NURSING: EXPERTS IN PATIENT CARE
LESSON PLAN OVERVIEW
Career: Nurses assess patient health problems and needs, develop and implement care plans and maintain medical records. They also monitor patients’ vital signs, administer medications, advise on health maintenance and disease prevention. Nurses provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members. Nursing careers include: Licensed Practical Nurses (LPN), Licensed Vocational Nurses (LVN), and Registered Nurses (RN).
Lesson: Activities in this lesson allow students to experience the care and monitoring of patients, including medication administration, planning how to prevent disease and other common nursing tasks.
Grade Level: High School
Learning Objectives:
〉 Students will explore the Nursing career and how nurses care for and monitor a patient’s health and calculate and administer medications.
〉 Students will also complete a strategic planning exercise focused on how to protect themselves from the spread of disease and exposure to bloodborne pathogens.
〉 Students will gain an insight into the Nursing profession, including common job tasks, salary, career pathway, and credentials required to perform the job.
Materials
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TEACHER GUIDE
Lesson Instructions: This lesson plan will help you demonstrate to students common skills and procedures used in the Nursing profession. Begin the lesson by reading the Class Message below to your students, then have them watch the recommended Video Introduction. Afterwards, facilitate discussion with the Class Questions listed.
After the discussion, students will work on the included activities. Each activity has a printable worksheet with student instructions and areas to record their work. Have students read their worksheets before beginning each activity.
You should also familiarize yourself with the student worksheets to help demonstrate any procedures and facilitate the ending activity discussion.
Class Message: Today we are going to explore the nursing profession. We will discuss some common nursing tasks, such as basic patient care and the importance of calculating and administering medication. We will also discuss the importance of personal protective equipment and procedures to prevent the spread of diseases and exposure to bloodborne pathogens.
A nurse provides and coordinates patient care, including assessing patients’ conditions, recording medical histories and symptoms, administering patient medicines and treatment, consulting and collaborating with doctors and other healthcare providers, performing diagnostic tests and analyzing results, and teaching patients and their families how to manage illness or injury at home.
Let’s watch this brief video to better understand the role of a Nurse and how they impact their patients’ lives.
Nurses: Experts in Patient Care (http://tn-caps.com/r/92VNR)
Class Discussion Questions:
〉 Think about your last visit to a doctor’s office, hospital, or medical clinic. What types of medical professionals did you come in contact with during the visit?
〉 Why do doctors’ offices and hospitals have different medical professionals performing medical processes and procedures?
〉 During your visit, did the doctor or nurse give you any medication or a shot? If so, did you ask questions about the medication and how it was administered?
〉 Did you notice what the medical professionals were wearing during your interaction? Did they have on gowns, gloves, or protective masks?
Activities Overview: This lesson plan includes two student activities. Activity #1 demonstrates an understanding of how to properly calculate and administer medications. Activity #2 challenges students to examine issues surrounding disease control and exposure to bloodborne pathogens and to find solutions to keep medical professionals safe.
Read and familiarize yourself with the student worksheet for each activity.
Activity #1:
Calculating and Administering Medications
This activity demonstrates how nurses calculate and administer medications to patients.
Activity Instructions:
〉 Handout the student worksheet.
〉 Facilitate introduction of the activity
〉 After completion, facilitate discussion questions for this activity.
Activity Results: Students will record their findings for this activity where indicated.
〉 Doctor prescribes IV ampicillin 200mg.
You have a vial of 500mg in 10ml
Answer: 200mg x 10ml / 500mg = 4ml
〉 Doctor prescribes 30 mg/hour.
You have a bag containing 250mg in 50ml.
Answer: 30mg/hr x 50ml / 250mg = 6ml/hr
〉 Doctor prescribes IV digoxin 187.5mcg
You have a vial of 0.5mg in 2ml.
Note: convert mg to mcg
Answer: Convert to mg first: 187.5 mcg x (.001 mg/mcg) = 0.1875 mg 0.1875mg x 2ml / 0.5 mg = 0.75ml
〉 Doctor prescribes 0.5mg/kg/hour.
You have a bag of 250mg in 50 ml
The patient weighs 70kg.
Note: Convert mg per kg into total mg by multiplying it by the patient’s weight.
