Preface

This Nursing Skills textbook is an open educational resource with a CC-BY 4.0 license developed for entry-level undergraduate nursing students. It is aligned with the Wisconsin Technical College System (WTCS) statewide nursing curriculum for the Nursing Skills course (543-102) that describes techniques for obtaining a health history and performing a basic physical assessment using a body systems approach. It also includes evidence-based clinical skills with related mathematical calculations and conversions.

Online learning activities are provided in each chapter using the free H5P software platform (https://h5p.org/). This textbook has also been uploaded to LibreTexts (https://libretexts.org/) for easy remixing by faculty. The project is supported by a $2.5 million Open Resources for Nursing (Open RN) grant from the Department of Education to create five free, open source nursing textbooks. However, this content does not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the federal government.

More information about the Open RN grant can be found at cvtc.edu/OpenRN. The first textbook of the Open RN textbook series, Nursing Pharmacology, received an OE Award for Excellence from OE Global. For more information, visit the 2020 OE Awards for Excellence site.

Usage Survey and Feedback

We would love to hear if you have integrated some or all of this resource into your course. Please use this short survey to report student usage information every semester for grant reporting purposes to the Department of Education.  Please use this survey to provide constructive feedback or report any errors.

About this Book

Editors

• Kimberly Ernstmeyer, MSN, RN, CNE, CHSE, APNP-BC
• Dr. Elizabeth Christman, DNP, RN, CNE

Graphics Editor

• Nic Ashman, MLIS, Librarian, Chippewa Valley Technical College

Developing Authors

Developing authors remixed existing open educational resources and developed new content based on evidence-based sources:

• Mallory Bohling, MSN, RN, Blackhawk Technical College
• Dr. Elizabeth Christman, DNP, RN, CNE, Chippewa Valley Technical College/Southern New Hampshire University
• Nicole Drees, MSN, RN, Northeast Wisconsin Technical College
• Kim Ernstmeyer, MSN, RN, CNE, CHSE, APNP-BC, Chippewa Valley Technical College
• Krista Huppert, MSN, RN, Chippewa Valley Technical College
• Erin Kupkovits, MSN, RN, Madison Area Technical College
• Dr. Tennille O’Connor, DNP, RN, CNE, Chippewa Valley Technical College/Pasco Hernando State College
• Barbara Peters, MSN, RN, Northeast Wisconsin Technical College
• Mary Pomietlo, MSN, RN, CNE, Chippewa Valley Technical College
• Rorey Pritchard, EdS, MEd, MSN, RN-BC, CNOR(E), CNE, Open RN Advisory Committee Member
• Dr. Julie Teeter, DNP, RN, CNE, Gateway Technical College

Contributors

Contributors assisted in the creation of this textbook:

• Samantha Bauer, MN, BS, RN, CNL, Madison Area Technical College
• Karrie Bruegman-May, MSN, BSN, MSOLQ, Moraine Park Technical College
• Jane Flesher, MST, Proofreader, Chippewa Valley Technical College
• Deanna Hoyord, Paramedic (retired), Human Patient Simulation Technician and Photographer, Chippewa Valley Technical College
• Lindsay Kuhlman, BSN, RN, HSHS Sacred Heart
• Theresa Meinen, MS, RRT, CHSE, Director of Clinical Education – Respiratory Therapy Program, Chippewa Valley Technical College
• Vince Mussehl, MLIS, Open RN Lead Librarian, Chippewa Valley Technical College
• Joshua Myers, Web Developer, Chippewa Valley Technical College
• Jody Myhre-Oechsle, MS, CPhT, Chippewa Valley Technical College
• Matthew Pomietlo, Technology Education Student, UW-Stout
• Meredith Pomietlo, Retail Design and Marketing Student, UW-Stout
• Lauren Richards, Graphics Designer, Chippewa Valley Technical College
• Celee Schuch, Nursing Student, St. Catherine University
• Dominic Slauson, Technology Professional Developer, Chippewa Valley Technical College
• Dr. Jamie Zwicky,  EdD, MSN, RN, Moraine Park Technical College

