Sistema Universitario Ana G. Méndez, Inc.
School for Professional Studies
Florida Campuses
Universidad del Este, Universidad Metropolitana, and Universidad del Turabo
NURS 204
Technical Skills Laboratory
Laboratorio Destrezas Técnicas
© Sistema Universitario Ana G. Méndez, Inc. 2012
Derechos Reservados
© Ana G. Méndez University System, Inc. 2012
All rights reserved
June 29, 2012.
NURS 204 Laboratorio de Destrezas Técnicas 2
Updated 06/29/2012
Please include all applicable information below:
Prepared based on the course syllabus 2012 of the School of Health Sciences, with the
collaboration of:
Alexandra García, MSN, FNP-B, Module Development Specialist
Mildred Negrón, Content Evaluator
Luis Díaz, English Language Specialist
Bárbaro Forteza, Spanish Language Specialist
Joe Hernández, Curriculum and Instructional Design
NURS 204 Laboratorio de Destrezas Técnicas 3
Updated 06/29/2012
TABLA DE CONTENIDO/TABLE OF CONTENTS
Página/Page
GUÍA DE ESTUDIO ...................................................................................................................... 4
STUDY GUIDE ............................................................................................................................ 15
TALLER UNO.............................................................................................................................. 26
WORKSHOP TWO ...................................................................................................................... 31
TALLER TRES ............................................................................................................................ 35
WORKSHOP FOUR .................................................................................................................... 39
TALLER CINCO/WORKSHOP FIVE ........................................................................................ 44
APPENDIX A NATIONAL PROFICIENCY LEVELS FOR DIFFERENTIATED
INSTRUCTION ............................................................................................................................ 50
APPENDIX B THE WRITING PROCESS 6-TRAITS WRITING RUBRIC ............................. 55
Appendix C ADMINISTRATION OF MEDICATION ............................................................... 63
APPENDIX D CATHETERAZATION ....................................................................................... 95
APPENDIX E BLOOD SAMPLING AND IV INFUSIONS .................................................... 100
APPENDIX F ORAL PRESENTATION .................................................................................. 114
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GUÍA DE ESTUDIO
Título del Curso: Laboratorio Destrezas Técnicas
Codificación: NURS 204
Créditos: 2
Duración: 5 semanas
Prerrequisito: NURS 201, NURS 303 o concurrente
Descripción: Este curso provee a los estudiantes el desarrollo de las destrezas técnicas de
enfermería requeridas en el nivel de bachillerato. Se espera que los estudiantes
completen estimados de clientes, formulen diagnósticos de enfermería, lleven a cabo
diferentes procedimientos de enfermería, evalúen resultados de salud y documenten datos
pertinentes, utilizando como guía NANDA, NIC y NOC.
Objetivos de Contenido Generales
Al finalizar el curso, los estudiantes podrán:
1. Demostrar los diferentes métodos de la administración segura y cuidadosa de los
medicamentos.
2. Proveer cuidado urinario e intestinal.
3. Llevar acabo la recogida segura de las muestras de laboratorio.
4. Demostrar los procedimientos de técnicas seguras para el cuidado de heridas y el
cambio de vendaje.
5. Llevar a cabo los procedimientos de seguridad adecuados, los relacionados con
todos los sistemas.
6. Proporcionar atención profesional utilizando los procedimientos correctos.
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Objetivos de Lenguaje Generales
Al finalizar el curso, los estudiantes podrán:
1. Escuchar: entender los términos y las instrucciones en inglés y español
presentadas en clase.
2. Hablar: compartir los conocimientos adquiridos con otros estudiantes.
3. Leer: leer diversas literaturas académicas con el fin de adquirir los conocimientos
necesarios para la adquisición de habilidades.
4. Escribir: escribir sobre técnicas básicas de enfermería.
Requisitos del Laboratorio de Lenguaje o Laboratorio Electrónico: (Tell Me More,
Net Tutor, Wimba Voice, Biblioteca Virtual y Voice E-mail.)
Requisitos Mínimos de Laboratorio de Lenguaje: Los estudiantes deben demostrar que
ellos han cumplido con 10 horas de uso en el laboratorio de lenguaje (inglés y español)
por curso. Esto iguala al uso del laboratorio de lenguaje por dos horas semanales para
cada lenguaje por curso. El facilitador podría requerir más horas de práctica basado en las
necesidades para las destrezas auditivas, orales, de lectura y escritura en cualquiera de los
lenguajes mencionados. El total de horas de práctica el laboratorio de lenguaje o e-
lab deben de estar integradas en la sección de actividades del módulo.
Descripción del Proceso de Evaluación: Debe de integrar el uso del laboratorio de
lenguaje o laboratorio de lenguaje electrónico en las rúbricas de evaluación. Las rúbricas
del lenguaje para escuchar, hablar, leer, y escribir se integran en el avalúo de los
estudiantes. Ver Apéndice A para las rúbricas a usarse. Para evaluar trabajos escritos en
los dos idiomas, el facilitador deberá usar el “Writing Process: Six Writing Traits
Rubrics” que aparecen en el Apéndice B. “Portfolio Performance Assessment” tiene que
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ser uno de los instrumentos para evaluar el progreso lingüístico y académico de los
estudiantes. Debido a la naturaleza del modelo bilingüe instruccional, el facilitador tiene
que documentar que el estudiante esté progresando hacia la meta de dominar dos idiomas
académicamente. El portfolio tiene que cumplir con los estándares establecidos. El
facilitador del curso le proveerá el estudiante el MANUAL DE PORTAFOLIOS.
Escala:
100-90 A 89-80 B 79-70 C 69-60 D 59-00 F
Evaluación:
La nota final de cada estudiante se basará en la evaluación de las siguientes actividades:
Participación Activa 10%
Asignaciones escritas 40%
Exámenes prácticas 50%
Total 100%
Requisitos de APA (versión 6) para citar los Textos a Usarse en el Módulo
Para los Textos Recomendados y Recursos utilice el estilo APA, (6ª. Ed.). Incluya al
menos un libro electrónico de la Biblioteca Virtual http://bibliotecavirtualut.suagm.edu/
La fecha de publicación de un libro no deberá ser mayor de cinco años según lo exige la
Comisión de Educación Independiente de la Florida.
NURS 204 Laboratorio de Destrezas Técnicas 7
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Libro(s)
Berman, A., & Kozier, B. (2008). Fundamentos de Enfermería Conceptos , Proceso y
Práctica. (8va edición). Pearson. ISBN: 9788483234052
Berman, A., Kozier, B. & Erb, G. (2007). Fundamentals of Nursing and MyNursingLab
(8th ed.). Prentice Hall. ISBN-10: 0132425998 Price: $112.00
Rifa, R., Olive, C., & Lamoglia, M. (2012). Lenguaje NIC para el aprendizaje teórica-
práctica en enfermería. 1era edición. Espana, Elsevier. ISBN: 9788480869454
Libro(s) Electrónico(s)
Perry, A. G. & Potter, P.A. (2011). Guías Mosby de Técnicas y procedimientos en
enfermería. España, Elevier. ASIN: B006NKT4QI.
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Descripción de las Normas del Curso
1. Este curso sigue el modelo “Discipline-Based Dual Language Immersion
Model®” del Sistema Universitario Ana G. Méndez, Inc. el cual está diseñado
para promover el desarrollo de cada estudiante como un profesional bilingüe.
Cada taller será facilitado en inglés y español, utilizando el modelo 50/50. Esto
significa que cada taller deberá ser conducido enteramente en el lenguaje
especificado. Los lenguajes serán alternados en cada taller para asegurar que el
curso se ofrezca 50% en inglés y 50% en español. Para mantener un balance, el
módulo debe especificar que se utilizarán ambos idiomas en el quinto taller,
dividiendo el tiempo y las actividades equitativamente entre ambos idiomas. Las
primeras dos horas son estrictamente en español y las últimas dos en inglés.
Los cursos de idiomas deben ser desarrollados en el idioma correspondiente, en
inglés o en español, según aplique.
2. El curso es conducido en formato acelerado y bilingüe, esto requiere que los
estudiantes sean sumamente organizados, enfocados y que se preparen antes de
cada taller de acuerdo al módulo. El estudiante debe hacer todo esfuerzo para
desarrollar las destrezas en los dos idiomas usando los recursos de lenguaje
disponibles dentro y fuera de la institución. El convertirse en un profesional
bilingüe es un proceso complejo y exigente. Cada taller requiere un promedio de
diez (10) horas de preparación y en ocasiones requiere más para poder tener éxito
lingüístico y académico.
3. La asistencia a todos los talleres es obligatoria. El estudiante que se ausente al
taller deberá presentar una excusa razonable al facilitador. El facilitador evaluará
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si la ausencia es justificada y decidirá como el estudiante repondrá el trabajo
perdido, de ser necesario. El facilitador puede elegir una de estas dos alternativas:
(a) permitirle al estudiante reponer el trabajo o (b) asignarle trabajo adicional
además del trabajo que el estudiante tenga que reponer.
Toda tarea a ser completada antes del taller deberá ser entregada en la fecha
asignada. El facilitador ajustará la nota de las tareas repuestas.
4. Si un estudiante se ausenta a más de un taller el facilitador tendrá las
siguientes opciones:
a. Si es a dos talleres, el facilitador reducirá la nota existente en un grado.
b. Si el estudiante se ausenta a tres talleres, el facilitador reducirá la nota
existente en dos grados.
5. La asistencia y participación en actividades de la clase y en presentaciones orales
es extremadamente importante pues éstas no se pueden reponer. Si el estudiante
provee una excusa válida y verificable, el facilitador determinará una actividad
equivalente a evaluar que sustituya la misma. Esta actividad deberá incluir el
mismo contenido y componentes del lenguaje como la presentación oral o
actividad que requiera repuesta.
6. En actividades grupales, el grupo será evaluado por su trabajo final. Sin embargo,
cada miembro de grupo deberá participar y cooperar para lograr un trabajo de
excelencia. Los estudiantes también recibirán una calificación individual.
7. Se espera que todo trabajo escrito sea de la autoría de cada estudiante y no
plagiado. Se requiere que todo trabajo sometido al facilitador cumpla con las
reglas para citar apropiadamente o que esté parafraseado y citado dando crédito al
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autor. Todo estudiante debe ser el autor de su propio trabajo. Todo trabajo que
sea plagiado, copiado o presente trazos del trabajo de otro estudiante o autor será
calificado con cero. El servicio de SafeAssign TM
de Blackboard será utilizado
por los facilitadores para verificar la autoría de los trabajos escritos de los
estudiantes. Es responsabilidad del estudiante de leer la política de plagio de su
universidad. Si usted es estudiante de UT, deberá leer la Sección 11.1 del Manual
del Estudiante. Si es estudiante de UMET y UT, refiérase al Capítulo 13,
secciones 36 y 36.1 de los respectivos manuales.
Se espera un comportamiento ético en todas las actividades del curso. Esto
implica que TODOS los trabajos tienen que ser originales y que para toda
referencia utilizada deberá indicarse la fuente, bien sea mediante citas o
bibliografía utilizando el estilo APA, versión 6. No se tolerará el plagio y, en caso
de que se detecte casos del mismo, el estudiante se expone a recibir cero en el
trabajo y a ser referido al Comité de Disciplina de la institución. Los estudiantes
deben observar aquellas prácticas dirigidas para evitar incurrir en el plagio de
documentos y trabajos pues va en contra de la ética profesional.
8. Para el facilitador poder hacer cambios a las actividades del módulo o guía de
estudio, deberá ser aprobado por el Director de Facultad y Currículo antes de la
primera clase. Es requisito que el facilitador discuta y entregue una copia de los
cambios a los estudiantes al principio del primer taller.
9. El facilitador establecerá los medios para contactar a los estudiantes proveyendo
su correo electrónico de SUAGM, teléfonos, día y horario disponibles.
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10. El uso de celulares está prohibido durante las sesiones de clase; de haber una
necesidad, deberá permanecer en vibración o en silencio.
11. La visita de niños y parientes no registrados en el curso no está permitida en el
salón de clases.
12. Todo estudiante está sujeto a las políticas y normas de conducta y
comportamiento que rigen al SUAGM, al curso y a un adulto profesional.
Nota: Si por alguna razón no puede acceder las direcciones electrónicas ofrecidas en el
módulo, notifique al facilitador pero no se limite a ellas. Existen otros motores de
búsqueda y sitios Web que podrá utilizar para la búsqueda de la información deseada.
Algunas de éstos son:
www.google.com
www.ask.com
www.pregunta.com
www.findarticles.com
www.bibliotecavirtualut.suagm.edu
www.eric.ed.gov/
www.flelibrary.org/
http://www.apastyle.org/
Para comprar o alquilar libros de texto o referencias nuevas o usadas puede visitar:
http://www.chegg.com/ (alquiler)
http://www.bookswim.com/ (alquiler)
http://www.allbookstores.com/ (compra)
http://www.alibris.com/ (compra)
NURS 204 Laboratorio de Destrezas Técnicas 12
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Éstos son sólo algunas de las muchas compañías donde puede comprar o alquilar libros.
El facilitador puede realizar cambios a las direcciones electrónicas y/o añadir otras de
índole profesional y que contengan las investigaciones más recientes del tópico del
módulo, de ser necesario.
CUMPLIMIENTO DE LA LEY DE INVESTIGACIÓN:
Si el facilitador o el estudiante requirieran o deseara llevar a cabo una investigación
o la administración de cuestionarios o entrevistas, éstos deberán referirse a las
normas y procedimientos de la Oficina de Cumplimiento y solicitar su autorización.
Para acceder a los formularios de la Oficina de Cumplimiento pueden visitar este
enlace:
http://www.suagm.edu/ac_aa_re_ofi_formularios.asp y seleccionar los formularios
que necesite. Además de los formularios el estudiante/facilitador puede encontrar
las instrucciones para la certificación de investigación en línea. Estas certificaciones
incluyen: Institutional Review Board (IRB), Health Information Portability and
Accountability Act (HIPAA), y Responsibility Conduct for Research Act (RCR).
De tener alguna duda, favor de comunicarse con las Coordinadoras Institucionales o a la
Oficina de Cumplimiento a los siguientes teléfonos:
Sra. Evelyn Rivera Sobrado, Directora Oficina de Cumplimiento
Tel. (787) 751-0178 Ext. 7196
Srta. Carmen Crespo, Coordinadora Institucional Cumplimiento – UMET
Tel. (787) 766-1717 Ext. 6366
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Sra. Josefina Melgar, Coordinadora Institucional Cumplimiento – Turabo
Tel. (787) 743-7979 Ext.4126
Dra. Rebecca Cherry, Coordinadora Institucional Cumplimiento - UNE
Tel. (787) 257-7373 Ext. 3936
Filosofía y Metodología Educativa
Este curso está basado en la filosofía educativa del Constructivismo. El Constructivismo
es una filosofía de aprendizaje fundamentada en la premisa, de que, reflexionando a
través de nuestras experiencias, podemos construir nuestro propio entendimiento sobre el
mundo en el que vivimos.
Cada uno de nosotros genera sus propias “reglas “y “modelos mentales” que utilizamos
para darle sentido a nuestras experiencias. Aprender, por lo tanto, es simplemente el
proceso de ajustar nuestros modelos mentales para poder entender nuevas experiencias.
Como facilitadores, nuestro enfoque es el de mantener una conexión entre los hechos con
las experiencias y fomentar un nuevo entendimiento en los estudiantes. También,
intentamos adaptar nuestras estrategias de enseñanza a las respuestas de nuestros
estudiantes y motivar a los mismos a analizar, interpretar, predecir información y
aplicarla a la vida diaria.
PRINCIPIOS DEL CONSTRUCTIVISMO:
1. El aprendizaje es una búsqueda de significados. Por lo tanto, el aprendizaje debe
comenzar con situaciones en las cuales los estudiantes estén buscando activamente
construir un significado.
NURS 204 Laboratorio de Destrezas Técnicas 14
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2. Para construir “un significado” se requiere comprender todas las partes: globales y
específicas (“from whole to parts”). Ambas partes deben entenderse en el contexto
del todo. Por lo tanto, el proceso de aprendizaje se enfoca en los conceptos primarios
en contexto y no en hechos aislados.
3. Para enseñar bien, debemos entender los modelos mentales que los estudiantes
utilizan para percibir el mundo y las presunciones que ellos hacen para apoyar dichos
modelos.
4. El propósito del aprendizaje, es para un individuo, el construir su propio significado,
y no sólo el de memorizar las respuestas “correctas” y repetir el significado de otra
persona. Como la educación es intrínsecamente interdisciplinaria, la única forma
válida para asegurar el aprendizaje es hacer de la evaluación parte esencial de dicho
proceso, asegurando que el mismo provea a los estudiantes con la información sobre
la calidad de su aprendizaje.
5. La evaluación debe servir como una herramienta de auto-análisis.
6. Proveer herramientas y ambientes que ayuden a los estudiantes a interpretar las
múltiples perspectivas que existen en el mundo.
7. El aprendizaje debe ser controlado internamente y analizado por el estudiante.
NURS 204 Laboratorio de Destrezas Técnicas 15
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STUDY GUIDE
Course Title: Technical Skills Laboratory
Code: NURS 204
Credits: 2
Time Length: 5 weeks
Pre-requisite: NURS 201, NURS 303 or concurrent
Description: This course provides students with the development of basic technical
nursing skills required at the baccalaureate level. Students are expected to assess the
client, formulate nursing diagnoses, perform different nursing procedures, evaluate
patient outcomes and document pertinent data following NANDA, NIC and NOC.
General Content Objectives:
1. Demonstrate safe, careful administration of medications by diverse methods.
2. Provide adequate urinary and intestinal care.
3. Carry out safe collection of laboratory samples.
4. Demonstrate safe techniques and procedures for wound care and dressing change.
5. Perform safe, adequate procedures related to all systems.
6. Provide professional care using correct procedures.
General Language Objectives:
1. Listening: Students will understand terms and directions in both English
and Spanish.
2. Speaking: Students will share their knowledge acquired with other
students.
