Nursing Program. NUR330: Advanced Health Assessment Fall Course Information: Course Title: Advanced Health Assessment Synonym Number: 93141

Transcription

1 Nursing Program NUR330: Advanced Health Assessment Fall 2015 I. Course and Instructor: Connie Geiman DNP, RN II. Format: Hybrid Experiential Based Learning Course Information: Course Title: Advanced Health Assessment Synonym Number: Course Code: NUR330 Credits: 3 (45 hours) Semester: Fall, 2015 Prerequisite: Admission to the BSN Program or Department Approval Meeting Times and Days: Mondays, 10/26/15 & 11/30/15, 5:30-6:30 Class Location: Collaborate, IVS on campus at Breck #219 & Spring Valley #127 Start Date: 10/12/15 End Date: 12/11/15 Refund Date: 10/27/15 Withdraw Date: 11/29/15 Instructor Information: Connie Geiman Phone: (970) Fax: (970) cgeiman@coloradomtn.edu Instructor Office Room #: Spring Valley Campus, Calaway Bld, rm 218 Office Hours: By appointment only II. III. Course Description: Extend concepts of health assessment skills and knowledge necessary to gather a complete and comprehensive database to determine the health status of clients throughout the lifespan. Interviewing skills and history taking, as well as advanced physical, psychological, social, and cultural aspects of clinical assessment are emphasized. The health status appraisal information is then utilized to assist the patient in maintaining a maximum level of health by guiding clients to adopt preventative health practices and/or reduce risk behavior. Course Outcomes: 1. Incorporates the roles of the professional nurse into conducting a health history on a variety of clients across the lifespan. (Program Outcome 1) 2. Demonstrates a comprehensive physical assessment, analyzes patient situations, and applies clinical reasoning/critical thinking skills as necessary to provide quality patient care to diverse populations. (Program Outcome 6) 3. Discriminates between normal or abnormal health assessment and physical assessment findings. (Program Outcome 5) 4. Analyzes health/illness beliefs, culture, values, attitudes, behavior, and lifestyle to collaboratively plan with the patient to promote optimal health. (Program Outcome 3)

2 5. Evaluates evidence-based care for promoting wellness, health promotion and disease prevention for individuals, families, groups, communities, and diverse populations across the lifespan and continuum of healthcare environments. (Program Outcome 3) 6. Appraises written, verbal, non-verbal, emerging technologies, and interpersonal communication and collaboration to communicate effectively normal and abnormal health assessment findings to the entire interdisciplinary team for improving patient health outcomes. (Program Outcome 4 and 6). Course Outcomes and Competencies: 1. Incorporates the roles of the professional nurse into conducting a health history on a variety of clients across the lifespan. (Program Outcome 1) a. Analyzes the roles of the professional nurse in conducting a health history. b. Performs a holistic health history and other subjective assessments on clients across the lifespan, including eliciting patient values, preferences, expressed needs, and impact of the developmental, emotional, cultural, religious, and spiritual influences on the patient s status. 2. Demonstrates comprehensive physical patient assessment, analyzes patient situations, and applies clinical reasoning/critical thinking skills as necessary to provide quality patient care to diverse populations. (Program Outcome 6) a. Analyzes the roles of the professional nurse in conducting a physical assessment. b. Demonstrates psychomotor skills needed to conduct a physical assessment including percussing, palpating and advanced ear, eyes, nose and throat assessment skills. c. Defends the importance of performing a comprehensive physical assessment patient assessment using developmentally and culturally appropriate approaches. d. Points out actual and potential health problems for diverse clients across the life span. e. Performs a comprehensive physical assessment on clients across the lifespan, including eliciting patient values, preferences, expressed needs, and impact of the developmental, emotional, cultural, religious, and spiritual influences on the patient s status 3. Discriminates between normal or abnormal health assessment and physical assessment findings. (Program Outcome 5) a. Evaluates and implements skills of inquiry and analysis to differentiate normal and abnormal findings when performing a health and physical assessment. 4. Analyzes health/illness beliefs, culture, values, attitudes, behavior, and lifestyle to collaboratively plan with the patient to promote optimal health. (Program Outcome 2) a. Outlines behaviors and lifestyles that affect health and wellness. b. Correlates health illness beliefs, culture, values, attitude, behavior and lifestyle to variations in the health assessment and physical assessment. c. Creates a plan of care for health promotion and disease prevention for clients. 5. Evaluates evidence-based care for promoting wellness, health promotion and disease prevention for individuals, families, groups, and diverse populations across the lifespan and continuum of healthcare environments. (Program Outcome 3) a. Appraises health promotion and disease prevention models, theories, and scholarly research. b. Compares and contrasts individual, family and assessments. c. Performs a variety of wellness assessments on clients across the lifespan. 6. Appraises written, verbal, non-verbal, emerging technologies, and interpersonal communication and collaboration to communicate effectively normal and abnormal health assessment findings to the entire interdisciplinary team for improving patient

