Calculate the duration of an IVPB infusion.
7. Calculate flow rates for medications requiring titration.
1. Read Giangrasso & Shrimpton (2013). Ch. 11.
2. Do assigned problems on Canvas, “D&C – Advanced IV Drip Rates”
PAGE 26 OF 62
Class 19: Project Presentations

This project will consist of two parts: a group paper and a brief (5-10 minutes) presentation of
the project during the last class period of the quarter.
Paper:
This paper will be completed as a group and should cover the following sections: presentation of
the case study, clinical significance of the topic as well as its impact on the patient, a description
of the topic using the nursing process (include relevant assessment findings, 3 priority nursing
diagnoses, expected outcomes, interventions with rationales, and evaluation of outcomes related
to the case study chosen), and identification of important teaching topics as related to the case
study.
This paper should be in APA format. Please refer to the AS Support site on Canvas for resources
on using APA format. Plan to include at least 3 scholarly references, with at least one being a
current (within the last 5 years), peer-reviewed journal article relating to the case study topic.
The body of the paper should be between 4 - 8 pages long, not including the cover page or
reference page.
Presentation:
During the last class, your group will do a brief slideshow presentation of the paper lasting no
more than 10 minutes. Plant to present the case study scenario and the essential points of the
paper. A good rule of thumb is to plan on 1 minute per slide. Remember the rule of 7s!
Summarize!
The grading rubrics for the paper and presentation are posted on Canvas.
PAGE 27 OF 62
NURSING III SYLLABUS –

CLINICAL
PAGE 28 OF 62
NURSING III – CLINICAL

About Clinical
Each medical-surgical nursing course is composed of Theory and Clinical requirements. It is
necessary to pass both Theory and Clinical to successfully complete the course. Clinical is a
pass/fail, however students will receive points for assignments, clinical preparation and journal
article presentations. Students will need to achieve a 75% to pass this clinical course. If students
are thorough, conscientious, and work hard, they will pass without difficulty. Included in clinical
lab is a pre-conference and post-conference. At that time, the discussion will be on the patient
and/or any skills that are applicable to the clinical setting.
Clinical Details
Clinical Lab Times and Locations
Clinical labs are on either:
• Mondays from 1430 – 2230 at St. Helena Hospital
• Tuesdays from 1430 – 2230 at St. Helena Hospital
• Thursdays from 1430 – 2230 at St. Helena Hospital
See the Class Calendar for exact clinical dates, times, and locations.
Learning Methods
Learning methods for clinical will include: major and mini patient documentation packets for
individual patient assignments, post-conferences, interactions with hospital staff from various
departments, observations in selected clinical areas, skills labs, individual conferences with
instructors, and/or simulation.
Evaluation of Learning
Clinical Labs are evaluated as follows:
1. Satisfactorily passing all designated areas on the Clinical Evaluation Tool (CET) at the
final evaluation time. The evaluation form is included at the end of the syllabus. There
will be a mid-quarter and a final conference with the clinical instructor to evaluate how
well you are meeting the objectives for clinical labs. Conference times will be arranged
during the clinical time.
2. Completing all assignments such as major patient documentation packets, mini patient
documentation packets (one due for each patient encounter), a journal article
presentation, etc.
3. There may be an informal “testing of knowledge” in pre- and post-conferences. You are
responsible for knowing the drugs studied in previous quarters as well as drugs that will
be introduced in this course. It is important to study the drugs in their classifications
rather than singly.
PAGE 29 OF 62
All assignments must be satisfactorily completed by the end of the quarter to pass the course.
Remember: Clinical must be passed with a 75% to pass NURS 125.
Clinical Guidelines and Policies

Overview
Since clinicals are in the afternoon, it can be difficult to guess what patients will still be in-house
during clinical. Therefore, in NURS 125 instead of receiving assignments the day before,
students will obtain their assignments on the day of clinical. There will not be an official “pre-
clinical” day. Students will come to the hospital prepared to accept their patient(s) and will be
given approximately 1 ½ hours to write up the pertinent information for safe care of the
patient(s). Students may come earlier than 1200 if needed, but please do not plan on arriving to
the hospital before 1100 to obtain patient assignments as it is more likely a patient may be
discharged prior to clinical. Pre-conference will begin at 1430.
Students may (and should expect to) be asked to give a verbal report on their patient(s) during
pre- and/or post-conference times. Post-conferences are a wonderful time to learn from each
other’s experiences.
After a student has cared for his or her assigned patients, he or she will complete all the
remaining paperwork in weekly patient documentation packets and turn it in on the next clinical
day.
Attendance and Attire