NURS 204 Laboratorio de Destrezas Técnicas 16
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3. Reading: Students will read various academic literature in order to acquire
knowledge necessary for acquiring skills.
4. Writing: Students write about basic nursing techniques.
E-Lab (Language Lab) Requirements (Tell Me More, Net Tutor, Wimba Voice, Virtual
Library, & Voice E-mail.)
Language Lab Minimum Requirement: Students must demonstrate that they have
complied with 10 hours of language lab or e-lab usage for each language (English
and Spanish) per course. This equates to the use of the language lab or e-lab for
two hours weekly for each language per course. The facilitator may require a
higher number of hours for language lab practice based on the language needs for
listening, speaking, reading, and writing skills in either or both languages. The
total amount of language lab or e-lab hours is integrated in the activities for
each workshop in the module.
Description of the Evaluation Process: Integrate the use of the language lab and e-lab to
all evaluation rubrics used in the instructional module. The language rubrics for listening,
speaking, reading, and writing provided in Appendix A are integrated to assess student
performance in all courses. The Writing Process: Six Writing Traits Rubrics provided in
Appendix B must be used to evaluate all writing activities in both languages in all
courses. Portfolio Performance Assessment must be one of the evaluation instruments
used in the module and throughout the content of all workshops and appendices. This
instrument must follow established guidelines. Due to the nature of our dual language
instructional model, documentation must be provided on the growth of students towards
NURS 204 Laboratorio de Destrezas Técnicas 17
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mastery of linguistic and academic skills in both languages (English and Spanish.) The
course facilitator will provide the student the PORTFOLIO MANUAL.
Scale:
100-90 A 89-80 B 79-70 C 69-60 D 59-00 F
The Evaluation:
The final grade for each student will be based on the evaluation of the following
activities:
Active Participation 10%
Written Assignments 40%
Practice exams 50%
Total 100%
Requirements for the Use of APA (Version 6) for Citations of Textbooks
For Recommended Texts and Resources, Use APA style version 6. Include at least ONE
e-book from the Virtual Library at http://bibliotecavirtualut.suagm.edu/
Textbooks must have a publication date of 5 years as required by the Florida
Commission of Independent Learning.
Book(s)
Lynn P. & Taylor C. (2008). Taylor's clinical nursing skills : a nursing process approach.
2nd ed. Philadelphia : Lippincott.
Stedman T. (2008). Stedman's medical dictionary for the health professions and nursing.
6th ed. Philadelphia : Lippincott Williams & Wilkins.
Bulechek G., Butcher K. & McCloskey J.(2008). Nursing Interventions Classification
(NIC). 5th Edition. St. Louis: Mosby
Moorhead S., Johnson M., Maas M. & Swanson E. (2008). Nursing Outcomes
Classification (NOC). 4th Edition. St. Louis: Mosby.
NURS 204 Laboratorio de Destrezas Técnicas 18
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E-Book (s)
Nicol, M., Bavin, C., Crorin, P., & Rawlings-Anderson, K. (2008). Essential nursing
skills. 3rd
edition. St. Louis: Mosby. ISBN: 9780723434740 Retrieved from:
http://books.google.com.pr/books?id=n9Df-
Tg78XsC&printsec=frontcover&dq=technical+skills+of+nursing&hl=en&sa=X&ei=E83
oT-
KqE6Xy0gHzy4iLCg&redir_esc=y#v=onepage&q=technical%20skills%20of%20nursin
g&f=false
Altman, G.B. (2009). Fundamental and Advanced Nursing. 3rd
edition. New York,
Delmar Cengage Learning. ISBN: 978-1-418-052331
Retrieved from:
http://books.google.com.pr/books?id=vwTHsYiRunQC&printsec=frontcover&dq=techni
cal+skills+of+nursing&hl=en&sa=X&ei=E83oT-
KqE6Xy0gHzy4iLCg&redir_esc=y#v=onepage&q=technical%20skills%20of%20nursin
g&f=false
NURS 204 Laboratorio de Destrezas Técnicas 19
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Description of Course Policies
1. This course follows the Sistema Universitario Ana G. Méndez, Inc. Discipline-
Based Dual Language Immersion Model® designed to promote each student’s
development as a Dual Language Professional. Workshops will be facilitated in
either English or Spanish, strictly using the 50/50 model. This means that each
workshop will be conducted entirely in the language specified for the workshop. The
language used in each workshop needs to be alternated to insure that 50% of the
course is conducted in English and 50% in Spanish. To maintain this balance, the
course module will indicate that both languages must be used during the fifth
workshop, dividing the workshop activities between the two languages. The first two
hours will be in Spanish and the last two hours in English. The 50/50 model does
not apply to language courses where the delivery of instruction must be conducted in
the language taught (Spanish or English only).
2. The course is conducted in an accelerated and dual language format. This requires
that students prepare in advance for each workshop according to the course module.
Students must be structured, organized, committed, and focused to ensure linguistic
and academic success. In order to achieve proficiency expectations in English and in
Spanish, the student must strive to take advantage of all language resources in the
university and in their community since becoming a dual language professional is a
complex and challenging task. Each workshop requires an average of ten hours of
preparation, but could require more.
NURS 204 Laboratorio de Destrezas Técnicas 20
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3. Attendance to all class sessions is mandatory. A student who is absent to a workshop
must present a reasonable excuse to the facilitator who in turn will evaluate the reason
for the absence. If it is justified, the facilitator will decide how the student will make
up the missing work, if applicable. The facilitator will decide on the following: allow
the student to make up the work, or allow the student to make up the work and assign
extra work to compensate for the missing class time.
Assignments required prior to the workshop must be completed and turned in on the
assigned date. The facilitator may decide to adjust the grade given for late
assignments and/or make-up work.
4. If a student is absent to more than one workshop, the facilitator will have the
following options:
a. If a student misses two workshops, the facilitator may lower one grade
level based on the student’s existing grade.
b. If the student misses three workshops, the facilitator may lower two
grade levels based on the student’s existing grade.
5. Student attendance and participation in oral presentations and special class activities
are extremely important as it is not possible to assure that they can be made up. If the
student provides a valid and verifiable excuse, the facilitator may determine a
substitute evaluation activity if he/she understands that an equivalent activity is
possible. This activity must include the same content and language components as the
oral presentation or special activity that was missed.
NURS 204 Laboratorio de Destrezas Técnicas 21
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6. In cooperative learning activities, the group will be assessed for their final work as a
group. However, each member will have to collaborate to assure the success of the
group. Students will also receive an individual grade for their work.
7. It is expected that all written work will be solely that of the student and should not be
plagiarized. That is, the student must be the author of all work submitted. All quoted
or paraphrased material must be properly cited, with credit given to its author or
publisher. It should be noted that plagiarized writings are easily detectable and
students should not risk losing credit for material that is clearly not their own.
SafeAssignTM
, a Blackboard plagiarism deterrent service, will be used by the
facilitators to verify students’ ownership of written assignments. It is the
student’s responsibility to read the university’s plagiarism policy. If you are a UT
student, read Section 11.1 of the Student Manual, and if you belong to UMET or
UNE, refer to Chapter 13, Sections 36 and 36.1 of the respective manuals.
Ethical behavior is expected from the students in all course related activities. This
means that ALL papers submitted by the student must be original work, and that all
references used will be properly cited or mentioned in the bibliography. Plagiarism
will not be tolerated and, in case of detecting an incidence, the student will obtain a
zero in the assignment or activity and could be referred to the Discipline Committee.
8. In order for the Facilitator to make changes to activities and the study guide, the
Faculty and Curriculum Director must approve such changes before the first day of
class. The Facilitator must discuss the approved changes with students in the first
class workshop. A written copy of the changes must also be provided to students at
the beginning of the first workshop.
NURS 204 Laboratorio de Destrezas Técnicas 22
Updated 06/29/2012
9. The facilitator will establish a means of contacting students by providing the SUAGM
e-mail address, phone number, hours to be contacted, and days available.
10. The use of cellular phones is prohibited during sessions; if there is a need to have one,
it must be on vibrate or silent mode during class session.
11. Children or family members that are not registered in the course are not allowed in
the classrooms.
12. All students are subject to the policies regarding behavior at the university
community established by the institution, and in this course.
Note: If for any reason you cannot access the URL’s presented in the module, notify the
facilitator immediately but do not stop your investigation. There are many search engines
and other links you can use to search for information. These are some examples:
www.google.com
www.ask.com
www.pregunta.com
www.findarticles.com
www.bibliotecavirtualut.suagm.edu
www.eric.ed.gov/
www.flelibrary.org/
http://www.apastyle.org/
To buy or rent new or used textbooks or references you can visit:
http://www.chegg.com/ (rent)
http://www.bookswim.com/ (rent)
http://www.allbookstores.com/ (buy)
http://www.alibris.com/ (buy)
NURS 204 Laboratorio de Destrezas Técnicas 23
Updated 06/29/2012
The facilitator may make changes or add additional challenging, research-based, and
professional educational Web Resources, if deemed necessary to reflect current trends in
the course topics.
RESEARCH LAW COMPLIANCE REQUIREMENT:
If the facilitator or the student is required, or wants to perform a research, or needs
to administer a questionnaire or an interview individuals, he/she must comply with
the norms and procedures of the Institutional Review Board Office (IRB) and ask
for authorization. To access the forms from the IRB Office or for additional
information, visit the following link:
http://www.suagm.edu/ac_aa_re_ofi_formularios.asp and select the forms needed.
Furthermore, in this Web site the student/facilitator will find instructions for
several online certifications related to IRB processes. These certifications include:
IRB Institutional Review Board, Health Information Portability and Accountability
Act (HIPAA), and the Responsibility Conduct for Research Act (RCR).
If you have any questions, please contact the following institutional coordinators:
Mrs. Evelyn Rivera Sobrado, Director of IRB Office (PR)
Tel. (787) 751-0178 Ext. 7196
Miss. Carmen Crespo, IRB Institutional Coordinator– UMET
Tel. (787) 766-1717 Ext. 6366
Sra. Josefina Melgar, IRB Institutional Coordinator – Turabo
Tel. (787) 743-7979 Ext.4126
Rebecca Cherry, Ph.D., IRB Institutional Coordinator - UNE
Tel. (787) 257-7373 Ext. 3936
NURS 204 Laboratorio de Destrezas Técnicas 24
Updated 06/29/2012
Teaching Philosophy and Methodology
The activities for the course reflect the educational philosophy of Constructivism.
Constructivism is an educational philosophy founded on the premise that, by reflecting
on our experiences, we construct our own understanding of the world in which we live.
Each of us generates our own “rules” and “mental models,” which we use to make sense
of our experiences. Learning, therefore, is simply the process of adjusting our mental
models to accommodate new experiences.
One of the main goals facilitators have is assisting students in making connections
between their prior knowledge of facts, and fostering new understanding that is relevant
to real live experiences. We will also attempt to tailor our teaching strategies to student
responses and encourage students to analyze, interpret, and predict information.
CONSTRUCTIVISM GUIDING PRINCIPLES:
1. Learning is a search for meaning. Therefore, learning must start with the issues
around which students are actively trying to construct meaning.
2. Meaning requires understanding “wholes” as well as “parts”. The “parts” must be
understood in the context of “wholes”. Therefore, the learning process focuses on
primary concepts, not isolated facts.
3. In order to teach well, we must understand the mental models that students use to
perceive the world, and the assumptions they make to support those models.
4. The purpose of learning is for an individual to construct his or her own meaning, not
just memorize the "right" answers and regurgitate someone else's meaning. Since
education is inherently interdisciplinary, the only valuable way to measure learning is
NURS 204 Laboratorio de Destrezas Técnicas 25
Updated 06/29/2012
to make assessment part of the learning process, thus ensuring that it provides
students with information on the quality of their learning.
5. Evaluation should serve as a self-analysis tool.
6. Provide tools and environments that help learners interpret the multiple perspectives
of the world.
7. Learning should be internally controlled and mediated by the learner.
NURS 204 Laboratorio de Destrezas Técnicas 26
Updated 06/29/2012
TALLER UNO
Objetivos específicos de contenido:
Al finalizar el curso, los estudiantes podrán:
1. Demostrar conocimientos sobre la administración de medicamentos vía oral,
intramuscular e intravenoso.
2. Identificar correctamente angios para la administración de medicamentos
intradermales, subcutáneos y musculares.
3. Demostrar la técnica correcta de inserción de tubo nasogástrico y la
discontinuación de los mismos.
4. Explicar y demostrar la forma correcta para administrar los alimentos vía tubo
nasogástrico.
Objetivos específicos de lenguaje:
Al finalizar el curso, los estudiantes podrán:
1. Escuchar: Escuchar atentamente la discusión y la charla que se den en el
contexto de aprendizaje entre los alumnos y el facilitador.
2. Hablar: Discutir el método correcto de administración de medicamentos e
inserción de un tubo nasogástrico.
3. Leer: Leer artículos relacionados con la administración de medicamentos, así
como los relacionados con la inserción del tubo nasogástrico y el cuidado de este.
4. Escribir: Escribir los pasos correctos de administración de medicamentos.
Enlaces electrónicos:
Biblioteca Virtual
http://bibliotecavirtualut.suagm.edu/
Tema: Guía de la administración de medicamentos seguros
http://ocw.uib.es/ocw/infermeria/farmacologia/recurso-3
Tema: Cuidados del paciente con sonda nasogástricos
http://www.enfermerasperu.com/cuidado_del_paciente_con_sonda_nasogastrica.php
Tema: Guía para la administración segura de medicamentos vía parental
NURS 204 Laboratorio de Destrezas Técnicas 27
Updated 06/29/2012
http://www.saludinnova.com/communities/seguridad/docs/download/Medicamentos/Gu
%C3%ADa%20de%20administración%20segura%20de%20medicamentos%20via%20pa
renteral.pdf
Asignaciones antes del taller:
1. Leer capítulos 5 y 11 del libro de texto de Lynn
2. Utilice la Biblioteca Virtual para buscar información sobre la administración de
medicamentos y sus vías. Prepare un bosquejo y llévelo a clase para discusión.
3. Utilice la Biblioteca Virtual para buscar información sobre la inserción de tubo
nasogástrico y alimentación parental. Prepare un bosquejo y llévelo a clase para
discusión.
Vocabulario clave de la lección:
1. Ampolleta
2. Inhalación
3. Inyección intradermal
4. Inyección intramuscular
5. Vía intravenosa
6. Calibre del aguja
7. Inyección subcutánea
8. Sublingual
9. Anorexia
10. Índice de masa corporal
11. Caloría
12. Colesterol
13. Nutrición enteral
Lista de materiales suplementarios para el taller:
1. PowerPoint
2. Libro de Texto
3. Biblioteca Virtual
NURS 204 Laboratorio de Destrezas Técnicas 28
Updated 06/29/2012
Componentes de SIOP (Sheltered-Instruction Observation Protocol): Coloque una
marca de cotejo (√) en la (__) en todas las estrategias por componente que se usarán en
el taller
B. Andamiaje
__x_ Modelaje
_x__ Práctica Dirigida
_x__ Práctica Independiente
_x__ Instrucción
Comprensible
C. Opciones para Agrupamiento
__x_ Grupo Completo
_x__ Grupos Pequeños
___ Pares
_x__ Trabajo Independiente
D. Integración del Proceso
_x__ Escuchar
_x__ Hablar
_x__ Leer
_x__ Escribir
E. Aplicación
__x_ Actividades Dinámicas de Aplicación
___ Significativas y Relevantes
___ Rigurosas
_x__ Alineadas a los Objetivos
_x__ Promueven Participación
A. Preparación
_x__ Adaptación de Contenido
___ Enlaces al Conocimiento Previo
___ Enlaces al Aprendizaje Previo
___ Estrategias Incorporadas
Estrategias de CALLA (Cognitive Academic Language Learning Approach)
_x__ Cognoscitivo
___ Meta-cognoscitivo
_x__ Socio/Afectivo
NURS 204 Laboratorio de Destrezas Técnicas 29
Updated 06/29/2012
Actividades integradas de contenido y lenguaje para lograr los objetivos del taller:
1. El facilitador comenzará la clase con un examen para diagnosticar los
conocimientos previos de los estudiantes.
2. El facilitador presentará a los estudiantes el tópico de administración de
medicamentos por vía oral, intramuscular, e intravenosa.
3. Los estudiantes serán divididos en grupos de cuatro personas para practicar con
los maniquís.
4. Los estudiantes demostrarán al facilitador sus conocimientos sobre el tema
presentado.
5. Luego de demostrar lo aprendido, cada grupo preparará un bosquejo de los temas
más importantes de la administración de medicamentos. Después un representante
de cada grupo lo discutirá frente a la clase.
6. El facilitador presentará a los estudiantes el tópico de tubo nasogástrico
7. Los estudiantes serán divididos en grupos de cuatro personas para practicar con
los maniquís la inserción, cuidado y remoción de tubo nasogástrico.
8. Los estudiantes demostrarán al facilitador los conocimientos aprendidos.
Evaluación:
1. Individual: El dominio del segundo idioma se evaluará mediante el uso del
apéndice C: “ADMINISTRATION OF MEDICATION”
2. Grupal: Las prácticas con los maniquís asignadas a cada equipo. Se evaluarán
mediante el uso del apéndice A.
3. Escrito: El bosquejo de los temas más importantes de la administración de
medicamentos se evaluarán mediante el uso del apéndice A.
4. Oral/Auditivo: Discusión oral grupal y frente a la clase completa se evaluarán
mediante el uso del apéndice A.
NURS 204 Laboratorio de Destrezas Técnicas 30
Updated 06/29/2012
Cierre del taller:
1. Individual: El Facilitador aplicará una segunda prueba comprobatoria para
verificar lo aprendido.
2. Grupal: Los estudiantes evaluarán las técnicas aprendidas por sus compañeros de
equipo.
NURS 204 Laboratorio de Destrezas Técnicas 31
Updated 06/29/2012
WORKSHOP TWO
Specific Content Objectives:
1. Summarize steps to adequate stool specimen collection for occult blood.
2. Dramatize the steps in collecting a urine specimen for urine analysis and culture.
3. Demonstration of correct method of urine specimen for urinary analysis and
culture in patients with indwelling catheter.
