UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING Rio Grande, Ohio RN-BSN Program

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1 UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING Spring Semester, 2008 Syllabus Course Title: Nursing 30808: Clinical Decision Making: Health Assessment Didactic: 5 hours/week, 9 hours lab, 8 credit hours Faculty: Donna Mitchell, Ph.D., R.N., C.N.S. Office: McKenzie Hall - Room 122 Office Phone: Kathy Carlisle, M.S.N., R.N., F.N.P. Office: McKenzie Hall - Room 112 Office Phone: Note: General University phone number is (740) or toll-free in OH, KY, PA, and WV: Course Description: This course is designed to provide the BSN student with the skills to perform a complete holistic health assessment and to plan nursing care for the individual. Through comprehensive assessment the student will identify stressors in the environment, as well as cultural influences. Specific attention is given to the development of skill used for comprehensive history taking and physical examination. Emphasis is on the assessment of the individual with appropriate analysis and interpretation of the data collected from individual families and groups. Stress concepts, theories, and models, as well as stress management are discussed. The aging process and common health alterations are discussed. Concepts introduced relate to physiologic, psychologic, and social issues pertinent to the aging population that relate to health care practices. These concepts are used to choose implementation strategies and to evaluate nursing care. Prerequisites: Official acceptance to the RN-BSN program; current Ohio RN License and nursing professional liability insurance, NUR with a grade of "C" or better in theory; and BIO Lab fee required. Time and Location: Thursdays, 9:30 a.m. 2:20 p.m. McKenzie Hall Clinical Lab times to be arranged between the faculty and the student. This syllabus is not to be construed as a contract with the student and may be subject to change.

2 2 Course Outcomes: Upon completion of this course, the student will be able to: 1. Utilize collected data to determine present health status, and to plan, implement, and evaluate care. 2. Write complete, succinct, clinical summaries of the data collected. 3. Demonstrate competency in assessing the eyes, and to plan and evaluate appropriate nursing care. 4. Demonstrate competency in assessing the ears, nose, and throat, and to plan and evaluate appropriate nursing care. 5. Demonstrate competency in assessing the musculoskeletal system, and to plan and evaluate appropriate nursing care. 6. Demonstrate competency in assessing the respiratory system, and to plan and evaluate appropriate nursing care. 7. Demonstrate competency in assessing the cardiovascular system, and to plan and evaluate appropriate nursing care. 8. Demonstrate competency in assessing the neurological system, and to plan and evaluate appropriate nursing care. 9. Demonstrate competency in assessing the abdomen, and to plan and evaluate appropriate nursing care. 10. Demonstrate competency in assessing the integumentary system, and to plan and evaluate appropriate nursing care. 11. Identify resources available for collaborative practice. 12. Demonstrate skills to perform a total integrated health assessment on a client. 13. Demonstrate an understanding of the purpose of family assessment. 14. Demonstrate the student s knowledge and understanding of specific disease process(es) and relate Pathophysiological changes related to the process(es) discussed. 15. Utilizes current nursing research, including evidenced based practice, into development of a teachinglearning presentation. Required Textbook(s): Barkauskas, V., Stoltenberg-Allen, K, Baumann, L., and Darling-Fisher, C. (2002). Health and Physical Assessment. St. Louis: C.V. Mosby, Company. Methods of Teaching/Learning: Material will be presented in a lecture/discussion format and through the use of guest speakers, student presentations, case studies, and/or videos. Students will be expected to participate in class by sharing insights related to the topics derived from assigned readings, clinical, and life experiences.