3 health outcomes. (Program Outcome 4 and 6) a. Summarizes the role of information technology in effective communication and improving patient outcomes. b. Incorporates skills in using clinical technology and information systems into safe nursing practice. c. Utilizes therapeutic communication skills when communicating and collaborating with clients and the entire interdisciplinary team. Topical Outline: 1. Health and wellness theories and models 2. Health history, wellness assessments, and other assessments 3. Physical Assessment of adults, geriatrics, and children 4. Assessment of Families IV. IDEA Objectives: 1. Learning to apply course material (to improve thinking, problem solving, and decisions). 2. Developing specific skills, competencies, and points of view needed by professionals in the field most closely related to this course. 3. Developing skill in expressing oneself orally or in writing. 4. Learning how to find and use resources for answering questions or solving problems. V. Evaluation Methods and Class Management: Teaching Strategies: Case Studies Group Discussion Handouts Student participation Scholarly Paper Demonstrations Evaluation Process: The final theory grade will be determined by averaging the points from all work. See the Nursing Student Handbook for details about how grades are rounded. Competency Performance Assessments: Quizzes 20% Comprehensive Health History 10% Comprehensive Physical Assessment with Write-up 30% Risk Reduction Paper 20% Group Case Studies 20% Total 100% Students must receive a 77% average in order to satisfactory pass this class. See Nursing Student Handbook for more details. Late assignments will be handled per the Nursing Program policy as described in the Nursing Student Handbook. NOTICE: A student judged to have engaged in academic misconduct as defined in the Academic

4 Policies and Requirements section of the Colorado Mountain College Student Handbook will, at a minimum, receive a zero for the work in question. The student may also be removed from the class, resulting in a failing grade. All student course material may be submitted to turnitin.com (or another anti-plagiarism program) at the instructor s discretion. Academic Expectations, the Student Code of Conduct and Judicial Process and more information about academic misconduct can be found in the Student Handbook. Students are responsible for course materials from assigned text(s) and reading, lectures, labs, and other assignments as required. The instructor may alter any, or all, of this syllabus during the semester as the learning environment requires. Students will be notified in writing of changes. Attendance at all class meetings is expected. VI. Attendance and No-show Reporting Attendance and early engagement are important elements for your success in this course. All students who do not attend the first class (es) or meet early attendance requirements must be reported by the instructor to the Registrar s Office. Financial aid students or students receiving Veteran s benefits who do not attend the first class(es) or meet early attendance requirements will be dropped from the course and may not receive financial assistance ( VII. Students with Disabilities If you have a disability protected by the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act and feel you may need classroom accommodations based on the impact of your disability, please contact the Disability Services Coordinator on your campus. Aspen, Carbondale, Glenwood Springs (including Spring Valley): Dr. Anne Moll at Breckenridge and Dillon: Karin Mitchell at Leadville and Chaffee County Jan Ohmstede at Leadville or ext Chaffee County Edwards: Sue O Connor at Steamboat Springs: Deb Farmer at Rifle: Libby Neal at VIII. Withdrawal from this Course Students wishing to withdraw from this course must INITIATE the course withdrawal/drop process at the site Registration Office. This class could be cancelled one week prior to the census date if a sufficient number of students are not enrolled by that date. IX. Grading System & Options: Information about the CMC grading scale is available in the College Catalog. You will

5 receive a grade report for current semester courses at the end of each term. This grade report is mailed to your permanent mailing address. Reports are mailed approximately two weeks after the end of the academic term. Grading Scale: The following grading scale will be used throughout the CMC Nursing Programs. A C A C B C B D B F 0 69 Faculty may use the Gradebook application on Canvas or another online LMS program to assist students in monitoring their progress and current grade based on completed assignments and exams. While this may be a useful tool for the student, calculated grades on Canvas or other LMS applications are not official grades. Official grades will be posted in Web-Advisor. X. Grading System & Options Information about grading is available in the Colorado Mountain College catalog. Grades will be posted to (WebAdvisor) by Thursday following the last day of classes at the end of each semester. Faculty may use the Gradebook application on Canvas or another online LMS program to assist students in monitoring their progress and current grade based on completed assignments and exams. While this may be a useful tool for the student, calculated grades on Canvas or other LMS applications are not official grades. Official grades will be posted in WebAdvisor. Grading Scale: The following grading scale will be used throughout the Nursing Programs: A C A C B C B D B F 0 69 XI. Required Course Materials: Jarvis, C. (2016) Physical Examination & Health Assessment (7TH ED). Philadelphia, PA: Saunders. CMC Nursing Program Student Handbook Recommended Course Materials: Jarvis, C. (2016). Student Laboratory Manual for Physical Examination and Health Assessment (7TH ED) Philadelphia, PA: Saunders. Jarvis, C. (2016). Physical Examination & Health Assessment Pocket Companion (7TH ED)

