County College of Morris

NUR 121
Fundamentals of Nursing

STUDY GUIDE

Revised 8.10.16

TABLE OF CONTENTS

Unit

Topics

Page

CCM Nursing Program

2A

Safe Environment: Environmental Hazard.....

2B

Safe Environment: Hygiene.

Oxygenation.

Nursing Process

11

Safe Environment: Infection Prevention Control.

13

Oral Communication.

15

Assessment of the Older Adult.

17

Nursing Health History...

20

Physical Assessment

22

10

Safe Environment: Pharmacology/Medication Administration

24

11

Nutrition: Fluid and Electrolyte Balance..

27

12

Elimination: Bowel & Bladder......

29

13

Safe Environment: Skin Integrity and Wound Healing

32

14

Rest and Activity: Activity, Rest & Sleep

34

15

Nutrition: Oral and Enteral..

37

16

Young & Middle Adult; Gender Identity..

40

17

Psychosocial: Self-Concept, Stress, & Coping .

41

18

Psychosocial: Loss, Death, & Grief.

44

Revised 8.10.16

UNIT 1
TOPIC:

CCM Nursing Program

PURPOSE:

Upon completion of this unit the student will describe CCMs organizing
framework, including the basic health needs of an individual (PERSON),
the wellness-illness continuum, the nursing implications of unmet needs
and the nursing process.

UNIT OBJECTIVES:
1. Explain the philosophy of the CCM Nursing Program.
2. Describe the major components of any nursing curriculum design.
Man
Health
Nursing
Environment
3. Identify the three major concepts of the CCM nursing programs organizing
framework and discuss their relationship to the program philosophy and
components of curriculum design.
P-E-R-S-O-N
Wellness-Illness continuum
Nursing Process
4. Explain Maslows Hierarchy of needs and its relationship to CCMs organizing
framework.
5. Identify each of the physiological needs in Maslows hierarchy.
6. Define each part of the P-E-R-S-O-N acronym and discuss its relationship to man.
7. Identify four specific groups of patients who will require assistance in meeting
Physiological needs.
8. Explain the component, Health in terms of the wellness-illness continuum.
9. How does the American Nurse Association (ANA) define nursing?
10. Define the Nursing Process.
11. Describe the Basic Human Needs Model and its relationship to CCMs organizing
framework.
12. List and explain each step of the nursing process in the appropriate sequence.

Revised 8.10.16

13. Differentiate between a norm and a deviation when assessing a patients health need.
14. Define 3 Levels of Preventive Care.
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention

REQUIRED RESOURCES:
Taylor:
Chapter 3: Health, Illness and Disparities
Chapter 4: Health of the Individual, Family and Community
Chapter 10: Blended Competencies, Clinical Reasoning and Processes of PersonCentered Care
CCM Nursing Students Handbook: Philosophy

Revised 8.10.16

UNIT 2A
HEALTH NEED:

Safety

TOPIC:

Safe Environment - Environmental Hazards

PURPOSE:

Upon completion of this unit the student will assess a safe environment;
identify common safety hazards; describe the nurses role in developing
strategies to assist the patient in maintaining a safe environment. Assess
a patient for sensory alterations.

UNIT OBJECTIVES:
1. Define the following terms:
asphyxiation
bed alarm
bioterrorism
disaster
environment
ground
immunization
Intimate Partner Violence (IPV)
medical asepsis
nuclear terrorism
pathogen

Personal Protective Equipment (PPE)

Poison Control Center
poison
QSEN
restraint
safety event report
sensory deprivation
sensory overload
sentinel event
standard precautions

2. Identify factors that affect safety in a persons environment.

3. Identify patients at risk for injury.
4. Describe nursing interventions to prevent injury to patients in healthcare settings.
5. Evaluate the effectiveness of safety interventions.
6. Describe the use and rationale of Standard Precautions and PPE in the healthcare
setting.
7. Discuss the importance of Hand Hygiene.
8. Describe the proper use of restraints and list ways to establish a restraint free
environment.
9. Describe nursing interventions to be followed when an individual has ingested a
poison.
10. List interventions for preventing sensory deprivation and controlling sensory
overload.
Revised 8.10.16

11. Identify the procedure for patient identification using the Joint Commission
National Safety Goals.

REQUIRED RESOURCES:
Taylor:
Chapter 26
pp. 686-697
pp. 704-724 (start with Adult) Review Chart 26-1 Adults & Older
adults
Chapter 23
pp.538-544 (Implementing Medical Asepsis) Preventing Healthcare
Associated Infections
pp. 548-553 Using PPE (omit donning and removing sterile gloves)
Nursing Diagnosis:
Risk for Falls
Website:
Joint Commission National Patient Safety Goals: 2016
http://www.jointcommission.org
QSEN: qsen.org/competencies/pre-licensure-ksas/

Revised 8.10.16

UNIT 2B
HEALTH NEED:

Safety

TOPIC:

Safe Environment - Hygiene

PURPOSE:

Upon completion of this unit the student will identify the

components of hygiene care, the techniques associated with
hygienic care, as well as the factors influencing hygienic practice.

UNIT OBJECTIVES:
1. Define the following terms:
alopecia
cerumen
halitosis
complete bed bath
perineal care
stomatitis
cheilosis

caries
gingivitis
glossitis
edentulous
partial bed bath
xerostomia

2. Describe the factors that influence hygienic practice, including cultural factors.
3. List assessment factors used to determine a patients ability to perform personal
hygienic care.
4. Describe the following hygienic care and identify its rationale.
a.
b.
c.
d.
e.
f.

Bed bath
Tub/whirlpool/shower
Oral care
Back rub
Perineal care
Hair care

5. Identify factors the nurse can control to create a comfortable environment for the
patient during hygienic care.
6. Identify activities the nurse can employ to promote proper hygiene techniques with
patients and their families.
7. Identify patients who are at risk for developing impaired skin integrity.
8. Identify the aspect or aspects of hygienic care the nurse can delegate to nonprofessional staff.

