Spring 2022

NURS 6438-01 AGACNP Dx & Mgmt: Clinical Application 2

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

Students are expected to follow all policies related to COVID-19 found on the university webpage: https://wp.uthscsa.edu/coronavirus/.

NOTE: Our campus has enabled the CANVAS MOBILE LEARN application. CANVAS tools such as discussions, quizzes or videos May or May NOT function on all mobile devices. This is because mobile devices are available with rapidly changing and different configurations. Hence, students must not depend on only a mobile device to access course materials. Students must have access to a laptop or desktop device to access course materials and complete assignments.

This course is Web Enhanced with WebCT icon
Please be sure to check the Current Computer Requirements

Link to Graduate Clinical Experiences and Typhon guidelines: http://nursing.uthscsa.edu/gradclinical/

Welcome to NURS 6438   AG-ACNP DX and Mgmt: Clinical Application 2.  This class is in concert with NURS 6137 AG-ACNP DX and Mgt: Clinical Seminar 2.

Review Canvas prior to the first day of class


Amanda S. Bridges, DNP, MSN, RN, ACNP-BC
Assistant Professor/ Acute Care Nurse Practitioner

School of Nursing

UT Health San Antonio

7703 Floyd Curl Drive

San Antonio, Texas  78229-3900

210.450.8026 | bridgesa1@uthscsa.edu

Office:  SON 2.212

Cell 301-456-3553  (Business Hours Only)


This course develops clinical competency and emphasizes the integration of theory, assessment and advanced therapeutics for the safe and patient-centered care of adults in a high acuity healthcare setting. Emphasis is placed on the management of acute, complex, and chronic health problems in the young adult, older adult, and elder adults as well as adults with critical illness under the direction of clinical preceptors. In addition, this course emphasizes collaborative partnership development between patients, their families, and inter-professional teams.


Credit hour allocation: 4 semester credit hours
Clock hour allocation: 240 clock hours clinical practicum


NURS 6435 AGACNP Diagnosis and Management: Concepts and Theory 1
NURS 6436 AGACNP Diagnosis and Management: Concepts and Theory 2
NURS 6235 AGACNP Diagnosis and Management: Concepts and Theory 3
NURS 6437 AGACNP Diagnosis and Management: Clinical Application 1
NURS 6135 AGACNP Diagnosis and Management: Clinical Seminar 1

NURS 6137 AGACNP Diagnosis and Management: Clinical Seminar 2


Upon completion of the Doctor of Nursing Practice (DNP) Program students will:

  1. Integrate nursing science, ethics, biophysical, psychosocial, analytical, and organizational sources to provide the highest level of specialty nursing practices.
  2. Develop, implement, and evaluate healthcare practices in healthcare systems that ensure quality improvement and patient safety.
  3. Use analytic methods and evidence based practices to improve practice outcomes and the practice environment.
  4. Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems.
  5. Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas.
  6. Employ interprofessional collaborative teams to improve patient and population health outcomes and healthcare delivery systems.
  7. Lead the integration and institutionalization of (evidence based) clinical prevention and population based health guidelines.
  8. Use clinical judgment, systems thinking, accountability, and specialized knowledge to design, deliver, and evaluate evidence based, culturally proficient care to improve patient, population, and health systems outcomes.


1.     Provide patient-centered acute care with emphasison health promotion, disease prevention, health protection, anticipatoryguidance, counseling, disease management, and palliative care to patients andfamilies during transitions and life-style adjustments as an integral member ofthe interprofessional team. (DNP EssentialsI, III, VI, VII, VIII; NONPF Competency: Independent Practice 3, 6)


2.      Apply knowledge of acute, complex, andchronic illnesses to diagnose and manage young adult, adult, and older adult patientsin high acuity healthcare settings. (DNP Essentials I, III, VIII; NONPF Competency: Independent Practice3, 6)


3.     Use evidenced-based guidelines related to patienthealth, disease management and prevention to impact health outcomes in this diversepopulation. (DNP Essentials I, III,VII, VIII; NONPF Competencies: Scientific Foundation 2, IndependentPractice 3, 4)


4.     Use advanced diagnostic reasoning anddifferential diagnosis for disease management of patients and families. (DNP Essentials I, VIII; NONPFCompetencies: Scientific Foundation 3, Practice Inquiry 6, Independent Practice8)



5.     Integrate history and physical examination data along with thepathophysiology of common acute and chronic diseases to develop appropriatedifferential diagnoses and implement an evidence-based management plan. (DNP Essentials I, III, VIII; NONPFCompetencies: Scientific Foundation 3, Independent Practice 3, 4, 8)


