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CALIFORNIA STATE UNIVERSITY, BAKERSFIELD
DEPARTMENT OF NURSING
NURSING 242: Beginning Physical Examination and Health Assessment
Syllabus
FALL QUARTER 2002
Faculty:
Office/Phone
Kathleen Gilchrist, PhD, CCRN, PHN, RN
Team Leader, Lecturer
RNEC 132/664-3229
Peggy Leapley, PhD, RN, CNS, FNP-C
RNEC 107/664-3110
Lab Section 1 Thursday
Brenda Pulskamp, RN, EdD
Lab Section 2 Wednesday
Marjorie E. O’Leary, MSN, RN, CPNP
Lab Section 3 Thursday
Julia Robinson, MS, RN, FNP-C
Lab Section 4 Friday
Cherie Rector, PhD, RN-C
Lab Section 5 Wednesday
Susan Pfettscher, DNSc, RN,
Lab Section 6 Friday
Days/Time/Location:
Lecture/discussion:
Laboratory:
RNEC 112/664-3498
RNEC 133/664RNEC 110/664-3105
RNEC 133/664-3292
RNEC 129/664-2050
Wednesday, 8:00am -9:50am, RNEC 105
Wednesday, 10:00am -12:30pm, RNEC 115, Sections 2, 5
Thursday, 10:00am -12:30pm, RNEC 115, Sections 1, 3
Friday, 10:00am -12:30pm, RNEC 115, Sections 4, 6
Credits:
Lecture/discussion:
Laboratory:
2 units; 2, 50-minute class hours per week
1 unit (3 hours laboratory); 3, 50 minute lab hours per week
Course Description:
Provides theoretical foundation for health assessment, physical examination and clinical experiences for
implementing knowledge in the practice setting. Assessment is stressed as a common foundation of knowledge and
of many shared skills among health professionals and as the initial phase of the nursing process for collecting and
analyzing data to identify nursing diagnoses (actual, risk, possible, syndrome, or wellness) and problems that are
collaborative in nature. The CSUB Department of Nursing Systems Model as a conceptual basis for the approach to
assessment is studied and applied. The basis for establishing a professional nurse-client relationship as a foundation
for communication is examined. Clinical laboratory experiences in the methods and process of an assessment of
adults are provided. Differentiation is made between various data bases -- complete, episodic or problem-centered,
follow-up, and emergency. Cultural and developmental considerations are included.
Prerequisites: Admission into the Nursing Program
Corequisites: Nursing 241, Biology 311, and Biology 355
Course Objectives:
Upon successful completion of N242, the student will:
1.
2.
3.
4.
5.
6.
Identify the process and content of the clinical interview for obtaining subjective health data.
Identify the components of a subjective and objective data base.
Identify the components of the nurse-client/patient relationship.
Utilize communication skills in development of a nurse-client/patient relationship.
Utilize appropriate interactive responses in the client/patient interview situation to obtain subjective data.
Utilize universal precautions in all clinical situations.
7.
8.
9.
10.
11.
12.
13.
2
Utilize the techniques of physical examination in completing a physical assessment.
Demonstrate skill in obtaining accurate basic assessment data including vital signs.
Perform and accurate and complete comprehensive health assessment on an adult.
Construct a complete and accurate record of the findings from a comprehensive assessment.
Compare/contrast the purposes and content of the mini-database and comprehensive data base.
List common deviations from normal physical findings in each body system.
Compare/contrast the purposes of the preventive health assessment and assessment in illness.
Teaching Methods:
Lecture/Discussion
Audio Visual
Web CT, CD Rom
Clinical Laboratory Practice with Demonstration/Return Demonstration
Textbooks:
California State University, Bakersfield, Department of Nursing. (2002). Baccalaureate Nursing Handbook: 2002.
Bakersfield, California. Author. *
Craven, R., & Hirnle, C. (2003). Fundamentals of nursing: Human health and function (4th ed.).
Philadelphia: Lippincott.*
Gilchrist, K. & Robinson, J. (2002). Nursing 242: Course Supplements. Bakersfield, CA: California State
University, Bakersfield; Department of Nursing.
Jarvis, C. (2000). Physical examination and health assessment (3rd ed.) with CD Rom. Philadelphia: Saunders.
Jarvis, C. (2000). Student laboratory manual for physical examination and health assessment (3rd ed.).
Philadelphia: Saunders.
Jarvis, C. (2000). Pocket companion for physical examination and health assessment (3rd ed.).
Philadelphia: Saunders.
Sauer, E. S. (2003). Procedure checklists to accompany Craven & Hirnle’s fundamentals of nursing:
Human health and function. Philadelphia: Lippincott.*
Stolte, K. M (1996). Wellness nursing diagnosis for health promotion. Philadelphia: Lippincott.*
*Required textbooks for N241. Selected chapters and/or sections are assigned from text for N242.
Student Evaluation
1. Grading Scale:***
A
= 100 - 93
A= 92 - 90
B+ = 89 - 87
B
= 86 - 83
B= 82 - 80
C+ = 79 - 77
C
CD+
D
DF
=
=
=
=
=
=
76 -73
72 - 70
69 - 67
66 - 64
63 - 60
59 & Below
***The policy of the Department of Nursing is that the lowest passing score for the course is 73%. There is no
rounding up of the final composite course grade to reach 73%.
Note: The grade of “C” in nursing courses is the minimal grade acceptable for progression into subsequent nursing
courses. Students who fail to achieve at least a “C” in a nursing course may repeat the course once. Students who fail
to achieve at least a “C” in a nursing course a second time are ineligible to remain in the Nursing major. A student
may only fail (achieve less than a “C”) a maximum of two (2) different nursing courses and remain in the nursing
program. A failure grade in a third nursing course will make the student ineligible to continue in the nursing
program.
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2. Evaluation Methods
Measuring Instrument*
Midterm Interview Performance Evaluation**
Written Midterm Examination
 Written Laboratory Assignments
Self Reflection Paper
Performance Evaluation (Includes
Written Client/Patient Report)
Final Written Course Examination

