MOUNT SAINT MARY COLLEGE Division of Nursing Newburgh, New York COURSE SYLLABUS

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1 MOUNT SAINT MARY COLLEGE Division of Nursing Newburgh, New York NUR 2043 Physical Assessment Fall 2006 Accelerated Session D1 COURSE SYLLABUS Course Description This course focuses on the collection, organization, and analysis of information relevant to a person s health status. Emphasis is on developing skills necessary for taking a health history and conducting a comprehensive assessment of a well adult. Additionally, emphasis is placed on correct documentation of assessment findings. 3 credits: 6:45p - 9:55p Monday evening lecture, 3 hour labs- Monday or Wednesday Pre-requisites: Bio 103, 104, Psych 101, Soc 101 Faculty Rochelle Roberts MSN, BA, RN Course Coordinator Office: Room 102 GA Office hours: Wednesdays 1:00-2:00 p.m. Phone: roberts@my.msmc.edu Adjunct Faculty Linda Dombroski FNP, MPS, MS, BS, RN Phone: Ldombroski@health-quest.org Course Objectives Through participation in course activities students will: 1. Use interviewing techniques to collect subjective data needed for a health history. 2. Complete a health history on a well individual. 3. Demonstrate sensitivity and awareness in the cultural dimensions of health care and be able to perform a cultural assessment. 1

2 4. Use the techniques of inspection, auscultation, palpation, and percussion to conduct a physical exam on a well adult. 5. Distinguish normal from abnormal findings in the health exam. 6. Organize assessment data and systematically write a report of the findings. 7. Integrate knowledge or universal precautions when conducting a physical examination 8. Accept responsibility and accountability for one s own actions. Texts Jarvis,C., Physical Exam and Health Assessment text and Physical Exam and Health Assessment student laboratory manual, 2004, Saunders, 4 th Edition. Required Equipment and Attire for Lab Students will need a stethoscope with bell and diaphragm. The following will be provided for lab use: penlight, clear plastic ruler, felt-tip marker with washable ink. Shorts and a tee-shirt or sports bra are appropriate lab attire.(students will work in small groups and examine each other). Students may bring a large towel (for draping) to lab. Attendance Policy Attendance is required. Students are expected to be on time and prepared. Students who come to lab unprepared will be dismissed and considered absent for that experience. Repeated absences and /or lateness will compromise the student s ability to meet course objectives. If a student is late or absent from lab due to an extenuating circumstance, he/she must contact the lab instructor by phone or . He or she must confer with the course instructor in regard to making up a lab. Students are responsible for all material covered in lecture and lab whether present or not. Class Participation Learning during class will be through lecture and class discussion of selected topics. Reading prior to class is mandated so that each student can be a full participant in the discussions, answering questions and raising issues or clinical concerns related to the topic. Class Participation consists of 5% of the total grade. Exams/Quizzes The final exam is 30 % of your total grade for this course. Quizzes will also comprise 30% of your final grade. All exams and quizzes may include multiple choice and short answer or essay questions. If a student misses an exam or quiz, he or she may take a make-up exam or quiz, only in the instance of extenuating circumstances. All missed quizzes and exams will receive a grade of 0. Homework Lab homework will comprise 20 % of the final course grade. The student will receive 10 points for a lab write-up if all the grading criteria are met (see grading criteria below). All missing homework will receive a grade of 0. Late homework will be accepted at the discretion of the instructor. 2

3 Lab homework grading criteria will consist of the following: Write up is complete with physical findings. *The physical exam findings will not be accepted if it is written as normal or within normal limits. You must write what the physical findings are (i.e. skin is pink, warm and dry : NOT skin is normal. Findings are appropriately organized. Spelling and punctuation are correct. Write-up is typed or neatly written. Appropriate use of medical terminology FINAL PERFORMANCE EXAM The final performance exam evaluates the student s ability to perform critical elements of a physical examination. The exam integrates history taking, physical examination, and written documentation of exam findings. All critical elements must be passed for the student to pass the exam. The student must pass the final performance exam to pass the course. Specific guidelines and exam criteria will be distributed in class prior to the exam. The exam is worth 15 % of your grade. COURSE GRADING Students are advised to consult the Nursing Student Handbook for grading policies and grade distributions for nursing students. Nursing students must earn a final course grade of C (73) or better for this course to apply toward completion of degree requirements. The final course grade will be determined by: Quizzes 30% Cumulative Final Exam 30% Lab Write-ups 20% Final Performance Exam (MUST PASS) 15% Class Participation 5% The following grading scale is used by the Nursing Division: Grade Percent Range A A B B B C C C D

4 D F 62 and below EXPECTATION OF PROFESSIONAL CONDUCT Professional conduct expectations of nursing students demand that students act in accordance with legal and ethical standards. This course is structured so that students will use each other as patients to learn the techniques of nursing assessment. Therefore, it is imperative that students protect the privacy of each other with regard to information learned within the context f this course. All due respect for your colleagues regarding both physical and environmental safety are expected. All health status information must be kept confidential. Failure to maintain confidentiality or safety may result in failure of the course. 4