6 Philadelphia, PA: Saunders. Colorado Mountain College has chosen to partner with Follett Virtual Bookstores to operate textbook services. The official textbook list for CMC will be available on Follett's site, You also can easily access this site by choosing "bookstore" from the quick links on Students and other members of the campus community should sign up for the Online Textbook Store's mailing list here to receive important messages from the CMC Online Textbook Store. Why did CMC choose Follett Virtual Bookstores? Follett offers its customers the best text rental program in the industry, which saves 50% or more off the cost of a new book. The online store also gives CMC students access to the largest supply of moneysaving used textbooks, with 2.5 million in stock and ready to ship direct from Follett's warehouse. Follett offers the best price when buying back books at the end of the term. Students can sell back books anytime online or in-person at Follett's CMC buyback events. Sign up for the online store's list at for more info on future buyback dates and times. If you ever have any online bookstore questions, you can coloradomtn@fvb.follett.com or call XII. Other Information: 1. Attendance may be required for specified course activities. It is the student s responsibility to notify the instructor if he/she is unable to attend a required course activity. 2. Students are responsible for following course polices found in the Colorado Mountain College Nursing Program Student Handbook and the Colorado Mountain College Student Handbook. 3. Student Expectations: Students will be active learners, engaged in course reading material and activities. Student s interactions with other students and faculty will be based on truth, trust, respect and responsiveness. XIII. Virtual Library Information: You will find online articles, books and other library resources on the following web site: Virtual Library Help Desk If you need help with the Virtual Library, reference@coloradomtn.edu or call , extension 2926 or 2804.

7 STATEMENT OF PROFESSIONAL BEHAVIOR Upon entering the profession of nursing, nurses accept the responsibilities and trust that have accrued to nursing over the years, and also nurses accept the obligation to adhere to the profession s code for ethics. The Code for Nurses, published by the American Nurses Association, is the standard by which ethical conduct is guided and evaluated by the profession. It provides a framework within which nurses can make ethical decisions and discharge their professional responsibilities to the public, to other members of the health team, and to the profession. The CMC Nursing Program supports The Code of Ethics for Nurses. This high standard of professional behavior applies to the classroom and student learning activities in all settings when representing CMC as a nursing student.

8 Week Topic Chapter Assignment 1 Unit 1 Health and Wellness Theories and Models Read Jarvis Chapter 1 & 2 Group Case Study 1 2 Unit 2: Overview of the Health and Physical Assessment Process including Health History and Additional Assessments Read Jarvis Chapter 3-7 Review Jarvis Chapters 8-11 Comprehensive Health History Write-up Due 3 Unit 3: HEENT & Neurological Assessment 4 Unit 4: Skin, hair, and nails Assessment & Thorax and Lung Assessment 5 Unit 5: Cardiac and Vascular & Lymphatic Assessment 6 Unit 6 Abdomen & Musculoskeletal Assessment 7 Unit 7: Male/Female Genitourinary, Anus, Rectum, Prostate & Breast and Lymphatic Assessment 8 Unit 8: Special Populations: Pediatric, the Older Adult & the Pregnant Woman Assessments Read Jarvis Chapters & 23 Read Jarvis Chapters 12 & 18 Read Jarvis Chapters 19 & 20 Read Jarvis Chapters 21 & 22 Read Jarvis Chapters 17 & Read Jarvis Chapters 28, 30 & 31 Group Case Study 2: Neurological Video or lab of HEENT assessment Quiz 1 Group Case Study 3 Quiz 2 Risk Reduction Paper Due Group Case Study 4 Quiz 3 Comprehensive Physical Assessment and Write-up

9 NUR330 Advanced Health Assessment Unit 1 Health and Wellness Theories and Models Purpose: Assessing health and wellness begins with understanding disease prevention and health promotion. A health care system that promotes wellness is more sustainable then one that focusses on curing illness. Nurses assist clients to adopt preventative health practices and reduce risk behaviors, thereby maximizing clients level of health and independence. This unit will be based on models and theories of disease prevention and health promotion. A focus will be on identifying health risk factors, and on health promotion and maintenance. Student learning objectives: Through student learning activities of reading, and case studies, and class participation the student will be able to: 1. Explore concepts of health, illness, wellness, and health beliefs. (Course Outcome 5) 2. Investigate theories and research findings for health promotion, risk reduction, and disease prevention. (Course Outcome 5) 3. Collaborate with clients to promote health and reduce risks. (Course Outcomes 4 and 6) 4. Analyze internal and external factors that influence health. (Course Outcome 4) 5. Explore avenues for responsible participation in socio-political action to influence the health of communities worldwide. (Course Outcome 5) 6. Perform a wellness assessment. (Course Outcome 1) Learning Activities: 1. Group Case Study 2. Jarvis, C. (2016) Physical Examination & Health Assessment (7TH ED). Philadelphia, PA: Saunders, Chapters Begin Risk Reduction Paper