Answer: Adjust for patient’s weight: 0.5 mg/kg/hr x 70kg = 35mg/hr 35mg/hr x 50 ml / 250mg = 7ml/hour
〉 Doctor prescribes 0.5mg/kg/min.
You have a syringe of 250mg in 50ml
The patient weighs 70kg.
Note: Calculate what you want by patient’s weight and calculate rate per hour.
Answer: Adjust for patient’s weight: 0.5 mg/kg/min x 70kg = 35mg/min
35mg/min x 50 ml / 250mg = 7ml/min
〉 7ml/min x 60 min/hr = 420ml/hour
Activity #2: Creating a Safe Environment for Medical Professionals
This activity challenges students to create new processes and procedures to prevent healthcare professionals from exposure to diseases and bloodborne pathogens.
Strategic Planning is a way of solving complex problems through a creative process that integrates brainstorming, collaboration, and the possibilities of new technologies. In this exercise, students will use Strategic Planning to explore ways that medical professionals can protect themselves against exposure to bloodborne pathogens and diseases.
Instructions are shown below, along with handouts that students can use to document their progress in the project. You may decide to extend this project over several class periods in order to let students work in depth to develop their own solutions to problems. This design challenge should take anywhere from 1 to 2 hours or more, depending on the age level and how detailed you expect the results to be. Students may select from the suggested scenarios in the activity, or come up with their own ideas for situations in which safety impacts medical professionals.
Activity Instructions:
〉 Hand out student worksheet
〉 Facilitate introduction of the activity.
〉 Assign students to teams.
〉 Students will need access to a computer
〉 After completion, facilitate discussion questions for this activity.
Activity Results: In teams, research the Ebola virus and the precautions needed to prevent exposure to this deadly virus. Research the technological advancements, procedures, and protective equipment and devices that are currently available.
Analyze the information and think about new ways or methods that could be implemented to improve how medical professionals protect themselves against bloodborne pathogens and diseases. Next, create a presentation for your solution(s) to present to the class. Include either a demonstration of a procedure, create a poster display, a PowerPoint presentation, or some other form of presentation.
CAREER INSIGHT
Career Highlight: This lesson plan highlights some of the skills a Nurse uses on a daily basis to care for patients. See the Employers in My Area section to contact businesses and organizations in your area about classroom demonstrations, on-site visits, or other additional career exposure opportunities
Featured Career:
LPN/LVN and Registered Nurse (RN)
Career Descriptions: LPN/LVN and Registered Nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members.
Nurses typically do the following:
〉 Assess patients’ conditions
〉 Record patients’ medical histories and symptoms
〉 Observe patients and record the observations
〉 Administer patients’ medicines and treatments
〉 Set up plans for patients’ care or contribute information to existing plans
〉 Consult and collaborate with doctors and other healthcare professionals
〉 Operate and monitor medical equipment
〉 Help perform diagnostic tests and analyze the results
〉 Teach patients and their families how to manage illnesses or injuries
〉 Explain what to do at home after treatment
Most nurses work as part of a team with physicians and other healthcare specialists. Some Registered nurses oversee Licensed Practical Nurses (LPN) and Licensed Vocational Nurses (LVN), nursing assistants, and home health aides.
Other Names for this Career: Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), Registered Nurse (RN), Emergency Department RN, Staff Nurse, Oncology RN, Staff RN, Director of Nursing (DON), School Nurse, Clinic Nurse, Public Health Nurse (PHN), Charge Nurse, Operating Room RN
EDUCATOR RUBRIC
ITEM
Career Connection
Does Not Meet Expectations Meets Expectations Exceeds Expectations
Student is not able to talk about the career of registered nurse in detail with specific examples.
Design/Modify/Create a New or Improved Safety Procedure or Solution
Student is unable to create a new idea for improving people’s health with new behaviors or practices
Presenting the Solution
Strategic Planning
Student’s presentation on the benefits of new healthcare procedures/device lacked preparation and supporting materials.
Student lacks evidence that strategic planning took place
Student understands the career and responsibilities of a registered nurse and can reference specifics about the career.
Student understands the career and responsibilities of a registered nurse and can reference specifics about the career as well as provide deeper level insight into the varying roles registered nurses play in the medical profession.
