COURSE: Nursing 202
TITLE: Client Assessment
SYLLABUS
COURSE DESCRIPTION
Determining and measuring variables relevant to assessment of psychosocial and physical
functioning
COURSE OVERVIEW
This course focuses on the assessment phase of the nursing process. Students develop a beginning
awareness of factors that influence health. This course emphasizes age-specific health promotion
recommendations as supported by clinical practice guidelines and the role of the nurse in primary,
secondary and tertiary prevention.. Students gain experience in obtaining health histories,
performing nutritional assessment and comprehensive physical assessments.
COURSE OUTCOMES
Upon completion of the course the student will:
Level II Outcomes
1)
initiate the assessment phase of the nursing process by the
accurate collection of subjective and objective data.
2, 5
2)
use appropriate interviewing techniques to obtain accurate
and complete health histories.
1, 2, 5
3)
identify family and genetic history, lifestyle factors and other
risk factors that increase risk for disease and disability.
2, 3, 5, 9
4)
formulate a list of client problems and risk factors based on
holistic health assessment.
2, 5, 9
5)
articulate the role of the nurse in primary, secondary and
tertiary prevention.
10, 11, 13
6)
use evidenced based clinical practice guidelines to identify age
specific health promotion recommendations.
2, 8, 9
7)
perform a nutritional analysis using nationally defined
recommendations for weight and nutrient intake.
2, 5, 9
8)
perform a complete and systematic physical exam using the
techniques of inspection, palpation, percussion and auscultation.
2, 5, 7
9)
demonstrate the skillful use of examination equipment in the
performance of the physical exam.
2, 5
10)
apply appropriate techniques for assessing and monitoring vital
2, 5
signs.
11)
Apply knowledge of anatomy and physiology to the assessment
of body systems (e.g., skin, hair, nails, head/neck, eye, ear, nose,
mouth, throat, lymphatics, thorax/lungs, heart, peripheral vascular,
breast, abdomen, male/female genitalia, urinary, and neuromuscular
systems).
2, 5
12)
distinguish between normal and abnormal assessment findings.
2, 5
13)
identify assessment findings that reflect normal developmental
changes and changes of aging.
2, 5
14)
identify assessment findings that are influenced by ethnic,
cultural and socioeconomic status.
3, 5
15)
document assessment findings in an accurate, concise and
organized way.
5, 7
Level Outcomes
Level II
Level III
Level IV
Upon completion of the first
year the student will:
1.2 Relate liberal educational
experiences to core
competencies in professional
nursing practice.
2.2 Utilize selected scientific
professional and contextual
knowledge in the application
of the nursing process.
Upon completion of the
second year the student will:
1.3 Recognize the application
of liberal education
experiences into professional
nursing practice.
2.3. Analyze selected
scientific, professional and
contextual knowledge in the
application of the nursing
process with families and
groups.
Upon completion of the
second year the student will:
1.4. Apply an integrated
liberal educational experience
in developing clinical
judgment.
2.4. Use the nursing process,
scientific, and contextual
knowledge in the delivery of
nursing care.
3.2 Understand human
diversity as it applies to health
and illness.
3.3 Use knowledge of human
diversity in planning care for
individuals and families.
4.2 Begin to demonstrate
fundamental nursing care
based on the central
professional value of caring.
4.3 Incorporate the central
professional value of caring in
planning care for individuals
and families.
5.2 Demonstrate critical
thinking, communication,
assessment, and technical
skills in the provision of
nursing care.
5.3 Integrate critical
thinking, communication,
assessment, and technical
skills in the planning of care
for individuals and families.
3.4 Demonstrate the ability
to deliver nursing care in a
variety of settings among
diverse populations.
4.4 Demonstrate the central
professional value of caring
by delivering. compassionate,
appropriate and culturally
sensitive care.
5.4 Consistently use critical
thinking, communication,
assessment, and technical
skills in the delivery of
nursing care.
6.2 Develop an awareness of
one’s ability to perform as a
professional nurse and seek
assistance when necessary.
7.2 Develop an awareness of
the professional values of
altruism, autonomy, human
dignity, integrity and social
justice as the foundation for
professional practice.
8.2 Develop an
understanding of teaching
learning theory in its
application to patient care.
9.2 Develop an awareness of
research based knowledge
from nursing and the sciences
as the foundation for
professional nursing practice.
10.2.1 Develop an awareness
of the roles of the professional
nurse as provider of care,
designer/manager/coordinator
of care and member of the
profession.
10.2.2 Recognize the practice
of professional nursing
requires a commitment to life
long learning.
11.2 Identify the role of the
professional nurse and the
various members of the health
care team and describe their
functions.
12.2 Recognize the
leadership role in the nursing
profession.
13.2 Gain awareness of
health care resources available
within the community.
Approved Level Outcomes
July 12, 2005
6.3 Demonstrate and accepts
responsibility for contributing
to one’s own learning and
critically appraises ability to
perform as a professional
nurse.
7.3 Demonstrate in clinical
practice professional values,
behaviors and standards.
6.4 Demonstrate
accountability for nursing
practice.