4. Demonstrate the correct method of obtaining a venipuncture for routine lab test.
5. Describe the correct method of obtaining venous bloods specimen for culture and
sensitivity.
Specific Language Objectives:
1. Listening: Students will listen to the discussion on proper techniques for
obtaining different laboratory samples.
2. Speaking: Students will explain and demonstrate correct method for collecting
stool, urine and blood specimens.
3. Reading: The students will read and analyze the articles given to them.
4. Writing: The students will answer the questions given to them as an assignment.
Electronic Links (URLs):
Biblioteca Virtual
http://bibliotecavirtualut.suagm.edu/
TOPIC: Flash cards on specimen collection and venopuncture
http://quizlet.com/6003663/metc-nursing-specimen-collection-and-venipuncture-flash-
cards/
TOPIC: Nasal specimen collection for MRSA
http://stage.smh.com/sections/services-
procedures/medlib/nursing/NursPandP/spe18_nasal_021309.pdf
TOPIC: Stool collection
http://www.medscape.com/viewarticle/754767
TOPIC: Specimen labeling
http://www.medscape.com/viewarticle/727907
NURS 204 Laboratorio de Destrezas Técnicas 32
Updated 06/29/2012
TOPIC: Urine screen for drug testing
http://www.medscape.com/viewarticle/718560
TOPIC: Understanding urinalysis
http://www.medscape.com/viewarticle/763579
Assignments before the Workshop:
1. Read chapter 18 from the book by Lynn, P. (2008). Prepare a written summary of
the chapter. Bring it to class for discussion.
2. Read one of the articles, which are found in the electronic links, and write a
synopsis of the article for discussion in class.
3. Visit the virtual library and read on a specific topic on specimen collection
assigned by facilitator. Write a PowerPoint presentation on the topic of
discussion.
Key Core Vocabulary:
1. Arterial blood gas
2. Lancet
3. Occult blood
4. Standard precautions
List of Supplementary Materials for the Workshop:
1. PowerPoint
2. Text book
3. Virtual library
4. Videos on Specimen collection
NURS 204 Laboratorio de Destrezas Técnicas 33
Updated 06/29/2012
SIOP Components - Place a checkmark (√) on the (___) for ALL strategies that will be
used in the workshop.
B. Scaffolding
___ Modeling
__x_ Guided Practice
___ Independent Practice
___ Comprehensible Input
C. Grouping Options
__x_ Whole Class
_x__ Small Groups
___ Partners
__x_ Independent Work
D. Integration of Processes
__x_ Listening
_x__ Speaking
__x_ Reading
_x__ Writing
E. Application
__x_ Hands-on
__x_ Meaningful/Relevant
___ Rigorous
__x_ Link to Objectives
___ Promote Engagement
A. Preparation
__x_ Adaptation of Content
___ Links to Background Knowledge
___ Links to Past Learning
__x_ Strategies Incorporated
CALLA Strategies (Cognitive Academic Language Learning Approach)
_x__ Cognitive
__x_ Meta-cognitive
__x_ Social/Affective
NURS 204 Laboratorio de Destrezas Técnicas 34
Updated 06/29/2012
Integrated Activities of Content and Language to achieve Content and Language
Objectives:
1. The facilitator will discuss with the student proper techniques of laboratory
specimen collection.
2. The students will view the video on specimen collection.
3. The students will be divided into groups of four students and discuss the articles
which they read for their assignments.
4. The students will present their PowerPoint presentation to the class.
5. The students will be divided into groups of four. Each group will be assigned a
case where they will need to dramatize the correct format in collecting the
specimen.
6. The students of each group will write a nurses note of the case given to them.
They will stand in front of the class and present it to their classmates.
7. The students will be divided into groups to prepare a poster on the different
specimen collection and present to the class.
8. The students will attend a conference and write a report on what they learned.
Assessment:
1. Individual: The students’ second language proficiency will be assessed on their
knowledge by using appendix E.
2. Group: The groups’ second language proficiency will be assessed by using
appendix A.
3. Written: The students’ second language proficiency will be assessed by using
appendix B and F.
4. Oral: The students’ second language proficiency will be assessed by using
appendix F.
Lesson Wrap-Up:
1. Individual: Demonstrate correct method of specimen collection.
2. Group: Write the appropriate nurses note.
NURS 204 Laboratorio de Destrezas Técnicas 35
Updated 06/29/2012
TALLER TRES
Objetivos específicos de contenido:
Al finalizar el curso, los estudiantes podrán:
1. Demostrar los conocimientos sobre los métodos para asistir a los pacientes
durante la utilización del equipo para eliminación urinario.
2. Explicar el cuidado del catéter de diálisis peritoneal.
3. Explicar el cuidado del catéter de hemodiálisis.
4. Demostrar conocimientos sobre la inserción del catéter urinario en pacientes de
los géneros femenino y masculino.
5. Demostrar conocimientos sobre la administración de enemas.
6. Demostrar conocimientos sobre el cambio y vaciado de bolsas de ostomias.
Objetivos específicos de lenguaje:
Al finalizar el curso, los estudiantes podrán:
1. Escuchar: Escuchar atentamente las discusiones que se generen durante las
presentaciones y charlas del contenido.
2. Hablar: Discutir el método correcto del cuidado del catéter de diálisis peritoneal
y hemodiálisis.
3. Leer: Leer artículos relacionados con el catéter urinario y el cuidado correcto de
estos.
4. Escribir: Escribir sobre el método correcto del cuidado del catéter urinario.
Enlaces electrónicos:
Biblioteca Virtual
http://bibliotecavirtualut.suagm.edu/
Tema: Anatomía Y fisiología de sistema urinario
http://www.youtube.com/watch?v=N4N4T88Lom4&feature=results_main&playnext=1&
list=PLDDCA619417F4779E
Tema: Caso clínico de paciente con ostomias: Plan de cuidado de enfermera
http://enfermeros.org/revista/ENE-RevistaDeEnfermeria-Vol3-Num2-septiembre2009-
pags-80-88.pdf
NURS 204 Laboratorio de Destrezas Técnicas 36
Updated 06/29/2012
Tema: Intervención educativa de enfermería para la rehabilitación de personas con una
ostomias
http://ojs.unam.mx/index.php/reu/article/view/26649
Tema: Diálisis peritoneal
http://www.eccpn.aibarra.org/temario/seccion9/capitulo143/capitulo143.htm
Asignaciones antes del taller:
1. Leer los capítulos 12-13 del libro de Lynn.
2. Utilice la Biblioteca Virtual para buscar información sobre la inserción de un
catéter urinario en pacientes de los géneros femenino y masculino. Escribir un
bosquejo de esta información para discutir en clase.
3. Utilice la Biblioteca Virtual para buscar información sobre el cuidado de
ostomias. Escribir un bosquejó de esta información para discutir en clase.
Vocabulario clave de la lección:
1. Fístula arteriovenosa
2. Injerto arteriovenoso
3. Catéter de condón externo
4. Hemodiálisis
5. Sonda uretral
6. Diálisis peritoneal
7. Ileostomía
8. Ostomía
9. Estoma
Lista de materiales suplementarios para el taller:
1. Presentación de Power Point.
2. Libro de referencia
3. Biblioteca virtual
NURS 204 Laboratorio de Destrezas Técnicas 37
Updated 06/29/2012
Componentes de SIOP (Sheltered-Instruction Observation Protocol): Coloque una
marca de cotejo (√) en la (__) en todas las estrategias por componente que se
usarán en el taller.
B. Andamiaje
_x__ Modelaje
_x_ Práctica Dirigida
__x_ Práctica Independiente
___ Instrucción Comprensible
C. Opciones para Agrupamiento
__x_ Grupo Completo
_x__ Grupos Pequeños
___ Pares
_x__ Trabajo Independiente
D. Integración del Proceso
_x__ Escuchar
_x_ Hablar
_x_Leer
__x_ Escribir
E. Aplicación
_x__ Actividades Dinámicas de Aplicación
__x_ Significativas y Relevantes
___ Rigurosas
___ Alineadas a los Objetivos
_x__ Promueven Participación
A. Preparación
_x__ Adaptación de Contenido
___ Enlaces al Conocimiento Previo
___ Enlaces al Aprendizaje Previo
___ Estrategias Incorporadas
Estrategias de CALLA (Cognitive Academic Language Learning Approach)
_x__ Cognoscitivo
___ Meta-cognoscitivo
_x__ Socio/Afectivo
NURS 204 Laboratorio de Destrezas Técnicas 38
Updated 06/29/2012
Actividades integradas de contenido y lenguaje para lograr los objetivos del taller:
1. El facilitador presentará a los estudiantes los temas de eliminación urinario y
eliminación fecal.
2. Los estudiantes verán una película sobre la inserción de un catéter urinario.
3. Una enfermera/o enterostomal o especialista en cuidado de piel será invitado a la
clase para que los estudiantes lo entrevisten.
4. Los estudiantes se dividirán en grupos de cuatro y discutirán sobre los temas de
estudio asignados para el taller.
5. Los grupos harán un bosquejo de ideas sobre los temas, y lo compartirán con la
clase
6. Los estudiantes explicarán y demostrarán al facilitador las técnicas de inserción
de catéter de sonda urinario.
7. Los estudiantes harán un examen preliminar. Luego se dividirán en grupos y
repasarán las posibles respuestas.
8. Los estudiantes explicarán y demostrarán sus conocimientos sobre la
administración de enemas.
Evaluación:
1. Individual: El dominio sobre la administración de enemas se evaluará mediante
el uso de apéndice A y D.
2. Grupal: El bosquejo de ideas sobre los temas de estudio asignados se evaluará
mediante el uso de apéndice A y B.
3. Escrito: El un examen preliminar para evaluar el dominio del contenido y del
idioma se evaluará mediante el uso de apéndice B.
4. Oral/Auditivo: La película y la entrevista para valorar el dominio del idioma se
evaluará mediante el uso de apéndice A y B.
Cierre del taller:
1. Individual: Demostración de inserción de sonda urinario, cuidado de estomas y
inserción de enemas
2. Grupal: Bosquejos de ideas.
NURS 204 Laboratorio de Destrezas Técnicas 39
Updated 06/29/2012
WORKSHOP FOUR
Specific Content Objectives:
1. Identify and explain different stages of pressure ulcers.
2. Demonstrate the proper cleaning techniques of wound care and application of
sterile dressings.
3. Knows and demonstrates proper application of saline–moistened dressing,
hydrocolloid dressing and wound vacuum-assisted closure device.
4. Explains and demonstrates correct techniques on removal of sutures and surgical
staples.
5. Shows correct technique and application of external heating devices, warm sterile
compresses to an open wound, cooling blanket and cold therapy.
6. Demonstrate IV infusion insertion, changing solution, and tubing.
7. Explain complications associated with intravenous fluids.
8. Demonstrate the appropriate method of administration of a blood transfusion.
Specific Language Objectives:
1. Listening: Students will listen to the discussion on proper wound care techniques,
IV insertion and blood transfusion.
2. Speaking: Students will explain and demonstrate proper wound care techniques,
application of hot and cold therapy, IV insertion and blood transfusions.
3. Reading: The students will read and analyze the articles given to them.
4. Writing: The students will answer the questions given to them in assignment.
Electronic Links (URLs):
Biblioteca Virtual
http://bibliotecavirtualut.suagm.edu/
TOPIC: Skin anatomy and physiology
http://emedicine.medscape.com/article/1294744-overview
http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000029.htm
NURS 204 Laboratorio de Destrezas Técnicas 40
Updated 06/29/2012
TOPIC: Preventing pressure ulcers and skin tears
http://books.google.com.pr/books?id=7a3sYp5HAEQC&pg=PA304&dq=skin+ulcers+an
d+nursing&hl=en&sa=X&ei=jXXPT-awEY-
YhQe77unyCw&redir_esc=y#v=onepage&q=skin%20ulcers%20and%20nursing&f=fals
e
http://jama.jamanetwork.com/article.aspx?volume=296&issue=8&page=974
http://www.kfmc.org/cpe/programs/pu/kickoff/WOCNPOAarticle.pdf
TOPIC: Lower Extremities Ulcers
http://my.clevelandclinic.org/heart/disorders/vascular/legfootulcer.aspx
TOPIC: Diabetes foot care with negative pressure vacuum system
http://care.diabetesjournals.org/content/31/4/631.full
TOPIC: Pressure ulcer training
https://www.nursingquality.org/ndnqipressureulcertraining/module2/default.aspx
TOPIC: IV Insertion
http://www.youtube.com/watch?v=mVLSX2RlZ3s&feature=related
Assignments before the Workshop:
1. Read Chapter 8 of the text book.
2. Armstrong, D.G., Ayello, E.A., Capitulo, K.L., Fowler, E., Krasner, D.L., Levine,
J.M., Sibbald, R.G., & Smith, A.P. (2008) New opportunities to improve pressure
ulcers prevention and treatment.-Implications of the CMS inpatient hospital care
present on admission (POA) indicates / hospital- acquired conditions (HAC)
policy. A consensus paper from the international expert wound care advisory
panel. Journal Wound Ostomy Continence Nurse. 35 (5) 485-492.
3. Answer cross word puzzle using the vocabulary words.
4. Read chapter 15 of the textbook by Lynn.
5. Complete the NCLEX questions from the link and print out your answers to
discuss in class
http://wps.prenhall.com/chet_kozier_fundamentals_7/11/2987/764799.cw/index.h
tml
NURS 204 Laboratorio de Destrezas Técnicas 41
Updated 06/29/2012
6. Visit the virtual library, read articles on IV solutions, and blood transfusions.
Summarize content learned with your partner in a PowerPoint presentation.
Key Core Vocabulary:
1. Edema
2. Approximated wound
3. Ecchymosis
4. Edema
5. Epithelialization
6. Erythema
7. Eschar
8. Granulation tissue
9. Ischemia
10. Jaundice
11. Maceration
12. Necrosis
13. Peripheral neuropathy
14. Pressure ulcer
15. Sinus tract
16. Vasoconstriction
17. Dehydration
18. Diffusion
19. Edema
20. Electrolyte
21. Filtration
22. Hydrostatic pressure
23. Hypervolemia
24. Ion
25. Osmosis
26. Solute
27. Solvent
NURS 204 Laboratorio de Destrezas Técnicas 42
Updated 06/29/2012
List of Supplementary Materials for the Workshop:
1. Virtual Library
2. Text book
3. Articles
SIOP Components - Place a checkmark (√) on the (___) for ALL strategies that will be
used in the workshop.
B. Scaffolding
___ Modeling
___ Guided Practice
___ Independent Practice
___ Comprehensible Input
C. Grouping Options
_x__ Whole Class
___ Small Groups
_x__ Partners
___ Independent Work
D. Integration of Processes
_x__ Listening
_x_ Speaking
_x__ Reading
_x__ Writing
E. Application
_x__ Hands-on
__x_ Meaningful/Relevant
___ Rigorous
__x_ Link to Objectives
_x__ Promote Engagement
A. Preparation
__x_ Adaptation of Content
__x_ Links to Background Knowledge
___ Links to Past Learning
__x_ Strategies Incorporated
CALLA Strategies (Cognitive Academic Language Learning Approach)
_x__ Cognitive
__x_ Meta-cognitive
__x_ Social/Affective
NURS 204 Laboratorio de Destrezas Técnicas 43
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Integrated Activities of Content and Language to achieve Content and Language
Objectives:
1. Build a model of the integumentary system and present to the class.
2. Prepare a poster comparing the stages of pressure ulcers and present to the
class.
3. View a video on wound care and hot and cold therapy.
4. Demonstrate wound care on mannequins.
5. Divide the students into groups, each group will discuss what they learned in the
assignment and prepare a poster to present to the class.
6. The students will prepare and build a model on how an IV infusion works, tell a
story applying concepts on a person.
7. Attend a conference and write a report using questions given as a guide
8. The students prepare a PowerPoint presentation on the chapter and present a
demonstration of the IV catheter insertion.
9. Facilitator will view all students’ implementation of catheter insertion cleansing.
Assessment:
1. Individual: The students’ second language proficiency will be assessed by using
appendix A and B.
2. Group: The students’ second language proficiency will be assessed by using
appendix A and B.
3. Written: The students’ second language proficiency will be assessed by using
appendix A and B.
4. Oral: The students’ second language proficiency will be assessed by using
appendix A and B.
Lesson Wrap-Up:
1. Individual: Demonstrtation of tecniques
2. Group: Poster presentation
NURS 204 Laboratorio de Destrezas Técnicas 44
Updated 06/29/2012
TALLER CINCO/WORKSHOP FIVE
(TWO HOURS IN SPANISH AND TWO HOURS IN ENGLISH)
NOTA: Este taller es bilingüe. Tanto, el
Facilitador como los estudiantes, deberán
utilizar el idioma asignado para cada tarea y
actividad. No mezcle los dos idiomas!
UTILICEN SOLAMENTE UN LENGUAJE
A LA VEZ! Las primeras dos horas serán en
español. Las últimas dos horas serán en
inglés.
NOTE: This is a bilingual workshop. Both the
facilitator and the student must use the
language assigned for each homework and
activity. Do not mix both languages! USE
ONE LANGUAGE AT A TIME- KEEP
BOTH LANGUAGES SEPARATE! The
first two hours must be in Spanish. The last
two hours must be in English.
Objetivos específicos de contenido:
Al finalizar el curso, los estudiantes podrán:
1. Identificar el método correcto de la oxigenación para el paciente (una cánula
nasal, mascarilla, etc).
2. Explicar y demostrar el cuidado correcto del tubo endotraqueal y la traqueotomía.
3. Explicar y demostrar el método correcto para la obtención de un
electrocardiograma.
4. Explicar y demostrar CPR.
5. Explicar las técnicas atención segura y eficaz para el paciente preoperatorio.
6. Demostrar técnicas de atención segura y eficaz para el paciente preoperatorio y la
aplicación de los dispositivos de calentamiento de aire forzado.
Objetivos específicos de lenguaje:
Al finalizar el curso, los estudiantes podrán:
1. Escuchar: Escuchar atentamente las discusiones y charlas que se den en el
entorno de aprendizaje y reflexionar críticamente a las mismas.
