Patient Assessment (PHAR 3240) Spring 2015 Lecture and Lab Objectives. Lectures

Transcription

1 Patient Assessment (PHAR 3240) Spring 2015 Lecture and Lab Objectives Lectures Lecture #: 1 Instructor: Mary Klein Date/Time: January 5, :30-10:20 Lecture Name/Topic: Course Introduction, Vitals, BP, and Medication Histories Describe components of measuring a radial pulse List the components of a general exam Describe proper placement of a stethoscope in manual BP measurement Describe proper placement of the BP cuff in manual BP measurement Determine appropriate BP cuff size List the steps to taking a manual BP reading Explain the timing of systolic and diastolic measurements (Korotkoff phases and sounds) List components of a medication history Lecture #: 2 Instructor: Maegan Patterson/Taryn Satterwhite Date/Time: January 12, :30-10:20 Lecture Name/Topic: HEENT and Antibiotic Streamlining List major eye structures that should be inspected in an eye exam. List the process for performing a comprehensive ear exam. Describe steps to complete nasal & sinus assessment. Describe steps to perform a comprehensive assessment of the mouth and oropharynx. List and locate the lymph nodes of the head and neck. Discuss the benefits of antibiotic streamlining. Identify and interpret the basic components of a culture and susceptibility report. Define normal flora and identify examples of contaminated cultures Lecture #3: Instructor: Mary Klein Date/Time: January 19, :30-10:20 Lecture Name/Topic: Documentation Review and Practical Considerations for SOAP writing List components of the subjective, objective, assessment, and plan Discuss appropriate placement of information in the SOAP format Discuss common concerns with verbiage in SOAP notes

2 Lecture #4: Instructor: Mary Klein Date/Time: January 26, :30-10:20 Lecture Name/Topic: Respiratory Assessment 1 Identify the midclavicular, scapular, and vertebral lines on the chest. List adventitious breath sounds such as crackles, wheezes, and rhonchi. Define peak expiratory flow, forced expiratory volume, and total lung capacity. List the steps of performing a spirometry test. Classify asthma severity based upon symptom frequency and pulmonary function tests Classify PEF as measured by peak flow meter as Green Zone, Yellow Zone, Red Zone Lecture #5: Instructor: Livia Macedo Date/Time: February 2, :30-10:20 Lecture Name/Topic: Respiratory Assessment 2 Identify distinguishing features of various inhaler products List the steps for using various inhaler products and identify common errors Understand the role of spacers Review appropriate interview questions to assess a patient s asthma and COPD control Review asthma/copd main medications counseling points Lecture #6: Instructor: Thomas Parker Date/Time: February 9, :30-10:20 Lecture Name/Topic: Endocrine Assessment 1 Identify and demonstrate the basic steps in using the various monitoring tools Recall why and how we use these tools in management List the major complications of diabetes and the monitoring parameters of each. Describe the signs and symptoms of hypothyroidism and hyperthyroidism. Lecture #7: Instructor: Shanna James Date/Time: February 16, :30-10:20 Lecture Name/Topic: Endocrine Assessment 2 Review insulin pumps used in DM therapy. Counsel a patient on the proper use of a glucometer and Accuchek Softclix/Fastclix/Multiclix lancing devices. Identify differences between a variety of glucometers. Interview and assess patient for DM control and monitoring of DM complications.

3 Lecture #8: Instructor: George Jacob Date/Time: February 23, :30-10:20 Lecture Name/Topic: Cardiovascular Auscultation Briefly review basic cardiovascular pathophysiology Discuss the parts of a comprehensive cardiovascular assessment including patient interview, inspection, palpation, percussion, & auscultation Review cardiovascular specific laboratory data Briefly review vital signs measurement Lecture #9: Date/Time: March 2, :30-10:20 Lecture Name/Topic: No Lecture Midterm Practical Exam Lecture #10: Instructor: Kayley Will Date/Time: March 9, :30-10:20 Lecture Name/Topic: Peripheral Vascular Exam Perform a comprehensive patient assessment of the peripheral vascular system Develop an appropriate assessment and plan for a suspected deep vein thrombosis Explain the steps for performing a comprehensive diabetic foot exam Lecture #11: Instructor: Mary Klein Date/Time: March 16, :30-10:20 Lecture Name/Topic: Specifics on Standardized Patient Scenario Describe the scenario for the standardized patient interview List physical assessment skills that should be performed during the interview Explain the components of the SOAP rubric Lecture #12: Instructor: Jill Frost Date/Time: March 23, :30-10:20 Lecture Name/Topic: Cardiovascular Diagnostics Identify risk factors associated with cardiovascular disease Interpret common laboratory and diagnostic tests used in the assessment of cardiovascular disease Perform a fingerstick using appropriate technique Demonstrate proper use of Cholestech, CoaguChek, and Cardiochek Point of Care (POC) devices

