BNS 111: Clinical Nursing Skills (I & II) & Health Assessment

Ward Environment & Procedural Foundations

• Subtopic: Types and Functional Organization of Health Units and Hospitals
• Subtopic: Managing the Patient's Micro-Environment: Lighting, Ventilation, Noise Control & Humidity
• Subtopic: Principles and Methods of Hospital Ward Cleanliness and Furniture Decontamination
• Subtopic: Disposal of Hospital Refuse, Medical Waste Segregation & Sharps Management
• Subtopic: Management and Decontamination of Contaminated Articles, Linen & Utility Rooms

Admission, Transfer & Clinical Reporting

• Subtopic: Basic Considerations and Psychological Preparation During Patient Admission
• Subtopic: Procedures for Planned (Elective) vs. Emergency Ward Admissions
• Subtopic: Baseline Nurses’ Observations, Patient Reassurance, Comfort, and Pain Assessment
• Subtopic: Inventory, Safekeeping, and Legal Custody of Patient Property and Valuables
• Subtopic: Gathering Patient Particulars, Next of Kin Documentation & Medical History Taking
• Subtopic: Ward Orientation: Introducing Ward Routine, Staff, Timetables, Bathrooms & Toilets
• Subtopic: Indications, Preparation, Equipment, and Inter-Ward Patient Transfer Protocols
• Subtopic: Nursing Record Keeping: Ward Reports, Kardex, Shift Handovers & Evaluation Writing

The Art and Biophysical Sciences of Bed Making

• Subtopic: Principles, Biophysical Sciences, and Clinical Aims of Bed Making
• Subtopic: Hospital Beds: Structure, Mattresses, Bed Accessories, Bed Cradles & Balkan Frames
• Subtopic: Technique of Making an Admission (Unoccupied / Simple) Bed
• Subtopic: Technique of Making an Occupied Bed with Minimal Patient Disturbance
• Subtopic: Technique of Preparing an Operation (Surgical / Post-Anaesthesia) Bed
• Subtopic: Specialized Beds: Cardiac Bed, Divided (Amputation) Bed & Fracture Bed

Positions Used in Nursing & Patient Mobilization

• Subtopic: Supine (Dorsal Recumbent) & Semi-Recumbent Positions: Indications and Pressure Points
• Subtopic: High Fowler's, Standard Fowler's, and Semi-Fowler’s Positions
• Subtopic: Orthopneic Position for Respiratory Distress and Cardiac Failure
• Subtopic: Lateral Positions (Left and Right Lateral) & Prone / Semi-Prone Positions
• Subtopic: Sim’s (Semi-Prone Recumbent) Position for Rectal Examinations and Enemas
• Subtopic: Knee-Chest (Genu-Pectoral) Position, Lithotomy Position & Trendelenburg Position
• Subtopic: Ergonomics & Body Mechanics: Grips, Holds, Lifting Principles & Preventing Nurse Back Injuries
• Subtopic: Moving a Helpless Patient Up in Bed, Bed-to-Chair, and Bed-to-Stretcher Transfers
• Subtopic: Complications of Bed Rest & Immobility: Pathophysiology and Prevention
• Subtopic: Active and Passive Range-of-Motion (ROM) Joint Exercises: Flexion, Extension, Abduction, Rotation

Personal Hygiene & Pressure Sore Prevention

• Subtopic: Clinical Indications, Requirements, Equipment, and Procedure for a Bed Bath
• Subtopic: Assisting Bedridden and Postoperative Patients with Baths and Assisted Showers
• Subtopic: Specialized Oral Hygiene for Conscious, Dependent, and Unconscious Patients
• Subtopic: Hair Care: Pediculosis Treatment, Combing, and Bedside Shampooing
• Subtopic: Nail Care, Perineal Care, and Foot Hygiene
• Subtopic: Pressure Sores (Decubitus Ulcers): Etiology, Risk Groups, Stages (I–IV) & Norton/Braden Scales
• Subtopic: Nursing Measures for Pressure Sore Prevention: Turning Schedules, Water Beds & Massage
• Subtopic: Treating Cutaneous Parasitic Infestations: Head Lice, Body Lice, Pubic Lice & Jiggers