Student is able to describe an idea for improving people’s health with new behaviors or practices.
Student presentation of their solution was clear and contained supporting aids to help in sharing their idea.
Student has evidence he/she used strategic planning in order to complete the assignment.
Student demonstrated creativity by expressing an original idea for improving people’s health with new behaviors or practices.
Student demonstrated originality and creativity in their presentation on the benefits of new healthcare procedures/device.
Student has evidence he/she used strategic planning in order to complete the assignment. The strategic plan is organized and thorough.
Introduction: In some states and medical environments, nurses are allowed to administer certain levels of medications to patients. Nurses must know how to properly calculate the exact dose of medication that has been prescribed by a doctor. A mistake in the dosage amount of medication, whether too much or too little, can negatively impact a patient’s health, and in some cases, be lethal.
A dose refers to a specified amount of medication taken at one time. By contrast, dosage is the prescribed administration of a specific amount, number, and frequency of doses over a specified period of time. The problem with dosage is the number of units prescribed by the doctor might not match the units in the ampule or vial available to the nurse.
While new technology and devices have improved the dosing of medication, the lack of basic math skills can be a major problem when it comes to nurses administering drugs to patients. Calculations are still a significant source of error in drug administration.
Activity Description: You are a nurse in the critical care unit of a hospital and are responsible for monitoring and administering medications to patients.
In this activity, you will be converting units and calculating dosages. You will have an opportunity to practice those skills by calculating dosages for patients.
Activity Procedure: Practice calculating the following dosages.
The first step in calculating dosages is to convert all of the units into like units. If a medication is in milligrams (mg), you will need to convert the dosage to milligrams (mg).
Use this memory aid to help create the dosage equation:
What you Want X What it’s In / What you’ve got or “WIG”
For example: A doctor prescribes 200mg of a drug (what you want) for a patient. You have 500 mg of the drug (what you’ve got) contained in a 4ml ampule of liquid (what it’s in). What is the correct dosage of the liquid for the patient?
What you want X What it’s in / What you’ve got
So the correct equation is:
200mg x 4ml / 500mg = 1.6ml of the liquid from the ampule.
Measurement Conversion
1 gram (g) = 1000 milligrams (mg)
1000 grams = 1 kilogram (kg)
.001 milligram (mg) = 1 microgram (mcg)
1 liter (L) = 1000 milliliters (ml)
1 milliliter = 1 cubic centimeter (cc)
1 meter = 100 centimeters (cm)
1 meter = 1000 millimeters (mm)
1 milliliter = 12 drops (gtt) 1 kilogram = 2.2 pound (lb)
5 milliliters = 1 teaspoon (tsp)
1 gram (g) = 1000 milligrams = 15 grains (gr)
15 milliliters = 4 fluidrams = 1 tablespoon (T) 0.6 gram = 600 milligrams = 10 grains
30 milliliters = 1 ounce (oz) = 2 tablespoons 0.5 gram = 500 milligrams = 7.5 grains
500 milliliters = 1 pint (pt) 0.3 gram = 300 milligrams = 5 grains
1000 milliliters = 1 quart (qt) 0.06 gram = 60 milligrams = 1 grain
Solve the dosage problems below. What is the correct dosage?
Doctor prescribes IV ampicillin 200mg. You have 500mg of ampicillin in a 10ml vial.
Doctor prescribes 30 mg/hour You 250mg in a 50ml bag.
Doctor prescribes IV digoxin 187.5mcg.
You have 0.5mg in a 2ml vial.
Note: First, convert mg to mcg using the chart above
Doctor prescribes 0.5mg/kg/hour You 250mg in a 50 ml bag. The patient weighs 70kg.
Note: Convert mg per kg into total mg by multiplying it by the patient’s weight.
Doctor prescribes 0.5mg/kg/min. You have 250mg in a 50ml syringe. The patient weighs 70kg.
Note: Calculate what you want by patient’s weight and the resulting rate to mg per hour.
Activity Discussion:
〉 Did you realize that nurses are required to calculate dosage amounts?
〉 What do you think some of the consequences would be if a nurse miscalculated a dosage?