*
Percent of Final Grade
10% (interview: 5%; write-up: 5%)
20%
20%
05%
20% (performance: 10%;
written: 10%)
25%
All written laboratory assignments are due by 4pm the day after the laboratory session, 5% per day including
weekends will be deducted if assignments are turned in late.
All evaluation materials must be completed in order to receive a passing course grade (73 or above).
**Mid-term Interview Performance Evaluation: This is a taped interview of a “practice” patient completed outside of class
time. Record a 5-10 minute interview on an adult (18+ years). The interview is to be the investigation of a symptom
(problem oriented type of history) reported to you by the person you are interviewing. The exercise should demonstrate your
skill in both (1) the process of interviewing (communicating effectively by setting the stage for the interview, using facilitative
responses, etc.), and (2) obtaining the essential content (data about a reported symptom). Both (1) the cassette (labeled with
your name and the name of the instructor) and (2) the write-up of the interview are to be submitted by October 23 (W);
October 24 (Th); October 25 (F). Your instructor will use the Interview Performance Evaluation form included in the N242
Course Supplements to determine your grade.
Examination Dates:
Midterm Written Test:
Midterm Interview Tape/Write-up:
Final Performance Evaluation:
Final Written (Theory) Examination:
October 17
October 23(W); Oct. 24(Th); Oct. 25(Fri).
November 27
December 4: 08:00-10:00am
3. Services for Students with Disabilities:
CSUB provides services for students with disabilities through the Services for Students with Disabilities
Office (661) 664-3360; TDD (661) 664-4263.
4. Academic Honesty:
All students are expected to read and adhere to the Academic Honesty policy detailed on page59 of the 20012003 CSUB Catalog and the Ethical Standards found in the Undergraduate Nursing Student Policy Handbook
2002, pages 66-69.
All work must be original work written for this course by the individual submitting it. See definition of
plagiarism according to University General Catalogue and Department of Nursing Student Handbook. The
penalty for plagiarism is an “F” in the course for first offense and termination from the University for second
offense. If any questions, ask your instructor.
5. Attendance Policy:
Students are required to attend all lecture and laboratory sessions. If a lecture session is missed, it is the student’s
responsibility to obtain notes for that day from another student. Laboratory instructors will not arrange for make-up sessions.
ONLY extreme and/or extenuating circumstances will be considered by the faculty teaching team for laboratory make-ups.
6. During Class or Lab:
All pagers, cellular/digital telephones are to be turned off.
7. Clinical Warning:
Students are advised to familiarize themselves with the provision of Clinical Warning
Procedure (Nursing Student Policy Handbook).
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Summary of Content:
Unit I: Health Assessment: Purpose, Process and Content
A.
Assessment for Health/Illness
B.
Four Types of Data: Complete (Total Health), Problem Centered (Episodic), Followup, Emergency
C.
Developmental Tasks and Health Promotion for Adults
Unit II: Communication
A.
B.
C.
D.
E.
F.
G.
Nurse-Client/Patient Relationships
The Process of Communication:
Facilitative vs. Nonfacilitative Responses
Developmental Considerations
Interviewing People with Special Needs
Transcultural Considerations
Establishing Reliability
Unit III: Skills Basic to Assessment
A.
The Complete Health History: Process and Content
B.
Eliciting/Recording Subjective and Objective Data; the SOAP Format
C.
Identification of Nursing Diagnoses
D.
Universal Precautions: Hand-washing and Gloving
E.
General Survey, Vital Signs (Height, Weight, Temperature, Pulse, Respiration)
F.
Techniques of Physical Examination (Inspection, Palpation, Percussion, Auscultation)
Unit IV: Assessment of Individual Body Systems
A.
Integument
B.
Head, Nose, Mouth, Throat
C.
Vision/Hearing Screening, Eyes, Ears
D.
Breast/Regional Lymphatics, Thorax/Lungs
E.
Head/Neck Vessels, Peripheral Vascular System, Lymphatics
F.
Abdomen, Genitalia (Male/Female)
G.
Musculoskeletal, Neurological
Unit V: Nutritional Assessment
Unit VI: Health Assessment/Records -- Putting It All Together
A.
Categorization of Assessment Data and Assessment of Functional Health Patterns
B.
Recording of Assessments in Clinical Agencies -- Endemic Practices
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California State University, Bakersfield
Department of Nursing
N242: Beginning Physical Examination and Health Assessment
Calendar: Lecture and Laboratory Topics, Reading/Written Assignments,
Assignment Due Dates


