NSG 210 Syllabus and Clinical Packet

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ASSOCIATE DEGREE NURSING NSG 210 - SYLLABUS

COURSE TITLE: NURSING III - Caring for Women and Children -
CURRENT SEMESTER: Summer 2014
CREDITS: 9 HRS. Classroom: 90 hours 6.0 credits
Nursing Skills Laboratory: 12 hours 0.4 credits
Clinical: 117 hours 2.6 credits
TOTAL: 9.0 credits

Course Faculty: Nancy ONeill, MSN, APRN, CNM
Course Coordinator/Obstetrics faculty
106 Anne Hart Raymond
859-846-5324 (office)
859-229-1015
noneill@midway.edu
Office hours Posted and by appointment

David Coffey, MSN, APRN, CPNP
Pediatric faculty
105 Anne Hart Raymond
859-846-5743 (office)
859-608-8010
dcoffey@midway.edu
Posted and by appointment

Clinical Faculty: Valerie Smith, BSN, RN, IBCLC
Iniko Sallee, BSN, RN,
Davonna Hutcherson, MSN, RN
Shay Arambasick, BSN, RN
David Coffey, MSN, APRN, CPNP
Amy Brassfield, MSN, RN
TBA
Course Location: Lecture -Anne Hart Raymond, Rm 113

Clinical Sites: OBSTETRICS
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Baptist Health Lexington Lexington, KY
Kentucky One Health-Saint Joseph East Lexington, KY
University of Kentucky Chandler Medical Center-Lexington, KY

PEDIATRICS
University of Kentucky Childrens Hospital- Lexington, KY

Community Affiliations: The recent trend of nursing expansion into the community encourages
students to become acquainted with alternative health care delivery methods. Community
experiences may be integrated in both the obstetric and pediatric rotations. Students are required
to adjust their schedules to accommodate these experiences.

REQUIRED Textbooks:
Hockenberry, M. J. & Wilson, D. (2013). Wongs Essentials of Pediatric Nursing, 9
th
ed. St.
Louis: Mosby, an imprint of Elsevier. ISBN: 978-0-323-08343-0
Hockenberry, M. J., & Wilson, D. (2013). Wongs Essentials of Pediatric Nursing-Study Guide,
9
th
ed., St. Louis: Mosby, an imprint of Elsevier. ISBN: 978-0-3230-84444-4
Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2012). Maternity & Womens
Health
Care, 10
th
ed., St. Louis: Mosby, and affiliate of Elsevier. ISBN: 978-0-323-07429-2
Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K.R. (2012). Maternity & Womens
Health-
Study Guide, 10
th
ed. St. Louid: Mosby, an affiliate of Elsevier. IBSN: 978-0-323-07430-8

Previously Required Textbooks for NSG 115 & NSG 120: Also required for NSG 210
American Psychological Association. (2010). Publication manual of the American Psychological
Association (6
th
ed.). Washington, D.C. ISBN#: 9781433805615

Deglin, J. H. and Vallerand, A. H. (2013). Davis drug guide for nurses (13
th ed.
). Philadelphia: P.
A. Davis. ISBN# 97814333805615

Dienges, M., Moorhouse, M., and Murr, A. (2010). Nursing diagnosis manual: Planning,
individualizing, and documenting client care (3
rd
ed.). Philadelphia: F. A. Davis. ISBN#
9780803622210

Gahart, B. and Nazareno, A. (2011) 2011 Intravenous medications: A handbook for nurses and
health professionals (28
th
ed.). St. Louis, MO: Mosby. ISBN#: 9780323084819

Ignatavicius, D., Workman, L., (2013). Medical-surgical Nursing: Patient-Centered Collaborative
Care (7
th
ed,). St. Louis: Elsevier. ISBN#: 9781437727999

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Kee, J. L., Hayes, E. R., and McCurstion, L. E. (2012). Pharmacology: A nursing process
approach (7
th
ed.). St. Louis: Elsevier. ISBN# 9781437717112

Lynn, P. (2011). Taylors clinical nursing skills: A nursing process approach (3
rd
. ed.).
Philadelphis: Lippincott Williams and Wilkins. ISBN# 9781582557359

Taylor, C., LeMone, C., Lillis, P., & Lynn, P. (2011). Fundamentals of nursing: The art and
science of nursing care (7
th
ed.). Philadelphia: Lippincott Williams & Wilkins.
ISBN#: 9780781793834

Recommended Websites:
The American Academy of Pediatrics http://www.aap.org
Association of Womens Health, Obstetric and Neonatal Nurses, www.awhonn.org
Centers for Disease Control and Prevention website (CDC) www.cdc.gov
Healthy People 2020 website www.healthypeople2020.gov
American Nurses Association website www.ana.org
Kentucky Board of Nursing website www.kbn.ky.gov
American Public Health Association website www.apha.org
World Health Organization (WHO) website www.who.gov
Kentucky Department of Public Health website www.kdph.ky.gov
Preventative Taskforce website www.preventivetaskforce.org
The OWL (Online Writing Lab) at Purdue University http://www.owl.english.purdue.edu
ATI - www.atitesting.com
The Point - http://thepoint.lw.com/taylor6E
QSEN - http://www.qsen.org/ksas-prelicensure.php
Learn APA http://www.apastyle.org/learn/index.aspx

Course Description (Midway College Catalogue):
NSG 210 Nursing III Obstetrics and Pediatric/Clinical (Day/Evening Track) ............... 9 hr
This course is designed to further develop students theoretical knowledge and clinical application
of the nursing process as it applies to child-bearing, pediatric, and community settings. Emphasis
is on the childbearing family, newborn, and pediatric client. Additional foci include:
Enhancement of students knowledge, communication techniques, critical thinking skills, and
concepts of maternal-child nursing. This course includes didactic, clinical and nursing skills
laboratory experiences. This is a reading intensive course. Prerequisite: Grade of C or higher
in NSG 120. Co-requisites: BIO 225 and BIO 226 if not previously taken.
This course requires a minimum of two hours of work (readings, reports, and other
assignments) outside of class per credit hour per week. Please schedule your time
accordingly. Grades do reflect compliance.

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COURSE ALIGNMENT TO STANDARDS/Learning outcomes:
This course is in alignment with the Accreditation Commission for Education in Nursing
(ACEN), formerly known as the National League of Nursing Accreditation Commission, Inc.,
Standards 3.8 and 4.0, and SACSCOC, Standard 4.2.

COMPETENCIES OF THE ADN PROGRAM

Within the framework of the philosophy, mission, and goals of Midway College, the nursing faculty
has developed specific core competencies. The core competences are based on those of the National
League for Nursing. The model illustrates the dynamic process of mastering core competencies
that are essential to the practice of contemporary and futuristic nursing. The components of the
NLN Education Competencies Model including: core values, integrating concepts, program
outcomes and nursing practice are infused throughout the ADN didactic curriculum, skills lab
activities and clinical component. These competencies are reflected in the Student Learning
Outcomes for the program.

The NLN Education Competencies Model consists of:

Core Values: The nursing program and graduate competencies are grounded in the
fundamental values that are shown at the root of the model (p. 8).
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The seven core values are:

Caring- promoting health, healing and hope in response to the human condition
(p.11).
Diversity- recognizing differences among persons, ideas, values, and ethnicities,
while affirming the uniqueness of each (p. 12).
Ethics-integrates knowledge with human caring and compassion, while respecting
the dignity, self determination, and worth of all persons (p.13).
Excellence- creating and implementing transformative strategies with daring
ingenuity (p.12).
Holism- nurses consider every aspect of the human condition when planning,
implementing, and managing care for patients (p.14).
Integrity- respecting the dignity and moral wholeness of every person without
conditions or limitations (p.13).
Patient-Centeredness-an orientation to care that incorporates and reflects the
uniqueness of an individual patients background, personal preferences, culture,
values, traditions, and family (p.14).

Integrating Concepts: The six integrating concepts emerge from the seven core values and are:

Context and Environment- the condition or social system within which the
organizations members act to achieve specific goals (p.16).
Knowledge and Science- the integration of biological sciences.social
sciences. arts and humanities. and the development of a unique nursing
science (p.19).
Personal and Professional Development- a lifelong process of learning refining
and integrating values and behaviors that: are consistent with the professions code
of ethics; serve to distinguish the practice of nurses from that of other healthcare
providers; and give nurses the courage needed to continually improve the care of
patients, families, and communities and to ensure the professions ongoing
viability (p.23).
Quality and Safety- the degree to which healthcare services: are provided in a
way consistent with current professional knowledge; minimize the risk of harm to
individuals, populations, and providers; increased likelihood of desired health
outcomes; and are operationalized from an individual, unit and systems
perspective (p.25).
Relationship-Centered Care-caring, therapeutic relationships with patients,
families, and communities and professional relationships with members of the
healthcare team is the core of nursing practice (p.27).
Teamwork- to function effectively within nursing and interprofessional teams,
fostering open communication, mutual respect , and shared decision making to
achieve quality patient care (p.30).
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These concepts are shown as bands around the program. These bands illustrate the progressive
and multidimensional development of students during their learning experiences (p. 8).

Nursing Practice: Classroom lectures, workshops, seminars, skills laboratory and clinical
experiences are planned with increasing levels of difficulty and complexity to provide the student
with those components of client care necessary to satisfy these program outcomes. Upon satisfactory
completion of the nursing education program at Midway College, the student is awarded an
Associate of Science Degree in Nursing and is eligible to take the National Council for Licensure
Examination (NCLEX).
The nursing process is used to organize the ADN curriculum, combining general education studies
with basic nursing education to enable students to accomplish the competencies/outcomes. The
curriculum including the Clinical Evaluation Forms for each course and are leveled in increasing
difficulty and complexity.

CORE COMPETENCIES AT GRADUATION

1. Human Flourishing- Advocate for patients and families in ways that promote their self
determination, integrity, and ongoing growth as human beings.

2. Nursing Judgment- Make judgments in practice, substantiated with evidence, that
integrate nursing science in the provision of safe, quality care and promote the health
of patients within a family and community context.

3. Professional Identity- Implement ones role as a nurse in ways that reflect integrity,
responsibility, ethical practices and an evolving identity as a nurse committed to
evidence based practice, caring, advocacy, and safe, quality care for diverse patients
within a family and community context.

4. Spirit of Inquiry- Examine the evidence that underlies clinical nursing practice to
challenge the status quo, question underlying assumptions, and offer new insights to
improve the quality of care for patients, families and communities.

Reference
National League for Nursing (NLN). (2010). Outcomes and competencies for graduates of practical/vocational, diploma,
associate degree, masters, practice doctorate and research doctorate programs in nursing. New York: Author.
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STUDENT LEARNING OUTCOMES (SLO):
At the completion of Nursing 210 the student should be able to:
Demonstrate proficiency in knowledge of nursing and clinical skills necessary to provide safe,
competent nursing care.
Evaluation
Earn a course grad of 77% or better as a final passing grade.
Satisfactorily meet clinical evaluation criteria of 2 or above as outlined in NSG
210 Clinical Evaluation tool.
Successfully complete safe and competent check-off of required skills.
Attain the cut score on each of the following ATI exams:
Maternal Newborn Nursing (cut score 68)
Community Health Nursing (cut score 65)
Nursing Care of Children (cut score 67)
OR
Earn a minimum of 90% on ATI remediation.
Maintain dosage calculation competency by completing the following:
Scoring a 90% or higher on the medication exam within two attempts
Analyze and synthesize information related to medication administration by
completing the following:
Complete 10 pharmacology concept maps.
Safe and accurate administration of medications in the clinical setting.
Meeting Student Learning Outcomes:
1. Utilize the Nursing Process to assess clients and families and to plan, implement, and
evaluate care to clients and families while functioning within the Scope and Standards of
Nursing Practice.
Evaluation:
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Complete a satisfactory nursing careplan as outlined on the Nursing 210 care plan
rubric in both obstetrics and pediatrics.
Satisfactorily meet the clinical evaluation criteria as outlines on the Nursing 210
Clinical Evaluation Form in both obstetrics and pediatrics.
Review and adhere to the guidelines as outlined within the American Nurses
Association Scope and Standards of Practice.
2. Read and think critically and synthesize new information in a logical manner.
Evaluation:
Complete a critical thinking written assignment based on the Critical Thinking
Rubric.
Complete a satisfactory nursing care plan for OB and Pediatrics according to the
criteria outlined in the Nursing 210 syllabus.
3. Communicate effectively and professionally, both in speaking and writing.
Evaluation:

Complete a critical thinking written assignment based on the Critical Thinking Rubric.
Students will be given the opportunity to participate in collaborative testing following
each unit exam.
Complete a teaching presentation during the obstetric rotation and a case presentation
during the pediatric rotation at a satisfactory level according to the grading scale for
these activities in the clinical syllabus.
4. Demonstrate professional behavior at all times.
Evaluation:
Adhere to the standards of professional decorum and behavior as outlined in the
Midway College Catalog, Midway College ADN Handbook, and course syllabi.

Review and sign the Midway College Honor Code.

Satisfactorily meet the clinical evaluation criteria as outlined on the NSG 210
Clinical Evaluation form.

Review and adhere to the provisions outlined within the American Nurses
Association Code of Ethics and the Scope and Standards of Practice.

5. Develop leadership skills that include caring, compassion and responsibility.
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Evaluation:
Develop a Leadership Portfolio.
Satisfactorily meet the clinical evaluation criteria of as outlined on the NSG 210
6. Demonstrate Servant Leadership and Community Service awareness.
Evaluation:
Complete two hours of health related community service this semester.

8. Possess personal integrity and practice within the ethical and legal framework of nursing.
Evaluation:
Adhere to the American Nurses Association Code of Ethics.
Adhere to the standards of professional decorum and behavior as outlined in the
Midway College Catalog, Midway College ADN Handbook and course syllabi.
Review and sign the Midway College Honor Code.
Review and adhere to the guidelines as outlined within the American Nurses
Association Scope and Standards of Practice.
9. Utilize current research evidence and technology in the provision of nursing care.
Evaluation:
Utilize current evidence based research when completing clinical paper work i.e.
pathophysiology assignment and care plan.
Clinical Evaluation from.
10. Work independently and collaboratively with other health care workers in providing care
and teaching about health promotion and illness prevention to diverse and complex
clients and families.
Evaluation:
Satisfactorily meet clinical evaluation criteria as outlined in NSG 210 Clinical
Evaluation form by completing the following:
o Successfully complete safe and competent check-off of required skills.
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o Choose the best nursing action from selected client situations in the clinical
area, on course exams and in class case studies.
o Perform clinical techniques with beginning competencies as evidenced by
clinical evaluation and successful completion of skills check-off.
o Develop culturally sensitive interventions for diverse populations as evidenced
by clinical paper work and care plan completion with a satisfactory score.
o Successfully complete a teaching plan and a case presentation in the clinical
setting.
o Incorporate client teaching each clinical day as part of their clinical paper
work.
o Complete nursing care plans (obstetric and pediatric) in the clinical setting,
each care plan will identify client teaching.
o Begin to incorporate collaborative efforts with other healthcare workers as
evidenced by the clinical evaluation tool.

Course Objectives:
Upon completion of NSG 210, the student will be able to:
1. Demonstrate an understanding of the nurses role in maternal-child nursing.
2. Utilize the nursing process in providing nursing care to childbearing and child-rearing families
with consideration of cultural, spiritual and developmental needs.
3. Apply principles of growth and development in the provision of nursing care to childbearing
and child-rearing families.
4. Demonstrate appropriate communications techniques in the assessment and care of
childbearing and child-rearing families.
5. Provide safe and competent care for obstetric and pediatric clients in clinical and community
settings.
6. Utilize current evidence based research and technology in providing care to childbearing and
child-rearing families in clinical and community settings.
7. Demonstrates professional behaviors in providing client care and in interactions with other
members of the healthcare team.
8. Complete two hours of health related community service.

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Alignment of Course Objectives with Associate Degree Student Learning
Outcomes (SLO):

1. Demonstrate proficiency in knowledge of nursing and clinical skills necessary to provide
safe, competent nursing care.
Course Objective(s):
CO#2. Utilize the nursing process in providing nursing care to obstetric and
pediatric patients and their families with consideration of cultural, spiritual
and developmental needs.
CO#5. Provide safe nursing care and performance of clinical skills while caring
for obstetric and pediatric patients and their families in the acute care
and community setting.
2. Utilize the Nursing Process to assess clients and families and to plan, implement, and
evaluate care to clients and families while functioning within the Scope and Standards of
Nursing Practice.
CO#3. Apply principles of growth and development in the provision of nursing
care to obstetric and pediatric patients and their families.
CO#3. Apply principles of growth and development in the provision of nursing
care to obstetric and pediatric patients and their families.
CO#6. Utilize current evidence based research and technology in developing and
implementing nursing plans of care for obstetric and pediatric patients and
their families.
4. Communicate effectively and professionally, both in speaking and writing.
CO#4. Demonstrate therapeutic and professional communication techniques in
the assessment and care of obstetric and pediatric patients and their
families.
CO#7. Demonstrate professional behaviors and leadership skills in interactions
with other members of the multidisciplinary healthcare team.
CO#4. Demonstrate therapeutic and professional communication techniques in
the assessment and care of obstetric and pediatric patients and their
families.

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CO#8. Complete two hours of health related community service this semester.
8. Possess personal integrity and practice within the ethical and legal framework of nursing.
CO#5. Provide safe nursing care and performance of clinical skills while caring
for obstetric and pediatric patients and their families in the acute care
and community settings.
CO#6. Utilize current evidence based research and technology in developing and
implementing nursing plans of care for obstetric and pediatric patients and
their families.
10. Work independently and collaboratively with other health care workers in providing care and
teaching about health promotion and illness prevention to diverse and complex clients and
families.
CO#1. Demonstrate an understanding of the nurses role in maternal-child
Nursing in providing health teaching and health promotion to diverse
groups of obstetric and pediatric patients and their families.

NSG 210 Students are expected to be professional at all times and adhere to the
professional standards listed below. Students will be held accountable professional behavior
and standards.
Adapted from the American Nurses Association Code of Ethics:
Professionalism: Professional behaviors within nursing practice are characterized by a
commitment to the profession of nursing. The student nurse adheres to the same standards of
professional practice, is accountable for individual actions and behaviors, and practices nursing
within legal, ethical and regulatory frameworks. The student nurse values the profession of
nursing and participates in ongoing professional development.
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Ethics for Nursing: Ethics is part of the foundation upon which nursing is built. A code of ethics
makes explicit the primary goals, values and obligations of the profession. The Code of Ethics is a
succinct statement of the moral obligations and duties of every individual who enters the nursing
profession. While used by the profession as its nonnegotiable moral standard of practice, the Code
also articulates for the public nursings own understanding of its commitment to society.
Obligations as expressed in the provisions of the Code constitute a general framework, providing
guidance for nurses when confronted with moral uncertainty. The Code of Ethics provides a
framework from which nurses can engage in ethical analysis and decision-making, a process to
which nurses also bring their own moral understanding and world view. The Code of Ethics for
Nursing is the foundation for all nursing practice.
Legal Framework: Nurses are expected to follow all federal and state laws. Legal accountability
is an essential concept of professional nursing practice. The Nurse Practice Act, the law passed by
a state legislative body, defines the scope of nursing practice. The practice of nursing is further
defined by the rules and regulations enacted by each states Board of Nursing, standards of care
defined by professional nursing organizations, and policies and procedures of employing
institutions. Legal guidelines serve to protect the public. The Kentucky Nurse Practice Act, the
law passed by the state legislative body, defines the scope of nursing practice. The practice of
nursing is further defined by the rules and regulations enacted by the Kentucky Board of Nursing
(KBN), standards of care defined by professional nursing organizations, and policies and
procedures of employing institutions. Legal guidelines serve to protect the public. Students should
familiarize themselves with the Kentucky Board of Nursing website (www.kbn.ky.gov);
specifically Kentucky Nursing Laws and Kentucky Administrative Regulations.
Regulatory Frameworks: Nurses practice under the Nurse Practice Act, Rules and Regulations
of the Board of Nursing, and other regulatory administrative bodies. The laws, rules, and
regulations establish and govern the nurses professional scope of nursing practice. The regulatory
practice framework has the primary intent of protecting the public.
Standards: The practice of nursing is guided by standards of nursing practice and standards of
client care. These standards are agreed upon levels of excellence and describe the responsibilities
for which nurses are accountable. These standards are defined by professional nursing
organizations and employing institutions policies and procedures.
Standards of nursing practice are written expectations of care the nurse should give.
Standards of client care are written expectations of care the client should receive.
Accountability: Accountability and autonomy are essential elements to the practice of nursing.
With increased autonomy comes greater responsibility and accountability. Accountability
involves follow-up and reflective analysis of ones own decisions which affect client outcomes.
The nurse is accountable for maintaining and updating skills and knowledge needed to perform
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nursing care. The nurse is accountable to clients, the profession, employer and society. To remain
accountable nursing professionals evaluate practices and act to preserve nursing excellence.
Adapted from:
American Nurses Association. (2010). Code of ethics for nursing. Silver Springs, MD: Author.

AMERICAN NURSES ASSOCIATION
STANDARDS OF PROFESSIONAL NURSING PRACTICE

Standards of Practice
The Standards of Practice describe a competent level of nursing care as demonstrated by the
critical thinking model known as the nursing process. The nursing process includes the
components of assessment, diagnosis, outcomes identification, planning, implementation, and
evaluation. Accordingly, the nursing process encompasses significant actions taken by registered
nurses and forms the foundation of the nurses decision making.

Standard 1. Assessment
The registered nurse collects comprehensive data pertinent to the healthcare consumers health
and/or the situation.

Standard 2. Diagnosis
The registered nurse analyzes the assessment data to determine the diagnoses or the issues.

Standard 3. Outcomes Identification
The registered nurse identifies expected outcomes for a plan individualized to the healthcare
consumer or the situation.

Standard 4. Planning
The registered nurse develops a plan that prescribes strategies and alternatives to attain expected
outcomes.

Standard 5. Implementation
The registered nurse implements the identified plan.

Standard 5A. Coordination of Care. The registered nurse coordinates care delivery.

Standard 5B. Health Teaching and Health Promotion. The registered nurse employs
strategies to promote health and a safe environment.

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Standard 6. Evaluation.
The registered nurse evaluates progress toward attainment of outcomes.
Standards of Professional Performance

The Standards of Professional Performance describe a competent level of behavior in the
professional role, including activities related to ethics, education, evidence-based practice and
research, quality of practice, communication, leadership, collaboration, professional practice
evaluation, resource utilization, and environmental health. All registered nurses are expected to
engage in professional role activities, including leadership, appropriate to their education and
position. Registered nurses are accountable for their professional actions to themselves, their
healthcare consumers, their peers, and ultimately to society.

Standard 7. Ethics
The registered nurse practices ethically.

Standard 8. Education
The registered nurse attains knowledge and competence that reflects current nursing practice.

Standard 9. Evidence-Based Practice and Research
The registered nurse integrates evidence and research findings into practice.

Standard 10. Quality of Practice
The registered nurse contributes to quality nursing practice.

Standard 11. Communication
The registered nurse communicates effectively in all areas of practice.

Standard 12. Leadership
The registered nurse demonstrates leadership in the professional practice setting and the
profession.

Standard 13. Collaboration
The registered nurse collaborates with healthcare consumer, family, and others in the conduct of
nursing practice.

Standard 14. Professional Practice Evaluation
The registered nurse evaluates her or his own nursing practice in relation to professional practice
standards and guidelines, relevant statutes, rules, and regulation.

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Standard 15. Resource Utilization
The registered nurse utilizes appropriate resources to plan and provide nursing services that are
safe, effective, and financially responsible.

Standard 16. Environmental Health
The registered nurse practices in an environmentally safe and healthy manner.

Source:
American Nurses Association. (2010). Scope and standards of practice (2
nd
ed.) Silver Springs,
MD: Author.

AMERICAN NURSES ASSOCIATION CODE OF ETHICS

Provision One: The nurse, in all professional relationships, practices with compassion and
respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by
considerations of social or economic status, personal attributes, or the nature of health problems.

Provision Two: The nurses primary commitment is to the patient, whether an individual,
family, group, or community.

Provision Three: The nurse promotes, advocates for, and strives to protect the health,
safety, and rights of the patient.

Provision Four: The nurse is responsible and accountable for individual nursing practice
and determines the appropriate delegation of tasks consistent with the nurses obligation to
provide optimum patient care.

Provision Five: The nurse owes the same duties to self as to others, including the
responsibility to preserve integrity and safety, to maintain competence, and to continue personal
and professional growth.

Provision Six: The nurse participates in establishing, maintaining, and improving
healthcare environments and conditions of employment conducive to the provision of quality
health care and consistent with the values of the profession through individual and collective
action.
Provision Seven: The nurse participates in the advancement of the profession through
contributions to practice, education, administration, and knowledge development.
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Provision Eight: The nurse collaborates with other health professionals and the public in
promoting community, national, and international efforts to meet health needs.

Provision Nine: The profession of nursing, as represented by associations and their
members, is responsible for articulating nursing values, for maintaining the integrity of the
profession and its practice, and for shaping social policy.

Source:

Major Topics Covered: Nursing care of childbearing and child-rearing families. Selected
community health concepts.
Course Overview
UNIT I REPRODUCTION / PRENATAL CARE / NEWBORN
The student is expected to review human reproduction. Assessment and care of the prenatal
patient and newborn will be discussed.
Class Hours: 15
Exam #1: 15%
Lab: Demonstration of skills specific to the newborn regarding
gestational age assessment, newborn physical assessment and prenatal care. (See lab calendar for
check-off date).
UNIT II LABOR & BIRTH / POSTPARTUM CARE
The birthing process will be covered with normal physiology and selected problems discussed.
Physiologic changes after giving birth and care of the postpartum patient will be discussed.
Community heath will be discussed in preparation for the ATI exam.
Class Hours: 15
Exam #2: 15%
Lab: Continuation of skills utilized in the care of laboring and postpartum clients.
(See lab calendar for check-off dates).