Infection Control, Barrier Nursing & Sleep

• Subtopic: The Chain of Infection: Causative Agent, Reservoir, Portal of Exit, Transmission & Susceptible Host
• Subtopic: Standard Precautions & Hand Washing Techniques (Social, Aseptic & Surgical Scrubs)
• Subtopic: Barrier Nursing & Isolation Precautions: Contact, Droplet, Airborne & Reverse Isolation
• Subtopic: Personal Protective Equipment (PPE): Donning and Doffing Protocols
• Subtopic: Physiology of Sleep and Rest: Sleep Cycles (NREM, REM) and Recommended Sleep Durations
• Subtopic: Nursing Measures to Promote Sleep & Sleep Disorders (Insomnia, Somnambulism, Nocturnal Enuresis)

Naso-Gastric (NG) Feeding & Diets

• Subtopic: Clinical Indications, Contraindications, and Types of Nasogastric Tubes
• Subtopic: Technique and Procedure for Inserting a Nasogastric Tube (Measuring NEX Distance)
• Subtopic: Verifying NG Tube Placement: Gastric Aspirate pH Testing vs. Radiography vs. Whoosh Test
• Subtopic: Procedure for Administering Enteral Tube Feeds and Medication Administration via NG Tube
• Subtopic: Complications of NG Tube Feeding: Aspiration, Diarrhea, Tube Dislodgement & Prevention
• Subtopic: Therapeutic Hospital Diets: Low Salt (DASH), High Protein, Renal, Fluid-Restricted & Diabetic Diets

Elimination & Fluid-Electrolyte Balance

• Subtopic: Physiology of Bowel Elimination: Assisting with Bedpans and Commodes
• Subtopic: Nursing Management of Constipation, Fecal Impaction, and Diarrhea
• Subtopic: Administration of Enemas (Evacuant, Retention) & Insertion of Flatus Tubes
• Subtopic: Management of Urinary Elimination: Urinals, Bedside Urinalysis & Specimen Collection
• Subtopic: Urinary Retention vs. Urinary Incontinence: Pathophysiology and Nursing Care
• Subtopic: Urethral Catheterization: Sterile Technique for Male and Female Patients
• Subtopic: Indwelling Catheter Care, Closed Drainage Systems & Continuous Bladder Washout/Irrigation
• Subtopic: Body Fluid Compartments (ICF vs. ECF), Intake and Output Charting & Dehydration Assessment
• Subtopic: Fluid Imbalances (Hypovolemia, Hypervolemia) & Electrolyte Imbalances (Sodium, Potassium)
• Subtopic: Intravenous (IV) Cannulation, Infusion Setup, Drop Rate Calculations & Complications (Phlebitis)
• Subtopic: Blood Transfusion: Cross-Matching, Patient Verification, Administration & Managing Transfusion Reactions

Assisting in Difficult Breathing & Airway Clearance

• Subtopic: Assessment of Respiratory Distress, Orthopnea, Cyanosis, and Dyspnea
• Subtopic: Sputum Collection, Color/Consistency Observation & Use of Sputum Mugs
• Subtopic: Teaching Deep Breathing, Huffing, and Controlled Coughing Exercises
• Subtopic: Oropharyngeal, Nasopharyngeal, and Tracheal Suctioning Procedures
• Subtopic: Postural Drainage Techniques, Percussion, and Chest Physiotherapy

Oxygen Administration & Cardiopulmonary Resuscitation (CPR)

