NUR 314-A Acute Care of the Adult Patient I

Concordia College
Division of Nursing
COURSE NO. AND TITLE:
CREDITS:
PREREQUISITES:
COREQUISITES

NUR 314 Acute Care of the Adult Patient I

4 Credits (4 hours lecture, 12 hours lab/7 weeks)
NUR 311
NUR 321 NUR 312

FACULTY:

Ms. Lucia Alfano (Course Coordinator)

Dr. Christine Corcoran
Dr. Kathleen Flaherty
Ms. Sarit Orlofsky
Ms. Hyacinth Charles
Ms. Katherine Irizarry
Ms. Annmarie Kornobis
Ms. Allyne Kulk
Ms. Joan Parkes
Ms. Eileen Power
Ms. Charlene Scotton
Ms. Susan Tighe
Mr. Ken Tuttle
Ms. Barbara Ventura

PLACEMENT IN THE CURRICULUM:

First Semester

COURSE DESCRIPTION:
This course is the first in a two course series which focuses on
the development of theoretical knowledge and clinical skills involved in nursing care of the adult
patient. Concepts which address prevention, health promotion, disease management and
therapeutic interventions for adults with actual or potential alterations in fluid balance, and
neurologic, respiratory and cardiac systems will be addressed. Health issues and disease
processes commonly experienced by individuals and their families in the adult years will be
explored. Clinical practice experiences are provided in both out-patient and acute care settings
and will focus on knowledge and skills necessary for competent and compassionate care of adults
within the context of their families and community.
OBJECTIVES:
Upon successful completion of this course, the student will be able to:
1. Utilize evidence from physical and social sciences and nursing to the care of the adult patient
as measured by examinations, case study, nursing care plans, and clinical performance;
2. Apply the nursing process in the care of the adult patient and family as measured by
examinations, case study, nursing care plans, and clinical performance;
3. Select safe and effective therapeutic interventions based on the needs of the adult patient and
family and grounded in sound evidence and best-practices as measured by examinations,
case study, nursing care plans, performance in simulation laboratory, and clinical
performance ;
4. Utilize information systems and technology correctly in the delivery of patient care to adults
as measured by performance in the simulation laboratory and clinical performance;

NUR 314-A Acute Care of the Adult Patient I

5. Recognize the nurses role as part of the interdisciplinary health care team as measured by
clinical performance and participation in clinical conferences;
6. `Demonstrate precise written and therapeutic oral communication skills as measured by
participation in clinical conferences, case study, nursing care plans, and clinical
performance;
7. Identify processes and procedures that influence continuous efforts to maintain safety and
improve quality as measured by participation in clinical conferences, and case study.
8. Demonstrate responsibility for one's own learning and professional practice in the delivery of
client care as measured by performance in the simulation laboratory and clinical
performance.
TEACHING STRATEGIES:

Lecture/discussion, case studies, concept mapping,

story-telling, role-play, collaborative group work,
demonstration/return demonstration, clinical experience

EVALUATION:
Lecture:

Exam 1
Exam 2
Final Examination

30%
30%
35%

Clinical:

Nursing Care Plans

Clinical Performance
Performance in the Simulation Laboratory
ATI Practice Exams

P/F
P/F
P/F
5points possible

ATI:

1. All students are required to achieve at least 50% on the ATI Targeted MedicalSurgical practice tests that correspond with the syllabus for NUR 314
(Perioperative, Fluid Electrolyte, and Acid-Base, Respiratory, and
Cardiovascular).
2. Students are to complete RN Fundamentals Online Practice 2013 A by week 6.
All students regardless of the score achieved on the online practice assessment,
are required to complete an ATI Focused Review and remediation assignment.
The remediation assignment is as follows: for each topic listed in the Focused
Review report, the student must complete an active learning template and/or
identify three critical points to remember. The remediation assignment must be
hand-written and handed to the course coordinator prior to the proctored exam
(Week 8). Each student must spend a minimum of one hour in the Focused
Review and hand in their remediation assignment to be awarded credit (2 points).
3. Students will then take the RN Fundamentals Proctored Assessment (Week 8).
The students score on the ATI proctored exam will result in the rewarding of
additional points (see chart below)

NUR 314-A Acute Care of the Adult Patient I

4. No student will be allowed to take the proctored exam without completing the
Targeted Medical-Surgical 2013 Practice tests, the RN Fundamentals Online
Practice 2013 A, and the Focused Review/remediation assignment.
ATI Credit

Targeted Medical-Surgical 2013:

Perioperative
Fluid, Electrolyte, and Acid-Base
Cardiovascular
Respiratory
Achieve at least 50% on all practice assessments
2 pts.

Complete Practice Assessment and

Remediation:
Minimum one hour Focused Review
Complete active learning templates and/or three critical points
to remember for each topic missed

Level 3
3 pts.

Proctored Assessment
Level 2
Level 1
2 pts.
1 pt.

Below Level 1
0 pts.

