MINISTRY OF PUBLIC HEALTH

National Center for the Technical and Professional Perfection in Health

FUNDAMENTALS OF NURSING
STUDY PLAN

CARICOM Project
1 - GENERALITIES

SPECIALTY: Nursing

SUBJECT: Fundamentals of Nursing

QUALIFICATION OF THE GRADUATE: Nursing Technician (Registered Nurse)

INITIAL LEVEL: 9th grade

VOCATIONAL TRAINING: Complete

TYPE OF COURSE: Regular

SEMESTER OF COURSE: 1st and 2nd

YEAR: First

No. OF WEEKS: 40

WEEKLY FREQUENCY: 7

TOTAL OF HOURS OF THE SUBJECT: 280

2. PROGRAM OBJECTIVE

To explain the role that the nursing personnel carries out in the health care team, as the
main protagonists of the prevention, maintenance and recovery of man's health, through
the application of the principles that govern the nursing care actions, allowing the
nursing students to develop correctly the procedures on the methods for the cleaning,
preparation and disinfection of materials and sanitary instrumental, as well as the
admission and reception of the patient, the arrangement of the patient’s unit, the
participation in the physical exam and the administration of medical therapy through the
different via, having present the identification and satisfaction of the human necessities in
adults and children.
3. ORIENTATIONS FOR THE DEVELOPMENT OF THE SUBJECT
The social changes that have taken place have produced a revolution in the health field,
where Nursing has stopped to depend on other disciplines and has become an
independent profession with its own methodology for its development and application on
the base of a scientific conception.

This profession belongs to the social and morphological sciences, assisting the man
integrally, identifying the man’s necessities that are affected or modified and guiding the
nursing actions toward the application of the knowledge acquired from other sciences.

The subject Fundamentals of Nursing has been conformed keeping in mind the man's
current requirements, to maintain the homeostasis and all those actions that are meant to
satisfy his necessities. This subject is taught to 1st-year students and it is related to, and
leans on, other subjects like Anatomy and Physiology, Microbiology, Epidemiology and
Hygiene and Pharmacology, which facilitates the understanding of the contents that are
approached in the program. It is a basic subject since, as its name indicates, it stays
closely linked to programs that are taught later on such as Medical-Surgical Nursing,
Mother and Child Nursing, Nursing in Psychiatry and Nursing in Primary Health
Attention.

The Program is imparted in 280 hours at a reason of 7 periods weekly.

The contents of this program are designed to equip the students with the necessary
knowledge, habits and basic skills that will allow them to analyze and solve the problems
related with the care and security of their patients.

The head-teacher responsible for the Nursing specialty should veil for the existence of
criteria unity between the teachers
The head-teacher responsible for the Nursing Specialty should veil for the existence of
approaches unity among the teachers when teaching the different nursing procedures.
He/She should demand from the teachers the use of active methods of teaching, the
fulfillment of the didactic principles, as well as the continuous consultation of
bibliographies for the preparation and development of the lessons.

It is of vital importance that the teachers when beginning each one of the contents of the
program consolidate the knowledge already acquired by the students through this one and
other subjects and that keep relationship with the contents that will be developed.

Teachers should keep in mind that it is not only about supplying the students with a
logical system of knowledge, but rather that they are capable of applying this knowledge
in the practice of the nursing profession. This implies that the teacher should encourage
and guide the students to upgrade their knowledge by means of the systematic revision of
the contents, individually or in groups, making use of different resources like the school
library, the Internet, etcetera, which will provide them a wider horizon of the matter in
study, thus, not restricting the students to read only the text book or their lesson notes,
which will enable them to carry out theoric expositions of the contents with a bigger
domain of the matter in question, and also will provide them with the scientific basement
that will allow them to discern with initiative and precision the handling of instruments
and equipment to be used during their practices, and to be able to solve the different
situations that may arise during the practical activities.

Teachers should encourage the students to participate actively in the Practical Lessons in
the Laboratory. For these lessons the teacher should properly plan and orientate the
procedures to be exercised by the students avoiding conglomeration in the local. The
students will repeat and train each procedure until being able to execute it with a
minimum of errors.

To facilitate the teaching of this subject we recommend dividing the class according to
the type of lesson to be performed. For example:
For theoric lessons (whole class: 20 to 30 students)
For theoric-practical lessons (1/2 of the class: 10-15 students)
For practical lessons (1/3 of the class: 6-10 students)

As for each study unit of this program it is shown to the teachers the particular objectives
to be achieved, the theoric and practical activities to be carried out, as well as the contents
that need to be exercised and consolidated.

It is very important that teachers make sure that after having performed all the practical
activities of this program the students are able to carry out correctly the basic nursing
procedures and have satisfactorily fulfilled the program’s objectives being able to link in
an effective way the theoretical and practical knowledge.

In a year time the students will have acquired knowledge about a great number of nursing
procedures they should keep on practicing during the 2nd and 3rd year of study until
mastering the abilities and skills required for the nursing profession.