• Subtopic: Indications, Flow Rates, and Hazards of Oxygen Administration (Oxygen Toxicity, Retinopathy)
• Subtopic: Equipment: Cylinders, Manometers, Flow Meters, Humidifiers & Central Pipeline Outlets
• Subtopic: Delivery Devices: Nasal Prongs/Cannula, Simple Face Mask, Venturi Mask, Non-Rebreather Mask
• Subtopic: Oxygen Tents, Head Boxes, and Oxygen Funnels in Pediatric Care
• Subtopic: Signs and Clinical Manifestations of Sudden Cardiac and Respiratory Arrest
• Subtopic: The Chain of Survival & Basic Life Support (BLS) Algorithm
• Subtopic: High-Quality Cardiopulmonary Resuscitation (CPR): Chest Compression Depth, Rate, and Chest Recoil
• Subtopic: Airway Opening Maneuvers: Head-Tilt Chin-Lift vs. Jaw-Thrust Maneuvers
• Subtopic: Artificial Ventilation: Pocket Masks, Bag-Valve-Mask (Ambu Bag) & Mouth-to-Mouth Resuscitation
• Subtopic: Automated External Defibrillator (AED) Operation, Pad Placement, and Safety Precautions
• Subtopic: Post-Resuscitation Care and Continuous Patient Monitoring

Wound Classification, Dressing & Sutures

• Subtopic: Classification of Wounds: Clean, Clean-Contaminated, Contaminated, Dirty/Infected
• Subtopic: Physiology of Wound Healing: Hemostasis, Inflammatory, Proliferative, and Maturation Phases
• Subtopic: Local and Systemic Factors Promoting and Delaying Wound Healing
• Subtopic: Trolley Setup, Aseptic Non-Touch Technique (ANTT) & Sterile Wound Dressing Procedures
• Subtopic: Antiseptics, Topical Cleansing Solutions, and Wound Irrigation Protocols
• Subtopic: Management of Surgical Drains (Penrose, Redivac, Jackson-Pratt, Corrugated Drains)
• Subtopic: Technique for Suture (Stitch) and Surgical Staple Removal
• Subtopic: Bandages and Binders: Circular, Spiral, Reverse Spiral, Figure-of-Eight, Spica & Recurrent Bandaging

Perioperative Nursing Care & Pain Alleviation

• Subtopic: Surgical Classifications: Curative, Diagnostic, Reconstructive, Palliative, Major vs. Minor
• Subtopic: Preoperative Physical Preparation: NPO Protocols, Bowel Evacuation, Skin Prep, Denture Removal
• Subtopic: Preoperative Psychological Preparation, Legal Informed Consent & Premedication Administration
• Subtopic: Immediate Postoperative Care in PACU: Airway Patency, Vital Signs & Consciousness Recovery
• Subtopic: Prevention and Management of Postoperative Complications (Shock, Hemorrhage, DVT, Sepsis, Paralytic Ileus)
• Subtopic: Wound Dehiscence and Evisceration (Burst Abdomen): Emergency Clinical Nursing Interventions
• Subtopic: Assessment of Pain: Subjective Self-Report, Behavioral Pain Indicators, and Pain Rating Scales
• Subtopic: Pharmacological Analgesia (Opioid/Non-Opioid) & Non-Pharmacological Comfort Interventions

Assisting with Diagnostic & Therapeutic Bedside Procedures

• Subtopic: Lumbar Puncture: Indications, Positioning, Equipment, Assisting, and Post-Procedure Flat Rest
• Subtopic: Thoracentesis (Pleural Tap): Patient Positioning, Equipment, Assisting, and Complications
• Subtopic: Abdominal Paracentesis (Ascitic Tap): Pre-Procedure Bladder Emptying, Assisting & Fluid Monitoring
• Subtopic: Bone Marrow Aspiration & Biopsy: Sites (Iliac Crest, Sternum), Patient Reassurance & Post-Care
• Subtopic: Liver Biopsy: Preparation, Breath-Holding Coaching & Right-Lateral Pressure Recovery
• Subtopic: Stomach Washout (Gastric Lavage): Indications in Toxic Ingestion, Contraindications & Procedure
• Subtopic: Local Application of Heat (Hot Water Bottles, Compresses) and Cold (Ice Packs, Tepid Sponging)
• Subtopic: Specimen Collection: Labeling, Preservation, Chain of Custody & Interpretation of Results