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Critical Thinking:
What factors should the nurse consider in assigning hygienic care to nonprofessional staff?

REQUIRED RESOURCES:
Taylor:
Chapter 30: Hygiene
Nursing Diagnosis:
Self-care Deficit

Revised 8.10.16

UNIT 3
HEALTH NEED:

Oxygen

TOPIC:

Oxygenation

PURPOSE:

Upon completion of this unit the student will have the necessary
information needed to assess whether an individual is adequately
meeting his/her need for oxygen. Critical to the assessment is the
measurement and interpretation of vital signs and selected laboratory
data.

UNIT OBJECTIVES:
1. Define the following terms and identify which are deviations:
adventitious
hypothermia
afebrile
hypoventilation
alveoli
hypoxemia
angina
hypoxia
antipyretic
incentive spirometer
antitussives
ischemia
apical rate
Korotkoff sounds
apnea
metered dose inhaler
atelectasis
myocardial infarction
blood pressure
nebulizer
bradycardia
orthopnea
bradypnea
orthostatic hypotension
bronchial
pallor
bronchodilator
perfusion
bronchovesicular
peripheral pulse
crackles
pulmonary ventilation
cyanosis
pulse
diastolic pressure
pulse deficit
diffusion
pulse oximetry
dry powder inhaler
pulse pressure
dyspnea
respiration
dysrhythmia
rhonchi
eupnea
systolic pressure
expectorant
tachycardis
febrile
tachypnea
fever
temperature
hypertension
vesicular
hyperthermia
vital signs
hyperventilation
wheezes
hypotension

Revised 8.10.16

2. Describe the principles of respiratory and cardiovascular anatomy and physiology.

3. Describe the function and role of the respiratory and cardiovascular systems in
oxygenation.
4. Describe age-related differences that influence the care of patients with
oxygenation problems.
5. Identify factors that affect respiratory and cardiovascular function.
6. Perform a cardiopulmonary assessment using appropriate interview questions and
physical assessment skills.
7. Develop nursing diagnoses that correctly identify problems that may be treated by
independent nursing interventions.
8. Describe nursing strategies to promote adequate oxygenation and identify their
rationale.
9. Plan, implement, and evaluate nursing care related to select nursing diagnoses
involving oxygenation problems.
10. Explain the physiologic processes involved in homeostatic regulation of
temperature, pulse, respirations, and blood pressure.
11. Compare and contrast factors that increase or decrease body temperature, pulse,
respirations, and blood pressure.
12. Identify sites for assessing temperature, pulse, and blood pressure.
13. Assess temperature, pulse, respirations, and blood pressure accurately.
14. Demonstrate knowledge of the normal ranges for temperature, pulse, respirations,
and blood pressure across the lifespan.
15. Provide information to patients about measuring pulse and blood pressure.

REQUIRED RESOURCES:
Taylor:
Chapter 24: Vital Signs
Chapter 28: Oxygenation and Perfusion
Omit pp. 1430-1437
Omit Skills 38-2, 38-5, and 38-6
Omit Tables 38-2 and 38-3
Revised 8.10.16

Kee & Hayes:

Table 40-4 codeine, dextromethorphan, guaifenesin
Table 41-1 albuterol, ipratropium with albuterol, and tiotropium
Table 41-4 fluticasone and salmeterol
For the above medications, know the generic and brand names, and uses
and considerations.

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10

UNIT 4

TOPIC:

Nursing Process

PURPOSE:

Upon completion of this unit the student will identify the key concepts
associated with the nursing process as applied in the practice of nursing.

UNIT OBJECTIVES:
1. Define the following terms:
Actual Nursing Diagnosis
Assess
Clinical Pathways
Collaborative Interventions
Computerized Plans of Care
Consultation
Data
Data Cluster
Database
Defining Characteristics
Delegation
Discharge Planning
Emergency Assessment
Evaluate
Evaluating
Evaluative Statement
Expected Outcomes
Focused Assessment
Goal
Health Problem
Implement
Implementing
Initial Assessment

Interview
Medical Diagnosis
North American Nursing Diagnosis Association
(NANDA)
Nurse Initiated Intervention
Nursing Diagnoses
Nursing History
Nursing Intervention
Nursing Process
Objective Data
Ongoing Planning
Outcome Evaluation
Outcome Identification
Patient Outcome
Physical Assessment
Physician Initiated Intervention
Planning
Protocols
Risk Nursing Diagnosis
Standardized Care Plans
Standards
Standing Orders
Subjective Data
Unlicensed Assistive Personnel (UAP)

2. Describe the Nursing Process and each one of its steps.

3. List three patient benefits and three nursing benefits of using the Nursing Process
correctly.
4. Differentiate between objective and subjective data.
5. Identify five sources of patient data useful to the nurse.
6. Describe the purpose of nursing observation, interview and physical assessment.
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11

7. Describe the purpose and benefits of outcome identification and planning.

8. Prioritize patient health problems.
9. Develop a plan of nursing care with properly constructed outcomes and related nursing
interventions.
10. Differentiate nurse-initiated interventions, physician initiated interventions, and
collaborative interventions.
11. Use ongoing data collection to determine how to safely and effectively implement a plan
of care.
12. Explain reassessment after nursing intervention is important.
13. Describe the risks and responsibilities of delegating nursing interventions.
14. Describe evaluation, its purpose and its relation to the other steps of the nursing process.
15. Use the patients response to the plan of care to modify the plan as needed.

REQUIRED RESOURCES:
Taylor:
Chapter 10: Blended Competencies, Clinical Reasoning and Processes of Person
Center Care - start on page 213 Nursing Process
(omit pp. 219-223 Concept Mapping and Reflective Practice)
Review Box 10-9; p. 220
Chapter 11: Assessing
Chapter 12: Diagnosing
Chapter 13: Outcome Identification and Planning
Chapter 14: Implementing
Chapter 15: Evaluating (up to p. 332. Omit Evaluative Programs)

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12

UNIT 5
HEALTH NEED:

Safety

TOPIC:

Safe Environment - Infection Prevention and Control

PURPOSE:

Upon completion of this unit, the student will discuss the nature and chain of
infection and the factors that influence infection prevention and control.

