92195 Adult Nursing: GIT and Orthopaedic

Subject level: Undergraduate

Handbook description

This subject contributes to the overall course aims by integrating knowledge drawn from other course subjects and by continuing the development of students' knowledge and skills in the provision of adult nursing care. This subject provides the opportunity for students to develop generic nursing skills using clinical exemplars from the gastro-intestinal and/or musculo-skeletal systems which reflect current epidemiological trends in health care. The theoretical basis incorporates psychomotor skills development, patient assessment and the provision of nursing care based on current best nursing practice. The development of the relationship between the nurse and the patient will include transitions through health and illness, respect for cultural identity, ethical considerations and resource availability. The concept of clinical judgment in acute care settings continues to be developed in both the theory component and in clinical settings.

Subject objectives/outcomes

On successful completion of this subject students should be able to:

1. understand skills needed in the nursing assessment, nursing diagnosis and nursing management of adults with alterations to their gastrointestinal and musculoskeletal systems (ANMC competencies:1.2; 5.1; 5.2; 5.3; 6.1; 6.2; 6.3; 7.1; 7.2; 7.3; 8.1; 8.2)
2. students reflect on their own professional practice (ANMC competencies: 4.2; 4.4;4.4)
3. apply the principles of manual handling of patients within a medical/surgical environment (ANMC competencies: 1.2; 7.1; 9.1)
4. understand the principles of wound care assessment and management (ANMC competencies: 1.2; 2.2; 2.3; 2.6;7.1; 10.3)
5. begin to use the skills necessary in caring for the older adult who is nursed in the acute environment (ANMC competencies: 2.3; 2.4; 7.1; 7.7; 9.3; 10.4)
6. extend your knowledge about pain assessment (ANMC competencies:1.1; 2.1;2.2; 6.1;7.7; 9.3; 10.4)
7. understand the need to provide care that is culturally safe and is consistent with the Code of Professional Conduct for Nurses in Australia (2003) (ANMC competencies: 2.1; 2.3; 9.5)
8. provide beginning levels of nursing care for patients based on the ANMC (Australian Nursing Midwifery Competencies, 2005) for the Registered Nurse (all domains)
9. understand the safe handling and administration of medications (NOT parenteral) all domains)
10. begin to manage patients undergoing intravenous therapy i.e. manual calculation of drip rates and assessment of the intravenous site (ANMC competencies: 1.2; 1.3; 2.2; 2.7; 10.4).

See the ANMC website for more details about the competencies: www.anmc.org.au

Content

• An introduction to the subject, subject content, the case studies and the subject assessments.
• Nursing care and potential problems for patients undergoing surgical procedures: Introduction and distribution of outlines; Immediate postoperative care – the nurse's role in patient assessment and 'general care' particularly IVI assessment and common IVI clinical problems that need intervention and evaluation; Medical calculations — arithmetic formula and IVI calculations will be demonstrated and practiced; A medical calculation diagnostic quiz
• The RN role in the safe handling & administration of medications for adults (not parenteral)
• Disruption to the MS system and the principles of fracture care: Case studies: immediate postoperative fracture nursing care; Administering medications using the ANMC competencies as a framework for quality and safety. To include oral schedule 4 & 8 medications, eye, ear and application of skin creams; Minimising pain – concept of comfort.
• Nursing patients with arthritis and joint replacements
• Maximising mobility and comfort; minimising pain in common spinal problems: Prevention of the complications of bed rest — What may be the problems? How can they be prevented? Minimising infection — Wound Field Concept (wet/dry dressings); Standard precautions revisited; Procedural hand washing; Open gloving; Wound swab taken; Demonstrations and practice; Assessment for the older confused patient.
• Minimising hospitalisation: laparoscopic surgery. Nursing care and responsibilities
• Nursing care and management of the adult with common disorders of the oesophagus & upper GIT tract: Maximising patients mobility; Maximising nutrition when in hospital. Methods of feeding, nasogastric tubes, PEG feeding; In-class medication test; Wound care practise
• Lower bowel: inflammation, ulcers. Nursing management, diet minimising pain and discomfort
• Nursing management of the adult patient with a stoma : maximising comfort , diet and minimising infection: Abdominal assessment — How to perform effectively? Why needed? When needed?; Bowel care and charting; Medications used in bowel care; Write objectives for Clinical Placement; Subject evaluations.