Teachers will determine the most appropriate modality to carry out the 4 seminars
contemplated in the program. To assess the student’s performance in the seminars the
following qualitative scale will be used:
A (equivalent to a score of 90-100 )
B (equivalent to a score of 80-89 )
C (equivalent to a score of 70-79 )
D (equivalent to a score of 60-69 )
E (equivalent to a score of 0-59 )
To obtain the student’s final mark it is necessary to assess the students in a minimum of
7 basic nursing procedures, which are listed below:
- Checking Vital Signs
- Administration of Intramuscular Injection
- Use of the Insulin and Tuberculin Syringes
- Intravenous infusion, dropping calculation and scale
- Nasogastric tube Procedures
- Administration of oxygen by nasal catheter
- Dressing Septic and Aseptic wounds

There have been dedicated 23 hours out of the total of practical hours of the program for
assessing the students on these procedures. During the examination progress the rest of
the students that are not being assessed, will be carrying out other activities orientated by
the teacher with the purpose of consolidating the student’s knowledge and skills on the
nursing procedures. The number of procedures to be carried out by the students during
the examination exercise will depend on the time available and the number of students to
be assessed. The student’s performance will be marked on the base of 100 points.

The correct use of teaching aids by teachers to impart this subject will make more
effective the teaching-learning process. It is also important that students and teachers
realize that the practical activities and exercises the students carry out are the main ways
to acquire the habits and skills they need for their performance as technician nurses.

4. - SUBJECT PLAN
Year: 1st r
Semester: 1st and 2nd
Frequency: 7 hours per week
Total of hours: 280 hours
UNIT THEME TOTAL hours PRACTICAL hours
1 Generalities of the nursing care 8 -
2 The man as subject and object of the
nursing care 4
3 Medical ethics and its link to the
nursing personnel work 4