4 Lecture #13: SPRING BREAK Lecture #14: Instructor: Jessica Garza Date/Time: April 6, :30-10:20 Lecture Name/Topic: Gastrointestinal, Hepatic, Renal Locate the four quadrants of the abdomen, and identify major gastrointestinal located within them. Explain the purpose of listening for bowel sounds and elucidate the procedure for doing so Explain the procedure for performing an H. pylori finger stick test, and interpret the results. Explain key drug related causes of diarrhea and constipation. List signs and symptoms of a GI bleed Appropriately calculate a patient s creatinine clearance based on the patient s weight Interpret a urinalysis to determine presence or absence of a urinary tract infection Lecture #15: Instructor: Rachel Basinger Date/Time: April 13, :30-10:20 Lecture Name/Topic: Psychiatric Assessment Define medical terminology commonly used during a psychiatric assessment Classify common mental disorders Name assessment tools used for the discussed mental disorders State the 4 domains of the MSE and provide examples of each Lecture #16: Instructor: Trista Bailey Date/Time: April 20, :30-10:20 Lecture Name/Topic: Neurologic Assessment Match names of the cranial nerves with their numbers Describe the function of Cranial Nerves I through XII, and match abnormal physical assessment findings to the corresponding cranial nerve List the features of common abnormalities of balance and gait, and what diseases these abnormalities are associated with Explain the Romberg test and the use of its findings Define proprioception, and recall which spinal tract it is related to Define stereognosis and graphesthesia, and explain what portion of the brain abnormalities in these tests relate Explain the difference in a positive and negative Babinski sign Describe the differences between the types of headaches

5 Lecture #17: Instructor: Trista Bailey Date/Time: April 27, :30-10:20 Lecture Name/Topic: Musculoskeletal Assessment Briefly review musculoskeletal A&P Briefly review musculoskeletal pathology Describe techniques for performing Phalen s Test and Tinel s Test Describe techniques for assessing range of motion and strength Describe procedures for using a qualitative ultrasound machine and reference ranges for assessment of related scores. Lecture #18: Date/Time: May 4, :30-10:20 Lecture Name/Topic: No Lecture Final Practical Exam Labs Lab #1: Date/Time: January 5-9, :30-4:10 Lab Name/Topic: Vitals, BP, and Medication Histories Measure a radial pulse using proper technique Appropriately describe a general exam for a patient case Describe proper placement of a stethoscope in manual BP measurement Describe proper placement of the BP cuff in manual BP measurement Determine appropriate BP cuff size Taking a manual BP reading on a partner Take a complete medication history using patient interview techniques given a patient case Lab #2: Date/Time: January 12-16, :30-4:10 Lab Name/Topic: HEENT and Antibiotic Streamlining Demonstrate inspection of the major eye structures. Demonstrate a comprehensive ear exam. Perform complete nasal & sinus assessment. Perform a comprehensive assessment of the mouth and oropharynx. Demonstrate palpation of the lymph nodes of the head and neck. Identify and interpret the basic components of a culture and susceptibility report. Practice appropriate antibiotic selection based on cultures Identify antibiotics that provide duplicate therapy and recognize when to narrow spectrum

6 Lab #3: Date/Time: January 12-16, :30-4:10 Lab Name/Topic: No Lab MLK Week Lab #4: Date/Time: January 26-30, :30-4:10 Lab Name/Topic: Respiratory Assessment 1 Perform auscultation of posterior respiratory sounds using the Z or U method. Perform 3 Peak Flow tests, record the best value, and compare to the Normal Peak Flow charts(in Pre-lab). Calculate your personal Green, Yellow, and Red peak flow zones. Identify normal and abnormal respiratory sounds using a manikin and ventriloscope Lab #5: Date/Time: February 2-6, :30-4:10 Lab Name/Topic: Respiratory Assessment 2 Interview a standardized patient who with asthma and analyze his/her medication regimen Perform a spirometry test and review spirometry reports for interpretation of results. Analyze COPD and Asthma patient medication regimens given a patient case using current guidelines. Lab #6: Date/Time: February 9-13, :30-4:10 Lab Name/Topic: Endocrine Assessment 1 Demonstrate proper technique for running a point-of-care A1c using the DCA Vantage machine. Given a patient case, evaluate A1c results and develop an assessment and plan for diabetes. List fasting and post-prandial blood glucose goals for a diabetic patient. Explain the steps to properly using an Accuchek Multiclix lancet device and an Accuchek Softclix lancet. Demonstrate how to program an insulin pump and fill a reservoir Lab #7: Date/Time: February 16-20, :30-4:10 Lab Name/Topic: Endocrine Assessment 2 Identify differences between glucometers based on sample size and availability of alternate site testing. Demonstrate proper technique in performing a point of care blood glucose test using a glucometer. Counsel a patient on the proper use of a glucometer and lancet device. Describe the signs and symptoms of thyroid disorders and interpret TSH lab results for hypothyroidism management