Students are expected to report to pre-conference at the specified room at the appropriate time in
full nursing uniform with equipment (i.e. stethoscope, ID badge, pen, calculator, etc.). Please
refer to the ASN Student Handbook for policies regarding uniform. If a student is not
appropriately attired, he or she may be sent home and receive a clinical failure for the day.
For clinical objectives to be met and for adequate evaluation opportunities to be available, on-
time attendance is expected at all clinical experiences, simulations, and skills tests.
1. In the unlikely event that the student must miss class, clinical, campus lab or a skills test
due to illness or unavoidable emergency, it is the student’s responsibility to notify the
instructor. Absences may jeopardize class standing and the successful completion of the
program.
a. If orientation to class or clinical is missed, the student may be denied the privilege
of continuing in the program that quarter.
b. It is the students’ responsibility to obtain missed information when absent from a
learning experience. It is also the student’s responsibility to contact the instructor
to determine what make-up activities must be completed to meet the learning
objectives and allow for teacher evaluation.
PAGE 30 OF 62
2. Excused Absences
a. With proper notification, an absence is considered excused if due to illness or
unavoidable emergency.
b. Proper notification is generally considered to mean a telephone call to the
instructor at least one hour before the start of class/clinical or as soon as the
student knows he or she cannot attend that day.
c. The instructor will assign make-up activity equal to the number of hours missed.
Make- up activities may include a written assignment, scheduling make-up hours
at a different day/time, simulation or other activities as described by the course
instructor.
d. A physician’s release may be required for return to clinical.
3. Unexcused Absence
a. Absence from class or clinical is considered unexcused if the student does not
directly and personally notify the instructor at least one hour before the start of
class/clinical. An absence from class or clinical for reasons other than illness or
unavoidable emergency is considered unexcused.
b. An unexcused absence from clinical results in a failure of clinical for the day.
c. Two unexcused absences from clinical result in a failure of the clinical course.
Tardiness
Because on-time arrival is an expectation of professional performance, a pattern of late arrival is
detrimental to a student’s success. On-time arrival is defined as being ready to begin clinical in
the appointed location at the time stated in the syllabus.
A student late to clinical for the first time will receive a warning; any further instances of
tardiness will result in an unexcused absence.
Conduct
1. Lab is not a social occasion. Socializing should be kept to a minimum.
2. Personal visitors or phone calls are not permitted. Please use cell phones only for
contacting the instructor and they should be used only in “off-stage” areas.
3. No running, loud talking, loud laughing or chewing of gum is allowed.
4. Students should be careful not to "congregate" in busy areas such as hallways and nursing
stations. Please be very sensitive to the nursing staff that are working for 12 hours.
Taking up needed chairs in the nurses’ station is not acceptable, so always ask if the chair
is taken or offer the chair to other personnel. Remember, while nursing students are an
important part of the health team, they are also guests on the floor.
5. Students are responsible for the care of the patient(s) assigned to them during their lab
hours. If, for any reason, the student is not able to do any part of the care assigned, he or
she should communicate this to the instructor as soon as possible. It is too late to do this
at charting or post-conference time. Failure to do this will be considered a lack of
responsibility on the part of the student and will be reflected as such on the student's
evaluation.
PAGE 31 OF 62
6. Personal belongings should be kept to a minimum. Any belongings that are brought to the
hospital should be kept neatly out of the way in the area provided. Students should not
bring money or valuables that cannot be kept on their person.
7. Students should introduce themselves to the staff members caring for the patient, telling
them why they are there and what their responsibilities will be. The Scope of Practice
sheet must be brought to every clinical!
8. Lastly, remember students are professionals and the patients, as well as hospital staff,
look to them as just that. Choose your actions to reflect this.
Confidentiality
As a reminder, HIPPA standards are applicable to all patient information. All patient information
(including whether a person has been admitted to the hospital or not) is to be kept in the strictest
confidence both inside and outside the hospital. Any breach of confidentiality will have serious
consequences for the student and will result in a clinical failure for the day. Depending on the
circumstances, it can be grounds for failure of the course.
Academic Integrity and Honesty

It is the responsibility of the student, as a part of professionalism, to maintain and adhere to the
highest standards of honesty and integrity in the clinical setting. These activities include, but are
not limited to: reporting any medication/procedure errors (either observed or made personally),
reporting theft of hospital property, truthful documentation of events, and writing assignments in
the best quality form per the policy found in the PUC Catalog. Failure to perform at this level
may mean dismissal from the clinical setting and ultimately failure for the course.
Performance of Skilled Nursing Procedures

Perform skilled nursing procedures ONLY under the direct observation of the instructor OR a
registered nurse on the unit. Always look for opportunities to practice skills. This is the safest
place to practice, under the guidance of other RNs or the instructors. Please make sure to have
the scope of practice sheet at each clinical and readily available for reference.
Parking at the Hospital for Labs

Security at St. Helena Hospital requests that nursing students park their vehicles in the middle or
upper Hillcrest employee parking lots. Please do not park in patient/visitor designated lots. If
students do not abide by parking policies, their vehicles may be towed and/or ticketed. For
safety, Security is available to escort students to their cars when they leave the hospital at night if
needed.
Role of the Instructor in the Clinical Setting