8.3 Incorporate teaching
learning theory in the delivery
of nursing care to individuals
and families.
9.3 Analyze the relationship
of research based knowledge
to the delivery of nursing care.
8.4 Use teaching-learning
theory appropriately in
nursing practice.
10.3 Demonstrate an
understanding of the present
and emerging role
responsibilities of the
professional nurse.
10.4 Accept responsibility
for professional growth and
life-long learning in
consonance with the emerging
role of the nurse in a changing
society.
11.3 Participate as a team
member in providing health
care to patients utilizing the
knowledge and principles of
interdisciplinary models of
health care delivery.
12.3 Develop beginning
leadership skills in clinical
settings.
13.3 Identify social, economic,
and political agendas affecting
the delivery of health care.
11.4 Collaborate with patients
and interdisciplinary health
care teams to plan, manage
and influence health care
standards, methods, and
systems.
12.4 Demonstrate leadership
behaviors within one’s scope
of practice.
13.4 Support agendas that
enhance awareness of the
social, economic, and political
agendas that influence health
care delivery.
7.4 Incorporate professional
values and standards of
practice as the foundation for
nursing practice.
9.4 Incorporate research as a
foundation for evidence-based
practice.
Course Credit/Hours:
4 units; 2 hours lecture, 6 hours lab
Faculty:
S. Hadley, Ph.D, APRN, GNP, ANP-BC
Office: HT 170
E-mail: shadley@mail.sdsu.edu
Laboratory Instruction
D. Burns, MSN, APRN, FNP-BC
L. Fitzsimmons, Ph.D, APRN, FNP, ANP-BC
P. Gray, MSN, FNP
S. Hadley, Ph.D, APRN, GNP, ANP-BC
L. Long, MSN, FNP
Required Texts
Jarvis, C. (2012). Physical examination and health assessment (6th ed.). Philadelphia:
W. B. Saunders.
Jarvis, C. (2012). Student laboratory manual for physical examination and health
assessment (6th ed.). Philadelphia: W. B. Saunders.
Important: the lab manual must be new. Used, marked copies will NOT be acceptable.
Optional Texts
Jarvis, C. (2012). Pocket companion for physical examination and health assessment (6th ed.).
Philadelphia: W. B. Saunders.
Websites
Nutrition information
http://caloriecount.about.com
http://calorieking.com
Physical Assessment
http://meded.ucsd.edu/clinicalmed
http://stanford25.wordpress.com
Heart Sounds
http://depts.washington.edu/physdx/heart.html/tech
Required Equipment/supplies
Stethoscope
Metric ruler
Watch with second hand
Examination gown
Sports bra or bathing suit for women
Teaching Methods
Lecture/Demonstration/Discussion
Audiovisuals
Required readings
Campus laboratory activities
Utilization of the nursing process
Grading Criteria
There will be 4 exams in the course.
Exam 1: 50 questions
Exam 2: 50 questions
Exam 3: 50 questions
Final Exam: 90 questions
To successfully complete the course, the student must:
1) achieve 174 points out of 240 exam points (73%).
Extra credit is NOT an option for failure to achieve the minimum points.
2) demonstrate proficiency on the Midterm Performance Evaluation (MPE) and Final
Performance Evaluation (FPE).
• Satisfactory achievement is determined by performing ≥ 85% of the physical exam
techniques correctly.
• The MPE and FPE may be repeated one time for failure to achieve 85%.
• Failure to achieve an 85% by the second attempt will preclude successful course completion.
• The MPE and FPE are evaluated on a satisfactory-unsatisfactory basis and will not be
calculated in the final grade.
3)
demonstrate satisfactory performance in laboratory activities as noted below:
• document weekly assessment data in the laboratory manual
• accurately complete the nutrition self-assessment
• prepare for and participate in the simulation laboratory
• gain proficiency in health assessments/physical exams
Grading Scale:
Final grades will be determined using the following grading scale:
POINTS
PERCENT
GRADE
222-240
93-100%
A
215-221
90-92%
A-
208-214
87-89%
B+
198-207
83-86%
B
191-197
80-82%
B-
184-190
77-79%
C+
174-183
73-76%
C
167-173
70-72%
C-
160-166
67-69%
D+
150-159
63-66%
D
143-149
60-62%
D-
< 143
< 60%
F
Preparation for the Clinical Laboratory
Maximizing the clinical laboratory experience requires that the student be prepared for each
laboratory session. The student should complete the required readings and on-line lectures prior to
each lab.
The minimal expectation is that the student has read the required readings and has a beginning
understanding of the skills required to perform the required physical assessments in the laboratory.
Failure to consistently show adequate preparation for the laboratory will result in failure to meet
course outcomes and subsequent course failure.
Some physical examination techniques require close physical contact (e.g., auscultation of heart and
lungs) however, efforts to protect modesty are encouraged by the use of appropriate examination
clothing (e.g., examination gowns). Synthetic breast models are available for performance of the
breast exam.
Classroom/Laboratory Etiquette
The use of electronic devices (computers, smart phones, IPADs, etc.) may only be used to access
course-related information. These devices may not be used to send or receive text messages/email
during class or lab time. Cell phones should be turned off or on vibrate mode and are not to be used
during class or lab. You may use these devices during designated break times.