7 Lab #8: Date/Time: February 23-27, :30-4:10 Lab Name/Topic: Cardiovascular Auscultation Inspect, palpate, and auscultate the thoracic cavity for heart sounds using the diaphragm and bell of a stethoscope on a human. Demonstrate knowledge of correct placement of a stethoscope through the use of a ventriloscope on a 2G manikin. Demonstrate the palpitory method to estimate systolic BP. Perform the 13 step process for collecting an accurate BP with a stethoscope and sphygmomanometer. Lab #9: Date/Time: March 2-6, :30-4:10 Lab Name/Topic: Midterm Practical Assess student ability to perform skills learned in the first 8 weeks of the course Lab #10: Date/Time: March 9-13, :30-4:10 Lab Name/Topic: Peripheral Vascular Exam Demonstrate proper technique for palpating and evaluating peripheral pulses in both the upper and lower extremities. Perform and properly document a diabetic foot exam using a monofilament. Evaluate the treatment challenges associated with vascular insufficiencies of the lower extremities. Perform a complete patient history with emphasis on identifying actual and potential risk factors for developing a deep vein thrombosis (DVT). Assess a patient s acute risk for developing a DVT using a standardized assessment sheet. Assess a patient s current edematous state (or lack thereof) using the palpation method. Lab #11 Date/Time: March 16-20, :30-4:10 Lab Name/Topic: Standardized Patient Scenarios Complete a full patient interview and assessment including all pertinent medical history Display professionalism and cordiality when speaking with a patient during a patient interview Perform a diabetic foot exam Correctly perform a blood pressure, pulse, and respiratory rate check. Assess a patient s diabetes, blood pressure, and cholesterol control based on information obtained in a patient interview Develop a full treatment plan for a patient with diabetes, hypertension, and hypercholesterolemia. Document a patient encounter using the SOAP format

8 Lab #12 Date/Time: March 23-27, :30-4:10 Lab Name/Topic: Cardiovascular Diagnostics Demonstrate correct use of the Cardiochek point of care (POC) equipment. Demonstrate correct use of the Coagucheck POC equipment. Perform a technically correct finger stick. Demonstrate the assessment of a lipid panel using a mock patient scenario. Demonstrate the assessment of an INR using a mock patient scenario. Demonstrate the assessment of cardiac enzymes using a mock patient scenario. Demonstrate the ability to write an assessment and plan using a mock patient scenario. Demonstrate the assessment of blood pressure and pulse. Lab #13 Date/Time: March 30-April 4, :30-4:10 Lab Name/Topic: SPRING BREAK NO LAB Lab #14 Date/Time: April 6-10, :30-4:10 Lab Name/Topic: GI, Renal and Hepatic Locate the four quadrants of the abdomen and distinguish the presence of bowel sounds in each quadrant. Solve a GERD or PUD patient case and develop an appropriate plan. Given a patient s lab values, calculate his or her estimated creatinine clearance and provide recommendations for medication dose adjustments based on renal function Solve a constipation and diarrhea patient case. Analyze a patient s urinalysis and interpret the results. Lab #15: Date/Time: April 13-17, :30-4:10 Lab Name/Topic: Psychiatric Assessment Perform a St. Louis University Mental Status Examination (SLUMS) and Geriatric Depression Scale (GDS) on a patient Calculate and document a SLUMS exam score and a GDS score Explain the results of a SLUMS exam and GDS score Communicate verbally with a patient Interpret a mental status exam Compare and contrast the Patient Health Questionnaire-9 and the Montgomery-Asberg depression rating scale

9 Lab #16: Date/Time: April 20-24, :30-4:10 Lab Name/Topic: Neurological Assessment Describe the function of Cranial Nerves I through XII, and match abnormal physical assessment findings to the corresponding cranial nerve. Demonstrate assessment of balance and gait. Demonstrate the Romberg test, and explain the use of its findings. Demonstrate the assessment of proprioception, and match abnormal findings to the corresponding ascending spinal tract. Demonstrate assessment of bicep, triceps, patellar, and Achilles deep tendon reflexes, and grade these reflexes on a standardized zero to four plus scale. Describe the differences between the types and causes of headaches. Lab #17 Date/Time: April 27-May 1, :30-4:10 Lab Name/Topic: Musculoskeletal Assessment Obtain a person s medical history related to the musculoskeletal system and the ability to carry out activities of daily living. Inspect and palpate the musculoskeletal system by assessing the muscles, bones, and joints for size, symmetry, swelling, nodules, deformities, atrophy, and range of motion. Watch a video on a musculoskeletal exam and DXA. Obtain a T-score from a quantitative heel ultrasound machine for one partner in your group. Document history and physical examination findings, assessment, and plan of care for musculoskeletal exam. Write a comprehensive SOAP note individually in class. Lab #18 Date/Time: May 4-8, :30-4:10 Lab Name/Topic: Final Lab Practical Assess student ability to perform skills learned in the last 9 weeks of the course