SEMINAR ONE 2 2

4 Cleaning methods and disinfection techniques 14 8

5 Corporal mechanics 24 18
6 The patient’s unit and its components 16 10
7 Vital signs 26 18

SEMINAR TWO 2 2

8 Physical examination 8 4
9 Reception and admission of the patient 6 1
10 Hygienic needs 16 10

SEMINAR THREE 2 2
11 Nutritional needs 12 10
12 Medical therapy 104 72

SEMINAR FOUR 2 2

13 Sample collection 2 -
14 Wounds care 22 17

15 Patient’s discharge 4 2

SEMINAR FIVE 2 2

TOTAL 280 180

5. – ANALYTICAL PROGRAM
UNIT 1: GENERALITIES OF THE NURSING CARE
OBJECTIVE:
To explain the historical antecedents of Medicine, emphasizing on the definition of
Nursing, the evolution of this profession in the world, as well as the qualities a health
professional should possess and the principles that govern the nursing actions applying
them in their ways of acting.
TOPICS:
1.1- General description of the subject
1.2- Definitions of Nursing.
1.3- History of the national,region and world-wide evolution of Nursing
1.4- Qualities a health professional should possess as part of the society: honesty,
modesty and simplicity
1.5- Importance of the nurse’s behavior in society to set an example in the fight of habits
that are harmful to human health (smoking, drinking alcohol, drug addition, etcetera).
1.6- Principles that govern the nursing care.
1.7- Nursing personnel’s duties and rights
1.8- Nursing personnel’s functions
1.9- Ways for the professional upgrading of the nursing personnel
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
Before approaching the content of this unit the teacher will offer a general description of
the subject, its interrelation with other subjects and its importance for the exercise of the
nursing profession; as well as the student’s assessment ways, the bibliography to be used
and other aspects of interest for the students.
The historical antecedents of Nursing in the world will be exposed.
When approaching the topics 1.4 and 1.5, the teacher should put emphasis on the
importance of exhibiting a good behavior in society to set an example in the fight against
hazardous habits to health, as well as the importance of showing good presence as a
conditional factor for interacting with the patients and their relatives, insisting on the
appropriate use of the school uniform.
The teacher will describe the nursing principles, highlighting the value of applying them
in the patient's care.
The functions of the nursing personnel will be explained in a general way, as well as the
different forms available in the country for the development and upgrade of the nurse’s
professional level.
The duties and rights of nursing personnel and The Low of Health will be left as a
homework for students to read from the corresponding bibliography and it will be check
in the next lesson.
UNIT 2: THE MAN AS SUBJECT AND OBJECT OF THE NURSING CARE
OBJECTIVE:
To explain the importance of the balance between the man and the environment for the
maintenance of health, as well as the human necessities as starting point for the nursing
personnel’s scientific ways of acting, having as a premise the student’s precedent
knowledge
TOPICS:
2.1- The man as a biosocial being.
2.2- The man and the environment where he lives. Favorable and non-favorable
environmental conditions
2.3- Health and Illness. Concept of Physiologic Homeostasis
2.4- Concept and classification human necessities. Ways of satisfying the human
necessities.
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
Through a lecture the teacher will expose the interaction between the man and his
surroundings, as well as how the environment influences on the man’s health. For this,
the teacher can explore and use the background knowledge the students may already have
about other sciences like Microbiology and Hygiene & Epidemiology.
The students will be asked to list the environmental factors that influence negatively in
the man's health, being the result of this study, presented and analyzed in the next lesson.
The topic human necessities should be imparted according to the Maslow & Kalish’s
classification, making sure that the students are able to identify the human necessities as
well as the measures to be taken to satisfy them in health or sick individuals. The teacher
will highlight that the nursing work is meant to help the patient to satisfy his necessities
totally, when he is not able to satisfy them by himself.
This knowledge constitutes the basics of the Nursing Care Processes (NCP), for which
the teacher should offer at this moment a shallow explanation about the NCP, mentioning
that this aspect is fully studied in the Medical Surgical subject.
UNIT 3: MEDICAL ETHICS AND ITS LINK TO THE NURSING
PERSONNEL’S WORK
OBJECTIVE:
To value the fulfillment of ethical principles in the patient-doctor relations and in the
nursing performance, through the interpretation of the Medical Ethics’ concept, historical
evolution and principles
TOPICS:
3.1- Ethics and Deontology concepts.
3.2- Medical ethics as a peculiar manifestation of General Ethics.
3.3- Historical evolution of Medical Ethics and Medical Deontology.
3.4- Medical ethics general principles
3.5- The doctor-patient relations as an ethical question. Types of doctor-patient relations
3.6- Relations of the health professionals with patients and the influence of their personal
presence, manners, gestures, and capability to listen, understand and support the patient.
3.7- Specific characteristics of the doctor-patient relations as for the Primary Care Level
and for admitted patients.
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
The contents of this Unit will be approached on the bases of a general conception of
moral and ethics as forms of the social consciousness, making emphasis on its class
character.
The teacher will approach the general elements of the topic and the historical details of
the establishment and approval of the Medical Ethics Principles as well as the importance
of the nursing personnel having knowledge about and applying these principles,
