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PCCN test Format | PCCN Course Contents | PCCN Course Outline | PCCN test Syllabus | PCCN test Objectives


The PCCN and PCCN-K certification exams focus 80 percent on clinical judgment and 20 percent on professional caring and ethical practice. Their comprehensive course prepares you in the following categories:

Clinical Judgment

- Cardiovascular
- Pulmonary
- Endocrine
- Hematology
- Gastrointestinal
- Renal
- Neurology
- Behavioral/Psychosocial
- Musculoskeletal
- Professional Caring and Ethical Practice
- Advocacy/Moral Agency
- Caring Practices
- Response to Diversity
- Facilitation of Learning
- Collaboration
- Systems Thinking
- Clinical Inquiry
- Learning Outcomes

At the completion of this learning activity, participants should be able to:

Validate their knowledge of progressive care nursing Briefly review the pathophysiology of single and multisystem dysfunction in adult patients and the medical and pharmacologic management of each Identify the progressive care nursing management needs for adult patients with single or multisystem organ abnormalities Successful Completion

Learners must complete 100 percent of the activity and the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.
12.8 contact hours awarded, CERP Category A
Exam Eligibility

Are you eligible to take the PCCN or PCCN-K exam=> Eligibility requirements and links to handbooks with test plans are available on their Get Certified pages click here to get started: PCCN (Adult) or PCCN-K (Adult) .

PCCN and PCCN-K certifications emphasize the knowledge that the progressive nursing specialty requires and the essential acute care nursing practices that you can apply in your role every day in a step-down unit, emergency or telemetry department or another progressive care environment.

PCCN and PCCN-K specialty certifications also demonstrate your knowledge and dedication to hospital administrators, peers and patients, while giving you the satisfaction of your achievement. PCCN and PCCN-K credentials are granted by AACN Certification Corporation.

Validate and enhance your knowledge and Strengthen patient outcomes. Take advantage of this detailed review course and earn your PCCN or PCCN-K certification.

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Centers (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California Board of Registered Nursing (CBRN), Provider number CEP 1036. This activity is approved for 12.8 contact hours.

AACN programming meets the standards of most states that require mandatory CE contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