Discharge, Unconscious Care & The Last Office

• Subtopic: Planning for Hospital Discharge: Medication Reconciliation, Home Care & Follow-Up Referrals
• Subtopic: Discharge Against Medical Advice (DAMA): Legal Implications, Documentation & Nurse's Safeguards
• Subtopic: Nursing Care of the Unconscious Patient: Airway Maintenance, Eye Care, Nutrition & Skin Integrity
• Subtopic: Physical and Spiritual Needs of the Dying Patient: End-of-Life Symptom Relief & Palliative Care
• Subtopic: Clinical Signs of Approaching Death and Verification of Clinical Death
• Subtopic: Communicating Death to Bereaved Relatives with Empathy and Cultural Sensitivity
• Subtopic: The Last Office (Care of the Body After Death): Basic Equipment, Procedure, Tagging & Packing
• Subtopic: Cultural, Tribal, and Religious Customs Surrounding Death, Dying, and Bereavement in Uganda
• Subtopic: Care of the Deceased’s Property, Ward Documentation & Transfer to the Hospital Mortuary

Assessment Frameworks & Emergency Triage

• Subtopic: Introduction to Health Assessment: Definitions, Purposes, and Scope in Nursing Practice
• Subtopic: Types of Health Assessment: Comprehensive, Focused/Problem-Oriented, Ongoing & Emergency
• Subtopic: Emergency Triage & Primary Survey in Trauma: Airway, Breathing, Circulation, Disability & Exposure (ABCDE)
• Subtopic: Integrating Health Assessment with the Nursing Process (Assessment, Diagnosis, Planning, Implementation, Evaluation)
• Subtopic: Critical Thinking, Clinical Judgment & Standardized Communication (SBAR Framework)
• Subtopic: Subjective vs. Objective Clinical Data: Sources, Verification, and Documentation

Components of the Comprehensive Health History

• Subtopic: Purposes, Principles, and Psychological Setting of the Diagnostic Health Interview
• Subtopic: Therapeutic Communication During Interviewing: Facilitation, Silence, Clarification & Summarizing
• Subtopic: Symptom Analysis: PQRST (Provocative/Palliative, Quality, Region, Severity, Timing) & OLDCARTS
• Subtopic: Biographical Data & Establishing the Chief Complaint (Reason for Seeking Care)
• Subtopic: History of Present Illness (HPI): Chronological Narrative of Health Alterations
• Subtopic: Past Medical, Surgical, Obstetric, Immunization, Pharmacological & Allergy History
• Subtopic: Family Pedigree Construction: Documenting Genetic Diseases Over Three Generations
• Subtopic: Personal, Social, Lifestyle, Occupational, and Environmental Health Exposure History
• Subtopic: Comprehensive Review of Systems (ROS): Systematic Head-to-Toe Subjective Inquiry
• Subtopic: Peer Interviewing Practice, Self-Evaluation & Identifying Clinical Interviewing Weaknesses

The Four Cardinal Techniques (IPPA) & Instrumentation

• Subtopic: Technique and Clinical Application of Systematic Inspection
• Subtopic: Palpation: Light vs. Deep Palpation, Bimanual Palpation, Assessing Tenderness & Organomegaly
• Subtopic: Percussion: Direct vs. Indirect Percussion, Tone Qualities (Resonant, Tympanic, Dull, Flat)
• Subtopic: Auscultation: Using Bell vs. Diaphragm of Stethoscope, Pitch, Intensity, Quality, and Murmurs
• Subtopic: Equipment Preparation: Ophthalmoscope, Otoscope, Tuning Fork, Percussion Hammer & Penlight

General Survey, Baseline Observations & Pain

• Subtopic: General Physical Examination: General Survey, Physical Appearance, Body Habitus, Mobility & Posture
• Subtopic: Vital Signs Measurement, Calibration, Error Avoidance & Clinical Interpretation
• Subtopic: Nutritional Assessment: BMI Calculation, Waist-to-Hip Ratio & Anthropometric Indices
• Subtopic: Pain Assessment as the Fifth Vital Sign: Numerical, Visual Analog (VAS) & Wong-Baker Faces Scales
• Subtopic: Formulating Summary Statements of Clinical Impression and Professional Documentation