3 Course Requirements: The student will: 1. Function under the ANA Code of Ethics. 2. Continue the portfolio process. 3. Complete all course requirements. 4. Complete and submit a School of Nursing course evaluation form. 5. Be expected to spend nine hours per week practicing the physical assessment skills learned in class. Each student maintains a record (log) of clinical practice documenting time spent developing assessment skills and assessing clients. 6. Have weekly health assessments specific to what is presented in class. The student will select an individual to complete their weekly assessment. Each individual will sign a consent form. If the individual is a minor then parental consent must be obtained. The consent form (see attached) must be submitted with the weekly assignment and the course instructor will retain these on file in the School of Nursing Office. Attendance Policy: Class attendance is expected of all students. If the student misses 4 or more full class days, the student s final course grade will automatically be lowered one letter grade. It is the student s responsibility to notify the School of Nursing on the day the course meets if he/she will not be in attendance. If the student misses a class, it is the student s responsibility to obtain the information presented in class. 3 Evaluation Methods: Students will be evaluated according to the following criteria: 1. Health Assessment Profiles: Date Due 1) Skin Assessment 20 points 1/24/08 2) Ear, Nose, and Throat Assessment 20 points 1/31/08 3) Eye Assessment 20 points 2/07/08 4) Respiratory Assessment 20 points 2/14/08 5) Abdominal Assessment 20 points 2/28/08 6) Cardiovascular Assessment 20 points 3/13/08 7) Musculoskeletal Assessment 20 points 3/27/08 8) Neurological Assessment 20 points 4/8/08 9) Family Assessment 20 points 4/17/08 TOTAL: 180 points 2. Total Integrated Assessment 80 points* The student will retain a copy of these to be included in the student s portfolio. 3. Tests 135 points 4. Class Presentation 80 points 5. Class participation 25 points TOTAL POSSIBLE POINTS: 500 points 6. Unannounced quizzes maybe used at the discretion of the faculty. If utilized the points possible will be added to the total possible points. *Paper(s) is/are due on assigned date(s). Failure to submit on time constitutes an automatic 10% deduction in the student s earned grade for that paper.

4 American Disabilities Act Statement: 4 If a student wishes to be identified as having a physical, mental, or learning disability that may require accommodation(s), that student must register with the Office of Accessibility as soon as reasonably possible. The registered student should identify himself/herself to each instructor in a reasonable time-frame by providing a written statement from the Accessibility Office which indicates the appropriate accommodations. The Office of Accessibility phone is (740) and is located in Rhodes Hall room 116. Health Assessment Guidelines: During Nursing the student will have the opportunity to complete several assessments on each of the systems reviewed in class. Students will submit a total of eight (8) system assessments and will complete a total integrated assessment to meet course requirements. Guidelines for collecting this data will be furnished in class, in the text, and is available in the enrichments. Assessments are to be completed on persons from a minimum of five (5) of the nine (9) age groups identified in the text: Infants Toddlers School Age Adolescent Young Adult Adult Middle Adult Older Adult Elderly Adult Age 0-1 year 1-5 years 6-11 years years years years years years 75 and older Forms for each assessment will be distributed by the instructor in class. The assessment is complete when it includes the assessment data, a summary of all significant findings, identification of abnormal findings, plan of care to address abnormal findings, and identification of resources to meet client needs. Students are loaned an assessment kit containing equipment necessary to complete health assessments. These kits contain expensive equipment and are to be returned in the same condition as loaned. Kits must be returned to the school at the time of the integrated physical exam. Failure to return the assessment equipment will result in withholding grades. Clinical Guidelines: During Nursing the student will maintain a log record of all clinical practice time. Students are required to document the following information in the log: 1) date and length of time of practice, 2) system reviewed, 3) patient's initials, 4) age, 5) brief narrative summary of clients assessed and documentation of all learning activities other than required assignments (i.e. computer assisted instruction, interactive video, audiovisuals, etc.) will be required. Journal: The student will maintain a current journal documenting their thoughts, ideas, and feelings as they progress through the BSN-RN Program. Entries must be made weekly and shared periodically with course faculty. Faculty will announce when journals will be reviewed.

5 5 UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING Nursing 30808: Clinical Decision Making: Health Assessment Course Outline WEEK 1: January 10, 2008 Course Overview. Discussion of Poster Contest. Draft letter to teachers. WEEK 2: January 17, 2008 Nursing History, Assessment Skills, and Cultural Considerations. Assessment of the Integumentary System. Barkauskas, Chapters WEEK 3: January 24, 2008 Ear, Nose, Throat and Head Assessment Barkauskas, Chapter 13 Integumentary Assessment due. Clinical time logs due. WEEK 4: January 31, 2008 Exam Integumentary and ENT: 30 points ENT Assessment due. Clinical time logs due. Eye Assessment (Make sure you bring your ophthalmoscope with you. We will practice internal eye exams.) Barkauskas, Chapter 12 WEEK 5: February 7, 2008 Respiratory Assessment Eye Assessment due. Clinical time logs due. Barkauskas, Chapter 15 Student Presentations: 1. IRDS vs ARDS