2. Hablar: Expresarse mutuamente sobre los conocimientos aprendidos acerca de
las competencias de enfermería en la oxigenación, la atención cardiovascular, y
técnicas atención segura y eficaz para el paciente preoperatorio.
NURS 204 Laboratorio de Destrezas Técnicas 45
Updated 06/29/2012
3. Leer: Analizar la literatura sobre las destrezas de enfermería en la oxigenación ,
la atención cardiovascular, y técnicas atención segura y eficaz para el paciente
preoperatorio.
4. Escribir: Escribir sobre las habilidades de enfermería en la oxigenación, la
atención cardiovascular, y técnicas atención segura y eficaz para el paciente
preoperatorio.
Enlaces electrónicos:
Biblioteca Virtual
http://bibliotecavirtualut.suagm.edu/
Topic: Cardiopulmonary resusitation (CPR)
http://www.mayoclinic.com/health/first-aid-cpr/FA00061
http://www.webmd.com/heart-disease/heart-failure/news/20101015/new-cpr-guidelines-
chest-compressions-first
Topic: Defibrillation
http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhyt
hmia/Defibrillation_UCM_305002_Article.jsp
Tema: Guías para realizar el oximetro de pulso
http://www.scielo.cl/pdf/rcher/v26n1/art10.pdf
Tema: Guías de manejo de tracheostomia
http://respira.com.mx/docs/f1286296627-0.pdf
Tema: Cuidado de enfermería quirúrgica (perioperativo)
http://books.google.com.pr/books?id=e2jqLEpXlDAC&pg=PA2&dq=tecnicas+de+enfer
meria+en+perioperatorio&hl=en&sa=X&ei=8QXpT7iRIY6E8ATcg4C_DQ&redir_esc=
y#v=onepage&q=tecnicas%20de%20enfermeria%20en%20perioperatorio&f=false
Tema: Factores de riesgo en paciente operado de cadera
http://www.scielo.br/pdf/rlae/v19n6/es_12.pdf
Asignaciones antes del taller:
Asignaciones a discutirse durante las primeras dos horas de instrucción (2).
1. Los estudiantes harán un PowerPoint de uno de los siguientes tópicos para
presentar a la clase:
NURS 204 Laboratorio de Destrezas Técnicas 46
Updated 06/29/2012
el cuidado del paciente con traqueotomía, con tubo endotraqueal,
el cuidado del paciente que tenga un sistema de drenaje torácico.
2. Los estudiantes visitarán la biblioteca virtual y buscarán información sobre los
diferentes tipos de técnicas de oxigenación en enfermería.
3. Divide al grupo en grupos de cuatro personas. Cada grupo preparará una
presentación de PowerPoint en la materia asignada por el facilitador.
4. Visitar la bibloteca virtual y leer sobre el tema. Traer un resumen a la clase.
Assignments to be discussed during the last two hours of instruction:
1. The students will be divided into groups of two and will develop a PowerPoint
presentation on the following topics: obtaining an electrocardiogram, latest
guidelines to performing CPR, use of an external pacemaker and removing
arterial and femoral lines.
2. The students will visit the virtual library and look for information securing and
suctioning tracheostomy.
Vocabulario académico clave –
1. Los gases arteriales- Arterial Blood Gases
2. Paro cardíaco- cardiac arrest
3. Monitoreo cardiaco- Cardiac Monitoring
Academic Core Vocabulary
1. Hyperventilation
2. Hypoventilation
3. pneumothorax
List of Supplementary Materials for the Workshop:
1. Video
2. PowerPoint
3. Text Book
NURS 204 Laboratorio de Destrezas Técnicas 47
Updated 06/29/2012
SIOP Components - Place a checkmark (√) on the (___) for ALL strategies that will be used in the
workshop.
1.
2.
3.
4.
5.
6.
7.
8.
Actividades integradas de contenido y lenguaje para lograr los objetivos del taller:
Actividades en español para las primeras dos horas del taller:
1. Los estudiantes tomarán el entrenamiento de CPR.
2. Los estudiantes explicarán y demostrarán la habilidad de obtener un electrocardiograma
correctamente.
3. Los estudiantes presentarán el PowerPoint a la clase.
4. Los estudiantes se dividían en grupos de cuatro y desarrollarán un plan educativo para el
paciente sobre el uso del espirómetro. Los estudiantes presentarán su plan durante la clase.
5. Ver una película sobre cuidado perioperativo e intervenciones ortopédicas.
6. Presentar PowerPoint a la clase sobre el cuidado a paciente sometido a cirugía general.
7. Demostrar atención segura y eficaz para el cuidado del paciente perioperatorio con maniquíes.
B. Scaffolding
___ Modeling
_x__ Guided Practice
__x_ Independent Practice
___ Comprehensible Input
C. Grouping Options
_x__ Whole Class
_x__ Small Groups
___ Partners
_x__ Independent Work
D. Integration of Processes
_x__ Listening
__x_ Speaking
__x_ Reading
_x__ Writing
E. Application
__x_ Hands-on
_x__ Meaningful/Relevant
_x__ Rigorous
_x__ Link to Objectives
___ Promote Engagement
A. Preparation
_x__ Adaptation of Content
___ Links to Background Knowledge
___ Links to Past Learning
_x__ Strategies Incorporated
CALLA Strategies
(Cognitive Academic Language Learning Approach)
_x__ Cognitive
___ Meta-cognitive
___ Social/Affective
NURS 204 Laboratorio de Destrezas Técnicas 48
Updated 06/29/2012
Integrated content and language activities aligned to achieve workshop objectives:
Activities in English for the last two hours of the workshop:
1. The students will be divided into groups to discuss what they learned from the article: Tagney,
J. & Lackie, D. (2005). Bed rest past femoral arterial sheath removal- What is safe practice? A
clinical audit. British Association Critical care nursing. 10,p 167-173. Retrieved from:
http://www.uhbristol.nhs.uk/media/1385243/02_ncr121.pdf
2. Divide the students in groups of four. Each group will discuss the case study found in the
textbook on pages 1009 and 1033. They will discuss the answers with other classmates.
3. The students will explain and demonstrate the different techniques of oxygenation of a patient
to the facilitator.
4. The students will watch a video on CPR and early defibrillation.
Assessment:
1. Individual: The students’ second language proficiency will be assessed by using appendix A
and B
2. Group: The students’ second language proficiency will be assessed by using appendix A, B and
F.
3. Written: The students’ second language proficiency will be assessed by using appendix A, B
and F.
4. Oral: The students’ second language proficiency will be assessed by using appendix A, B and
F.
Lesson Wrap-Up:
1. Individual: Written test
2. Group: The objectives will be discussed.
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APÉNDICES / APPENDIXES
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APPENDIX A
NATIONAL PROFICIENCY LEVELS FOR DIFFERENTIATED INSTRUCTION
Retrieved from: WIDA Consortium http://www.wida.us/
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Updated 06/29/2012
“Can Do” Listening Rubric
National Proficiency Levels Criteria
Starting
Identifies objects
Names concrete objects
Points to picture/object of the word heard
Follows simple commands
Repeats words or simple phrases
Understands simple messages – gestures, pointing
Emerging
Draws a picture
Requires continuous repetition
Follows verbal dictations
Checks-off words that were heard
Repeats information heard to determine comprehension
Understands slow speech and multiple repetitions
Developing Understands more details of spoken language
Needs limited or no repetition and slow speech
Understands basic academic vocabulary which is frequently used in class discussions
Understands class discussions with some difficulty
Understands most of what was said
Expanding Needs limited or no repetition at normal speed speech
Understands academic vocabulary used in class discussions
Understands class discussions with little difficulty
Understands nearly everything said
Bridging Needs no repetition at normal speed speech
Understands elaborate academic vocabulary used in class discussions
Understands class discussions with no difficulty
Demonstrates a native-like English speaker’s understanding of what is said
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“Can Do” Speaking Rubric
National Proficiency
Levels
Criteria
Starting Names concrete objects
Responds a simple yes or no to questions
Repeats words or simple phrases
Uses one word commands
Mispronounces words making it difficult to be understood
Breaks speech into parts making comprehension difficult
Uses limited or no vocabulary to support message
Emerging Uses a few more words to respond to questions although grammatically incorrect
Uses one-, two-, and multiple-word commands
Uses verb tenses interchangeably
Misuses words in daily speech
Repeats spoken words or phrases to improve understanding due to pronunciation flaws
Uses grammar and word order incorrectly
Uses vocabulary (emerging stage) to support oral messages
Developing Responds using longer phrases/sentences
Initiates and carries out conversations; however, there may be interruptions due to thinking of the
correct words to say
Applies grammar and word order correctly most of the time
Demonstrates correct use of basic academic vocabulary which is frequently used in class
discussions and/or oral assignments.
Speaks with some hesitation
Uses vocabulary to support oral messages
Speaks with less difficulty, but listener must pay close attention to pronunciation.
Expanding Responds using elaborate phrases/sentences
Uses and interprets idiomatic expressions
Converses more fluently in social settings
Uses academic vocabulary frequently in class discussions
Participates in class discussions using academic content with slight hesitation
Misuse of grammar and word order seldom occurs and does not interrupt meaning
Pronounces most words accurately and clearly
Bridging Speaks fluently
Uses elaborate academic vocabulary in all class discussions correctly
Participates in class discussion using academic content without hesitation
Uses appropriate vocabulary to support oral messages at all times
Uses correct grammar and word all the time
Speaks with native-like pronunciation and intonation
NURS 204 Laboratorio de Destrezas Técnicas 53
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“Can Do” Reading Rubric
National Proficiency
Levels
Criteria
Starting Lacks comprehension of a wide array of written material (not developed)
Lacks ability to interpret graphs, charts, tables, and forms in textbooks (not developed)
Struggles with use of pre-reading and reading skills (not developed)
Lacks ability to apply reading strategies in order to guess meanings of unfamiliar words from context (not
developed)
Struggles with use of strategic reading skills (in order to plan his/her reading assignments, diagnose deficiencies,
resolve deficiencies independently or with the help of others, etc.) (not developed)
Emerging Improving comprehension (slowly emerging) of a wide array of written material (e.g., fictional and non-fictional
texts that bridge personal, professional and academic themes, news articles, short stories, short novels, etc.)
Demonstrates correct interpretation of basic graphs, charts, tables and forms in textbooks
Applies limited pre-reading (e.g., activation of prior knowledge, semantic maps, etc.) and reading skills (e.g.,
skimming, scanning, inferences, paragraph frames, DRA, SQ4R, etc.) (slowly emerging)
Struggles with ability to use limited reading strategies to guess meanings of unfamiliar words from context (e.g.,
definition, restatement, examples, surrounding words, etc.) is
Strives to understand (even when not successful) the relationship between ideas (e.g., time, logical order,
comparison/contrast, cause/effect), and reading patterns in order to identify literary genres (as listed above)
Applying successful reading skills (as listed above) are still emerging
Developing Comprehends a wide array of written material (as listed above)
Interprets basic graphs, charts, tables and forms
Applies correctly pre-reading and reading skills (as listed above)
Applies correct use of reading strategies to guess meanings of unfamiliar words from context (as listed above)-
evidence of emerging.
Understands the relationship between ideas (as listed above)-evidence of emerging..
Uses strategic reading skills (as listed above) that are evident.
Expanding Comprehends a wide array of level-appropriate written materials (as listed above) with mature accuracy
Interprets increasingly complex graphs, charts, tables, and forms accurately
Applies pre-reading and reading skills (as listed above) very strongly
Applies strategies to guess meanings of unfamiliar words from context (as listed
above) which is clearly evident
Identifies signal words to understand the relationship between ideas (as listed above), and reading patterns to
identify literary genres (as listed above)- emerging strongly
Understands the relationship between ideas (as listed above)-strongly evident.
Uses strategic reading skills (as listed above) with mature accuracy
Bridging Comprehends various types and lengths of level appropriate written materials (as listed above)-fully developed
Interprets complex graphs, charts, tables, and forms accurately
Applies pre-reading and reading skills (as listed above)-fully developed
Applies reading strategies to determine the meaning of unfamiliar words in a text (as listed above) with accuracy
Understands the relationship between ideas (time, logical order, comparison/contrast, cause/effect)
Demonstrates fully developed strategic reading skills (as listed above)
NURS 204 Laboratorio de Destrezas Técnicas 54
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“Can Do” Writing Rubric
National Proficiency
Levels Criteria
Starting Lacks clear writing and focus.. Details are limited or unclear. There’s no clear distinction to what is important and what is supported.
Lacks engaging and drawing a conclusion. Paper simply starts and ends. Lack of transitions make it difficult to understand the paper.
Writes with limited use of vocabulary or specific words to transmit meaning of the essay. Misuse of parts of speech makes it difficult to understand
the writing.
Rambles- use of incomplete sentences that are too long to understand. Sentences follow a simple structure and or style.
Struggles with spelling, punctuation capitalization and other writing conventions. This makes it very difficult to understand the writing.
Lacks strategic writing skills (e. g., knowledge of the writing process; declarative, procedural and conditional knowledge; and strategies for inquiry, for
drafting [such as investigating genre, considering audience, and responding to purpose], and for product revision) that are clearly not developed.
Emerging Writes sentences that are still unclear there seems to be a guide to a focused topic; however, it may drift at times. There is an attempt in details to
support main idea. Reader can still feel confused.
Attempts to write an introduction and or conclusion. Use of transitions helps, but paper is in need of more details.
Struggles with some vocabulary terms that are used inappropriately. Greater command of the parts of speech is developing,.
but many words are still used incorrectly.
Attempts to create a style of sentence structure here and there; although, for the most part it sticks to one style.
Shows need of improving spelling, punctuation, capitalization, and other writing conventions. It is still difficult to read the writing; but there are signs
of improvement.
Demonstrates emerging strategic writing skills.
Developing Writes with an unclear focus. Writing appears to be on one topic, but shifts to another topic at times. Support of main idea is lacking. Reader is left
with unanswered questions.
Attempts to write a proper introduction and conclusion however, both are dull or unclear. Transitions help connect ideas although at times they
distract the flow.
Selects and uses words appropriately; however, they are not higher level and need more vigor.
Formulates well-written sentences; however, style and structure of sentences are repetitious.
Demonstrates control of spelling, punctuation, capitalization, and other writing conventions. However, the writing could read and sound better by
improving conventions.
Utilizes strategic writing skills properly (now evident).
Expanding Writes with a focus in mind; however, there is room for improvement. Needs more relevant details to support the main idea.
Some readers’ questions can be answered, while others are left with doubt.
Uses a proper introduction and conclusion, however, some improvement is needed. Needs to continue using transitional words are properly in order to
allow the proper flow of ideas.
Selects and uses vocabulary words that are much more livelier and appropriate. Some common wording can be improved.
Writes with a definite style, and sentence structure is “catchy” with few mistakes.
Demonstrates good control of spelling, punctuation, capitalization, and other writing conventions. Mistakes are few and nothing distracts from the
writing.
Applies mature strategic writing skills.
Bridging Writing is clear and focused on a narrowed topic. Details are relevant and accurate, and they support the main ideas. Reader’s questions are answered
Writing has a clear introduction that’s hooks the reader and conclusion that leaves a lasting impression. Use of transitions helps the reader to connect
ideas. Reading flows and not dull.
Words used in the writing are specific and accurate. Vivid verbs and modifying words are present. Words used enhance the meaning of the writing.
There is a variety in length and structure of the sentences. The style of sentences varies on how they begin. Sentences create fluency and rhythm.
Excellent control of spelling, punctuation capitalization and other writing conventions.
Strategic writing skills are fully developed.
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APPENDIX B
THE WRITING PROCESS
6-TRAITS WRITING RUBRIC
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Appendix B
Six-Traits of Writing Rubric
Student’s Name:______________________________________ Date:___________________
Facilitator:______________________Course: ____________Assignment:_________________
Instructions: This rubric will be used to evaluate all written work done by the student in both
English and Spanish. Please refer to the trait that you are evaluating (i.e., Ideas and Content) and
write the score in the appropriate box. Select the criteria per level (6= highest, 1=lowest) that
best reflects the student’s writing ability.
Refer to all the Appendix (D) sheets that describe, in detail, all the writing traits that you are
evaluating in order to complete this rubric properly.
Criteria per Level
(From Highest to Lowest)
Writing Traits 6 5 4 3 2 1
1. Ideas and Content
2. Organization
3. Voice
4. Word Choice
5. Sentence Fluency
6. Conventions
Totals (Add all the totals down, then
across to obtain the Grand Total.)
Grand Total:
Final Score:_________________
Scoring Scale: (36-0)
Outstanding: 33-36 points = A
Very Good: 29-32 points = B
Satisfactory: 24-28 points =C
Fair: 19-23 points =D
Poor: 0-18 points = F
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Six Traits for Analytic Writing Rubrics
Trait #1: Idea and Content
Criteria per Level Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
6
The writing is exceptionally clear, focused and interesting. It holds the reader’s attention throughout. Main ideas stand out and are developed by strong support and rich details suitable to audience and purpose. The writing is characterized by • clarity, focus, and control. • main idea(s) that stand out. • supporting, relevant, carefully selected details; when appropriate, use of resources provides strong, accurate, credible support • a thorough, balanced, in-depth explanation/ exploration of the topic; the writing makes connections and shares insights. • content and selected details that are well suited to audience and purpose.
5
The writing is clear, focused and interesting. It holds the reader’s attention. Main ideas stand out and are developed by supporting details suitable to audience and purpose. The writing is characterized by • clarity, focus, and control. • main idea(s) that stand out. • supporting, relevant, carefully selected details; when appropriate, use of resources provides strong, accurate, credible support. • a thorough, balanced explanation/exploration of the topic; the writing makes connections and shares insights. • content and selected details that are well-suited to audience and purpose.
4
The writing is clear and focused. The reader can easily understand the main ideas. Support is present, although it may be limited or rather general. The writing is characterized by • an easily identifiable purpose. • clear main idea(s) • supporting details that are relevant, but may be overly general or limited in places; when appropriate, resources are used to provide accurate support. • a topic that is explored/explained, although developmental details may occasionally be out of balance with the main idea(s); some connections and insights may be present. • content and selected details that are relevant, but perhaps not consistently well chosen for audience and purpose.