UNIT OBJECTIVES:
1. Define the following terms:
aerobic
anaerobic
antibody
antigen
antimicrobial
artificial immunity
asepsis
asymptomatic
colonization
disinfection
endogenous infection
exogenous
exudate
hand washing
Healthcare-Associated
Infections (HAIs)
immunizations
immunocompromised
inflammatory response
isolation
leukocytosis
localized

medical asepsis
microorganisms
Multi-drug Resistant Organisms (MDRO)
natural immunity
normal flora
passive immunity
pathogen
prophylaxis
purulent
sanguinous
serous
standard precautions
sterile field
surgical asepsis
susceptibility
systemic
transmission-based precautions
vaccine
vector
virulence
virus

2. Explain the infection cycle.

3. List the stages of an infection.
4. Identify patients at risk for developing an infection.
5. Describe nursing interventions used to break the chain of infection.
6. Identify situations in which hand hygiene is indicated.
7. Identify multidrug-resistant organisms that are prevalent in hospitalized patients and
community settings.
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13

8. List nursing diagnoses for a patient who has or is at risk for infection.
9. Describe strategies for implementing CDC guidelines for standard and transmission-based
precautions when caring for patients.
10. Implement recommended techniques for medical and surgical asepsis.

REQUIRED RESOURCES:
Taylor:
Chapter 23 Asepsis & Infection Control
Kee & Hayes:
p. 418 Glycopeptides (Vancomycin)
include: side effects, adverse reactions and drug interactions
p. 424-426 Fluoroquinolones ciprofloxacin, levofloxacin
p. 446 Metronidazole
Website:
2016 National Patient Safety Goals
http://www.jointcommission.org

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14

UNIT 6
TOPIC:

Oral Communication

PURPOSE:

Upon completion of this unit the student will identify the components of the
communication process and its role in the nurse-patient relationship.

UNIT OBJECTIVES:
1. Define the following terms:
Active listening
Assertiveness
Autonomy
Channels
Communication
Empathy
Environment
Feedback
Communication, interpersonal
Communication, intrapersonal
Message
Nonverbal communication
Perception
Perceptual biases

Presence
Public communication
Receiver
Referent
SBAR
Sender
Small-group communication
Social Media
Sympathy
Therapeutic communication
Techniques
Variables, interpersonal
Verbal communication

2. Describe the communication process.

3. Identify and discuss levels of communication.
4. Discuss the various aspects of verbal communication.
5. Identify and give examples of interpersonal variables which influence
communication.
6. Discuss the various means of non-verbal communication.
7. List nursing actions that take place in each zone of personal space and touch.
8. List and discuss the elements of professional communication including 2015 National
Patient Safety Goals Improve Staff Communication.
9. Identify the factors the nurse assesses that influence a patients communication.
10. Identify and give examples of techniques that promote therapeutic communication.
11. Identify and give examples of techniques that inhibit effective communication.

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15

12. List the characteristics of a helping relationship.

13. Describe the phases of a helping relationship.
14. List three methods of environmental control to facilitate interpersonal communication.
15. Use effective communication techniques when interacting with patients from different
cultures.
16. Discuss adapting communication techniques for patients that have conditions that
impair their communication.

REQUIRED RESOURCES:
Taylor:
Chapter 20: Communication
Nursing Diagnosis:
Impaired Verbal Communication

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16

UNIT 7
HEALTH NEED:

P.E.R.S.O.N.

TOPIC:

Assessment of the Older Adult

PURPOSE:

Upon completion of this unit the student will have the knowledge necessary to
assess the health needs of older adults and to assist this population to meet their
P.E.R.S.O.N. needs.

UNIT OBJECTIVES:
1. Define the following terms:
ageism
Alzheimers Disease
Cascade latrogenesis
delirium
dementia
depression
despair
developmental tasks
functional health

gerontological nursing
gerontology
integrity
polypharmacy
reality orientation
reminiscence
sundowning syndrome
validation therapy

2. Discuss the demographics and variability of older adults in our society and the
implications for health care.
3. Identify the myths and stereotypes of aging in our society.
4. Discuss the developmental crisis of ego integrity vs. despair.
5. Describe the major developmental tasks of the older adult.
6. Describe the major health concerns of older adults.
7. Describe health prevention and maintenance activities appropriate for old adults
including: screening activities and immunizations.
8. Identify the P.E.R.S.O.N. norms and deviations for the older adult.
a. Psychosocial Assessment:
Describe changes in self-concept and body image.
Describe the potential changes in:
Orientation
Memory
Thought
Describe adjustment to retirement and fixed income.
Describe techniques of reality orientation, validation therapy and
reminiscence and how the nurse uses these interventions in the health care
setting.
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17

b. Elimination assessment
Determine the normal bowel and bladder patterns of the older adult.
Describe the changes in the genitourinary tract and the gastrointestinal tract.
Identify the normal sexual patterns of the older adult.
Identify potential changes in toileting ability.
c. Rest and Activity assessment
Describe the exercise requirements for an older adult.
Describe the requirements for rest and sleep.
Identify the norm for the older adult for:
muscle strength and tone
posture and skeletal
gait
motor function
range of motion
coordination
balance
Identify potential need for mobility/assistive devices.
Describe the older adults response to pain.
d. Safe Environment assessment
Identify the normal changes in the senses of older adult.
Identify the changes in skin integrity of the older adult.
Identify potential needs for general hygiene.
Identify potential changes in WBC.
Identify potential changes in temperature regulation.
Explain the physiologic changes of the aging process that have a major
effect on drug therapy.
e. Oxygen assessment
Determine the normal vital signs for the older adult.
Describe the changes in the respiratory and cardiovascular systems.
f. Nutrition assessment
Identify the normal nutritional requirements of the older adult.
Identify the fluid balance requirements of the older adult.
Identify the potential changes in ability to chew, swallow, tolerate food and
feed self.
9. Describe therapeutic nursing interventions related to physiological, cognitive and
psychosocial changes of aging.
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18