especially in their relations with the patient and patient’s relatives, emphasizing on the
positive personal qualities this personnel should have and highlighting and criticizing the
negative aspects that some times are observed in practice.
SEMINAR Nr. 1
The teacher should prepare and hand in to the students well in advance a guide for them
to get ready for this seminar. The seminar is meant to assess the students on the
knowledge and abilities acquired by them through the study of the contents of units 1, 2
and 3. The teacher will decide the type of seminar to be carried out, for which it is
suggested to simulate situations, in a for of a role play or other, where the students will be
asked to observe and criticize the fulfillment of different aspects of the Medical Ethics
such as nursing personnel’s behavior, manners, personal presence, doctor-nurse relations,
and nurse-patient relations.
UNIT 4: CLEANING METHODS AND DISINFECTION TECHNIQUES
OBJECTIVE:
To perform the different asepsis and antisepsis techniques, through the cleaning,
disinfection and sterilization of materials, instrumental, equipment, apply concurrent and
terminal disinfection, carry out the social, medical and surgical washing of hands, as well
as fulfill the norms established for the Central Sterile Supply Department (CSSD) and the
functions of the nursing personnel in this department.
TOPICS:
4.1- Definition of cleaning, asepsis, antisepsis and sterilization.
4.2- High, intermediate and low-level disinfection.
- Definition of concurrent and terminal disinfection.
4.3- Definition of critical, semi-critical, non-critical and general maneuvers
4.4- Handwashing techniques (Definition, classification, objectives, precautions to
Consider, equipment to use and procedures)
4.5- Techniques for using disposable and surgical gloves.
4.6- Definition, structure and organization of the Central Sterile Supply Department
(CSSD) and its relations with other departments.
- Flow-chart (also flow-diagram) of work at the CSSD
- The CSSD requisites.
- Requirements established for the CSSD workers
4.7. - Functions of the nursing personnel working at the CSSD
4.8. - Sterilization methods (using physical means and using chemical means)
4.9. - The pre-sterilization and sterilization processes
4.10.-Preparation of materials
- Norms for the sterilization of instrumental, equipment, glassware, textile, rubber
materials and dressing materials.
4.11. - Control methods. The post – sterilization process
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
The understanding of the aspects approached in this Unit by the students is fundamental
for their correct formation as future nurses. It is essential that the teacher uses all possible
resources to achieve that the students interiorize that in the nursing practice, the asepsis is
constantly appealed to.
The teacher will highlight that for the different sterilization methods to be effective, it is
necessary the previous cleaning of materials, equipment and instrumentals with water and
soap to guarantee the decrease of bacteria and the removal of organic matters.
The teacher will explain the procedures for the cleaning and preparation for sterilization
of the different types of tubes, as well as the procedures for chemical disinfection,
standing out that for these substances to exercise their action it is indispensable to dry the
materials, instrumental and equipment after the mechanical cleaning. It will also be
insisted in the correct application of the different chemical solutions.
The teacher will show how carry out the concurrent and the terminal disinfection.
The students will consolidate their knowledge about sterilization when carrying out their
practices at the services and at the CSSD.
To prepare the lessons related to this Unit, the teacher will use the Epidemiology Norms
available in the country, emphasizing on the handling precautions to be obeyed when
cleaning and disinfecting materials, instrumental and equipment used for the care of
patients suffering from sexually transmitted diseases.
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN LABORATORY:
1. - Current (or social) handwashing
2. - Hygienic (or medical) handwashing
3. - Surgical handwashing
4. - Techniques for using disposable and surgical gloves
5. - Preparation of different types of materials for sterilization.
UNIT 5: CORPORAL MECHANICS:
OBJECTIVE:
To carry out the different procedures for patient’s transfer, patient’s positioning, ways of
mobilizing the on-bed patient, and application of active and passive exercises, as well as
the restriction techniques applied in adults and children and the appropriate nurse’s
positioning when delivering services.
TOPICS:
5.1 – Concept and Objectives of Corporal mechanics. Application of the Corporal
Mechanics based on the scientific principles
5.2 - Mobilization of the on-bed patient. Objective and general cautions
5.2.1- Active and passive exercises. Demonstration
5.2.2- Pressure ulcers. Signs and symptoms of pressure ulcers
Risk factors and susceptible regions for the development of pressure ulcers. Ways of
prevention
5.2.3- The transfer of the patient from the seat to the bed and vice versa.
5.2.4- The transfer of the patient from the stretcher to the bed and vice versa.
5.3. – Positioning a patient in bed: decubituses and positions
5.3.1- Dorsal decubitus or Supine Position
5.3.2- Lateral decubitus.
5.3.3- Prone decubitus.
5.3.4- Sited and semi-sited position
5.3.5- Sims’ position
5.3.6- Trendelenburg’s position
5.3.7- Gynecological position
5.3.8- Litotomia’s position
5.3.9- Genupectoral position
5.3.10-Sevillan-Knife’s position
5.3.11-Demonstration of the different decubituses and positions
5.4. – Restriction techniques applied in adults and children. Objectives and Precautions to
Consider
Demonstration of the restriction techniques
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT :
The study of this Unit will have as a premise the precedent knowledge the students may
have about Anatomy and Physiology. The teacher will emphasize on the importance of
fulfilling the corporal mechanics principles.