3
The reader can understand the main ideas, although they may be overly broad or simplistic, and the results may not be effective. Supporting detail is often limited, insubstantial, overly general, or occasionally slightly off-topic. The writing is characterized by • an easily identifiable purpose and main idea(s). • predictable or overly-obvious main ideas or plot; conclusions or main points seem to echo observations heard elsewhere. • support that is attempted; but developmental details that are often limited in scope, uneven, somewhat off-topic, predictable, or overly general. • details that may not be well-grounded in credible resources; they may be based on clichés, stereotypes or questionable sources of information. • difficulties when moving from general observations to specifics.
2
Main ideas and purpose are somewhat unclear or development is attempted but minimal. The writing is characterized by • a purpose and main idea(s) that may require extensive inferences by the reader. • minimal development; insufficient details. • irrelevant details that clutter the text. • extensive repetition of detail.
1 The writing lacks a central idea or purpose. The writing is characterized by • ideas that are extremely limited or simply unclear. • attempts at development that are minimal or non-existent; the paper is too short to demonstrate the development of an idea.
Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
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Trait #2: Organization
Criteria per Level
6
The organization enhances the central idea(s) and its development. The order and structure are compelling and move the reader through the text easily. The writing is characterized by • effective, perhaps creative, sequencing; the organizational structure fits the topic, and the writing is easy to follow. • a strong, inviting beginning that draws the reader in and a strong satisfying sense of resolution or closure. • smooth, effective transitions among all elements (sentences, paragraphs, and ideas). • details that fit where placed
5
The organization enhances the central idea(s) and its development. The order and structure are strong and move the reader through the text. The writing is characterized by. • effective sequencing; the organizational structure fits the topic, and the writing is easy to follow. • an inviting beginning that draws the reader in and a satisfying sense of resolution or closure. • smooth, effective transitions among all elements (sentences, paragraphs, and ideas). • details that fit where placed. .
4
Organization is clear and coherent. Order and structure are present, but may seem formulaic. The writing is characterized by • clear sequencing. • an organization that may be predictable. • a recognizable, developed beginning that may not be particularly inviting; a developed conclusion that may lack subtlety. • a body that is easy to follow with details that fit where placed. • transitions that may be stilted or formulaic. • organization which helps the reader, despite some weaknesses.
3
An attempt has been made to organize the writing; however, the overall structure is inconsistent or skeletal. The writing is characterized by • attempts at sequencing, but the order or the relationship among ideas may occasionally be unclear. • a beginning and an ending which, although present, are either undeveloped or too obvious (e.g. “My topic is...”, “These are all the reasons that…”) • transitions that sometimes work. The same few transitional devices (e.g., coordinating conjunctions, numbering, etc.) may be overused. • a structure that is skeletal or too rigid. • placement of details that may not always be effective. • organization which lapses in some places, but helps the reader in others.
2
The writing lacks a clear organizational structure. An occasional organizational device is discernible; however, the writing is either difficult to follow and the reader has to reread substantial portions, or the piece is simply too short to demonstrate organizational skills. The writing is characterized by • some attempts at sequencing, but the order or the relationship among ideas is frequently unclear. • a missing or extremely undeveloped beginning, body, and/or ending. • a lack of transitions, or when present, ineffective or overused. • a lack of an effective organizational structure. • details that seem to be randomly placed, leaving the reader frequently confused.
1
The writing lacks coherence; organization seems haphazard and disjointed. Even after rereading, the reader remains confused. The writing is characterized by • a lack of effective sequencing. • a failure to provide an identifiable beginning, body and/or ending. • a lack of transitions. • pacing that is consistently awkward; the reader feels either mired down in trivia or rushed along too rapidly. • a lack of organization which ultimately obscures or distorts the main point.
Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
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Trait #3: Voice
Criteria per Level
6
The writer has chosen a voice appropriate for the topic, purpose and audience. The writer seems deeply committed to the topic, and there is an exceptional sense of “writing to be read.” The writing is expressive, engaging, or sincere. The writing is characterized by • an effective level of closeness to or distance from the audience (e.g., a narrative should have a strong personal voice, while an expository piece may require extensive use of outside resources and a more academic voice; nevertheless, both should be engaging, lively, or interesting. Technical writing may require greater distance.). • an exceptionally strong sense of audience; the writer seems to be aware of the reader and of how to communicate the message most effectively. The reader may discern the writer behind the words and feel a sense of interaction. • a sense that the topic has come to life; when appropriate, the writing may show originality, liveliness, honesty, conviction, excitement, humor, or suspense.
5
The writer has chosen a voice appropriate for the topic, purpose, and audience. The writer seems committed to the topic, and there is a sense of “writing to be read.” The writing is expressive, engaging or sincere. The writing is characterized by • an appropriate level of closeness to or distance from the audience (e.g., a narrative should have a strong personal voice while an expository piece may require extensive use of outside resources and a more academic voice; nevertheless, both should be engaging, lively or interesting. Technical writing may require greater distance.). • a strong sense of audience; the writer seems to be aware of the reader and of how to communicate the message most effectively. The reader may discern the writer behind the words and feel a sense of interaction. • a sense that the topic has come to life; when appropriate, the writing may show originality, liveliness, honesty, conviction, excitement, humor, or suspense.
4
A voice is present. The writer demonstrates commitment to the topic, and there may be a sense of “writing to be read.” In places, the writing is expressive, engaging, or sincere. The writing is characterized by • a questionable or inconsistent level of closeness to or distance from the audience. • a sense of audience; the writer seems to be aware of the reader but has not consistently employed an appropriate voice. The reader may glimpse the writer behind the words and feel a sense of interaction in places. • liveliness, sincerity, or humor when appropriate; however, at times the writing may be either inappropriately casual or personal, or inappropriately formal and stiff.
3
The writer’s commitment to the topic seems inconsistent. A sense of the writer may emerge at times; however, the voice is either inappropriately personal or inappropriately impersonal. The writing is characterized by • a limited sense of audience; the writer’s awareness of the reader is unclear. • an occasional sense of the writer behind the words; however, the voice may shift or disappear a line or two later and the writing become somewhat mechanical. • a limited ability to shift to a more objective voice when necessary.
2
The writing provides little sense of involvement or commitment. There is no evidence that the writer has chosen a suitable voice. The writing is characterized by • little engagement of the writer; the writing tends to be largely flat, lifeless, stiff, or mechanical. • a voice that is likely to be overly informal and personal. • a lack of audience awareness; there is little sense of "writing to be read." • little or no hint of the writer behind the words. There is rarely a sense of interaction between reader and writer.
1
The writing seems to lack a sense of involvement or commitment. The writing is characterized by • no engagement of the writer; the writing is flat and lifeless. • a lack of audience awareness; there is no sense of “writing to be read.” • no hint of the writer behind the words. There is no sense of interaction between writer and reader; the writing does not involve or engage the reader.
Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
NURS 204 Laboratorio de Destrezas Técnicas 60
Updated 06/29/2012
Trait #4: Word Choice
Criteria per Level
6
Words convey the intended message in an exceptionally interesting, precise, and natural way appropriate to audience and purpose. The writer employs a rich, broad range of words, which have been carefully chosen and thoughtfully placed for impact. The writing is characterized by • accurate, strong, specific words; powerful words energize the writing. • fresh, original expression; slang, if used, seems purposeful and is effective. • vocabulary that is striking and varied, but that is natural and not overdone. • ordinary words used in an unusual way. • words that evoke strong images; figurative language may be used.
5
Words convey the intended message in an interesting, precise, and natural way appropriate to audience and purpose. The writer employs a broad range of words which have been carefully chosen and thoughtfully placed for impact. The writing is characterized by • accurate, specific words; word choices energize the writing. • fresh, vivid expression; slang, if used, seems purposeful and is effective. • vocabulary that may be striking and varied, but that is natural and not overdone. • ordinary words used in an unusual way. • words that evoke clear images; figurative language may be used
4
Words effectively convey the intended message. The writer employs a variety of words that are functional and appropriate to audience and purpose. The writing is characterized by • words that work but do not particularly energize the writing. • expression that is functional; however, slang, if used, does not seem purposeful and is not particularly effective. • attempts at colorful language that may occasionally seem overdone. • occasional overuse of technical language or jargon. • rare experiments with language; however, the writing may have some fine moments and generally avoids clichés.
3
Language is quite ordinary, lacking interest, precision and variety, or may be inappropriate to audience and purpose in places. The writer does not employ a variety of words, producing a sort of “generic” paper filled with familiar words and phrases. The writing is characterized by • words that work, but that rarely capture the reader’s interest. • expression that seems mundane and general; slang, if used, does not seem purposeful and is not effective. • attempts at colorful language that seem overdone or forced. • words that are accurate for the most part, although misused words may occasionally appear, technical language or jargon may be overused or inappropriately used. • reliance on clichés and overused expressions.
2
Language is monotonous and/or misused, detracting from the meaning and impact. The writing is characterized by • words that are colorless, flat or imprecise. • monotonous repetition or overwhelming reliance on worn expressions that repeatedly distract from the message. • images that are fuzzy or absent altogether.
1
The writing shows an extremely limited vocabulary or is so filled with misuses of words that the meaning is obscured. Only the most general kind of message is communicated because of vague or imprecise language. The writing is characterized by • general, vague words that fail to communicate. • an extremely limited range of words. • words that simply do not fit the text; they seem imprecise, inadequate, or just plain wrong.
Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
NURS 204 Laboratorio de Destrezas Técnicas 61
Updated 06/29/2012
Trait #5: Sentence Fluency
Criteria per Level
6
The writing has an effective flow and rhythm. Sentences show a high degree of craftsmanship, with consistently strong and varied structure that makes expressive oral reading easy and enjoyable. The writing is characterized by • a natural, fluent sound; it glides along with one sentence flowing effortlessly into the next. • extensive variation in sentence structure, length, and beginnings that add interest to the text. • sentence structure that enhances meaning by drawing attention to key ideas or reinforcing relationships among ideas. • varied sentence patterns that create an effective combination of power and grace. • strong control over sentence structure; fragments, if used at all, work well. • stylistic control; dialogue, if used, sounds natural.
5
The writing has an easy flow and rhythm. Sentences are carefully crafted, with strong and varied structure that makes expressive oral reading easy and enjoyable. The writing is characterized by • a natural, fluent sound; it glides along with one sentence flowing into the next. • variation in sentence structure, length, and beginnings that add interest to the text. • sentence structure that enhances meaning. • control over sentence structure; fragments, if used at all, work well. • stylistic control; dialogue, if used sounds natural.
4
The writing flows; however, connections between phrases or sentences may be less than fluid. Sentence patterns are somewhat varied, contributing to ease in oral reading. The writing is characterized by • a natural sound; the reader can move easily through the piece, although it may lack a certain rhythm and grace. • some repeated patterns of sentence structure, length, and beginnings that may detract somewhat from overall impact. • strong control over simple sentence structures, but variable control over more complex sentences; fragments, if present, are usually effective. • occasional lapses in stylistic control; dialogue, if used, sounds natural for the most part, but may at times sound stilted or unnatural.
3
The writing tends to be mechanical rather than fluid. Occasional awkward constructions may force the reader to slow down or reread. The writing is characterized by • some passages that invite fluid oral reading; however, others do not. • some variety in sentences structure, length, and beginnings, although the writer falls into repetitive sentence patterns. • good control over simple sentence structures, but little control over more complex sentences; fragments, if present, may not be effective. • sentences which, although functional, lack energy. • lapses in stylistic control; dialogue, if used, may sound stilted or unnatural.
2
The writing tends to be either choppy or rambling. Awkward constructions often force the reader to slow down or reread. The writing is characterized by • significant portions of the text that are difficult to follow or read aloud. • sentence patterns that are monotonous (e.g., subject-verb or subject-verb-object). • a significant number of awkward, choppy, or rambling constructions.
1
The writing is difficult to follow or to read aloud. Sentences tend to be incomplete, rambling, or very awkward. The writing is characterized by • text that does not invite—and may not even permit—smooth oral reading. • confusing word order that is often jarring and irregular. • sentence structure that frequently obscures meaning. • sentences that are disjointed, confusing, or rambling. Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
NURS 204 Laboratorio de Destrezas Técnicas 62
Updated 06/29/2012
Trait #6: Conventions
Criteria per Level
6
The writing demonstrates exceptionally strong control of standard writing conventions (e.g., punctuation, spelling, capitalization, paragraph breaks, grammar and usage) and uses them effectively to enhance communication. Errors are so few and so minor that the reader can easily skim right over them unless specifically searching for them. The writing is characterized by • strong control of conventions; manipulation of conventions may occur for stylistic effect. • strong, effective use of punctuation that guides the reader through the text. • correct spelling, even of more difficult words. • paragraph breaks that reinforce the organizational structure. • correct grammar and usage that contribute to clarity and style. • skill in using a wide range of conventions in a sufficiently long and complex piece. • little or no need for editing.
5
The writing demonstrates strong control of standard writing conventions (e.g., punctuation, spelling, capitalization, paragraph breaks, grammar and usage) and uses them effectively to enhance communication. Errors are so few and so minor that they do not impede readability. The writing is characterized by • strong control of conventions. • effective use of punctuation that guides the reader through the text. • correct spelling, even of more difficult words. • paragraph breaks that reinforce the organizational structure. • correct capitalization; errors, if any, are minor. • correct grammar and usage that contribute to clarity and style. • skill in using a wide range of conventions in a sufficiently long and complex piece. • little need for editing.
4
The writing demonstrates control of standard writing conventions (e.g., punctuation, spelling, capitalization, paragraph breaks, grammar and usage). Minor errors, while perhaps noticeable, do not impede readability. The writing is characterized by • control over conventions used, although a wide range is not demonstrated. • correct end-of-sentence punctuation, internal punctuation may sometimes be incorrect. • spelling that is usually correct, especially on common words. • basically sound paragraph breaks that reinforce the organizational structure. • correct capitalization; errors, if any, are minor. • occasional lapses in correct grammar and usage; problems are not severe enough to distort meaning or confuse the reader. • moderate need for editing.
3
The writing demonstrates limited control of standard writing conventions (e.g., punctuation, spelling, capitalization, paragraph breaks, grammar and usage). Errors begin to impede readability. The writing is characterized by • some control over basic conventions; the text may be too simple to reveal mastery. • end-of-sentence punctuation that is usually correct; however, internal punctuation contains frequent errors. • spelling errors that distract the reader; misspelling of common words occurs. • paragraphs that sometimes run together or begin at ineffective places. • capitalization errors. • errors in grammar and usage that do not block meaning but do distract the reader. • significant need for editing.
2
The writing demonstrates little control of standard writing conventions. Frequent, significant errors impede readability. The writing is characterized by • little control over basic conventions. • many end-of-sentence punctuation errors; internal punctuation contains frequent errors. • spelling errors that frequently distract the reader; misspelling of common words often occurs. • paragraphs that often run together or begin in ineffective places. • capitalization that is inconsistent or often incorrect. • errors in grammar and usage that interfere with readability and meaning. • substantial need for editing.
1
Numerous errors in usage, spelling, capitalization, and punctuation repeatedly distract the reader and make the text difficult to read. In fact, the severity and frequency of errors are so overwhelming that the reader finds it difficult to focus on the message and must reread for meaning. The writing is characterized by • very limited skill in using conventions. • basic punctuation (including end-of-sentence punctuation) that tends to be omitted, haphazard, or incorrect. • frequent spelling errors that significantly impair readability. • paragraph breaks that may be highly irregular or so frequent (every sentence) that they bear no relation to the organization of the text. • capitalization that appears to be random. • a need for extensive editing.
Source: Arizona Department of Education. AIMS Six Trait Analytic Writing Rubric. Retrieved from https://www.ade.state.az.us/standards/6traits/
NURS 204 Laboratorio de Destrezas Técnicas 63
Updated 06/29/2012
Appendix C
ADMINISTRATION OF MEDICATION
NURS 204 Laboratorio de Destrezas Técnicas 64
Updated 06/29/2012
University of Turabo
School of Health Science
Baccalaureate Nursing Program
Name: __________________ Date: ______________
Administering an Intradermal Injection Y N/I
1. Gather equipment. Check each medication order against the original
physician’s order according to agency policy. Clarify any inconsistencies.
Check the patient’s chart for allergies.
2. Know the actions, special nursing considerations, safe dose ranges,
purpose of administration, and adverse effects of the medications to be
administered. Consider the appropriateness of the medication for this
patient.
3. Perform hand hygiene.
4. Move the medication cart to the outside of the patient’s room or
prepare for administration in the medication area.
5. Unlock the medication cart or drawer. Enter pass code and scan
employee identification, if required.
6. Prepare medications for one patient at a time.
7. Read the MAR and select the proper medication from the patient’s
medication drawer or unit stock.
8. Compare the label with the MAR. Check expiration dates and perform
calculations, if necessary. Scan the bar code on the package, if required.
9. If necessary, withdraw medication from an ampule or vial as described
NURS 204 Laboratorio de Destrezas Técnicas 65
Updated 06/29/2012
in Skills 5-2 and 5-3.
10. When all medications for one patient have been prepared, recheck
the label with the MAR before taking them to the patient.
11. Lock the medication cart before leaving it.
12. Transport medications to the patient’s bedside carefully, and keep the
medications in sight at all times.
13. Ensure that the patient receives the medications at the correct
time.
14. Identify the patient. Usually, the patient should be identified using
two methods. Compare information with the MAR or CMAR.
a. Check the name and identification number on the patient’s
identification band.
b. Ask the patient to state his or her name.
c. If the patient cannot identify him or herself, verify the patient’s
identification with a staff member who knows the patient for the second
source.
15. Close the door to the room or pull the bedside curtain.
16. Complete necessary assessments before administering medications.
Check allergy bracelet or ask patient about allergies. Explain the purpose
and action of the medication to the patient.