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UNIT III HIGH RISK ANTEPARTUM, INTRAPARTUM, POSTPARTUM AND
NEWBORN / WOMENS HEALTH CARE
Care of the pregnant woman and family faced with unexpected outcomes will be addressed.
System-by-system physiological changes in the neonate are covered as well as conditions putting
an infant at high risk for mortality and/or morbidity. Womens health issues will also be
discussed.
Class Hours: 15
Exam #3: 15%
UNIT IV LIFE SPAN CONSIDERATIONS/PEDIATRIC HEALTH PROMOTION
AND ASSESSMENT/MEDICATION ADMINISTRATION

The overall focus of this unit is the application of fundamental nursing skills to maternal-
child patients. Students will identify age-related considerations for familiar nursing
diagnosis.
Age specific principles of pharmacology and physical assessment will be addressed,
building on the basic concepts learned in previous semesters. Nutritional and
developmental assessments for the pediatric patient will be discussed along with the
nurses role in maintaining the patients health through medication administration,
immunizations and disease prevention and adequate nutrition. Care of the hospitalized
child and acute pain assessment, intervention and reassessment will be discussed. Certain
pediatric integumentary conditions will also be addressed.
Class Hours: 15
Exam #4: 15%
Lab: New Pediatric skills check-off (See lab calendar)

UNIT V PEDIATRIC CONDITIONS: FLUID ELECTROLYTE IMBALANCE,
GASTROINTESTINAL DYSFUNCTION, RESPIRATORY
DYSFUNCTION, CARDIAC DYSFUNCTION, DISORDERS OF
BLOOD/CIRCULATION, & ENDOCRINE DYSFUNCTION.

Many pediatric conditions will be discussed along with various system abnormalities.
Class Hours: 15
Exam #5: 15%
Lab: Selected Peds. Skills practice.
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UNIT VI PEDIATRIC CONDITIONS: NEUROMUSCULAR DYSFUNCTION,
COGNITIVE/SENSORY DYSFUNCTION, CEREBRAL DYSFUNCTION,
MUSCULOSKELETAL/ARTICULAR DYSFUNCTION, PAHT, END OF
LIFE CONSIDERATIONS
Pediatric conditions will be continued.
Class Hours: 15
Exam #6: 20% (Comprehensive final exam)
65% pediatric content
o 50% new pediatric material
o 15% old pediatric material
35% obstetric content

Teaching Methods:
(1) Lecture. This is meant to supplement required reading as well as to facilitate
understanding and application. The student is expected to prepare for class by keeping
current with recommended learning activities. Handouts may supplement lectures.
Audiovisuals may be used in class and/or assigned for viewing.
(2) Discussion. The faculty focusing on classroom content will facilitate structured small
group discussions. Students are expected to participate. This may include case studies.
(3) Readings. The student is responsible for information contained in the bibliography and
text as designated by the instructor and/or course outline.
(4) Pharmacology Concept Maps: To increase understanding of specific drug classifications,
students will be assigned weekly Pharmacology Concepts Maps. There will be a total of
13 Pharmacology Concepts Maps to be completed in this course (worth 2% of course
grade). See assignment description and rubric located within the syllabus.
(4) College Laboratory. The student is expected to maintain his/her technical skills learned in
previous semesters. He/she will be introduced to skills specific and appropriate to
obstetric and pediatric patients.
Sign-up times for lab practice will be announced. The student is expected to use his/her
designated time so that overcrowding is avoided. The student may be referred to the lab to
practice a specific skill as recommended by his/her instructor.
THESE METHODS ARE REQUIRED TO INSURE SAFE PATIENT CARE. (See
additional information regarding skills check-offs, as an evaluation method.) The student
handbook discusses the consequences of not completing lab hour requirements.
20
(5) Audiovisuals. Within the college lab are housed a number of videos. The student may
view these on the VCR in the lab. Some audiovisuals are required.
(6) Exam Review. There will be no review sessions prior to unit exams. Students are
expected to bring questions to class while content is being presented.
Exam rationale will be provided after each exam. No pens, pencils, cellular phones, or
tape recorders are permitted while viewing rationale. No direct questions will be read
during the rationale. Students with concerns about particular questions must submit,
in writing, evidence based research to support the rationale he or she chooses. The
evidence must be turned in to the faculty within 1 week of the exam. The reference
must be cited and written in APA format. Exam rationale will be provided after each
exam. Concerns about particular questions must be submitted in writing to faculty
within 1 week of the exam.
(7) Clinical Experiences:
Students will have one 9-hour clinical experience weekly for 7 weeks (one in OB and
one in Pediatrics) in which they will provide nursing care to clients under the supervision
of a clinical instructor. Students will complete all clinical objectives for the current
rotation during the seven week time frame for that rotation.
Transportation to and from the clinical site(s) is the responsibility of the student.
See Clinical Syllabus for clinical objectives and assignments for each clinical
experience. Certain clinical experiences outside of the hospital setting will be
required and students will be asked to adjust their schedules accordingly. See Clinical
absence policy in syllabus.

Evaluation Methods/Grade Computation/Grading Scale:
Grading Scale: A = 91-100%
B = 83-90%
C = 77-82%
D = 70-76% (not passing in nursing)
F = 69% and below
Dosage calculation: A dosage calculation exam will be given prior to the student administering
medications in the clinical setting. The student must achieve a score of 90% or higher on the
dosage calculation exam within two attempts. If the student is not successful on the first attempt,
the student is responsible to schedule a time to take the second dosage calculation exam before
the due date specified in the course calendar. If the student does not achieve a score of 90% or
higher on the dosage calculation exam by the second attempt, the student may not pass
medications in the clinical setting, and therefore, cannot successfully pass the clinical portion of
21
the course and will fail the course. The dosage calculation exam is recorded as pass or fail; the
score is not averaged into the classroom grade average. IF A STUDENT IS UNABLE TO
ACHIEVE A 90% ON THE SECOND AND FINAL DRUG CALCULATION TEST, THE
STUDENT WILL RECEIVE AN UNSATISFACTORY CLINICAL GRADE AND AN
AUTOMATIC DISMISSAL FROM THE NURSING PROGRAM.
Exams:
There will be five unit exams throughout the semester and a comprehensive final exam. There
will be NO make-up exams during the semester. It is recommended that students not miss an
exam during the semester. If an exam is missed, the percentage of that exam will be divided
equally among the remaining exams (Excluding Final Exam). See the ADN Student Handbook
for more details on the exam guidelines. No electronic devices are allowed in the exam area. A
simple calculator will be allowed. If a student is found with an electronic device during the exam
the student will receive a zero for that exam and be asked to leave.
Exam rationale will be provided after each exam. No pens, pencils, cellular phones, or tape
recorders are permitted while viewing rationale. No direct questions will be read during the
rationale. Students with concerns about particular questions must submit in writing evidence
based research to support the rationale he or she chooses. The evidence must be turned in to the
faculty within 1 week of the exam. The reference must be credible and cited with the page
number. Material must be written in APA format.
Critical Thinking paper:
Students will complete a 4-5 page (not including title page or reference page) critical thinking
writing assignment worth 3% of the course grade. The paper will address one of the Healthy
People 2020 Focus and Topic Areas related to maternal-child health. The focus of the paper is to
offer an evidence-based strategy that would facilitate the attainment of the set target for that topic
area. The student MUST be familiar with Healthy People 2020 and reference the specific target
and goal in the paper in order to meet the criteria of this assignment. The student will need at least
one nursing scholarly source of reference; it MUST BE from an evidence-based, peer-reviewed
journal. Other scholarly resources may include course textbooks, class handouts, or citations from
evidence-based practice websites, health organization (ie. WHO, NIH, CDC). All papers must be
formatted and referenced in 6th edition, 2
nd
printing, APA style (Times New Roman or Arial font
size 12 with margins of 1 at top/bottom and sides). The paper is graded based on the Critical
Thinking Rubric. Students are to follow formatting for a manuscript style paper as described in
the APA manual 6th edition, 2
nd
printing. Students are encouraged to meet with Mr. Coffey
before the assignment is due to review their paper/progress. Papers will not be proofread by
email. (Please make an appointment by using the sign up sheet located on Mr. Coffeys door.)
Students not adhering to APA format/style will lose up to 10 points off the final paper grade. The
final draft of the paper is to be submitted to the course faculty prior to class time on the due date.
22
The nursing scholarly source must be attached with the paper. Papers without the article will not
be graded. Please refer to specific description of assignment and grading rubric found in this
syllabus. Papers are to be submitted electronically (without the nursing article) also. Late papers
will not be graded.
Pharmacology Concept Mapping:
Pharmacology Concept Mapping

A concept map is a visual representation of a topic and the interrelationship of concepts and ideas.
Concept mapping uses both the left and right hemispheres of the brain, increasing comprehension
and long term storage of information in the memory. The purpose of this assignment is to increase
your understanding of medications covered in this course and to learn to apply this information
utilizing the nursing process. You will be assigned medication classifications for which you will
create a concept map in preparation for lecture content and classroom discussion. This map is a
visual representation of the application of the nursing process related to medications. This
assignment is to be handwritten and may be completed according to your unique learning style
(linear outline format, pictorial images, etc) while following the guidelines for content as listed:

Required elements for EACH concept map
23
Center Node: Begin the assignment with the drug classification as your center concept. This
concept should include a listing of the classification, general class characteristics (mechanism of
action), common brand and generic names, and common suffix (if applicable).
Assessment Node: List 3 (minimum) key pieces of information that should be assessed prior to
giving a medication within this drug class. This may include specific vital signs, laboratory
results, or physical examination needed prior to administration.
Nursing Diagnosis Node: List one priority nursing diagnoses for a client receiving a medication
within this drug class (i.e. digoxin (Lanoxin): Altered Cardiac Output R/T alteration in heart
rhythm).
Planning Node: Include an appropriate goal statement (client centered, measurable, and within a
specific timeframe) related to the nursing diagnosis for a client receiving a medication within this
drug class (i.e. The client will maintain adequate cardiac output AEB HR 60-100 bpm with
regular rhythm, urinary output > 30 ml/hr, and maintain warm & dry skin by time of hospital
discharge).
Intervention Node: List 3 nursing interventions (minimum), 1 of which must be client teaching.
Evaluation Node: List an outcome that evaluates the effectiveness of planning, interventions and
teaching.
Special Nursing Considerations Node: Please list any information in this node that is important
to understanding this medication class that has not been addressed. This may include information
regarding cultural considerations, geriatric considerations, pregnancy considerations, pediatric
dosing, safety, unique preparation requirements, and administration.

Submission of Drug Classifications See Course calendar
Completed Concept Maps should be submitted by the deadline noted on the course calendar.
All concept maps must be handwritten.

24

CONCEPT MAP GRADING RUBRIC FOR NSG 210

Assignment Rubric: % value
Describes Mechanism of Action for drugs within this classification 15%
Lists common brand/generic names of drugs within this classification 5%
Identifies common suffix of this drug classification (where applicable) 5%
Provides at least 3 examples of assessment data necessary to evaluate prior to drug
administration
15%
Prioritizes the most important Nursing Diagnosis for clients receiving medications within this
drug classification; is written appropriately and includes related-to information
10%
Outcomes: Provides comprehensive goal statement that is client-centered, measures specific
parameters, includes an appropriate timeframe, and directly relates to the provided Nursing
Diagnosis
20%
Incorporates at least 3 nursing interventions that will assist in goal attainment, and/or would
be important to perform for safe and effective medication administration. One intervention
must be client teaching.
10%
Evaluates the effectiveness of planning, interventions, and teaching. Addresses anticipated
outcomes of medication administration and measure how to determine effectiveness of
medication, and/or provided nursing interventions.
10%
Discusses Special Nursing Considerations (not previously addressed) that would be important
to consider prior to, during, and/or following medication administration.
10%
% value for each map : 100%

Concept Maps are 2% of your final NSG 210 grade see NSG 210 syllabus

25

COMPUTING NSG 210 COURSE GRADE:
Name:____________________________
ACTIVITY VALUE GRADE POINTS CUMULATIVE
POINTS/AVERAGE
EXAM 1
PRENATAL/NEWBORN
15%
EXAM 2
L&D/POSTPARTUM/
COMMUNITY
HEALTH
15%
EXAM 3
HIGH RISK/WOMENS
HEALTH
15%
EXAM 4
PEDS
15%
EXAM 5
PEDS
15%
PAPER 3%
PHARMACOLOGY
CONCEPT
MAPS
2%
FINAL EXAM-
COMPREHENSIVE
20%
26

FINAL GRADE

ATI POINTS ADDED
AFTER ALL
DEDUCTIONS ARE
APPLIED

Collaborative testing:
Based on evidence presented in a recent Nurse Educator article regarding Collaborative Testing,
we want to offer each of you an opportunity to participate in the Nursing and Science Department
Collaborative Testing project. Participation is strictly voluntary. The goal of this project is to
increase the students knowledge and understanding of the material, facilitate communication, and
increase the students retention of the course contents.
Students participating in collaborative testing will be placed in collaborative testing groups. On
exam day, after the unit exam, students will be placed in their collaborative testing groups. Students
will be given 30 minutes to discuss and complete the exam. Questions to faculty members or other
class members will not be allowed. You may ONLY discuss exam questions with members of your
collaborative group. The group as a whole will receive additional points added to their test grade.
You MUST be present and take part in collaborative testing to receive group points. Points will be
given as follows: A (91-100) = 1 point, B (83-90) = 0.75 points, C (77-82) = 0.5 points. No points
will be given for any grade lower than 77 (C).
Any collaborative group found with any electronic devices will receive a zero on the exam both
collaborative and individual exam.

ATI Testing:
Assessment Technologies Institute (ATI) is a process that strives to strengthen the student
remediation program that consists of assessments, books, and DVDs that work in tandem to aid
the student in review and remediation of the nursing program curriculum. There are two types of
assessments: proctored and non-proctored; both are taken on a computer. Non-proctored exams
are exams that students take on their own without a faculty member present; may be taken any
place including at the students home. Proctored exams are those in which a faculty member
supervises students taking the exam.
Students will be given identification numbers and ATI materials early in the semester and are
encouraged to practice taking the non-proctored exams prior to taking the proctored exam.
27
Students are strongly encouraged to use the books and DVDs and non-proctored (practice) exams
to prepare for the proctored exam(s).
An ATI proctored exam(s) will be given during each course (more than one exam for some
courses) in which:
A score corresponding to the enclosed table for each particular exam (on the
Individual score) is required to pass that exam.
A student whose score meets the cut score provided in the enclosed table on all
proctored exams will earn five (5) points at the end of the course provided the
student has a final grade of 77% in the course and completed all proctored exams
within specified timeframe that semester. All classroom minutes and lab
deductions will be applied before ATI points. Note: In courses where there is
more than one proctored exam, to earn five (5) points, a student must meet or
exceed the cut score on all exams to earn five (5) points.
No ATI points will be applied until the final grade is determined.
If the student makes or exceeds the cut score, remediation is still recommended on
areas of weakness.
After a student completes an exam, the results/score and remediation outline will
be displayed immediately on the computer screen. The remediation assignment
will be on areas in which he or she scored below the listed cut score for that
particular proctored exam.
Students who score lower than the cut scores provided must remediate and make
90% on the non-proctored exam(s) to pass the course. The students will be
expected to utilize the ATI books and DVDs in the remediation process and may
retake the non-proctored exam as many times as it takes within seven days of the
time of the proctored exam (unless otherwise stated by course faculty) in order
to achieve a 90% score. The student, however, may only take the non-
proctored exam once every 24 hours.
After achieving 90% on the non-proctored exam, the student is expected to print
his or her test results and give it to the course instructor. A student who has earned
a 90% on all non-proctored exam(s) within seven days of the time of the
proctored exam (unless otherwise stated by course faculty) that course will earn
two (2) points at the end of the course provided the student has a final grade of
77% in the course. All classroom minute deductions will be applied before ATI
points.
A student who earns 90% on the non-proctored exams but fails to complete the
exams within seven days of the time he or she took the proctored exam will
earn no additional points. Exams must be completed and results turned in to
the instructor by the time their proctored test was taken.
Students are expected to attend ATI testing at their assigned time. Failure to do so
will result in the student not being eligible for additional points. If the student
cannot attend their assigned time, faculty must be notified prior to testing time.

28
Those students who do not have a final grade of 77%, those that do not achieve the
posted cut score on all proctored exams, or 90% on all non-proctored exams within
the above guidelines will fail the course.

The final grade is the earned grade after all deductions including, but not limited to
classroom minutes and lab deductions are applied.

Proctored Assessment Cut Score
Fundamentals for Nursing Practice 68
Adult Medical-Surgical Nursing NSG120
Adult Medical-Surgical Nursing NSG225
64
69
Nursing Leadership 72
Community Health Nursing 65
Maternal-Newborn Nursing 68
Nursing Care of Children 67
Nursing Pharmacology 70
Mental Health Nursing 68
RN-Comprehensive 75

Date adopted: January 28, 2005; Revised March 22, 2005; Revised May 18, 2007; Revised June
30, 2008; Revised May 20, 2009.

CLINICAL WORK GRADING SCALE

Students do not receive a separate grade for clinical/college laboratory experiences. If the student
achieves satisfactory progress in clinical practice, the grade earned by the student is the theory
grade. A failing grade will be assigned if clinical practice is unsatisfactory regardless of the
theory grade. Students must satisfactorily complete both theory and clinical to pass the
course.

CLINICAL EVALUATIONS
29

Clinical progress evaluations between instructor and student will be scheduled at mid-semester
and at the end of the semester. Should the student have two instructors during these periods, the
evaluation will contain combined input from each instructor. The student may be asked to
schedule a conference during a rotation. The evaluation sheet is included in the clinical syllabus.

CLINICAL LABORATORY:
Experiences are planned in order to provide the student with the opportunity to apply knowledge
and skills in the clinical area. Students are expected to prepare for these experiences by
completing worksheets, drug cards/medication sheets, and other work assigned by the clinical
instructor. Specialty areas will require a skills check-off prior to patient care. Each student
should note the dates for his/her groups orientation and plan his/her lab time accordingly.
The student may not participate in patient care until the lab check-off is completed.
Therefore, a clinical absence will be given to the student who comes to the clinical setting
unprepared to give safe patient care.
Clinical Presentations:
1. Obstetric Teaching Plan and Presentation: As part of the clinical experience in the obstetric
setting students will be required to select a relevant obstetric topic of choice, prepare and teach a
patient about this topic, and then briefly present this topic to the clinical group during a post
conference. The teaching plan must include a visual aid that is used with the patient and the
presentation should not be longer than 10 minutes. See criteria located in clinical syllabus.

2. Pediatric Presentation: As part of the clinical experience in the pediatric setting student will be
required to present a brief post conference topic. Students are to work together with another
classmate in the clinical group to present a relevant pediatric topic. Date due will be announced
the first meeting of class. The approved topics, guidelines, and evaluation form are located in the
clinical syllabus.

NURSING SKILLS LABORATORY AND WORKSHOPS:
Students are required to attend all Skills Workshops as listed on the course and/or nursing skills
laboratory schedule(s). Students must attend the Skills Lab a minimum of one hour per week.
Students will be assigned a weekly Skills Lab time at the beginning of the semester and are
encouraged to utilize the lab for extra practice with clinical skills as needed. After demonstration
and practice, the student must demonstrate safe performance of the skill (check off) to the Skills
30
Lab instructors before being allowed to perform the skill in the clinical setting. Students are
responsible for providing documentation of check-offs to the clinical instructor. Attendance in
the Skills Lab is mandatory; in the event a student must be absent (illness, etc.) the student must
contact the Skills Lab instructors as soon as possible to arrange make-up time. See Lab
Attendance Policy.

CLINICAL SKILLS:
All previous skills must be reviewed. The student is expected to spend one hour of lab time
reviewing old skills.
New clinical skills specific to maternal-child nursing will be introduced throughout the course.
Designated skills will require check-off prior to performing in the clinical setting (see 210 Lab
requirements). The dates for check-offs are on the SKILLS LAB calendar. Please refer to your
lab book for the critical requirements for each skill.

PRE-AND POST-CONFERENCES:
The conferences before and following clinical/college laboratory experiences are an integral part
of the course. Students are expected to meet specific objectives in each clinical assignment.
Students are expected to attend all pre and post conferences.

CLASS ATTENDANCE AND CLINICAL POLICY: Refer to the ADN Student Handbook.
Classroom attendance and promptness is expected. Students are responsible for reading and
understanding the attendance policy for each nursing course. Course faculty defines the
attendance policy and the policy is printed in the course syllabus and reviewed in class at the
beginning of the course. Students enrolled in the Nursing Program are expected to attend all
planned nursing classes, clinical, skills lab, and mandatory workshops. In addition, the student is
expected to be on time. Class roll will be taken each day. The faculty for each course is expected
by the college to maintain an accurate record of each students class attendance. This record shall
be available to the student, his/her faculty advisor and the offices of the college. It is the
students responsibility to sign the roll sheet--students may not sign in for each other.
Failure to sign the class roll will result in the student being counted absent. If a student arrives late
or leaves early, they will be expected to signify the appropriate arrival/departure time on the
attendance sheet.

Students are required to notify the appropriate course faculty/instructor if an absence is deemed
necessary. This applies to classroom, clinical, skills lab, or workshop absences. If an absence is
necessary, the student must call the course faculty/nursing office (classroom absence) or the
clinical instructor (clinical absence) thirty (30) minutes before the assigned time to report.
Students are not permitted to report absences for another classmate. It may be considered a
voluntary withdrawal if a student does not call to report an absence/tardy and does not show up
31
for clinical as determined by instructors and the Nursing Department Chair. The student must go
through the formal withdrawal process to make this official. Students absent from class are
responsible for acquiring all materials discussed during the missed class lecture. Evidence-based
research has linked successful academic performance with good class attendance; therefore,
students are expected to attend all class sessions. Students make meaningful contributions to
classroom discussions as collaborative learning occurs while listening to the viewpoints and
experiences of others. All students suffer when viewpoints of colleagues are missed. Student
attendance is a necessary component of professionalism.

After a student misses 500 minutes (or 10 class hours) of class during any given semester; each
subsequent hour (50 minutes) of absence, up to and including 1000 minutes (or 20 class hours) of
absence, will result in a loss of 0.5% from the final grade. The student, whose absence exceeds
20 class hours or 1000 minutes, is subject to automatic failure of the course and may be
involuntarily dropped from the program.

Faculty members may give special consideration to students involved in college-sponsored
activities. Each student is responsible for conferring with his or her professors regarding
participation in such activities. The student is advised that participation in college-sponsored
activities shall not excuse him or her from the completion of all course assignments required by
the faculty for a satisfactory grade in the course.
CLINICAL ABSENCES POLICIES:

There are NO excused absences from the clinical area. Faculty members reserve the right to
assign make-up assignments at their discretion. A clinical absence on a day prior to an exam will
be reviewed by the nursing faculty. Any time a student is absent from the clinical and/or college
laboratory, he/she must call that area 30 minutes before assigned time to report his/her absence
directly to the clinical instructor. It may be considered a voluntary withdrawal if a student does
not call and does not show up for clinical. There may be a fee of $350.00 per clinical day for
any makeup clinical. All clinical make-up times MUST be scheduled with the clinical
instructor and at the instructors availability.

If a student is tardy from clinical, all minutes must be made up before the student can successfully
pass the clinical portion of the course. An intervention by conference form will also be completed
with excessive tardiness. Excessive classroom and/or clinical absences and tardiness may lead to
possible dismissal from the Nursing Program. Students are expected to be on time.

Students must comply with the Midway College dress code (see Student Handbook) AND
WEAR HIS/HER OFFICIAL MIDWAY NAME BADGE AT ALL TIMES. IF THE
CLINICAL FACILITY REQUIRES A NAME BADGE AS WELL, BOTH SHOULD BE
WORN FOR CLINICAL.
For clinical greater than 5 hours in length, a student is allowed one 30-minute lunch break. No
student should leave the hospital without his/her clinical instructors permission. Students are
32
responsible for staggering their meal times so that no more than half the students are off the floor
at any one time. Report off to each other and staff as appropriate; and, cover each others patients
during mealtime or anytime it becomes necessary for the student to leave the unit.

LATE WORK (Clinical): Assignments are to be complete and submitted on time according to
the timeline posted by the instructor. This is necessary in order for the instructor to give
appropriate feedback. Any clinical paperwork received after the posted deadline will be
considered late and full credit will not be given. Late weekly paperwork will be reflected in the
clinical evaluation and can lead to an unsatisfactory clinical grade. The course instructors will
have the final decision regarding late paperwork.