There are two roles that the instructor assumes in the clinical setting: Facilitator and Evaluator.
As a facilitator, the instructor assists the student in obtaining educational experiences to promote
learning about the client and the care provided. This is often seen as a supportive role. The
instructor is there to encourage, support, guide and teach. The instructor also acts as a liaison
between students and staff when issues arise. It is important that students have a positive learning
PAGE 32 OF 62
experience in clinical, and the instructor is there to help. Please do not hesitate in contacting the
instructor when an uncomfortable situation arises.
The second role – that of the evaluator – is one where the instructor evaluates the performance of
a student. It is important to keep in mind that the instructor has a responsibility to ensure that the
student is providing the safest care possible to the client while learning the role of a nurse. Any
guidance or critiquing will be done with the utmost respect for the student and will never take
place in the presence of patients, nurses, doctors, or other students. It is important that the student
be open to suggestions and not takes them as a personal criticism. Remember, every RN was a
student at one time! Students will become excellent RNs if they are open to objective critiquing.
Neat Work Area

It is the student’s responsibility to leave the work area clean and neat. When students leave the
patient's room, the hospital unit, or when they are finished in the skills lab, they should make
sure that the area is neat and clean. A student’s work is not done until this is completed.
Skills Testing
All skills tests must be completed by the assigned due date to receive full points. Failure to
complete the skills test by the due date will count as one failure for that skills test. Missing a
skills test for any reason other than the ones listed under Excused Absences counts as a failure
for that skills test attempt. There will be three attempts to pass a skills test. Failure to pass the
second retake results in a failure for the clinical course.
Prior to taking the skills test, students must have two peer-reviews completed within two
business days of skills testing time. Time to practice will be provided during clinical and students
must log an additional two hours of practice time on their own. In the event of a failure to pass a
skills test, students will need to log an additional 1 hour of practice time and obtain an additional
peer-review prior to the retake. Please review the policies listed on the Skills Test sign-up page
for more information as well as in the ASN Student Handbook.
Pre-lab Activities
Pre-lab time will be spent preparing for the day’s activities. Review of the chart, looking up
medications, and planning for the patient’s care will be the focus. The clinical instructor will be
available to answer questions and guide the student in gathering pertinent information. Each
student will prepare for the day on the appropriate floor he or she has been assigned to for that
day.
Subjects for Post-conference

There are various topics covered in post-conference. Subjects may include, but are not limited to
spiritual care, dosage & calculation, tracheostomy care, interpretation of EKGs, and other select
topics related to concepts and/or exemplars. If there is a particular topic a student would like to
discuss as part of a pre- or post-conference, please let the instructor know.
PAGE 33 OF 62
BSN or MSN Mentorship – Educational Focus

During this clinical rotation, it is possible that a BSN or MSN student will be mentoring with the
clinical instructor. If a mentoring student is present, it is important to note that the mentoring
student’s learning objectives focus on learning and applying the educational process; the
mentoring student is not responsible for providing essential instruction to, or evaluating the
performance of any student enrolled in this clinical course.
• A mentoring student is not responsible for:
o Grading assignments
o Evaluating student clinical performance
o Supervising nursing skills requiring direct RN supervision
• With mentor supervision, a mentoring student may:
o Coach AS students on skill improvement and implementation of the nursing
process
o Identify appropriate teaching methods/techniques for the different learning styles
o Identify strategies that may assist in addressing student performance issues that
have been identified by the mentor
o Observe and appreciate various evaluation strategies
PAGE 34 OF 62
Clinical Paperwork Requirements

There is a patient care documentation packet posted on Canvas that will be required for each
patient encounter each week. There will also be a major care plan due once during the quarter
(marked as *MCP on the clinical rotation schedule). In addition to the patient care
documentation packet, there will also be a journal article report due on the assigned ICU week.
There will also be a worksheet to fill out for the rotation to the Martin O’Neil Cancer Center,
which will also be posted on Canvas.
Requirements for patient care documentation packets:

At the beginning of pre-conference:
1. Patient demographics
2. Medication sheet with the medications—including IV fluids—that the patient will receive
during the clinical time.
3. IV location and current IV fluids
4. Pertinent labs and/or diagnostics
By 1700:
1. Physical Assessment (documented on the patient care documentation packet)
By the following clinical:

1. All completed paperwork
2. The rest of the scheduled medications that the patient received that day as well as any
PRN medications given during the clinical lab.
Journal Article Presentation

Look at clinical schedule for the date of the journal presentation (marked as *JA on the
schedule). The clinical instructor may ask the student to present at pre- or post-conference.
Please include a reference page using APA format. See assignment guidelines on the next page.
PAGE 35 OF 62
Journal Reading Template

Name
NURS 125
Today’s Date
1. In 3 or more paragraphs, describe the contents of the article and the important points the
article was trying to express.
2. In 1-2 paragraphs, did you agree with this article? Why? Does this article agree with
“evidence-based practice”? Why or why not?
3. In 1-2 paragraphs, give one patient (or staff, if appropriate) teaching point and one
nursing priority point. Also, give one specific example of application of this article to
your practice of nursing.
Reference
(in APA format)
Point Breakdown for Journals