17. Scan the patient’s bar code on the identification band, if required.
18. Perform hand hygiene and put on clean gloves.
NURS 204 Laboratorio de Destrezas Técnicas 66
Updated 06/29/2012
19. Select an appropriate administration site. Assist the patient to the
appropriate position for the site chosen. Drape as needed to expose only
area of site to be used.
20. Cleanse the site with an antimicrobial swab while wiping with a firm,
circular motion and moving outward from the injection site. Allow the
skin to dry.
21. Remove the needle cap with the non-dominant hand by pulling it
straight off.
22. Use the non-dominant hand to spread the skin taut over the injection
site.
23. Hold the syringe in the dominant hand, between the thumb and
forefinger with the bevel of the needle up.
24. Hold the syringe at a 10-to-15 degree angle from the site. Place the
needle almost flat against the patient’s skin, bevel side up, and insert
the needle into the skin so that the point of the needle can be seen
through the skin. Insert the needle only about 1/8″ with entire bevel
under the skin.
25. Once the needle is in place, steady the lower end of the syringe. Slide
your dominant hand to the end of the plunger.
26. Slowly inject the agent while watching for a small wheal or blister to
appear.
27. Withdraw the needle quickly at the same angle that it was inserted.
NURS 204 Laboratorio de Destrezas Técnicas 67
Updated 06/29/2012
28. Do not massage area after removing needle. Tell patient not to
rub or scratch site. If necessary, gently blot the site with dry gauze
square. Do not apply pressure or rub the site.
29. Do not recap the used needle. Engage the safety shield or needle
guard, if present. Discard the needle and syringe in the appropriate
receptacle.
30. Assist the patient to a position of comfort.
31. Remove gloves and dispose of them properly. Perform hand hygiene.
32. Observe the area for signs of a reaction at determined intervals after
administration. Inform the patient of the need for inspection.
NURS 204 Laboratorio de Destrezas Técnicas 68
Updated 06/29/2012
University of Turabo
USA Campuses
School of Health Science
Baccalaureate Nursing Program
Name: __________________ Date: ______________
Administering an Intramuscular Injection YES NO
1. Gather equipment. Check each medication order against the original
physician’s order according to agency policy. Clarify any
inconsistencies. Check the patient’s chart for allergies.
2. Know the actions, special nursing considerations, safe dose ranges,
purpose of administration, and adverse effects of the medications to be
administered. Consider the appropriateness of the medication for this
patient.
3. Perform hand hygiene.
4. Move the medication cart to the outside of the patient’s room or
prepare for administration in the medication area.
5. Unlock the medication cart or drawer. Enter pass code and scan
employee identification, if required.
6. Prepare medications for one patient at a time.
7. Read the MAR and select the proper medication from the patient’s
medication drawer or unit stock.
8. Compare the label with the MAR. Check expiration dates and
perform calculations, if necessary. Scan the bar code on the package, if
required.
NURS 204 Laboratorio de Destrezas Técnicas 69
Updated 06/29/2012
9. If necessary, withdraw medication from an ampule or vial as
described in Skills 5-2 and 5-3.
10. When all medications for one patient have been prepared,
recheck the label with the MAR before taking them to the patient.
11. Lock the medication cart before leaving it.
12. Transport medications to the patient’s bedside carefully, and keep
the medications in sight at all times.
13. Ensure that the patient receives the medications at the correct
time.
14. Identify the patient. Usually, the patient should be identified using
two methods. Compare information with the MAR or CMAR.
a. Check the name and identification number on the patient’s
identification band.
b. Ask the patient to state his or her name.
c. If the patient cannot identify him or herself, verify the patient’s
identification with a staff member who knows the patient for the second
source.
15. Close the door to the room or pull the bedside curtain.
16. Complete necessary assessments before administering medications.
Check allergy bracelet or ask patient about allergies. Explain the
purpose and action of the medication to the patient.
17. Scan the patient’s bar code on the identification band, if required.
NURS 204 Laboratorio de Destrezas Técnicas 70
Updated 06/29/2012
18. Perform hand hygiene and put on clean gloves.
19. Select an appropriate administration site.
20. Assist the patient to the appropriate position for the site chosen.
Drape as needed to expose only area of site to be used.
21. Identify the appropriate landmarks for the site chosen.
22. Clean the area around the injection site with an antimicrobial swab.
Use a firm, circular motion while moving outward from the injection
site. Allow area to dry.
23. Remove the needle cap by pulling it straight off. Hold the syringe in
your dominant hand between the thumb and forefinger.
24. Displace the skin in a Z-track manner by pulling the skin down or
to one side about 1″ (2.5 cm) with your non-dominant hand and hold
the skin and tissue in this position.
25. Quickly dart the needle into the tissue so that the needle is
perpendicular to the patient’s body. This should ensure that it is given
using an angle of injection between 72 to 90 degrees.
26. As soon as the needle is in place, use the thumb and forefinger of
your non-dominant hand to hold the lower end of the syringe. Slide
your dominant hand to the end of the plunger.
27. Aspirate by slowly (for at least 5 seconds) pulling back on the
plunger to determine whether the needle is in a blood vessel. Watch
for a flash of pink or red in the syringe.
NURS 204 Laboratorio de Destrezas Técnicas 71
Updated 06/29/2012
28. If no blood is aspirated, inject the solution slowly (10 seconds per
milliliter of medication).
29. Once the medication has been instilled, wait 10 seconds before
withdrawing the needle.
30. Withdraw the needle smoothly and steadily at the same angle at
which it was inserted, supporting tissue around the injection site with
your non-dominant hand.
31. Apply gentle pressure at the site with a dry gauze.
32. Do not recap the used needle. Engage the safety shield or needle
guard, if present. Discard the needle and syringe in the appropriate
receptacle.
33. Assist the patient to a position of comfort.
34. Remove gloves and dispose of them properly. Perform hand
hygiene.
35. Evaluate patient’s response to medication within an appropriate
time frame. Assess site, if possible, within 2 to 4 hours after
administration.
NURS 204 Laboratorio de Destrezas Técnicas 72
Updated 06/29/2012
University of Turabo
USA Campuses
School of Health Science
Baccalaureate Nursing Program
Name: __________________ Date: ______________
Administering an Intramuscular Injection Yes No
1. Gather equipment. Check each medication order against the original
physician’s order according to agency policy. Clarify any
inconsistencies. Check the patient’s chart for allergies.
2. Know the actions, special nursing considerations, safe dose ranges,
purpose of administration, and adverse effects of the medications to be
administered. Consider the appropriateness of the medication for this
patient.
3. Perform hand hygiene.
4. Move the medication cart to the outside of the patient’s room or
prepare for administration in the medication area.
5. Unlock the medication cart or drawer. Enter pass code and scan
employee identification, if required.
6. Prepare medications for one patient at a time.
7. Read the MAR and select the proper medication from the patient’s
medication drawer or unit stock.
8. Compare the label with the MAR. Check expiration dates and
perform calculations, if necessary. Scan the bar code on the package, if
NURS 204 Laboratorio de Destrezas Técnicas 73
Updated 06/29/2012
required.
9. If necessary, withdraw medication from an ampule or vial as
described in Skills 5-2 and 5-3.
10. When all medications for one patient have been prepared,
recheck the label with the MAR before taking them to the patient.
11. Lock the medication cart before leaving it.
12. Transport medications to the patient’s bedside carefully, and keep
the medications in sight at all times.
13. Ensure that the patient receives the medications at the correct
time.
14. Identify the patient. Usually, the patient should be identified using
two methods. Compare information with the MAR or CMAR.
a. Check the name and identification number on the patient’s
identification band.
b. Ask the patient to state his or her name.
c. If the patient cannot identify him or herself, verify the patient’s
identification with a staff member who knows the patient for the second
source.
15. Close the door to the room or pull the bedside curtain.
16. Complete necessary assessments before administering medications.
Check allergy bracelet or ask patient about allergies. Explain the
purpose and action of the medication to the patient.
NURS 204 Laboratorio de Destrezas Técnicas 74
Updated 06/29/2012
17. Scan the patient’s bar code on the identification band, if required.
18. Perform hand hygiene and put on clean gloves.
19. Select an appropriate administration site.
20. Assist the patient to the appropriate position for the site chosen.
Drape as needed to expose only area of site to be used.
21. Identify the appropriate landmarks for the site chosen.
22. Clean the area around the injection site with an antimicrobial swab.
Use a firm, circular motion while moving outward from the injection
site. Allow area to dry.
23. Remove the needle cap by pulling it straight off. Hold the syringe in
your dominant hand between the thumb and forefinger.
24. Displace the skin in a Z-track manner by pulling the skin down or
to one side about 1″ (2.5 cm) with your non-dominant hand and hold
the skin and tissue in this position.
25. Quickly dart the needle into the tissue so that the needle is
perpendicular to the patient’s body. This should ensure that it is given
using an angle of injection between 72 to 90 degrees.
26. As soon as the needle is in place, use your thumb and forefinger of
your non-dominant hand to hold the lower end of the syringe. Slide
your dominant hand to the end of the plunger.
27. Aspirate by slowly (for at least 5 seconds) pulling back on the
plunger to determine whether the needle is in a blood vessel. Watch
NURS 204 Laboratorio de Destrezas Técnicas 75
Updated 06/29/2012
for a flash of pink or red in the syringe.
28. If no blood is aspirated, inject the solution slowly (10 seconds per
milliliter of medication).
29. Once the medication has been instilled, wait 10 seconds before
withdrawing the needle.
30. Withdraw the needle smoothly and steadily at the same angle at
which it was inserted, supporting tissue around the injection site with
your non-dominant hand.
31. Apply gentle pressure at the site with a dry gauze.
32. Do not recap the used needle. Engage the safety shield or needle
guard, if present. Discard the needle and syringe in the appropriate
receptacle.
33. Assist the patient to a position of comfort.
34. Remove gloves and dispose of them properly. Perform hand
hygiene.
35. Evaluate patient’s response to medication within an appropriate
time frame. Assess site, if possible, within 2 to 4 hours after
administration.
NURS 204 Laboratorio de Destrezas Técnicas 76
Updated 06/29/2012
University of Turabo
USA Campuses
School of Health Science
Baccalaureate Nursing Program
Name: __________________ Date: ______________
Administering Oral Medications YES NO
1. Gather equipment. Check each medication order against the original
physician’s order according to agency policy. Clarify any
inconsistencies. Check the patient’s chart for allergies.
2. Know the actions, special nursing considerations, safe dose ranges,
purpose of administration, and adverse effects of the medications to be
administered. Consider the appropriateness of the medication for this
patient.
3. Perform hand hygiene.
4. Move the medication cart to the outside of the patient’s room or
prepare for administration in the medication area.
5. Unlock the medication cart or drawer. Enter pass code and scan
employee identification, if required.
6. Prepare medications for one patient at a time.
7. Read the MAR and select the proper medication from the patient’s
medication drawer or unit stock.
8. Compare the label with the MAR. Check expiration dates and
perform calculations, if necessary. Scan the bar code on the package, if
NURS 204 Laboratorio de Destrezas Técnicas 77
Updated 06/29/2012
required.
9. Prepare the required medications:
a. Unit dose packages: Place unit dose-packaged medications in a
disposable cup. Do not open wrapper until at the bedside. Keep
narcotics and medications that require special nursing assessments in a
separate container.
b. Multi-dose containers: When removing tablets or capsules from a
multi-dose bottle, pour the necessary number into the bottle cap and
then place the tablets in a medication cup. Break only scored tablets, if
necessary, to obtain the proper dosage. Do not touch tablets with hands.
c. Liquid medication in multi-dose bottle: When pouring liquid
medications in a multi-dose bottle, hold the bottle so the label is against
the palm. Use the appropriate measuring device when pouring liquids,
and read the amount of medication at the bottom of the meniscus at eye
level. Wipe the lip of the bottle with a paper towel.
10. When all medications for one patient have been prepared,
recheck the label with the MAR before taking them to the patient.
Replace any multi-dose containers in the patient’s drawer or unit
stock. Lock the medication cart before leaving it.
11. Transport medications to the patient’s bedside carefully, and keep
the medications in sight at all times.
12. Ensure that the patient receives the medications at the correct
NURS 204 Laboratorio de Destrezas Técnicas 78
Updated 06/29/2012
time.
13. Identify the patient. Usually, the patient should be identified using
two methods. Compare information with the MAR or CMAR.
a. Check the name and identification number on the patient’s
identification band.
b. Ask the patient to state his or her name.
c. If the patient cannot identify him or herself, verify the patient’s
identification with a staff member who knows the patient for the second
source.
14. Complete necessary assessments before administering
medications. Check allergy bracelet or ask patient about allergies.
Explain the purpose and action of each medication to the patient.
15. Scan the patient’s bar code on the identification band, if required.
16. Assist the patient to an upright or lateral position.
17. Administer medications:
a. Offer water or other permitted fluids with pills, capsules, tablets, and
some liquid medications.
b. Ask whether the patient prefers to take the medications by hand or in
a cup.
18. Remain with the patient until each medication is swallowed.
Never leave medication at the patient’s bedside.
19. Perform hand hygiene. Leave the patient in a comfortable position.
NURS 204 Laboratorio de Destrezas Técnicas 79
Updated 06/29/2012
20. Check on the patient within 30 minutes, or time appropriate for
drug(s), to verify response to medication.
NURS 204 Laboratorio de Destrezas Técnicas 80
Updated 06/29/2012
UNIVERSIDAD DEL TURABO
USA CAMPUSES
DEPARTAMENTO CIENCIAS DE LA SALUD
PROGRAMA DE ENFERMERIA
EVALUACIÓN PROCEDIMIENTO DE ADMINISTRACIÓN DE MEDICAMENTOS I.V
PUSH
PROCEDIMIENTO EJECUCIÓN COMENTARIOS
SI NO 1. Coteja la tarjeta de Kardex del medicamento con la
orden médica.
1. Interpreta correctamente la orden.
2. Si hay algún error notifica a los miembros pertinentes.
3. Revisa los 6 correctos: nombre del medicamento,
dosis, vía, hora de administración, paciente correcto y
dosificación.
5. Consulta con el P.D.R. o con el farmacéutico sobre el
medicamento a ser administrado.
6. Conoce el diagnóstico, la acción del medicamento,
dosis usual del medicamento a ser administrado.
6. Verificar la edad, sexo y peso del cliente.
7. Verifica antecedentes de alergias, historial
farmacológico e historial dietético.
8. * Se lava las manos.
10. Obtiene acceso al almacén de medicamento, “stock”
de medicamento o carrito de medicamento, si es
narcótico.
10. Reúne todo el equipo a utilizar.
11. Prepara un medicamento a la vez.
12. Coteja el medicamento correctamente, observa el
nombre del medicamento 3 veces.
A. al tomarlo
B. al verificarlo con la tarjeta
C. al servirlo
NURS 204 Laboratorio de Destrezas Técnicas 81
Updated 06/29/2012
13. Observa la fecha de expiración.
15. Calcula dosis correctamente.
16. Prepara la dosis correcta medicamento correctamente
usando medidas asépticas (de acuerdo al
procedimiento), ya sea extrayéndolo de una ampolleta
o de un vial. En todo momento se debe mantener la
esterilidad de del procedimiento.
17. Coloca etiqueta a la jeringuilla si se va a utilizar otra
jeringuilla para irrigar con heparina y normal salina.
18. Prepara la solución salina en otra jeringuilla si es
necesario. Coloca etiqueta a esta jeringuilla.
18. Coloca la tarjeta y el medicamento en el carrito
(método convencional).
20. Cierra el gabinete de medicamento antes de abandonar
el área.
20. Lleva el material a utilizar y al medicamento ya
preparado a la unidad del cliente.
21. Identifica al paciente correctamente utilizando la
pulsera.
22. Explica el procedimiento al paciente utilizando un
vocabulario sencillo.
23. Proveer privacidad al cliente. Cierre la puerta, corra
la cortina y exponga solo la parte del cuerpo a utilizar.
24. Se lava las manos y se coloca los guantes limpios.
25. Ayuda al paciente a colocarse en una posición
adecuada.
27. Mide si es necesario los signos vitales.
28. Verifica retorno venoso según equipo.
28. Limpia con alcohol al 70% la salida más cerca de la
línea primaria.
29. Detener el flujo de la línea primaria.
NURS 204 Laboratorio de Destrezas Técnicas 82
Updated 06/29/2012
31. Inyecta de .5 a 2 ml de normal salina.
31. Inserta el medicamento según el flujo calculado.
32. Abre el flujo de la línea primaria.
33. Re-ajusta el flujo de la línea primaria
34. Deja cómodo al cliente.
35. Sube la baranda, baja la cama y deja el timbre cerca
del cliente.
36. Desecha el material en el recipiente adecuadamente
rotulado. Deja el área limpia.
37. Remueve sus guantes.
38. Se lava las manos.
39. Si es narcótico lo documenta inmediatamente después
de ser administrado.
40. Anota en el Kardex de medicamentos o en la hoja
correspondiente la administración de medicamento.
41. Documente en el expediente clínica del paciente
medicamento, dosis, horario, vía en que fue
administrado el medicamento.
42. Si se omitió el medicamento, si el paciente lo vomitó,
etc. documéntelo en el expediente y notifíquelo al
médico.
43. Regresa a la habitación para evaluar la respuesta del
paciente al medicamento a los 15-30 minutos.
45. Reporta en el expediente clínico.
1. Fecha
2. Hora
3. Medicamento
4. Ruta o vía
5. Reacción
6. Firma
46. Administrar el medicamento en un tiempo razonable.
Preparado por: Profa. Carmen L. Martínez Ortiz
FEBRERO 2011.
NURS 204 Laboratorio de Destrezas Técnicas 83
Updated 06/29/2012
Universidad del Turabo
Escuela de Ciencias de la Salud
Programa Sub-Graduado de Enfermería
Nombre___________________________ Fecha_________________ NURS 204
EVALUACIÓN PROCEDIMIENTO DE ADMINISTRACIÓN DE MEDICAMENTOS
SIMULTANEOS
PROCEDIMIENTO EJECUCIÓN
SI NO COMENTARIOS
1- Coteja la tarjeta de Kardex del medicamento
con la orden médica. Interpreta correctamente
la orden y si hay algún error notifica a los
miembros pertinentes.