10 NUR330 Advanced Health Assessment Unit 2 Overview of the Health and Physical Assessment Process including Health History and Additional Assessments Purpose: The health history and other subjective assessments are often conducted on initial meeting of the patient. The health history and additional assessments will give the nurse a holistic, qualitative picture of the patient. There will be discussion on how to obtain the components of a health history while using therapeutic communication skills. Focus will be on best ways to elicit patient values, preferences, and expressed needs while understanding the patient s developmental, emotional, cultural, religious and spiritual values. The goal of a holistic assessment will be achieved by covering additional subjective assessments. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Analyze history and assessment data as they relate to a health history, mental health assessment, spiritual assessment, cultural assessment, and nutrition assessment. (Course Outcome 1) 2. Select subjective assessment data as they relate to a mental health assessment, spiritual assessment, cultural assessment, substance use assessment, domestic & family violence assessment and nutrition assessment. (Course Outcome 2) 3. Explain various cultural influences and developmental influences on mental health. (Course Outcome 4) 4. Analyze influence of spirituality on healthcare. (Course Outcome 4, 5, and 6) 5. Differentiate nutritional requirements across the lifespan. (Course Outcome 5) 6. Summarize the components of the health history. (Course Outcome 1) 7. Perform and document a health history, mental health assessment, spiritual assessment, cultural assessment, and nutrition assessment. Use the skills and techniques needed for the physical assessment including percussion and palpation. (Course Outcome 2 and 3) 8. Defend the role of assessment in all levels of preventive healthcare. (Course Outcome 5) 9. Distinguish between phases of the interview. (Course Outcome 6) 10. Appraise various nursing and interdisciplinary documentation methods for charting assessment data (Course Outcome 6) 11. Summarize the components of the physical assessment. (Course Outcome 2) Learning Activities: 1. Comprehensive Health History Write-up Due 2. Jarvis, C. (2016). Physical Examination & Health Assessment (7TH ED). Philadelphia, PA: Saunders, Chapters 3-11.

11 NUR330 Advanced Health Assessment Unit 3 HEENT & Neurological Assessment Purpose: The purpose of this unit is to assess the head, face, neck, eyes and ears (HEENT) and the neurological system. The head, neck and face are complex in their actions and contribute to the body s communication, expression, nourishment and sensation. Finally, the eyes and ears are major sensory structures that allow us to communicate with the outside world. The topics covered in this unit are often the initial objective and subjective data that nurses observe in their clients. The nursing student will understand that when clients are having a functional problem with the structures of the HEENT, the dysfunction can: prevent the patient from communicating with the outside world, prevent the patient from eating. Furthermore, the nursing student will be able to discuss how alterations in the integumentary system or structures in the HEENT can be a window into problems with other systems. In addition, this unit covers the neurological system, which is large and unique and allows the body to interact with the external environment. The neurological system directs homeostasis for many of the body s functions. Manifestations of alterations in the nervous system can vary from paresthesia to complete immobility. The professional nurse must recognize variances between cultures and the diverse patient populations. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Outline pertinent HEENT and neurological history questions. (Course Outcome 1) 2. Explain developmental and cultural variations of the HEENT and neurological system. (Course Outcome 4) 3. Develop a list of actual/potential health problems of the HEENT and neurological system. (Course Outcome 2 and 3) 4. Differentiate normal and abnormal HEENT and neurological system findings for diverse populations across the lifespan. (Course Outcome 3) 5. Perform a HEENT and neurological history and physical assessment and document findings. Utilize advanced ear, eyes, nose and throat assessment skills. (Course Outcome 1, 2 and 6) Learning Activities: 1. Jarvis, C. (2016). Physical Examination & Health Assessment (7TH ED) Philadelphia, PA: Saunders, Chapters & Group Case Study: Neurological System 3. Video or lab of HEENT assessment

12 NUR330 Advanced Health Assessment Unit 4 Skin, Hair, and Nails Assessment & Thorax and Lung Assessment Purpose: The purpose of this unit is to assess the integumentary and the respiratory system. The topics covered in this unit are often the initial objective and subjective data that nurses observe in their clients. The integumentary system is the largest organ of the body and provides invaluable information about all the body systems. Alterations in the respiratory systems can cause detrimental problems throughout the body, including death. Being able to recognize normal and abnormal within the respiratory system is key for the professional nurse. The professional nurse must recognize variances between cultures and the diverse patient populations. The role of the teacher is also stressed in this unit when it comes to recognizing those at risk for alterations in the integumentary and respiratory system and educating the patient in prevention of integumentary and respiratory diseases. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Outline pertinent skin, hair, nails, thorax and lung questions. (Course Outcome 1) 2. Explain developmental and cultural variations of the skin, hair, nails, thorax and lung. (Course Outcome 4) 3. Develop a list of actual/potential health problems of the skin, hair, nails, thorax and lung. (Course Outcome 2 and 3) 4. Differentiate normal and abnormal skin, hair, nails, thorax and lung findings for diverse populations across the lifespan. (Course Outcome 3) 5. Perform a skin, hair, nails, thorax and lung history and physical assessment and document findings. (Course Outcome 1, 2, and 6) Learning Activities: 1. Jarvis, C. (2016). Physical Examination & Health Assessment. (7TH ED) Philadelphia, PA: Saunders, Chapters 12 & Quiz

13 NUR330 Advanced Health Assessment Unit 5 Cardiac and Vascular & Lymphatic Assessment Purpose: The purpose of this unit is to assess the cardiovascular system, the peripheral-vascular system, and the lymphatic system. The cardiovascular system is considered the lifeline of the body. Acting as one of the most important organs, the heart pumps oxygenated blood to the cells and removes toxic carbon dioxide. The peripheral vascular disease aids in these functions. The lymphatic system functions to collect and drain excess tissue fluid and return it to the heart. The professional nurse will use critical thinking skills to assess the patient and determine alterations. Cardiovascular disease is the leading cause of death in adults in the United States. Health promotion will be stressed. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Outline pertinent cardiac, vascular & lymphatic history questions. (Course Outcome 1) 2. Explain developmental and cultural variations of the cardiac, vascular & lymphatic system. (Course Outcome 4) 3. Develop a list of actual/potential health problems of the cardiac, vascular & lymphatic systems. (Course Outcome 2 and 3) 4. Differentiate normal and abnormal cardiac, vascular & lymphatic system findings for diverse populations across the lifespan. (Course Outcome 3) 5. Perform a cardiac, vascular & lymphatic history and physical assessment and document findings. (Course Outcome 1, 2 and 6) Learning Activities: 1. Jarvis, C. (2016). Physical Examination & Health Assessment (7TH ED). Philadelphia, PA: Saunders, Chapters 19 & Group Case Study