10. Identify the community-based agencies and institutional health care services that assist
the older adult.
11. Compare the clinical features of delirium, dementia, and depression.
12. Describe the progression of dementia and appropriate nursing interventions.
13. Discuss polypharmacy in older adults and the challenges of safe medication use.
14. Describe the action, indication and nursing implications (side effects, assessments and
patient teaching) for the following medication:
Classification:
Acetyl Cholinesterase inhibitor
Prototype:
Tacrine (Cognex); Donepezil (Aricept)
15. Delegation & Critical Thinking:
The nurses aide reports to you that the 82 year old patient in Room 402B is a dirty
old man because he states he misses having sex with his girlfriend since he has been
in the hospital for 3 weeks. How would you respond to the nurses aide? What nursing
interventions for the patient might be appropriate?

REQUIRED RESOURCES:
Taylor:
Chapter 17: Developmental Concepts (Focus on Old Age)
Chapter 19: The Aging Adult
Kee & Hayes: pp. 88-97 (Geriatric Pharmacology)
pp. 321-325 (Alzheimers Disease)
Nursing Diagnosis:
Chronic Confusion
Websites:
http://consultgerirn.org
www.nursingcenter.com/AJNolderadults
www.alz.org

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19

UNIT 8
HEALTH NEED:

P.E.R.S.O.N.

TOPIC:

Nursing Health History

PURPOSE:

Upon completion of this unit the student will be able to obtain a health history
using effective interviewing techniques.

UNIT OBJECTIVES:
1. Describe the essential characteristics for conducting efficient nursing assessment.
2. Identify effective communication and interviewing techniques to collect and validate
information.
3. Describe the importance of understanding cultural diversity when conducting health
assessment.
4. Describe the nurse-client helping relationship.
5. State the objectives of a nursing health history.
6. Describe the components of a health history.
7. List questions the nurse should ask for each component of health history.
8. Discuss health promotion and health teaching to incorporate during health history taking.
9. Describe assessment categories and rationale when obtaining nursing history during the
Review of Systems (ROS):
Integumentary System: Skin, Hair, Nails
Head & Neck
Eyes
Ears
Nose
Mouth & Throat
Musculoskeletal system
Endocrine system
Neurologic system
Cardiovascular system
Pulmonary system
Gastrointestinal system
Genitourinary system
Male reproductive
Female reproductive
Psychological status
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20

10. Document data gathered during health history taking using the appropriate tool.

REQUIRED RESOURCES:
Taylor:
Chapter 11: Assessing
Chapter 20: Communicator
Chapter 25: Health Assessment: Health History

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21

UNIT 9
HEALTH NEED:

P.E.R.S.O.N.

TOPIC:

Physical Assessment

PURPOSE:

Upon completion of this unit the student will have knowledge and skills
necessary to perform a basic head to toe physical assessment.

UNIT OBJECTIVES:
1. Define the following terms:
Acromegaly
Adventitious sounds
Allens test
Alopecia
Aneurysm
Apical impulse
Arcus senilis
Aphasia
Atherosclerosis
Atrophied
Borborygmi
Bruit
Caries
Cerumen
Cherry angiomas
Cirrhosis
Clubbing
Comatose
Cyanosis
Cystocele
Dermatitis
Distension
Dysrhythmia
Ecchymosis
Ectropion
Edema

Entropion
Erythema
Excoriation
Exostosis
Exophthalmos
Glasgow Coma Scale
(GCS)
Goniometer
Hemorrhoids
Hernia
Hirsutism
Hydrocephalus
Hypertonicity
Hypotonicity
Indurated
Integument
Jaundice
Lethargic
Leukoplakia
Murmurs
Nystagmus
Obtunded
Occlusion
Ophthalmoscope

Orthopnea
Otoscope
Ototoxicity
Papanicolaou (pap smear)
Paralytic ileus
Peristalsis
PERRLA
Petechiae
Phlebitis
Pigmentation
Point of Maximal
Impulse (PMI)
Polyps
Ptosis
Pulse deficit
Rectocele
Stenosis
Striae
Stuporous
Syncope
Tactile fremitus
Thrill
Turgor
Varicosities

2. Describe the locations and proper terminologies of anatomical body parts and internal
organs.
3. Discuss the purpose of physical assessment.
4. Describe the techniques of assessment skills: inspection, palpation, percussion,
auscultation, and olfaction.

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22

5. Describe proper preparation of the environment, equipment, and client for physical
assessment.
6. Identify the components of the general survey and expected findings.
7. Discuss ways to incorporate health teaching into the examination.
8. Identify self-screening examinations commonly performed by clients.
9. Describe the appropriate techniques used when performing a head to toe examination of
the following.
a. Integument
b. Head and Neck
c. Thorax (chest) and Lungs
d. Heart
e. Vascular System
f. Breast
g. Abdomen
h. Female genitalia and reproductive tract
i. Male genitalia
j. Rectum and Anus
k. Musculoskeletal System
l. Neurologic System
10. Identify expected normal findings when performing physical assessment of the adult.
11. Describe common changes associated with aging.
12. Describe the different Levels of Consciousness (LOC).
a. Alert
b. Lethargic
c. Stuporous
d. Obtunded
e. Comatose
13. Describe the components of the Glasgow Coma Scale and corresponding numeric values.
14. Describe the methods used to communicate abnormal findings to appropriate
personnel.
15. Document physical assessment findings using appropriate terminologies and
documentation tool.

REQUIRED RESOURCES:
Taylor:
Chapter 25: Health Assessment: Physical Examination
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UNIT 10
HEALTH NEED:

Safety

TOPIC:

Safe Environment - Pharmacology/Medication Administration

PURPOSE:

Upon completion of this unit the student is introduced to the study

of pharmacology and the nursing responsibilities associated with
safe medication administrations.