Students With Disabilities
If you are a student with a disability and believe you will need accommodations for this class, it is
your responsibility to contact Student Disability Services at (619) 594-6473. To avoid any delay
in the receipt of your accommodations, you should contact Student Disability Services as soon as
possible. Please note that accommodations are not retroactive, and that accommodations based upon
disability can not be provided until the Course Coordinator (Dr. Hadley) has received an
accommodation letter from Student Disability Services. Your cooperation is appreciated.
Confidential Information
In the course of your professional education you will encounter personal and sensitive information
about others. It is your legal and ethical responsibility to maintain the confidentiality of this
information and to protect the anonymity of those involved. This includes, but is not limited to,
avoiding discussions that would allow others to identify the subject of the information and removing
patient names from course papers/class assignments. Failure to protect the privacy of others may
have serious repercussions.
Lost or Damaged Laboratory Supplies/Equipment
The student is responsible for the replacement of lost or damaged laboratory supplies and equipment.
Final grades will be held until laboratory items are returned or replaced.
Attendance
Please bring the Attendance Policy (next two pages) to your first lab. You will be asked to read, sign
and submit the form to your laboratory instructor.
Attendance Policy
Laboratory Attendance
Attendance is required for all laboratory sessions except for serious or extenuating circumstances.
Students are entering a professional environment where full participation is essential to the
acquisition of knowledge and skills required for safe and effective nursing practice.
Definitions
Definition of an EXCUSED ABSENCE
An absence will be excused ONLY if:
1) the student notifies the Course Coordinator (Dr. Hadley) by email prior to the beginning of the
missed lab. The student should state the nature of the intended absence. If the student would
like to discuss the absence with the Course Coordinator, then contact information should be
provided. Excused absences could include personal illness, illness of an immediate family
member, death of an immediate family member and compelling events beyond the students
control.
2) the student provides written documentation justifying the absence (e.g., a note from a
healthcare provider, a letter from the court, a time/dated receipt showing automobile
breakdown en route to lab).
3) the written documentation for the absence is presented to the Course Coordinator or placed in
her mailbox (HT 58) on the first day that the student returns to school. Documentation placed
in the Course Coordinator’s mailbox must be stamped with date and time.
Note. All three of the above conditions must be met for an absence to be excused.
Definition of an UNEXCUSED ABSENCE
An absence which does NOT meet the definition of an excused absence is one in which the Course
Coordinator (Dr. Hadley) was NOT notified prior to the start of the clinical lab. In addition,
examples of unexcused absences include: routine healthcare or dental appointments, job interviews,
employment/work commitments, child care issues, attendance at family gatherings/events,
oversleeping, etc. Please note that employment and job-related obligations are not to interfere with
the laboratory experience. Please plan accordingly. Failure to present acceptable documentation for
the missed lab will result in an unexcused absence since the reason for the absence can not be
validated.
An unexcused absence will result in the loss of 5 points in the calculation of the final course
grade. In some cases this may drop the total points below the minimal passing score for successful
course completion. Two unexcused absences will result in course failure.
Absences from Lab
1) Students may NOT attend labs to which they are not assigned as an alternative to missing their
lab.
2) Extra credit is NOT an option to compensate for lost points from unexcused absences.
3) Evidence of falsifying documents will be treated as academic dishonesty and will be subject to
University sanctions and may include dismissal from the University.
4) Excessive absences (even if excused) may result in failure to meet course outcomes. Please
contact the Course Coordinator if you are having problems that affect your attendance.
Tardiness
Arriving late to lab is disruptive and adversely affects the professional learning environment. Unless
the student provides written documentation justifying the late arrival to lab (i.e., same as for excused
absences), then points will be deducted from the cumulative grade points as follows:
6-30 minutes late = 1 point deducted
31-59 minutes late: 2 points deducted
1-3 hours late = 3 points deducted
More than 3 hours late = 5 points deducted
Leaving the clinical laboratory early, without permission, will result in a clinical counseling form
being placed in the student’s file. Multiple occurrences can result in course failure.
Please note.
1) Eight or more points deducted for unexcused absences and/or tardiness will result in course
failure.
2) An attendance book will be kept in the lab at all times. The lab instructor will document
the points deducted for late arrival to lab and the student will be asked to sign the book.
Examination Attendance
Please note. Exams may not be taken earlier or later than the scheduled date.
No provision is made for examinations that are missed because of unexcused absences. An
unexcused absence will result in a grade of F (0%) for the exam. In order to avoid an unexcused
absence, the course coordinator must be notified prior to the beginning of the exam. For an absence
to be excused, the student must provide appropriate written documentation justifying the absence
as noted above.
If a make-up examination is necessary, it may differ in format from the original exam (e.g., essay,
short answer, or other test forms may be given). Please note that examinations are “timed tests”,
therefore, arriving late to class on exam days will limit the amount of time available to complete
the exam.
********************************************
I have read the N202 Course Policy for Attendance
_______________________________________________ _________________________
(Student Signature)
(Date)