2- Revisa los 6 correcto: nombre del cliente,
medicamento, dosis, vía, hora de
administración y dosificación
3-Consulta con el P.D.R. o con el farmacéutico
sobre el medicamento a ser administrado.
4- Verifica el diagnóstico médico del cliente,
edad, sexo, peso, nivel de conciencia,
antecedentes de alergias, historial
farmacológico e historial dietético.
5- Reúne todo el equipo a utilizar
6- Se lava las manos.
7- Obtiene acceso al almacén de
medicamentos, carrito de medicamentos, “stock
de medicamento” etc, si es narcótico.
8- Prepara un medicamento a la vez.
9- Coteja el medicamento tres (3) veces:
a. al tomarlo
b. al verificarlo con la tarjeta
al servirlo
10-Evalúa la fecha de expiración del
medicamento
11- Calcula dosis correcta.
12-Prepara la dosis correcta del medicamento
(de acuerdo al procedimiento), ya sea
extrayéndolo de una ampolleta o de un vial.
I13-13-Inserta el medicamento en la bolsa
NURS 204 Laboratorio de Destrezas Técnicas 84
Updated 06/29/2012
pequeña según compatibilidad del
medicamento. En todo momento mantiene la
esterilidad del procedimiento 14- Identifica la bolsa del medicamento
correctamente.
15- Coloca línea secundaria con medidas
asépticas y llena la línea.
16- Coloca la tarjeta y el medicamento en el
carrito (método convencional).
17- Cierra el gabinete de medicamentos antes
de abandonar el área
18- Lleva el material a utilizar y el
medicamento a administrar ya preparado a la
unidad del cliente
19- Identifica correctamente al cliente
utilizando la pulsera.
20- Explica al paciente el objetivo de la
medicación y su acción.
21- Provee privacidad. Cierra la puerta, corre
la cortina y solo expone el área a intervenir.
22- Se lava las manos y se coloca los guantes
limpios.
23- Sube la cama, baja la baranda y acomoda al
cliente
24- Toma si es requerido el pulso, respiración y
presión arterial al paciente
25- Baja la bolsa primaria de 6-8 pulgadas
26- Limpia con alcohol al 70% la salida de la
línea primaria donde se va a conectar la línea
secundaria.
27- De ser necesario por incompatibilidad de
sustancia, limpia la línea primaria insertando
solución IV
28- Inserta aguja de la línea secundaria y la
asegura.
29- Abre el regulador y ajusta el flujo según
calculado.
30- Al terminar re-ajusta el flujo de la línea
primaria y cierra la línea secundaria
31- Deja al cliente cómodo. Sube la baranda,
NURS 204 Laboratorio de Destrezas Técnicas 85
Updated 06/29/2012
baja la cama y deja el timbre cerca.
32- Desecha el material en el recipiente
adecuadamente rotulado. Deja el área limpia.
33- Se retira los guantes y se lava las manos
34- Cuando se administra narcóticos tiene
mayor precaución y cuidado. Documenta
inmediatamente después de administrarlo
35-Documenta en el kardex de medicamento o
en la hoja correspondiente la administración del
medicamento
36- Documenta en el expediente clínico del
paciente la dosis y horario en que fue
administrado el medicamento
37- Si se omite el medicamento, lo documenta
en el expediente y notifíca al médico.
38-Realiza un estimado de la reacción del
paciente a la terapia de medicamentos, tanto en
efectos adversos como los deseados. Regresa a
la habitación para evaluar la respuesta del
cliente de 15 a 30 minutos después de la
medicación
39- Si ocurre alguna reacción o algún error,
notifica al médico y llena las formas
pertinentes y documéntelo en el record del
paciente.
40- Reporta en el expediente clínico.
a. Fecha
b. Hora
c. Medicamento
d. Ruta o vía
e. Reacción
Y Firma
41- Administra el medicamento en un tiempo
razonable.
Preparado por: Carmen L. Martínez
Marzo 2011.
NURS 204 Laboratorio de Destrezas Técnicas 86
Updated 06/29/2012
Universidad del Turabo
Escuela de Ciencias de la Salud
Programa Sub-Graduado de Enfermería
Nombre___________________________ Fecha_________________
NURS 204
EVALUACIÓN PROCEDIMIENTO DE ADMINISTRACIÓN DE MEDICAMENTOS
SIMULTANEOS
PROCEDIMIENTO EJECUCIÓN
SI NO COMENTARIOS
1- Coteja la tarjeta de Kardex del medicamento
con la orden médica. Interpreta correctamente
la orden y si hay algún error notifica a los
miembros pertinentes.
2- Revisa los 6 correcto: nombre del cliente,
medicamento, dosis, vía, hora de
administración y dosificación
3-Consulta con el P.D.R. o con el farmacéutico
sobre el medicamento a ser administrado.
4- Verifica el diagnóstico médico del cliente,
edad, sexo, peso, nivel de conciencia,
antecedentes de alergias, historial
farmacológico e historial dietético.
5- Reúne todo el equipo a utilizar
6- Se lava las manos.
7- Obtiene acceso al almacén de
medicamentos, carrito de medicamentos, “stock
de medicamento” etc, si es narcótico.
8- Prepara un medicamento a la vez.
9- Coteja el medicamento tres (3) veces:
c. al tomarlo
d. al verificarlo con la tarjeta
al servirlo
10-Evalúa la fecha de expiración del
medicamento
11- Calcula dosis correcta.
12-Prepara la dosis correcta del medicamento
(de acuerdo al procedimiento), ya sea
extrayéndolo de una ampolleta o de un vial.
I13-13-Inserta el medicamento en la bolsa
NURS 204 Laboratorio de Destrezas Técnicas 87
Updated 06/29/2012
pequeña según compatibilidad del
medicamento. En todo momento mantiene la
esterilidad del procedimiento 14- Identifica la bolsa del medicamento
correctamente.
15- Coloca línea secundaria con medidas
asépticas y llena la línea.
16- Coloca la tarjeta y el medicamento en el
carrito (método convencional).
17- Cierra el gabinete de medicamentos antes
de abandonar el área
18- Lleva el material a utilizar y el
medicamento a administrar ya preparado a la
unidad del cliente
19- Identifica correctamente al cliente
utilizando la pulsera.
20- Explica al paciente el objetivo de la
medicación y su acción.
21- Provee privacidad. Cierra la puerta, corre
la cortina y solo expone el área a intervenir.
22- Se lava las manos y se coloca los guantes
limpios.
23- Sube la cama, baja la baranda y acomoda al
cliente
24- Toma si es requerido el pulso, respiración y
presión arterial al paciente
25- Baja la bolsa primaria de 6-8 pulgadas
26- Limpia con alcohol al 70% la salida de la
línea primaria donde se va a conectar la línea
secundaria.
27- De ser necesario por incompatibilidad de
sustancia, limpia la línea primaria insertando
solución IV
28- Inserta aguja de la línea secundaria y la
asegura.
29- Abre el regulador y ajusta el flujo según
calculado.
30- Al terminar re-ajusta el flujo de la línea
primaria y cierra la línea secundaria
31- Deja al cliente cómodo. Sube la baranda,
NURS 204 Laboratorio de Destrezas Técnicas 88
Updated 06/29/2012
baja la cama y deja el timbre cerca.
32- Desecha el material en el recipiente
adecuadamente rotulado. Deja el área limpia.
33- Se retira los guantes y se lava las manos
34- Cuando se administra narcóticos tiene
mayor precaución y cuidado. Documenta
inmediatamente después de administrarlo
35-Documenta en el kardex de medicamento o
en la hoja correspondiente la administración del
medicamento
36- Documenta en el expediente clínico del
paciente la dosis y horario en que fue
administrado el medicamento
37- Si se omite el medicamento, lo documenta
en el expediente y notifíca al médico.
38-Realiza un estimado de la reacción del
paciente a la terapia de medicamentos, tanto en
efectos adversos como los deseados. Regresa a
la habitación para evaluar la respuesta del
cliente de 15 a 30 minutos después de la
medicación
39- Si ocurre alguna reacción o algún error,
notifica al médico y llena las formas
pertinentes y documéntelo en el record del
paciente.
40- Reporta en el expediente clínico.
f. Fecha
g. Hora
h. Medicamento
i. Ruta o vía
j. Reacción
Y Firma
41- Administra el medicamento en un tiempo
razonable.
Preparado por: Carmen L. Martínez
Marzo 2011.
NURS 204 Laboratorio de Destrezas Técnicas 89
Updated 06/29/2012
Universidad del Turabo
Escuela de Ciencias de la Salud
Programa Sub-Graduado de Enfermería
Nombre___________________________ Fecha_________________
NURS 204
EVALUACIÓN PROCEDIMIENTO ADMINISTRACIÓN DE UN MEDICAMENTO SUBCUTANEO
ejecución
S
s
i
I
COMENTARIOS
2. Coteja la tarjeta de Kardex del
medicamento con la orden médica.
Interpreta correctamente la orden y si
hay algún error notifica a los
miembros pertinentes.
4. Revisa los 6 correcto: nombre del
cliente, medicamento, dosis, vía, hora
de administración y documentación.
6. Consulta con el P.D.R. o con el
farmacéutico sobre el medicamento a
ser administrado.
Verifica el diagnóstico médico del cliente,
edad, sexo, peso, nivel de conciencia,
antecedentes de alergias, historial
farmacológico e historial dietético.
7. Reúne todo el equipo a utilizar.
7. Se lava las manos.
8. Obtenga acceso al almacén de
medicamentos, carrito de
medicamentos, “stock de
medicamento” etc, si es narcótico.
9. Prepare un medicamento a la vez.
NURS 204 Laboratorio de Destrezas Técnicas 90
Updated 06/29/2012
9. Coteje el medicamento tres (3) veces:
a. al tomarlo
b. al verificarlo con la tarjeta
c. al servirlo
13. Evalúa la fecha de expiración del
medicamento.
Calcule dosis correcta
16. Lávese las manos.
Prepara el medicamento correctamente (de
acuerdo al procedimiento), ya sea
extrayéndolo.
17. Coloca la tarjeta y el medicamento en
el carrito (método convencional).
18. Cierra el gabinete de medicamentos
antes de abandonar el área.
18. Lleva el material a utilizar y el
medicamento a administrar ya
preparado a la unidad del paciente.
19. Identifique correctamente al cliente
por la pulsera.
19. Explica al paciente el objetivo de la
medicación y su acción.
Provee privacidad cierre la puerta y la cortina.
Si hay visitantes en el cuarto pídale
gentilmente que esperen en el exterior
de la habitación. Solo exponga la
parte del cuerpo a utilizar.
Se lava las manos y coloca guantes
limpios.
21. Sube la cama, baja la baranda y
NURS 204 Laboratorio de Destrezas Técnicas 91
Updated 06/29/2012
acomode al cliente.
22. Escoge la zona de punción apropiada.
Palpa y observa la zona en busca de
edema y dolor. Evita las zonas donde
hay cicatriz, hematomas, abrasiones, o
infección y amputación.
23. Cuando administra heparina
subcutánea usa las zonas de punción
abdominales.
24. En caso de inyecciones de insulina
diarias repetida, no utiliza la misma
zona de punción. Rota dentro de una
región anatómica y cambia luego la
zona anatómica. No volve a utilizar la
misma zona en un período de tres (3)
semanas.
25. Ayuda al paciente a colocarse en una
postura cómoda dependiendo de la
zona escogida.
a. Abdomen - el paciente
sentado en decúbito
supino.
b. Pierna - el paciente sentado
en la cama o silla.
26. Pide al paciente que relaje el brazo o
pierna, dependiendo la zona elegida.
Háblele de algún tema de interés.
Vuelve a situar las zonas utilizando las
prominencias anatómicas.
28. Limpia la zona con alcohol al 70%.
Coloque el “swabs” de alcohol en el
centro de la zona y realice
movimientos rotativos hacia afuera
NURS 204 Laboratorio de Destrezas Técnicas 92
Updated 06/29/2012
durante unos segundos. Coloca un “alcohol wipes” limpio entre el
tercer y cuarto dedo de la mano no
dominante.
29. Retira la cubierta de la aguja de la
jeringuilla tirando de este.
29. Sujeta la jeringuilla entre el dedo
pulgar y el dedo índice de su mano
dominante (como si fuera un dardo).
32. Aplica la inyección:
a. Para un paciente promedio con la
mano no dominante puede estirar
la piel de la zona de inyección o
coger un pellizco.
b. Para el paciente obeso, coja un
pellizco en la zona de punción e
inyecta la aguja debajo del
pliegue de tejido.
c. Introduzca rápidamente y con
firmeza la aguja en un ángulo e
45 grados. (Si coge un pellizco
suéltelo).
Una vez que la aguja penetre en la zona, coja
con la mano no dominante el extremo
inferior del cilindro de la jeringuilla.
Lleve la mano dominante al final del
embozo. Evite mover la jeringuilla.
32. Tire lentamente del embolo hacia
atrás para aspirar. En caso de
aparecer sangre en la jeringuilla, retire
la aguja, deseche la jeringuilla y
vuelva a preparar el medicamento. Si
no aparece sangre inyecte lentamente
el medicamento.
NURS 204 Laboratorio de Destrezas Técnicas 93
Updated 06/29/2012
32. Retira rápidamente la aguja a la vez
que coloca el “swabs” de alcohol
encima de la zona de punción.
33. Aplica masaje en la zona sino está
contraindicado..
34. Ayuda al paciente a colocarse en una
posición cómoda.
35. Desecha el material en el recipiente
adecuadamente rotulado. Deja el área
limpia.
36. Se quita los guantes y se lava las
manos.
37. Anota en el kardex de medicamento o
en la hoja correspondiente la
administración del medicamento.
38. Documenta en el expediente clínico
del paciente la dosis y horario en que
fue administrado el medicamento.
39. Si se omitió el medicamento, etc.
documéntelo en el expediente y
notifíquelo al médico.
40. Realiza un estimado de la reacción del
paciente a la terapia de medicamentos,
tanto en efectos adversos como los
deseados. Regresa a la habitación
para evaluar la respuesta del cliente de
15 a 30 minutos después de la
medicación.
41. Si hubo alguna reacción o algún error,
notifíquelo al médico y llene las
formas pertinentes y documéntelo en
el record del paciente.
NURS 204 Laboratorio de Destrezas Técnicas 94
Updated 06/29/2012
42. Reporta en el expediente clínico.
a. Fecha
b. Hora
c. Medicamento
d. Ruta o vía
e. Reacción
f. Firma
44. Administra el medicamento en un
tiempo razonable.
Preparado por Prof. Carmen L. Martínez RN MSN
Marzo 2011.
NURS 204 Laboratorio de Destrezas Técnicas 95
Updated 06/29/2012
APPENDIX D
CATHETERAZATION
NURS 204 Laboratorio de Destrezas Técnicas 96
Updated 06/29/2012
Universidad del Turabo
Escuela de Ciencias de la Salud
Programa Sub-Graduado en Enfermería
Nombre__________________ Fecha______________
Puntuación
EVALUACIÓN TO DE CATETERISMO DE VEJIGA
URINARIA FEMENINO Y MASCULINO
Procedimiento si no comentarios 1. Verifica orden médica.
2. Reúne todo el equipo y lo lleva a la
unidad del cliente.
3. Identifique al paciente correctamente.
4. Orienta sobre el procedimiento y
propósito al paciente y de le tiempo de
hacer preguntas.
5. Se lava las manos.
6. Provee privacidad.
7. Coloca al paciente en posición
apropiada.
A. Mujer: litotomía o dorsal
B. Varón: supina
8. Cubre al paciente adecuadamente.
9. Se asegura que tiene buena iluminación.
10. Se coloca guantes limpios de ser
necesario (según estimado de salud del
NURS 204 Laboratorio de Destrezas Técnicas 97
Updated 06/29/2012
cliente).
11. Lava la zona perineal y genital con agua
y jabón si es necesario.
12. Coloca el equipo cerca del área perineal
y prepárelo utilizando técnicas estériles.
13. Toma la toalla absorbente por las puntas
y la coloca debajo de los glúteos si es
mujer. Si es varón sobre los muslos,
evitando contaminarlo.
14. Se coloca los guantes estériles. Arregle
y prepare material de forma que no se
contamine.
15. Coloca la toalla fenestrada sobre el
área del periné del paciente,
evitando contaminarlo.
16. Crea un campo estéril, prepara y maneja
el resto del material sin contaminarlo.
17. Lubrica la punta del catéter:
A. Mujer: 1 1/2 pulgada (3.7 cm.)
B. Varón: 4-5 pulgadas (7.5 -10
cm). 18. Mujer: Con su mano no dominante
coloca el dedo pulgar e índice entre los labios
menores, isualice el meatus. Mantenga los
dedos es esa posición hasta que haya insertado
el catéter a la vejiga.
Varón: Con su mano no dominante
sujeta el pene en un ángulo de 900,
retraiga el prepucio (si no hay
circunsición) y visualice el meatus.
NURS 204 Laboratorio de Destrezas Técnicas 98
Updated 06/29/2012
Conserva su mano en esta posición hasta
que haya insertado el catéter a la vejiga.
19. Mujer: Con su mano dominante coge
la pinza y con ésta un algodón y limpiar
de arriba hacia abajo y descartar. Para
cada limpieza coger un algodón nuevo.
Varón: Con la mano dominante coge
una pinza y con ésta un algodón y
limpiar el pene utilizando movimientos
circulares desde el meatus hacia la base
del glande. 19. Levanta el catéter cuidando no
contaminarlo, coloque el extremo distal
en el envase para recoger la orina.
20. Inserta el catéter en el meatus hasta que
la orina empiece a salir.
Mujer: introduce entre 5 a 7.5
cm. (2-3 pulgadas).
Varón: Introduce entre 17.5 a 22
cm (6-10 pulgadas).
21. Recoje la muestra de orina según
indicada. Llena el frasco o vaso de la
muestra hasta el nivel deseado (20-30
ml.) Sujetando el final de la sonda con la
mano dominante sobre el envase. Luego
de colectar la orina deseada, deje que la
orina restante en la vejiga caiga dentro
de la bandeja.