Program Procedures
Academic Integrity and Ethics
At Concordia College New York, we are guided in all of our work by the values of
academic integrity and ethics: honesty, trust, fairness, responsibility, and respect. As a
student, you are required to demonstrate these values in all of the work you do.
Participating in behavior that violates academic integrity and ethics (e.g., plagiarism,
unauthorized collaboration, multiple submissions, cheating on examinations, or
fabricating information) will result in your being sanctioned. Violations of Concordia
Colleges academic integrity and ethics policies are very serious and documentation of
violations will be forwarded to the office of the Dean of Students where records are kept
for five years after the student graduates or withdraws from the college. Violations may
subject you to disciplinary action including the following: receiving a failing grade on an
assignment or examination; receiving a failing grade for the course; and/or suspension or
expulsion from the program and/or college. Refer to the Student Guide section on
Academic Integrity and Ethics for complete policies.

NUR 314-A Acute Care of the Adult Patient I

Academic Integrity All students are expected to comply with Concordia Colleges and
the Division of Nursings Academic Integrity Policy. Plagiarism is the use of work by
another as ones own. Cheating is the use of aides or the theft of information from
another. Both of these activities violate the premise of academic integrity and
professional nursing standards. Academic dishonesty in any form will result in
disciplinary action including but not limited to course failure. Students are responsible to
refer to the Undergraduate Nursing Handbook, 2015 and the College Student Handbook.
Accommodations for Students with Documented Disabilities
Concordia College complies with Section 504 of the Rehabilitation Act of 1973 and the
Americans with Disabilities Act of 1990 as amended by the ADA Amendments Act of
2008. Students with disabilities who need special accommodations must submit
documentation of the disability to the Concordia Connection Program in order for
reasonable accommodations to be granted. Students are encouraged to notify their
instructors and the Connection Program as soon as they determine accommodations are
necessary; however, documentation will be reviewed upon receipt at any point in the
semester. The Connection Program will partner with students to determine the
appropriate accommodations and, in cooperation with the instructor, will work to provide
all students with a fair opportunity to perform in the particular class. Specific details of
the disability will remain confidential between the student and the Connection Program,
unless the student chooses to disclose or there is legitimate academic need for disclosure
on a case-by-case basis.
Attendance
Attendance is expected for all class sessions including both lecture and
clinical/simulation laboratory sessions (as applicable to the course) for successful course
completion. All students are required to be punctual for all lecture and laboratory
sessions. Students are responsible for all missed work. Instructors are under no
obligation to provide make-up quizzes or examinations or to extend deadlines. 100%
attendance is required for all lab/clinical/simulation rotations (refer to the Nursing
Student Handbook).
College and Program Policies: Refer to Nursing Program and College Handbook

REQUIRED TEXTBOOKS:

Ackley, B., & Ladwig, G. (2014). Nursing Diagnosis Handbook, (10th Ed).
Philadelphia: Elsevier Mosby.
Deglin, J. & Vallerand, A. (2014). Daviss Drug Guide for Nurses, (14th Ed).
Philadelphia: F. A. Davis Company.
Halter, M.J. (Ed.) (2014). Varcarolis Foundations of Psychiatric-Mental Health
Nursing (7th ed.). St. Louis: Elsevier-Saunders.

NUR 314-A Acute Care of the Adult Patient I

Lewis, S., Dirksen, S., Heitkemper, M. & Bucher, L. (2014). Medical-Surgical Nursing,
(9th Ed.). St. Louis: Elsevier Inc.
Pagana, K. & Pagana, T. (2015). Mosbys Laboratory and Diagnostic Test Reference
(12th ed.). Philadelphia: Elsevier Mosby.
Gray-Morris, D.C. (2013). Calculate with Confidence (6th ed.). Philadelphia: Elsevier
Mosby.
RECOMMENDED:
Potter, P & Perry, A. (2012). Fundamentals of Nursing, (8th Ed.). Philadelphia: Elsevier Mosby

NUR 314-A Acute Care of the Adult Patient I

Week
Week I
October 14
8:30 to 11 am
Ms. Alfano

Week 2
October 19
8:30 to 11 am
Dr. Alfano
Oct. 21
8:30 to 11 am
Ms. Alfano

Week 3
October 26
8:30 to 11 am
Ms. Orlofsky
October 28
8:30 to 11 am
Ms. Orlofsky

Content
I Management of Perioperative Patients
A. Categories and Purposes of Surgery
B. Surgical Settings
C. Preoperative Assessment and Teaching
D. Members of the Surgical Team
E. Preparation of the Surgical Suite and Team
and Team Safety
F. Anesthesia
G. Care of the patient in the Intraoperative Period
H. Post-operative care
II. Care of patients with Problems with Oxygenation

Preparation for Class

Lewis, S., Dirksen, S.,

Heitkemper, M. & Bucher, L.
(2014). Medical-Surgical
Nursing, 9th Ed. St. Louis:
Elsevier Inc
Chapters 18, 19, 20

Lewis & Dirksen:

A. Care of Patients with Infectious Resp. Problems
1. Pneumonia
2. Pulmonary tuberculosis

Chapter 28, pp 551-553

B.