Advisory Committee

The Open RN Advisory Committee consists of industry members and nursing deans and provides input for the Open RN textbooks and virtual reality scenarios:

• Jenny Bauer, MSN, RN, NPD-BC, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
• Gina Bloczynski, MSN, RN, Dean of Nursing, Chippewa Valley Technical College
• Angela Branum, Western Wisconsin Health
• Lisa Cannestra, Eastern Wisconsin Healthcare Alliance
• Travis Christman, MSN, RN, Clinical Director, HSHS Sacred Heart and St. Joseph’s Hospitals
• Sheri Johnson, UW Population Health Institute
• Dr. Vicki Hulback, DNP, RN, Dean of Nursing, Gateway Technical College
• Jenna Julson, MSN, RN, NPD-BC, Nursing Education Specialist, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
• Brian Krogh, MSN, RN, Associate Dean – Health Sciences, Northeast Wisconsin Technical College
• Hugh Leasum, MBA, MSN, RN, Nurse Manager Cardiology/ICU, Marshfield Clinic Health System, Eau Claire, WI
• Pam Maxwell, SSM Health
• Mari Kay-Nobozny, NW Wisconsin Workforce Development Board
• Dr. Amy Olson, DNP, RN, Nursing Education Specialist, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
• Rorey Pritchard, EdS, MEd, MSN, RN-BC, CNOR(E), CNE, Senior RN Clinical Educator, Allevant Solutions, LLC
• Kelly Shafaie, MSN, RN, Associate Dean of Nursing, Moraine Park Technical College
• Dr. Ernise Watson, PhD, RN, Associate Dean of Nursing, Madison Area Technical College
• Sherry Willems, HSHS St. Vincent Hospital

Reviewers

Reviewers provided constructive feedback on the final draft of the textbook based on a rubric.