To impart these contents, it is suggested that the teacher use slides or sheets showing the
different corporal mechanics forms, types of patients’ transfer, as well as the decubitus
and positions. The teacher can also simulate the corporal mechanics with the students
participation.

When explaining the causes of pressure ulcers the teacher will put emphasis on the
importance of providing appropriate nursing cares to those patients that cannot move
freely, to prevent the development of pressure ulcers. For that reason it is necessary to
insist in the importance of the mobilization and the exercises in this type of patient.

The topic positions should be started by explaining the anatomical position, since to
mobilize the patients that don't have freedom of movements, it is necessary to keep in
mind the principles of this position, that’s to say, the appropriate alignment of all parts of
the body, the balanced distribution of weight, keeping maximum space in corporal
cavities for internal organs and keeping articulations in functional position.

The teacher will explain the differences between decubitus and positions making sure that
the students use these terms appropriately.
It should be explained that the basic principles of corporal mechanics must be applied
every moment it is carried out the transfer of the patient, the changes of patient position,
either to provide comfort to the patient, for therapeutic reasons or to fulfill the suitable
medical treatment
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN LABORATORY
6. - Transfer of the patient from the seat to the bed or vice versa.
7. - Transfer of the stretcher to the bed or vice versa
8. - Decubitus Supine, Lateral Left, Lateral Right and Prone.
9. - Seated Position, Semi-seated position, Sims’ position, and Trendelenburg’s position
10. - Gynecological Position
11. - Mobilization of the patient in bed.
12. - Active and passive exercises.
13. - Restriction techniques applied in children and adults.
UNIT 6: THE PATIENT’S UNIT AND ITS COMPONENTS:
OBJECTIVE:
To carry out the different procedures for the arrangement of beds, verifying previously
the components and hygiene of the patient's unit.
TOPICS:
6.1. The patient’s unit definition and components.
6.1.1- Preparation of the patient's unit.
6.1.2- Requirements to guarantee a comfortable atmosphere
6.2- The arrangement of the patient’s bed, definition and objectives.
6.2.1-Types of bed arrangements: closed bed, open bed, occupied bed, post-operative
bed, and cradle bed.
6.2.2- Precautions to Consider, equipment used and demonstration of bed makings.
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
The teacher will explain the components of the patient's unit and its hygiene, based on
the student’s precedent knowledge about Microbiology, Hygiene, Corporal Mechanics,
Epidemiology, Asepsis, Antisepsis, as well as concurrent and terminal disinfection.
He will insist that it is the nursing personnel's duty to veil for the hygienic conditions of
the medium that surrounds the patient.
The teacher will demonstrate the different procedures for making the patient’s bed;
highlighting the impact this has on the sick person who will enjoy lying on a bed that is
clean, without wrinkles, and comfortable for resting and sleeping, emphasizing in the
application of correct techniques for unmaking and remaking the bed to avoid the
propagation of microorganisms and infections in the hospital. The teacher will also
demonstrate the aesthetic conditions that patient's unit should maintain, with aligned beds
and the patient's belongings kept at the corresponding place.
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN LABORATORY:
Arranging the patient’s bed:
14. - The closed bed and open bed ( unoccupied bed)
15. - The occupied bed
16. - The post-operative bed
17. - The cradle bed
UNIT 7: VITAL SIGNS
OBJECTIVE:
To define vital signs, identifying the vital signs components, normal limits, and factors
that modify them, as well as to carry out the procedures for taking vital signs.
TOPICS:
7.1- Vital signs definition and classification
7.2- Body temperature definition and objectives
7.2.1-Factors that produce normal modifications of heat variations
7.2.2-Body temperature alterations, classification and symptoms
7.2.3-Normal body temperature limits and regions where it is measured
7.2.4- Procedures for measuring body temperature in the buccal region, axillary region,
flexion of the elbow and knee, and the rectal region. Precautions to Consider and
equipment to be used
7.2.5-Temperature registration graph
7.3- Pulse definition and objectives.
7.3.1- Factors that modify the pulse rate. Normal pulse limits and regions where it is
measured
7.3.2-Procedures for measuring the pulse in the arteries: temporal, carotid, radial,
humeral, femoral, foot. Cautions and equipment to be used
7.3.3-Pulse registration graph
7.4- Heart frequency definition and objectives. Normal heart frequency limits.
7.4.1- Procedures for measuring the heart frequency. Precautions to Consider and
equipment to be used
7.4.2-Heart frequency registration graph
7.5- Breathing rate definition and objectives.
7.5.1- Factors that modify the breathing movements. Normal breathing rate limits.
7.5.2-The different breathing rate types.
7.5.3- Procedures for measuring the breathing rate. Precautions to Consider and
equipment to be used
7.5.4- Breathing rate registration graph.
7.6- Blood pressure definition and objectives.
7.6.1- Factors that modify the blood pressure. Normal blood pressure limits and regions
where it is measured.
7.6.2- Procedures for measuring the blood pressure. Precautions to Consider and
equipment to be used
- Blood pressure registration graph.
7.7- The integrated measurement of vital signs.
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
Each one of the aspects of this Unit is considered as primordial for the student’s
knowledge and domain of the theoretical and practical contents, for which the teacher
will deliver the required scientific explanation of each epigraph with the use of the
appropriate teaching aids.
The teacher will put emphasis on the factors that modify the parameters of the vital
signs. As for the breathing frequency, the teacher will just enunciate physiological and
pathological alterations, without deeply explaining them.
The teacher will show the students the measuring instruments that are used for taking
the different vital signs, explaining in details the parts each instrument consists in, and
insisting in the importance of knowledge this for the right use of them.