AACN and AACN Certification Corporation consider the American Nurses Association (ANA) Code of Ethics for Nurses foundational for nursing practice, providing a framework for making ethical decisions and fulfilling responsibilities to the public, colleagues and the profession. AACN Certification Corporations mission of public protection supports a standard of excellence where certified nurses have a responsibility to read about, understand and act in a manner congruent with the ANA Code of Ethics for Nurses.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (27%)
1. Acute coronary syndromes
a. non-ST segment elevation myocardial infarction
b. ST segment elevation myocardial infarction
c. unstable angina
2. Acute inflammatory disease (e.g., myocarditis, endocarditis, pericarditis)
3. Aneurysm
a. dissecting
b. repair
4. Cardiac surgery (e.g., post ICU care)
5. Cardiac tamponade
6. Cardiac/vascular catheterization
a. diagnostic
b. interventional
7. Cardiogenic shock
8. Cardiomyopathies
a. dilated (e.g., ischemic/non-ischemic)
b. hypertrophic
c. restrictive
9. Dysrhythmias
10. Heart failure
a. acute exacerbations (e.g., pulmonary edema)
b. chronic
11. Hypertension (uncontrolled)
12. Hypertensive crisis
13. Minimally-invasive cardiac surgery (i.e. nonsternal approach)
14. Valvular heart disease
15. Vascular disease
B. Pulmonary (17%)
1. Acute respiratory distress syndrome (ARDS)
2. Asthma (severe)
3. COPD exacerbation
4. Minimally-invasive thoracic surgery (e.g., VATS)
5. Obstructive sleep apnea
6. Pleural space complications (e.g., pneumothorax, hemothorax, pleural effusion, empyema, chylothorax)
7. Pulmonary embolism
8. Pulmonary hypertension
9. Respiratory depression (e.g., medicationinduced, decreased-LOC-induced)
10. Respiratory failure
a. acute
b. chronic
c. failure to wean
11. Respiratory infections (e.g., pneumonia)
12. Thoracic surgery (e.g., lobectomy, pneumonectomy)
C. Endocrine/Hematology/Neurology/Gastrointestinal/Renal (20%)
1. Endocrine
a. diabetes mellitus
b. diabetic ketoacidosis
c. hyperglycemia
d. hypoglycemia
2. Hematology/Immunology/Oncology
a. anemia
b. coagulopathies: medication-induced (e.g., Coumadin, platelet inhibitors, heparin [HIT])
3. Neurology
a. encephalopathy (e.g., hypoxic-ischemic, metabolic, infectious, hepatic)
b. seizure disorders
c. stroke
4. Gastrointestinal
a. functional GI disorders (e.g., obstruction, ileus, diabetic gastroparesis, gastroesophageal reflux, irritable bowel syndrome)
b. GI bleed
i. lower
ii. upper
c. GI infections (e.g., C. difficile)
d. GI surgeries (e.g., resections, esophagogastrectomy, bariatric)
e. hepatic disorders (e.g., cirrhosis, hepatitis, portal hypertension)
f. ischemic bowel
g. malnutrition (e.g., failure to thrive, malabsorption disorders)
h. pancreatitis
5. Renal
a. acute kidney injury (AKI)
b. chronic kidney disease (CKD)
c. electrolyte imbalances
d. end-stage renal disease (ESRD)
D. Musculoskeletal/Multisystem/Psychosocial (16%)
1. Musculoskeletal
a. functional issues (e.g., immobility, falls, gait disorders)
2. Multisystem
a. end of life
b. healthcare-acquired infections
i. catheter-associated urinary tract infections (CAUTI)
ii. central-line-associated bloodstream infections (CLABSI)
iii. surgical site infection (SSI)
c. infectious diseases
i. influenza
ii. multidrug-resistant organisms (e.g., MRSA, VRE, CRE, ESBL)
d. pain
i. acute
ii. chronic
e. palliative care
f. pressure injuries (ulcers)
g. rhabdomyolysis
h. sepsis
i. shock states
i. anaphylactic
ii. hypovolemic
j. toxic ingestion/inhalation/drug overdose
k. wounds (e.g., infectious, surgical, trauma)
3. Behavioral/Psychosocial
a. altered mental status
b. delirium
c. dementia
d. disruptive behaviors, aggression, violence
e. psychological disorders
i. anxiety
ii. depression
f. substance abuse
i. alcohol withdrawal
ii. chronic alcohol abuse
iii. chronic drug abuse
iv. drug-seeking behavior
v. drug withdrawal
II. PROFESSIONAL CARING AND ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry Cardiovascular
Identify, interpret and monitor
o dysrhythmias
o QTc intervals
o ST segments
Manage patients requiring
o ablation
o arterial closure devices
o arterial/venous sheaths
o cardiac catheterization
o cardioversion
o defibrillation
o pacemakers
o percutaneous coronary intervention (PCI)
o transesophageal echocardiogram (TEE)
Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
Select leads for cardiac monitoring for the indicated disease process
Titrate vasoactive medications
o Dobutamine
o Dopamine
o Nitroglycerin Pulmonary
Interpret ABGs
Maintain airway
Monitor patients pre and post
o bronchoscopy
o chest tube insertion
o thoracentesis
Manage patients requiring mechanical ventilation
Manage patients requiring non-invasive O2 or ventilation delivery systems
o BiPAP
o CPAP
o face masks
o high-flow therapy
o nasal cannula
o non-breather mask
o venti-masks
Manage patients requiring respiratory monitoring devices:
o continuous SpO2
o end-tidal CO2 (capnography)
Manage patients requiring tracheostomy tubes
Manage patients with chest tubes (including pleural drains)
Recognize respiratory complications and initiate interventions
Endocrine/Hematology/Neurology/Gastrointestinal/Renal
Endocrine
o manage and titrate insulin infusions
Hematology/Immunology/Oncology
o administer blood products and monitor patient response
Neurology
o perform bedside screening for dysphagia
o use NIH Stroke Scale (NIHSS)
Gastrointestinal
o manage patients pre- and post-procedure (e.g., EGD, colonoscopy)
o manage patients who have fecal containment devices
o manage patients who have tubes and drains
o recognize indications for and complications of enteral and parenteral nutrition
Renal
o identify medications that can be removed during dialysis
o identify medications that may cause nephrotoxicity
o initiate renal protective measures for nephrotoxic procedures
o manage patients pre- and post-hemodialysis Musculoskeletal/Multisystem/Psychosocial
Musculoskeletal
o initiate and monitor progressive mobility measures
Multisystem
o administer medications for procedural sedation and monitor patient response
o differentiate types of wounds, pressure injuries
o manage patients with complex wounds (e.g., fistulas, drains and vacuum-assisted closure devices)
o manage patients with infections
Psychosocial
o implement suicide prevention measures
o screen patients using a delirium assessment tool (e.g., CAM)
o use alcohol withdrawal assessment tools (e.g., CIWA)
General
Administer medications and monitor patient response
Anticipate therapeutic regimens
Monitor diagnostic test results
Perform an assessment pertinent to the system
Provide health promotion interventions for patients, populations and diseases
Provide patient and family education unique to the clinical situation
Recognize procedural and surgical complications
Recognize urgent situations and initiate interventions
Use complementary alternative medicine techniques and non-pharmacologic interventions