Explanation and summarization of article (item 1) /2
Critically analyzing information in article (item 2) /2
Evaluating article for evidence-based practice application (item 2) /2
Application of information in article (item 3) /2
Choice of appropriate article (professional journal); reference page in APA format /2
Total /10
*Presentation of journal article will be assigned at the beginning of the quarter and the same
rubric above will be used.
PAGE 36 OF 62
Clinical Day #1, Part I: Hospital Orientation
Objectives:
1. Review syllabus with emphasis on student assignments and expectations.
2. Review patient care documentation expectations and due dates.
3. Orient to the floors using Orientation Guide
4. Create a familiarity with the hospital to reduce apprehension and stress.
Lab Assignment:
1. Review clinical syllabus
2. Complete Student Nurse Plan of Orientation.
3. Complete Self-Orientation of Unit for the unit assigned for the quarter.
PAGE 37 OF 62
PAGE 38 OF 62
Student Nurse Plan of Orientation – St. Helena Hospital
Name:
Unit: Date:
Mark with an “x” for each topic discussed.

1. Safety Fire/disaster evacuation plan
Incidents/accidents (documentation, notification,

assessment)
Physical/chemical restraints
Universal Precautions
2. Patient Confidentiality HIPPA requirements
3. Documentation Type:
Frequency:
Standard of care
Defensive charting
Documentation approval
4. Pre-/Post-conference Location: TBA
Times
5. Reporting system Obtain report from the nurse in charge of the patient
Report any change in condition to nurse in charge of

patient
End of clinical lab report to nurse in charge of patient.
PAGE 39 OF 62
6. Med system Pour/draw of med observed by instructor (or) primary

R.N.
Administration of medication observed by instructor or

primary R.N.
Medication policies (manuals)
Documentation/co-signature by instructor or primary

R. N.
7. Unit routines Baths, meals, activities, etc
8. Chart review Physical chart/computer location
History & physical
Physician progress notes
Labs/Diagnostics
Case Management notes
9. Agency’s expectations Nursing instructor
Nursing students
Staff
10. Student’s expectations Nursing instructor
Agency/staff
11. Instructor’s Student

expectations
Agency/staff
12. Staff roles & Student RN

relationship
CNA
PAGE 40 OF 62
Self-Orientation to Unit
Student’s Name:
Unit: Date:
*Please locate the following items then place a check in the space.
PHYSICAL SETTING CHART FORMS (client’s chart)
Charts EMAR
CPD (central processing department) Doctor’s orders
Crash cart (code blue) Plan of Care
Charting area(s) for students IView
Elevators for transporting patient Fingerstick Record
Fire extinguishers & alarms Patient Data Profile
Fire exits History and Physical
Escape route for disaster Labs
Nurses' lounge Diagnostics
Restroom Physician Progress Notes
Stock medications
Supply room
Pantry
Soiled utility
PLEASE INDICATE WHERE THESE ITEMS ARE FOUND:

Medication Refrigerator
Syringes
Dressing Supplies
Medications
IV Solutions
IV Tubing
Medicine Cups
Alcohol Wipes
Tape
Catheter Kit
NG Tubes
Toothbrushes
Thermometer
Blood Sugar Machine
Bed Pans
PAGE 41 OF 62
PAGE 42 OF 62
Clinical Lab Day 1, Part II: Tracheostomy Care
Objectives:
1. Perform a thorough assessment of a patient who has a tracheostomy.
2. Identify signs and symptoms of urgent complications in patients with a tracheostomy.
3. Describe clinical signs of hypoxia.
4. Outline the steps in artificial airway suctioning.
5. Identify side effects that may occur as the result of artificial airway suctioning.
Lab Preparation:
1. Nursing: a concept-based approach to learning, pp. 969 – 970
2. View the ATI Skills Modules → Airway Management → Step-By-Step Viewing →
Tracheostomy Care video
3. Clinical Nursing Skill (Vol. III), pp. 442 – 447
a. Skill 13.18
b. Skill 13.19
Testing Policies:
1. Students must log 2 hours of practice time prior to taking the skills test as well as have 2
peer-reviews completed within two business days of testing. Students should be able to
demonstrate this skill within 20 minutes.
2. Students must pass critical elements of skill with 100% accuracy.
3. Students may retake a skills test up to two times. They may not retake the test on the
same day they tested.
4. If students fail a skills test, they must log an additional hour of practice time prior to
retesting as well as have a 3rd peer review completed within two business days of
retesting.
5. Failure of the second retake is failure for clinical lab.
6. Not completing the skills test by the assigned due date results in a failure of one of the 3
attempts.
PAGE 43 OF 62
PAGE 44 OF 62
Clinical Competency – Tracheostomy Suctioning

Name
1. Peer Date Start: Stop:
PREPARATION: Peer Peer Peer Test 1 Test 2 Test 3
1. Review chart for physician’s orders & documentation of
previous suctioning attempts. (QSEN S-S)
2. Gather needed supplies (sterile gloves, suction kit,
Yankauer, sterile saline, & towel).
ASSESSMENT:
1. Wash hands
2. Introduce self and identify client in two ways.
(Remember, patient can’t talk!) (QSEN S-S)
3. Provide privacy (QSEN PCC-S).
4. Assess patient to determine need for suctioning
(listening to lung sounds, check O2 sat, HR & rhythm).
5. Explain what you are going to do and why even if
patient is not alert. State that suctioning usually
stimulates the cough reflex. This helps remove
secretions. Explain that you will pause if patient
experiences respiratory difficulty. (QSEN PCC-S,A)
IMPLEMENTATION: (QSEN S-S)