14 NUR330 Advanced Health Assessment Unit 6 Abdominal & Musculoskeletal Assessment Purpose: The purpose of this unit is to assess the abdomen and the motor-musculoskeletal system. The abdominal cavity contains many of the major organs of the body including the liver, spleen, gallbladder, pancreas, kidneys, stomach and intestines. The organs contribute to the body s ability to digest and clear the body of toxins. The abdominal assessment can be complex because of the sheer number of organs that are contained in the cavity. It is important for the nurse to understand the location and function of the organs within the abdominal cavity. When a patient complains of abdominal pain, the professional nurse must be able to recognize that there are a few abdominal disease conditions that are medical emergencies. Because of the complexity of the abdomen, the professional nurse will have to use his or her critical thinking skills. Additionally, the musculoskeletal system provides shape, support, and protection to the body while the motor portion allows for movement. Alterations in the musculoskeletal system can occur in all ages and these deficits can be life-altering for the patient. The professional nurse must recognize variances between cultures and the diverse patient populations. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Outline pertinent abdomen and musculoskeletal assessment history questions. (Course Outcome 1) 2. Explain developmental and cultural variations of the abdomen and musculoskeletal assessment. (Course Outcome 4) 3. Develop a list of actual/potential health problems related to the abdomen and musculoskeletal assessment. (Course Outcomes 2 and 3) 4. Differentiate normal and abnormal abdomen and musculoskeletal assessment findings for diverse populations across the lifespan. (Course Outcome 3) 5. Perform an abdomen and musculoskeletal assessment history and physical and document findings. (Course Outcomes 1, 2, and 6) Learning Activities: 1. Jarvis, C. (2016). Physical Examination & Health Assessment(7TH ED). Philadelphia, PA: Saunders, Chapters 21 & Quiz 3. Risk Reduction Paper Due

15 NUR330 Advanced Health Assessment Unit 7 Male/Female Genitourinary, Anus, Rectum, Prostate & Breast and Lymphatic Assessment Purpose: This unit contains a variety of information ranging from the female and male genitourinary system to the anus, rectum, and prostate. An introduction to the female and male genitourinary systems as well as the anus, rectum and prostate will be covered, and a discussion on how it is important to the overall care of the clients. There are medical emergencies that men can present with pertaining to the male genitourinary system. Additionally, there are many opportunities for health promotion related to sexually transmitted infections (STI). Any genitourinary and prostate dysfunction can impact either or both the reproductive or urinary functions of the body. In addition, learning how to perform a safe, quality breast exam will aid in the detection of breast cancer. Assessing breasts is often a sensitive area for many clients; therefore, compassionate communication will be discussed. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Outline pertinent Male/Female Genitourinary, Anus, Rectum, Prostate & assessment history questions. (Course Outcome 1) 2. Explain developmental and cultural variations of the Male/Female Genitourinary, Anus, Rectum, Prostate & Breast and Lymphatic Assessment. (Course Outcome 4) 3. Develop a list of actual/potential health problems related to the Male/Female Genitourinary, Anus, Rectum, Prostate & Breast and lymphatic Assessment. (Course Outcome 2 and Differentiate normal and abnormal Male/Female Genitourinary, Anus, Rectum, Prostate & Breast and Lymphatic Assessment findings for diverse populations across the lifespan. (Course Outcome 3) 5. Perform a Male/female Genitourinary, Anus, Rectum, Prostate & Breast and Lymphatic history and physical assessment and document findings. (Course Outcome 1, 2, and 6) Learning Activities: 1. Jarvis, C. (2016). Physical Examination & Health Assessment(7TH ED). Philadelphia, PA: Saunders, Chapters 17 & Group Case Study