EMPLOYMENT HOURS:
A nursing student is NOT permitted to work 11:00 p.m.-7:00 a.m. prior to a day (7:00 a.m.)
clinical. It is strongly recommended that students not work prior to classes. Employment should
be accepted with caution against overload. Many students have realized that, to insure success,
outside workload must decrease as they progress through the program. Each student should select
work hours carefully. Students will be counseled on an individual basis if work seems to be
interfering with clinical or class performance. It is recommended that no student work more than
20 hours per week to give adequate study time for this course.
WRITING POLICY:
Written assignments must be typed, double-spaced, with one-inch margins and 11 or 12-point
font. Academic writing at Midway College should be composed in Edited American English;
colloquial language and dialect are appropriate in other contexts but should not be used in
academic work. Avoid the use of the first person (I, we), the second person (you), and slang
jargon in formal writings in this course. Even when you are asked to state your opinion, your
reader will assume the ideas are yours unless you specifically say that they belong to someone
else. Course faculty expects that students have knowledge of appropriate forms of documentation
and use it where appropriate. Use the APA 6
th
edition format and style of notation to credit all
sources not your own. Students are encouraged to utilize the college Writing Lab for assistance in
topic development. There is a craft to writing. Spelling, grammar, punctuation and diction (word
usage) are all tools of that craft. Writing at the collegiate level will show careful attention to these
elements of craft. Work that does not exhibit care with regard to these elements will be considered
as inadequate for college writing and graded accordingly. Students are encouraged to utilize the
college academic support center for assistance as needed.
WRITTEN ASSIGNMENTS:
Papers are due by the end of the class period on the assigned due date. Any papers received
after this time will be considered late and the student will receive a zero on the assignment.
If a student is absent on the day a paper is due, it is the students responsibility to fax or e-
mail the paper in its entirety (including journal articles) to the assigned instructor before
33
the beginning of the class period on the due date. Failure to comply with this policy will
result in the student obtaining a zero on the assignment.

ACADEMIC HONESTY POLICY:
Please review the policies in the Midway College Catalog. Academic dishonesty, including
cheating, fabrication and plagiarism, is regarded as an act of fraud and will be reported to the
appropriate Dean. Proper documentation is necessary for maintaining standards regarding
academic honesty. Any student needing assistance in understanding appropriate documentation
should consult with the course faculty, utilize college writing center, and/or seek other assistance.
Students may receive a zero for plagiarized work.

SERVANT LEADERSHIP:
A minimum of 2 hours community service is required of each student every semester. The
service MUST be health-related. Check with your instructor to see if your service will complete
this requirement. Experiences that are part of clinical cannot be used for community service hours.
Please make copies of the form included in this syllabus for your personal use. Final course grade
will be held until community service is completed and recorded. A copy of the Servant Leadership
form is in the syllabus.

LEADERSHIP PORTFOLIO:
Students are to continue to develop their Leadership Portfolio and bring to every academic advising
session. Students should be prepared to submit their portfolios for final grading in NSG 230. It is
the students responsibility to observe for announcements of opportunities to obtain portfolio points.
Announcements are posted on the bulletins boards for each class and outside the nursing classroom.
It is also the responsibility of the student to meet regularly with his or her advisor to receive feedback
on their progress. The Leadership Portfolio is a graduation requirement.

34

Weekly Schedule: Specific reading assignment can be found with lecture objectives. This is
a general outline. Faculty retain the right to alter the schedule as they deem necessary. Any
changes will be announced in class and/or notification will be made via email.
Date Topic Assignment Work Due
August 18

Orientation-
Intro to Maternity Nursing & Community
Health Concepts; Heredity & Genetics;
Reproduction/Fetal Development;
Chapters 1,2,3,4,12,
Review previously
learned material
from A & P courses
Dosage
Calculation
Exam
August 20

Anatomy/Physiology of Pregnancy
Physiologic/Psychosocial Adapt.
Maternal/Fetal Nutrition during
Pregnancy
Chapters 13, 14 Dosage
retake 1:00
pm
August 25

Nursing Care during Pregnancy
Prenatal Care/ Risk Assessment
Chapter 15, 26
August 27

Newborn Physiologic Adaptations
Newborn Nursing Care & Nutrition
Chapters 23, 24, 25

Sept. 1
Labor Day
No Class
Sept 3

Exam 1
Sept 8

Labor & Birth Chapters 16,

Sept 10

Pain Management/ Fetal Assessment
during Labor
Chapters 17, 18
Sept 15

Intrapartum Care/
Postpartum Adaptation/Postpartum Care
Chapter 19
Chapter 20, 21, 22

Sept 17
Exam 2
Sept 22

Complications of Pregnancy Chapters 27, 28, 29

35
Sept 24

Complications of Pregnancy; L&D
Complications
Chapters 30, 32, 33
Sept 29

Postpartum Complications
Complications of the Newborn
Chapter 34, 38
Chapters 35,36,37

Oct 1 Community Health ATI BOOK OB ATI
Oct 6 Womens Health Chapters
Handouts
Community
ATI
Oct 8
Exam 3

36
Oct 13

Lect.1 Begin Pediatric Nursing
Growth and Development
Chapters 3,4,5

Oct 15

Lect
2,3
Communication, Physical Assessment;
Growth, Development & Health
Problems of Infants & Toddlers
Chapters 6,10,11
Oct 20

Lect.4 Health Promotion and Problems of
Preschoolers, School-Age children
and Adolescents
Chapters13,14,15,16,17
Oct 22 Lect
5,6
Pain, Care of the Hospitalized Child,
Medication Administration
Chapter 7, 21, 22
Oct 27

Lect 7 Integumentary Dysfunction Chapter 30
Oct 29

Exam 4
Nov 3

Lect 8 Fluid/Electrolyte Imbalance;
Gastrointestinal Dysfunction

Nov 5

Lect 9 Genitourinary Dysfunction Chapter 27
Nov 10

Lect
10
Respiratory Dysfunction Chapter 23
Nov 12

Lect
11,12
Hematology/Oncology
Cardiac Dysfunction,
Chapter 25, 26 PAPER DUE
Nov 17

Exam 5
Nov 19

Lect
13
Endocrine Dysfunction Chapter 29
Nov 24 Lect
14
Neuromuscular Dysfunction,
Cognitive Sensory Dysfunction
Chapter 32, 19

Nov 26
NO CLASS- THANKGIVING
BREAK

Dec 1 Lect
15,
Cerebral Dysfunction, Chapter 28, 31 PEDS ATI
Dec 3 Lect
16, 17
Musculoskeletal/Articular
Dysfunction;
PAHT CE
PPT; pp. 555-566

37

STUDENTS WITH DISABILITIES:
It is the policy of Midway College to accommodate individuals with disabilities pursuant to
Federal law and the Colleges commitment to equal educational opportunities. It is the
responsibility of the student to request accommodations through the ADA procedures of the
college found in the Midway College Catalog and Midway College Student Handbook. It is the
responsibility of the student to inform the instructor of any necessary accommodations at the
beginning of the course.
TAPE RECORDING:
Taping of classes is not prohibited by Midway College. However, individual faculty retains the
right to determine whether students may tape in a specific course. Students may not share any
tape recorded lecture with any other student. Students may not share recorded lectures
through social media platforms of any kind. Students should use tapes only as a refresher for
the topics discussed and the flow of content and ideas generated in class. TAPE RECORDING
OF RATIONALE REVIEWS FOLLOWING TESTS IS STRICTLY PROHIBITED. It is
the students responsibility to turn off the recorder during breaks and when the lecture is
complete. Failure to comply with the above classroom rules may result in the student not being
allowed to record.

BEEPERS AND CELLULAR PHONES:
Beepers and cellular telephones must be turned off in class and clinical. The instructor reserves
the right to request cellular devices be brought to the front of the classroom if a distraction is
occurring as a result of their use.

DISRUPTIVE BEHAVIOR:
Disruptive behavior (which includes talking or texting to fellow classmates during lecture) in the
classroom will not be tolerated. Faculty reserves the right to dismiss a student from the
classroom if behavior is deemed disruptive. Security will be notified if the behavior continues.
Continued disruptive behavior by a student may be cause for permanent dismissal from the
classroom and a subsequent failing grade in the course.

SYLLABUS INFORMATION:
Students are responsible for obtaining assignments for each class and keeping track of any
changes throughout the course. If the student is unsure about any assignment or assistance is
needed, the instructor should be the first contact.

Faculty reserves the right to make changes or corrections to the syllabus throughout the
semester if necessary. Students will be notified either by mail, e-mail, or verbally of any
changes made.

38
*To Keep Updated*: It is the responsibility of the student to frequently check the BULLETIN
BOARDS located in the nursing lab and outside the classrooms for classroom updates and
personal messages. Students should check their Midway College email daily.

MIDWAY EMAIL:
All students are expected to maintain and check their Midway email address daily for updates or
course information. It is the responsibility of the student to make sure his/her email is working.
If not, the student should contact the technology department. The student must provide the
instructor(s) with an alternate method to contact them if necessary. Students are responsible for
clearing out their mailboxes so that course information can be received.
STUDENT REPRESENTATION:
Each semester students elect a classroom and clinical representative to facilitate communication
between students and faculty by meeting regularly with course coordinators, as well as attending
Nursing and Science Division meetings. Student feedback is seriously considered in governance
of the nursing program. Reports of student
satisfaction, positive learning experiences, and suggestions related to curriculum and program
operations are encouraged.
RESOURCES:
Accreditation Commission for Education in Nursing (ACEN), formerly known as the National
League of Nursing Accreditation Commission, Inc., Standards 3.8 and 4.0, and SACSCOC,
Standard 4.2.
American Nurses Association. (2010). Scope and standards of practice (2
nd
ed.) Silver Springs,
MD: Author.
NLN Education Competencies Model

39
CLASSROOM OBJECTIVES
UNIT 1

Introduction to Maternity Nursing
Learning Objectives:
1. Describe the scope of maternity, pediatric and womens health nursing.
2. Examine the Healthy People 2020 goals for maternal-child health care.
3. Explain risk management and standards of practice in the delivery of nursing care to women
and children.
4. Discuss legal and ethical issues in the health care of women and children.
5. Identify National Goals and QSEN Competencies as they related to maternity nursing.
Assignments/Learning Activities:
Maternity & Womens Health Care: Chapters 1, 2
Visit the Healthy People 2020 website: www.healthypeople2020.gov

COMMUNITY HEALTH
1. Identify the roles and functions of the community health nurse.
2. Describe the foundations of community health.
3. Discuss the basic premise of Healthy People 2010/2020.
4. Identify the roles of a community health nurse in preventing and assisting in the aftermath of
bioterrorism.
5. Discuss the components of the community nursing process.
6. Review the fundamentals of epidemiology and provide a worldly example of how a
community health nurse can interrupt the Epidemiologic Triad.
7. Analyze the different types of immunity and provide an example of each.

Learning Activities:
Required Reading: Read your Community ATI book
Complete the study questions at the end of each section.
Visit the Healthy People 2020 website.
Community paper (see syllabus for due date).

40
Heredity and Genetics
1. Discuss the Human Genome project and its implications for maternal-child nursing.
2. Explain patterns of genetic transmission leading to disorders seen in children:
a. multifactorial inheritance
b. unifactorial inheritance
1) Autosomal dominant
2) Autosomal recessive
3) Inborn errors of metabolism
4) X-linked dominant inheritance
5) X-linked recessive inheritance
3. Identify the nurses role in caring for families seeking genetic testing.

Maternity & Womens Health Care: Chapter 3
Study Guide Chapter 3

Human Reproduction and Fetal Development


1. Identify the external and internal structures of the male and female reproductive system.
2. Explain the menstrual cycle in relation to hormonal, ovarian and endometrial responses.
3. Summarize the significant milestones in growth and development during the embryonic and
fetal periods.
4. Describe the development, structure and functions of the placenta.
5. Relate the composition and functions of amniotic fluid.
6. Compare and contrast fetal circulation in utero and the transition that occurs at birth.
7. Utilize reproductive knowledge in health promotion of women and expectant mothers.


Maternity & Womens Health Care: Chapter 4 pgs. 60 69; Chapter 12.
Study Guide Chapter 4 Key Terms/Matching; Review as needed from A & P courses
Chapter 12 Key Terms/Key Concepts
www.Khanacademy.org Fetal circulation meet the placenta
Recommended Miracle of Life video for those who have never seen this film
Evolve Learning Animations for Chapter 12

41
Anatomy and Physiology of Pregnancy
Physiologic and Psychosocial Adaptations


1. Describe the physiologic and psychosocial changes occurring during pregnancy.
2. Explain causes for common discomforts experienced during pregnancy.
3. Differentiate between presumptive, probable and positive signs of pregnancy.
4. Discuss available methods of pregnancy testing.
5. Apply methods used to record an obstetrical history.
6. Compare laboratory values in non-pregnant and pregnant women.
7. Identify alterations in laboratory values that that may place women at risk.
8. Identify nursing diagnoses related to the management of common discomforts of pregnancy.


Maternity & Womens Health Care: Chapter 13, 14 pgs. 330-336.
Study Guide Chapter 13 (complete all activities prior to class)

Maternal and Fetal Nutrition in Pregnancy


1. Relate the importance of adequate nutrition and weight gain during pregnancy and lactation.
2. Compare the recommended level of intake of energy sources, protein, and key vitamins and
minerals during pregnancy and lactation.
3. Calculate Body Mass Index (BMI) to obtain the desirable weight gain for selected clients.
4. Identify conditions that may alter the nutritional status of a pregnant woman.
5. Summarize foods and substances that should be avoided during pregnancy.
6. Incorporate cultural and ethnic preferences in planning nutritional intake for pregnant women.
7. Recognize difference in needs of adolescent pregnant women.
8. Examine the role of nutritional supplements during pregnancy.
9. Give examples of food sources to supply optimal nutrition during pregnancy.


Study Guide Thinking Critically Discussion of scenarios, pg. 113-114.
Evolve Learning Review online care plan

42
Nursing Care of the Woman and Family during Pregnancy


1. Describe the process of confirming pregnancy and establishing the estimated date of birth
(EDB).
2. Recognize signs and symptoms of pregnancy.
3. Explain the nursing and health care provided to pregnant women during each trimester of
pregnancy.
4. Relate the components of an initial prenatal history and physical exam.
5. Identify warning signs of potential problems during pregnancy.
6. Determine a plan of care for managing common discomforts throughout pregnancy.
7. Select evidenced based interventions aimed at providing quality nursing care to pregnant
women and their families.
8. Examine the effect of cultural, age, parity, and multifetal pregnancy on the response of the
women and her family during the prenatal period.
9. Describe options available for prenatal care and birth settings.


Maternity and Womens Health Care: Chapter 15 Particular attention to all tables, boxes and
nursing care plans.
Study Guide- Chapter 15 Prepare for class by listing common self-care interventions the nurse
can teach pregnant women to help them manage the discomforts of pregnancy. Prioritize teaching
needs by trimester.

43
Assessing For Risk Factors in Pregnancy
.

1. Identify indications for prenatal diagnostic procedures.
2. Relate the role and responsibility of the nurse when assisting pregnancy women undergoing
diagnostic screenings and procedures.
3. Compare advantages, disadvantages, risks and information that can be obtained when utilizing
each of the following procedures:
Ultrasound
Alpha-Fetoprotein/Multiple Marker Screenings
Chorionic Villus Sampling (CVS)
Amniocentesis
Nonstress Testing (NST)
Contraction Stress Testing (CST)
Biophysical Profile
4. Interpret diagnostic testing results related to fetal wellbeing and implement appropriate
nursing interventions.
5. Recognize psychological and psychosocial aspects of a pregnancy at risk.


Maternity & Womens Health Care: Chapter 26.
Study Guide Chapter 26 Prepare for class by completing Key Terms, Key Concepts, Critical
thinking exercises #3, #4, #5, #6
Evolve Assisting with Amniocentesis (video)

44
The Newborn
Physiologic and Behavioral Adaptations


1. Describe the physiologic adaptations the neonate must make in transitioning from intrauterine
to extrauterine life.
2. Explain the mechanisms of thermoregulation in the newborn and consequences of hypothermia
or hyperthermia.
3. Compare four mechanism of heat loss in the newborn:
Evaporation
Conduction
Convection
Radiation
4. Recognize newborn reflexes and how they are elicited.
5. Differentiate between the periods of reactivity and inactivity following birth.
6. Compare and contrast characteristics and normal deviations in the physical assessment of
newborns.
8. Interpret parameters of normal for weight loss and gain in the newborn.
9. Identify signs that a neonate is at risk for problems related to each body system.


Maternity & Womens Health Care: Chapter 23, 24
Classroom handouts; PowerPoints.
Complete the Newborn Assessment Guide found in clinical packet
Review videos available through Evolve Assessing a Newborns Reflexes and Auscultating
Newborn Heart Sounds
The following videos available in the nursing lab:
Physical Assessment of the Newborn (VHS)
Gestational Age Assessment of the Newborn (VHS)
Newborn Assessment www.youtube.com/watch?v=manXzhiXqME
UMDNJ School of Nursing instructor led video

45
Nursing Care of the Newborn and
Newborn Nutrition
1. Describe the procedure and expected findings for a newborn physical examination.
2. Explain the components of a gestational assessment for the newborn (Modified Ballard Exam).
3. Compare and contrast the characteristics of the preterm, term, and postterm neonate.
4. Recognize methods/interventions to ensure newborn safety.
5. Explain the purpose, methods and nursing responsibilities related to circumcision of the
newborn.
6. Relate significant findings in maternal history that may impact the health of her newborn.
7. Identify teaching need of parents related to newborn care and specific conditions.
8. Differentiate between physiologic and pathologic jaundice in the newborn.
9. Compare and contrast characteristics of newborns that are formula fed with those who
are breast fed.
10. Utilize the nursing process in prioritizing newborn assessment and care.
* Breastfeeding will be covered in depth with Postpartum content

Maternity & Womens Health Care: Chapter 23, 24, 25
Classroom handouts; PowerPoints.
Complete the Newborn Assessment Guide
Review videos available through Evolve Assessing a Newborns Reflexes and Auscultating
Newborn Heart Sounds
The following videos available in the nursing lab:
Physical Assessment of the Newborn (VHS)
Gestational Age Assessment of the Newborn (VHS)
Newborn Assessment www.youtube.com/watch?v=manXzhiXqME
UMDNJ School of Nursing instructor led video
View the following: New Ballard Exam (YouTube), Chap 1, 2, 3, & 4 Dr. Ballard explain her
assessment tool.
Video: Nursing Skills Lab Gestational Assessment of the Newborn (VHS)

46
UNIT II
Labor and Birth
1. Relate various theories of the onset of labor.
2. List the promonitory signs of labor.
3. Describe the physiologic adaptations in body systems during labor.
4. Identify the anatomic structure of the bony pelvis.
5. Recognize the normal measurements of the diameters of the pelvic inlet, cavity, and outlet.
6. Relate the significance of the size and position of the fetal head during the labor and birth
process.
7. Summarize the cardinal movements of labor for a vertex presentation.
8. Describe the primary and secondary powers of labor.
9. Differentiate between the four stages of labor.
10. Analyze the effect of the following on the process of labor:
Fetal Lie Dilation Station Presentation
Fetal Attitude Effacement Position

Study Guide Chapter 16
Handouts/PowerPoints/Flip Charts/Anatomic Models
Evolve Video Assessment Presentation, Fetal Lie, Position

47
Pain Management during Labor
1. Relate how pain can affect the laboring women and labor progress.
2. Compare various non-pharmacologic strategies used to enhance relaxation and facilitate the
labor process.
3. Identify complementary and alternative methods for pain relief during labor.
4. Distinguish between selected types of analgesia and anesthesia utilized during labor and birth:
Systemic analgesia
Nerve block analgesia and Anesthesia
Local
Pudendal
Spinal
General
5. Delineate nursing interventions and responsibilities for laboring mothers receiving analgesia
and anesthesia during labor and birth.
6. Recognize adverse effects of pharmacologic intervention on the woman and fetus during labor
and birth.
7. Utilize the nursing process in providing pain management for the woman in labor

Study Guide Key Terms, Fill in the Blanks, Key Concepts #37, and Thinking Critically
exercises #8, and #9.
PowerPoints

48
Fetal Assessment during Labor
Fetal Monitoring


1. Compare intermittent auscultation of the fetal heart rate with external and internal electronic
methods of monitoring.
2. Identify typical signs of reassuring (normal) and non-reassuring (abnormal) fetal heart rate
patterns.
3. Explain baseline and period changes in the fetal heart rate during monitoring.
4. Describe nursing responsibilities related to fetal heart rate monitoring during labor.
5. Differentiate among the nursing interventions used for managing selected fetal heart rate
patterns:
Tachycardia Minimal variability Variable decelerations
Bradycardia Absent variability Late decelerations
6. Identify appropriate documentation for the monitoring process during labor.
7. Relate standards of care for fetal heart monitoring.
8. Explain client teaching regarding fetal heart rate monitoring.

Maternity & womens Health Care: Chapter 18
Study Guide Key Terms; Reviewing Key Concepts (#27, A-E), #28, #29, #30, #31; Thinking
Critically 1-5.
Additional Fetal Heart Monitoring Guidelines in nursing skills lab (notebook). Students may
make copies if you wish.
Video: Fetal Heart Monitoring In nursing skills lab.
Evolve: Key Points

49
Nursing Care of the Family during Labor and Birth
1. Distinguish between true labor and false labor.
2. Compare methods for determining rupture of membranes.
3. Describe ongoing assessment of progress throughout the stages and phases of labor:
First stage (latent phase, active phase, transition)
Second stage
Third stage
Fourth stage
4. Recognize physical and psychosocial findings indicative of maternal progress during labor.
5. Describe fetal assessment parameters during labor.
6. Identify nursing interventions that facilitate labor progress.
7. Identify evidenced based practices that enhancing the labor and birth process.
7. Utilize the nursing process to plan the care of the woman and fetus during labor.
8. Analyze the influence of cultural, ethic, and religious beliefs and practices on the process of
labor and birth.
9. Describe the role of the nurse during emergency childbirth.
10. Summarize immediate care of the newborn in the birth setting.


Maternity and Womens Health Care: Chapter 19.
Study Guide Chapter 19 (all sections)
Video Immediate Care of the Newborn (in nursing skills lab)
Evolve

50
Postpartum
Adaptations and Nursing Care
1. Evaluate the physiologic and psychosocial changes that occur during the postpartum period.
2. Describe components of a systematic postpartum assessment.
3. Identify factors that affect family adaptation to the birth of a baby.
4. Recognize positive and negative bonding behaviors.
5. Assess cultural influences on family adaptation.
6. Compare and contrast nursing intervention applicable to women who have given birth
vaginally and by cesarean section.
7. Describe teaching related to self-care during the postpartum period and after discharge.
8. Identify cause, manifestations, and nursing interventions related to postpartum blues.
9. Discuss the benefits of breastfeeding for the newborn and family.
10. Describe nursing interventions to facilitate and promote successful infant feeding (breast and
formula feeding).
11. Analyze common problems associated with breastfeeding.
12. Examine special considerations related to breastfeeding.

Maternity and Womens Health Care Chapters 20, 21, 22, 25.
Handouts/PowerPoints
Postpartum Skills Laboratory Check off Information Sheet.

51
UNIT III
Complications during the Prenatal Period

Learning objectives:

1. Explain the pathophysiologic mechanisms of the following disorders/conditions and their
effect on pregnancy, labor, and the fetus:
A. Hypertensive disorders
1) Gestational hypertensive disorders
a. Gestational hypertension
b. Preeclampsia
c. Eclampsia
2) Chronic hypertensive disorders
a. Chronic hypertension
b. Superimposed preeclampsia or eclampsia
B. Hemorrhagic disorders
1) Spontaneous abortion (miscarriage)
2) Incompetent cervix
3) Ectopic pregnancy
4) Hydatidiform mole (Molar pregnancy)
5) Placenta Previa
6) Abruptio Placentae (Placental Abruption)
7) Cord insertion variations
C. Endocrine disorders
1) Diabetes Mellitus ( Pregestational Diabetes)
2) Gestational Diabetes Mellitus
3) Hyperemesis Gravidarum
4) Thyroid disorders
D. Medical/Surgical conditions
1) Cardiovascular disorders
2) Anemia
3) Pulmonary disorders
4) Integumentary disorders
5) Neurologic disorders
6) Autoimmune disorders
7) Gastrointestinal disorders
8) Urinary tract infections
E. Mental health conditions
1) Mood/ Anxiety disorders
2) Substance abuse
2. Identify risk factors, manifestations, and assessment parameters for each condition
complicating pregnancy.
3. Differentiate among screening and diagnostic techniques, including when they are used in
pregnancy and for what purposes.
4. Recognize deviations from normal results of diagnostic testing.
5. Describe nursing care related to each condition complicating pregnancy.
52
6. Identify teaching needs of pregnant women experiencing select complications during
pregnancy.

Maternity & Womens Health Care Chapters 27, 28, 29, 30, 32

53
Complications of Labor and Birth

1. Explain the maternal and fetal risks associated with premature rupture of
membranes.
2. Analyze factors that increase a womans risk for preterm labor.
3. Relate problems that may occur if pregnancy persists beyond 42 weeks.
4. Evaluate common intrapartum emergencies and the therapeutic management
of complications:
Prolapsed umbilical cord
Placental abnormalities
Shoulder dystocia
Uterine rupture
Uterine Inversion
Anaphylactoid syndrome (amniotic fluid embolism)
Trauma
Precipitous labor and birth
5. Compare and contrast types of dysfunctional labor.
6. Recognize signs and symptoms of intrauterine infection.
7. Apply the nursing process to plan care for women with preterm labor.
8. Describe the assessment process in caring for women with specific
complications during the intrapartum period.
9. Delineate appropriate nursing interventions for women with specific
complications during the intrapartum period.
10. Summarize nursing care for a trial of labor, induction and augmentation of labor, operative
vaginal birth, cesarean birth, and vaginal birth after cesarean (VBAC).


Required readings: Maternity & Womens health Care: Chapter 33.
Study guide: Chapter 33.
PowerPoint/ Lecture
Suggested: YouTube Medi-Visual: Shoulder Dystocia Injury

54
Postpartum Complications


1. Explain major predisposing factors, causes, manifestations, and therapeutic
management of the following conditions:
Postpartum hemorrhage
Thromboembolic disorders
Subinvolution of the uterus
Puerperal infection
Postpartum depression and postpartum psychosis
2. Analyze the role of the nurse in the assessment, implementation and evaluation of women
with these selected postpartum complications.