UNIT OBJECTIVES:
1. Define the following terms:
agonist
antagonist
antidote
bioavailablity
blood-brain barrier
half-life
loading dose

OTC medications
pharmacogenetics
pharmacology
plasma protein binding
polypharmacy

2. Differentiate the nomenclature of drugs:

a. official name
b. generic name
c. trade or brand name
3. Discuss drug legislation in the United States.
4. Identify several references where the nurse can obtain information about drugs.
5. Describe the following phases of drug action:
a. Pharmaceutic Phase
b. Pharmacokinetic Phase
i. Absorption
ii. Distribution
iii. Biotransformation
iv. Elimination
c. Pharmacodynamic Phase
i. Onset, peak and duration of actions
ii. Receptors
iii. Therapeutic Index and range
iv. Peak and trough levels
6. Identify the variables that influence drug action.

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7. Define and describe the various types of drug actions:

a. Therapeutic effects
b. Side effects
c. Toxic effects
d. Adverse Drug Events
e. Adverse Drug Reactions
f. Idiosyncratic reactions
g. Allergic reactions
8. Describe the following drug interactions and indicate nursing responsibilities of each:
a. Drug-drug interactions
b. Drug-food interactions
c. Drug-laboratory interactions
9. Discuss the effects of the following drug interactions:
a. additive
b. synergistic/potentiation
c. antagonistic
10. Describe the following routes of administration for drugs and indicate advantages and
disadvantages for each:
oral
parenteral
buccal
subcutaneous
sublingual
intramuscular
topical
intradermal
otic
intravenous
rectal
vaginal
nasal
inhalation
ophthalmic
transdermal
11. Differentiate non-specific drug from a non-selective drug.
12. List the components of a complete medication order.
13. Define and indicate the rationale for the various types of medication orders:
pre-op
standing
prn
stat
on call
now
single
14. Review the systems of drug measurement including:
metric
apothecary
15. Identify nursing responsibilities in relation to the 3 checks and rights of safe
medication administration.

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25

16. Discuss the nursing responsibilities associated with the administration of controlled
substances.
17. Explain the nurses responsibilities in the event of a medication error.
18. Identify nursing diagnosis associated with medication administration.
19. Discuss helpful points when teaching patients regarding safe medication practices to
include discharge instructions.
20. Discuss the physiological changes of aging and the special considerations to remember
when administering medications to the older adults.
21. Discuss the cultural and genetic considerations regarding medication administration.
22. Identify the Joint Commission medical abbreviation Do Not Use List.
23. Discuss the National Patient Safety Goals (NPSG) to improve safe medication
administration and management.
a. Goal 1 Improve the accuracy of patient identification.
b. Goal 3 Improve the safety of using medications.
i. NPSG.03.04.01 Medication labeling
ii. NPSG.03.05.01 Anticoagulation safety practices
iii. NPSG.03.06.01 Accurate patient medication information: Medication
reconciliation

REQUIRED RESOURCES:
Taylor:
Chapter 31: Medication Administration
Omit administering medications intravenously
Kee & Hayes:
Unit I Chapters 1, 2, 3 and 4
Unit II Chapters 11, 12 and 13
Websites:
National Patient Safety Goals:
http://www.jointcommission.org
Joint Commission Official Do Not Use List:
http://www.jointcommission.org/assets/1/18/Do_Not_Use_List.pdf
Institute for Safe Medication Practices:
http://www.ismp.org
Food and Drug Administration
http://www.fda.gov
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UNIT 11
HEALTH NEED:

Nutrition

TOPIC:

Fluid and Electrolyte Balance

PURPOSE:

Upon completion of this unit the student will identify the mechanisms of fluid
and electrolyte balance and the assessment and nursing care of patients with
imbalances.

UNIT OBJECTIVES:
1. Define the following terms:
Active Transport
Anion
Capillary Filtration
Cation
Colloid Osmotic Pressure
Dehydration
Diffusion
Edema
Electrolytes
Extracellular Fluid (ECF)
Fluid Volume Excess (ECF)

Fluid Volume Deficit (FVD)

Homeostasis
Hydrostatic Pressure
Hypertonic
Hypotonic
Intracellular Fluid (ICF)
Isotonic
Osmolarity
Osmosis
Solutes
Solvents
Specific Gravity

2. Describe the location and functions of body fluids, including factors that affect variations in
fluid compartments.
3. Describe the functions, regulation, sources and losses of the main electrolytes of the body.
Include Sodium (Na+), Potassium (K+), Calcium (Ca++), Magnesium (Mg++),
Chloride (Cl-), Phosphae (PO-).
4. Explain the principles of osmosis, diffusion, active transport and filtration.
5. Describe how thirst and the organs of homeostasis (kidneys, heart and blood vessels, lungs,
adrenal glands, pituitary gland, parathyroid glands) function to maintain fluid homeostasis.
6. Identify the etiologies and defining characteristics for common fluid and electrolyte
imbalances.
7. Perform a fluid and electrolyte assessment.
8. Describe the role of dietary modification, modification of fluid intake, medication
administration, IV therapy, parenteral nutrition (TPN) in resolving fluid and electrolyte
imbalances.

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27

9. Assess, plan, implement and evaluate nursing care involving fluid and electrolyte
imbalances.
10. Describe and give examples of the three types of crystalloid solutions. Indicate its use and
expected effects on the patients fluid status.
a. Hypotonic
b. Hypertonic
c. Isotonic
11. Describe the purpose and complications related to venipuncture.
12. Describe the different types of vascular access devices (VAD).

REQUIRED RESOURCES:
Taylor:
Chapter 39: Fluid, Electrolyte and Acid-Base Balance
(Omit Acid Base Balance pp. 1479-1480, 1483-1484, Table 39-7)
(Omit Arterial Blood Gases pp. 1490-1491, Table 39-8)
(Omit Administering Blood and Blood Products pp. 1513-1515, Table 39-13)

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UNIT 12
HEALTH NEED:

Elimination

TOPIC:

Bowel and Bladder Elimination

PURPOSE:

Upon completion of this unit the student will identify the basic concepts
associated with the need for elimination and the nurses role in assisting an
individual to meet this need.