6. Position patient in semi-Fowlers if conscious.
7. Drape patient with towel below tracheostomy. Don PPE
per facility protocol.
8. Turn on suction. Describe only: Set wall suction @ 80-
120 mmHg.
9. Hyper-oxygenate patient for one minute at 100%
oxygen using a bag-valve-mask if patient’s secretions
are not copious. Otherwise, use high-flow oxygen (12-
15 L/min). Encourage patient to deep breathe.
10. Prepare sterile field. Apply sterile gloves. Open box
container and use non-dominant hand to fill with normal
saline.
11. Holding the catheter in the sterile hand and the suction
tubing in the non-dominant hand, attach catheter to
suction tubing.
12. Flush catheter with sterile saline to lubricate.
13. Remove patient’s oxygen mask and insert catheter about
5 inches in adults or until patient coughs without
applying suction. If you feel resistance, the catheter has
probably hit the carina. Pull catheter back 1 cm before
applying suction.
14. Apply intermittent suction for 5 to 10 seconds while
slowly rotating catheter during withdrawal. Be sure
sterile hand and catheter do NOT touch anything.
15. Hyper-oxygenate patient for at least one minute between
suction attempts. Clear suction catheter with sterile
saline.
16. Assess patient for need to repeat suctioning (HR, O2 sat,
patient’s report). No more than 3 suction passes per
episode.
17. Once suctioning is complete, peel the sterile glove off so
that it turns inside out over the catheter. Discard gloves
and catheter.
PAGE 45 OF 62
18. Suction patient’s mouth with Yankaeur as needed. You

may leave this with the patient if appropriate to do so.
19. Put oxygen back to original setting.
20. Perform hand hygiene.
EVALUATION & DOCUMENTATION:

21. Evaluate client’s tolerance
22. Reassess parameters assessed prior to suctioning
(listening to lung sounds, check O2 sat, HR & rhythm).
23. Check for SAFETY – call light in place, bed rails up,
bed low, etc. (QSEN S-S)
24. Document procedure.
COMMENTS:
Test #1 Tester Signature Date:
PAGE 46 OF 62
Clinical Lab Day 2: IV Skills
Objectives:
1. Identify equipment used in peripheral IV catheter insertion.
2. Identify at least 3 screening questions to ask clients regarding safety or risk factors prior
to peripheral IV insertion.
3. Identify at least 4 possible complications of IV therapy and the appropriate nursing
actions to take.
4. Describe the steps involved in successful insertion of peripheral IV catheters.
5. Demonstrate three successful insertions of a peripheral IV catheter.
Lab Preparation:
1. READ the IV syllabus posted on Canvas.
2. WATCH Ohio University School of Nursing Skills/IV Start on YouTube. The link is
provided on Canvas. Students are expected to show up at their scheduled time having
already watched the video.
3. WEAR the full nursing uniform including the name badge. Stethoscopes are not needed
for this clinical.
4. BRING 3 volunteers on which to demonstrate the 3 required IV starts. Three successful

IV starts will need to be demonstrated to complete the skills test. Volunteers are limited
to 2 attempts per quarter. When asking for volunteers, look at the arm veins first.
Students are likely to be successful sooner if they choose volunteers who have veins that
are already visible even before application of a tourniquet. It will also be easier if
volunteers have big, straight veins as opposed to small, squiggly ones. Also, remind
volunteers to hydrate well that day. It is much easier to start an IV on a well-hydrated
patient than on a dehydrated one.
5. IV lab will begin at 1300 on the student’s assigned clinical day. The location will be
announced.
6. Complete the IV Clinical Worksheet. This will be handed out at lab time. Complete the
IV Certification test. The test will be available on CANVAS and will be completed
during lab. The test is open resource and students must pass by 90%. Students will have
one hour to complete the test once it is begun.
PAGE 47 OF 62
Clinical Lab #3 – Patient Care
Focus: Alterations in Cellular Regulation
Upon completing this clinical, the student will have:

1. Collected relevant patient information needed to plan care for a patient with an
alteration in cellular regulation.
2. Performed an accurate, focused assessment on a patient with an alteration in cellular
regulation.
3. Identified the highest priority nursing diagnosis based on assessment findings.
4. Created a holistic plan of care utilizing the information gained in the focused
assessment.
5. Provided relevant education to the patient based on identified learning needs.
6. Reflected on his or her performance to identify areas for improvement.
PAGE 48 OF 62
Clinical Labs #4, 5, & 6 – Patient Care
Focus: Alterations in Oxygenation

alteration in oxygenation.
2. Performed an accurate, focused assessment on a patient with an alteration in
oxygenation.
assessment.
PAGE 49 OF 62
Clinical Labs #7, 8, & 9 – Patient Care
Focus: Alterations in Perfusion

alteration in perfusion.
2. Performed an accurate, focused assessment on a patient with an alteration in
perfusion.
assessment.
PAGE 50 OF 62
Clinical Lab #10 – Sim Lab
Focus: Quarter Synthesis

alteration in cellular regulation, oxygenation, and/or perfusion.
2. Performed an accurate, focused assessment on a patient with an alteration in cellular
regulation, oxygenation, and/or perfusion.
assessment.
6. Identified ways in which various alterations in one concept affect alterations in other
concepts.
PAGE 51 OF 62
Out Rotation – Martin O’Neil Cancer Center, St. Helena Hospital
Focus: Alterations in Cellular Regulation