Required Reading: Maternity & Womens Health Care: Chapter 34
Study guide: Critical thinking exercises, pp. 283-284.
PowerPoint/In class discussion.
Suggested: YouTube Bakri Postpartum Balloon Cook Medical

55
HIGH RISK NEWBORN: Problems related to Gestational
Age and Development

1. Explain special needs and problems of the preterm infant.
2. Differentiate between the complications that may result from preterm and
postterm birth.
3. Interpret the effects of intrauterine growth restriction (IUGR).
4. Compare and contrast the problems of small-for-gestational-age (SGA) and
large-for-gestational-age (LGA) infants.
5. Identify common nursing diagnoses and interventions for the:
Preterm infant
SGA infant
LGA infant
IUGR infant
6. Analyze nursing interventions for high risk newborns with problems related
to gestational age and development.

Learning Activities

Required Reading: Maternity & Womens Health Care, Chapter 37.
Study guide: Chapter 37, pg. 310 Baby ANNE
PowerPoint/class discussion.
Review: Video Gestational Age Assessment.

56
HIGH RISK NEWBORN: Acquired and Congenital Conditions


1. Describe the components of neonatal resuscitation.
2. Explain common respiratory problems in the newborn:
Asphyxia
Respiratory Distress Syndrome (RDS)
Meconium Aspiration Syndrome (MAS)
Transient Tachypnea of the Newborn (TTN)
3. Describe the mechanisms leading to persistent pulmonary hypertension
in the newborn.
4. Interpret the causes and significance of pathologic jaundice.
5. Identify causes of neonatal infections.
6. Analyze effects of maternal diabetes on the newborn.
7. Describe the effects of maternal substance abuse in the newborn.

8. Assess signs and symptoms of acquired and congenital conditions in the
newborn.
9. Relate the nursing care for the newborn with respiratory complications.
10. Explain the needs and nursing care of infants undergoing phototherapy.
11. Compare and contrast the care of the newborn born to a mother with
diabetes vs. those born to non-diabetic mothers.
12. Relate the nursing care for infants experiencing neonatal abstinence
syndrome.

Learning Activities

Required Reading: Maternity & Womens Care: Chapter 35, 36,37.
PowerPoint/class discussion.
*Hypoxia in the Term Newborn Parts One, Two & Three. MCN (2009), 34(2 & 3).
. *Required. Article in Skills Lab.

57
WOMENS HEALTH

1. Explain examinations and screenings recommended for womens health
maintenance.
2. Differentiate between benign and malignant breast disorders.
3. Evaluate the importance of self-breast exam and mammography in the
detection of breast cancer.
4. Define terms related to menstruation and conditions of the female reproductive
tract:
Dysmenorrhea Menorrhagia Menometrorrhagia
Metrorrhagia Dysplasia Dysuria
Climacteric Rectocele Cystocele
Endometriosis Enterocele Pelvic Inflammatory Disease
5. Describe selected conditions related to the menstrual cycle:
Amenorrhea Secondary Amenorrhea
Abnormal Uterine Bleeding Premenstrual Syndrome
Premenstrual Dysphoric Disorder Infertility
6. Identify signs and symptoms of malignant disorders of the female
reproductive tract.
7. Describe treatment regimens for women with cancer of the reproductive track.
8. Identify populations at risk for osteoporosis.
9. Explain prevention and treatment regimens for osteoporosis.
10. Differentiate between perimenopause and me
11. Describe physiological and psychological changes associated with
menopause.
12. Analyze the benefits and risks of hormonal therapy in the post menopausal
Patient
13. Describe infectious disorders of the reproductive tract.
14. Discuss physical and psychosocial needs of women experiencing:
Battered Woman Syndrome
Infertility
Induced Abortion
15. Compare and contrast contraceptive methods available to women.
16. Implement health teaching pertinent to women with menstrual disorders.
17. Identify potential nursing diagnoses for women related to their reproductive
changes across their lifespan.
18. Relate nursing interventions for women during perimenopause and
menopause.
19. Explain nursing assessment and interventions for women with reproductive
tract disorders.
20. Evaluate community resources for womens health promotion, maintenance,
and evaluation.
21. Relate nursing responsibilities in assisting women with contraceptives.

58
Learning Activities

Required Reading: Maternity & Womens Health Care: Chapters 4, 5, 6, 8, 9, 10,
& 11 Specific points will be emphasized from each chapter.

PowerPoint
Suggested Video : Self Breast Exam (Available in Lab).

Suggested Video: Infertility (Available in Lab).
Handout: Common Contraceptive Methods

59
CLASSROOM OBJECTIVES PEDIATRICS
UNIT IV
Lecture 1: Pediatric Growth and Development
1. Identify the key points from the following theorists for each psychosocial
developmental stage: Erikson, Piaget, and Freud.
2. Describe the major developmental growth expectations for each developmental age
group.
3. Describe concepts of family, family centered care
4. Identify developmental age periods
5. Describe different types of play and incorporate concept of play into nursing care of
children.
6. Describe the Denver II as a tool for gathering developmental data on the child.
7. Discuss the concept of critical milestone and referral.
Required Reading: Essentials of Pediatric Nursing Chapter 3,4,5

Required Video in Nursing Lab on Growth and Development (be sure you sign the
attendance sheet in the lab indicating you have competed this before your second clinical
day)

Powerpoint

60

Lecture 2: Physical Assessment and Communicating with Children
and Families

1. Describe how to prepare children for a physical examination based on their
developmental needs.
2. Examine the importance of growth measurement.
3. Identify normal vital signs in children of various age groups.
4. Identify the components of communication theory with emphasis on active listening
5. Identify communication strategies for interviewing parents.
6. Formulate guidelines for using an interpreter
7. Identify communication strategies for communicating with children of different age
groups.
8. Describe four communication techniques that are important with children.
9. List three areas that are evaluated as part of a nutritional assessment.
10. Discuss the areas of a medical history to be included in an assessment of a child.
11. Describe the appropriate sequence in gathering physiological data during a physical
examination.
12. Describe the appropriate methods in obtaining vital signs in the child.
13. Describe normal findings of a physical examination for a child.
14. Apply nursing diagnoses for the data gathered during a pediatric assessment.

Required Reading: Essentials of Pediatric Nursing Chapter 6
Powerpoint

61

Lecture 3: Growth, Development, Health Promotion and Health
Problems of Infants and Toddlers


1. Define prevention, health maintenance, and health promotion.
2. Describe the components of the nurses role in the promotion of childrens health.
3. Recognize the recommended schedule for health maintenance visits from infancy through
24 months of age.
4. Outline immunization requirements as recommended by CDC and the American Academy
of Pediatrics.
5. Identify situations that may alter the immunization schedule.
6. Identify the major biologic, psychosocial, cognitive, and social developments during the
first 2 years of life.
7. Relate parent-child attachment, separation anxiety, and stranger fear to developmental
achievements during infancy.
8. Provide parents with feeding recommendations for infants
9. Provide anticipatory guidance to parents regarding safety and injury prevention based on
infants/toddlers developmental achievement.
10. Identify children at increased risk of developing nutritional disorders.
11. List measures that can be used to alleviate colic.
12. Plan nursing care that meets the physical and emotional needs of the infant and family
13. Identify infants at increased risk for sudden infant death syndrome.
14. Discuss apnea and apnea monitoring
15. Recognize readiness for toilet training
16. Help parents foster toddlers language development.
17. Provide parents with guidelines for handling temper tantrums.
18. Discuss preventative dental hygiene and prevention of caries
.


Required Reading: Essentials of Pediatric Nursing: Chapters 10, 11,12.

Powerpoint

62
Lecture 4: Health Promotion and Problems of Preschoolers, School-
Age Children and Adolescents
1. Identify the major biologic, psychosocial, cognitive, moral, spiritual and social
developments that occur during the preschool years, middle childhood years and during
adolescence.
2. List the benefits of imaginary playmates.
3. Prepare preschoolers for preschool or daycare experience.
4. Provide parents with guidelines for sex education
5. Provide parents with guidelines for dealing with a childs fears, stresses, aggression and
sleep problems
6. Recognize the causes of stuttering in the preschool years.
7. Recognize the feeding patterns of .preschoolers
8. Analyze developmental differences that make children of these age groups at risk for
injury and provide anticipatory guidance regarding safety and injury prevention based on
the childs developmental achievements.
9. Examine specific injury prevention strategies for infants, toddlers, pre-school, school age,
and adolescents
10. Identify common communicable childhood diseases such as measles, mumps, rubella,
diphtheria, tetanus, acellular pertussis, rotavirus, chicken pox, hepatitis A & B, and
meningitis
11. List three principles of nursing care of children with communicable diseases.
12. Name four sources of lead in the environment
13. Describe four areas of the history that should arouse suspicion of child abuse.
14. Describe ways to help a child develop a sense of accomplishment
15. Demonstrate an understanding of the changing intererpersonal relationships, socialization
of school age children
16. Demonstrate an understanding of problems related to elimination in school-age children
17. Discuss school age disorders with behavioral components: ADHD, PTSD, school phobia,
bullying, conversion reaction, childhood depression and schizophrenia.
18. Demonstrate an understanding of the processes by which adolescents develop a sense of
identity
19. Discuss sexuality issues surrounding adolescence and sexual identity.
20. Discuss common STIs and disorders of the reproductive system
21. Discuss nutrition and eating disorders
22. Discuss Adolescent behavioral disorders : substance abuse and suicide.

Required Reading: Essentials of Pediatric Nursing: 13,14,15,16 & 17;

63
Lecture 5: Pain Assessment and Management in Children

1. Identify measures to assess pain in children.
2. List various types of pain assessment tools for use with children
3. Outline essential pain management strategies to reduce pain in children..
4. Review common types of pain experienced by children
5. Demonstrate an understanding of the AIR cycle (assessment, intervention, reassessment).
6. Discuss assessment of pain in specific populations: neonates, children with communication
and cognitive impairment, cultural groups and children experiencing chronic pain..
7. Implement safe administration of medications in the clinical setting with varied age
groups.


Required Reading: Essentials of Pediatric Nursing: Chapter 7
Powerpoint

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Lecture 6: Family Centered Care of The Hospitalized Child and
Pediatric Variations of Nursing Interventions


1. Identify stressors of illness and hospitalization for children during each developmental stage
2. List essential priorities of nursing care upon a childs admission to the hospital.
3. Review nursing interventions that prevent or minimize the stress of separation during
hospitalization..
4. Describe nursing interventions that minimize the fear of bodily injury during hospitalization.
5. Outline nursing interventions that support parents, siblings and family during a childs illness.
6. Describe nursing interventions needed when children are admitted to special units such as the
emergency department.
7. Identify instances in which informed consent is required and in which minors may be
considered emancipated.
8. Discuss the role of child life specialists in preparing children for surgery or procedures
9.List general strategies for enhancing compliance in children and families
10.Implement feeding techniques that encourage food and fluid intake
11.Describe methods of reducing the temperature of a child with hyperthermia.
12.Describe systems that can be used for infection control.
13.Describe safe methods of administering oral, parenteral, rectal, optic, otic, and nasal
medications.
14.Identify nursing responsibilities in maintaining fluid balance in children.
15.Describe the procedures involved in providing nutrition via gavage, gastrostomy and
parenteral routes.
16. Describe ostomy care in children.

Required Reading: Essentials of Pediatric Nursing: Chapters 21, 22;.
Required Videos in Nursing Lab on The Hospitalized Child and The Acutely Ill
Child
Powerpoint

65
Lecture 7: The Child with Integumentary Alterations


1. Describe the distribution and configuration of various skin lesions.
2. List the benefits of a moist environment for wound healing
3. Discuss the nursing care related to therapies for skin disorders
4. Contrast the manifestations of and therapies for bacterial, viral and fungal infections of the
skin..
5. Compare the skin manifestations of children related to age.
6. Discuss the rules of nine in assessing burns.
7. Compare and discuss thermal, electrical, and chemical burns. .
8. Describe a plan of care and nursing management of a child with major burn injuries.
9.. Demonstrate how to calculate fluid requirements using the Parkland Formula
10. Identify ways to educate children and parents on burn prevention


Required articles:
Powerpoint

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Unit V
Lecture 8: Gastrointestinal Dysfunction and Fluid & Electrolyte
Balance in Children


1. Explain differences in body fluid, electrolyte composition, and their regulation, which can
contribute to imbalances in various age children.
2. Contrast the types of fluid imbalances.
3. Predict causes of fluid imbalances.
4. Analyze daily fluid requirements based on body weight.
5. Describe the role of the nurse in providing parenteral fluid therapy and total parental nutrition.
6. Examine a plan of care for a child with fluid and electrolyte health problems
7.Compare and contrast the inflammatory disease processes of the GI tract.
8.Describe the nursing care of a child with hepatitis.
9. Discuss teaching considerations for parents of a child with a cleft lip/palate.
10.Discuss structural, obstructive and malabsorption disorders in children.


Required Readings: Essentials of Pediatric Nursing: Chapter 24
Powerpoint

67
Lecture 9: Urinary and Renal Health Problems


1. Describe the various factors that contribute to urinary tract infections in infants and children.
2. Discuss preoperative considerations for the child with a GU structural defect.
3. Demonstrate an understanding of the causes and mechanisms of edema formation in nephrotic
syndrome.
4. Compare minimal change syndrome and acute glomerulonephritis in terms of clinical
manifestations and nursing care.
5. Contrast the causes, complications, and management of acute and chronic renal failure.
urinary and renal system
6. List the types of renal dialysis
7. Recognize signs and symptoms of kidney transplant rejection.



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Lecture 10: Respiratory Dysfunction

1. Identify factors leading to respiratory tract infection in infants and young children.
2. Contrast the effects of various upper and lower respiratory infections in children
3. Explain the signs and symptoms of respiratory distress.
4. Describe the perioperative care of a child with tonsillitis.
5. Explain pulmonary dysfunction caused by non-infectious irritants..
6. Review a nursing care plan for a child with croup.
7. Describe the priorities of nursing care for an infant with otitis media.
8. Identify priorities of nursing care for an infant with RSV..
9. Describe the various therapeutic measures to relieve the symptoms of asthma.
10. Discuss Asthma core measures: the Home Management Plan of Care (HMPC)
11. Describe the physiologic effects of cystic fibrosis on the GI, Endocrine, and Pulmonary
system.
12. Describe emergent procedures for the relief of foreign body obstruction in infants and
children.


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Lecture 11: Cardiovascular Health Problems

1. Compare pathophysiological assessment among cardiac defects with increased
pulmonary blood flow, decreased pulmonary blood flow, obstructive defects and mixed
defects.
2 Demonstrate an understanding of the hemodynamics, distinctive manifestations, and therapeutic
management of congenital heart disease.
3. Describe the care of a child with hypoxia.
4. Describe the care of an infant or child with a congenital heart defect and its surgical repair.
5. Differentiate between rheumatic fever and rheumatic heart disease.
6. List the criteria for selected cholesterol screening of children.
7. Discuss the assessment and management of hypertension in children and adolescents..
8. Discuss the diagnostic criteria and treatment for Kawasakis disease.
9. Discuss shock and the emergency treatment for shock.


Required Reading: Essentials of Pediatric Nursing: Chapter 25.
Powerpoint

70

Lecture 12: Hematologic/Immunologic dysfunction and Blood
Disorders

1. Describe the various kinds of anemia.
2. Describe the prevention and care of a child with iron deficient anemia
3. Compare sickle cell anemia and Beta Thalassemia major in relation to pathophysiology
and nursing care
4. Describe the mechanisms of inheritance and nursing care of the child with hemophilia.
5. Relate the pathophysiology and clinical manifestations of leukemia.
6. Demonstrate an understanding of the rationale of therapies for neoplastic disease.
7. Discuss the plan of care for a child with neoplastic disease and the family.
8. Contrast the pathophysiology and management of immunodeficiency disorders
9. List nursing precautions and responsibilities during blood transfusions
10. Describe the types of hematopoietic stem cell transplants.


Required Reading: Essentials of Pediatric Nursing: Chap 26
PowerPoint

71
Lecture 13: Endocrine and Metabolism Dysfunction


1. Differentiate between the disorders caused by hypopituitary and hyperpituitary dysfunction.
2. Describe the manifestations of thyroid hypofunction and hyperfunction and management of
children with these disorders.
3. Distinguish between the manifestations of adrenal hypofunction and hyperfunction..
4. Differentiate between the various categories of diabetes mellitus..
5. Discuss the management and nursing care and teaching of a child with diabetes mellitus in the
acute care setting.
6. Distinguish between a hypoglycemic and a hyperglycemic reaction.
7. Demonstrate an understand of the rule of 15.
8. Plan nursing interventions for the family of child with diabetes


Required Reading:
Essentials of Pediatric Nursing: Chapter 29.

Review the structure and function of the endocrine system.

Powerpoint

72
Unit VI
Lecture 14: Cognitive/Sensory & Neuromuscular Dysfunction


1. Define the classification of intellectual disability.
2. Define developmental delay.
3. Outline nursing interventions for the child with cognitive impairment that promote optimal
development including during hospitalization.
4. Identify the major biologic and cognitive characteristics of children with Down Syndrome.
5. Outline nursing interventions for children with Down Syndrome.
6. Identify major characteristics associated with fragile X.
7 List the general classifications of hearing impairment and effect on speech.
8. Outline nursing interventions for children with visual impairment including during
hospitalization.
9. Outline nursing interventions for children with retinoblastoma
10.Outline nursing interventions for children with an autism spectrum disorder.
11.Discuss the nursing role in helping parents care for the child who has cerebral palsy.
12.Discuss nursing interventions for a perioperative child with a myelomeningocele.
13. Discuss the plan of care for a child with Guillain-Barr Syndrome.
14.Discuss the home management of a child with a neuromuscular disease such as spinal
muscular atrophy.
15.Discuss the prevention and treatment of tetanus.
16. Identify the causes of botulism in infants and children.
17. List three causes of spinal cord injury in children.


Required Reading: Essentials of Pediatric Nursing: Chapters 19, 32
Powerpoint

73
Lecture 15: Cerebral Dysfunction


1. Describe the various modalities for the assessment of cerebral function.
2. Differentiate among stages of consciousness
3. Distinguish among types of cerebral trauma and submersion injuries.
4. Describe the nursing care of a child with a
nervous system tumor.
5 Contrast bacterial meningitis and aseptic meningitis.
6. Differentiate between the various types of seizure disorders..
7. Describe the perioperative care of a; child with cerebral malformations
8. Describe the nursing interventions needed for preparation of a child
for an LP, MRI, CT scan, and EEG.



Powerpoint

74

Lecture 16: Musculoskeletal and Articular Dysfunction

1. Discuss the immobilization and the plan of care for an immobilized child.
2. Discuss teaching parents to care for the child in a cast.
3. Explain the functions of the various types of traction.
4. Discuss the nursing care of a child in traction.
5. Differentiate various congenital skeletal defects.
6. Describe therapies and nursing care of a child with idiopathic scoliosis.
7. Describe the nursing care and teaching necessary for a child with osteomyelitis.
8. Differentiate between osteosarcoma and Ewings sarcoma.
9. Discuss and describe the nursing care of a child with juvenile idiopathic arthritis
10. Demonstrate an understanding of the management of a child with systemic lupus
erythyematosus.


Required Reading: Essentials of Pediatric Nursing Chapter 31.
Powerpoint

75

Lecture 17: Pediatric Abusive Head Trauma CE (PAHT)

This lecture fulfills the one time KBN requirement for the recognition and prevention of PAHT
for nurses.
It is a 1.5 hour CE.

1. Define PAHT
2. Recognize risk factors for PAHT
3. Discuss mechanism of injury for PAHT
4. Discuss medical management of PAHT
5. Identify injuries associated with PAHT
6. Identify evidence-based prevention strategies for PAHT


Powerpoint

76

MIDWAY COLLEGE

NSG 210

Clinical
Packet

Summer 2014

Rev. April 2014
77

Personal Information Form
In order to help you in the best way, I would like to get to know you better.

Name

Address

________________________________________________(Street)

__________________________________________(City/State/Zip)

Telephone #

(___________) __________-_______________
Past experience related to:
Obstetrics:

Pediatrics:

What would you like to get out of the experience?

How can I best help you during this rotation?

What other classes are you taking currently:

Responsibilities outside those of a student (social, family, church, work, etc.).

78

CRITERIA FOR CLINICAL SETTING

1. No external fever blisters in labor, delivery or NB nursery. On occasion you may be
allowed to work with postpartum patients if no contact is made with the infant. Fever
blisters can be fatal to the newborn!

2. No fever over 100.4, vomiting or diarrhea is acceptable in any area of clinical.

3. No infected external skin lesions. See a physician if you have a problem with shingles,
boils, or similar lesions.

4. Wear masks for febrile colds and/or upper respiratory conditions.

5. Have all throat infections cultured for Strep if they are accompanied by (1) fever, (2) pus
on tonsils, (3) petechiae on palate or posterior pharynx, or (4) enlarged lymph nodes.

6. Receive prompt medical treatment for all vaginal infections such as yeast infections or
genital herpes.

7. If any hospital experiences an increased rate of infection during our rotation, you will be
asked to obtain a nasopharyngeal culture at your own expense.

8. Must meet all immunization requirements of Midway ADN program and any additional
vaccines required by clinical facility.

9. CPR must be current, and must have included pediatric skills.

10. TB skin test must be negative and no older than one year.

11. It is highly recommended that you obtain Hepatitis B vaccine, followed by a titer. Sign a
release form if you have not done this.

12. Review techniques for hand washing, and standard precautions, and perform these
faithfully.

13. Be aware of the implications of taking any medications prior to clinical practice. MANY
MEDS ALTER YOUR AWARENESS LEVEL. Evaluate this carefully.

The drug or alcohol impaired student will be promptly dismissed from clinical, and potentially
from the program.
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Obstetrical Clinical Information
Overview
All students must successfully complete and pass their clinical experience to
receive a passing grade in NUR 210. NUR 210 requires 9 hours of clinical
experience weekly. There will be of 7 weeks of obstetric clinical. Clinical assignments
will be announced no later than the first day of class. There is no guarantee that students
will be scheduled for clinical the same time and location that they indicated as their
preference. Clinical assignment is contingent upon instructor and clinical site availability.
Students are required to attend post conference as part of the clinical experience. Students
may be required to attend a childbirth education class or other prenatal experience outside
of the hospital setting.
Equipment
Each student will need the following:
1. Stethoscope
2. Watch with second hand
3. Black pen
4. Pencil with eraser
5. Small pocket calculator
6. Folder with pockets (for clinical paperwork)

Immunizations

Each student is required to document proof of immunizations as stated
in the student handbook prior to administering patient care. It is the students
responsibility to ensure that these documents are on file in the nursing office.

Clinical Attendance and Tardiness

There are NO excused absences from the clinical area. Faculty members reserve the right to
assign make-up assignments at their discretion.

A clinical absence on a day prior to an exam will be reviewed by the nursing faculty.

Any time a student is absent from the clinical and/or college laboratory, he/she must call that area
30 minutes before assigned time to report his/her absence directly to the clinical instructor. It will
be considered a voluntary withdrawal if a student does not call and does not show up for clinical.
This student must go through the formal withdrawal process to make this official.

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1. Excessive classroom and/or clinical absences may lead to possible dismissal from the
nursing program.

2. For a clinical greater than 5 hours in length, a student is allowed one 30 minute lunch
break. No student should leave the hospital without his/her clinical instructors
permission. Students are responsible for staggering their meal times so that no more
than half the students are off the floor at any one time. Report off to each other and
cover each others patients during meal time.

Attire
1. Students must comply with the Midway College dress code as outlined in the student
handbook and wear his or her name tag at all times.
2. A student may be sent home for not wearing appropriate attire and items listed such as
stethoscope, etc. (see p. 4). This will count as a clinical absence.

Daily Expectations
1. The student is expected to be prepared for each clinical and arrive at clinical on
time, have all paperwork completed, and ready to listen to report with the staff.
During the clinical day each student is expected to perform a head-to-toe
assessment on each assigned patient, administer all medications except
chemotherapy and blood, and provide all care for the patient. The assessment will
be charted on the hospital record or submitted in writing to the clinical instructor.
2. The student nurse is expected to write a shift note for the patient(s) that he or she
cared for. When feasible this will be transferred to the legal record. If this is not
recorded on the chart, the student will submit this to the instructor. The charting
style of the specific agency will be followed.
3. The student nurse must notify the staff nurse and clinical instructor of changes in
patients status as they occur and report to the staff nurse and instructor when the
assignment is completed and/or leaving the unit.

Assignments
Completion of clinical assignments will contribute toward a satisfactory clinical
evaluation. Various activities are expected throughout the semester. The student
will have daily clinical assignments that are due in preconference AND
assignments that are to be completed and submitted to the instructor the next
clinical day during pre-conference. All assignments are to be written and
referenced using APA style, 6
th
ed.

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Daily Assignments:

1. Clinical Assignment Worksheet: This worksheet will be prepared and turned in during
the obstetric clinical rotation. A sample form is provided in the syllabus. All
components must be complete. This worksheet is to be turned in to the clinical
instructor during pre-conference.
Follow-up/completion of this work will be due on the next clinical day during pre-
conference along with clinical assignment worksheet for the current day.

