NURS 4315-001 Care of the Adult II: Theoretical Foundations
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Welcome to NURS. 4315 Care of the Adult II: Theoretical Foundations
Date: March 10, 2022
More information on this course will be presented during the first day of class from 1300-1600. Thursdays 1300-1600 Fridays 0800-1200 Please note 4316 Adult II Clinical begins before 4315.
FACULTY CONTACT INFORMATION
Isabell Stoltz, DNP, MN, RN, CCNS
Office phone: 210-567-9360
Office room number: NSG 2.334
Office hours: By appointment
This course addresses holistic care of the acutely and critically ill adult experiencing complex health alterations within acute care settings.
CREDIT AND TIME ALLOCATION
3 semester hours (3 hours theory)
Completion of Care of the Adult I: Theoretical Foundations and Care of the Adult I: Clinical Application
At the completion of the baccalaureate program the student will demonstrate the following:
- Incorporate knowledge, skills, and attitudes from the liberal arts and sciences in professional nursing education and practice.
- Apply knowledge and skills of organizational and systems leadership, quality improvement and patient safety in promoting safe, high-quality care for diverse patients across healthcare systems and environments.
- Analyze and apply evidence from research and other information sources as a basis for nursing practice.
- Incorporate knowledge and skills in using information systems and a range of patient-care technologies to facilitate delivery of quality patient care.
- Advocate for financial and regulatory healthcare policies, processes, and environments that improve the nature and functioning of the healthcare delivery system and nursing practice.
- Collaborate and communicate effectively with healthcare professionals to promote positive working relationships, improve patient health outcomes, and deliver quality, safe patient care.
- Promote individual and population health by assessing factors that influence individual and population health and apply principles and culturally appropriate health promotion and disease-prevention strategies.
- Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
- Integrate the knowledge, skills, and attitudes expected of baccalaureate prepared nurses by providing professional nursing care to diverse patients and populations across the lifespan, healthcare settings, and healthcare environments.
- Integrate knowledge from liberal arts, sciences, and nursing to plan complex disease management for adults with acute and life-threatening illnesses. (Essential I, IX)
- Synthesize evidence, clinical judgment, interprofessional perspectives, and patient preferences in assessing, planning, and evaluating quality nursing care of acutely and critically ill adults. (Essential II, VII, IX)
- Evaluate the psychosocial impact of acute and life-threatening illness on adults and multigenerational families. (Essential I, IX)
- Examine end-of-life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences. (Essential IX)
- Evaluate effective communication strategies when interacting with the patient, the patient’s support systems, and within the interprofessional healthcare team. (Essential II, IV, IX)
- Integrate age, culture, spirituality, patient preferences, and health literacy to plan teaching for acutely and critically ill adult patients and their families. (Essential IX)
- Examine patient care technologies that support safe and quality nursing care of acutely and critically ill adult patients. (Essential IV)
GRADING SCALE FOR UNDERGRADUATE COURSES
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)
CRITERIA FOR EVALUATION / GRADES
Successful completion of NURS 4315 requires the achievement of objectives for the course.
70% - Exams
15% - ATI Medical Surgical Content Mastery Exam (CME)
15% - Assignments/graded activities
100% - Total
NOTE: Completing the proctored ATI Medical-Surgical Content Mastery Exam (CME) is mandatory for all students in this course. Please refer to ATI section below.
1. Each course exam will have questions of equal weight and will be timed.
2. To reinforce learning, promote understanding of content, and maintain the integrity of exams, the following policies apply:
a. Students who wish to review missed exam items must make an appointment with the assigned theory faculty. Timeframe to schedule an exam review will be announced prior to and after the exam.
b. Group test reviews will not be done.
3. A blueprint of each examination will be available prior to the scheduled date of the exam. Scheduled time for each exam may vary based on the number of items on the exam.
4. Examinations will be administered using a virtual approach with remote proctoring and will be given in a synchronous mode.
