Wayland Baptist University
NURS 3421 Health Assessment
COURSE DESCRIPTION: Basic technical aspects of anatomy, pathophysiology, bedside assessment
skills, laboratory tests and diagnostic tests are emphasized. The emphasis on caring is displayed through
themes of assessment of the whole person: cultural, spiritual, familial, and environmental considerations,
patient dignity and health promotion. Emphasis will be placed on communication of specific health
assessment findings and acquiring health assessment knowledge and skills based on scientific rationale.
ATI assessment exam will be required at the end of this course; and will be part of the course grade
Prerequisites: NURS 3424, NURS 3922.
CREDIT: 4 Credit hours (2 hrs. class/wk and 6 hrs. lab/wk)
PROGRAM LEVEL: I
TEXTBOOKS:
Bickley, L. & Szilagyi, P., (2007). Guide to Physical Examination and History Taking, 9th Edition.
Philadelphia: Lippincot Williams & Wilkins.
Malarkey, L. & McMorrow, M., (2006). Mosby’s Manual of Diagnostic and Laboratory Tests, 3rd
Edition. St. Louis: Mosby.
Wissmann, J., Knippa, A., Lawler, K.M., Brant, L.S., (2006) Fundamentals in Nursing Version 4.1
Overland Park, Kansas. WWW. ATITESTING.COM
Note: A fee of $20.00 will be attached to your ATI exam and must be paid before mid-term.
Course Coordinator: Assistant Professor, Carolyn Fralix Gold MSN, RN
Office Hours: Posted schedule and by appointment
Office: Rm 109 Telephone 210-590-5657
Email: Carolyn.FralixGold@wbusa.wbu.edu
Class Schedule: Lecture: Monday 1300 – 1510
Skills Lab: Tuesday 1000 – 1630
COURSE OBJECTIVES:
Upon completion of this course, the student should be able to:
1. Use interviewing skills to obtain a nursing health history and entry level nursing physical
assessment.
2. Apply concepts of history-taking, interviewing and physical assessment of the adult client and to
distinguish between abnormal findings and normal variations.
3. Describe the steps of the nursing process.
4. Utilize critical thinking and reasoning skills and reflection to identify functional health patterns
and develop a basic nursing plan of care for clients in collaboration with the client and the
interdisciplinary health care team.
5. Describe clinically relevant laboratory and diagnostic tests.
6. Apply concepts of developmental, cultural, and spiritual assessment. Identify holistic concerns
when assessing the client.
7. Demonstrate and document a bedside nursing interview, general survey, and head to toe
assessment and document findings.
1
EVALUATION AND GRADING: A point system is used to determine the grade in Health
Assessment.
A = 90-100
B = 80-90
C = 75-80
D = 70-74
F = 69 and below
75 or greater required to pass course
Course Assignments:
Health History paper
Exam One
Exam Two
Final Exam
Physical Assessment paper
ATI Exam
20%
20%
20%
20%
15%
5%
(ATI point distribution is as follows: score < level 1= O pts, level 1 = 1pt, level 2 =3 pts, level 3 = 5pts)
------Total
100%
The lab portion of the class is on a pass/fail basis and must be passed to pass the course. Students will be
required to demonstrate accurate assessments in each system: the skin, hair, and nails; the lymphatic
system; the head, neck, ears and eyes; the lungs and respiratory system; the heart and peripheral vascular
system; the breasts, axillae, abdomen, and gastrointestinal system; the female and male genitalia; the
musculoskeletal system; the neurological system and age related differences. Maintain professional
behavior, scholastic integrity and complete all assigned paperwork. Up to 5 points may be deducted form
you course grade if weekly assignments/worksheets are not completed on time. Medication calculations may
be a section of each exam; math score of less than 85% results in a 2-point deduction from the exam grade.
The final course average must be a 75 or better to pass.
Class Attendance
1.
2.
The student must attend classes for which he/she is enrolled.
A student enrolled at Wayland Baptist University should make every effort to attend all class meetings. All
absences must be explained to the satisfaction of the instructor, who will decide whether the omitted work
may be made up.
3. A student who misses twenty –five percent or more of the regularly scheduled class meetings will receive a
grade of “F” for that class.
4. When a student reaches a number of absences considered by the instructor to be excessive for this course
content, the instructor will so advise the student and file an Unsatisfactory Progress Report at the San
Antonio Campus.
5. The instructor will count three tardies as one absence.
6. If an instructor fails to appear or fails to send notification of late arrival within the first fifteen minutes of a
class period, the student may leave without incurring an absence.
University Policy precludes exclusion of qualified disabled persons from participation in, or is denied the benefits
of, or is subject to discrimination under any educational program or activity in the University. Students should
inform their instructor of any documented disabilities in the first class meeting.