2. Drug Cards/Passing Medications: The student should be prepared to give medications
to their patient. The students are responsible for knowing the drug name, dose, route, and
frequency; classification, reason for administration, safe dose range, common side
effects, and nursing implications (assessment, implementation, patient/family teaching,
and evaluation) for each of the patients medications and for all prn medications given. A
pharmacology assessment sheet will be provided in the syllabus. Please make several
copies for your use. You will turn in your completed copies to your clinical
instructor the following clinical day in pre-conference for any medications your
patient has prescribed . Clinical instructors may assign certain drug cards to be done
during the clinical rotation. A list of common medications used in obstetrics is
included in the syllabus.

3. Daily Objectives: Daily objectives have been provided to enhance the students learning
experience in the clinical setting. The student is to choose the objective that relates to the
patient in which they are caring for that day. The objectives list activities, discussions,
and paperwork should be initiated during the clinical day to increase the students
learning. All paperwork for that objective must be submitted to the clinical
instructor by the next clinical date during pre-conference. Each objective must be
covered by every student for each clinical rotation. Late work will not be accepted.

4. Complete a daily narrative nursing note to be reviewed with your clinical instructor.

5. SBAR report: Students will report using the SBAR method with instructor, peers, and
staff as appropriate.

Other Assignments
1. Obstetric Teaching Plan and Presentation: As part of the clinical experience in
the obstetric setting students will be required to select a relevant obstetric topic of
choice, prepare and teach a patient about this topic, and then briefly present this
topic to the clinical group during a post conference. The teaching plan must
include a visual aid/object that can be used with the patient and the presentation
should not be longer than 10 minutes. See criteria located in this syllabus. This is
an individual assignment and students may not share information or teaching aids.
This may result in failure of the clinical rotation.

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2. Obstetric Care Plan: The student will construct one care plan on an obstetric
patient. The care plan should include 4 nursing diagnoses and 8 interventions for
each diagnosis; the interventions for all 4 diagnoses will include rationale with
source. Specific instructions for the care plan are listed in the syllabus. The due
date for the obstetric care plan will be announced on the first day of clinical and is
listed on the calendar. Students must submit complete work for evaluation in order
for the clinical instructor to be able to provide appropriate feedback and assistance.
Late work or incomplete work will not be accepted.

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Practice Nursing Shift Documentation

Student Name: ___________________________ Date: ____________ Pt. Initials: _________

DATE TIME NOTES

84

Initials Signature

85

PHARMACOLOGY ASSESSMENT

Medication
Dose, Route,
Frequency
Classification
Reason for
Administration
Safe Dose
Range
Common Side
Effects
Nursing Implications/Client
Teaching Needs

86

87

Daily Obstetrics Clinical Assignment Worksheet

Using the nursing process:
1. Definition and brief pathophysiological description of the medical diagnosis. This may be a
narrative of the normal physiologic and psychosocial changes with pregnancy, childbirth or
adaptation of the newborn to extrauterine life.
Cite document source.

2. Results of any significant diagnostic test:

3. Signs and symptoms associated with the condition described in #1:

DATE OF ADMISSION: ________ DATE OF CARE: ________ ROOM #: _______

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4. Medications: Read/review and highlight dose, action, assessment, implications, side effects, and
evaluation of each drug.

5. Completed Care Map for the clinical days assignment: ( ex. 4 possible diagnoses/goal
and 2 appropriate interventions see pg. 10

6. Normal vital signs for age:

7. Using Erikson and Piaget, describe the normal growth and development for the patient.

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OB Care Map

To be completed prior to your assigned day in postpartum, newborn nursery, and labor and delivery. This
Care Map can be expanded and utilized when developing your nursing care plan. Due at preconference
the day you are assigned to the area.
Nursing DX Pt. Goal Intervention#1 Intervention#2

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Clinical Objective #1: The Newborn Assessment

Preparation For Clinical: Due at Pre-Conference

1. Read appropriate chapters covering the newborn.
2. Familiarize self with modified Ballard Gestational Age Assessment Tool (Ballard Exam
see video Gestational Assessment of the Newborn in skills lab).
YouTube: New Ballard Exam, Chap.1, 2, 3, 4 features
Dr. Ballard explaining her tool
3. View video Physical assessment of the Newborn (in skills lab).
4. Complete Normal Finding column of Newborn Database provided in syllabus before your
clinical time in newborn. Objective assessment will be completed after you receive your
Newborn patient).
5. Review Newborn check-off skills.
6. Familiarize self with Critical Criteria of Newborn Care (next page in syllabus).
7. Formulate a nursing care map with 3 nursing diagnoses with goals. Include a minimum of 2
Interventions for each diagnosis (document source, ex. Maternity & Womens Care, pg.111).

Complete care Activities:
Using the nursing process complete the following:

1. Perform newborn skills according to Critical Criteria provided in syllabus.
2. Estimate the gestational age of a newborn using the Modified Ballard method (Ballard
Exam).
3. Perform a thorough assessment of a newborns physical and behavioral characteristics. You may work
individually or in groups.

91

o Complete the objective assessment column of the Newborn database using your assessment
findings (Include babys biographical data and age)
o Develop a plan based on your comparison of Normal Findings and your assessment
findings.
o Note: It may be necessary to utilize more than one baby, as circumstances within the
clinical setting may not allow a lengthy interaction with one baby. Note this on your
database.

Discussion:
1. Compare observations of newborns in admissions nursery (few hours old) with those of
selected older newborns.

2. Discuss the results of the Modified Ballard Gestational Age Assessment Tool (Ballard
Exam)and how the results compare with the Estimated Date of Delivery (EDD).

3. Discuss any abnormal assessment findings and what interventions might be indicated as a
result.

Paperwork: Due at Preconference the following clinical day.

1. Completed Newborn Database with all three columns addressed. If your findings are normal, address
how you will monitor and maintain this in your plan. Include a written summary of the above
discussion questions and submit to the clinical instructor.
2. Medication sheet for any drugs administered.
3. Completed nursing care map with the following:
Nursing diagnoses Prioritized for the patient you were assigned with supportive data added
from your assessment and chart review. Nursing diagnoses may be different from your pre care
map.
Interventions Expand to include 2 additional interventions specific to assigned patient
Include one teaching intervention appropriate for mother/baby/family.

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Critical Criteria of Newborn Care

A. Immediate Care of the Newborn (Note: Wear gloves for all procedures until newborn has
received first bath. Continue to wear gloves for diapering.)

1) Assess Apgar score. (Note score if not present)
a. Heart rate
b. Respiratory effort
c. Muscle tone
d. Reflex irritability
e. Color

2) Assess cord
a. Check bleeding
b. Number of vessels

3) Prevention of hypoxia
a. Position to facilitate drainage
b. Use bulb syringe: depress and gently apply suction to mouth then nose.
c. Stimulate crying.

4) Prevention of cold stress:
a. Dry infant
b. Wrap in warm blanket/use warmer

5) Identification: (Done in Delivery Room)

93

a. Baby: Apply bracelets and obtain footprint
b. Mother: Apply bracelets and obtain thumbprint

6) Eye prophylaxis
a. Cleanse the eyelids carefully
b. Instill medication in lower conjunctival sac of each eye
c. Chart appropriately

7) Vital statistics
a. Obtain blood pressure by palpation method (or other as available)
b. Monitor temperature, pulse and respirations as hospital protocol dictates
c. Measure length in inches and centimeters (from crown to heel)
d. Measure heat circumference in centimeters (around largest portion of occiput)
e. Chart or plot on graph appropriately

8) Vitamin K administration
a. Select appropriate needle size (25 g to 27 g )
b. Appropriately stabilize infant and administer intramuscularly in the lateral thigh (amount as
ordered or per protocol)

9) After determining mothers Hepatitis B status administer Hepatitis B vaccine to infant per
hospital protocol
a. Select appropriate needle size (25 g to 27 g )
b. Appropriately stabilize infant and administer intramuscularly in the lateral thigh
(amount as ordered or per protocol)

94


B. Lifting and Holding the Infant
1. Handle gently and securely
2. Provide head, neck and back support
3. Demonstrate:
a. Football hold
b. Cradle hold
c. Upright position (against shoulder)
d. Sitting position

C. Weighing
1. Cover scales:
a. Place infant-scale paper on scale.
2. Balance scale to zero.
3. Position individual: Place nude infant in center of scale.
4. Protect infant: Hold hand immediately over but not touching.
5. Assess weight in grams, pounds, and ounces.

D. Bathing the Newborn
1. Maintain warmth
2. Cleanse eyes from inner canthus outward with warm water, using a clean part of cloth for each
stroke.
3. Wash with warm water and dry newborn, paying special attention to creases.
4. Cleanse genitalia.
5. Apply clean diaper, leaving cord stump exposed.
6. When using cloth diapers:

95

a. Remove pins and place out of babys reach.
b. Fold back over front with finger between diaper and baby.
c. Insert pin horizontally.
7. Utilize universal precautions as directed by facility.

E. Bottle feeding the Newborn
1. Obtain specified feeding.
2. Maintain sterility of formula and nipple.
3. Check identification of newborn.
4. Hold infant with head higher than stomach.
5. Hold bottle so that nipple remains full.
6. Position nipple so newborn can suck effectively.
7. Burp newborn after each ounce taken, at the end of each feeding, and/or as necessary.
8. Position newborn on right side after feeding to prevent aspiration.
9. Record amount of feeding taken and if feeding retained.

F. Breast feeding the Newborn
1. Assist mother to comfortable position.
2. Provide opportunity for appropriate hygiene of mothers hands and nipples.
3. Instruct mother in nipple preparation.
4. Assist getting newborn latched on.
5. Instruct mother on how to remove infant from breast.
6. Burp infant.
7. Instruct mother on use of supportive bra
8. Nutritional counseling (as needed).
9. Record length of time infant nursed each breast and if feeding retained.

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Newborn Database

Instructions:

Thoroughly assess the newborns physical and behavioral characteristics.

It may be necessary to utilize more than one newborn for this assignment, as circumstances within the
clinical setting may not allow a lengthy interaction with one baby. To note this, draw a line beneath data
gathered on first baby, then note next babys biographical data, plus age (as hours or days).

You may work together, taking turns being the examiner. Verbally share your findings and discuss
expected norms.

Prepare for clinical by completing column one, NORMAL FINDINGS from textbook.

Wash hands before handling each newborn. Do not lay papers on cribs, as this would be a source of
contamination for the baby.

Use common sense regarding amount of time for examination. Avoid disrupting babys sleep pattern.
Handle gently following feedings.
Data from the chart may be used when available if it is not feasible to gather it.
Record objective data for each area addressed.
Note if assessment is within normal limits.

*Note: All columns and areas must be complete. Do not leave blanks.

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Infants Initials ___ __________ Mothers Initials _________________
Age at time of assessment ____ AGE ____ G ___ _ P_________
Gestational age ____________ Significant Hx___________________
Apgar 1 min. ____5 min. ____Rationale for any points subtracted:________________________________________________________

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

I. Posture

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EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
II. Vital Signs

A. B/P

B. Temperature

(If more room is needed for each column,
continue on back)

99

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

C. Respirations
1. Rate
2. Breath Sounds
3. Rhythm
4. Muscular Activity Involved
5. Grunting/
Flaring/ Retracting

D. Pulse
1. Rate
2. Rhythm
3. Peripheral Circulation

III. Measurements

A. Weight

100

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

B. Length

C. Head circumference

D. Chest circumference

E. Abdominal
Circumference

101

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

IV. Integument

A. Color

B. Condition/Texture

C. Birthmarks

D. Lanugo

E. Vernix

F. Characteristics
1. Milia
2. Ecchymosis
3. Nails

102

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
4. Desquamation
5. Hydration

V. Head

A. Shape

B. Size
1. Proportion to body length
2. In relation to chest circ.

103

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

C. Sutures

D. Fontanels

E. Hair

VI. Eyes
A. Color

B. Movement

C. Pupil (reaction to light)

D. Tears

VII. Ears

104

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

A. Reaction to Noise

B. Position

C. Visualize Patency of ear canals
(without use of otoscope)

D. Cartilage Structure

105

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

VIII. Nose

A. Shape

B. Mucus

C. Patency

IX. Mouth

A. Palate intact

B. Tongue movement

C. Gums

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EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
X. Neck

A. Length

B. Mobility

XI. Chest

A. Size

B. Breast tissue

C. Shape

D. Clavicles

107

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

XII. Abdomen

A. Contour

B. Musculature

C. Bowel sounds

D. Movement with respirations

E. Umbilicus
1. Number of vessels
2. Appearance
3. Cord Clamp

108

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
XIII.Genital/Urinary

A. Female
1. Labia
a. Size
b. Appearance

2. Vaginal discharge
a. Color
b. Type

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EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

B. Male
1. Testes in scrotum
2. Appearance of scrotal sac
3. Urethral meatus at end of penis
4. Circumcised
a. Appearance

C. Urine
1. Color
2. Amount
3. Frequency

XIV. Rectum

A. Patency
B. Stools

110

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
1. Number
2. Color
3. Consistency
4. Frequency

XV. Hips
A. Symmetry of gluteal folds
B. Protrusion of femoral heads
C. Hip click
D. Knee Height
E. Barlow & Ortolani

111

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

XVI. Back

A. Appearance of integument

B. Alignment

C. Head control when in prone
position.

D. Dimples /Hair tufts

112

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
XVII. Extremities

A. Arms/Hands
1. Length
2. Movement
3. Muscle tone
4. Fingers
a. Number
b. Webbing
5. Position
6. Appearance

B. Legs/Feet
1. Length
2. Movement
3. Alignment

113

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

4. Muscle tone
5. Toes
a. Number
b. Webbing
6. Position

114

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
XVIII.
Reflexes (describe how to elicit)
A. Rooting
B. Sucking/Swallowing
C. Gag
D. Tonic Neck
E. Grasp
F. Moro
G. Babinski
H. Stepping
XIX.
Avoidance Cues
A. Yawn, Stretch, Burp, Hiccough, Sneeze

115

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA

XX.
Cry
A. Frequency
B. Pitch
C. Associated behavior

116

EVALUATION CRITERIA

NORMAL FINDINGS

OBJECTIVE DATA
XXI. Personality/Behavior
A. Response to being held and
consoled

B. Feeding behaviors

C. Sleeping/ Wakefulness

D. Parent/Infant
Interactions

E. Sensory capabilities
1. Vision
2. Auditory
3. Tactile
4. Kinesthetic

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Comments/Notes:

118

Clinical Objective #2: Obstetrical/Postpartum Assessment

Preparation For Clinical: Due at Pre-Conference

1. Read appropriate chapters.
2. Formulate a nursing care map with 4 nursing diagnoses/goals and 2 interventions. Submit in
preconference.

Activities:


1. Perform a postpartum assessment on selected postpartum patients according to critical
criteria noted in lab check off.
2. Provide individualized care for the postpartum patient in the clinical setting.
3. Complete the Obstetrical Postpartum Database.
4. Review the hospitals policy for discharge teaching. Assist whenever possible.

Discussion:
1. Compare the nursing needs of the vaginally delivered patient and the C-section patient. (Use
the Critical Pathways to help you discuss this)

2. Compare the nursing needs of the bottle-feeding patient with the breast-feeding patient.

3. Discuss any abnormal assessments and the nursing implications related to these findings.

Paperwork:
1. Complete Postpartum Nursing Database and physical assessment
2. Complete the nursing care map to include 4 prioritized nursing diagnoses/goals with at least 4
interventions specific for the assigned patient.
3. Include patient teaching for discharge.

119
MIDWAY COLLEGE
NURSING 210
OBSTETRICS

NURSING HISTORY AND PHYSICAL EXAM/POSTPARTUM ASSESSMENT

Student:_________________________________ Date:____________

Client initials:________ Medical Diagnosis(es)_______________________________
Admission Date:_________ Delivery Date:__________ PPD_____ POD_______

BIOGRAPHICAL/SOCIAL HISTORY

Age_____ Religious Preference_______________ Ethnicity_______________
Marital Status: ___Single ___Married ___Divorced ____Separated
Nearest relative/Support Person_________________________________

Educational level________________ Occupation______________________________
Cultural considerations____________________________________________________
Other__________________________________________________________________

PRENATAL INFORMATION
Gravida______ Para_______ Term________ Preterm_______ AB_______ Ectopic_____
Multiple Births_______ Living Children________
Childbirth Preparation Yes, type_________________________ No______
Allergies________________________________________________________________

120

Past Pregnancy History

Year Sex Weight Type Delivery Complications Other

Prenatal Laboratory Assessment:
HgB_______ Hct_________ Date______________ VDRL_________ Date:_______
Blood Type_______________ Rh______ Antibody Screen____________
RhoGam candidate? Yes ___ No ___ Rubella Titer_________
Screenings/results:
HepB _________ HIV________ GBS________
Chlamydia____________ Gonnorrhea _________ Other_________________________
Urinalysis_____________Albumin_______ Glucose________
1 hr Glucose Challenge__________ 3 hr. GGT: ___Fasting___1hr___2hr____3hr
Prepregnant weight___________ Total weight gain this pregnancy_________________
Height__________ BMI______

121
Alcohol intake______________________ Tobacco Use_________________________
Drug use________________________________________________________________

Problems this pregnancy and any
treatment:_____________________________________________________________________
_________________________________________________________________

Medications during this pregnancy:_________________________________________

Prenatal Screenings (Ultrasounds, NSTs, Biophysical profile, Etc.)

LABOR AND BIRTH INFORMATION

Date of delivery;__________________ Time of birth:________________
____Labor induced _____Augmentation
____Physician _____Midwife

____Vaginal _____Epsiotomy _____Lacerations/Tears_________________
____Cesarean section description

____Epidural ______Spinal _____Natural

Membrane Rupture_________________(date/time) ___spontaneous ___amniotomy

122
Fluid characteristics: _____________________________________________________

Medications received during labor (drug, dose, times)____________________________

Apgar Scoring
0 1 2
Heart Rate
Respiratory Effort
Muscle Tone
Reflex Irritability
Color

Score at 1 minute____________ Score at 5 minutes_____________
If scores are different, what changed and why?____________________________
_________________________________________________________________

____Breastfeeding _____Bottle feeding _____Circ

Birth weight___________ Length__________ Sex_______________ Gest. Age______
Pediatrician________________________

123
POSTPARTUM PHYSICAL ASSESSMENT Postpartum Day_____

General appearance:_______________________________________________________

Vital Signs: B/P________ Temp._________ Pulse:_______ Resp._________
Breath sounds__________ Bowel sounds________________

BREASTS: Full ____ Firm____ Tender____ Shiny____ Reddened areas_____
Colostrum______ Breastmilk in_______
Wearing bra________ Wearing binder________Pumping______

UTERUS: _____Firm _____Boggy Placement_______________

INCISION ( if applicable):
___________________________________________________________

BLADDER: _______Distended ______Dysuria ______Foley catheter

BOWEL: ___Bowel sounds ____Bowel movement ____Flatus

LOCHIA: Amount_________________ Type__________________
Odor___________________

EPISIOTOMY: Type_______________________________
____Erythema ____Edema ____Ecchymosis ____Approximated
____Drainage

124

HOMANS SIGN( if required to asses)/ EXTREMITIES:
_____Pain _____Tenderness ______Redness

EMOTIONAL STATUS:___________________________________________________

Taking In________ Taking Hold________ Letting Go ________

125
LABORATORY DATA ( Note admission labs and post delivery labs)
Patient results Normal values Interpretation
Hgb
Hct
WBC
Platelets
BUN
Creatine
Na
Cl
K
Uric Acid
Glucose
Co2
ABGs
Ph
PO2
PCO2
HCO2
O2 Sat
PT/PTT
Other

126

Intake Output

*MEDICATIONS (USE MEDICATION SHEET IN CLINICAL PACKET)

Teaching needs:______________________________________________________

Follow up/ Referrals:

127
NSG 210 POSTPARTUM ASSESSMENT
Bubble-he

B Breast Note contour of breasts. Are they full, firm, shiny, veins distended?
Is there any redness present? Is the skin warm to touch? Are the nipples intact?
Does the patient complain of sore nipples? Take the opportunity to teach
care of the nipples when breastfeeding. Ask the patient about her experience
with breastfeeding at this time.
If bottle feeding, does patient have a breast binder? Opportunity to teach
care of breasts to prevent engorgement.

U Uterus Palpate the uterus noting the degree of firmness. Massage if needed. Note the
position (midline) and relationship to the umbilicus (fingerbreadths above or
below). Is the bladder palpable?

B Bladder Checked simultaneously with the fundal height. Check to see that client is
emptying her bladder with each voiding. Did she need a catheterization past
delivery(risk for infection)?

B Bowel Has patient had a bowel movement since delivery? Is she passing flatus?
Function Take the opportunity to teach measures to prevent constipation.

L Lochia Note the type and amount of lochia present. Teaching opportunity: What
changes should the client expect? What changes would need to reported
after discharge?

E Episiotomy Inspect the site. Make sure you have adequate light. Check the rectal area
for
the presence of hemorrhoids. Note if the episiotomy is healing. Note any
edema, inflammation or drainage. Teaching opportunity for care of the
perineal area post-delivery. Remember REEDA:
-Redness
-Edema
-Ecchymosis
-Drainage
-Approximation

H Homans Not all providers order this assessment, however, you need to note the
sign presence or absence of calf tenderness and/or redness which may indicate
possible thrombophlebitis.

E Emotional Evaluate the clients emotional status. Is there evidence of postpartum blues?
Status Does she appear dependent or independent? Are the positive or negative
bonding behaviors noted?

128
Clinical Objective #3: Promotion of Parent-Infant Attachment

Preparation for clinical:
1. Read/research kangaroo care.
2. Complete a care map with 1 diagnosis r/t parent-infant attachment. Include 4
interventions that could be implemented to facilitate bonding between mother/baby.
DUE AT PRECONFERENCE
Activities:
1. Implement nursing measures to initiate bonding between parents and their newborns.
2. Compare the advantages and disadvantages for the new mother on a mother/baby unit
(i.e. rooming in).
3. Evaluate the impact of kangaroo care on parent-infant attachment.
4. Explore supportive services provided by the institution for parents who experience death
of an infant.

Discussion:
Discuss practices on the mother-baby unit that promote or discourage parent-infant
attachment.

Paperwork:
Complete a written summary of the above activities from your observations, teaching,
and interactions with the mother/baby/family.

Write a nursing note dealing with Parent-Infant Attachment and include interventions to
promote bonding.

129

Clinical Objective #4: LABOR AND DELIVERY

Preparation for clinical assignment:
1. Complete Study Guide Chapter 16, Section 1-Fill in the Blanks
2. Complete a list of possible comfort measures that could be implementing during labor

DUE AT PRECONFERENCE the day you are assigned to Labor & Delivery

Activities:
1. Complete the following questions in detail. You will need to use a separate paper(s).
A. What phase of labor was your patient experiencing when you first observed her?

B. Describe the other stages of labor you observed. What were the physical and behavioral
changes seen in your client?

C. Describe the techniques/treatments utilized to promote comfort during the laboring process.

D. Describe the role of the support person. Who acted a support person? Doula present?

E. What type of monitoring equipment was being used?

F. What type of interventions were carried out to promote parent/infant bonding immediately after
delivery?

G. What medications did your client receive? Nursing Implications?

130

2. Complete the Labor and Delivery Assessment Sheet.

3. Review the clients prenatal record and note any risk factors.

Discussion:

1. Be prepared to share your experience with your peers during post conference.

131
Objectives for Midway College NUR 210 Surgical Observation Experience.
Students who observe a Cesarean Section should complete the following and submit with your labor and delivery
objective or with the paperwork due on your following clinical day.

1. Identify the needs of the surgical patient before, during, and after surgery.

2. Identify the safety measures taken to protect the surgical patient

3. Apply knowledge of principles of sterile technique, as learned in lab, to student nurse role in OR.

4. Observe a surgical procedure from the pre-operative phase through the post-operative phase.

5. Identity the roles of the various OR team members, including the verbal and non-verbal communication between
the team members.

6. Identify the roles and special education of the OR team (pre-, intra-, & post-operative) with the goal of developing
a beginning understanding of the specialized role of the OR nurse.

7. Identify and describe the indications for surgery, the surgical procedure performed, and provide a brief
description of the short term and long term rehabilitative program

8. Demonstrate professional behavior (honesty, confidentiality, responsibility, respect to patients and
colleagues, commitment and enthusiasm towards learning).

132
LABOR & DELIVERY FLOW SHEET Student:_________________

Pt. initials:______ Gravida_____ Para_____ Instructor:________________

Onset of Labor: Date______ Time______

Epidural: NO
YES

Time

30min/
15min
Ctx:
Frequency
Duration
Intensity
Fetal
Heart
Rate
Monitor:
External
Or
Internal
D/E/S
(if
exam
done)
Membranes
(I) or (R)
Variability Reassuring/
Non-
Reassuring
Other,
Late,
Early,
Var.

Comments:

133
MEDICATION LIST FOR OBSTETRICS

*STUDENTS ARE TO COMPLETE MEDICATION SHEETS FOR ALL MEDICATIONS GIVEN TO THEIR
ASSIGNED PATIENTS. STUDENTS MAY BE TESTED OVER ANY OF THE MEDICATIONS LISTED BELOW
AS PART OF THEIR UNIT EXAMS DURING OBSTETRICS

POSTPARTUM:
Motrin Hemabate
Dulcolax suppository Pitocin
Colace Tucks
Methergine Dermaplast topical spray
Percocet
RhoGam
Rubella vaccine

NEWBORN:
Hepatitis B vaccine (Recombivax HB, Engerix-B)
Vitamin K: Phytonadine (AquaMEPHYTON, Konakion)
Erythromycin Opthalmic Onintment, 0.5% and Ophthalmic Ointment 1%
Hepatitis B Immune Globulin
Naloxone Hydrochloride Narcan (neonatal)

LABOR & DELIVERY
hydromorphone hydrochloride (Dilaudid)
meperidine hydrochloride (Demerol) * rarely used
morphine sulfate
fentanyl citrate (Sublimaze)
sufentanil citrate (Sufenta)
butorphanol tartrate (Stadol)
nalbuphine hydrochloride (Nubaine)
oxytocin (Pitocin)
naloxone hydrochloride (Narcan)
Bicitra
Pencillin (strep B prophalaxis)
Magnesium sulfate
Nifedipine
Terbutaline (Brethine)
Ephedrine
Phenylephrine
Phenergan
Vistaril

STUDENTS ARE TO ADMINISTER MEDICATIONS ONLY UNDER DIRECT SUPERVISION OF
THE INSTRUCTOR.