• Dr. Caryn Aleo, PhD, RN, CCRN, CEN, CNEcl, NHDP-BC, NPD-BC, Pasco-Hernando State College, New Port Richey, FL
• Dr. Kimberly Amos, PhD, MS(N), RN, CNE, Isothermal Community College, Spindale, NC
• Sara Annunziato, MSN, RN, Rockland Community College, Suffern, NY
• Megan Baldwin, MSN, RN, CNOR, MercyOne Medical Center, Des Moines, IA
• Lisa Bechard, MSN, RN, Mid-State Technical College, Wisconsin Rapids, WI
• Dr. Kim Belcik, PhD, RN-BC, CNE, Texas State University St. David’s School of Nursing, Round Rock, TX
• Nancy Bonard, MSN, RN-BC, St. Joseph’s College of Maine, Standish, ME
• Dr. Joan Buckley, PhD, RN, Nassau Community College, Garden City, NY
• Valerie J. Bugosh, MSN, RN, CNE, HACC, Harrisburg Area’s Community College, Harrisburg, PA
• Dr. Sara I. Cano, PhD, RN, College of Southern Maryland, La Plata, MD
• Katherine Cart, MSN, RN, MAM, CEN, Blinn College, Brenham, TX
• Travis Christman, MSN, RN, HSHS Sacred Heart Hospital & St. Joseph’s, Eau Claire, WI
• Dr. Andrea Dobogai, DNP, RN, Moraine Park Technical College, Fond du Lac, WI
• Stacy Svoma Doering, MAEd, RDMS, RVT, Chippewa Valley Technical College, Eau Claire, WI
• Jessica Dwork, MSN-Ed, RN, Phoenix College, Phoenix, AZ
• Dr. Kim English, RN, BScN, MN, EDD(c), Trent/Fleming School of Nursing, Peterborough & Durham Greater Toronto Area, Canada
• Dr. Rachael Farrell, EdD, MSN, RN, CNE, Howard Community College, Columbia, MD
• Kathleen Fraley, MSN, RN, St. Clair County Community College, Port Huron, MI
• Kailey Funk, MSN, RN, Madison College, Madison, WI
• Kristin Gadzinski, MSN, RN, Lakeshore Technical College, Cleveland, WI
• Amy Gatton, MSN, RN, CNE, Nicolet Area Technical College, Rhinelander, WI
• Julia Geurs, Nursing Student, St. Catherine University, St. Paul, MN
• Jillian Golde, MSN, RN, CMSRN, Vermont Technical College, Randolph, VT
• Anna Golembiewski, MSN, RN, Waukesha County Technical College, Pewaukee, WI
• Melissa Hauge, MSN, RN-BC, Madison College, Madison, WI
• Sharon Rhodes Hawkins, MPA, MSN/ed, RN, Sinclair Community College, Dayton, OH
• Lexa Hosier, Nursing Student, St. Catherine University, St. Paul, MN
• Katherine Howard, MS, RN-BC, CNE, Raritan Bay Medical Center Nursing Program at Middlesex County College, Edison, NJ
• Tracy Joosten, MSN, RN, FNP-BC, Mid-State Technical College, Wisconsin Rapids, WI
• Jenna Julson, MSN, RN, NPD-BC, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
• Dr. Andrew D. Kehl, DNP, MPH, APRN, RN, Vermont Technical College, Randolph, VT
• Lindsay Kuhlman, BSN, RN, HSHS Sacred Heart Hospital, Eau Claire, WI
• Dr. Colleen Kumar, PhD, RN, CNE, JFK Muhlenberg Harold B. and Dorothy A. Snyder Schools, Plainfield, NJ
• Erin Kupkovits, MSN, RN, Madison College, Madison, WI
• Dawn M. Lyon, MSN, RN, St. Clair County Community College, Port Huron, MI
• Jennifer Madkins, MSN, RNC-OB, C-EFM, CNE, Prince George’s Community College, Largo, MD
• Dr. Lydia A. Massias, EdD, MS, RN, Pasco-Hernando State College, New Port Richey, FL
• Dr. Jamie Murphy, PhD, RN, State University of New York, Delhi, NY
• Jody Myhre-Oechsle, CPhT, MS, Chippewa Valley Technical College, Eau Claire, WI
• Kelly Nelson, MSN, RN, Mid-State Technical College, Wisconsin Rapids, WI
• Dr. Colleen Nevins, DNP, RN, CNE, CSU Channel Islands, Camarillo, CA
• Angela Ngo-Bigge, MSN, RN, FNP-C, Grossmont College, EI Cajon, CA
• Dr. Allison A. Nicol, PhD, RN, CNE, Milwaukee Area Technical College, Milwaukee, WI
• Dr. Tennille O’Connor, DNP, RN, CNE, Pasco-Hernando State College, New Port Richey, FL
• Dr. Amy Olson, DNP, RN, Mayo Clinic Health System, Eau Claire, WI
• Dr. Grace Paul, DNP, RN, CNE, Glendale Community College, Glendale, AZ
• Barbara B. Peters, MSN, RN, Northeast Wisconsin Technical College, Niagara, WI
• Krista Polomis, MSN, RN, Nicolet College, Rhinelander, WI
• Mary A. Pomietlo, MSN, RN, CNE, University of Wisconsin-Eau Claire, Eau Claire, WI
• Dr. Regina Prusinski, DNP, APRN, CPNP-AC, FNP-BC, Otterbein University, Westerville, OH
• Jenna E. Raths, MSN, RN, Chippewa Valley Technical College, Eau Claire, WI
• Dr. Debbie Rickeard, DNP, MSN, BScN, BA, RN, CNE, CCRN, University of Windsor, Windsor, Ontario, Canada
• Ann K. Rosemeyer, MSN, RN, Chippewa Valley Technical College, Eau Claire, WI
• Callie Schlegel, Nursing Student, St. Catherine University, St. Paul, MN
• Celee Schuch, Nursing Student, St. Catherine University, St. Paul, MN
• Dr. Barbara Sinacori, PhD, RN, CNRN, CNE, Rutgers University, New Brunswick, NJ
• Dominic Slauson, MA, Chippewa Valley Technical College, Eau Claire, WI
• Jenna Sorenson, MSN, RN, CNE, Chippewa Valley Technical College, Eau Claire, WI
• Chassity Speight-Washburn, MSN, RN, CNE, Stanly Community College, Albemarle, NC
• Dr. Suzanne H. Tang, DNP, MSN, RN, FNP-BC, PHN, Rio Hondo College, Whittier, CA
• Alison L. Thompson, MSN, RN, Austin Community College, Austin, TX
• Barbara Timmons, MSN, RN, Fox Valley Technical College, Appleton, WI
• Jacquelyn R. Titus, MS, RN, Pasco-Hernando State College, New Port Richey, FL
• Jacqueline Tousignant, MSN, RN, WCC, Nicolet College, Rhinelander, WI
• Dr. Venius Turner-Gwin, DNP, RN, Jefferson State Community College, Birmingham, AL
• Amy Tyznik, MSN, RN, Moraine Park Technical College, Fond du Lac, WI
• Jennie Ver Steeg, MA, MS, MLS, Mercy College of Health Sciences/MercyOne Des Moines, Des Moines, IA
• Dr. Nancy Whitehead, PhD, APNP, RN, Milwaukee Area Technical College, Milwaukee, WI
• Dr. LaDonna Williams, DNP, RN, Lord Fairfax Community College, Warrenton, VA
• Dr. Jamie Zwicky, EdD, MSN, RN, Moraine Park Technical College, Fond du Lac, WI

