SUNY Orange 
Middletown, New York 
DEPARTMENT of NURSING 


GUIDE 
College Laboratory 
Nursing IV: Physical and Mental Illness 
57202 
Spring, 2007 
Week 1 
SKILL REVIEW LABORATORY

 I. BEHAVIORAL OBJECTIVES: 
At the completion of this unit, the student should be able to: 
1. demonstrate previously learned selected nursing interventions R/T the care of the 
client. 
* a. demonstrate knowledge of standard precautions by donning and removing 
protective barrier clothing and gloves. 
* b. assess blood pressure and apical pulse. 
c. identify steps in care of intravenous therapy with selected IV infusion pump. 
d. demonstrate changing gown with client on IV infusion pump. 
* e. prepare equipment and deliver medication via IV piggyback. 
f. change an intravenous infusion to a peripheral IV access cap. 
* g. perform tracheostomy suctioning. 
h. assess proper functioning of closed chest drainage and review equipment. 
* i. demonstrate mixing two types of medication in one syringe. 
j. demonstrate placement and irrigation of nasogastric tube. 
* k. prepare equipment and apply a sterile dressing. 
* l. demonstrate insertion of Foley catheter. 
m. measure hourly urine from urometer and obtain a sterile urine sample. 
n. perform removal and replacement of antiembolic stockings. 
(* INDICATES SKILLS TO BE ASSESSED THIS SEMESTER.)


 2. evaluate the effectiveness of expected outcomes. 
3. document procedure appropriately on a nurse�s note. 

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II. ACTIVITIES: 
Activity 1 (5 minutes) (BT 206) 


Orientation to Nursing IV college laboratory sessions. 


a. Review ground rules. 
b. Discuss skill performance evaluation. Sign and hand in sheet. 
Activity 2


 Data Collection


 a. Review performance evaluations guides on: (10 minutes) 
(1) Tracheostomy suctioning (BT 206 and BT 229) 
(2) Donning and removing protective barrier clothing 
(3) Blood pressure and apical pulse 
(4) Administration of an IV 
(5) Mixing two types of medication in one syringe 
(6) Sterile dressing change 
(7) Urinary catheterization 
b. Instructor demonstration: (20 minutes) 
(1) tracheostomy suctioning (closed and open method); demonstrate Ambu bag on 
tracheostomy. 
Review Nurses Note 


Activity 3 (65 minutes) 


Nursing Interventions


 Students will divide into groups of three or four, rotate to each station, and 
practice previously learned nursing skills. Practice the activities in any sequence 
that the individual student deems necessary and then document your care on a 
nurse�s 
note. Each group should allow themselves approximately 15 minutes at each station. 


Remember: You are responsible for competency of these skills in the 
clinical area.


Station 1 -85 year old female, status post respiratory arrest, with permanent 
tracheostomy inserted 2 weeks ago. Positive sputum cultures for pseudomonas and 
MRSA. Subclavian triple lumen catheter. Order for Levaquin 500 mg q 24 hrs. 


Skills: 


(1) Standard precautions: donning and removing protective barrier clothing 
(2) Tracheostomy suctioning - open technique and dressing 
(3) Obtaining a sputum culture 
(4) Change T/L dressing 
(5) Prepare and administer Levaquin IVPB 
(6) Evaluate outcomes and document care 

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Activity 3 (continued) 


Nursing Interventions


Station 2 - 18 year old female, status post MVA X 1 day with E/T tube to closed 
suctioning, chest tube. 


Skills: 


(1) Closed suctioning of E/T tube technique 
(2) Assessment of chest tube drainage and maintenance 
(3) Assessment of lung sounds 
(4) Insert Foley catheter and attach urinemeter 
(5) Obtain urine culture specimen from Foley 
(6) Evaluate outcomes and document care 
Station 3 - 50 year old male, 1 day P.O. for intestinal resection with N/G tube 
to intermittent suction. IV of D5/RL to infuse at 1000 mL q 8 h on pump. Foley 
to gravity drainage and A.E. hose. 


Skills: 


(1) Change sterile dressing 
(2) Irrigate N/G tube; assess bowel sounds 
(3) Program IV on pump; change gown with IV in place without disconnecting IV tubing 
(4) Apply A.E. hose 
(5) Evaluate outcomes and document care 
Station 4 - 45 year old female with hx of D.M., CHF and hypertension admitted 
for intractable vomiting. Initial orders include a stat injection of 20 U of NPH 
Humulin insulin with 5 U of Regular Humulin insulin and insertion of N/G tube. 


Skills: 


(1) Insert N/G tube 
(2) Prepare 2 meds in one syringe and inject in arm 
(3) Assess peripheral pulses with doppler (use a partner) 
(4) Assess blood pressure and apical pulse (use a partner) 
(5) Evaluate outcomes and document care 
FACULTY PREPARED MATERIALS: 


"Ground Rules" for Multisensory Laboratory 
Skill Performance Evaluation Policy 
Pharmacotherapy for Endocrine Dysfunctions 
Skill Performance Evaluation Sheets: 


Tracheostomy Suctioning 
Donning and Removing Protective Barriers 
Blood Pressure and Apical Pulse 
Administration of Intravenous Piggyback 
Mixing Two Types of Medication in One Syringe 
Sterile Dressing Change 
Urinary Catheterization 


ms lab wk1 NSG IV 1 07(41)