134
S
Situation
Patient name:

Diagnosis:

Procedures since admission:

Changes in patients condition or episodic events:
B
Background
Significant medical history:

A
Assessment
Current condition of patient:

VS q ______: _________Temp; _________B/P; _________Resp; _________Pulse

Condition/location of tubes, drains, IVs, incisions, wounds, etc.:

Other significant information:
R
Recommendation
What needs to be done and when:

135
Obstetrical Teaching Plan Outline

I. Patient initials and background data: (Obstetric history)

II. Knowledge deficit related to: (your topic)

III. Goal: (In relation to your teaching)

IV. Method:
A. What will you teach and how will you accomplish it?
B. Learning activities in relation to kind or learning you expect to occur (cognitive, psychomotor,
affective).
C.
V. Evaluation:
Patient outcome
Did the patient learn what you expected? If not, why not? If so, how did you measure learning?

Include:
Visual Aid used with teaching (May be created however you must cite source(s) of information
on any handouts, etc.)
Journal article abstract
Bibliography list
OVERALL PRESENTATION: Includes general flow of the presentation, clarity, spoken grammar, minimum
use of fillers (such as umm, like, you know. so), professional demeanor and summary.
MUST BE TYPED AND SUBMITTED TO CLINICAL INTRUCTOR. ATTACH ANY MATERIALS
UTILIZED IN YOUR PRESENTATION

136
TEACHING PLAN EVALUATION
Student Name(s): Instructor:

POINTS
POSSIBLE
Date:

STUDENT
SCORE

History ....................................................................................
Readiness of Patient ..............................................................
Goal ........................................................................................
Method ...................................................................................
Evaluation...............................................................................
Journal Article .........................................................................
Overall
Presentation..

2
2
2
5
2
2
5

.......
.......
.......
.......
.......
.......
...
(Satisfactory 15-20 points) 20 pts
Areas in need of
improvement.....................................................................................................................................
...........................................................................................................................................................
Comments:

137
Obstetric Care Plan

As part of the clinical experience in the obstetric setting, the student will be required to present a
written major care plan on an obstetric patient on the fourth week of clinical or on a date designated by
the clinical instructor. Students must submit the care plan on time in order for the clinical instructor to
have time to grade and return for any needed revisions.

Criteria:
1) A completed nursing history assessment database including the postpartum assessment tool.
2) Lab Flow Sheet (must include hospital norms).
3) A completed, clean copy of the clinical assignment worksheet.
4) Completed drug cards/med sheet for each of the patients prescribed medications.
5) Minimum of four prioritized nursing diagnoses.
a. Each diagnosis will contain a patient stated goal that is measurable and appropriate to the
diagnosis.
b. Each diagnosis will contain 8 interventions.
c. At least one intervention will address patient or family teaching.
d. All 4 diagnoses will be supported by written rationale, one of which will be from a professional
nursing journal (the same or different journal article(s) can be used for the rationale in more
than one diagnosis).
e. The evaluation statements should describe the outcomes of the patient in relationship to the each
intervention.
6) A growth and development summary.
7) The professional nursing journal(s) used to support the rationale are to be submitted with the care
plans
8) An APA style bibliography.
9) A copy of the care plan evaluation form.

NOTES
1. The care plan must be typed.
2. Each area of the care plan will be graded independently and may require revision based on the
discretion of your clinical instructor. A ZERO IN ANY AREA WILL AUTOMATICALLY
REQUIRE A REVISION.

138
NSG210
ADN EVALUATION for Use of Nursing Process with Care Plan
GRADE: INSTRUCTOR:
2 = SATISFACTORY
1 = NEEDS IMPROVEMENT STUDENT: __________________
0 = UNSATISFACTORY
DATE:________________________
TOPIC DIAG. #1 DIAG. #2 DIAG. #3 DIAG. #4
Nursing diagnosis are stated correctly

Incorporation of history into care planning: Subjective data is sufficient (patient
complaints, allergies, etc.)

Incorporation of history into care planning: Objective data is sufficient (labs,
physical exam, tests, V.S., I & O, X-Ray, etc.)

Goals are stated in patient terms.

Goals are measurable and appropriate to the diagnosis and within a realistic
time frame.

Nursing assessment of patient/family tells me what to look, listen or feel for.

Nursing actions are individualized and specific (indicate what to do to or for the
patient; how, how often, how much, and are age appropriate.)

Nursing actions are appropriate to the diagnosis and goal based on physical
and psychosocial needs.

Nursing actions include independent and collaborative actions (ie-medications
integrated appropriately, physical therapy consult.)

Patient/family teaching is addressed.

Evaluated effectiveness of every intervention including conclusion statements.

Satisfactory = 19-22 Unsatisfactory = < 19 TOTAL

139

TOPIC

GRADE

Pathophysiology is described appropriately.

Nursing diagnoses are comprehensive.

Problems/diagnosis are prioritized appropriately.

Care plan construction (neatness, organization, uses appropriate format, etc.)

Rationale appropriate to level intervention and patient situation.

Growth and Development Summary (see following page)

Satisfactory = 9 - 12 Unsatisfactory = < 9 TOTAL

Comments:____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

140
MIDWAY COLLEGE
NSG 210 CARE PLAN
STUDENT NAME: DATE: / / PATIENT INITIALS:

The Care Plan is to be developed using the nursing process and turned in to the clinical instructor with the following items:
1. Clinical Assignment Worksheet
2. Nursing Narrative History / Assessment database
3. Lab Flow Sheet
4. Drug Cards
5. Four prioritized nursing diagnoses/minimum of 8 interventions (at least one teaching intervention)
6. A copy of the nursing journal article(s)
7. A growth and development summary
8. Bibliography
9. Care Plan Evaluation Summary

Please place in a binder/folder with tabs indicating each of the above items

For the narrative history include the following information:
Identifying (initials, age, sex, marital status, occupation, culture)
General health history (medical history, injuries, caffeine intake, smoking history, drug/alcohol use)
Family history (pertinent genetics, familial, economic and social data)
Brief recent history (development of presenting problem over the past several weeks or days).

141
210 CAREPLAN TEMPLATE
NURSING DIAGNOSIS:

SUBJECTIVE DATA:

OBJECTIVE DATA:

GOAL:

INTERVENTION

RATIONALE EVALUATION (Of goal)

142

143
GROWTH AND DEVELOPMENTAL SUMMARY
(To be done with each care plan, regardless of patients age.)
Using Erikson and Piaget, describe the normal growth and development for your patients age.
List the stage that corresponds to the age of this patient and describe the skills and abilities of
this stage.

Then provide objective data from observations of your selected patient and indicate if they
compare to the textbook picture. Finally, develop a plan of care to address lags in development
or to maintain appropriate development. Be sure to follow format below and include with each
care plan.

1. Textbook picture as described using Erikson and Piagets development theories.

2. Objective data- Describe your observations of the patient and compare them to the textbook
picture.

3. Plan - List several interventions which could maintain G&D, or improve lags. (e.g. "At least
twice/day read to child and encourage word sounds"; or "encourage parent to do this.)

144

MIDWAY COLLEGE
NURSING PROGRAM

CLINICAL
EVALUATION FORM
NSG 210

STUDENT NAME:

INCLUSIVE DATES: TO

145
Midway College
Associate Degree Nursing Program
Clinical Evaluation Tool
COURSE: Nursing 210 Semester:___________________
Student Name: _________________________________ Clinical Faculty:_____________________
Clinical Site and Unit: _____________________
Skills Performance Checklist Reviewed Midterm____ Final_____
Midterm Evaluation Date: __________________ Final Evaluation Date: _____________________
Absent/Tardy Dates:___________________ Specify Clinical Makeup Assignment completed:_____________
Key: Evaluation Scale:
CO: Course Objectives 4: Exceptional
SLO: Student Learning Outcomes 3: Above Average
KSA: Knowledge , Skills, Attitude 2: Satisfactory
QSEN: Quality and Safety Education for Nurses 1: Unsatisfactory
0: Unsafe performance
Evaluation Scale:
4-Exceptional: Consistently excels in demonstrating outcome behavior. Demonstrated a thorough
and in-depth understanding of concepts and applies them to patient care. Utilizes creative and
confident approaches to nursing practice. Shows insight when analyzing and evaluating patient
care situations.
3-Above average: Consistently demonstrates and at times exceeds outcome behavior.
Demonstrates expanded understanding of concepts and applies them to patient care. With
increasing confidence utilizes effective approaches to nursing practice. Analyzes and evaluates
patient care situations with greater discernment.
2-Satisfactory: Consistently demonstrates outcome behaviors. Demonstrates satisfactory
understanding of concepts and applies them to patient care situations. Utilizes effective
approaches to nursing practice. Analyzes and evaluates patient care in situations accurately.
Meets expectations.
1-Unsatisfactory: Inconsistent in demonstrating outcome behaviors. Requires consistent
guidance when applying concepts to patient care situations. Consistently requires verbal cues
when analyzing and evaluating patient care situations.
0-Unsafe performance: Does not independently demonstrate outcome behaviors. Unable to
perform safely with guidance.

146
Note: The student must be performing satisfactorily (2-Satisfactory) overall in the clinical
setting upon completion of the final clinical evaluation. Any rating below a 2-Satisfactory at
The completion of the clinical rotation in any area reflects unsatisfactory performance and
will result in course failure.

Quality and Safety Education for Nurses (QSEN) Competencies:
1. Patient Centered Care- Recognizes the patient as source of control and partner in providing
compassionate and coordinated care based on respect for patient preferences, values, and needs.
2. Teamwork and Collaboration Functions effectively within nursing and interdisciplinary
teams, fostering open communication, mutual respect, and shared decision-making to achieve
quality patient care
3. Evidence-Based Practice- Integrate best current evidence with clinical expertise and
patient/family preferences and values for delivery of optimal health care.
4. Quality Improvement- Uses data to monitor the outcomes of care processes and use
improvement methods to design and test changes to continuously improve the quality and safety
of health care systems.
5. Safety- Minimizes risks of harm to patients and providers through both system effectiveness
and individual performance.
6. Informatics- Use information and technology to communicate, manage knowledge, mitigate
error, and support decision making.

Course Objectives:
The student will be able to:
2. Utilize the nursing process in providing nursing care to childbearing and childrearing families
and childrearing families.
4. Demonstrate therapeutic and professional communication techniques in the assessment and
care of childbearing and childrearing families and members of the healthcare team.
5. Provide safe and competent nursing care and teaching for obstetric and pediatric clients in
clinical and community settings while adhering to ethical, legal and regulatory standards of
practice.
childrearing families in clinical and community settings.

147
Student learning Outcome:
1: Demonstrate competency in knowledge of nursing and clinical skills necessary to provide safe, competent
nursing care.
CO QSEN/KSA Expected Behaviors Midterm Final
1, 2, 4 1K, 1S

1. Utilizes the nursing process in providing care to the obstetric client
and newborn:
Identifies problems based on collected data, knowledge, and
evidenced based practice.
Elicits patient values, preferences, and expressed needs as part of
clinical interview, implementation of plan of care, and evaluation
of care.
Identifies and initiates appropriate nursing interventions.
Evaluates the plan of care based on desired outcomes.

1,2 1K, 1A 2. Demonstrates respect and sensitivity for diverse childbearing and
child rearing families and individual clients.
Considers client preferences, values, and needs in providing
compassionate care, recognizing own values and beliefs.
Respects and encourages individual expression of clients values,
preferences, and expressed needs.
Provides client- centered care with sensitivity and respect for the
diverse human experience.
Incorporates clients current condition, lifestyle, culture, spiritual
beliefs and developmental stage into the plan of care.

5 5K,6K
6S, 6A
3.Safely and efficiently administers medications to clients in the
obstetric and pediatric setting:
Utilizes the 6 Rights/3 checks of Medication Administration.
Demonstrates accurate dosage calculations.
Reviews medications with clinical instructor prior to
administration.
Demonstrates competent knowledge of all medications
administered.
Recognizes benefits/limitations of selected safety-enhancing
technologies (i.e., barcode medication administration, computer
provider order entry, medication pumps, and automatic
alerts/alarms).
Implements appropriate assessment and evaluation of the client in
preparation/follow-up of medication administration including but
not limited to: monitoring vital signs, appropriate laboratory and
radiologic results, and objective and subjective client data).
Completes accurate and timely documentation.

148
5, 6 4K, 5K 4. Performs clinical skills competently and safely, adapting to client
needs and situation while adhering to principles of nursing practice:
Demonstrates safe and competent performance of clinical skills,
including those skills learned in prior nursing courses.
Seeks opportunities to perform and demonstrate competency of
clinical skills.
Verbalizes and demonstrates an understanding of safe client care.
Incorporates use of technology and standardized practices that
support safety and quality.

5 1K, 5K 5. Demonstrates safe care of assigned clients.
Adheres to National Patient Safety Goals, acceptable safety
standards, and facility policies of quality improvement. Uses
safety resources for own professional development and focuses
attention on safety in healthcare settings.
Communicates observations and concerns related to hazards and
errors to clients, families, visitors, and the healthcare team.
Recognizes human factors and other basic safety design
principles, as well as commonly used unsafe practices (work-
arounds, use of unapproved abbreviations).
Adapts environment for the safety of clients and identifies
expected and unexpected outcomes if safety precautions are not
met.
Identifies factors that create a culture of safety (open
communication, organizational error reporting systems).

Specific events/evidence/examples to support rating by instructor: Note: Mandatory for Exceptional, Unsatisfactory
and Unsafe performance. Optional for Good and Satisfactory performance:

Student Learning Outcome:
2. Utilize the Nursing Process to assess clients and families and to plan, implement, and evaluate care to clients and
families while functioning within the scope and standards of nursing practice.
1, 2, 3,
5, 6
1K,3K,5K
1S, 3S, 5S
1A, 3A, 5A
1. Satisfactorily completes a nursing care plan during the obstetric
clinical experience.
Collects pertinent objective and subjective client data, including
a comprehensive obstetric/prenatal history.
Prioritizes nursing diagnoses.
Individualizes goals/outcomes that client centered, measurable,
and achievable within a specified timeframe.
Includes appropriate interventions for each diagnoses/outcome
that are individualized, client-specific with measurable
parameters, based on reliable evidenced based practice

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(referenced scholarly journals).
Uses scholarly, evidenced based practice resources as supportive
evidence (including, but not limited to: course textbooks,
professional journals, evidence-based practice websites).
Assignments submitted in a timely manner, all components of the
assignment included with submission, and submitted in neat and
organized manner.

1, 2, 3,
4, 5
1K, 3S 2. Uses the nursing process to develop and implement a plan of care
that:
Is relevant to clients needs.
Addresses teaching-learning principles.
Reflects desired outcomes.
Is based on client values, evidence and standards of practice.
Reflects an understanding of multiple dimensions of client
centered care including:
1. Client/family/community preferences, values
2. Information, communication, and education
3. Physical comfort and emotional support
4. Involvement of family and friends
5. Transition and continuity

1,2, 4,
5
1K, 1S,
2K
3. Assists in maintaining an environment that actively promotes the
client and family as central to care including informed healthcare
choices:
Identifies strategies to empower clients or families in all aspects
of the healthcare process.
Values active partnership with clients and/or families in planning,
implementing and evaluating the plan of care.
Engages patients and families in active partnerships that promote
health, safety and well-being, and self-care management.
Communicates with members of the healthcare team about plan
of care.
Recognizes contributions of other healthcare providers,
individuals, and groups in helping client/families achieve
healthcare goals.
Respects patient preferences for degree of active engagement in
care process.

1, 2, 4,
6
1K, 1S
3K
4. Develops a teaching plan for an obstetric client based on:
Clients level of development, knowledge and learning needs.
Evidenced based practices.
Client readiness to learn.

2, 5 5A 5. Demonstrates time management skills and prioritization of care.
Able to function without continuous direction from the clinical
instructor.
Completes clinical activities (assessment, personal care, clinical
kills and documentation) in a timely manner.

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1,2,4 1K, 1S, 1A
4K, 4S, 4A
1. Identifies and reports changes in client status immediately to
clinical instructor and/or staff.
Identifies trends in client data (i.e. vital signs, physical
assessment, laboratory findings, etc.) to identify client stability.
Provides a patient report (handoff) using accepted communication
and institutional formats (i.e., SBAR, I-SBAR-R, SHARED).
Assesses level of physical and emotional comfort; presence and
extent of pain.
Initiates interventions as appropriate to relieve distress in light of
client values, preferences and expressed needs.
Identifies integrative/alternative approaches of care where
appropriate in accordance with agency policies and client values.
Requests help/assistance when appropriate.

1,4, 7

2A

2. Identifies need for collaboration with the multidisciplinary team to
provide clients and families with available resources to enhance
quality and continuity of care.

1,4, 7 5K, 5S 3. Identifies aspects of nursing care that can be delegated to other
members of the healthcare team commensurate with their educational
preparation and experience.

151
Specific events/evidence/examples to support rating by instructor: Note: mandatory for Exceptional, Unsatisfactory

4. Communicate effectively and professionally both in speaking and writing.
4 1K, 1S 1. Utilizes therapeutic communication skills when interacting with clients,
families and the healthcare team including but not limited to:
listening, clarifying, verbal, nonverbal, personal space, open
ended questioning.

4 1K 2. Identifies barriers to effective communication (hearing, vision,
speech impairments; language barriers, cultural differences, etc).

4 1K, 1S 3. Provides a patient report (handoff) as appropriate in a given
clinical setting, including but not limited to:
Relevant, accurate and complete data of client status/changes in
status.
Concise, clear and documented/reported in a timely manner.
Utilizes accepted forms of communication for handoff.
Reports client status changes to clinical instructor and/or staff.

4, 6 1K 3. Actively participates in pre and post clinical conferences.
Protect confidentiality of electronic health records

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CO QSEN/KSA Expected Behaviors Mi dterm Final
5, 7 1A, 2K, 2S
5K
1. Practices professional behaviors within the parameters of individual
knowledge and experience including:
Performing nursing roles with self- direction and minimal
assistance from clinical instructor.
Follows the parameters of Patient Care Partnerships (i.e., Patient
Bills of Rights).
Recognizes and reports unsafe practice by self and others.
Maintains patient privacy and confidentiality.
Follows applicable Midway College and clinical agency policies
including, but not limited to: dress code, name badge
identification, punctuality, absenteeism, and HIPAA guidelines.
Timely completion of assignments and clinical documentation.

7 1K, 1S, 1A
5K
2. Demonstrates accountability:
Display honesty and trustworthiness.
Arrives prepared for clinical day (adherence to dress code,
completed assignments, knowledge of clinical objectives/goals.
etc).
Accepts responsibility for follow-up on patient care/tasks
performed by self and those delegated to others.
Informs clinical instructor/staff of unusual, abnormal, or
untoward events in a timely manner.
Recognizes own limits and seeks resources appropriately.
Provides safe, quality care within the level of preparation.
Accepts constructive comments as a basis for personal and
professional growth.
Demonstrates initiative and seeks learning opportunities.
Values own and others contributions to outcomes of care.

7 2A 3. Serves as a positive role model within the clinical group and within

153
the multidisciplinary team.
7 1A 4. Demonstrates core values: caring, diversity, ethics, excellence,
holism, integrity, and patient-centeredness.

7 2A 5. Maintains professional behavior and appearance with representing
the Midway College Nursing Program.


Student Learning Outcomes:
1,2,3,7 1K, 1S, 1A 1. Demonstrates positive and unconditional regard toward
childbearing and childrearing clients and families.
Demonstrates caring behaviors.
Serves as an advocate for clients and families.
Respects diverse cultures, values, and belief systems and
incorporates these in plan of care.
Communicates patient values, preferences, and expressed needs
to members of the healthcare team.

1, 7 1K, 1S, 1A 2. Protects and promotes clients dignity and privacy.
Willingly supports patient-centered care for individuals and
groups whose values differ from their own.
Respects the clients right to access personal health
information/records.
Protects confidentiality of protected health information
(electronic health records, verbal communications and
conversations, paper documentation).
Respects the centrality of the client/family as core members of the
healthcare team.

154
2, 7 1A 3. Values clients expertise with own health and symptoms; views
healthcare situations through patients eyes.


6 1. Completes required community service/servant leadership hours
during NSG 210.
Verified
by
Course
Faculty
2,6 2A 2. Functions as a team player:
Identifies plan for self-development as a team member.
Seeks learning opportunities with clients and families.
Values nursing as a career and values own nursing practice.

1,6 2K, 2A 3. Recognizes nursing roles in assuring coordination, integration, and
continuity of care; Values need for continuous improvement in clinical
practice based on new knowledge.


155

8. Possess personal integrity and practice within the ethical framework of nursing.
7 1S 1.Practices within ethical, legal, and regulatory guidelines for nursing
practice:
Identifies ethical and legal implications of patient-centered care.
Recognizes and maintains professional boundaries of
nurse/patient (therapeutic) relationships.
Complies with the Code of Ethics for Nurses, Nursing Standards
of Practice, and policies and procedures of Midway College,
Midway College AND Program, and clinical agencies.

7 3A 2. Accepts individual responsibility and accountability for nursing
interventions, outcomes, and other actions.

7 3A 3. Assumes responsibility for learning.


CO QSEN/KSA Expected behaviors Midterm Final
6,7 4K, 4S,4A 1. Identifies quality measures and key quality indicators (Core
Measures, Care Maps/Pathways) within delivery of holistic patient care
to improve overall patient outcomes:
Recognizes that continuous quality improvement is an essential
part of daily work of all health professionals.
Recognizes nursing and other healthcare profession students are
parts of systems of care and care processes that affect outcomes for
patients and families.

156
6 3K, 3S 2. References clinical based activities utilizing evidenced based
literature.
Cites information from evidence based literature in nursing care
plan.

6 6K, 6S
3. Utilizes informatics and technological resources (i.e., electronic medical records, bar-code
medication administration, infusion devices, etc) where appropriate in the delivery of safe
and effective client care.
Applies technology and information tools to support safe processes of care.
Navigates electronic health records as appropriate in clinical setting.


10: Work independently and collaboratively with other healthcare workers in providing care and teaching about
health promotion and illness prevention to diverse and complex clients and families.
7 3A 1. Identifies plan for self-development as a member of the
multidisciplinary healthcare team.

7 2A 2. Values teamwork and the relationships upon which it is based.
7 2K 3. Identifies roles of healthcare team members appropriate to meet the
defined health needs of childbearing and childrearing families.

7 2K 4. Identifies own strengths, limitations and values in functioning as a
member of a team.

7 2K, 2S 5. Functions within the scope of practice as a student member of the
intra and inter-professional healthcare team.

157

Specific events/evidence/examples to support rating by instructor: Note mandatory for Exceptional, Unsatisfactory
and unsafe performance. Optional for God and Satisfactory performance:

158
Midterm Comments (Address Strengths and weaknesses)
Faculty

Student

Student Signature __________________________________ Date ________

Faculty Signature __________________________________ Date ________

159
Final Comments (Address Strengths and weaknesses)
Faculty

Student



Course Coordinator __________________________________ Date ________

Pediatric Clinical

Overview
All students must successfully complete and pass their clinical experience to receive a

160
passing grade in NUR 210. NUR 210 requires 9 hours of clinical experience weekly.
There will be 7 weeks of pediatric clinical. Clinical assignments will be announced no
later that the first day of class. There is no guarantee that students will be scheduled
for clinical the same time and location that they indicated as their preference. Clinical
assignments are contingent upon instructor and clinical site availability. Students are
required to attend post conference as part of the clinical experience.

Equipment
Each student will need the following:
1. Stethoscope
2. Watch with second hand
3. Black pen
4. Pencil with eraser
5. Small pocket calculator

Immunizations
Each student is required to document proof of immunizations as stated in the student handbook
prior to administering patient care. It is the students responsibility to ensure that these
documents are on file in the nursing office.

Clinical Attendance and Tardiness
1. There are NO excused absences from the clinical area. Faculty members reserve
the right to assign make-up assignments at their discretion.

2. A clinical absence on a day prior to an exam will be reviewed by the nursing faculty.

3. Any time a student is absent from the clinical and/or college laboratory, he/she must
call that area 30 minutes before assigned time to report his/her absence directly to
the clinical instructor. It will be considered a voluntary withdrawal if a student does
not call and does not show up for clinical. This student must go through the formal
withdrawal process to make this official.

4. Excessive classroom and/or clinical absences may lead to possible dismissal from
the Nursing Program.

5. For clinical greater than 5 hours in length, a student is allowed one 30 minute lunch
break. No student should leave the hospital without his/her clinical instructors

161
permission. Students are responsible for staggering their meal times so that no
more than half the students are off the floor at any one time. Report off to each other
and cover each others patients during meal time.

Attire
Students must comply with the Midway College dress code as outlined in the student
handbook and wear his or her name tag at all times.
A student may be sent home for not wearing appropriate attire and this will count as a
clinical absence.