1. Identified 3 different examples of alterations in cellular regulation.
2. Compared and contrasted the 3 examples of alteration in cellular regulation.
3. Identified potential health complications that could occur with the 3 examples, either
from the alteration or from treating the alteration.
4. Identified any pertinent labs and/or diagnostics used to diagnose or monitor the
alterations in cellular regulation.
5. Identified 2 important nursing assessments to make for each example relating to the
diagnosis, monitoring, or treatment the alteration.
6. Identified at least 2 other disciplines needing to be involved with treatment of the
patient.
7. Created a diagram demonstrating the connection between the alterations in cellular
regulation and at least 2 other concepts.
PAGE 52 OF 62
Formulas to Know – Dosage Calculations
Formula #1: Desired Over Have
Desire
× Quantity = Amount Desired
Have
Formula #2: Ratio-Proportion
Dosage on Hand Dosage Desired

=
Amount on Hand Amount Desired
Formula #3: Fluid Rate
Volume
× Calibration = Rate
Time
Calculate total IV infusion time use ratio formula:
Total mL
= mL/h
Total Hours
Problems involving check of safe dosage:

Step 1: Convert to like units
Step 2: Calculate recommended mg/min
Step 3: Calculate ordered mg/h
Step 4: Calculate ordered mg/ min
Step 5: Compare ordered and recommended dosages
Convert > Think > Calculate > Think (does it make sense?)
PAGE 53 OF 62
PAGE 54 OF 62
Scope of Practice: NURS 125
The following skills must be

done under direct supervision
COMPUTER DOCUMENTATION PATIENT CARE
of the primary nurse or the
instructor:
Vitals signs HS care (bathing, oral care, Urinary catheter insertion
massage, etc.)
Patient care tasks Meal assistance (ordering & NG tube insertion &
feeding) management
• Level of assistance Bed making Any medications
• Activity Dressing changes Any injections
• ADLs Moving & positioning Tube feedings
• Equipment Intake & output Insulin administration
Medications (MUST have RN Head-to-toe assessment (no Anything to do with

co-signature) computer documentation) peripheral IVs
Range of motion Blood sugar checks*
Vital signs Tracheostomy suctioning**
SKILLS NOT YET LEARNED

No IV push medications! NO Central line care OR use!!
*May be done independently per instructor discretion

**After skills test has been passed
PAGE 55 OF 62
PAGE 56 OF 62
Pacific Union College

Department of Nursing
Clinical Evaluation Tool
Student Name: Clinical Rotation:
Passing – A rating of 2 or 1 results in a clinical pass. A rating of 1 in any area requires the student and faculty member to
develop a performance improvement plan. Initiation of a performance improvement plan will be communicated with course
faculty for the next clinical rotation.
2 – Supervised, may require moderate prompting and support; demonstrates steady improvement in efficiency, coordination,
and confidence; clarifies and ask questions appropriately; uses instructor guidance and supervision appropriately.
1 – Assisted, performance meets level specific criteria with frequent instructor prompting and support; performance may
demonstrate problems with efficiency and coordination but remains safe.
Failing – A zero in any area at the final evaluation results in a clinical failure.
0 – Dependent, performance below level specific criteria even with instructor prompting and support, inefficient, lacks
confidence and coordination, inaccurate or infrequent communication with instructor, poor accountability for own practice.
Any over-riding concern results in immediate clinical failure.
Professionalism
1. Collaborate with other health professionals and employ interdisciplinary MT MT F F

interventions. S I S I
Clarifies role with RN and CNA/UAP.
Communicates respectfully with peers, clients, staff, and instructor.
Works with interdisciplinary team members to provide safe client care.
Inspires confidence and trust among faculty, staff, and clients.
Comments:
2. Demonstrate integrity in all interactions, functioning with the ethical, legal, and MT MT F F
professional guidelines for the nursing profession. S I S I
Takes responsibility for actions and practices with integrity and honesty.
Functions within the scope of practice of a registered nurse.
Maintains professional appearance.
Remains calm and therapeutic while in the clinical setting and maintains professional
boundaries in all interactions.
Comments:
3. Contribute to accountability in nursing practice through resource management MT MT F F

and quality improvement. S I S I
Meets attendance requirements.
Prepares adequately for nursing care and skills prior to clinical.
PAGE 57 OF 62
Completes written documentation in a timely manner.
Prepares thoroughly, in order to be efficient, prior to entering a client’s room.
Follows incident reporting process as needed.
Comments:
4. Exhibit a spirit of inquiry and engage in lifelong learning to maintain currency in MT MT F F

