1 Lincoln Memorial University Caylor School of Nursing Nursing 115 Fall 2008 UNIT VII LESSON PLAN Safety Activity and Rest DATES TIMES See Class Schedule OBJECTIVES Upon the completion of this unit the student will be able to demonstrate in the clinical campus laboratory setting in individual and group conferences and on written materials the ability to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 8 08 Describe ways in which the patient s safety can be promoted in the home and health care setting Discuss safety risks across the lifespan Describe safety devices used in health care settings and indications for their use Describe nursing responsibilities for fire safety Describe preventive strategies to decrease the incidence of patient falls Utilize the nursing process to develop a plan of care for a patient with safety needs Explain ways to maintain a safe environment for patients with sensory alterations Describe the role of the skeletal muscular and nervous system in the physiology of movement Identify variables that influence body alignment and mobility Differentiate isotonic isometric and isokinetic exercise Describe the effects of exercise and immobility on major body systems Discuss the safe use of assistive devices when ambulating and positioning patients including proper body mechanics Describe the psychosocial effects of immobilization Utilize the nursing process to plan care for an immobilized patient Describe circadian rhythms and their influence on biological function Describe the characteristics of each stage of the sleep cycle Compare and contrast the sleep requirements of patients at different adult age levels Describe the functions of sleep Identify factors that normally promote and disrupt sleep Discuss characteristics of common sleep disorders Utilize nursing process for patients with sleep disorders Describe how room environment affects rest and sleep Recognize the nurse s legal responsibilities in drug prescription and administration Describe drug names types of preparation and types of drug orders Discuss adverse effects of drugs including allergy tolerance cumulative effect idiosyncratic effect and interactions Calculate drug dosages using the various systems of equivalents Describe principles used to safely prepare and administer medications orally parenterally topically and by inhalation List the essential information that is included in a correctly stated medication order Describe principles used to safely prepare and administer medications orally 2 30 31 32 33 34 35 36 parenterally topically and by inhalation Outline information necessary in obtaining a patient s medication history Use the nursing process to meet patient needs specific to medication administration Discuss factors unique to an individual that influence drug actions Describe factors to consider in choosing routes of drug administration List the 7 rights of drug administration Explain the different sites and equipment used in each type of injection Use military time in administering documenting medications TOPICAL OUTLINE I II 8 08 Safety A Environmental Hazards B Risks factors affecting safety in adults C Safety and the Nursing Process 1 Assessment of Behavior Stimuli a History b Physical assessment c Environment d Risk factor assessment 2 Nursing Diagnosis 3 Goal Setting 4 Intervention a Identification of related issues 1 Adult 2 Older adult b Teaching safety 1 Prevention 2 Use of Safety Checklists 5 Evaluation 6 Documentation Activity A Overview Definitions B Effects of Body Mechanics on Body Systems 1 Adaptive Responses Benefits 2 Ineffective Responses Complications 3 Types of Exercise a Isotonic b Isometric c Isokinetic C Immobility and the Nursing Process 1 Assessment of Behavior Stimuli a Nursing History b Physical Assessment 1 Gait 2 Alignment 3 Joint structure and function 4 Mass tone strength 3 2 3 4 5 6 III 8 08 5 Endurance Nursing Diagnosis a mobility vs immobility b problem vs etiology Goal Setting Intervention a Positioning b ROM exercises c Safety related to activity d Physical conditioning e Use of assistive devices f Teaching regarding exercise programs activity Evaluation Documentation Rest and Sleep as a Basic Need A Basic Concepts Definitions 1 Rest 2 Sleep 3 Circadian rhythms B Physiology of Sleep 1 Stages of sleep a NREM b REM 2 Characteristics C Factors Affecting Sleep 1 Developmental considerations 2 Motivation 3 Culture 4 Lifestyle Habits 5 Environment 6 Stress 7 Illness 8 Medications D Common Sleep Disturbances 1 Parasomnias a Somnambulism b Sleep talking c Bruxism 2 Dysomnias a Insomnia b Narcolepsy c Sleep apnea d Sleep deprivation E Sleep and the Nursing Process 1 Assessment of Behavior Stimuli a Sleep History b Sleep Diary c Physical Assessment 4 F IV 8 08 1 Snoring 2 Nocturnal myoclonus 2 Nursing Diagnosis a Problem b Etiology 3 Goal Setting 4 Intervention a Environment b Rituals c Dietary d Relaxation techniques e Comfort f Sleep wake patterns g Provision of nursing care 5 Evaluation 6 Documentation Pharmacological Management See accompanying medication list 1 Sedatives 2 Hypnotics 3 Related Medications a Antianxiety Anxiolytics b Antihistamines c Narcotics d Amphetamines Administering Medications A Drug Nomenclature B Pharmacokinetics C Terminology 1 Serum drug levels a Therapeutic level b Peak c Trough d Threshold 2 Adverse effects 1 Allergic reactions 2 Anaphylaxis 3 Cumulative effect 4 Tolerance 5 Toxicity 6 Idiosyncratic effect D Routes of Administration E Medication Delivery 1 Components of medication orders 2 Supply 3 Safety F Medication and the Nursing Process 1 Assessment of Behavior Stimuli a History 5 G b Physical Assessment 2 Nursing Diagnosis 3 Goal Setting 4 Intervention a Administration 1 Routes 2 Techniques 3 Equipment 4 Special considerations 5 Medication errors b Teaching 1 Medication administration 2 Incorrect use abuse of pharmaceuticals 5 Evaluation 6 Documentation a Omissions b Refusal Pharmacologic Classes 1 Antiarrhythmics 2 Antihypertensives 3 Antidiabetics 4 Anti inflammatories 5 Anticoagulants REQUIRED READINGS Buchholz S 2006 Henke s med math dosage calculation preparation administration 5th ed Philadelphia Lippincott Williams Wilkins chap 12 13 Karch A 2008 2008 Lippincott s nursing drug guide Philadelphia Lippincott Williams Wilkins TBA Lynn P 2008 Taylor s clinical nursing skills A nursing process approach 2nd ed Philadelphia Lippincott Williams Wilkins chap 5 Taylor C Lillis C LeMone P and Lynn