Refer to the N242 Course Supplements, Laboratory Guides, for specific directions for each laboratory session.
All forms for written laboratory assignments are located in (1) Jarvis, Student laboratory manual for physical
examination and health assessment (accompanies the textbook by Jarvis) or (2) Sauer, Procedure checklist to accompany
fundamentals of nursing ( accompanies the textbook by Craven & Hirnle, Fundamentals for nursing: Human health and
function), or (3) the N242 Course Supplements. Written assignments are due by 4pm the day after the laboratory,
5% per day including weekends will be deducted if assignments are turned in late.
Date/Time
Lecture/Laboratory Topic
Readings/Written Assignments/
Due dates
Lecture 1: Wednesday, September 25
8:00-9:00am
9:00-9:50 am
Unit 1
Health Assessment: A. Assessment for Health/Illness.
B. Four Types of Data: Complete
(Total Health), Problem Centered
(Episodic), Follow-up, Emergency
C. Developmental Tasks and Health
Promotion for Adults

Jarvis, Chapters:
1: p. 4-12
2: p. 28-36
3: p. 45-56
Unit III
Skills Basic to Assessment:
A. A. The complete Health History”
Process and Content
*Functional Health Patterns (including
Functional Health Assessment and
Activities for Daily Living) are discussed
B. Eliciting/Recording Subjective
And Objective Data; SOAP Format
C. Mental Status
D. Identification of Nursing Diagnosis
(Brief)
E. Universal Precautions:
Handwashing and Gloving

Jarvis, Chapters:
5: p. 79-102
6: p. 103-128
8: p. 165-178
Stolte, Chapters:
1, 2, 3: p. 1-63
Craven & Hirnle, Chapters:
4: p. 66
5: p. 76-79
15: p. 238-240
26: p. 488-491, 493-494
Communication:
A. Nurse-Client/Patient Relationships
B. The Process of Communication
C. Facilitative vs Nonfacilitative
Responses
D. Developmental Considerations