The students will learn how to measure each vital sign separately and later on they
perform the different techniques in an integrated way, taking into account the fulfillment
of the corresponding medical ethics principles.
The students can practice taking vital signs among them in the classroom, making sure
they acquire the basic abilities, before they do it for real with patients.
It is of a great importance that students know that the taking of vital signs should be done
following a logical order, at the right regions, considering the relationship that exists
between them, as well as the correct registration in the graph taking into account the
normal figures according to the patient’s age.
In this unit the teacher will use 4 hours for assessing the students on the measurement of
vital signs.
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN LABORATORY
18. - Measuring body temperature
19. - Measuring pulse rate
20. - Measuring Heart frequency
21. - Measuring breathing frequency
22. - Measuring blood pressure
23. - Integrated measurement of vital signs
SEMINAR Nr.2
The teacher should prepare and hand in to the students well in advance a guide for them
to get ready for this seminar. The seminar is meant to assess the students on the
knowledge and abilities acquired by them through the study of units 4, 5, 6 and 7. The
teacher will decide the type of seminar to be carried out, which it is suggested to be
developed in 2 hours.
UNIT 8 THE PATIENT’S PHYSICAL EXAMINATION
OBJECTIVE:
To carry out the nursing personnel's functions for the preparation of the examination
room, the positioning of the patient, the taking of vital signs, as well as the patient’s
ponderation and mensuration, collaborating with the doctor in the physical examination
and to value the importance of the anamnesis for the registration of the obtained data in
the patient’s chart.
TOPICS:
8.1. - The patient’s chart definition and importance as an official document.
- Forms for data registration in the patient’s chart
- Order for data registration in the in-patient’s chart and the out-patient’s chart
8.2- Physical examination. Definition and Objectives
8.2.1-Parts of the physical examination: - General - Regional -By apparatuses
8.2.2-Exploratory Techniques: Inspection (Palpation, Percussion, Auscultation)
8.3- Investigations
8.4- Work of the nursing personnel in the physical examination. Preparation of the
examination room. Necessary equipment.
8.5- Ponderation definition and objectives.
- Demonstration of the procedure in children and adults. Precautions to Consider
and equipment to be used
- Registration of the results in the patient’s chart
8.6- Mensuration definition and objectives.
- Demonstration of the procedure for measuring height, and for measuring the
cephalic, abdominal and thoracic perimeters in children. Precautions to Consider
and equipment to be used
 SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT:
The teacher will explain the anamnesis and the patient’s chart, showing their elements
and uses when registering the results of the physical examination, the investigations that
are carried out to the patients, and the daily reports made by the nursing personnel,
insisting that the patient’s chart is an official document, therefore it should be well taken
care of by doctors and nurses.
It will be also emphasized in the privacy conditions in which the physical examination
should be carried out, as well as the duties of the nursing personnel during the course of
it.
The teacher will explain the different exploratory techniques for the physical
examination, highlighting that the taking of vital signs and the mensuration and
ponderation are done by the nurses as part of the physical examination
The students should handle and familiarize with the materials and equipment used for
medical examinations.
The teacher will also explain about the investigations carried out with more frequency in
the Clinical Laboratory and the x-ray Department and that contribute to a medical
diagnosis. It should be mentioned that there are also more advanced investigations, other
than the x-rays, that can be carried out on patients to get images of parts of his body, such
as Ultrasound, Nuclear Magnetic Resonance (NMR), and Axial Computerized
Tomography (ACT).
Besides, the teacher can relate a series of other investigations that are indicated for the
diagnosis of different illnesses, as well as the Departments where they are carried out.
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN LABORATORY:
24. - Preparation of the examination room
25. - Procedure for measuring weight
26. - Procedure for measuring height
27. - Procedure for measuring the cephalic, thoracic and abdominal perimeters
UNIT 9: THE ADMISSION AND RECEPTION OF THE PATIENT
OBJECTIVE:
To explain the importance of the admission of the patient and his companion in a health
institution, standing out the nursing personnel's functions in the patient's reception, as
well as the relations among the members of the health-care team and their relations with
the patient and his relatives, highlighting the duties and rights of the nursing personnel
and that of the patients, the combative attitude to criticize the performance of other
professionals and the keeping of the professional secret in certain situations.
Also, to value the utility of the Patient’s Chart and the importance of the forms that
compose it, and the official character of it, as well as to emphasize in the obligatory
notification measures followed by the health institution, when being diagnosed an illness
that can spread and affect the health of other people.
TOPICS:
9.1- Patient’s admission definition
9.1.1- The reception of the patient and his companions
9.2- The health personnel’s relations with the patient’s relatives
9.2.1- The special character of the doctor's relations with the patient’s relatives
* In the pediatric practice
* When giving information
* With the patient’s companions
9.3- The patient’s and his companion’s duties and rights
9.4- The health personnel’s relations with the rest of the workers and society in general
9.4.1-The doctor’s relations with other doctors, with other health workers and with the
community in general.
9.4.2- Deontological questions of the doctor's interrelations, the nursing personnel, other
technicians, the auxiliary personnel and the students.
9.4.3- The indiscrete criticism to the performance of other health professionals
9.4.4- The health personnel’s obligation to combat and to communicate violations of the
medical ethics principles
9.5- The Patient’s Chart components, classification and use. Registration of data, nurse’s
observations (evolution notes) in the patient’s chart
9.6- The Professional Secret and how far to keep it when giving information to the patient
and his relatives on the diagnosis and prognosis of an illness
9.6.1. Obligation of notifying the questions related to an illness, when it may affect the
health other people
SUGGESTIONS FOR THE DEVELOPMENT OF THE UNIT
The teacher will highlight that the initial impression that the patient and his companion
get about the Hospital, is the one that takes place during the admission and reception
process. He will also alert about the negativity of routine procedures that make the patient
lose his identity and will insist in the importance of the appropriate relationships that
between the health personnel and the patients' relatives and companions.