Class Cancellation: If class is canceled for any reason, the student is expected to complete the readings and class objectives for that day(s). The content will still be included on course examinations.
1. All course work must be completed on or before the due date. Late work will not be accepted.
2. All course assignments must represent the student's own accomplishments. Group work may be allowed and in that case, each student must submit his/her own assignment. Disciplinary action will be taken in the event of scholastic dishonesty. Scholastic dishonesty includes such acts as cheating, plagiarism, and collusion.
CELL PHONE POLICY
- Respect for classroom and clinical communication processes are necessary for teaching and learning.
- Silence mobile devices / cell phones in classrooms and clinical settings.
- Remove Bluetooth devices prior to entering the classroom and when in ANY clinical setting.
- Failure to do so can / will / may (depending on the faculty) either affect your class participation, clinical or final course grade.
Faculty are dedicated to providing optimum testing environments that demonstrate the values of fairness, honesty, accountability, and integrity, consistent with the School of Nursing Code of Professional Conduct.
In the School of Nursing Code of Professional Conduct, students vow to promote and maintain an honest and effective physical and online learning environment. As a reminder, all nursing students vow on their honor as a member of the nursing profession to take ownership for their actions and to uphold the values of nursing.
This is achieved during exams by observance of these instructions:
All students must present their university photo ID badge for entry into the exam, whether on-campus or remote. For remote exams using ExamMonitor, a baseline photo and biometric data to identify each student is required and established during the mock exam process. For on-campus exams, if the badge is forgotten, the student will present state or government ID. If the student has no ID available, they may be admitted to the exam with a printout of their Starfish Profile picture.
The immediate testing seating area is limited to: computer, required privacy screen, calculator (if necessary) and pencil. Drinks are allowed only for exams more than two hours in length. For on-campus testing, earplugs and scratch paper are allowed. For remote testing, earplugs and scratch paper are prohibited. Exceptions can be sought through consultation with the Associate Dean.
Hats, caps, or head coverings may not be worn during exams except those required for religious purposes.
Students who must leave the room, should notify the proctor. No extra time is provided when a student must leave the room. For remote testing, students without accommodations may not leave the room, take the computer to another room, or use headsets.
For remote testing, exam behaviors that may be flagged as lacking integrity include:
excessive eye movement away from the computer screen during the exam
talking during the exam
communicating with others during the exam
other persons in the room
A post exam review may be conducted. Note-taking during the review is prohibited.
Discussion of test content should not occur. Any sharing of information related to the exam is grounds for a zero grade for all students involved and may result in further disciplinary actions.
The following guidelines support a quiet environment, as free from distraction as possible:
Stored electronic devices must be powered down to reduce distraction and reduce interference with WiFi access. Proctors will take action to remove any items causing noise disturbances during testing.
Students must move away from the door area as outside conversations can be heard while students are exiting the exam. Repeated violations will be addressed according to the Code of Professional Conduct.
If testing remotely, the student will secure an off-campus location/environment for testing. The testing environment should be quiet, non-distracting, and well-lit. Overhead lighting in the testing room is recommended. If there is no overhead lighting available, the light should not be behind the student. All background noise (television, music, radio, etc.) must be turned off during the exam. If the student is unable to find an off-campus location/environment for testing, they should notify the course coordinator at least 7 calendar days before the scheduled exam to secure an on-campus location. An on-campus room may not be possible if less than 7 days of notice is given.
Faculty understand that unexpected events may occur on the day of an exam and offer support in these ways:
Testing at scheduled times is expected. Please refer to the Excused Absence section in the Undergraduate Student Handbook, for detailed information about notification. Make up exams may contain alternate questions of similar rigor and/or may be a different format.
It is recommended that students perform periodic computer checks including:
Recommended to turn off auto update
Wait to upgrade to any new MacOS version
Check Examplify’s website for compatibility
Log in at https://examsoft.com to check minimum system requirements
Contact UT Health San Antonio Help Desk Phone Number with questions on computer readiness:
210-567-7777 option 1
Available Mon - Fri 6:00am - 6:00pm
In the case of an exam or computer dysfunction, the student may be offered a written paper and pencil test or may be scheduled for a makeup exam. The course coordinator will discuss the options with the student based upon the time left in the exam and related issues.