2
Testing
A test blueprint will be prepared by the faculty and made available to the student before the exam. The
blueprint will provide the student with the generalized subject content, the number of questions in that
subject area and the type of question. The type of question will be categorized by the areas of the nursing
process: assessment, planning, implementation and evaluation and by cognitive level, knowledge,
analysis, application, and comprehension. In the event a faculty must change a test date, students will be
notified before the scheduled exam. If the student must miss an exam, they must notify the faculty prior
to the exam and schedule a date for the make-up exam within one week of the date of the exam.
Make-up Tests
Only ONE make up exam is permitted per course. A student should contact his/her instructor to arrange
the make-up test. The staff at the IH 35 location will administer the make-up test; both the instructor and
the individual student will contact the office to schedule the test. Tests begin at either 9:00 a.m. or 1:00
p.m. on Tuesday, Wednesdays, or Thursday and completed before the office closes at 5:00 p.m. Missed
exams must be taken within one week of the date of the exam. Failure to do so will result in course
failure.
Criteria for Comprehensive Physical Examination Paper
Paper will be written in a narrative head-toe format, using proper medical/nursing abbreviations and
vernacular. All body systems must be addressed. Maximum length of this paper is three (3) pages,
including cover sheet. Late papers will not be accepted and a 0 will be assigned. Pages exceeding three
will have a 20 pts deduction per page. Success on this paper depends greatly on the quality of your
weekly lab assignments /worksheet, succinct writing skills and lab attendance.
Course Outline*
Unit 1: Foundations of Physical Examination, History Taking & Documentation
Unit 2: Skin, Hair, Nails and Head & Neck
Unit 3: The Thorax and Lungs
Unit 4: Heart and Peripheral Vascular System
Unit 5: Breasts and Axillae, Abdomen and Gastrointestinal System
Unit 6: Female and Male Genitalia
Unit 7: Musculoskeletal System
Unit 8: Nervous Systems
Unit 9: Life Span Considerations
Physical Assessment Comprehensive Paper
Course Schedule is attached at the end of Syllabus
* All contents and schedules for this course are subject to change during the term. Their Instructor will
inform students of changes as soon as possible.
3
Unit 1: Foundations of Physical Examination & History Taking
Unit Objectives
1. Describe the purpose and application
of a Health Assessment
2. List the components of the Health
Assessment
3. Review proper interviewing techniques
and sequence.
4. Review interviewing to obtain a health
history
5. Discuss the techniques of inspection,
palpation, percussion and auscultation
necessary for a physical assessment
6. Describe the equipment necessary for a
physical assessment
7. Review concepts of general and
physical assessment
8. Describe the process of conducting a
mental health and mental status
assessment
9. Describe the process for conducting a
pain assessment
10. Review the process for conducting a
sleep assessment and describe some of
the problems and conditions a patient
may be experiencing
11. Review general survey, physical exam
and vital signs
Student Assignments
Bickley, L. & Szilagyi, P.,
(2007). Bates Guide to
Physical Examination and
History Taking, 9th Edition
Chapter 1 - 4, pp 3-113
Wissmann, J. et al
Fundamentals of Nursing
ATI text and online
testing
ATI text and online practice exam
assigned for preparation of end term
exam for the duration of this course.
Learning Activities
Lecture and Discussion
Skills Lab: Perform a
comprehensive health history,
using interviewing
techniques.
This lab requires a Written
Comprehensive Health
History to be performed
following a specific criteria
sheet. Including a tape
recording of your interview.
Using standard size tape
deck.
(20% of course grade)
REGIONAL EXAMINATIONS
Unit 2: Skin, Hair, Nails and Head & Neck
Unit Objectives
1. Describe and perform an examination
of the skin, hair and nails
2. Discuss common problems and
conditions of the skin, hair, and nails
3. Describe the age-related variations in
client’s hair, nails, and skin
4. Perform an examination of the head
and neck; axillary and breast; arm; and
Student Assignments
Read Bates,
Chapter 5 & 6, pp 121-240,
Learning activities
Lecture and discussion
Skills Lab: Perform an
assessment of the Skin, Hair
and Nails, the lymphatic
system, the head and neck,
ears and eyes
Wissmann, J. et al
4
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
groin to common problems and
conditions of the lymphatic system
Discuss age-related variations of the
lymphatic system
Describe and perform an examination
of the head, neck and thyroid.