16 NUR330 Advanced Health Assessment Unit 8 Special Populations: Pediatric, the Older Adult, and the Pregnant Woman Assessments Purpose: This unit covers special populations: pediatrics, older adult and the pregnant woman. In order to accommodate for the growing fetus within, the pregnant mother goes through many physical and emotional changes. The gestation of a fetus is 9 lunar months and each month is met with a wide range of changes. The nurse will have a survey of changes as well as health promotion during this time. Another special population discussed in this unit is the pediatric patient (birth to 17 years old). The pediatric patient offers many challenges and are not just little adults. Recognizing respiratory and cardiac abnormalities early is extremely important. There is much opportunity for the nurse to engage with the family unit and provide education. Finally, the older adult will be covered. The geriatric population is often regarded as a vulnerable population. Attention to the normal changes and health promotion related to the older adult will be covered. The summary of the unit and the course is a brief overview on how to complete a head-totoe, which will help the nursing student prepare for his or her final exam in the class. Student learning objectives: Through learning activities of reading, class, case studies, and class participation the student will be able to: 1. Differentiate normal physiological changes in the pediatric patient, the older adult, and the pregnant woman. (Course Outcome 3) 2. Outline various cultural influences in the pediatric, the older adult, and the pregnant women populations. (Course Outcome 4) 3. Identify health issues and risks for the pediatric, the older adult, and the pregnant women populations. (Course Outcome 5) 4. Identify pertinent history data included in a pertinent pediatric, older adult, and the pregnant woman assessment. (Course Outcome 1) 5. Point out additional physical assessment components specific to the pediatric, the older adult, and the pregnant women populations. (Course Outcome 3) 6. Develop a list of actual/potential health problems common to pediatric, the older adult, and the pregnant women population. (Course Outcome 2 and 3) 7. Perform a pediatric, older adult, and/or pregnant woman history and physical assessment and document findings. (Course Outcome 1, 2 and 6) Learning Activities 1. Jarvis, C. (2016). Physical Examination & Health Assessment(7TH ED). Philadelphia, PA: Saunders, Chapters 28, 30 & Comprehensive Physical Assessment and Write-up 3. Quiz

17 NUR330 Advanced Health Assessment Health History Write-up Purpose: Nursing professionals need to have comprehensive in-depth assessment skills. Assessment provides nurses a window into an individual s physiologic condition. Interview skills are imperative to eliciting information that will lead the nurse to a complete holistic assessment. Directions: Each student will be completing a health history write-up in this course. The nursing student will choose either an adult or a special populations (pediatric, older adult or pregnant woman) patient to assess. Students are encouraged to pick a population that they are interested in or a field in which the student wishes to specialize in. Students must include at least 2 of the special subjective assessments discussed in Unit 2. Use your textbook to guide your health history interview and write up. The following is a sample of a Complete Health History 1. Biographical Data Name: Address: Sex: Age: Birth date: Marital Status: Number of children and ages: Current Occupation: Religion/practice and attitude toward religion: Race: Ethnic origin Level of Education/ability to read and write: Health insurance plan: Advanced directives: Yes/No. Need information? Health history informant and reliability: 2. Chief Complaint: Signs and symptoms that led patient to seek health care: 3. Current Health Status and History of Present Illness: Precipitating/Palliative Factors: Quality/Quantity Region/Radiation/Related Symptoms: Severity: Timing: Pain rating and scale used: Effect on ADLs and other life areas: 4. Past History

18 Childhood Illnesses: Mumps, Chickenpox, rubella, frequent ear infections, frequent streptococcal infections or sore throats, rheumatic fever, scarlet fever, pertussis, asthma Chronic illnesses: heart disease, hypertension, diabetes, cancer, seizures Medications: prescription, over-the-counter, and herbals Immunizations: smallpox, measles, mumps, rubella, chickenpox, hepatitis B, diphtheria, tetanus, polio, Haemophilus influenza B (BHIB), pneumococcal vaccine, flu shot, swine flu shot, PPD, BCG Allergies: yes/no. Type: Response: Food/Latex/Medication Past Illnesses Surgeries: Type? When? Difficulties? Previous Hospitalizations: When and why? Blood transfusions: Trauma or other serious injuries: Recent Travel: Military Service 5. Family History: Pertinent specific illness in family: hypertension, strokes, ulcers, mental illness, alcoholism, epilepsy, gout, bleeding disorders, diabetes, heart disease, cancer, arthritis, ulcerative colitis. Also include a genogram. Spouse: Children: Brothers: Sisters: Mother: Father: Paternal grandparents: Maternal grandparents 6. Review of Systems: (to be referred to system assessments) 7. Developmental Considerations: include stage and theorist. Briefly (one to three sentences) describe how this patient is meeting or failing to meet the criteria for this stage 8. Psychosocial Profile

19 Health Practices and beliefs: how does the patient perceive his/her role in maintaining his/her health? How often does the patient visit a health care provider? Typical day: (have patient describe what he or she does in a typical day): Diet: Mealtimes: Prepared by: 24 hour recall: Special diet: Yes/NO, Type, when started Vitamins and/or diet pills: Satisfied with current weight: Specific difficulties: Activity and exercise Patterns: How often? Easy/moderate/difficult? Belong to a gym? Recreation/hobbies/pets: type? How often? Sleep/rest patterns: Average number of hours of sleep per day: Naps: Difficulty sleep: Yes/No How long? Remedies tried? Personal habits: Current smoker: Yes/No, Pack years Past smoker: how long, pack years, when did he/she quit? Other tobacco products: Yes/No Alcohol: Yes/No, Type, Amount, CAGE Drugs: Yes/No, Type (prescription, OTC, recreational or street), Amount: Caffeine: type: (coffee, tea, chocolate) how much? Occupational history: Exposed to toxins (asbestos, pesticides, plastics, anesthetics, radiation or solvents), require protective gear, heavy physical exercise, repetitive movements, job satisfaction (what does he/she like most? Least?) Socioeconomic status: Health insurance Dental insurance Limited financial resources Environmental Health Patterns: Type of community: urban, suburban, rural Type of dwelling: Water source: city or well Type of heating/adequate heating

