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Course Number: NUR 241
Course Title:  Care of Patients with Complex Health Problems
Credit Hours: 12
Lecture Hours: 60
Lecture/Lab Hours: 0
Lab Hours: 180
Special Fee: none

Course Description

Covers clinical decision-making when providing care to patients with complex physical and mental health problems. Emphasizes increased independence, judgment and critical thinking in the nursing role. Includes the fourth skills laboratory section in the Nursing sequence.

Intended Outcomes for the Course

1. Develop comprehensive, holistic, individualized plans of care for patients with acute and chronic psychiatric disorders, infectious disease, gastrointestinal problems, acute and chronic pain, endocrine problems and fluid/ electrolyte/acid-base problems.
2. Function with increased independence in clinical decision-making and the application of nursing process to patients with complex physical and/or mental health problems.
3. Evaluate the effectiveness of health teaching plans that are culturally sensitive and revise plans appropriately.
4. Communicate therapeutically with patients experiencing difficulty coping across the mental health continuum.
5. Organize and prioritize components of care requiring complex assessments and interventions for assigned patients; consistently reports pertinent information to the health care team.
6. Differentiate the scope of practice and legal responsibilities of the registered nurse and licensed practical nurse in Oregon.

Course Activities and Design

1. Lecture
2. Skills practice lab with simulation
3. Clinical practice
4. Clinical post-conference
5. Reflective journaling
6. Written Assignments
7. Community Based Project

Outcome Assessment Strategies

1. Satisfactory completion of three electronic patient care planning tools (75% or above complete in all categories).
2. Multiple choice, short answer, and essay questions that require integration, application, and critical examination of material covered in class.
3. Weekly and final clinical performance evaluation.
4. Written assignments designed to stimulate critical thinking related to clinical experiences.
5. Oral presentation resulting from group research, analysis, and critical evaluation.
6. Written journals designed to promote integration of clinical outcomes with personal reflection on clinical experience.
7. Skill practice laboratory formative and summative performance evaluation
8. Completion of drug dose math exam at 90% or above.
9. ATI comprehensive student assessment program (Skill modules; practice and proctored exams).

Course Content (Themes, Concepts, Issues and Skills)

1. Nursing Care of Clients with Psychiatric Problems
   • Overview of mental health & illness
   • Therapeutic use of self
   • Schizophrenic disorders
   • Bipolar disorders
   • Affective disorders and suicide
   • Personality disorders
   • Anxiety disorders
   • Infant, child & adolescent disorders
   • Therapeutic modalities: psychotherapy, family, group, milieu, ECT; geriatric mental health
2. Psychopharmacology
3. Foundations of Nursing Practice for the Registered Nurse
   • Delegation, education and the nursing process
4. Nursing Care of Patients with Gastrointestinal Problems
   • Nursing care of patients with gallbladder, liver, and pancreatic disorders Part
5. Nursing Care of patients with Pain
   • Acute & chronic pain
6. Nursing Care of Clients with Infectious Disease
   • HIV & AIDs
7. Nursing Care of Patients with Gastrointestinal Problems~
   • Nursing care of patients with gallbladder, liver, and pancreatic Disorders Part 2.
8. Nursing Care of Clients with Infectious Disease
   • Altered immune response
   • Current trends in infectious diseases
9. Physiologic Concepts for the Registered Nurse
10. Nursing Care of Patients with Altered Fluid, Electrolyte, and Acid-Base Balance Part 2
11. Foundations of Nursing Practice for the Registered Nurse
    • Ethical & legal Dilemmas
12. Nursing Care of the Patient with Endocrine Problems
    • Pituitary & adrenal emergencies
    • Acute complications of diabetes

Skills

1. Central venous access devices
2. Caring for patients with chest tubes
3. Peripheral IV insertion
4. Administering intravenous push medications.
5. Caring for patients receiving patient controlled analgesia
6. Assisting with procedures.
7. Administration, nursing considerations, and complications of blood transfusions
8. Basic code management