22. Cuando la orina comienza a disminuir,
retira el catéter suavemente, hasta que
deje de salir la orina.
23. Limpia y descarta el material utilizado.
Coloque al paciente en una posición
NURS 204 Laboratorio de Destrezas Técnicas 99
Updated 06/29/2012
cómoda.
24. Identifica la muestra tomada. La coloca
en una bolsa y la envia al laboratorio
clínico con la bolsa indicada.
25. Se lava bien las manos.
26. Reporta en el expediente clínico.
(Resultados del procedimiento
incluyendo tamaño de la sonda, cantidad
y características de la orina y tolerancia
del paciente, etc.).
NURS 204 Laboratorio de Destrezas Técnicas 100
Updated 06/29/2012
APPENDIX E
BLOOD SAMPLING AND IV INFUSIONS
NURS 204 Laboratorio de Destrezas Técnicas 101
Updated 06/29/2012
UNIVERSIDAD DEL TURABO
ESCUELA DE CIENCIAS DE LA SALUD
PROGRAMA DE ENFERMERIA
EVALUACIÓN PROCEDIMIENTO DE UNA INFUSIÓN INTRAVENOSA
Nombre___________________________ Fecha_________________
Prof. __________________ NURS 204
PROCEDIMIENTO EJECUCIÓN
SI N
O
COMENTARIOS
1-Toma la orden médica y la pasa al Kardex.
2. Revisa los 6 correcto: nombre del cliente,
medicamento, dosis, vía, hora de administración y
dosificación.
3-Consulta con el P.D.R. o con el farmacéutico sobre el
medicamento a ser administrado.
4-Verifica el diagnóstico médico del cliente, edad, sexo,
peso, nivel de conciencia, antecedentes de alergias,
historial farmacológico e historial dietético.
5-Reúne todo el equipo a utilizar.
*6- Se lava las manos.
7-Obtiene acceso al almacén de medicamentos, carrito de
medicamentos, “stock de medicamento” etc, si es
narcótico.
8-Prepare un medicamento a la vez.
9-Coteja el medicamento tres (3) veces:
al tomarlo
al verificarlo con la tarjeta
al servirlo
10-Evalúa la fecha de expiración del medicamento.
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11. Calcula dosis correcta.
12. Prepara la dosis correcta del medicamento (de
acuerdo al procedimiento), ya sea extrayéndolo de una
ampolleta o de un vial. Inserta el medicamento en la bolsa
según compatibilidad del medicamento. En todo
momento se debe mantener la esterilidad del
procedimiento.
a- Abre el “set” de infusión (el empaque de la línea
primaria) manteniendo la esterilidad de ambos tubos (el
principio y final de la línea).
b- Sitúa el regulador (el “clamp”) de 2 a 4cm sobre la
cámara de goteo y colocar el rolo del regulador en “off”
(cerrar la línea
c-Retira la cubierta protectora de la bolsa o la botella
manteniendo esterilidad
d-Inserta el “set” de infusión a la bolsa o botella evitará
tocar los bordes de la línea
e- Rotula la bolsa de la solución: Nombre del paciente, la
fecha, la hora en que se preparó y frecuencia
f- Coloca el contenedor de la solución en el “stand” o pie
de suero. Ajustar el “stand” de forma que la bolsa quede
suspendida aproximadamente un metro por encima de la
cabeza del cliente
g- Llena parcialmente la cámara de goteo. Presionar la
cámara de goteo suavemente hasta que esté medio llena de
solución
h- Abre la línea y dejar que el fluido discurra a través del
tubo hasta que se eliminen todas las burbujas de aire
13- Organiza todo el equipo y llevarlo cerca del paciente.
14- Identifica al paciente y presentarse
15- Explica el procedimiento al cliente y a los padres. Si
el pte. es un menor o incapacitado Utilizar un muñeco
para hacer una demostración a niños y para explicar el
procedimiento a los padres.
16- Proporciona cualquier cuidado necesario antes de
establecer la infusión para minimizar el movimiento de la
extremidad afectada durante el procedimiento.
17- Se lava las manos y se coloca guantes limpios
18- Prepara el equipo.
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19-Selecciona y prepara el punto de punción venosa.
Comenzando por el extremo distal de la vena, seleccionar
un punto de ésta mediante palpación. En niño es
importante colocar la aguja en la mano, no dominante y en
la que no se chupe del dedo
20- En caso de necesidad, afeita la piel donde se va a
aplicar la cinta adhesiva (aproximadamente una zona de
5cm alrededor del punto elegido). Comprobar el
protocolo del centro.
21- Dilata vena. Coloca la extremidad en una posición
dependiente (más baja que el corazón del cliente
22- Aplica un torniquete firme de 15 a 20 cm por encima
del punto de punción. En niños, explicar que el torniquete
se sentirá como algo tenso.
23-Si la vena no está suficientemente dilatada.
a. Aplica masaje o presión sobre la vena,
distalmente al punto y en la dirección del
flujo venoso hacia el corazón.
b. Solicita al paciente que abra y cierre la
mano rápidamente.
Percute ligeramente la vena con la yema de los dedos
24- Ponernos guantes y limpiar el punto de punción
venosa.
c. Limpia la piel del punto de punción con
un antiséptico tópico, Ej. Alcohol y
después con una solución de Iodo
Povidona (Betadine).
d. Aplica un movimiento circular desde el
centro hacia afuera, varias pulgadas.
25- Inserta la aguja o el angio catéter e iniciar la infusión.
e. Utiliza un pulgar para tensar la piel bajo
el punto de entrada.
26-Introduce la aguja.
f. Para una aguja de mariposa, sujetar la
aguja con la punta en la dirección del
flujo sanguíneo, con un ángulo de 15
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grados, con el lumen hacia arriba y
punzar la piel sobre la vena
aproximadamente 1cm por debajo del
punto donde pretendemos punzar la
vena.
Para un angio catéter. Inserta el catéter por el método
directo o indirecto. El método directo es preferible para
venas grandes y el indirecto para venas pequeñas. Para
método directo sujetar el catéter con el lumen hacia arriba,
con ángulo de 15 grados e insertar a través de la piel.
Para el método indirecto, primero punzar la piel, después
reducir el ángulo y avanzar el catéter hasta que penetre en
la vena
27- En el momento que entra sangre en la aguja o el
catéter o experimentamos la falta de resistencia bajar el
catéter de forma que quede paralelo a la piel y después
terminarlo de entrar.
28- Soltar el torniquete.
29-Quitar la tapa protectora del extremo distal del tubo y
sujetarlo de forma que esté listo para unirlo al catéter,
manteniendo la esterilidad del extremo. Si es la aguja del
angio catéter, obstruir la vena donde está la punción y
retirar la aguja de metal
30- Unir la línea al angio catéter
31- Fija la aguja o catéter con cinta adhesiva.
g. Fija la aguja de mariposa colocando una
cinta adhesiva a lo largo de las alas, otro
pedazo de cinta adhesiva en forma de
corbata.
h. Hace un arco con el tubo y fijarlo al
apósito con cinta adhesiva.
Si es un niño coloca una tablilla en la mano para asegurar
el área de punción y cubrir con el esparadrapo necesario.
32- Cubree identifica el ärea de punción según el
protocolo del centro.
33- Coloca una etiqueta a la línea de la solución con la
fecha y hora en que se colocó y la fecha y la hora en que
se debe cambiar.
34- Regula el flujo de la solución. Si hay disponibles
colocar un “IV Pump”
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35- Recoge la unidad y descarta todo el material usado.
36- Se lava las manos.
37- Reporta en el expediente los datos relevantes,
incluyendo valoraciones.
i. Incluye fecha y hora de la punción
venosa.
j. Cantidad y tipo de solución utilizada.
k. Velocidad de la instilación
l. El número de la aguja o catéter.
m. Área corporal donde se administra la
infusión endovenosa .
Respuestas generales del cliente.
Preparado por: Prof. Carmen L. Martínez RN MSN
Marzo 2011.
NURS 204 TECHNICAL SKILLS 106
Updated 06/29/2012
University of Turabo
School of Health Science
Baccalaureate Nursing Program
Name: __________________ Date: ______________
Starting an Intravenous Infusion YES NO
1. Verify IV order against the physician order. Clarify any
inconsistencies. Check the patient’s chart for allergies. Check for color,
clarity, expiration date, etc.
2. Know techniques for IV insertion, precautions, purpose of the IV
administration, and medications if ordered.
3. Gather all equipment and bring to bedside.
4. Identify the patient. Ask the patient if allergic to any medication,
iodine, or tape, as appropriate. If considering using an anesthetic
(numbing) cream or 1% lidocaine injection, check for allergies for these
substances as well.
5. Explain the need for the IV and procedure to patient.
6. Perform hand hygiene. If using an anesthetic cream, apply the
anesthetic cream to a few potential insertion sites.
7. Prepare IV solution and tubing:
a. Maintain strict aseptic technique when opening sterile packages
and IV solution. Remove administration set from package.
b. Clamp IV tubing, uncap spike on administration set, and insert into
entry site on IV bag or bottle as manufacturer directs.
c. Squeeze drip chamber and allow it to fill at least halfway.
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d. Remove cap at end of the IV tubing and while maintaining its
sterility, open the IV tubing clamp, and allow fluid to move through
tubing. Allow fluid to flow until all air bubbles have disappeared and
the entire length of the tubing is primed (filled) with IV solution. Close
clamp and recap end of tubing, maintaining sterility of the setup.
e. If an electronic device is to be used, follow manufacturer’s
instructions for inserting tubing and setting infusion rate.
f. Apply label if medication was added to container (pharmacy may
have added medication and applied label). Label tubing with date and
time that tubing was hung.
g. Place time-tape on container and hang IV on pole.
8. Place patient in low Fowler’s position in bed. Place protective towel
or pad under patient’s arm. Close the door to the room or pull the
bedside curtain.
9. Provide emotional support as needed.
10. Select and palpate for an appropriate vein. Avoid an arm that
has been compromised such as with presence of arteriovenous
fistula.
11. If the site is hairy and agency policy permits, clip a 2″ area around
the intended site of entry.
12. Apply a tourniquet 3” to 4” above the venipuncture site to obstruct
venous blood flow and distend the vein. Direct the ends of the
tourniquet away from the site of entry. Make sure the radial pulse is still
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present.
13. Instruct the patient to hold the arm lower than the heart.
14. Ask patient to open and close fist. Observe and palpate for a suitable
vein. Try the following techniques if a vein cannot be felt:
a. Massage the patient’s arm from proximal to distal end and gently tap
over intended vein.
b. Remove tourniquet and place warm, moist compresses over intended
vein for 10 to 15 minutes.
15. Put on clean gloves.
16. If using intradermal lidocaine, cleanse insertion site with alcohol
using a circular motion. Inject a small amount (0.2–0.3 mL) of lidocaine
into the area. If numbing cream was used, wipe cream off insertion site.
Cleanse site with an antiseptic solution such as chlorhexidine or
according to agency policy. Use a circular motion to move from the
center outward for several inches.
17. Use the non-dominant hand, placed about 1″ or 2″ below entry site,
to hold the skin taut against the vein. Avoid touching the prepared
site. Ask the patient to remain still while performing the venipuncture.
18. Enter the skin gently, holding the catheter by the hub in your
dominant hand, bevel side up, at a 10- to 15-degree angle. Catheter may
be inserted from directly over the vein or the side of the vein. While
following the course of the vein, advance the needle or catheter into the
vein. A sensation of “give” can be felt when the needle enters the vein.
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19. When blood returns through the lumen of the needle or the
flashback chamber of the catheter, advance either device 1/8″ to 1/4″
farther into the vein. A catheter needs to be advanced until the hub is at
the venipuncture site, but the exact technique depends on the type of
device used.
20. Release the tourniquet as soon as possible. Quickly remove the
protective cap from the IV tubing and attach the tubing to the catheter or
needle. Stabilize the catheter or needle with your nondominant hand.
21. Start the flow of solution promptly by releasing the clamp on the
tubing. Examine the tissue around the entry site for signs of infiltration.
22. Secure the catheter with narrow non-allergenic tape (1/2″), placed
sticky side up under the hub and crossed over the top of the hub.
23. Place sterile dressing over venipuncture site. Agency policy may
direct nurse to use gauze dressing or transparent dressing. Apply tape to
dressing if necessary. Loop the tubing near the site of entry, and anchor
to dressing.
24. Label the IV dressing with the date, time, site, and type and size of
catheter used for the infusion on the tape anchoring the tubing.
25. Remove all equipment and dispose of properly. Remove gloves and
perform hand hygiene.
26. Anchor arm to an arm board for support if necessary, or apply a site
protector or tube-shaped mesh netting over the insertion site. Explain to
patient the purpose of the arm board and the importance of safeguarding
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the site when using the extremity.
27. Adjust the rate of solution flow according to the amount prescribed,
or follow manufacturer’s directions for adjusting flow rate on infusion
pump.
28. Document procedure and patient’s response. Chart time, site, device
used, and solution.
29. Return to check flow rate and observe IV site for infiltration 30
minutes after starting infusion. Ask the patient if experiencing any pain
or discomfort related to the IV infusion.
NURS 204 TECHNICAL SKILLS 111
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University of Turabo
School of Health Science
Baccalaureate Nursing Program
Name: __________________ Date: ______________
Using Venipuncture to Collect a Venous Blood Sample for Routine Testing S N/I
1. Gather the necessary supplies. Check product expiration dates. Identify
ordered tests and select the appropriate blood-collection tubes.
2. Identify the patient. Explain the procedure. Allow the patient time to ask
questions and verbalize concerns about the venipuncture procedure.
3. Close curtains around bed and close door to room if possible.
4. Provide for good light. Artificial light is recommended. Place a trash
receptacle within easy reach.
5. Assist the patient to a comfortable position, either sitting or lying. If the
patient is lying in bed, raise the bed to a comfortable working height. Expose
the arm, supporting it in an extended position on a firm surface, such as a table
top.
6. Perform hand hygiene.
7. Determine the patient’s preferred site for the procedure based on his or her
previous experience. Apply a tourniquet to the upper arm on the chosen side
approximately 3” to 4” above the potential puncture site. Apply enough
pressure to impede venous circulation but not arterial blood flow.
8. Assess the veins to determine the best puncture site. Observe the skin for the
vein’s blue color, or palpate the vein for a firm rebound sensation.
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9. Release the tourniquet. Check that the vein has decompressed.
10. Attach the needle to the Vacutainer device. Place first blood-collection tube
into the Vacutainer, but not engaged in the puncture device in the Vacutainer.
11. Put on non-sterile gloves. Clean the patient’s skin at the selected puncture
site with the antimicrobial swab. If using chlorhexidine, use a back-and-forth
motion, applying friction for 30 seconds to site, or procedure recommended by
the manufacturer. If using alcohol, wipe in a circular motion spiraling outward.
Allow the skin to dry before performing the venipuncture.
12. Reapply the tourniquet approximately 3” to 4” above the identified puncture
site. Apply enough pressure to impede venous circulation but not arterial blood
flow.
13. Hold the patient’s arm in a downward position with your nondominant
hand. Align the needle and Vacutainer device with the chosen vein, holding the
Vacutainer and needle in your dominant hand. Use the thumb or first finger of
non-dominant hand to apply pressure and traction to the skin just below the
identified puncture site.
14. Inform the patient that he or she is going to feel a pinch. With the bevel of
the needle up, insert the needle into the vein at a 15-degree angle to the skin.
15. Grasp the Vacutainer securely to stabilize it in the vein with your
nondominant hand, and push the first collection tube into the puncture device in
the Vacutainer, until the rubber stopper on the collection tube is punctured. You
will feel the tube push into place on the puncture device. Blood will flow into
the tube automatically.
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16. Remove the tourniquet as soon as blood flows adequately into the tube.
17. Continue to hold Vacutainer in place in the vein and continue to fill the
required tubes, removing one and inserting another. Gently rotate each tube as
you remove it.
18. After you have drawn all required blood samples, remove the last
collection tube from the Vacutainer. Place a gauze pad over the puncture
site and slowly and gently remove the needle from the vein. Engage needle
guard. Do not apply pressure to site until the needle has been fully removed.
19. Apply gentle pressure to the puncture site for 2 to 3 minutes or until
bleeding stops.
20. After bleeding stops, apply an adhesive bandage.
21. Check specimen labels with patient identification bracelet. Label should
include patient’s name and identification number, time specimen was collected,
route of collection, identification for person obtaining sample, and any other
information required by agency policy. Place label on the tubes per facility
policy. Place tubes in plastic sealable biohazard bag. Immediately transport to
laboratory.
22. Check the venipuncture site to see if a hematoma has developed.
23. Discard Vacutainer and needle in sharps container. Remove gloves and
perform hand hygiene.
24. Assist the patient to a comfortable position. If patient’s bed was raised,
place the bed in the lowest position.
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APPENDIX F
ORAL PRESENTATION
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UNIVERSIDAD DEL TURABO
ESCUELA DE CIENCIAS DE LA SALUD
PROGRAMA SUB-GRADUADO EN ENFERMERIA
Nombre ______________________ Fecha_______________
Profesor_______________________ Tópico______________
NURS________________________ Puntuación___________
Criterios de Evaluación para Informe Oral
Criterios 4 3 2 1 0 n/a Comentarios
1- Introduce el tema con claridad.
2-Menciona los objetivos del informe y
se guía por ellos.
3-Utiliza literatura profesional.
4- Promueve la participación del grupo.
5-Utiliza lenguaje profesional.
6-Demuestra dominio del tema.
7-Discute la implicaciones para
enfermería.
8- Se presenta el día y la hora asignada.
9-Utiliza tecnología informática en la
preparación y /o presentación del tema.
10- Hace un resumen al finalizar la
presentación
11- Evalúa el cumplimiento de los
objetivos.
Escala:
4 = Excelente- Cumple totalmente con los criterios.
3 = Bueno-Cumple los criterios con algunas limitaciones.
2 = Satisfactorio-Cumple con los criterios parcialmente.
1 = Deficiente- No cumple con la mayoría de los criterios
0 = No cumple con ninguno de los criterios