CYPRESS COLLEGE

DEPARTMENT OF NURSING
NURS 292 MEDICAL SURGICAL NURSING II
I. Clinical Learning Objectives
1. Clinical objectives
A. Daily objectives
1) Research your patient diagnoses including pathophysiology,
signs and symptoms, laboratory values, and application of nursing
process.
2) Demonstrate physical assessment of the client, recognizing
normal and abnormal assessment findings.
3) Identify the nursing priorities for assessments related to the
above information.
4) Maintain a patient worksheet reflecting the patient’s current
clinical condition.
5) Evaluate the medical and nursing management of the assigned
patient, based on the data collected pertinent to the presenting
need and behaviors demonstrating progress toward expected
patient outcomes.
6) Incorporate discharge planning and patient education in the
nursing specific cultural needs.
7) Document the patient’s condition and progress towards goals
according to documentation standards and hospital
policy/procedure.
8) Perform clinical objectives relating to theoretical objectives.
9) Seek instructor assistance in applying new theory and clinical
content.
B. Need for acid-base balance
1) List assessment data required for definition on an acid-base
imbalance.
2) Identify normal values fro ABGs. Discuss the significance of
abnormal values.
3) Identify medical treatments instituted for correction of an acid-
base imbalance and identify nursing implications.
4) Identify the nursing interventions directed toward a problem of
potential or actual acid-based imbalance.
5) Evaluate the nursing goals directed toward correction of a
potential or actual acid-base imbalance.
C. Need for metabolic regulation
1) List assessment data required for definition of a disorder of the
thyroid, parathyroid, or adrenal function tests.
2) Identify normal lab values for thyroid, parathyroid, and adrenal
function tests. Discuss the significance of abnormal values.
3) Identify medical treatments instituted for correction of a
metabolic disorder and identify nursing implications.
4) Identify the nursing interventions directed toward a problem of
metabolic regulation.
5) Evaluate the nursing goals directed toward correction of a
metabolic imbalance.
 CYPRESS COLLEGE
DEPARTMENT OF NURSING
NURS 292 MEDICAL SURGICAL NURSING II
6) Identify needs that the patient may have for referral to
community resources for continued support outside the acute
hospital setting.
D. Need for oxygenation
1) Develop a diet plan for the client with anemia, integrating
cultural preferences.
2) Diagnose alterations in nutrition, such as albumin levels, total
protein, total iron binding capacity, and immunologlobulin levels.
3) Identify blood component therapy for treatment of hematologic
disorders.
4) Administer blood/blood components following procedural steps
based on appropriate rationales.
5) Use the nursing process as a framework to develop a plan of
care for the patient with leukemia.
6) Differentiate between bleeding disorders, those that are platelet
defects, and those that are clotting factor defects.
7) Develop learning/teaching guidelines for people with blood
dyscrasias at risk of developing life-threatening infections (e.g.,
people with agranulocytosis, aplastic anemia, and leukemia).
8) Use the nursing process as a framework to develop a plan of
care for the patient with Hodgkin’s disease.
9) Assess patients with bleeding disorders for signs of hemorrhage
and intervene appropriately.
E. Need for neurologic integrity
1) Identify lab values and diagnostic tests used to diagnose
dysfunction of the neurologic system. Discuss the significance of
abnormal results.
2) Develop a teaching plan related to diagnostic preparation and
exams. Implement when possible.
3) Identify medical treatments to correct problems of the neurologic
system.
4) Use the nursing process as a framework to develop a plan of
care for the patient with a neurologic disorder.
5) Evaluate the nursing goals directed toward corrections of a
neurologic disorder.
6) Implement a teaching plan related to the safety needs of the
patient with neurologic dysfunction.
7) Identify needs that the patient may have for referral to
community resources.
F. Needs of the oncology patient
1) Correlate results of diagnostic procedures, lab findings used to
diagnose/analyze the extent of a malignancy.
2) Identify normal lab values for organs affected by a malignancy.
Discuss the significance of abnormal values.
3) Identify medical treatments instituted for correction of specific
oncologic implications.
 CYPRESS COLLEGE
DEPARTMENT OF NURSING
NURS 292 MEDICAL SURGICAL NURSING II
4) Identify the nursing interventions directed towards alleviating the
nursing diagnoses identified.
5) Identify the cultural needs that the patient may have.
6) Identify the safety precautions required for the care of patients
with radiation therapy.
7) Evaluate the nursing goals directed towards the patient’s
identified needs.
8) Prepare a teaching plan for skin, testicular and breast self-
exam. Be prepared to teach content to peers, instructor, or patients.
Incorporate the effects of culture and age on attitudes toward self-
examination.
9) Prepare a patient education outline for the post-operative
mastectomy patient. Be prepared to teach content to patients.
10)Identify needs that the patient may have referral to community
resources for continued support outside the acute hospital setting.
G. Needs of the immunologically suppressed patient with AIDS
1) Identify physiological changes that occur with AIDS and
correlate these changes with your patient’s clinical status.
2) Identify the nursing assessments utilized for patients with AIDS.
3) Identify medical treatments instituted to treat and control AIDS.
4) Identify the safety needs of the patient with AIDS.
5) Prepare a nursing care plan including interventions for a patient
with AIDS and implement when possible.
6) Discuss societal, cultural, and psychological influences that
affect patients with SIDS.
7) Investigate community resources available to the patient with
AIDS and their families/significant others.
8) Implement the safety precautions utilized to protect the health
care personnel.
H. Professional nursing management
1) Record pertinent observations relating to the patient’s nursing
diagnoses and general status as designated in the hospital
policy/procedure.
2) Implement and record patient education to prevent, modify, or
maintain behaviors that impact on a patient’s health status.
3) Communicate verbally and in writing with other health care
providers to promote quality patient care.
4) Interpret, implement, and document medical and nursing orders
on assigned patients.
5) Identify areas of clinical research which would benefit nursing.
6) Identify the quality improvement indicators in your assigned
clinical area. Compare you findings with students in other clinical
facilities.
7) Identify the managed care outcomes in your assigned clinical
area. Compare your findings with students in other clinical facilities.
 CYPRESS COLLEGE
DEPARTMENT OF NURSING
NURS 292 MEDICAL SURGICAL NURSING II
8) Utilize the hospital delivery system to progressively assume the
registered nursing role in managing patient care.
2. Skills/knowledge transfer: Intermediate skill application
A. Management of IV therapy
1) Medication administration via IVPB
2) Conversion of an IV to saline/heparin lock
3) Administration of blood/blood components
B. Central line management
1) Identification and assessment of access sites
2) Maintenance of central lines
3) Changing central line dressings
C. Nursing process for intermediate complex patients
D. Community resources
3. Clinical competencies
A. Nursing Process Focus: Complex Priority Needs
B. Professional Communication:
C. Physical Assessment
D. Administration of IVPB medication
E. IV Calculation Exam