6 2. Lung Cancer 6 WEEK 6: February 14, 2008 Exam: Eye and Respiratory: 30 points Abdominal Assessment. Respiratory Assessment Due. Clinical time logs due. Barkauskas, Chapter 16. Student Presentations: 1. DKA vs HHNK 2. Acute vs Chronic Renal Failure WEEK 7: February 21, 2008 Continue Abdominal System Student Presentations: 1) Pancreatic and Spleenic Function 2) Complications of Liver Failure WEEK 8: February 28, 2008 WEEK 9: March 6, 2008 Cardiac Assessment. Abdominal Assessment due. Clinical time logs due. Barkauskas, Chapter 17. Cardiac Assessment continued Student Presentations: 1) Cyanotic vs Acyanotic Congenital Defects 2) Left Sided vs Right Sided Heart Failure March 7, 2008 Clinical WEEK 10: March 13, 2008 WEEK 11: March 20, 2008 Exam: Abdomen and Cardiac: 30 points Musculoskeletal Assessment Cardiac Assessment due. Clinical time logs due. No Classes Spring Break Enjoy your time off! WEEK 12: March 27, 2008 Neurological Assessment. Clinical time logs due. Musculoskeletal Assessments Due Barkauskas, Chapter 19 Student Presentations: 1. Intracranial Bleeds WEEK 13: April 3, 2008 Neurological Assessment (con t). Student Presentations: 1. Parkinson s Disease

7 2. Lupus 7 WEEK 14: April 10, 2008 Clinical time logs due. Barkauskas, Chapter 18 Exam: Neurological System: 30 points Family Theories Required reading: TBA Neurological Assessment due WEEK 15: April 17, 2008 Review of Systems Family Assessment due. WEEK 16: April 24, 2008 WEEK 17: May 1, 2008 *Exam Family Assessment: 15 points Musculoskeletal Assessment due. Journals due. *Total Integrated Health Assessments Checkoffs Finals Week *Total Integrated Health Assessment Checkoffs *When ready, make an appointment with instructor to perform complete physical integrated exam. Allow at least 1 1/2-2 hours to perform this. Make an appointment to take Exam, worth 15 points, on Family Series and Assessment. You must turn in your completed clinical time logs and journal. Upon completion of the health assessment check off exam: Return Assessment Bags for inventory to Skills Lab Coordinator. You must have Assessment Bags inventoried and bags must be complete to receive a grade in this course. Additional readings may be assigned on a weekly basis. Web sites will be announced.

8 UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING 8 Clinical Log NAME: WEEK OF: Date & Time Description Amount of Time Total Hours This Week: Accumulative Hours:

9 9 UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING Nursing 30808: Clinical Decision Making: Health Assessment Disease Entity Presentation The purpose of this oral group presentation is to demonstrate the student's knowledge and understanding of specific disease process(es) and relate pathophysiologic changes related to the process(es) discussed. Students will also discuss treatment modalities and nursing interventions, especially those interventions that are collaborative. Student must include a minimum of one current research-based article in the references. Presentation should be 60 minutes. Allow the last 10 minutes for questions and answers. Specific areas to be presented: 1. Textbook Picture - relate classic description of the disease process as found in text. Note common symptoms and relate pathophysiology, diagnostic studies, medical treatment, expected outcomes, and potential complications. Relate critical assessments for nurses to make. 2. Nursing Diagnoses - Discuss common nursing diagnoses related to this disease process. 3. Nursing Care - discuss nursing care related to the disease process. 4. Collaboration - Identify collaborative resources to plan the care of the patient from a multidisciplinary approach. 5. Manner of Presentation and References Be creative - Material presented in an orderly logical fashion. Provides audience with up-to-date reference list.

10 10 UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING Nursing 30808: Clinical Decision Making: Health Assessment Student Group Oral Presentation Evaluation Form Title: Students: Date of Presentation: Evaluator: (All course faculty will evaluate the presentation. The earned points for the group will be an average of the ratings of the course faculty.) Points Possible (Average) Earned Points 20 Textbook Picture & Symptomatology 20 Nursing Diagnosis and Nursing Care 20 Collaborative Resources for Multidisciplinary Approach 20 Manner of Presentation and References Total: 80 Total:

11 11 UNIVERSITY OF RIO GRANDE-HOLZER SCHOOL OF NURSING Nursing 30808: Clinical Decision Making: Health Assessment Presentation Dates and Topics IRDS vs ARDS: Lung Cancer: Left Sided vs Right Sided Heart Failure: Cyanotic vs Acyanotic Congenital Defects: Pancreatic and Spleenic Function: Complications of Liver Failure: Diabetic Ketoacidosis vs HHNK: Acute vs Chronic Renal Failure: Parkinson s Disease: Lupus:

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