Daily Expectations
The student is expected to be prepared for each clinical and arrive at clinical on time,
have all paperwork completed, and ready to listen to report with the staff. During the
clinical day each student is expected to perform a head-to-toe assessment on each
assigned patient, administer all medications, except chemotherapy and blood, and
provide all care for the patient. The assessment will be charted on the hospital record or
submitted in writing to the clinical instructor.

The student nurse may need to write a shift note for the patient(s) that he or she cared
for. When feasible this will be transferred to the legal record. If this is not recorded on
the chart, the student will submit this to the instructor. The charting style of the specific
agency will be followed.
The student nurse must notify the staff nurse and clinical instructor of changes in
patients status as they occur and report to the staff nurse and instructor when the
assignment is completed and/or leaving the unit.

Assignments
Completion of clinical assignments will contribute toward a satisfactory clinical
evaluation. Various activities are expected throughout the semester. The student will
have daily clinical assignments that are to be completed and submitted to the instructor
the next clinical day during pre-conference. All assignments are to be written and
referenced using APA style, 6
th
ed.

Daily Assignments:
1. Clinical Documentation: Students will document on their patient(s) using Kentucky
Childrens Hospital forms. These are paper forms that you will be given prior to the
clinical experience. Keep a clean copy and always bring a copy of these documentation
forms to clinical with you. This documentation will be turned into the clinical
instructor during pre-conference on the following clinical day.

162
2. Drug Cards/Passing Medications: The student should be prepared to give medications
to their patient. The students are responsible for knowing the drug name, dose, route,
and frequency; classification, reason for administration, safe dose range, common side
effects, and nursing implications (assessment, implementation, patient/family teaching,
and evaluation) for each of the patients medications and for all prn medications given.
A pharmacology assessment sheet will be provided in the syllabus. Please make
several copies for your use. You will turn in your completed copies to your clinical
instructor the following clinical day in pre-conference.

3. Objectives: Objectives have been provided to enhance the students learning
experience in the clinical setting. The student is to choose the objective that relates to
the patient in which they are caring for that day. The objectives list activities,
discussions, and paperwork should be initiated during the clinical day to increase the
students learning. All paperwork for that objective must be submitted to the
clinical instructor by the next clinical date. Each objective must be covered by every
student for each clinical rotation.

4. Complete a daily nursing narrative note to be reviewed with your clinical instructor This
will be part of the Clinical documentation form (See #1).

5. Daily Pediatric Nursing Process/Organizational Tool: This tool has been designed to
promote communication and assist you in providing high quality, individualized care to
your patient. This should be completed at the beginning of your day. This is due to your
instructor at the end of the clinical day. A copy of this form is found in the syllabus.
Please bring a clean form to clinical each day.

Other Assignments:
1. Pediatric Presentation: As part of the clinical experience in the pediatric setting student
will be required to present a brief post conference topic. Students are to work together with
another classmate in the clinical group to present a relevant pediatric topic. Date due will be
announced the first meeting of class. The approved topics, guidelines, and evaluation form
are located in the syllabus.

2. Pediatric Care Plan: The student will construct one care plan on a pediatric patient. The
care plan should include 4 nursing diagnoses and 8 interventions for each diagnosis; the
interventions for all 4 diagnoses will include rationale with source. Specific instructions for
the care plan are listed in the syllabus. The due date for the pediatric care plan will be
announced on the first day of class.

163

Daily Pediatric Nursing Process/Organizational Tool

Date of Care_____
Pt. initials and room number____________
Admit Diagnosis_____

Recent Vital Signs T_____ P_____R_____B/P_____
Abnormal V/S___________________________________________________________

164
Trends_________________________________________________________________

Recent Lab Results_____________________________________________________________
Abnormal Values________________________________________________________
Trends_________________________________________________________________

Medications: Include name, class and reason medication is ordered
______________________________________________________________________________
______________________________________________________________________________

Development Stage and Developmental Considerations
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________

Top 3 Prioritized Nursing Diagnoses:
1._____________________________________ 3. ____________________________
a. a.
b. b.
c. c.

2._____________________________________
a.

165
b.
c.

How will you evaluate each of the nursing diagnoses above?
1_____________________________________________________________________________
2_____________________________________________________________________________
3_____________________________________________________________________________
Prioritized Plan for the day:

166
PHARMACOLOGY ASSESSMENT

Medication Dose,
Route, Frequency
Classification
Reason for
Administration
Safe Dose
Range
Common Side Effects Nursing Implications

167

168
Clinical Objective #1: Nutritional Assessment

Preparation:
1. Read appropriate chapters in textbook.
2. Review nutritional history form.
3. Reflect on your own personal nutritional patterns.

Instructions:
1. Complete the following subjective and objective data on your assigned
pediatric patient.
2. Mark all nursing diagnoses that apply to your patient.
-Personalize all your diagnoses for your patient.
3. Prioritize your list of nursing diagnoses.
4. Create patient-centered goals for your patient based upon your nursing
diagnoses.
5. Describe 3 nursing interventions that will help your patient achieve each
goal.
6. Write a short evaluation statement regarding your patient and your goals.

169
Pediatric Nutritional History
NAME AGE
DIET DAILY VITAMIN/IRON SUPPLEMENT
DIAGNOSIS
PAST MEDICAL HISTORY (# weeks gestation, birth weight, chronic problems)

FAMILY HISTORY (Obesity, HTN, cancer, DM, heart dx, include parents statures)

I. Subjective Data
1. Ask child or parent to describe usual eating habits and list foods eaten for:

Breakfast:_______________________________________________

Lunch:__________________________________________________

Dinner:_________________________________________________

Snack:__________________________________________________

2. Favorite foods_______________________________________________

170
3. Disliked foods_______________________________________________
4. What do you do while eating? (Watch TV, listen to music)____________
___________________________________________________________
5. How do you feel about your size?_________________________________
6. Have you ever tried to diet?______________________________________
7. How many minutes a day do you exercise? What type? At what intensity?
___________________________________________________________
8. What are your eating habits? (Drive thru meals, microwave dinners, baked vs.
fried foods)__________________________________________________
9. Breast_________ Bottle__________
10. How many bottles (or feedings) per day? __________________________
11. What is the schedule (How many oz. how far apart)?_________________
12. What foods groups have been introduced?__________________________
13. Any feeding problems? (Colic, reflux, poor suck)____________________
14. Any religious or cultural beliefs that affect your diet?_________________
____________________________________________________________
II. Objective Data:
1. Weight: _____ Percentile: _____
2. Height: _____ Percentile: _____
3. Head circumference: _____ Percentile: _____
4. Vital Signs: _____________________________________________________
5.

171
Physical Exam
General Appearance (Look at muscle mass & tone, hydration status): ______________
______________________________________________________________________
Skin (Smooth & elastic vs. dry, wrinkled, scaling): _____________________________
______________________________________________________________________
Hair (Lustrous & strong vs. dull, thin, balding): ________________________________
______________________________________________________________________
Eyes (Clear & bright vs. scaling or cornea & conjunctiva): _______________________
______________________________________________________________________
Teeth (White, smooth, intact vs. brown, pits, & fissures; Include # teeth):
______________________________________________________________________
Gums (Firm, coral pink vs. swollen & spongy): ________________________________
______________________________________________________________________
Lips (Smooth & moist vs. fissures and inflamed): ______________________________
______________________________________________________________________
Tongue (Rough texture vs. smooth texture): __________________________________
______________________________________________________________________

172
Abdomen (Soft & flat vs. distended & flabby): ________________________________

Labs
Serum albumin Patient_____ Normal Range_____
Serum prealbumin Patient_____ Normal Range _____
Plasma Triglycerides Patient_____ Normal Range_____
Hemoglobin Patient_____ Normal Range_____
Serum transferrin Patient_____ Normal Range_____
Cholesterol Patient_____ Normal Range_____
Serum creatinine Patient_____ Normal Range_____
Potassium Patient_____ Normal Range_____
Sodium Patient_____ Normal Range_____
III. Nursing Diagnoses, Prioritization, Goals, & Interventions
Priority#__Altered nutrition: High risk for more than body requirements r/t___________

173
Goal: ___________________________________________________________________
Interventions ____________________________________________________________

Priority#____ Altered nutrition: Less than body requirements r/t____________________

Goal: ___________________________________________________________________
Interventions: ____________________________________________________________

Priority#_____ Altered nutrition: more than body requirements r/t __________________
Goal: ___________________________________________________________________
Interventions: ____________________________________________________________

Priority#_____ Knowledge deficit r/t _________________________________________
Goal: ___________________________________________________________________
Interventions: ____________________________________________________________

174
I. Evaluation Statement

175
Clinical Objective #2: Developmental Assessment

Preparation:
1. Read appropriate chapters in your textbook.
2. Watch the Denver II training video in the nursing lab.
3. Make yourself familiar with developmental milestones for children ages 0-18.

Instructions:
1. Identify your selected patients developmental level and list at least one developmental
milestone (1 gross motor, 1 fine motor, 1 verbal and 1 social) you observed during your
care of this patient.
2. If you notice any delays or regression please not this in your write-up.
3. Choose a minimum of 1 nursing diagnosis in relation to growth and development for this
patient.
4. If you have more than 1 nursing diagnosis, prioritize your list.
5. Create a patient-centered goal for each nursing diagnosis.
6. Describe 3 nursing interventions that will help your patient achieve each goal.
7. Write a short evaluation statement regarding your patients development and each goal.

176
Denver II: Developmental Assessment
NAME:
AGE (Chronological and corrected):
DIAGNOSIS:
PAST MEDICAL HISTORY: _______________________________________________
________________________________________________________________________

Nursing Diagnoses, Prioritization, Goals, & Interventions
Priority#___ Risk for altered development r/t_________________________________
___________________________________________________________________
Goal: ______________________________________________________________
Interventions: _______________________________________________________
___________________________________________________________________

Priority# ____ Altered growth and development r/t ___________________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: _______________________________________________________
___________________________________________________________________
Priority#____ Knowledge deficit r/t _______________________________________
__________________________________________________________________

177
Goal: _____________________________________________________________
Interventions: ______________________________________________________
__________________________________________________________________
Priority#____ (Other diagnosis) r/t________________________________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: ______________________________________________________
__________________________________________________________________

IV. Evaluation Statement (Were goals met or not? Why or why not?)

________________________________________________________________________

178
Clinical Objective #3: Medicating Children

Please note: you must show your work to receive credit

Preparation:
Read appropriate chapters in text.
Look up all medications given to your assigned patient; calculate safe dosage range for
each drug.
Review lecture PowerPoint and handouts concerning pediatric medication
administration
Activities:
1. Demonstrate all safety measures to establish accuracy of drug order.
a. Consult order written on chart.
b. Check date written.
c. Review drug data found in PDR, etc.

2. Calculate the pediatric drug dosage for each medication of your patients. Compare your
calculations with the dosage prescribed.

3. Establish identification of your patient.

4. Re-establish nurse-patient relationship after all medication procedures.

5. Evaluate and record effects of medications and fluids given.

6. List possible nursing diagnoses

179

7. Complete the following medication problems.
A. An 18-month-old infant weighs 24 lb. How many kg does this infant weigh? _____

B. Order: Kefzol 400mg Q6h over 30 minutes via IV Buretrol. The maximum recommended
infusion concentration is 10mg/mL. The vial of medication has a concentration of
250mg/mL.
1. How many mL of medication will provide 400mg? ___________
2. After adding the medication to the Buretrol, how many mL of IV solution should
be added to equal the final concentration? ____________
3. How many mL/hr should the pump be set? ___________

C. Order: Ampicillin 150 mg Q6h over 15 minutes via IV Buretrol. The maximum
recommended infusion concentration is 20mg/mL. The vial of medication has a
concentration of 250mg/mL.
1. How many mL of medication will provide 150mg? __________
2. After adding the medication to the Buretrol, how many mL of IV solution should
be added to equal the final concentration? ____________
3. How many mL/hr should the pump be set? ___________

D. A physician prescribes Tylenol 200mg po Q4h prn to a 3-year-old child weighing 34 lb.
The safe dose range for Tylenol is 10-15mg/kg. Is this dose safe to administer? _____

E. Post-op orders: Morphine Sulfate 2mg IV Q1h prn for a 12-year-old child weighing
101 lb. The safe dose range of Morphine is 0.05-0.1mg/kg. Is this a safe dose? _____
F. Order: Phenobarbital 55mg po BID. Phenobarbital is available in a liquid suspension of
20mg/5mL. How many mL will you administer per dose? ____

G. Flagyl 750mg po TID for 5 days for a yeast infection. Flagyl tablets are 250mg each.
How many tablets will the nurse administer per dose? _____
How many tablets will the nurse administer in 24 hours? _____

180

H. Order: Hepatitis B Vaccine once. Patient is a 4-month-old infant. Where will you
administer this vaccine? ___________________ What is the maximum volume that can
be administered in this site? _____________

8. List possible nursing diagnoses.

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Clinical Objective #4: Pain Assessment & Control/Other Stressors

Preparation:
1. Read appropriate chapters in the textbook.
2. Familiarize yourself with the pain scales used at your clinical facility.

Instructions:
1. Complete the following subjective and objective data on your assigned
pediatric patient.
If the patient is non-verbal base the answers to the questions on your
objective assessment data or subjective data received from parents/family
members
2. Mark all nursing diagnoses that apply to your patient. (Minimum of 2)
-Personalize all your diagnoses for your patient.
5. Prioritize your list of nursing diagnoses.
6. Create a patient-centered goal for your patient based upon your nursing
diagnosis.
5. Describe 3 nursing interventions that will help your patient achieve each
goal.
6. Write a short evaluation statement regarding your patient and your goals.

182
Pediatric Pain and Stress Assessment
NAME AGE
DIAGNOSIS

PAST MEDICAL HISTORY

I. Subjective Data (May ask parent if patient is an infant)

1. Are you in any pain currently? ___________________________________
____________________________________________________________
2. Choose the appropriate scale and have the patient rate his/her pain. _______
3. Have you had any pain recently (last 2 weeks)? _______________________
_____________________________________________________________
4. Have the patient point to where the pain is located. ____________________
5. Can you describe the pain (dull, crushing, burning)? ___________________
_____________________________________________________________
6. What do you do when you are in pain? ______________________________
______________________________________________________________
7. What makes the pain better? _______________________________________
______________________________________________________________
8. What makes the pain worse? _______________________________________
______________________________________________________________
9. How you tried any medicine for the pain? What medicine? Does it work?___
_______________________________________________________________
10. How long have you been in the hospital away from your family? ___________
11. What degree of separation is present (mom stays, dad visits)? ______________
________________________________________________________________
12. According to your patients age group, what type of fear is probably their
#1concern? ______________________________________________________
________________________________________________________________
13. Identify any threats that may arouse this fear (surgery for preschooler)? ______
________________________________________________________________
14. Assess your child for s/s of separation anxiety. __________________________
________________________________________________________________
15. Using Robertsons 3 phases, categorize your patients behavior (protest, despair,
detachment)? ____________________________________________________
16. Evaluate the family /child situation for other stress factors present. _________
_______________________________________________________________

II. Objective Data
1. Vital Signs_____________________________________________________
2. Current pain medications for patient_________________________________

183

Assessment (Mark any of the following that are present in your patients age group.)
Infant: Grimacing, facial flinching, increased BP and/or HR, high-pitched harsh cry,
generalized body response with crying, tremors, thrashing of extremities,
guarding, or pulling away from touch.

Toddler: Loud crying, verbalization of discomfort, generalized restlessness, guarding,
and touching of painful area.

Preschooler: Crying, kicking, thrashing of arms and legs, restless, irritable, clingy with
parent, requests hugs and other forms of physical comfort, regressive
behaviors, withdrawal, and denies pain, even when present.

School-age: Stiff body posture, clinched fists, gritting teeth, closed eyes, wrinkled
forehead, contracted limbs, and withdrawal.

Adolescent: Increased muscle tension, withdrawal, and decreased motor activity.

III. Nursing Diagnoses, Prioritization, Goals, & Interventions
Priority#___ Pain r/t____________________________________________________
___________________________________________________________________
Goal: ______________________________________________________________
Interventions: _______________________________________________________
___________________________________________________________________

Priority# ____ Ineffective individual coping r/t ______________________________
__________________________________________________________________
Goal: _____________________________________________________________

184
Interventions: _______________________________________________________
___________________________________________________________________
Priority#____ Anxiety: separation r/t ______________________________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: ______________________________________________________
__________________________________________________________________
Priority#____ Knowledge deficit r/t________________________________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: ______________________________________________________
__________________________________________________________________
Priority#___ Fear r/t____________________________________________________
___________________________________________________________________
Goal: ______________________________________________________________
Interventions: _______________________________________________________
___________________________________________________________________

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Priority# ____ (Risk for) Altered growth and development r/t __________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: _______________________________________________________
___________________________________________________________________
Priority#____ Altered family processes r/t __________________________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: ______________________________________________________
__________________________________________________________________

Priority#____ (Other diagnosis) r/t________________________________________
__________________________________________________________________
Goal: _____________________________________________________________
Interventions: ______________________________________________________
__________________________________________________________________

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IV. Evaluation Statement (Were goals met or not? Why or why not?)

________________________________________________________________________

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Clinical Objective #5: Knowledge Deficit

Preparation:
Read appropriate chapters in text.

Activities:

1. Identify one teaching need for your assigned patient/family, (examples below).
a. Pre-operative teaching.
b. Pre-procedural preparation.
c. One aspect of nutrition.
d. Value of exercise.
e. Proper hand washing, tooth brushing, etc.

2. Implement this at an age-appropriate level.
a. Utilize play whenever possible.
b. Consider the three domains of teaching/learning.
1. Cognitive
2. Psychomotor
3. Affective

3. Evaluate effectiveness of teaching:

a. Patient verbalizes understanding.
b. Patient demonstrates the skill.

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4. Listed below are possible nursing diagnoses (identify others):

a. Knowledge deficit (specify)
b. Powerlessness

Discussion:
Report teaching experiences
Short written summary to include the following sections:
Teaching Need, Implementation, Evaluation, Nursing Diagnoses

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Pediatric Case Presentation

As part of clinical in the pediatric setting student will be required use the nursing process when
presenting this topic, a brief post conference topic. Students are to work together with another
classmate in the clinical group to present a relevant pediatric topic. The due date will be
announced the first day of class. The list of topics is below.

The presentation will include:
1. All components listed in the clinical case situation guide.
2. A bibliography to turn in the day of the presentation, minimum of 3 sources, one
of which must be a current professional nursing journal (additional sources can include a
book, internet source, etc.).
3. An article to hand out to your classmates that coincides with the topic (this can be one of
your sources).
4. A visual aid (can be a poster, pamphlets, health equipment, etc.)
5. A description of the community support that is available for the child and family.
6. A 1-2 page typed summary to turn in the day of the presentation.
Pediatric Topics for Case Presentation
1. Failure to thrive
2. Congenital heart anomalies
3. Sickle Cell Disease
4. Cystic fibrosis
5. Diabetes
6. Shaken Baby Syndrome
7. Gastroschisis
8. Viral vs. Bacterial Meningitis
9. Pyloric Stenosis
10. Scoliosis
11. Poisonings/ Safety
12. Hirschsprungs disease
13. Juvenile rheumatoid arthritis

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Pediatric Clinical Case Presentation Guide

Disease: ______________________________________

Using the nursing process:

I. Explain the pathophysiology of this condition.

A. Include the etiology, contributing factors, and hereditary pattern if indicated.

B. Describe pathophysiological changes that occur.

C. At what age would this condition most likely be present?

II. How would you assess for this condition? (Include methods of assessment, i.e., health
history, diagnostic tests, and observation of signs and symptoms).

III. List four anticipated nursing diagnoses.

II. Select one developmental stage and discuss the impact of this condition on the achievement of
developmental tasks. (You may choose either the stage in which the
III. condition is diagnosed or a later stage.)

V. How might you prevent or deal with this "accidental crisis" superimposed on the
"development crisis"?
Name: _________________________________________ Date: ___________________

191

VI. Describe support and resources available through a community based agency.

VII. Each "group" must use one visual aid (ie. pamphlets, poster, handout, etc.) in the
presentation.

Evaluation of the case presentation is Pass/Fail.

The evaluation form is on following page.

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Pediatric Case Presentation Evaluation Form
Grading Scale: Excellent: 4 Good: 3 Fair: 2 Poor: 1

Grade

Participants presented equal material.

Comments:

Participants presented all areas according to guide in syllabus.

Comments:

Material presented was informative and thorough.

Comments:

Visual aid was well-prepared and useful in relaying the information.

Comments:

All written work was submitted on-time and was complete.

Comments:

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Overall Comments:

Total score (must be at least 15/20 to pass) ___________

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Pediatric Care Plan

As part of the clinical experience in the pediatric setting, the student will use the nursing process to develop
a written care plan on a pediatric patient.

Criteria:
1. A completed nursing history assessment database.
2. Lab Flow Sheet
3. Completed drug cards for each of the childs prescribed medication.
4. 4 prioritized nursing diagnoses.
a. Each diagnosis will contain a patient stated goal that is measurable and appropriate to the
diagnosis.
b. A completed assignment worksheet.
c. Each diagnosis will contain 8 interventions.
d. At least one intervention will address patient or family teaching.
e. All 4 diagnoses will be supported by written rationale, one of which will be from a
professional nursing journal (the same or different journal article(s) can be used for the
rationale for each diagnosis).
f. The evaluation statements should describe the outcomes of the patient in relationship to the
each intervention.
5. The professional nursing journal(s) used to support the rationale are to be submitted with the care
plans.
6. A growth and development summary.
7. An APA style bibliography.
8. A copy of the care plan evaluation form.
9. A clean copy of the pathophysiology sheet.

NOTES

1. The care plan must be typed.

2. Each area of the care plan will be graded independently and may require revision based on the
discretion of your clinical instructor. A ZERO IN ANY AREA WILL AUTOMATICALLY REQUIRE A
REVISION

195

3. The care plan is to be handed in complete by the date assigned by the clinical instructor. No
partially completed care plans will be accepted for grading.

4 The care plan must be individualized for the selected patient. It is highly recommended that care
plan books be used as a reference only. The care plan should reflect your own thought processes
related to your patient using evidence to substantiate your interventions.

5 Students are to work individually on their own care plan. Even though two or more students may
share the same patient in clinical, each student will submit a care plan that is his/her work only.
Evidence of cheating and plagiarism will be dealt with according to policy.

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MIDWAY COLLEGE

NSG 210 CARE PLAN

STUDENT NAME: DATE: / / PATIENT INITIALS:

The nursing process will be utilized to develop a care plan is to be turned in to the clinical instructor with the following
items:
1. Clinical Assignment Worksheet
2. Nursing History Assessment database
3. Lab Flow Sheet
4. Drug cards
5. 4 prioritized nursing diagnoses.
6. A copy of the nursing journal article(s)
7. A growth and development summary.
8. Bibliography.
9. Care Plan Evaluation Summary

197

For the narrative history include the following information:
Identifying (initials, age, sex, marital status, occupation, culture)
General health history (medical hx, injuries, caffeine intake, smoking hx, drug/alcohol use)
Family history (pertinent genetics, familial, economic and social data)
Brief recent history (development of presenting problem over the past several weeks or days).

198
MIDWAY COLLEGE PEDIATRIC NURSING HISTORY/ASSESSMENT FORM Student Name: ___________________________

Patient Initials: Age: Admission Date: Date of care: Date of interview:

Source of information:
Admitting Diagnosis:
Other health problems:
Allergies: Food, Drug, Blood, or Environmental (describe):

HT: Percentile: WT Percentile

Head circumference (if appropriate) T P R B/P

I. HEALTH PERCEPTION

SUBJECTIVE:
Child's health in general (before admission)

First hospitalization? If yes, describe

What treatment is child receiving?

NARRATIVE HISTORY

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How do you think the treatment is working?

Health of other family members? (Specify)

Measures to keep child well?

Periodic health checkups? Yes No

Opportunities for exercise?

Immunizations up-to-date? Yes No

Recent exposure to chicken pox ; flu ; other

Database Directions --indicate "No Data", "Yes", "No", etc.

200

Medications taken at home?

OBJECTIVE:
Medications while in hospital (dose, route, frequency)

1.

2.

3.

4.

Signs/symptoms of infection

Safety hazards in child's environment

NURSING DIAGNOSES/PATIENT NEEDS:

Body Temperature, Altered: High risk
Health Maintenance Management, Impaired
Infection: High risk
Injury: High risk
Knowledge Deficit (specify)
Noncompliance (specify)
Poisoning: High risk
Suffocation: High risk
Trauma: High risk

TEACHING NEEDS:

201
COMMENTS:

202

II. ROLE RELATIONSHIP

SUBJECTIVE
Who does this child live with?

Other significant persons?

Does child play with other children?

Any concerns regarding friendships?

Has your lifestyle changed due to this illness?

OBJECTIVE:
Describe interactions with others

How does child "separate" from parents?


Alteration in family process
Alteration in parenting
Communication, impaired verbal
Grieving, anticipatory

TEACHING NEEDS:

203

III. COGNITIVE/PERCEPTIVE

SUBJECTIVE:
Any deficits in sensory perception (hearing, sight, touch)? If yes, specify

What is child's grade in school?

How does s/he do in school?

Tell me about child's language ability.

Any concerns about his/her speech?


Communication, Impaired: verbal
Pain (acute/chronic)
Sensory, perceptual alterations (specify)

TEACHING NEEDS:

204

Comfort level? (pain)

OBJECTIVE:
Speech pattern (age/development appropriate)

Level of consciousness.

Orientation: time; place; person.

Neurological: pupils equal reactive

Fontanels: flat depressed bulging .

Reflexes present (Babinski, Moro, grasp)

Behaviors indicating pain.

Physiological signs of pain.