a profession with rapidly evolving knowledge, technology and trends. S I S I
Identifies appropriate resources for gathering current, reliable information.
Seeks out and actively participates in learning experiences and exhibits a spirit of
inquiry.
Identifies own learning needs and has a plan to achieve them.
Actively participates in post-conference.
Comments:
Caring
5. Demonstrate compassion and respect for diverse individuals, groups, and MT MT F F

communities in a manner that exemplifies Christian values. S I S I
Provides individualized care that is age, gender, and culture appropriate.
Demonstrates compassion and respect for all individuals regardless of age, gender,
culture, ability, etc.
Provides nursing care that is sensitive to the client’s spiritual and cultural needs in an
unfamiliar health care setting.
Recognizes situations for client advocacy and begins to advocate for client.
Functions in the role of client advocate.
Comments:
6. Address a client’s physical, mental, emotional, social, and spiritual needs in a MT MT F F

holistic plan of care. S I S I
Identifies client needs and develops a holistic plan of care, revising as needed based on
ongoing assessment.
Comments:
Critical Thinking
7. Integrate prior knowledge and assessment data from a wide array of sources to MT MT F F
inform clinical decision-making. S I S I
Performs, documents, and reports accurate, comprehensive, holistic assessment for
increased number of clients.
PAGE 58 OF 62
Researches client chart and gathers information from client to develop a thorough
perspective of the client and plan of care.
Refines ability to gather and understand pertinent data for increased number of clients.
Analyze lab values and trends and relates them to client condition and initiates
appropriate nursing interventions.
States rationale for medical orders pertaining to lab values.
Comments:
8. Employ tools of critical thinking, including the nursing process, in order to solve MT MT F F
problems and provide appropriate care. S I S I
Applies the nursing process for increasingly complex and increasing numbers of
clients.
Evaluates and updates nursing care plan based on reassessment and changing
circumstances.
Accurately documents all elements of the nursing process in the client plan of care.
Comments:
Excellence in Practice
9. Provide safe, quality interventions to assist the client toward optimum health. MT MT F F
S I S I
Promotes the hygiene of all clients to maintain skin integrity and well-being.
Maintains a safe client environment.
Handles equipment appropriately and safely.
Demonstrates efficiency and coordination while safely and accurately performing

procedures.
Demonstrates basic organization and prioritization.
Establishes priorities of care with recognition of the client’s needs.
Prior to administration, identifies the action, compatibility, side effects, signs of

toxicity, and rationale for each medication as it relates to individual client.
Obtains pertinent assessment data prior to administration of each medication.
Demonstrates safe, accurate and timely administration of medications with increasing

independence.
Evaluates effect of medication.
Promptly reports abnormal findings and initiates appropriate interventions.
Comments:
PAGE 59 OF 62
10. Practice in a manner that is consistent with available evidence and guided by MT MT F F
national standards. S I S I
Locates and follows policies and procedures of the clinical and educational institution.
Researches clinical questions adequately to make appropriate decisions.
Accesses client care guidelines and identifies appropriate care based on evidence.
Recognizes, accesses, and uses specialty-specific standards of care appropriately.
Comments:
11. Communicate effectively with clients, family, community, and health team MT MT F F
members. S I S I
Speaks clearly and understandably using professional language.
Compensates for sensory deficits and language barriers to promote communication.
Communicates appropriately in response to client’s needs while giving care.
Verbal and written communication reflects client condition and care priorities.
Provides timely client updates and validates plan of care with staff nurse while
developing increased independence. Communicates assessment and plan of care with
instructor.
Begins to use ISBARR as a communication tool, and practices hand-off, and end-of-
shift report.
Uses ISBARR appropriately; provides thorough and organized hand-off and end-of-
shift reports.
Comments:
12. Provide culturally competent care to diverse individuals, groups, and MT MT F F

communities. S I S I
Considers an individual’s age, gender, culture, and primary language, physical and
mental abilities in implementing the plan of care.
Adapts interventions to account for the physical and mental abilities of clients
including those who are unable to care for themselves.
Considers the individual’s socioeconomic, environmental, adaptive, cultural, and social

support needs in planning for discharge. Makes referrals as appropriate.
Demonstrates increasing awareness of client advocacy needs for individuals and

groups who are members of at-risk communities.
Comments:
Teaching and Learning
13. Apply the teaching process to meet the learning needs of individuals, groups, and MT MT F F
communities. S I S I
Provides basic instruction to one or more clients about medications and interventions.
PAGE 60 OF 62
Provides increasingly complex instruction to clients about medications and

interventions.
Assesses client’s learning needs related to plan of care and condition.
Provides needed instruction and evaluates client’s response to and understanding of

instruction.
Documents instruction and any follow-up needed.
Considers client’s age, gender, culture, language, physical and mental abilities, and
emotional readiness in developing and implementing the teaching process.
Includes family in the teaching process where possible and appropriate.
Comments:
14. Appropriately incorporate technologies and emerging information modalities MT MT F F