Unit II


Film: “Medical Asepsis and Infection
Prevention” (View prior to performing
procedures)
Jarvis, Chapter:
4: p. 57-69
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Laboratory 1: Wednesday September 25; Thursday, September 26; Friday, September 27
10:00am-12:30pm Unit III
Skills Basic to Nursing:
Complete study questions prior to
A. Health History-Clinical Interviews
Laboratory
B. Mental Status
 Jarvis, Lab Manual, Chapters:
C. Universal Precautions:
1: p. 1-4
Handwashing and Gloving
2: p. 5-11
D. Review Techniques of Physical
3: p. 13-18
Examination (Inspection, Palpation,
4: p. 19-23
Percussion, Auscultation
5: p. 25-35
6: p. 37-43
 Written Assignments:
Jarvis, Lab Manual:
“Cultural Assessment,” p. 17-18
“Health History,” p. 29-35
“Mini Mental Status Examination,” p. 43
Jarvis, CD ROM Case Study #6
SPECIAL INSTRUCTIONS FOR LABORATORY I: For evaluation of hand washing and gloving procedure in this laboratory
session, utilize checklists in Sauer as a guide” Procedure 26-1 (Handwashing, p. 17) and Procedure 26-3, p. 19 (Review
pg. 493-494 in Fundamentals of Nursing, by Craven & Hirnle) as a guide for Clean Gloving. Submit completed procedure
checklist to your clinical instructor.
Lecture 2: Wednesday, October 2
8:00-9:00am
Unit III
E. General Survey, Vital Sign
 Craven & Hirnle, Chapters:
Examination
24: p. 393-410
F. Techniques of Physical
25: p. 443-476
Examination: Inspection, Palpation,
 Jarvis, Chapter 9: p. 179-193
Percussion, Auscultation
9:00-9:50am
Unit II
Communication
 Jarvis, Chapter 4: p. 69-78
Film: “Vital Signs”
Laboratory 2: Wednesday, October 2; Thursday, October 3; Friday, October 4
10:00am-12:30pm Unit III
G. General Survey, Vital Sign
Complete study questions prior to
Examination
Laboratory
E. Techniques of Physical
 Jarvis, Lab Manual, Chapters:
Examination: Inspection, Palpation,
8: p. 61-64
Percussion, Auscultation
9: p. 65-69
 Written Assignments:
Jarvis, Lab Manual, “General Survey,
Vital Signs,” p. 71.
Jarvis, CD ROM Case Study #5
Record of Vital Signs (BP & radial pulse)
on 10 adults (18 years or older). Utilize
form provided.
SPECIAL INSTRUCTIONS FOR LABAORTORY 2: For evaluation of vital sign procedures practiced in this laboratory session,
utilize checklists form Sauer as a guide: Procedures: 24-1 Measuring Weight, p. 1-2; 25-1 Assessing Body Temperature, p. 10-11;
25-2 Obtaining a Pulse, p. 12-13, 25-3 Assessing Respirations, p. 14; 25-4 Obtaining a Blood Pressure, p. 15. Submit completed
procedure checklists to your clinical instructor.
Review/Discuss Midterm Interview tape/Written Report DUE on October 23, 24, 25
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Lecture 3: Wednesday October 9
8:00-9:50am
Unit IV
Assessment of Individual Body Systems
A. Integument
B. Head, Nose, Mouth, Throat

Jarvis Chapters:
10: p. 213-266
11: p. 207-296
14: p. 377-414
Film: “Nose, Mouth, Throat, and Neck”
Laboratory 3: Wednesday, October 9, Thursday, October 10; Friday, October 11
10:00am-12:30pm Unit IV
Assessment of individual Body Systems Complete study questions prior to
A. Integument
Laboratory
B. Head, Nose, Mouth, Throat
 Jarvis, Lab Manual Chapters:
10: p. 73-85
11: p. 87-94
14: p. 117-126
 Written Assignments:
Jarvis, Lab Manual
“Skin, Hair, Nails,” p. 83-84; “Teaching
Skin Self-Examination,” p. 85; “Head and
Neck,” p. 93-94; “Nose, Mouth, and
Throat,” p. 125-126
Lecture 4: Wednesday, October 16
8:00-9:50am
Unit IV
A. Vision/Hearing Screening;
B. Eyes/Ears