205
COMMENTS:

206

IV. NUTRITIONAL/METABOLIC

SUBJECTIVE:
Usual appetite?
Food restrictions (due to allergies, religious practice, etc.)
_________________________________________________________________________

Diet: Difficulty with: Feeding aids: Complaints:
Breast Chewing Bottle Nausea
Formula Swallowing Utensils Vomiting
Solids Feeding Cup Fever
Special Pacifier Wt. loss
Regular Wt. gain
Vitamin supplements Colic

OBJECTIVE:
Skin: General Assessment
Color Temperature Condition Turgor
Pink Warm Dry Elastic
Pale Hot Moist Loose
Flushed Cool Clammy Dehydrated
Other Cold Diaphoretic Edema

NURSING DIAGNOSES/PATIENT NEEDS

Alteration in Nutrition: Less
Alteration in Nutrition: More
Fluid volume deficit: High risk
Ineffective thermoregulation
Self-care deficit (specify)
Skin integrity impairment: High risk

TEACHING NEEDS:

207

Comments:

Skin Condition (give location)
Abrasion Bites Laceration Rash Bruising
Dressing Petechiae Decubitus Surgical Wound

Hair Shiny Dry Clean; Dull Oily Dirty
Recent Hair Loss: Yes No

Nails: Clean Dirty Pink Pale

Mucous Membranes: Pink ___Pale Intact ____Other ___ Moist ___ Dry

Teeth: Number
Dentures Loose Caries Missing Retainer Braces
Regular Dental Care: Yes No

Amount of fluid intake: 8 hrs. 24 hrs.
(Specify po and IV intake): _______________________

Percentage of hospital diet eaten: Labs:

COMMENTS:

208

V. ELIMINATION

SUBJECTIVE:
Pattern of bowel elimination before illness?

Voiding pattern before illness?

Expression indicating need to eliminate?

Toilet trained/use of diapers?

Recent Changes/Problems:
Constipation Diarrhea Pain Bleeding (stools/urine)
Burning Incontinence (stools/urine)

OBJECTIVE:
Appearance of excretion (amount, color, consistency) Urine Stool

Artificial means of elimination (bowel/bladder program)?


Bowel Incontinence
Diarrhea
Knowledge deficit (specify)
Urinary elimination, altered

TEACHING NEEDS:

209

Bowel sounds

Diaper rash

Last BM Frequency of voiding

History of UTIs

Assistance needed for toileting

Urine output 8 hr. total: 24 hr. total

COMMENTS:

210

VI. ACTIVITY/EXERCISE

SUBJECTIVE:
Motor abilities child has achieved:
roll over sit walk alone climb stairs
reach grasp feed self
Any concerns about these?__________________________________________________
How independent is your child?______________________________________________
Energy level before illness ; after illness
Use of assistive devices
Tobacco use: Yes; No; Smokeless

OBJECTIVE:
Respiratory: R L Breath Sounds: Nasal Passages:

Rate Clear Normal Rhinorrhea
Dyspnea Diminished Red Bleeding
Retract Adventitious Pale Sneezing
Irregular
Cough

Oximetry reading (if available)


Activity intolerance
Aspiration: High risk
Decreased cardiac output
Diversional activity deficit
Ineffective airway clearance
Impaired gas exchange
Mobility impaired
Self-care deficit (specify)
Tissue perfusion, alteration

Arterial Blood Gases (ABG):
Norms (ABG's)
Ph ph 7.35-7.45
pO2 pO2 80-100
pCO2 pCO2 35-45
HCO3 HCO2 22-28
SATS SAT 90-100

Normal? Abnormal?

211

Blood Pressure:

Pulse (note whether Radial or Apical): Capillary Refill Pedal Pulses:
Rate Brisk Left
Regular Sluggish Right
Irregular
Weak

Describe: ______ gait ______ coordination/balance _______muscle tone
ROM:
full limited (specify)
passive active

Level of ability for ADL's

COMMENTS:

TEACHING NEEDS:

212

VII. SLEEP/REST

SUBJECTIVE
Difficulty sleeping? Yes No Explain:

Bedtime ritual? _________________________________________________________

Security object(s)?

Nightmares? Yes No

Bed wetting? Yes No

Usual bedtime?

Wake up time?

Naps:


Sleep pattern disturbance

TEACHING NEEDS:

213

OBJECTIVE:
Sleep pattern noted:

Physical appearance related to sleep/rest:

Energy level:

COMMENTS:

214

VIII. SELF PERCEPTION/SELF CONCEPT

SUBJECTIVE:
Tell me about yourself:

How does your illness make you feel?

Draw a picture of yourself (provide materials)

If you could make three wishes, what would they be?

OBJECTIVE:
Present mood:


Body image disturbance
Hopelessness
Self-esteem, low: chronic or situational
Powerlessness

TEACHING NEEDS:

215

Eye Contact:

Does child initiate conversation?

Does child warm up easily?

Remain shy?

General appearance?

What procedures/surgeries are being performed?

COMMENTS:

216

IX. COPING/STRESS

SUBJECTIVE:
What are your concerns/fears?

Who helps you most when you are afraid/stressed?

What do you do when things build up?

What kind of music do you like?

Ever used illegal drugs?

Alcohol?


Alteration in Parenting
Anxiety
Fear
Ineffective coping, individual or family

TEACHING NEEDS:

217

(Parent) How does your child respond to stress?

How do you manage child care, housework, and other responsibilities?

What can nurses do to help?

OBJECTIVE:
Present mood:

Observed behaviors during stress:

Noted stress reducers implemented by family?

218
COMMENTS:

219

X. SEXUALITY/REPRODUCTIVE

SUBJECTIVE:
Female: Age of menarche? Regular periods?
Usual duration _ Discomfort?

Any concerns about your periods?

Examine breasts regularly?

Sexually active?

Birth Control?

History of sexually transmitted disease?
Male:
Circumcised? Yes No

Any concerns?

Sexually active?


Infection, High risk
Sexuality patterns, altered
Knowledge deficit (specify)

TEACHING NEEDS:

220

Birth Control?

History of sexually transmitted disease?

OBJECTIVE:
Observations regarding sex role acquisition (boys play with trucks; girls play with
dolls).

COMMENTS:

221

XI. VALUE/BELIEF

SUBJECTIVE:
Do you have a church preference?

Denomination?

Religious, family practices that will influence hospitalization?

OBJECTIVE:
Religious support apparent (clergy visits)

COMMENTS:


Spiritual distress

TEACHING NEEDS:

222

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XII. DEVELOPMENTAL STAGE

OBJECTIVE:
What are child's stages, according to:

Erikson

Piaget

Freud

Is the child's psychosocial/cognitive/moral development appropriate for his/her
chronological age?

What behaviors contribute to this inference?

COMMENTS:


Altered growth and development

TEACHING NEEDS:

224
Lab Flow Sheet

LAB

HOSPITAL NORM

ADMISSION

CURRENT

Date:
Time:

Hgb

HCT

WBC

Platelets

Control
PT

Control
PTT

NA

K

225
CO2

C1

BUN

Creat.

Calcium

Blood Glucose

Acetone

Urine
Specific Gravity

Urine pH

Enzymes

Other:

226
GROWTH AND DEVELOPMENTAL SUMMARY
(To be done with each care plan, regardless of patients age.)

Using Erikson and Piaget, describe the normal growth and development for your
patients age. List the stage that corresponds to the age of this patient and describe the
skills and abilities of this stage.

Then provide objective data from observations of your selected patient and indicate if
they compare to the textbook picture. Finally, develop a plan of care to address lags in
development or to maintain appropriate development. Be sure to follow format below
and include with each care plan.

1. Textbook picture as described using Erikson and Piagets development theories.

2. Objective data- Describe your observations of the patient and compare them to the
textbook picture.

3. Plan - List several interventions which could maintain G&D, or improve lags. (e.g.
"At least twice/day read to child and encourage word sounds"; or "encourage parent to
do this")

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NSG210
ADN EVALUATION for Use of Nursing Process with Care Plan
GRADE: INSTRUCTOR:
2 = SATISFACTORY
1 = NEEDS IMPROVEMENT STUDENT:
0 = UNSATISFACTORY
DATE:

TOPIC

DIAG. #1

DIAG. #2

DIAG. #3

DIAG. #4

Nursing diagnosis are stated correctly

Incorporation of history into care planning: Subjective data is sufficient (patient
complaints, allergies, etc.)

Incorporation of history into care planning: Objective data is sufficient (labs,
physical exam, tests, V.S., I & O, X-Ray, etc.)

Goals are stated in patient terms.

Goals are measurable and appropriate to the diagnosis and within a realistic
time frame.

Nursing assessment of patient/family tells me what to look, listen, or feel for.

Nursing actions are individualized and specific (indicate what to do to or for the
patient; how, how often, how much, and are age appropriate.)

Nursing actions are appropriate to the diagnosis and goal based on physical
and psychosocial needs.

Nursing actions include independent and collaborative actions (i.e.-
medications integrated appropriately, physical therapy consult.)

228

Patient/family teaching is addressed.

Evaluated effectiveness of every intervention including conclusion statements.

Satisfactory= 19-22 Unsatisfactory = <19 Total

TOPIC

GRADE

Pathophysiology is described appropriately.

Nursing diagnoses is comprehensive.

Problems/diagnosis is prioritized appropriately.

Care plan construction (neatness, organization, uses appropriate format, etc.)

Rationale appropriate to level intervention and patient situation.

Growth and Development Summary (see following page)

Satisfactory = 9 - 12 Unsatisfactory = < 9 TOTAL

Comments:________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
.

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MIDWAY COLLEGE
NURSING PROGRAM

CLINICAL
EVALUATION FORM
NSG 210

STUDENT NAME:

INCLUSIVE DATES: TO

230

Midway College
Associate Degree Nursing Program
Clinical Evaluation Tool
COURSE: Nursing 210 Semester:___________________

Student Name: _________________________________ Clinical Faculty:_____________________

Clinical Site and Unit: _____________________
Skills Performance Checklist Reviewed Midterm____ Final_____
Midterm Evaluation Date: __________________ Final Evaluation Date: _____________________

Absent/Tardy Dates:___________________ Specify Clinical Makeup Assignment completed:_____________

Key: Evaluation Scale:
CO: Course Objectives 4: Exceptional
SLO: Student Learning Outcomes 3: Above Average
KSA: Knowledge , Skills, Attitude 2: Satisfactory
QSEN: Quality and Safety Education for Nurses 1: Unsatisfactory
0: Unsafe performance
Evaluation Scale:
4-Exceptional: Consistently excels in demonstrating outcome behavior. Demonstrated a thorough
and in-depth understanding of concepts and applies them to patient care. Utilizes creative and
confident approaches to nursing practice. Shows insight when analyzing and evaluating patient
care situations.
3-Above average: Consistently demonstrates and at times exceeds outcome behavior.
Demonstrates expanded understanding of concepts and applies them to patient care. With
increasing confidence utilizes effective approaches to nursing practice. Analyzes and evaluates
patient care situations with greater discernment.
2-Satisfactory: Consistently demonstrates outcome behaviors. Demonstrates satisfactory
understanding of concepts and applies them to patient care situations. Utilizes effective
approaches to nursing practice. Analyzes and evaluates patient care in situations accurately.
Meets expectations.

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1-Unsatisfactory: Inconsistent in demonstrating outcome behaviors. Requires consistent
guidance when applying concepts to patient care situations. Consistently requires verbal cues
when analyzing and evaluating patient care situations.
0-Unsafe performance: Does not independently demonstrate outcome behaviors. Unable to
perform safely with guidance.
Note: The student must be performing satisfactorily (2-Satisfactory) overall in the clinical
setting upon completion of the final clinical evaluation. Any rating below a 2-Satisfactory at
The completion of the clinical rotation in any area reflects unsatisfactory performance and
will result in course failure.

Quality and Safety Education for Nurses (QSEN) Competencies:
1. Patient Centered Care- Recognizes the patient as source of control and partner in providing
compassionate and coordinated care based on respect for patient preferences, values, and needs.
2. Teamwork and Collaboration Functions effectively within nursing and interdisciplinary
teams, fostering open communication, mutual respect, and shared decision-making to achieve
quality patient care
3. Evidence-Based Practice- Integrate best current evidence with clinical expertise and
patient/family preferences and values for delivery of optimal health care.
4. Quality Improvement- Uses data to monitor the outcomes of care processes and use
improvement methods to design and test changes to continuously improve the quality and safety
of health care systems.
5. Safety- Minimizes risks of harm to patients and providers through both system effectiveness
and individual performance.
6. Informatics- Use information and technology to communicate, manage knowledge, mitigate
error, and support decision making.

Course Objectives:
The student will be able to:
2. Utilize the nursing process in providing nursing care to childbearing and childrearing families
and childrearing families.
4. Demonstrate therapeutic and professional communication techniques in the assessment and
care of childbearing and childrearing families and members of the healthcare team.
5. Provide safe and competent nursing care and teaching for obstetric and pediatric clients in
clinical and community settings while adhering to ethical, legal and regulatory standards of
practice.

232

childrearing families in clinical and community settings.

Student learning Outcome:
1: Demonstrate competency in knowledge of nursing and clinical skills necessary to provide safe, competent
nursing care.
1,2,4 1K, 1S 1. Utilizes the nursing process in providing care to the pediatric client:
Identifies problems based on collected data, knowledge, and
evidenced based practice.
Elicits patient values, preferences, and expressed needs as part of
clinical interview, implementation of plan of care, and evaluation
of care.
Identifies and initiates appropriate nursing interventions.
Evaluates the plan of care based on desired outcomes.

1,2 1K, 1A 2. Demonstrates respect and sensitivity for diverse childbearing and
child rearing families and individual clients.
Considers client preferences, values, and needs in providing
compassionate care, recognizing own values and beliefs.
Respects and encourages individual expression of clients values,
preferences, and expressed needs.
Provides client- centered care with sensitivity and respect for the
diverse human experience.
Incorporates clients current condition, lifestyle, culture, spiritual
beliefs and developmental stage into the plan of care.

5 5K,6K
6S, 6A
3.Safely and efficiently administers medications to clients in the
obstetric and pediatric setting:
Utilizes the 6 Rights/3 checks of Medication Administration.
Demonstrates accurate dosage calculations.
Reviews medications with clinical instructor prior to
administration.
Demonstrates competent knowledge of all medications
administered.
Recognizes benefits/limitations of selected safety-enhancing

233

technologies (i.e., barcode medication administration, computer
provider order entry, medication pumps, and automatic
alerts/alarms).
Implements appropriate assessment and evaluation of the client in
preparation/follow-up of medication administration including but
not limited to: monitoring vital signs, appropriate laboratory and
radiologic results, and objective and subjective client data).
5, 6 4K, 5K 4. Performs clinical skills competently and safely, adapting to client
needs and situation while adhering to principles of nursing practice:
Demonstrates safe and competent performance of clinical skills,
including those skills learned in prior nursing courses.
Seeks opportunities to perform and demonstrate competency of
clinical skills.
Verbalizes and demonstrates an understanding of safe client care.
Incorporates use of technology and standardized practices that
support safety and quality.

5 1K, 5K 5. Demonstrates safe care of assigned clients.
Adheres to National Patient Safety Goals, acceptable safety
standards, and facility policies of quality improvement. Uses
safety resources for own professional development and focuses
attention on safety in healthcare settings.
Communicates observations and concerns related to hazards and
errors to clients, families, visitors, and the healthcare team.
Recognizes human factors and other basic safety design
principles, as well as commonly used unsafe practices (work-
arounds, use of unapproved abbreviations).
Adapts environment for the safety of clients and identifies
expected and unexpected outcomes if safety precautions are not
met.
Identifies factors that create a culture of safety (open
communication, organizational error reporting systems).

Specific events/evidence/examples to support rating by instructor: Note: Mandatory for Exceptional,
Unsatisfactory and Unsafe performance. Optional for Good and Satisfactory performance:

234

2. Utilize the Nursing Process to assess clients and families and to plan, implement, and evaluate care to clients and
families while functioning within the scope and standards of nursing practice.
1,
2,3,
5, 6
1K,3K,5K
1S, 3S, 5S
1A, 3A, 5A
1. Satisfactorily completes a nursing care plan during the pediatric
clinical experience.
Collects pertinent objective and subjective client data, including a
comprehensive pediatric history.
Prioritizes nursing diagnoses.
Individualizes goals/outcomes that client centered, measurable,
and achievable within a specified timeframe.
Includes appropriate interventions for each diagnoses/outcome
that are individualized, client-specific with measurable
parameters, based on reliable evidenced based practice
(referenced scholarly journals).
Uses scholarly, evidenced based practice resources as supportive
evidence (including, but not limited to: course textbooks,
professional journals, evidence-based practice websites).
Assignments submitted in a timely manner, all components of the
assignment included with submission, and submitted in neat and
organized manner.

1, 2,
3, 4
1K, 3S 2. Uses the nursing process to develop and implement a plan of care
that:
Is relevant to clients needs.
Addresses teaching-learning principles.
Reflects desired outcomes.
Is based on client values, evidence and standards of practice.
Reflects an understanding of multiple dimensions of client
centered care including:
6. Client/family/community preferences, values
7. Information, communication, and education
8. Physical comfort and emotional support
9. Involvement of family and friends
10. Transition and continuity

1, 2,
4, 5
1K, 1S,
2K
3. Assists in maintaining an environment that actively promotes the
client and family as central to care including informed healthcare
choices:
Identifies strategies to empower clients or families in all aspects
of the healthcare process.
Values active partnership with clients and/or families in planning,
implementing and evaluating the plan of care.
Engages patients and families in active partnerships that promote
health, safety and well-being, and self-care management.
Communicates with members of the healthcare team about plan of
care.
Recognizes contributions of other healthcare providers,

235

individuals, and groups in helping client/families achieve
healthcare goals.
Respects patient preferences for degree of active engagement in
care process.

1, 2,
4, 6
1K, 1S
3K
4. Includes teaching in plan of care for a pediatric client based on:
Clients/parents level of development, knowledge and learning
needs.
Evidenced based practices.
Clients/parents readiness to learn.

2, 5 5A 5. Demonstrates time management skills and prioritization of care.
Able to function without continuous direction from the clinical
instructor.
Completes clinical activities (assessment, personal care, clinical
kills and documentation) in a timely manner.


1,
2,4
1K, 1S, 1A
4K, 4S, 4A
1. Identifies and reports changes in client status immediately to clinical
instructor and/or staff.
Identifies trends in client data (i.e. vital signs, physical
assessment, laboratory findings, etc.) to identify client stability.
Provides a patient report (handoff) using accepted communication
and institutional formats (i.e., SBAR, I-SBAR-R, SHARED).
Assesses level of physical and emotional comfort; presence and
extent of pain.
Initiates interventions as appropriate to relieve distress in light of
client values, preferences and expressed needs.
Identifies integrative/alternative approaches of care where
appropriate in accordance with agency policies and client values.
Requests help/assistance when appropriate.

1, 4,

2A

2. Identifies need for collaboration with the multidisciplinary team to
provide clients and families with available resources to enhance

236

7 quality and continuity of care.

1, 4,
7
5K, 5S 3. Identifies aspects of nursing care that can be delegated to other
members of the healthcare team commensurate with their educational
preparation and experience.

Specific events/evidence/examples to support rating by instructor: Note: mandatory for Exceptional,

4. Communicate effectively and professionally both in speaking and writing.
4 1K, 1S 1. Utilizes therapeutic communication skills when interacting with
clients, families and the healthcare team including but not limited
to: listening, clarifying, verbal, nonverbal, personal space, open
ended questioning.

4 1K 2. Identifies barriers to effective communication (hearing, vision,
speech impairments; language barriers, cultural differences, etc).

3, 4 1K, 1S
3. Provides a patient report (handoff) as appropriate in a given
clinical setting, including but not limited to:
Relevant, accurate and complete data of client status/changes in
status.
Concise, clear and documented/reported in a timely manner.
Utilizes accepted forms of communication for handoff.
Reports client status changes to clinical instructor and/or staff.

5 1K 3. Actively participates in pre and post clinical conferences.
Protect confidentiality of electronic health records

237

CO QSEN/KSA Expected Behaviors Mi dterm Final
5, 7 1A, 2K, 2S
5K
1. Practices professional behaviors within the parameters of individual
knowledge and experience including:
Performing nursing roles with self- direction and minimal
assistance from clinical instructor.
Follows the parameters of Patient Care Partnerships (i.e., Patient
Bills of Rights).
Recognizes and reports unsafe practice by self and others.
Maintains patient privacy and confidentiality.
Follows applicable Midway College and clinical agency policies
including, but not limited to: dress code, name badge
identification, punctuality, absenteeism, and HIPAA guidelines.
Timely completion of assignments and clinical documentation.

7 1K, 1S, 1A
5K
2. Demonstrates accountability:
Display honesty and trustworthiness.
Arrives prepared for clinical day (adherence to dress code,
completed assignments, knowledge of clinical objectives/goals.
etc).
Accepts responsibility for follow-up on patient care/tasks
performed by self and those delegated to others.
Informs clinical instructor/staff of unusual, abnormal, or untoward
events in a timely manner.
Recognizes own limits and seeks resources appropriately.
Provides safe, quality care within the level of preparation.
Accepts constructive comments as a basis for personal and
professional growth.
Demonstrates initiative and seeks learning opportunities.
Values own and others contributions to outcomes of care.

7 2A 3. Serves as a positive role model within the clinical group and within
the multidisciplinary team.

7 1A 4. Demonstrates core values: caring, diversity, ethics, excellence,
holism, integrity, and patient-centeredness.

238

7 2A 5. Maintains professional behavior and appearance with representing
the Midway College Nursing Program.


1,2,
3,7
1K, 1S, 1A 1. Demonstrates positive and unconditional regard toward
childbearing and childrearing clients and families.
Demonstrates caring behaviors.
Serves as an advocate for clients and families.
Respects diverse cultures, values, and belief systems and
incorporates these in plan of care.
Communicates patient values, preferences, and expressed needs to

1, 7 1K, 1S, 1A 2. Protects and promotes clients dignity and privacy.
Willingly supports patient-centered care for individuals and
groups whose values differ from their own.
Respects the clients right to access personal health
information/records.
Protects confidentiality of protected health information
(electronic health records, verbal communications and
conversations, paper documentation).
Respects the centrality of the client/family as core members of the
healthcare team.

5, 7 1A 3. Values clients expertise with own health and symptoms; views
healthcare situations through patients eyes.


239

7 1. Completes required community service/servant leadership hours
during NSG 210.
Verified
by
Course
Faculty
2,6 2A 2. Functions as a team player:
Identifies plan for self-development as a team member.
Seeks learning opportunities with clients and families.
Values nursing as a career and values own nursing practice.

1, 7 2K, 2A 3. Recognizes nursing roles in assuring coordination, integration, and
continuity of care; Values need for continuous improvement in clinical
practice based on new knowledge.


8. Possess personal integrity and practice within the ethical framework of nursing.
7 1S 1.Practices within ethical, legal, and regulatory guidelines for nursing
practice:
Identifies ethical and legal implications of patient-centered care.
Recognizes and maintains professional boundaries of
nurse/patient (therapeutic) relationships.
Complies with the Code of Ethics for Nurses, Nursing Standards
of Practice, and policies and procedures of Midway College,
Midway College AND Program, and clinical agencies.

240

7 3A
2. Accepts individual responsibility and accountability for nursing interventions, outcomes,
and other actions.

7 3A 3. Assumes responsibility for learning.


CO QSEN/KSA Expected behaviors Midterm Final
6, 7 4K, 4S,4A 1. Identifies quality measures and key quality indicators (Core
Measures, Care Maps/Pathways) within delivery of holistic patient care
to improve overall patient outcomes:
Recognizes that continuous quality improvement is an essential
part of daily work of all health professionals.
Recognizes nursing and other healthcare profession students are
parts of systems of care and care processes that affect outcomes for
patients and families.

6 3K, 3S 2. References clinical based activities utilizing evidenced based
literature.
Cites information from evidence based literature in nursing care
plan.

6 6K, 6S
3. Utilizes informatics and technological resources (i.e., electronic medical records, bar-code
medication administration, infusion devices, etc) where appropriate in the delivery of safe
and effective client care.
Applies technology and information tools to support safe processes of care.
Navigates electronic health records as appropriate in clinical setting.


10: Work independently and collaboratively with other healthcare workers in providing care and teaching about

241

health promotion and illness prevention to diverse and complex clients and families.
7 3A 1. Identifies plan for self-development as a member of the
multidisciplinary healthcare team.

7 2A 2. Values teamwork and the relationships upon which it is based.
7 2K 3. Identifies roles of healthcare team members appropriate to meet the
defined health needs of childbearing and childrearing families.

7 2K 4. Identifies own strengths, limitations and values in functioning as a
member of a team.

7 2K, 2S 5. Functions within the scope of practice as a student member of the
intra and inter-professional healthcare team.

Specific events/evidence/examples to support rating by instructor: Note mandatory for Exceptional, Unsatisfactory
and unsafe performance. Optional for God and Satisfactory performance:

242

Midterm Comments (Address Strengths and weaknesses)
Faculty

Student



243

Final Comments (Address Strengths and weaknesses)
Faculty

Student



Course Coordinator __________________________________ Date _______

244

Midway College

Acknowledgement of Nursing 210 Syllabus

I, ______________________, attest that I have read the
Syllabus and Clinical Packet for Nursing 210 provided to me as
a registered student in this course. I acknowledge my
responsibility for understanding the policies and procedures
outlined therein.

245

______________________
Printed Name
______________________ _____________
Signature date

NOTES

246

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ASSOCIATE DEGREE NURSING NSG 210 - SYLLABUS

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