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Medical Care information hunger

‘just like the starvation games’ out there: How Florida’s COVID vaccine distribution went haywire | PCCN test dumps and real Questions

Dozens of senior residents install camp in a single day in Florida to mark their quantity in line to get the COVID-19 vaccine. (Dec. 30) AP domestic

“every so often plans don’t work out,” Florida Emergency administration Director Jared Moskowitz stated.

Florida had a phased, orderly, step-via-step plan in area for distributing the COVID-19 vaccine to the public, beginning with essentially the most inclined months earlier than a vaccine become even authorised for emergency use.

Following tips laid out by way of the centers for ailment manage and Prevention, the state would center of attention on lengthy-time period care residents, health facility laborers on the front strains of the coronavirus combat, worker's essential to the working of society, and people with medical circumstances that put them at better chance of getting the disorder.

The plan outlined techniques for distribution, inventory administration, storage and dealing with, 2d-dose reminders, provider recruitment and enrolling, and verbal exchange with the general public. 

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more: Gov. Ron DeSantis requesting double allotment of COVID-19 vaccines as momentum picks up

Florida Emergency management director Jared Moskowitz, who became put in cost of the logistics of distributing the sparse quantities of doses, spoke of on the time, “We have a high-quality plan.”

before the primary week of vaccinations had even accomplished, Gov. DeSantis become going off script, pushing for more vaccines to head to elderly populations in nursing homes ahead of scheduled, and apart from folks in different lengthy-time period care facilities.

per week later, he turned into opening up availability to each person in Florida 65 and over, and going in opposition t the options of the CDC through leaving out primary employees.

Chaos ensued as allotments have been directed in all places the state and accusations of favoritism started flying. health facility systems and gated fifty five-plus communities had been accused of giving the vaccine to their board individuals.

County health branch web sites crashed. individuals couldn’t get via on the cell. Older Floridians stood in line overnight for hours the place counties had determined to present the vaccine on a primary-come, first-served foundation.

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And seniors who're the meant target of those adjustments are irritated. They complain they aren't in a position to get tips from the state or county fitness departments and native hospitals.

“occasionally plans don’t determine,” Moskowitz observed right through a Zoom convention call Wednesday night hosted by using Democratic state Rep. Anna Eskamani of Orlando. “instances on the floor exchange.”

A ‘hitch in the giddyup’

the two largest “situations on the ground” that affected the rollout were past the state’s control, Moskowitz talked about: Getting handiest a one-week enhance be aware on the amount of doses delivery to the state, then staring at that expected shipment slashed in half.

The confusion and absence of assistance from state and county health officers has sparked criticism from legislators, seniors and others. but Florida isn’t the only state experiencing a “hitch within the giddy-up,” as Democratic Sen. Linda Stewart of Orlando put it, contradicting DeSantis that the process become going smoothly. 

Dr. Leo Nissola (picture: Your flip)

All states have been stymied with the aid of a equipment set up via Operation Warp velocity, the federal government’s nationwide vaccine distribution application.

as a substitute of helping get the vaccine allotted quicker, DeSantis mentioned he’d take allotments far from hospitals and pharmacies that aren’t vaccinating people quickly sufficient. (big apple Gov. Andrew Cuomo, a Democrat, went extra: He noted he’d first-rate hospitals $one hundred,000.)

“It’s so frustrating to look that the distribution is as botched as the containment of this virus,” mentioned Dr. Leo Nissola, a melanoma professional who works with the COVID Act Now tracking undertaking. “It isn’t a shock ... actually, (both) President Trump and Gov. DeSantis downplayed the virus.”

observing his colleagues debating giving half doses or parsing the dosing schedules is “appalling,” pointed out Nissola, who practices drugs in San Francisco.

“Fining hospitals and suppliers when the fitness care system is at a breaking point is tyrannical,” he spoke of. “they are pushing their failures within the logistics of the distribution onto those who worked tougher than any person this (previous) 12 months.”

It isn't absolutely the fault of state and local health providers, although.

“to this point, hundreds of thousands of vaccine vials are sitting in warehouses, accredited existence-saving immunotherapy therapeutics are going unused, whereas heaps die from the unconventional coronavirus daily,” Nissola pointed out.