6.     Integrate traditional and complementary pharmacological interventions intothe treatment and management of common acute illnesses for the young adult,adult and older adult population. (DNP EssentialsI, VIII; NONPF Competencies: Independent Practice 3, 4, 5)


7.     Integrate social, cultural, explanatory models and spiritual components ina holistic patient-centered plan of care. (DNP Essentials I, VII, VIII; NONPF Competencies: Independent Practice3, 4, 5)


8.     Integrate knowledge of scope of practice, legal,and ethical principles in decision-making and demonstrate core professionalvalues in the implementation of the nurse practitioner role. (DNP Essentials I, II, V, VIII; NONPFCompetencies: Ethics 1, 2, 3, Independent Practice 1, 2, 8)


Create a climate of patient-centered care toinclude safety, confidentiality, privacy, comfort, emotional support,education, mutual trust and respect. (DNP Essentials II, VIII; NONPFCompetencies: Quality 1, Practice Inquiry 2, 3, Independent Practice 1, 2, 4,5)


A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)


Clinical Experience is Pass/Fail

Clinical Experience is Pass/Fail

No clinical can be started at any clinical site until an Intent of Relationship (IOR) is completed, submitted to the course coordinator  and approved by the faculty.  

All criteria noted in NURS 6137 syllabus applies to this course.


SOAP Notes:  50%

Complex Patient Presentation 30%

Critical Care Topic Presentation:20%

In this course, we will also take a practice certification exam to help you evaluate your areas of weakness.  Although the practice exam will not be counted as a grade, you must complete the exam to receive credit in this course.  Date of time of this certification exam practice opportunity will be noted in Canvas.



Attendance in class is an expectation of each student.


The School of Nursing faculty expects that its students will recognize that they have entered a profession in which commitment to full participation in clinical experiences is an essential component as students are considered to be part of the nursing team. Therefore, regular attendance in clinical, laboratory and simulation experiences is mandatory.

Missed hours can prevent adequate development and assessment of the required knowledge, skills, attitudes and clinical judgment. Absence from clinical/lab/simulation jeopardizes the student’s ability to successfully meet the required clinical course outcomes and competencies.

Punctuality is expected in professional workplaces. Students are expected to arrive on time for clinical/lab/simulation experiences and stay for the entire time allotted for that clinical/lab/simulation experience. Important information affecting patient care is communicated to students at the start of clinical experiences. Therefore, tardiness for clinical/lab/simulation experiences jeopardizes the student’s ability to give safe nursing care.

Absences from clinical experience are closely monitored by faculty and should occur only in rare circumstances. Clinical absences will be evaluated on an individual basis. If the student has any clinical absences during the semester, clinical may be made up through a plan developed by the clinical/lab instructor. However, the opportunity to make up absences may not be possible, depending on the length of the clinical rotation, the availability of the faculty and/or the agency to which the student is assigned and may result in inability of the student to meet course outcomes.

If it is determined by the faculty team that a student will be unable to meet course objectives due to clinical absences or if a pattern of absence develops or excessive absences exist, the appropriate course coordinator will refer the student the Associate Dean for Undergraduate Studies to determine progression in the program.
A student who is unable to attend a clinical experience must contact the clinical faculty personally prior to the beginning of the clinical experience. Leaving a message or e-mail for the faculty is not acceptable. Faculty will share specifics regarding appropriate means of communicating during orientation.

Travel to surrounding communities may be necessary.

Students are expected to demonstrate achievement of clinical objectives by the end of a clinical course. If, in the instructor‘s professional judgment, a student is consistently unable to provide safe nursing care to patients and cannot remedy the deficit in the given clinical time, the student will receive a grade of ―F for the course. Faculty, or staff in the clinical agency, has
the right to remove a student from the clinical area at any time for any cause.

Students are required to maintain a clinical passport and have this on their person at all times while in the clinical setting.

Students are required to maintain American Heart Association Health Care Provider Basic Life Support certification.


The APA Publication Manual 7th edition is required for use in all nursing school programs. 


Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.


Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.


School of Nursing Netiquette Guidelines for Online Interaction

Netiquette guidelines provide information for behaving properly online, when using email, tweets or texts so that you may successfully communicate your thoughts in a manner that is respectful and avoids misunderstandings with others.


Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.


No formal textbook required but recommend reference books and apps based on your clinical area.


Samford Guide to Anti-infectives


See Canvas

CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.

Please see canvas for details regarding site visits and Typhon use.

You are expected to email Amanda Bridges your cell phone number before February 1, 2022.

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