20 Access to transportation: own car/public transportation Number of people in the household, relationship Number of smoke detectors Number of carbon monoxide detectors Roles/Relationships/Self Concept: Self-image: Positive Negative 3 strengths 3 weaknesses Do he/she feel in control of what happens to him or her or does he/she believe that whatever will be will be Any recent loss of function or change Cultural Influences: Which culture does the patient identify with? Language barrier: yes/no. If yes, which language? Cultural practices that may conflict with prescribed treatment plan Specific cultural practices that may can be included in plan of care? Religious/Spiritual Influences: Religion: Dietary preferences associated with religion: Accept blood transfusions: Yes/No Need to see a chaplain for health problems? Family roles and relationship: Describe support system and their location(s): Is your support system reliable? Why or why not? Sexuality Patterns: Date of first menstruation: Date of last menstruation: Is the female patient in menopause? Describe complications/feelings? Is the male patient having difficulties having or maintaining an erection? Is the patient sexually active? Monogamous? Multiple partners? Samesex/opposite sex? Is the patient satisfied with sex life? Social Supports: Is there anyone outside the family the patient can call for help? Does the patient belong to a place of worship? Have any other social support groups? Stress and Coping Patterns: Types of stress in life (name at least two)

21 Ways the patient copes with stress: (exercise, eating, talking, etc.)

22 Criteria All portions of the template are addressed and all questions are answered. Rubric for Comprehensive Health History Write-up Excellent 4 points No omissions. Good 3 point One to Two items omitted Acceptable 2 points Three or five items omitted Unsatisfactory 1 point Six items or more omitted Points Received/ Comments Each history question will be answered completely. Pertinent positive and negatives addressed using OLD CART or PQRST format Assignment is typed using 12 point legible word font, with correct grammar and spelling and abbreviations. Able to identify all pertinent positives (and negatives) and addresses using OLD CART or PQRST format All requirements of professional writing fulfilled One to Two items missed Missing one of the requirement Three or five items missed Missing two of the requirements Six items or missed Missing three or more of the requirements Copy of the rubric attached Professionalism Health History is free of judgement and HIPPA is observed at all times Met all of the requirements Missing one of the requirement Missing two of the requirements Total: /20 points

23 NUR330 Advanced Health Assessment Comprehensive Physical Assessment Purpose: Nursing professionals need to have comprehensive in-depth assessment skills. Assessment provides nurses a window into an individual s physiologic condition. Assessment skills help nurses to care for their clients while creating awareness for subtle changes which may require interventions for improved patient outcomes. Directions: Each student will be completing a head-to-toe assessment during this course. The nursing student will choose either an adult or a special populations (pediatric, older adult or pregnant woman) patient to assess. Students are encouraged to pick a population that they are interested in or a field in which the student wishes to specialize in. Students may choose to make an appointment and assess their patient in the lab, or students may choose to video the assessment. A complete write-up of the assessment is also required. You will need to ensure all of the elements of the assessment are included. The video assessments will be completed in 15 minutes and require patient consent. The video assessment will be uploaded to Canvas. A consent form is required for videoed assessments and can be found at the back of this syllabus. Use your text book as a guide for a head-to-toe physical assessment and write up.

24 Colorado Mountain College Bachelors of Science in Nursing Voluntary Participation Consent Thank you for being willing to work with a CMC BSN Nursing student as he/she advances his/her education. The student will be performing a comprehensive nursing assessment on you which will be videotaped. The student will at all times be professional respect your privacy and dignity. At no time will you be put in a compromising position. The assessment is videotaped so that the student can demonstrate competency in his/her assessment skills. The video will be presented to the course faculty but not seen outside of the CMC BSN nursing program assessment course. At the completion of the course the video sent to CMC will be destroyed. Date: I (Printed Name) agree to be a voluntary participant in a video recorded nursing assessment. Signature For underage minors please write out the minors name and have the parent or guardian sign above.

25 Grading Rubric for Comprehensive Physical Assessment Criteria Points Received/ Comments Student provided signed consent form for assessment 5 Points Consent provided or N/A 0 Points No consent provided Video included all expected aspects of an advanced head to toe assessment 40 Points Video Assessment had 5 or fewer omissions 30 Points Video Assessment had 10 or fewer omissions 20 Points Video Assessment had 15 or greater omissions 0 Points No Video Submitted Written description included all aspects of an advanced head to toe assessment 40 Points Written Assessment had no omissions 30 Points Written Assessment had 5 or less omissions 20 Points Written Assessment had 10 or greater omissions 0 Points No Written assessment Submitted Writing Professional, Grammar, Punctuation and Spelling 15 Points Excellent formatting, no grammar, spelling or writing errors 10 Points Fair formatting, 8 or fewer grammar, spelling and writing errors 5 Points Poor formatting, 14 or fewer grammar, spelling and writing errors 0 Points Greater than 15 grammar, spelling and writing errors, inappropriate format /100