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national Institutes of fitness Director Francis S. Collins advised The Washington post that the nationwide distribution got off to a “rocky beginning.”

“We had this miraculous plan that (Operation) Warp pace had put in vicinity to have doses able to go the very next day after the FDA approval, however that’s a lot of logistics,” Collins informed the put up. “So might be they shouldn’t be too greatly surprised that it didn’t go like clockwork.”

Now, at a time when the state and nation are experiencing a surge in new cases, hospitalizations and deaths, the power is on fitness care laborers to immunize as many people as viable in the coming months. That’s even as they start to provide the vital 2nd dose, or booster shot, to those who already bought their first shot throughout the primary week of the rollout.

And the public is struggling to get solutions. united states of america today community – Florida examined the COVID-19 vaccination draft plan for Florida, which hasn’t been updated given that it become published and submitted to the CDC in October, to work out where the state strayed and where it stayed on path, and where the most effective laid plan diverged from fact.

more: 'i may tell you what i know and what I don't': inner a chaotic COVID-19 vaccine rollout | Column

‘which you can’t do any lengthy-range planning’

one of the crucial largest issues, in accordance with Moskowitz, is that the system install by means of Operation Warp velocity gives states a one-week increase on their scheduled allotments.

“nobody idea we’d only have a seven-day appear ahead,” Moskowitz explained. “you could’t do any long-latitude planning for those who can handiest see as far as next week.”

Florida branch of Emergency management Director Jared Moskowitz sits in the Senate gallery all through the Florida Legislature's organization Session at the Florida Capitol Tuesday, Nov. 17, 2020. (picture: Tori Lynn Schneider/Tallahassee Democrat)

He pointed out he couldn’t “confidently say the 2d dose changed into coming on time.” The “Pfizer five,” the first 5 hospitals in Florida to get the vaccine throughout the primary week of the rollout, did get their second doses. 

“We want them to get those doses out,” Moskowitz stated, explaining the purpose for reallocation. “Vaccines sitting in freezers are now not going to conclusion the pandemic.”

doubtful of these future doses, he stated, hospitals had been reluctant to run through their preliminary allotment, holding some lower back for these vital 2d doses.

also, the state assumed after the second week that it might be receiving round 500,000 doses a week, sufficient to warrant opening distribution to all Floridians sixty five and older even before the entire state’s nursing domestic residents had been vaccinated.

but doses dropped from simply under half 1,000,000 the 2d week to fewer than 300,000 the third week, and around 250,000 per week in view that.

more: Gov. Ron DeSantis blames Lee health center officers for seniors waiting in lengthy strains to get COVID-19 vaccine

“nobody notion their allocation would lower 50%,” Moskowitz spoke of, defending the governor’s resolution to open up the drug to the senior inhabitants, which is responsible for more than 80% of the deaths from COVID-19 in Florida.

It’s harking back to the early days of trying out, Moskowitz talked about, when demand outstripped deliver: “we are doing their superior, figuring out kinks. they will write the top-quality plan however can’t always assume the curveballs.”

A phased allocation

The plan expected a phased allocation across the availability of the vaccine. according to federal tips on the time, the primary groups focused had been fitness care personnel, basic people, individuals with underlying medical conditions that put them at high chance of getting the coronavirus, and individuals 65 and older.

That’s a large neighborhood: greater than 1.1 million licensed health care staff, 154,000 lengthy-term care residents, 220,000 long-term care workforce, 4.5 million americans 65 and over, and tens of hundreds of thousands of elementary worker's ranging from police and firefighters to utility employees and electricians, lecturers and even journalists.

When it grew to become clear that most effective 2.9 million doses could be attainable for nationwide distribution, and that Florida would get about a hundred and eighty,000 doses of both-dose Pfizer vaccine in the first go-circular, the CDC recommended giving them to health care personnel and lengthy-term care residents.

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Florida additional narrowed that to health center personnel that had direct contact with COVID-19 patients, and nursing home residents and body of workers.

When greater doses became obtainable within the second week, and Florida turned into slated to acquire nearly 500,000 doses of each Moderna and Pfizer, the CDC’s Advisory Committee on Immunization Practices advised the vaccine be provided to people 75 and older, and to standard frontline worker's no longer in the health trade.

The committee also counseled that seniors sixty five-74, americans sixteen-64 with high-possibility scientific conditions, and simple employees now not blanketed at the start be provided the vaccine. 