The teacher should also make emphasis in the practice of the professional secret which
unfulfillment can bring unfavorable transcendence for the patient, health personnel and
for the institution. For this he will indicate the students to study the patient and his
companion’s duties and rights.

Students will be given a guide to inform about the process of patient’s admission and use
of the Patient’s Clinical Chart. This will be discussed in class as a Practical Activity.
UNIT 10 HYGIENIC NEEDS
OBJECTIVE:
To carry out the procedures for personal hygiene, for the placement of the bedpan and
the male urinal and for the washingof hair, applying the corporal mechanics, as well as
for the treatment of pediculosis, using the suitable medication and patient's sanitary
education for its elimination
TOPICS
10.1 Definition of personal hygiene. Methods to achieve the personal hygiene.
10.1.1 Uses of the bedpan and urinal . Precautions. Demonstration.
10.1.2 Morning and evening cares. Cleaning of body cavities. Equipment. Demonstration.
10.2. The hygienic bath. Definition and Objectives. Types of baths.
10.2.1 Bath in bed. Definition and Objectives. Precautions. Equipment. Demonstration.
10.2.2 Techniques for dressing and undressing the patient. Demonstration.
10.3 Bath of the newborn. Definition and Objectives. Precautions. Equipment.
Demonstration
10.4 Pediculosis. Definition. Types of pediculosises. Precautions when applying the
treatment. Medications more frequently applied. Sanitary education. Equipment.
Demonstration of the elimination of the insect
10.5 Cares of the hair. Definition and Objectives. Precautions. Equipment. Demonstration
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN LABORATORY
No. 28 Placement of the bedpan and the male urinal (duck)
No. 29 Morning and Evening Cares
No. 30 Cleaning of body cavities.
No. 31 Bath in bed.
No. 32 Procedure to dress and undress the patient.
No. 33 Bath of the newborn.
No. 34 Cure of pediculosis.
No. 35 Wash of the hair.
SEMINAR No. 3
Will last two ours and the discussion will be about units 8, 9 and 10.
UNIT No. 11 NUTRITIONAL NEEDS.
OBJECTIVE:
To carry out the different procedures for feeding disabled sick persons
TOPICS
11.1 Concept of feeding. Classification of forms of feeding. Feeding
children and adults with affections that limit their movements. Feeding using
a tray, teaspoon and baby bottle. Definition and Objectives. Precautions. Equipment and
demonstration.
11.2 Nasogastric tube. Definition and Objectives. Precautions. Equipment and
demonstration.
11.3 Gastric suction. Definition. Objectives. Precautions. Equipment. Demonstration.
11.4 Nasogastric tube feeding. Definition. Objectives. Precautions. Equipment.
Demonstration.
PRACTICAL ACTIVITIES IN LABORATORY.
No. 36 Feeding procedure with tray, teaspoon and baby bottle.
No. 37 Procedure for nasogastric tube and gastric suctioning.
No. 38 Nasogastric tube feeding.
UNIT 12. MEDICATION THERAPY.
OBJECTIVE.
To manipulate and prepare the materials and equipment for the administration of
medication through different via, keeping in mind the normed general and specific
precautions and carry out the established procedures for the patient's recovery, avoiding
this way the medical mistake in the acting of the nursing personnel.
TOPICS
12.1 Definition and Objectives of medications. The nurses responsibilities in the
administration of medications. General and specific precautions.Precautions in the use of
narcotics
12.2 Medical error . Definition.
12.2.1 Ethical evaluation of the medical error.
12.2.2 Nature of the medical error. Analysis and behavior to follow.
12.2.3 Legal responsibility.
12.2.4 Effective legal dispositions for sanctioning medical errors.
12.3 Different via for the administration of medication
12.3.1 Measurements and equivalences more frequently used
12.4 Oral via. Definition. Objectives. Classification. Advantages and disadvantages.
Indications and contraindications. Precautions, equipment, and procedures.
12.5 Parenteral via. Definition. General classification. Administration of
medication by injection. Objectives, classification, and precautions.
12.5.1 Different types of needles and syringes used for the administration of
medications by injection.
12.5.2 Intramuscular-IM- injection . Definition and Objectives. Regions to be applied.
Advantages and disadvantages. Precautions, equipment, and procedures.
12.5.3 Subcutaneous-SQ- injection. Definition and Objectives. Regions to be applied.
Advantages and disadvantages. Precautions, Equipment, and Procedures.
12.5.4 Syringes of Insulin and tuberculin . Conversion of units at tenth and vice versa.
12.5.5 Intradermic-ID- injection. Definition and Objectives. Regions to be applied.
Precautions, Equipment and Procedure.
12.5.6 Intravenous-IV- injection. Definition. Objectives. Regions (election of the veins
in children and adults). Precautions and Complications. Equipment to be used and
Procedure
12.6 Canulation of veins with canula or catheter. Definition and Objective. Regions to be
applied, Precautions, and Procedures.
12.7 IVF-Intravenous infusion. Definition. Objectives. Precautions. Regions. Equipment
and procedure.
12.7.1 Drop scale. Calculation of IVF duration.
12.8 Topical medication. Definition. Objectives. General precautions. Different
methods: ointments, lotions, liniments, embrocations, brushstrokes. Equipment and
procedures.
12.8.1 Treatment by means of warm and cold compresses. Definition. Work in the
organism.Objectives. General principles. Indications and contraindications.
12.8.2 Methods for the application of heat and cold:
Warm and cold compresses and hot water bottles and ice bags. Definition. Objectives.
Precautions. Equipment. Procedure.
12.8.3 Methods for the application of the heat. Seat- bath. Definition. Objectives.
Precautions. Equipment and procedure. Foot-bath. Definition. Objectives. Precautions.
Equipment and procedure.
12.9 Medications for the Mucous. Definition. Scientific foundation. Classification.
Objectives. Precautions.
12.9.1Gastric mucous. Definition. Objectives. Precautions.
Gastric lavage. Definition. Objectives. Contraindications. Precautions. General
considerations in the event of urgencies. Equipment and Procedures.
12.9.2 Ophthalmic mucous. Definition. Treatment application (instilaciones, ointments
and ocular wash). Objectives. Precautions. Equipment and Procedures.
12.9.3 Otic mucous and Nasal mucous. Definitions. Application of treatments
(instilaciones). Objectives, precautions, equipments and procedures.
12.9.4 Breathing mucous. Definition. Objectives. Methods used for the administration of
medications.
12.9.4.1 Oxigen-therapy. Definition. Physiologic bases for the therapeutic application of
this gas. Objectives. Different forms of oxygen administration.
12.9.4.2 Oxygen administration by Nasal Catheter. Definition, objectives, precautions,
equipment and procedure
12.9.4.3 Oxygen administration by Fork and by Mask. Objectives, precautions,
equipment and procedures.
12.9.4.4 Oxygen administration by tent. Definition, precautions, equipment and
procedure.
12.9.4.5 Aerosol therapy. General considerations. Objectives, precautions, equipment to
be used and procedure.