Mental Status & Systemic Neurological Assessment

• Subtopic: Review of Neuro-Mental Functioning and Normal Age-Related Cognitive Changes
• Subtopic: Assessment of General Appearance, Hygiene, Grooming, Motor Activity & Posture
• Subtopic: Evaluation of Speech Patterns, Flow of Thought, and Emotional Mood and Affect
• Subtopic: Assessment of Thought Process, Thought Content, Perceptions (Hallucinations) & Insight
• Subtopic: Evaluation of Cognitive Functions: Orientation (Person, Place, Time), Attention & Concentration
• Subtopic: Memory Testing (Immediate, Recent, Remote), Abstract Thinking & Mini-Mental State Exam (MMSE)
• Subtopic: Systematic Assessment of Cranial Nerves I through XII: Testing Protocols & Clinical Abnormalities
• Subtopic: Motor System Assessment: Muscle Bulk, Tone, Muscle Strength (Medical Research Council 0–5 Scale)
• Subtopic: Cerebellar Testing: Coordination, Rapid Alternating Movements, Finger-to-Nose, Heel-to-Shin & Romberg Test
• Subtopic: Sensory System Assessment: Pain, Light Touch, Vibration, Position Sense & Cortical Sensations
• Subtopic: Deep Tendon Reflexes (Biceps, Triceps, Brachioradialis, Patellar, Achilles) & Babinski Sign
• Subtopic: Glasgow Coma Scale (GCS) Assessment for Conscious and Altered Mental Status Patients

Assessment of Special Populations

• Subtopic: Assessment of the Pregnant Woman: Obstetric History, Fundal Height (McDonald's Rule) & Leopold's Maneuvers
• Subtopic: Foetal Assessment: Pinard Stethoscope / Doppler Auscultation of Foetal Heart Rate & Movements
• Subtopic: Assessment of the Pediatric Patient: Developmental Milestones, Pediatric Vitals & Adapted Sequence
• Subtopic: Pediatric Anthropometry: Head Circumference, Mid-Upper Arm Circumference (MUAC) & Growth Charts
• Subtopic: Assessment of the Mentally Ill Patient: Psychiatric Triage, Violence & Suicide Risk Assessment
• Subtopic: Assessment of the Geriatric Patient: Functional Independence (ADLs/IADLs), Frailty & Morse Fall Scale

Integumentary, HEENT & Respiratory Systems

• Subtopic: Integumentary Assessment: Skin Colour (Pallor, Cyanosis, Jaundice, Erythema), Turgor, Moisture & Temperature
• Subtopic: Assessment of Primary and Secondary Skin Lesions, Wounds, Scars, and Pressure Ulcers
• Subtopic: Hair and Nail Assessment: Clubbing, Koilonychia, Capillary Refill, Texture, and Distribution
• Subtopic: HEENT: Skull Symmetry, Facial Symmetry, Thyroid Gland Palpation & Cervical Lymph Nodes
• Subtopic: Eye Assessment: Visual Acuity (Snellen), Ocular Structures, Pupillary Light Reflexes (PERRLA) & Extraocular Movements
• Subtopic: Ear Assessment: External Ear, Otoscopic Tympanic Membrane Inspection & Hearing Acuity (Weber, Rinne)
• Subtopic: Nose, Mouth & Pharynx: Mucosa, Dentition, Gums, Tongue, Tonsillar Grading & Gag Reflex
• Subtopic: Thorax & Lungs: Chest Wall Configuration, Respiratory Excursion & Tactile Vocal Fremitus
• Subtopic: Chest Percussion: Resonant Tones, Dullness, Hyperresonance & Diaphragmatic Excursion
• Subtopic: Auscultation: Normal Breath Sounds (Vesicular, Bronchial) vs. Adventitious Sounds (Crackles, Wheezes, Stridor)