If the student has technical issues during remote testing, a phone may be temporarily used to phone the course coordinator for guidance.
Technical requirements for proctored online exams:
At least 7 calendar days prior to the exam, students must ensure compliance with all technical requirements and necessary computer updates. Technical requirements include:
Find a full list of ATI’s technical requirements at: atitesting.com/technical requirements
Microphone: Any microphone, either internal or external
Webcam: 320x240 VGA resolution (minimum) internal or external
Desktop or laptop computer (NO iPads, Tablets, or Phones to be used) with the ability to download Google Chrome
Completing a Dry Run (Mock Exam)
ATI uses Proctorio for the remote proctoring. Please review the “Student Start Quick Guide: ATI Remote Proctoring with Proctorio” found at: www.getproctorio.com. Each first time test taker will complete the Dry Run exam prior to taking ATI content mastery exam in 5th semester.
ExamSoft uses ExamMonitor for remote proctoring. The follow site, www.examsoft.com/community, provides a tutorial for students.
GRADING POLICY GUIDELINES:
- To pass the course, a student must have a weighted average of 75% on all graded activities.
- Students must make a "C" (75) or higher in all nursing courses to progress in the program.
The final grade will be calculated to two decimal places and rounded mathematically as follows:
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.
- If written assignments are made in a course they are required.
- Students are expected to submit written work on the scheduled date and time.
- The student must notify the course coordinator prior to the scheduled due date and time if they are unable to submit the written work as scheduled. Failure to make this notification in advance will result in a "zero" for that written work.
- If the excuse is accepted as reasonable and necessary, arrangements will be made for an alternative due date and time.
- Each student is responsible for making sure that he or she has completed the written work prior to submission.
- Late work will be accepted with consequences as outlined per course syllabi.
The APA Publication Manual 7th edition is required for use in all nursing school programs.
Assessment Technologies Institute®, LLC (ATI) RN CONTENT MASTERY SERIES®
UTHSCSA School of Nursing utilizes the ATI RN Content Mastery Series®, RN Comprehensive Predictor® practice and proctored exams, and the ATI Virtual "greenlight" program to assist students in preparing for the NCLEX-RN® exam. Through practice and proctored examinations, students are able to assess their own knowledge and receive feedback and direction for content review throughout the program of study.
The ATI RN Content Mastery Exams (CME) are administered in specific courses in both undergraduate tracks
1. For a student to take the ATI content mastery exam:
•Completion of Practice A and B exams with a minimum score of 90% on both exams is required. Practice exam attempts include a 24 hour wait period between attempts.
•Students will be ineligible to take the initial administration of the ATI Content Mastery Exam (CME) if the practice exams are not completed by the due date outlined in the course calendar displayed in the institutional Learning Management System.
oUpon completion of Practice A and B with a 90% or better, student is only eligible to sit for the second CME exam and will receive the score commiserate with the second CME exam. Thus, student will not be eligible for a retake of the CME.
2. To strengthen the Practice A and B review method:
•Students who did not achieve a 90% or greater on the practice exam should understand the rationales for each distracter. It is recommended that students complete a Focused Review for the practice assessment to address gaps in knowledge.
3.Content Mastery Exams will comprise 15% of the total course grade.
The following provides guidelines for inclusion of the CME in the course grade:
oAn exception to this policy applies to NURS 4502 Disease Management II. The Content Mastery Exams which comprises 15% of the total course grade for NURS 4502 Disease Management II is split between the ATI Nursing Care of Children Content Mastery Exam (CME) and ATI Maternal Newborn Content Mastery Exam (CME). Each exam is worth 7.5%.