UNIT OBJECTIVES:
1. Define the following terms:
anuria
bacteriuria
cathartic
condom catheter
constipation
cystitis
defecation
diaphoresis
diarrhea
diuresis
dysuria
enuresis
feces
flatulence
frequency
glycosuria
hematuria
hemorrhoids
impaction
incontinence
ketonuria

laxative
melena
micturition
nocuria
occult blood
oliguria
peristalsis
perspiration
polyuria
proteinuria
pyuria
residual urine
retention
retention with overflow
sphincter
steatorrhea
stool
suprapubic
urgency
urosepsis
voiding

2. Review the anatomy and physiology of the renal system and the gastrointestinal system.
3. Describe an individuals need for elimination.
4. Describe the psychological and physiological factors that influence urinary and bowel
elimination process.
5. Describe the characteristics of normal urine/feces.
6. Describe nursing implications for common diagnostic examinations for urinary and
gastrointestinal tracts.

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29

7. Obtain a nursing history for a patient with urinary/bowel elimination problems.

8. Compare and contrast common alterations urinary elimination.
9. List four measures appropriate for promoting a patients normal urinary elimination.
10. Identify techniques that may be used to stimulate the micturition reflex.
11. Identify evidence-based practices to prevent indwelling catheter-associated urinary tract
infections (CAUTI): National Patient Safety Goal NPSG. 07.06.01
12. Describe the Valsalva maneuver and how it can be avoided.
13. Describe the risk factors for developing constipation.
14. Explain how high fiber diets promote bowel elimination.
15. Identify two problems associated with diarrhea.
16. Determine the possible cause of each fecal characteristic:
white or clay colored
black or tarry
red
melena
liquid consistency
narrow or pencil shapes
17. List factors to be included in a nursing history for a patient with altered elimination.
18. Outline five goals appropriate for a patient with bowel elimination problems.
19. Determine three ways to promote regular bowel habits.
20. Describe the action, indication and nursing implications for the following medication:
Classification:
urinary stimulant
Prototype:
bethanecol CI (Urecholine)

Revised 8.10.16

Classification:
Prototype:

urinary antispasmodics
oxybutynin (Ditropan)

Classification:
Prototype:

Anticholinergic
tolterodine lactrale (Detrol)

Classification:
Prototype:

antidiarrheal
diphenoxylate with atropine (Lomotil)

30

Classification:
Prototype:

laxatives/stimulant
bisacodyl (Dulcolox)

Classification:
Prototype:

laxatives/osmotics
magnesium hyproxide (Milk of Magnesia)

Classification:
Prototype:

laxative/bulk forming
Psyllium (Metamucil)

Classification:
Prototype:

laxative/emollient
docusate sodium (Colace)

REQUIRED RESOURCES:
Taylor:
Chapter 36: Urinary Elimination
Chapter 37: Bowel Elimination (omit care of ostomies)
Specimen Collection Techniques: see lab guide

Kee & Hayes:

Chapter 34: Drugs for Urinary Tract Disorders
Chapter 47: Drugs for Gastrointestinal Tract Disorders

Nursing Diagnosis:
Urinary Incontinence
Urinary Tract Infection
Bowel Incontinence
Constipation
Website:
National Patient Safety Goal:
http://www.jointcommission.org

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31

UNIT 13
HEALTH NEED:

Safety

TOPIC:

Safe Environment - Skin Integrity and Wound Care

PURPOSE:

Completion of this unit will provide the student with the necessary knowledge
to meet the patients safety need regarding skin and tissue integrity. The student
will have the necessary knowledge to understand the principles of surgical
asepsis.

UNIT OBJECTIVES:
1. Define the following terms:
approximate
aquathermia pad
blanching
collagen
darkly pigmented skin
debridment
dehiscence
dermis
desquamation
ecchymosis
edema
epidermis
epithelialization
eschar
evisceration
exudate
fibrin
fistula
friction
granulation tissue

hematoma
hemorrhage
ischemia
necrosis
negative pressure wound therapy (NPWT)
off-loading
pressure ulcer
primary intention
purulent
sanguinous
secondary intention
serosanguinous
serous
shear
Sitz bath
sloughing
subcutaneous tissue
surgical asepsis
sutures
wound

2. Review the anatomy and physiology of the skin.

3. Discuss the processes involved in wound healing.
4. Identify factors that affect wound healing.
5. Identify patients at risk for pressure ulcer development.
6. Describe the method of staging of pressure ulcers.

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32

7. Accurately assess and document the condition of wounds.

8. Provide nursing interventions to prevent pressure ulcers.
9. Implement appropriate dressing changes for different kinds of wounds.
10. Provide information to patients and caregivers for self-care of wounds at home.
11. Apply hot and cold therapy effectively and safely.

REQUIRED RESOURCES:
Taylor:
Chapter 31: Skin Integrity and Wound Care
Websites:
http://www.bradenscale.com/images/bradenscale.pdf
http://www.NPUAP.org The National Pressure Ulcer Advisory Panel website.
Excellent source for further information and guidelines.

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UNIT 14
HEALTH NEED:

Rest and Activity

TOPIC:

Activity, Rest and Sleep

PURPOSE:

Upon completion of this unit the student will acquire the knowledge necessary
to assess an individuals need for activity, rest and sleep. The student will learn
to use the principles of body mechanics to overcome the problems of
immobility. Concepts of acute and chronic pain are introduced.