Cardiovascular, Abdomen, Genitourinary & Musculoskeletal Systems

• Subtopic: Cardiovascular Assessment: Precordial Inspection, Palpating Point of Maximal Impulse (PMI), Heaves & Thrills
• Subtopic: Cardiac Auscultation: Normal Sounds (S1, S2), Gallops (S3, S4), Murmurs (Grading I–VI) & Pericardial Rub
• Subtopic: Vascular Examination: Jugular Venous Pressure (JVP), Carotid Bruits & Peripheral Pulse Palpation
• Subtopic: Abdominal Assessment: Inspection (Contour, Symmetry), Auscultation (Bowel Sounds, Bruits) & Percussion (Tympany, Liver Span)
• Subtopic: Abdominal Palpation: Light Palpation (Guarding) & Deep Palpation (Liver, Spleen, Masses)
• Subtopic: Peritoneal Signs: Rebound Tenderness, Rovsing's, Psoas, Obturator & Murphy's Signs for Acute Abdomen
• Subtopic: Genitourinary Examination: Costovertebral Angle (CVA) Tenderness, Bladder Palpation & External Genitalia
• Subtopic: Musculoskeletal Examination: Posture, Gait, Spinal Curvatures (Scoliosis, Kyphosis, Lordosis) & Joint Swelling/Crepitus

Hematology, Microscopy & Bedside Testing

• Subtopic: Full Blood Count (FBC/CBC): Clinical Indications, Normal Values, Hb, Platelets & Differentials
• Subtopic: Blood Slide for Malaria Parasites (Thick & Thin Smears) & Rapid Diagnostic Tests (RDTs)
• Subtopic: Hemoglobin (Hb) Estimation, Hematocrit / Packed Cell Volume (PCV) & Red Cell Indices
• Subtopic: Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) & Coagulation Profile (PT/INR, aPTT)
• Subtopic: Blood Grouping (ABO & Rh D System) and Compatibility Cross-Matching
• Subtopic: Urinalysis: Physical Inspection, Dipstick Chemical Testing (Protein, Glucose, Ketones, Nitrites) & Microscopy
• Subtopic: Stool Examination: Routine Microscopy for Helminth Ova, Protozoan Cysts & Occult Blood
• Subtopic: Acid-Alcohol Fast Bacilli (AAFBs): Sputum Smear Preparation, ZN Staining & GeneXpert MTB/RIF
• Subtopic: Microbiological Culture and Sensitivity (C&S) Testing for Blood, Urine, Wound, and Sputum Swabs
• Subtopic: Serological Tests: Rapid HIV Testing Algorithm, Syphilis Screening (VDRL/RPR) & Hepatitis B/C Markers

Chemical Pathology, Bio-Electrics & Diagnostic Imaging

• Subtopic: Renal Function Tests (RFTs): Blood Urea Nitrogen (BUN), Serum Creatinine & Calculated eGFR
• Subtopic: Serum Electrolytes: Sodium, Potassium, Chloride, Calcium & Arterial Blood Gas (ABG) Analysis
• Subtopic: Liver Function Tests (LFTs): ALT, AST, ALP, Total/Direct Bilirubin & Total Protein/Albumin
• Subtopic: Blood Glucose Monitoring: Random Blood Sugar (RBS), Fasting Blood Sugar (FBS) & HbA1c
• Subtopic: Endocrine Hormone Panels: Thyroid Function Tests (TSH, Free T3, Free T4) & Adrenal Hormones
• Subtopic: Electrocardiogram (ECG): Standard 12-Lead Placement, Rhythm Identification & Arrhythmia Analysis
• Subtopic: Plain Radiography (Chest X-Ray): Patient Preparation, Radio-Opacity & Identifying Consolidations
• Subtopic: Diagnostic Ultrasound (Abdominal, Pelvic, Obstetric Scans): Indications & Patient Preparation
• Subtopic: Cross-Sectional Advanced Imaging: Computed Tomography (CT) & Magnetic Resonance Imaging (MRI)