Lewis & Dirksen:

Care of Patients with Noninfectious

Lower Respiratory Problems
1. Chronic airflow limitation
a. Asthma
b. COPD

Exam 1 Oct. 28 Wednesday 2:20 to 3:30 Content from

Weeks 1 & 2
C.
Care of Patients with Critical Acute
Respiratory Problems
1. Pulmonary embolism
2. Acute Respiratory Failure & Acute Respiratory
Distress Syndrome
1. Care of the Patient on a Ventilator

Chapter 29, pp. 560-601; 607-608.

Lewis & Dirksen:

Chapter 28 - pp. 551-553
Chapter 68
Chapter 66, pp. 1613-1629
Lewis & Dirksen
Chapters 30 & 31

D. Hematologic System
1. Red blood cell disorders
2. Platelet disorders
3. Transfusion therapy
Week 4
Nov 2
8:30 to 11 am
Ms. Kulk
Nov 4
8:30 to 11 am
Ms. Kulk

III. Psychosocial Needs of Medical Surgical Patients

A. Care of the Patient with Anxiety and Fear
1. Generalized Anxiety Disorder
2. Phobias
3. Panic Disorder
4. Post-traumatic Stress Disorder
5. Obsessive-Compulsive Disorder
B. Loss, Grief, and Depression
1. Normal grief reactions & coping process
2. Depressive Disorders
3. Suicide

Halter, M. (2014) Varcaroliss

Foundations of Psychiatric Mental
Health Nursing, A Clinical
Approach.
Chapter 15

Chapter 14
Chapter 25

NUR 314-A Acute Care of the Adult Patient I

Week
Week 5
November 9
8:30 to 11 am
Ms. Alfano

November 11
8:30 to 11 am
Ms. Orlofsky
Week 6
November 16
8:30 to 11 am
Ms. Orlofsky
November 18
8:30 to 11 am
Ms. Orlofsky

Content
Exam II November 10th Tuesday 2:20 to 3:20
Content from Weeks 3 & 4
IV. Care of patients with Problems in Cardiac Output and
Tissue Perfusion
A. Care of the Patients with Shock
1. Oxygenation and Tissue Perfusion
2. Types of shock
3. Care of the Patient Experiencing
Hypovolemic Shock
4. Care of the Patient with Sepsis and Septic
Shock
C. Care of Patients with Vascular Problems
1. Arteriosclerosis and atherosclerosis
2. Hypertension
D. Care of Patients with Acute Coronary Syndromes
1. Coronary artery disease
2. Angina
3. Myocardial infarction
E. Care of Patients with Dysrhythmias
1 Normal rhythms
2. Atrial dysrhythmias
3. Ventricular dysrhythmias

Preparation for Class

Lewis & Dirksen:
Review Chapter 17
Chapter 67

Lewis & Dirksen:

Chapter 34
Chapter 33

Lewis & Dirksen:

Chapter 34

Lewis & Dirksen:

Chapter 36

NUR 314-A Acute Care of the Adult Patient I

Week
Week 7
November 23
8:30 to 11 am
Dr. Flaherty
Week 8
November 30
8:30 to 11 am
Dr. Flaherty

Content
V. Care of patients with Central Nervous and
Peripheral Nervous System Disorders
1. Guillain-Barre
2. Myasthenia Gravis
3. Multiple Sclerosis
VI. Care of patients with Traumatic Brain Injuries and
Central Nervous System Injuries/Problems
A. Traumatic Brain Injury

1. Incidence/risk factors
2. Pathophysiology
a. Types of traumatic brain injury
b. Intracranial Pressure
c. Cerebral Perfusion
3. Nursing care
a. Acute care
b. Rehabilitation: promoting maximum
functional, cognitive, memory,
judgment, and emotional stability
levels.
4. Care of client experiencing coma
5. Community Support Systems & Research
B. Care of the patient with seizures

1. Types of Seizures
2. Treatments & Nursing Care
3. Safety precautions
December 2
8:30 to 11 am
Dr. Flaherty

C. Spinal Cord Injury

1. Incidence/risk factors
2. Pathology
a. Levels of injury and related functional
levels
b. Neurological impairment
3. Nursing care
a. Acute care
b. Rehabilitation: promotion of
maximum functional levels &
prevention/management of
complications
4. Community support systems & research

December 2nd
Wednesday
December 7th
Monday

ATI Proctored Exam: 3:00 to 4:30 Room TBA

TBA

Med Math Calculation Exam for NUR 315

Final Exam: 2:30 4:00 pm, Room 201

Content from Weeks 5, 6, 7, & 8 will be on the final exam.

Preparation for Class

Lewis & Dirksen:
Chapter 61, pp. 1467-1468
Chapter 59, pp. 1437-1439
Chapter 59, pp. 1428-1432
Lewis & Dirksen:
Review Chapter 56
Lewis & Dirksen:
Chapter 57, pp. 1368-1375

Lewis & Dirksen:

Chapter 59, pp. 1419-1427

Lewis & Dirksen::

Chapter 61, pp. 1469-1485.