No timeline become offered for when these phases should still be initiated, but the state’s draft plan pondered that the state would extend its providing as more vaccine grew to be obtainable. 

DeSantis pushed back in opposition t the advice to offer the vaccine to tens of millions of primary worker's, issuing an government order prioritizing people sixty five and older.

Up beforehand the state has concentrated on its seven-hundred-plus nursing buildings at the neglect of residents of the three,000-plus assisted living and different long-term care amenities. these associations will delivery seeing vaccine disbursed to their residents beginning Monday, Moskowitz mentioned.

extra: Florida assisted dwelling facilities given good enough to agenda COVID-19 vaccinations

Low provide, turning out to be demand

Moskowitz pointed out the state’s vaccine distribution plan is sound and able to convey anything the federal executive sends them. It’s basically a question of provide purchasable to fulfill the pent-up and growing demand.

DeSantis caused that demand when he opened the vaccine to everybody within the ordinary population 65 and over, well earlier than the a whole lot of lots of folks identified for the first round of vaccine had been completely inoculated.

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a week after the governor opened the door to some 4.5 million seniors, the federal government cut the state’s allotment in half.

The plan called for a centralized state-coordinated distribution of the vaccine, the use of as a template the state’s already neatly-centered vaccination application, cast via training learned all over the H1N1 pandemic, seasonal flu vaccinations and the latest Hepatitis A application.

The state additionally activated Florida’s immunization counsel gadget, known as Florida photographs, and is coordinating with hospitals, pharmacies, county health departments and emergency scientific carrier corporations to aid distribute the vaccine.

Moskowitz explained that while the vaccine is being disbursed through the state fitness device, it isn't being delivered directly to the branch of health or Division of Emergency management.

“We don't seem to be a move-through equipment,” he referred to. “Vaccinations are being finished in the course of the fitness equipment, which is locally led. it is a decentralized effort amongst sixty seven health departments and over 300 hospitals.”

Getting vaccines through ‘live performance ticket equipment’

Some counties, like Orange County, have executed a superb job registering individuals for appointments, Moskowitz said. however other counties that created a primary-come, first-served “concert ticket gadget” didn’t do as smartly, he said, making older citizens both stand in long strains or sit in their cars.

Distribution has fallen short, with about 29% of some 1.15 million doses truly put in people’s fingers, Moskowitz spoke of. That’s below the national regular of 30.6%.

The decentralization has caused a lack of oversight, with studies across the state of county fitness departments giving parts of their allotment to gated 55-plus communities while firefighters and police are left unprotected.

To aid goose distribution and get extra of the purchasable vaccine out, DeSantis has introduced deals with health facility techniques, the Publix supermarket chain and black church buildings to get individuals inoculated.

Florida Gov. Ron DeSantis speaks to the media on Thursday, Jan. 7, 2020, backdropped by means of a line of county residents ready to acquire a COVID vaccination on the Indian River County Fairgrounds. The governor pointed out the state is slated to acquire an further 250,000 vaccinations and is engaged on a partnership with Publix to administer the vaccine. (image: PATRICK DOVE/TCPALM)

He’s also ordered Moskowitz to employ 1,000 contract nurses to aid with the effort, 800 of whom are already deployed throughout the lengthy-time period care native pharmacy program.  

period in-between, teachers, penitentiary inmates and corrections officers, migrant people, Native American communities, the uninsured and americans with developmental disabilities wait for his or her turn to be placed on the list.

“i can’t point to who’s going to be next,” Moskowitz talked about. “When the vaccine allotment increases, I will be satisfied to share their concept technique then. at this time, it’s like jogging and chewing gum at same time.”

With such a low and unreliable give, an inability to plan greater than per week ahead and the excessive demand, Moskowitz acknowledged, “It’s just like the hunger video games obtainable.”

ROLLOUT by means of THE NUMBERS

First Week — 179,four hundred doses, all Pfizer

2nd Week — 495,000 doses (127,000 Pfizer, 396,000 Moderna)

Third week — 289,000 doses (162,000 Pfizer, 157,000 Moderna)

Fourth Week — 253,000 doses (evenly split between Pfizer and Moderna)

Fifth week — 254,000 doses (cut up evenly between Pfizer and Moderna)

complete by means of Dec. 15 — 1.3 million doses (500,000 to hospitals, 500,000 to county fitness departments, 118,000 2nd photographs in third week, 103,000 2nd pictures  in fourth week)

Jeffrey Schweers is a statehouse reporter for the USA today network-Florida. He can also be reached at jschweers@gannett.com. comply with him on Twitter @jeffschweers.

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