UNIT OBJECTIVES:
1. Define the following terms:
abduction
Activities of Daily Living
(ADLs)
ambulation
adduction
ataxic gait
atrophy
bed rest
biological clock
body mechanics
center of gravity
circadian rhythm
circumduction
contracture
dyssomnias
external rotation
extension
flaccid
flexion
foot drop
gait
hyperextention

hypersomnolence
sedative-hypnotics
hypertrophy
sleep apnea
immobility
sleep hygiene
insomnia
internal rotation
kyphosis
lordosis
muscle tone
narcolepsy
nocturia
Non Rapid Eye Movement
(NREM)
osteoporosis
parasomnias
passive ROM
paralysis
paresis
patient care ergonomics
plantar flexion
posture
propioception
Range of Motion (ROM)
Rapid Eye Movement (REM)

2. Describe the role of the skeletal, muscular, and nervous systems in the physiology of
movement.
3. Identify variables that influence body alignment and mobility.
4. Describe the effects of exercise and immobility on major body systems.

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34

5. Assess body alignment, mobility, and activity tolerance, using appropriate interview and
assessment skills.
6. Develop nursing diagnoses that correctly identify mobility problems amenable to nursing
interventions.
7. Utilize principles of body mechanics when appropriate.
8. Use safe patient handling and movement techniques and equipment when positioning,
moving, lifting, and ambulating patients.
9. Plan, implement, and evaluate nursing care related to select nursing diagnoses involving
mobility problems.
10. Describe the functions and physiology of sleep.
11. Identify variables that influence rest and sleep.
12. Describe nursing implications that address age-related differences in the sleep cycle.
13. Perform a comprehensive sleep assessment using appropriate interview questions, a sleep
diary when indicated, and physical assessment skills.
14. Describe common sleep disorders, noting key assessment criteria.
15. Develop nursing diagnoses that correctly identify sleep problems that may be treated through
independent nursing interventions.
16. Describe nursing strategies to promote rest and sleep based on scientific rationale.
17. Plan, implement, and evaluate nursing care related to selected nursing diagnoses involving
sleep problems.
18. Describe the action, indication and nursing implications (side effects, assessments and
patient teaching) for the following medications:
Classifciation:
Sedative-hypnotic: Nonbenzodiazepine
Prototype:
zolpidem tartrate (Ambien) CSS IV
Classification:
Prototype:

Revised 8.10.16

Sedative-hypnotic: benzodiazepine
alprazolam (Xanax) CSS IV

35

REQUIRED RESOURCES:
Taylor:
Chapters 32: Activity
Chapter 33: Rest and Sleep
Kee & Hayes:
Chapter 21: Central Nervous System Depressants pp. 292-298 only
Website:
Morse Fall Scale
http://www.ahrq.gov/legacy/research/ltc/fallpxtoolkit/fallpxtool3h.htm

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UNIT 15
HEALTH NEED:

Nutrition

TOPIC:

Oral and Enteral Nutrition

PURPOSE:

Upon completion of this unit, the student will have the knowledge to
assess how an individual is meeting his/her need for nutrition.

UNIT OBJECTIVES:
1. Define the following terms:
anabolism
anemia
anorexia
anthropometry
appetite
aspiration
Basal Metabolic Rate (BMR)
Body Mass Index (BMI)
bolus
catabolism
cheilosis
dysphagia
emesis
enteral nutrition
essential amino acids
Fatty acids
a. monounsaturated
b. polyunsaturated
c. saturated

fiber
gastrostomy
glossitis
gluconeogenesis
glycogenesis
glycogenolysis
lipogenesis
malnutrition
mineral
nitrogen balance
nutrient destiny
obesity
parenteral nutrition
triglycerides
vitamin
a. fat-soluble
b. water-soluble

2. List the six basic nutrients, describing their food sources and functions in the body.
3. Identify clinical signs of deficiency and excess of vitamins and minerals.
4. Identify the sources of fiber and its role in nutrition.
5. Describe the state of nitrogen balance and its significance in nutrition.
6. Explain the significance of saturated, unsaturated, polyunsaturated lipids in nutrition.
7. Describe the USDHHS Dietary Guidelines for Americans 2015 and the ChooseMyPlate
program.
8. Outline the information needed to obtain a dietary history.

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37

9. Describe the components of a nutritional status assessment, including albumin, prealbumin,

glucose, total protein lipid profile, and laboratory data, calorie counts, identifying clinical
signs of inadequate nutrition, height, weight, BMI.
10. Discuss the influence religion, values, culture, lifestyle, economics, and health status have
on a persons diet and eating habits.
11. Identify individuals at risk for nutritional problems.
12. Describe ways to assist patients with meals.
13. Identify nursing interventions to stimulate appetite.
14. Describe some aids that enable self-feeding.
15. Explain the following diet orders and give the rationale for each:
NPO
diabetic
clear fluid
high fiber
full liquid
Na____Gm.
soft
sips/ice chips
pureed
semi-thick liquid
fluid restriction___ml.
thick liquids
low fat
renal
low cholesterol
no added salt
regular
ADA___cal.
dysphagia diet
16. Explain the rationale for enteral feedings.
17. Describe the guidelines for nutritional health promotion, including topic areas of Healthy
People 2020 Nutrition, Weight Status and Food Safety.
18. Compare and contrast the formulas used for tube feedings.
19. Discuss the use of supplemental nutrients including vitamins, minerals, electrolytes,
(sodium and potassium).
20. Identify food sources for sodium, potassium, calcium and iron.
21. Discuss the importance of diet counseling and teaching before a patient is discharged.
22. Identify community services and resources to meet the nutritional needs of certain groups
of the population.
23. Discuss the recent trends in obesity and the role of nutrition.

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38

24. Identify nursing interventions to safely deliver enteral nutrition.

25. Delegation:
The nurses aide is preparing to bathe a comatose patient receiving Jevity at 65 mL/ hour
via peg tube. What instructions would give the nurses aide?
26. Critical Thinking:
Your patient is NPO to rule out bowel obstruction. You enter the room, the wife is feeding
the patient and states Hes starving to death. What actions would you take?