Jarvis, Chapters:
12: p. 297-344
13: p. 345-376
Film: “Head, Eyes and Ears,”
Laboratory 4: Wednesday, October 16; Thursday, October 17; Friday, October 18
10:00am-12:30pm Unit IV
C. Vision/Hearing Screening;
Complete study questions prior to
Eyes/Ears
Laboratory
 Jarvis, Lab Manual Chapters:
12: p. 95-106
13: p. 107-116
 Written Assignments:
Jarvis, Lab Manual: Eyes,” p. 105-106
“Ears,” p. 115-116
Lecture 5: Wednesday, October 23
8:00-8:50am
Unit IV
9:00-9:50
MIDTERM EXAMINATION
 Jarvis, Chapters:
D. Breast/Regional Lymphatics/Thorax/
15: p. 415-446
Lungs
16: p. 447-495
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Laboratory 5: Wednesday, October 23; Thursday, October 24; Friday, October 25
10:00am-12:30pm Unit IV
D. Breast/Regional Lymphatics/Thorax/ Complete study questions prior to
Lungs
Laboratory
 Jarvis, Lab Manual Chapters:
15: p. 127-137
16: p. 139-150
 Written Assignments:
Jarvis, Lab Manual: “Breasts/Axillae,”
p. 135-136
“Teaching Breast Self-Examination,”
p. 137
“Thorax/Lungs,” p. 149-150
Jarvis, CD ROM Case Study #7, 9
 Breast Examination Exercise:
Complete form provided in N242 to
identify location, size, mobility of lumps in
breast model.
Films: “Breasts and Regional Lymphatics,”
“Thorax and Lungs”
Lecture 6: Wednesday, October 30
8:00-9:50am
Unit IV
E. Heart/Neck Vessels, PVS,
Lymphatics
 Jarvis, Chapters:
17: p. 497-549
18: p. 551-580
Films: “CVS: Heart & Neck Vessels;”
“CVS: PVS & Lymphatics
Laboratory 6: Wednesday, October 30, Thursday, October 31; Friday, November 1
10:00am-12:30pm Unit IV
F. Heart/Neck Vessels, PVS,
Complete study questions prior to
Lymphatics
Laboratory
 Jarvis Lab Manual,
Chapters:
17: p. 151-162
18: p. 163-173
 Written Assignments:
Jarvis, Lab Manual: “Cardiovascular system,”
p. 161-162;
“Peripheral Vascular system,”
p. 171-173
Jarvis, CD ROM Case Study #8
Lecture 7: Wednesday, November 6
8:00-9:50am
Unit IV
F. Abdomen, Genitalia (Male/Female)

Jarvis, Chapters:
19: p. 581-624
22: p. 751-780
23: p. 781-796
24: p. 797-837
Films: “Abdomen;” “Female Genitalia
& Male Genitalia”
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Laboratory 7: Wednesday, November 6; Thursday, November 7; Friday, November 8
10:00am-12:30pm Unit IV
F. Abdomen, Genitalia (Male/Female) Complete study questions prior to
Laboratory
 Jarvis, Lab Manual, Chapters:
19:” p. 175-186
22: p. 215-225
23: p. 227-233
24: p. 235-245
 Written Assignments:
Jarvis, Lab Manual:
“Abdomen,” p. 185-186, “Teaching
Testicular Self-Examination,” p. 225
 Testicular Examination Exercise:
Complete form provided in N242 to
identify location, size, mobility of lumps in
testicular model.
Lecture 8: Wednesday, November 13
8:00-9:50am
Unit IV
G. Musculoskeletal/Neurological
 Jarvis, Chapters:
20: p. 581-686
21: p. 687-750
Films: “Neurological: Cranial Nerves and
Sensory Reflexes,” “Neurological: Motor
System & Reflexes”
Laboratory 8: Wednesday, November 13; Thursday, November 14; Friday November 15
10:00am-12:30pm Unit IV
G. Musculoskeletal/Neurological
Complete study questions prior to
Laboratory
 Jarvis Lab Manual Chapters:
20: p. 187-200
21: p. 201-213
 Written Assignments:
Jarvis, Lab Manual:
“Musculoskeletal System,” p. 195-200;
“Neurological System” p. 211-213
Jarvis, CD ROM Case Study # 4
Lecture 9: Wednesday, November 20
8:00-9:50
Unit V
H. Nutritional Assessment
Unit VI
I. Health Assessment/Records
Putting It All Together
A. Categorization of Data and
B. Assessment of Functional
Health Patterns
C. Critical Thinking in Health
Assessment
D. Recording of Assessments in
Clinical Agencies: Endemic
Practices

Jarvis, Chapter 7, p. 129-162
 Jarvis, Chapters:
26: p. 875-898
27: p. 899-905
Film: “Head to Toe Examination of the
Adult”
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Laboratory 9: Wednesday November 20; Thursday, November 21
10:00am-12:30pm
Review
 Practice for Final Performance
Evaluation
 Jarvis, Lab Manual,
Chapter 7: p. 45-60
 Written Assignments:
Jarvis, Lab Manual:
“Admission Nutrition Screening Tool,” p. 51,
“Complete Physical Examination,” p. 251-255
Jarvis, CD ROM Case Study #1
Sign up for Final Performance Evaluation
Lecture 10: Wednesday, November 27
Final Performance Evaluation
Laboratory 10: Wednesday, November 27
07:00
Final Performance Evaluation
Wednesday, December 4
8:00am-10:30am FINAL WRITTEN THEORY EXAMINATION
 Written Assignment:
“Health History, Physical Examination,
Assessment, Plan”
Form will be provided for the student
at the time of the performance evaluation.
Written report completed and submitted
immediately following performance
evaluation