into teaching and learning. S I S I
Uses appropriate resources to gather data for lab preparation and care plan.
Identifies and retrieves quality resources from both print and electronic healthcare
journals and national healthcare organizations (e. g., CDC, IOM, WHO, QSEN, NIH,
NLN, AACN, AHRQ).
Comments:
Overriding Concerns:
The student nurse is expected to demonstrate the judgment and behavior necessary to protect the client from physical and
emotional jeopardy and relationships that interfere with comfort and healing. These areas of potential physical and emotional
jeopardy have been identified as areas of overriding concerns. These basic behavioral expectations in the areas of overriding
concerns are in effect and evaluated throughout the quarter in order to ensure safe practice. Failure in clinical would occur
because the student: (a) failed in the area of overriding concerns due to the seriousness of an incident, or (b) demonstrated a
pattern of unsafe behavior, despite guidance of the instructor.
1. Physical Jeopardy – Any action or inaction on the part of the student that threatens the physical well-being of a client (e.g.,
uses unsafe techniques in medication procedures, fails to identify clients, is inadequately prepared for procedures, fails to use
universal precautions).
2. Emotional Jeopardy – Any action or inaction on the part of the student that threatens the emotional well-being of a client or
increases stress (e.g., is abusive, violates ANA Code of Ethics or the Patient's Bill of Rights, violates the patient's privacy,
imposes own values upon the patient-client, denies the client the right to make decisions about his/her own care, fails to provide a
therapeutic environment).
3. Failure of Clinical Decision-Making – Clinical Decision Making is a problem-solving process by which choices are made in
nursing practice. A failure in clinical decision-making is demonstrated when a student makes a deliberate decision to omit a
critical element within an area of care (e.g., failure to follow agency policy or procedures).
CET Revised June 2013
PAGE 61 OF 62
Student Self-Evaluation
Review the student learning outcomes for this rotation. Indicate whether you believe you have met the outcomes. Please
explain your response.
Midterm –  Yes  No Final –  Yes  No
Please comment on your strengths in this clinical rotation according to the student learning outcomes:
Midterm Final
Please comment on the areas needing improvement in this rotation according to the student learning outcomes. What is your
plan for developing these areas?
Midterm Final
Instructor Comments
Midterm Final
Signatures – Midterm Evaluation Signatures – Final Evaluation
Student: Date: Student: Date:
Instructor: Date: Instructor: Date:
Final Clinical evaluation:  Pass  Fail
PAGE 62 OF 62

Nursing Syllabus

Uploaded by

Copyright:

Available Formats

Nursing Syllabus

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Nursing Syllabus

Uploaded by

Copyright:

Available Formats

COURSE: NURS 125 3RD QUARTER, 1ST YEAR

NURSING III SYLLABUS –

Meghan Gainer, RN, MSN, ONC

NURSING III – THEORY

Prerequisites: NURS 124, 212. Co-requisite: NURS 390.

Student Learning Outcomes

Upon completion of this course, nursing students will:

Teaching and learning

About the Course

Office hours will be posted on the Canvas scheduler.

2. Group Project (5%)

Class 1: D&C Exam Class 2:

Clinical #1: Orientation Clinical #1: Orientation Clinical #1: Orientation

Class 9: Class 10:

Class 11: Class 12:

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

Class 13: Class 14:

Class 15: Class 16:

NO CLASS : Class 17:

Class 18: Class 19:

SUMMER VACATION BEGINS

Preparation Guidelines by Class

*CO – Class Objective

Class 2: Cellular Regulation – Leukemia

Class 3: Cellular Regulation – Anemia & Thrombocytopenia

Class 4: Introduction to Oxygenation

Class 5: Cellular Regulation – Exam I

Class 6: Acid-Base Balance

Class 8: Oxygenation – Pneumonia

Class 9: Oxygenation – Asthma

Class 10: Oxygenation – Chronic Obstructive Pulmonary Disease

Class 11: Oxygenation – Exam II

Class 12: Introduction to Perfusion

Class 13: Perfusion – Dysrhythmias I

Class 14: Perfusion – Dysrhythmias II

Class 15: Perfusion – Hypertension

Class 16: Perfusion – Peripheral Vascular Disease

Class 17: Perfusion – Exam III

Class 18: Dosage and Calculation – Advanced IV Drip Rates

Class 19: Project Presentations

NURSING III SYLLABUS –

NURSING III – CLINICAL

Clinical Guidelines and Policies

Attendance and Attire

Academic Integrity and Honesty

Performance of Skilled Nursing Procedures

Parking at the Hospital for Labs

Role of the Instructor in the Clinical Setting

Neat Work Area

Subjects for Post-conference

BSN or MSN Mentorship – Educational Focus

Clinical Paperwork Requirements

Requirements for patient care documentation packets:

By the following clinical:

Journal Article Presentation

Journal Reading Template

(in APA format)

Point Breakdown for Journals

Clinical Day #1, Part I: Hospital Orientation