26 NUR31x: Advanced Health Assessment Nursing Risk Reduction Paper Purpose: The nursing student will write a scholarly paper using APA format focusing on risk reduction of a preventative disease. Many diseases processes that we see today are preventable and/or reversible, such as coronary artery disease, obesity, diabetes, lung cancer, skin cancer, etc. After choosing a common disorder, the nursing student will identify health risk factors, health promotion and health maintenance associated with the disorder. The professional nurse assists clients to adopt preventative health practices and reduce risk behaviors, thereby maximizing clients level of health and independence. This paper will discuss how the professional nurse bests changes clients behaviors to reduce risks in order to achieve good health outcomes. Directions: Once the student has chosen a topic, the student should investigate risks associated with the disease and method of risk reduction. The student will then perform a search, preferably using CINAHL, for current research and journal articles discussing the topic. Do not use medical research; this is a nursing scholarly paper. The nursing student will find a minimum of 4 nursing articles from nursing journals. You may not use Wikipedia as a resource. (Course Outcomes 1, 4 & 5) The paper will include the following major components: Introduction: The first few sentences and paragraph of a paper are extremely important. Your audience will form its initial perceptions of you, and of your interventions, from the introduction. If you go too far in your efforts to impress your readers, the strain will show in your writing. To avoid this problem, you need to step back and consider the specific purposes that an introduction is supposed to serve. A successful introduction will provide an overview of your paper, attracts the audience's attention, and prepares your audience for your interventions. Background: Identify the disease process, including a brief pathophysiology description, the population at risk, incident and prevalence rates. Describe factors that increase/decrease risk for the disease process Nursing Interventions: Discuss the nursing interventions to reduce risks for the disease process (i.e. smoking cessation). Please give at least 2 methods of reducing risk. Describe how to best approach the patient in assisting him or her to adopt health promotion behaviors. What level of prevention are the interventions? Implications: What are the implications for the patient and the nurse? What is the rationale for the proposed interventions or self-examinations or routine testing to reduce the risk? Propose future ideas for nursing research. The paper will be a formal paper in APA format and will be words long. It is suggested that the student use the 6 th Edition of the APA manual, found in the library or easily purchased, as an aid in writing and citing this paper. There is also information in the appendix of the Nursing Student Handbook that can act as a basic guide. Use the rubric as a guide to writing the paper. The faculty instructor will be grading based on criteria set forth in the rubric. Referencing the rubric as the students writes and edits the paper will ensure maximum points.

27 Finally, my hope is the student finds inspiration and excitement in discovering research and reflecting. Have fun writing this paper. If you feel like you are struggling, see your faculty instructor or one of the many free writing tutors on campus for help.

28 Criteria Organization Reader can easily identify each section: 1. Introduction 2. Background 3. Nursing Interventions 4. Implications 5. Conclusion Excellent 4 points Paper is organized. Includes all 5 sections in an organized fashion Paper is correct length. Rubric for Scholarly Paper Good Acceptable 3 point 2 points Paper shows moderate organization. Lacking one of the major components. OR Paper<1250 words OR>2250 words Paper shows minimal organization. Lacking two or more of the major components. OR Paper<1000 OR>2750 words Unsatisfactory 1 point Paper has no organization. Lacking three or more of the major components. OR Paper <900 OR>3000 words Points Received/ Comments Background The background includes main topic: Risk Reduction Clearly describes the background, importance to nursing. Partially describes the background, importance to nursing. Minimally describes the background, importance to nursing. Does not describe the background, importance to nursing. Body of Paper (Main idea) Includes clear descriptions of nursing interventions and implications for nursing Conclusion The conclusion of the paper is clear and succinct. Clear descriptions of nursing interventions and implications for nursing The conclusion of the paper is clear and succinct. Partially clear descriptions of nursing interventions or partially clear implications for nursing (ie. Omits questions asked in the directions) The conclusion of the paper is partially clear and wordy (not succinct) Unclear descriptions of nursing interventions or implications of nursing (i.e does not answer any questions presented in directions) The conclusion of the paper is unclear and wordy. No nursing interventions and/or implications for nursing discussed. The conclusion of the paper is absent. Professional Writing No problems that cause distraction for the reader. Includes correct title page, citations, and reference page. Pages are numbered with running head. 12 Point Font Double-spaced APA format followed with no errors. Free from spelling and grammatical errors. Four or more appropriate resources; Includes correct title page, citations, and reference page; APA format followed with minimal errors. One to two spelling or grammatical errors. Two to three appropriate resources used. APA format minimally used with three to five spelling or grammatical errors. One outside resource or inappropriate resource used. APA format not used. Six or more spelling or grammatical errors. No outside resources used. Total Points/20

29 throughout paper. Correct Reference Page and citations. Pages are numbered with running head

30 NUR330: Advanced Health Assessment Wiki Group Case Study Purpose: This is a group project that analyzes and evaluates a health assessment of a hypothetical patient. Your group will use Collaborate, a free application available through Canvas to complete the case study as a group. The end result will be one document that incorporates the entire group s thoughts and insights. (Course Outcome 1, 3, 4 & 6) Directions: Students will be notified of their group. Working as a team, answer the case study assigned to you. It is important that you incorporate all student s ideas and insights into each answer. You must cite all references used. The case study groups and case study will posted on Canvas.