〉 What other nursing responsibilities might require mathematical calculations?
〉 Can you think of some work aids or guides that might help nurses when calculating medications?
ACTIVITY #2: CREATING A SAFE ENVIRONMENT FOR MEDICAL PROFESSIONALS
Introduction: The work of nurses may put them in close contact with people who have dangerous infectious diseases, and they frequently come in contact with potentially harmful and hazardous drugs and other substances. Nurses must follow strict guidelines and procedures to protect themselves against diseases and other dangers, such as radiation, accidental needle sticks, or the chemicals used to create a sterile and clean environment.
One of the greatest dangers for medical professionals are bloodborne pathogens. Bloodborne pathogens can potentially expose a medical professional to Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Sharps injuries are the number one cause of exposure to bloodborne pathogens and diseases
Activity Description: In this scenario, you are a nurse working with Doctors Without Borders, a medical relief organization. You have been selected to work in Africa treating patients with the Ebola virus. Before leaving, you need to learn more about the disease and the precautions needed to prevent exposure to this deadly virus
Activity Procedure: In teams, research Ebola and methods for preventing exposure to the virus. Research the technological advancements, procedures, and protective equipment that are currently available to medical professionals treating Ebola victims.
Websites for OSHA or the Center for Disease Control provide information on safety and infection control for healthcare workers, the most common accidents on the job for healthcare professionals, and current protective equipment to prevent accidents and exposure.
Here are some TNCAPS links to get you started:
〉 OSHA’s Bloodborne Pathogens (http://tn-caps.com/r/92LN1)
〉 OSHA’s Healthcare Standards (http://tn-caps.com/r/92LN2)
〉 Bloodborne Pathogens and Workplace Sharps Injuries (http://tn-caps.com/r/92LN3)
Analyze the information and think about new ways or methods that could be implemented to improve how medical professionals protect themselves against bloodborne pathogens and diseases. Next, create a presentation for your solution(s) to present to the class. Include either a demonstration of a safety procedure, create a poster display, a PowerPoint presentation, or some other type of presentation.
DISCUSSING IDEAS FOR SAFETY IN MEDICAL ENVIRONMENTS
Separate into groups and discuss the following questions:
〉 What is the Ebola virus, where is it found, and how can you get it?
〉 What are some of the symptoms of the Ebola virus?
〉 What procedures do medical professionals currently follow to prevent exposure to the Ebola virus?
〉 What special equipment is available to protect medical professionals against exposure?
Discuss these issues in your group and assign a team member to take notes below:
RESEARCH FOR IMPROVING SAFETY FOR MEDICAL PROFESSIONALS
Now that you have researched current procedures that medical professionals should follow to prevent exposure to bloodborne pathogens and diseases, see if your team can imagine ways to improve procedures and/or use equipment or technology to protect workers more effectively. Use these questions to guide your discussions:
〉 How could we design a new or modify an existing safety procedure to better protect medical professionals from exposure to deadly diseases?
〉 How could existing medical protective equipment be improved to provide better protection?
〉 What new technology or equipment could be developed to better protect medical professionals from exposure to pathogens?
Brainstorm any ideas your team comes up with and have a team member take notes:
CREATE STRATEGIC PLAN TO IMPROVE EXISTING SAFETY PROCESSES AND PROCEDURES TO PROTECT MEDICAL PROFESSIONALS AGAINST DEADLY DISEASES
Task: Now, develop a presentation for your solution(s) to share with your class. Your presentation could include a demonstration of a procedure, a poster displaying your solution, a PowerPoint presentation, or other form of sharing your team’s ideas.
Use this space to sketch out your presentation.
Select a team member to present your solutions to the class
Activity Results: In this activity, students solved a problem using Strategic Planning. In this process, your team:
〉 Identified the problem
〉 Explored the problem
〉 Created ideas to solve the problem
〉 Tested the solution by presenting the solution to others
Activity Discussion:
〉 Did your team identify a new or different way to protect medical professionals from exposure to diseases?
〉 Was it difficult to improve on an existing procedure or create a new procedure?
〉 Through your research, what safety processes and procedures did you find most interesting and why?
〉 Would you be interested in working as a nurse or other medical professional? Why or why not?