5 Course Outline NUR 204 CLASS 1 - Unit 1- September 25 No Labs This Week Lecture Content for September 25: Critical thinking in health assessment - Ch 1 Interviewing techniques - Ch 4 The health history - Ch 6 Objectives: Through participation in class and activities the student will: 1. Develop critical thinking skills in performing a health assessment. 2. Describe how nursing assessment relates to the nursing process. 3. Use appropriate interviewing techniques to conduct a comprehensive health history. 4. Document assessment findings. 5. Differentiate normal from abnormal findings. 6. Develop a risk profile. Required reading: Chapters 1, 4, 6 CLASS 2 Unit 2-October 2 Quiz #1 LAB 1 Write-up: The Complete Health History Lecture Content for October 2: Assessment techniques and approaches to the clinical setting-ch 9 General survey, measurements, and vital signs- Ch 10 Assessment of skin, hair, and nails Ch 12 Objectives: Through participation in class and lab activities the student will: 1. Demonstrate the correct technique for inspection, auscultation, percussion, and palpation. 2. Use the correct technique to conduct a general assessment. 3. Use the correct technique to assess oral and axillary temperature with an electronic thermometer and a glass thermometer. 4. Assessment and documentation of hair, skin, & nails. 5. Integrate the use of universal precautions during physical examination. Required reading: Chapters 9, 10, 12 CLASS 3 Unit 3-October 9th -Quiz #2 LAB 2 Write-ups: General Survey & Vital Signs & Skin, Hair & Nails Lecture Content for Oct 9: Head and neck, regional lymphatics - Ch 13 5

6 Nose, mouth, throat eyes, ears Ch 14, 15, 16 Objectives: Through participation in class and lab activities students will: 1. Obtain a focused history related to the head and neck. 2. Use the correct technique to examine the head and neck. 3. Describe the physiological changes with aging related to head and neck. 4. Differentiate normal from abnormal findings. 5. Assessment and documentation of the lymphatic system. 6. Obtain a focused history related to the eyes, ears, nose, mouth, & throat. 7. Use the correct technique to examine the eyes, ears, nose, mouth, & throat. 8. Describe physiological changes with aging related to the eyes, ears, nose, mouth & throat. 9. Integrate the use of universal precautions during physical examination 10. Differentiate normal from abnormal findings. Required reading: Ch 13, 14, 15, 16 CLASS 4 Unit 4- October 16 -Quiz 3 LAB 3 Write-ups: Head & Neck, Eyes, Ears, Nose, Mouth, & Throat Lecture Content for Oct 16: Thorax and lungs- Ch 18 Objectives: Through participation in class and lab activities students will: 1. Obtain a focused history related to the thorax and lungs. 2. Use the correct technique to examine the thorax and lungs. 3. Describe physiological changes with aging related to the hart and peripheral vascular system. 4. Differentiate normal from abnormal findings. 5. Differentiate characteristics of cardiac, musculoskeletal, and gastrointestinal pain experienced in the epigastrium of the chest. 6. Integrate the use of universal precautions during the physical examination. Required readings: Ch 18 CLASS 5 Unit 5- October 23 Quiz # 4 LAB 5 Write-ups: Thorax & Lungs Lecture Content for Oct 23: Mental status assessment- Ch 7 Breasts and axillae - Ch 17 Objectives: Through participation in class and lab activities students will: 1. Assess and document a mental status exam. 2. Obtain a focused history related to the breasts and axillae. 3. Use the correct technique to examine the breasts and axillae. 4. Describe physiological changes with aging related to the breasts and axillae. 6

7 5. Differentiate normal from abnormal findings. 6. Integrate the use of universal precautions during physical examination. Required reading: Chapters 7, 17 CLASS 6 Unit 6- October 30-Quiz # 5 LAB 6 Write-up: Breast & Axillae Lecture Content For Oct 30: Heart Ch 19 Peripheral vascular system Ch 20 :Objectives: Through participation in class and lab activities students will: 1. Obtain a focused history related to the heart and peripheral vascular system. 2. Use the correct technique to examine the heart and peripheral vascular system. 3. Describe physiological changes with aging related to the heart and peripheral vascular system. 4. Differentiate normal from abnormal findings. 5. Integrate the use of universal precautions during physical examination. Required readings: CH 19, 20 CLASS 7 Unit 7 November 7 Quiz #6 LAB 7 Write-ups: Cardiovascular & Peripheral Vascular System Lecture Content for Nov 7: Abdomen -Ch 21 Objectives: Through participation in class and lab activities students will: 1. Obtain a focused history related to the abdomen and GI system. 2. Use the correct technique to examine the abdomen and GI system. 3. Describe physiological changes with aging related to the abdomen and GI system. 4. Differentiate normal from abnormal findings. 5. Integrate the use of universal precautions during physical examination. Required reading: Chapter 21 CLASS 8 Unit 8 November 14- Quiz #7 LAB 8 Write-up: Abdomen Lecture Content for Nov 14: Musculoskeletal system Ch 22 Neurological system Ch. 23, Objectives: 1. Obtain a focused history related to the musculoskeletal system. 2. Use the correct technique to examine the musculoskeletal system. 3. Describe physiological changes with aging related to the musculoskeletal system. 4. Differentiate normal form abnormal findings. 5. Integrate the use of universal precautions during physical examination. 6. Obtain a focused history related to mental status and the neurological system. 7

8 7. Use the correct technique to conduct a neurological examination. 8. Describe physiological changes with aging related to the neurological system. 9. Differentiate normal from abnormal findings. 10. Integrate the use of universal precautions during physical examination Required reading; Chapter 7, 22,23 CLASS 9 Unit 9 November 20- Quiz #8 No Lab On Wed, Nov. 23 RD * WILL MEET ON FRI. DEC. 1st LAB 9 Write-up: Musculoskeletal & Neurological System Lecture Content on Nov 21: Comprehensive Health Assessment: Putting it all together Ch 28 Objectives: 1. Integrate the steps of the complete health history and physical exam. CLASS 10 Unit 10 November 27 No lecture LAB 10 Nov 27, 29 Putting it all together; Review CLASS 11 Unit 11 December 4 - No Lecture *Final Lab Performance Exams Dec 4-6 as scheduled. CLASS 12 - December 11- Final Exam in class 8