REQUIRED RESOURCES:
Taylor:
Chapter 35: Nutrition
Kee & Hayes:
pp. 211-222 (Vitamin and Mineral Replacement)
pp. 243-251 (Nutritional Support)
Drug Guide: Megestrol Acetate (Megace), appetite enhancer
Nursing Diagnosis:
Obesity
Imbalanced Nutrition: Less Than Body Requirements
Website:
MyPlate.gov
USDA.gov (nutrient database)

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39

UNIT 16
HEALTH NEED:

P.E.R.S.O.N.

TOPIC:

Young and Middle Adult; Gender Identity

PURPOSE:

Upon completion of this unit, the student will acquire the knowledge
necessary to assess the health needs of the young and middle adult.

UNIT OBJECTIVES:
1. Define the following terms:
young adult
middle adult
gender identity
gender role behavior
gender dysphoria

sexual orientation
sexual health
Sexually Transmitted Infection (STI)

2. Summarize major physiologic, cognitive, psychosocial, moral, and spiritual developments in

the young and middle adult.
3. List common health problems of the young and middle adult.
4. Describe nursing interventions to promote health in young and middle adults.
5. Contrast different types of sexual expression.
6. Identify factors that affect a persons sexuality.
7. Assess how your personal beliefs and values about human sexuality affect your ability to
deliver competent, compassionate, and respectful care to patients who identify with a gender
other than that of their birth.
8. Describe the nurses role in identifying risk factors using the national health screening
recommendations for the young and middle adult.

REQUIRED RESOURCES:
Taylor:
Chapter 18: Concept Through Young Adult pp. 410-417
Chapter 19: The Aging Adult pp. 419-424
Chapter 44: Sexuality pp. 1659-1661

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40

UNIT 17
HEALTH NEED:

Psychosocial

TOPIC:

Self Concept, Stress, & Coping

PURPOSE:

Upon completion of this unit the student will have acquired the knowledge and
skills necessary to assist an individual to meet his/her psychosocial need. The
concepts of anxiety and defense mechanisms are introduced.

UNIT OBJECTIVES:
1. Define the following terms:
Adaptation
Anxiety
Body Image
Burnout
Caregiver Burden
Coping Mechanisms
Crisis
Crisis Intervention
Defense Mechanism
Depersonalization
False Self
Fear
Flight or Fight Response
Global Self
Hemostasis

Ideal Self
Identity Diffusion
Inflammatory Response
Lateral Violence
Local Adaptation Syndrome (LAS)
Personal Identity
Psychosomatic Disorder
Reflex Pain Response
Role Performance
Self-Actualization
Self-Concept
Self-Esteem
Stress
Stressor

2. Identify three dimensions of self-concept: self-knowledge, self-expectations, and selfevaluation (self-esteem).

3. Describe major steps in the development of self-concept.
4. Differentiate positive and negative self-concept and high and low self-esteem.
5. Identify six variables that influence self-concept.
6. Use appropriate interview questions and observations to assess a patients self-concept.
7. Develop nursing diagnoses to identify disturbances in self-concept (body image, self-esteem,
role performance, personal identity).
8. Describe nursing strategies that are effective in resolving self-concept problems.

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41

9. Plan, implement, and evaluate nursing care related to select nursing diagnoses for
disturbances in self-concept.
10. Summarize the mechanisms involved in maintaining physiologic and psychological
homeostasis.
11. Explain the interdependent nature of stressors, stress, and adaptation.
12. Differentiate the physical and emotional responses to stress, including local adaptation
syndrome, general adaptation syndrome, mind-body interaction, anxiety, and coping and
defense mechanisms.
13. Discuss the effects of short-term and long-term stress on basic human needs, health and
illness, and the family.
14. Compare and contrast developmental and situational stress, incorporating the concept of
physiologic and psychosocial stressors.
15. Explain factors that cause stress in the nursing professions.
16. Integrate knowledge of healthy lifestyle, support systems, stress management techniques, and
crisis intervention into hospital-based and community-based care.

REQUIRED RESOURCES:
Taylor:
Chapter 40: Self Concept
Chapter 41: Stress and Adaptation

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42

DEFENSE MECHANISM
Define each defense mechanism. Use a dictionary or psychology text.
DEFENSE MECHANISM

EXAMPLE

SUPPRESION
REPRESSION
INTELLECTUALIZATION
RATIONALIZATION
REACTION FORMATION
PROJECTION
DENIAL
DISPLACEMENT
SUBLIMATION
UNDOING
REGRESSION

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43

UNIT 18
HEALTH NEED:

Psychosocial

TOPIC:

Loss, Death, and Grief

PURPOSE:

Upon completion of this unit, the student will describe the experiences of loss,
grief and dying identify the appropriate nursing actions to employ in
each instance.

UNIT OBJECTIVES:
1. Define the following terms:
active euthanasia
actual loss
advance directives
allow natural death (AND)
anticipatory grief
bereavement
comfort measures only order
disenfranchised grief
Do Not Resuscitate (DNR)
durable power of attorney
dysfunctional grief
grief

hospice
living will
loss
maturational loss
mourning
palliative treatment
perceived loss
P.O.L.S.T.
terminal illness
terminal weaning

2. Explain the concepts of loss and grieving, including types of loss and grief reactions.
3. Describe the signs of impending death.
4. Compare and contrast the five emotional stages of dying defined by Kbler-Ross.
5. Identify ethical and legal issues in end-of-life care, including advance directives, physician
orders, and euthanasia.
6. Articulate and defend a personal response to a patients plea, Please help me die.
7. Explain six factors that affect loss, grief, and dying.
8. Describe physiologic, psychological, and spiritual care of a dying patient and family.
9. Use the nursing process to plan and implement care for dying patients and their families.
10. Describe P.O.L.S.T. and how it differs from an advance directive.
11. Outline nursing interventions when providing postmortem care.

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44

12. Discuss the role of the nurse in caring for the family of a dying patient.

REQUIRED RESOURCES:
Taylor:
Chapter 42: Loss, Grief and Dying
Website:
P.O.L.S.T.: www.polst.org

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45