Licensing/Terms of Use

This textbook is licensed under a Creative Commons Attribution 4.0 International (CC-BY) license unless otherwise indicated, which means that you are free to:

• SHARE – copy and redistribute the material in any medium or format
• ADAPT – remix, transform, and build upon the material for any purpose, even commercially

The licensor cannot revoke these freedoms as long as you follow the license terms.

• Attribution: You must give appropriate credit, provide a link to the license, and indicate if any changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• No Additional Restrictions: You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
• Notice: You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
• No Warranties are Given: The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.

Attributions

Some of the content in this textbook was adapted from the following open educational resources or materials available in the public domain. For specific citation and attribution details, please refer to the footnotes at the bottom of each page of the book.

• Nursing Pharmacology by Chippewa Valley Technical College is licensed under CC BY 4.0.
• Nursing Fundamentals by Chippewa Valley Technical College is licensed under CC BY 4.0.
• Anatomy & Physiology by OpenStax is licensed under CC BY 4.0. Access for free at https://openstax.org/books/anatomy-and-physiology/pages/1-introduction
• Clinical Procedures for Safer Care by British Columbia Institute of Technology is licensed under CC BY 4.0.
• The Complete Subjective Health Assessment by Lapum, St-Amant, Hughes, Petrie, Morrell, and Mistry is licensed under CC BY 4.0.
• Human Development Life Span by Overstreet is licensed under CC BY 4.0.
• StatPearls by StatPearls Publishing is licensed under CC BY 4.0.
• Vital Sign Measurement Across the Lifespan – 1st Canadian Edition by Ryerson University is licensed under CC BY 4.0.
• Anatomy and Physiology by Boundless is licensed under CC BY-SA 4.0.
• The Scholarship of Writing in Nursing Education: 1st Canadian Edition by Lapum, St-Amant, Hughes, Tan, Bogdan, Dimaranan, Frantzke, and Savicevic is licensed under CC BY-SA 4.0.
• World Health Organization (WHO)
• Centers for Disease Control and Prevention (CDC)
• U.S. National Institutes of Health’s National Heart, Lung, and Blood Institute (NHLBI)

Content that is not taken from the above OER or public domain should include the following attribution statement:

Ernstmeyer, K., & Christman, E. (Eds.). (2021). Open RN Nursing Skills by Chippewa Valley Technical College is licensed under CC BY 4.0.