Portland Community College | Portland, Oregon

This course introduces the learner to assessment and common interventions (including relevant technical procedures) for care of patients across the lifespan who require acute care, including normal childbirth. Disease/illness trajectories and their translation into clinical practice guidelines and/or standard procedures are considered in relation to their impact on providing culturally sensitive, patient-centered care. Includes classroom and clinical learning experiences.

Prerequisite: NRS 110

Prerequisites or Co-requisites: NRS 230 or 231 and NRS 232 or 233

At the end of the course, the student will be able to:
1. Conduct a culturally and age appropriate health assessment and interpret health data focusing on physiologic, developmental, and behavioral parameters of the disease trajectory, normal childbirth, and acute exacerbations of chronic conditions and their resolution, and the client response to acute conditions/processes.

2. Develop plans of care that are family-centered, developmentally and culturally appropriate, using evidence including clinical guidelines and integrative literature reviews to implement care plans safely for clients with common acute conditions/processes.

• manage common symptoms such as acute pain and acute anxiety,
•  follow evidence based procedures for performing skills safely,
• use expected illness trajectory,
• monitor progress toward recovery, occurrence of complications and client’s response to interventions.

3. Identify potential legal and ethical issues related to client decision-making and informed consent in acute care settings.

4.  Apply ANA Code of Ethics to care of clients with acute conditions/processes.
5. Use therapeutic communication skills in the development of therapeutic relationships with client and families.
6. Identify roles  and interact appropriately with members of the health care team involved in providing care to client and families with acute conditions/processes.
7. Discuss need for delegation of client care with experienced nurses.

Intended Outcomes for the course

1.  Conduct a culturally and age appropriate health assessment and interpret health data focusing on physiologic, developmental, and behavioral parameters of the disease trajectory, normal childbirth, and acute exacerbation of chronic conditions and their resolution, and the patient response to acute conditions/processes.

2.  Develop plans of care that are family/patient-centered, developmentally and culturally appropriate, using evidence including clinical practice guidelines and integrative literature reviews to implement care plans safely for patients with common acute conditions/processes.

• Manage common symptoms such as acute pain and acute anxiety,
• Follow evidence based protocols for procedures & performing skills safely,
• Use expected illness trajectory to implement patient-centered plans of care
• Monitor progress toward recovery, occurrence of complications and patient’s response to interventions.

3.  Identify potential legal and ethical issues related to patient decision-making and informed consent in acute care settings.

4.  Apply ANA Code of Ethics and Nursing Values to care of patients

5.  Use therapeutic communication skills in the development of relationships with patients, families, & the care team.

6.  Identify roles of the nurse within the healthcare team and roles of all members of the healthcare team, patients, and families.

7. Discuss need for delegation of patient care with experienced nurses.

8. Demonstrate professional behaviors in all interactions with member of the healthcare team including peers, faculty, and staff.

Discussion groups

Required Readings
Clinical evaluation
Project/Papers
Multiple choice exams
Lab performance evaluation

Clinical performance evaluation

Papers/Project Rubrics
Multiple choice exams
Lab performance evaluation

Themes, Concepts and Issues;

Environments of Care

Illness trajectory

Clinical Judgment Model

Care Planning

Communication

Teaching

Legal

Ethical

Evidence-based best practices

Delegation

Roles within the health care team

Skills: This is not an exhaustive list but is a minimum skill set to be completed anytime throughout  NRS 110, NRS 111 or NRS 112

Principles of Infection control & PPE

Handwashing

Isolation technique

 Body mechanics

 Client/environment safety, bed making

Vital signs & SpO2 (pulse oximetry)

Height & Weight

Basic ‘head to toe’ physical assessment

Health History interviewing (across the lifespan)

Client hygiene

Client Skin Care & Pressure Ulcer Prevention

Safe patient handling: positioning, transfers & mobilizing

Client range of motion

Client’s ADLs, mobility, fall risk

Nutrition and elimination procedures, I&O

Pain Assessment & Management: Acute & Chronic

Nursing Documentation

Capillary Blood Glucose Measurement

Diabetic Care (skin, foot, oral, illness, eyes)

Intramuscular Injection sites

Subcutaneous and Intradermal Injections sites

Insulin preparation/injection

Medication calculation

Medication administration: Topical (skin, ear, eye, rectal), Oral, Inhaled

Intravenous Therapy and Regulation – Peripheral

Peripheral Intermittent IV Therapy via Secondary Infusion (piggyback)

Peripheral saline lock flush

NGT insertion and maintenance

Postpartum/newborn assessment

Sterile Technique

Perioperative Care – Pre/Post Suture, Staple, & Clip removal

Wound Care Drains: JP, Hemovac, Penrose,T-tube

Urinary Catheter insertion, maintenance and removal

Bladder Scan