12.9.4.6 Inhalations. Definition and Classification.
Dry inhalations. Use and Objectives. Contraindications. Precautions, equipment and
procedure. Wet inhalations. Definition and Objectives. Precautions, equipment and
procedure.
12.9.5 Vesicular mucous. Definition, objectives and precautions.
12.9.5.1 Indwelling Foley Catheter (Urethral catheter insertion). Definition, objectives,
precautions, equipment to be used and procedure
12.9.6 Rectal mucous. Definition, objectives and precautions. Characteristic of the
medication used. Treatments applied through the rectal mucous.
12.9.6.1 Enema. Definition, objectives, classification and general precautions.
Evacuating Enema. General considerations. Objectives and precautions. Complications
that may arise. Classification, equipment and procedure.
Retention Enema. Definition and Objectives. Classification, precautions, equipment and
procedure
12.9.6.2 Suppositories. Definition. General considerations and Objectives. Precautions,
equipment and procedure.
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN THE LABORATORY
No. 39 Procedure for the administration of medications through oral via.
No. 40 Procedure for applying the intramuscular injection (IM)
No. 41 Procedure for applying the Subcutaneous Injection (SQ)
No. 42 Procedure for applying the Intradermic Injection (ID)
No. 43 Procedure for applying the Intravenous Injection (IV)
No. 44 Procedure for the Canulation of Veins
No. 45 Procedure for the preparation and application of intravenous fluids (IV fluids)
No. 46 Procedures for the application of medications of topic use
No. 47 Procedure for the application of compresses (cold and warm)
No. 48 Procedure for the application of hot water bottles and ice bags
No. 49 Procedure for the seat- bath
No. 50 Procedure for the foot-bath
No. 51 Procedure for the Gastric lavage
No. 52 Procedure for application of eye drops
No. 53 Procedure for the application of Ocular compress
No. 54 Procedure for the application of Ocular Ointments (it includes the placement of
ocular dressings)
No. 55 Procedure for the eye wash
No. 56 Procedure for the application of ear and nose drops
No. 57 Procedure for the application of oxygen by catheter
No. 58 Procedure for the application of oxygen by Fork
No. 59 Procedure for the application of oxygen by Mask
No. 60 Procedure for the application of oxygen by tent
No. 61 Procedure to apply the Aerosol-therapy with a plane nebulizer
No. 62 Procedure to administer inhalations
No. 63 Procedure for inserting the indwelling catheter
No. 64 Procedure for the application of Evacuating Enema
No. 65 Procedure for the application of Retention Enema
No. 66 Procedure for the placement of Suppositories
Out of the 72 hrs dedicated for practice in the laboratory, 14 hours will be used for
assessment of students on the procedures listed below:
Intramuscular Injections
Use of the Insulin and Tuberculin syringes
Intravenous infusions. Drop rate calculation and use of the scale
Administration of oxygenate by a Nasal Catheter
SEMINAR No. 4
Will approach the contents of units 11 and 12 with the purpose of consolidating the
students knowledge
UNIT 13 SAMPLE COLLECTION
OBJECTIVE
To explain the patient the measures to take for sample collection, contributing to get the
materials in good conditions, so as to obtain satisfactory results in the investigations that
will be filed in the Patient's Clinical Card to facilitate the medical diagnosis.
TOPICS
13.1 General considerations about sample collection
13.2 Urine. Definition and characteristics. Diuresis. Normal quantity of eliminated urine
according to the patient's age.
13.2.1 More frequent urine tests. Precautions.
- Partial urine exam
- Urine culture
- Addis Count
13.3. Feces (Stools). Definition and characteristics. Normal depositions in 24 hours.
13.3.1. More frequent feces tests. Precautions.
- Serial feces test
- Culture collection – stools -
- Anal scrape
- Fecal occult blood
13.4. More frequent blood tests.Precautions.
- Hemoglobin (Hb )
- Hematocrytes
- Leukocytes
- Factor RH
- VDRL (Serologic test)
- Transaminase
UNIT 14 WOUNDS CARE
OBJECTIVE.
To explain the nursing intervention in the identification of wound types, as well as to
carry out cures, to remove stitches and to apply wound dressings according to the wound
characteristics and to medical valuation, allowing a satisfactory evolution of the patient .
TOPICS
14.1Definition of wounds. Classification according to the presence or
absence of infection, degree of skin damage and causes. Observing the wounds.
14.1.1 Process of cicatrization: Latent phase, phase of fibroplasty and contraction phase.
Dressing types (first, second and third intention.) Factors that affect the cicatrization of
wounds.
14.1.2 Common problems in the cicatrization of the wounds: hemorrhages and infection.
Signs and general and local symptoms. Nursing Priorities when treating a wounds.
14.1.3 Dressing Methods : dry and wet bandages. Rules for the cure of wounds. General
precautions.
14.1.4 Dry cure. Definition and Objectives. Precautions, equipment and procedure.
14.1.5 Types of stitches. Procedures to remove stitches.
14.1.6 Wet dressing. Definition and Objectives. Precautions. Care with the drainages.
Equipment and procedure.
14.2 Use of Bandages. Objectives, precautions, materials used. Basic principles for the
application of bandages.
14.2.2 Types of bandages and procedures to be followed
Circular bandage
Bandage in hairspring.
Bandage in Eight
Invested bandage.
Bandage of the hand.
Bandage in capelina.
Esculteto bandage.
PRACTICAL ACTIVITIES TO BE CARRIED OUT IN THE LABORATORY
No. 67 Preparation of the area and the trolley for applying cures
No. 68 Procedure for applying a dry cure.
No. 69 Procedure for removing different types of stitches.
No. 70 Procedure for applying a wet cure
No. 71 Procedure for applying different types of bandages.
 UNIT 15 PATIENT'S DISCHARGE

OBJECTIVE

To differentiate the different types of patient's discharges, valuing the importance of

nurses responsibility in the case that the doctor has officially declared the patient's death,
where the nurse should proceed with dignity and respect to carry out the necessary
assistance to the corps and give appropiate emotional support to the relatives.

TOPICS

15.1 Discharge. Definition and Classification. Medical discharge due to transfer, patient's
petition, patient's scape and patient's death. The acting of nurses in each case.
15.1.1 Requirements for the closure of the patient's clinical card.
15.2 Discharge due to patient's death. Deceased's definition. Signs of Death
15.2.1 Nursing cares to the corps. The shroud (winding sheet). Definition, objectives,
equipment and procedure.

PRACTICAL ACTIVITIES TO BE CARRIED OUT IN THE LABORATORY

No. 72 Procedure for applying the shroud (winding sheet).

SEMINAR 5

A seminar will be carried out embracing the contents of units 13, 14 and 15 with a
duration of 2 hours.

6. - EVALUATION OF THE STUDENTS PERFORMANCE

The Practical Activities carried out by the students will be marked on the basis of 100
points each. Then the activities will be averaged together with the marks obtained by
them in the Seminars in order to conform the student's final note for the subject.