Content Mastery Examinations Requirements
1st ATI Exam (15% of Course Points)
2nd ATI Exam (15% of Course Points)
100% of points
85% of points
90% of points
80% of points
0% of points, complete focused review** and must retake exam
0% of points
Less than Level 1*
0% of points, complete focused review** and must retake exam
0% of points
•If a Level 1* or Less than Level 1* is achieved, an individualized student success plan will be developed and implemented in conjunction with faculty to help student attain content mastery.
o**A mandatory focused review is required to complete before retaking the Content Mastery Examination and consists of:
- Printing out the specific proctored results “report” and using either the available ATI templates or a plain piece of paper to handwrite all of the missed items under “Topics to Review.” Label each missed item with the topic descriptors.
- This handwritten remediation will be submitted to the institutional Learning Management System (LMS) along with the student’s proctored “report” prior to retaking the exam.
The RN Comprehensive Predictor will be given twice in NURS 4420 (traditional BSN track) and NURS 4423 (accelerated BSN track). The first RN Comprehensive Predictor will be given at the beginning of the course. The second RN Comprehensive Predictor will be given at the end of the course.
1.Each student will enroll in the designated comprehensive review course.
2.The student will complete two RN Comprehensive Predictor exams.
3.The student is expected to obtain a 74.0% or greater on one of the RN Comprehensive Predictor exams (96% predicted probability of passing the NCLEX-RN).
4.If the student makes less than a 74% on the first RN Comprehensive Predictor, the student will engage in a required handwritten focused review** on all missed items under “Topics to Review”. The student will submit the focused review along with their ATI “Report” to the institutional Learning Management System (LMS) within 10 business days.
•If the student has not completed the required focused review, the student will not be eligible to take the second RN Comprehensive Predictor exam and will not successfully pass the course.
5.A second RN Comprehensive Predictor will be given before the end of the semester. It is not required to complete a focused review however it is encouraged to complete a focused review to improve your comprehension of the content.
•If the student does not achieve the required 74.0% or greater on their individual score with either the first or second RN Comprehensive Predictor (96% predicted probability of passing the NCLEX-RN), the student will complete ATI Virtual Modules 6-9 (Module Six OB, Module Seven Pediatrics, Module Eight Mental Health, and Module Nine Leadership-Management).
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.
PROFESSIONAL CODE OF CONDUCT
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.
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.
REQUIRED TEXT / REFERENCE
Assessment Technologies Institute (ATI) Medical-Surgical Content Mastery Series (2019), Edition 11.
Harding, M.M., Kwong, J., Roberts, D., Hager, D. & Reinisch, C. (2020). Medical surgical nursing: Assessment and management of clinical problems. St.Louis: MO: Mosby.(11th edition).
RECOMMENDED (OPTIONAL) TEXT / REFERENCE
Required textbooks from previous courses.
Davis's Drug Guide for Nurses and Potter & Perry Fundamentals of Nursing are especially helpful textbooks to utilize.
1. Stress response
2. ICU Environment
3. End-of-Life Care
4. Organ Donation
5. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)
6. Acute Coronary Syndrome, Heart Failure, Cardiomyopathy, Cardiac Surgery & Cardiogenic Shock
8. Hypertensive Crisis
9. Aortic Aneurysm
10. Arterial Blood Gases (ABG’s)
11. Acute neurologic conditions
12. ARDS, pulmonary edema, pulmonary embolism, pneumothorax, flail chest, chest tubes, mechanical ventilation
14. Oncologic emergencies
15. Inflammation (SIRS/DIC/MODS) Sepsis/septic shock
16. Acute kidney injury
17. Liver failure
18. Acute abdomen
21. Acute Spinal Cord Injury
Content is not listed in order of presentation.
CALENDAR - 1st Day Only
Please check the schedule for recent updates on Class Dates & Room.
Date: March 10, 2022
First Class Day from 1:00 PM to 4:00 PM.
Course Orientation will be from 1:00 PM to 1:50 PM.
Attendance is mandatory.
Lecture is from 2:00 PM to 4:00 PM.
Objectives and reading assignments will be posted at least one week prior to the class.
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