Describe common problems and
conditions related to areas of the head
and neck
Discuss age-related variations of the
head and neck
Describe and perform an examination
of the Nose, Paranasal Sinuses, Mouth,
and Oropharynx
Describe common problems and
conditions of the Nose, Paranasal
Sinuses, Mouth and Oropharynx
Discuss the age-related variations with
the Nose, Paranasal Sinuses, Mouth,
and Oropharynx
Describe and perform an examination
of the Ears and Auditory System
Describe common problems and
conditions of the Ear and Auditory
System
Discuss age-related variations of the
Ear and Auditory System
Describe and perform an examination
of the Eyes and the Visual System
Describe common problems and
conditions of the Eye and the Visual
System
Discuss age-related variations of the
Eye and the Visual System
Fundamentals of Nursing
ATI text and online
testing
Document finding on lab
worksheet
Unit 3: Thorax and Lungs / Respiratory System
Unit Objectives
1. Review the anatomy and physiology of
the respiratory system
2. Describe the content obtained when
performing a health history
3. Describe and perform an examination
of the lungs and respiratory system
4. Discuss age-related variations of the
lungs and respiratory system
5. Describe common problems and
conditions of the respiratory system
Student Assignments
Read Bates,
Chapter 7, pp 241-278
Student Activities
Lecture and Discussion
Skills Lab: Perform an
assessment of the respiratory
system to include anterior and
posterior chest
Wissmann, J. et al
Fundamentals of Nursing
ATI text and online
testing
Document finding on lab
worksheet
5
Unit 4: Heart and Peripheral Vascular System
Unit Objectives
1. Review the anatomy and physiology of
the heart, the cardiac cycle, electrical
conduction, and the peripheral vascular
system
2. Describe the content obtained when
performing a health history for the
heart and peripheral vascular system
3. Describe and perform an examination
of the cardiac system and peripheral
vascular system
4. Discuss age-related variations of the
cardiac and peripheral vascular system
5. Describe common problems and
conditions of the cardiac and peripheral
vascular system
Student Assignments
Read Bates
Learning Activities
Lecture and discussion
Chapter 8, pp 279-336
Chapter 14, pp 473-496
Skills lab: Perform an
examination of the cardiac
and peripheral vascular
system
Document finding on lab
worksheet
Wissmann, J. et al
Fundamentals of Nursing
ATI text and online
testing
Unit 5: Breasts and Axillae, Abdomen and Gastrointestinal System
Unit Objectives
1. Describe the anatomy and physiology
of the female and male breast and the
abdomen and gastrointestinal system
2. Describe the content obtained when
performing a health history of the
breast and abdomen
3. Describe the technique and perform an
examination of the breasts and axillae
4. Describe and perform an examination
of the abdomen
5. Discuss age-related variations of the
breasts and axillae and the abdomen
and gastrointestinal system
6. Describe common problems and
conditions associated with the breasts
and axillae and the abdomen,
gastrointestinal tract, and urinary
system
Student Assignments
Read Bates,
Chapter 9, pp 337-358,
Chapter 10, pp 359-410
Learning Activities
Lecture and discussion
Skills Lab: Perform an
assessment of the breasts,
axillae, and abdomen
Document finding on lab
worksheet
6
Unit 6: Female and Male Genitalia
Unit Objectives
1. Review the anatomy and physiology of
the external and internal genitalia, the
menstrual cycle, menopause, and the
bony pelvis
2. Discuss the content obtained when
performing a health history for a
female patient including a reproductive
history
3. Describe the content obtained when
performing a health history for a male
patient
4. Review the anatomy and physiology of
the testes, ducts, glands and external
genitalia
5. Describe an examination of the female
genitalia and male genitalia
6. Discuss age-related variations of the
female and male genitalia
7. Discuss common problems and
conditions of the female and male
genitalia
8. Describe the anatomy and physiology
of the anus, rectum, and prostate
9. Describe the content obtained when
conducting a health history related to
the anus, rectum, and prostate
10. Describe and perform an assessment of
the anus, rectum, and prostate
11. Describe age-related variations of the
anus, rectum, and prostate
12. Describe common problems and
conditions of the anus, rectum and
prostate
Student Assignments
Read Bates,
Chapter 11, pp 411-428,
Chapter12, pp 429-458
Chapter 13, 459-472
Wissmann, J. et al
Fundamentals of Nursing
ATI text and online
testing
Learning Activities
Lecture and Discussion
Skills Lab: Practice
performing assessments of
the female and male genitalia
And assessment of the anus,
rectum and prostate [on
anatomical models if
available]
Document finding on lab
worksheet
Unit 7: Musculoskeletal System
Unit Objectives
1. Review the anatomy and physiology of
the musculoskeletal system
2. Describe the content obtained when
conducting a health history of the
musculoskeletal system
3. Describe and perform an examination
of the musculoskeletal system
4. Discuss age-related variations of the
musculoskeletal system
5. Describe common problems and
conditions of the musculoskeletal
system
Student Assignments
Read Bates,
Learning Activities
Lecture and Discussion
Chapter 15, pp 497-572
Skills Lab: Practice performing
an examination of the
musculoskeletal system
Wissmann, J. et al
Fundamentals of Nursing
Document finding on lab
worksheet
ATI text and online
testing
7
Unit 8: Neurologic System
Unit Objectives
1. Describe the anatomy and physiology
of the neurologic system
2. Describe the content obtained when
conducting a health history of the
neurologic system
3. Describe and perform an examination
of the neurologic system
4. Describe age-related variations of the
neurologic system
5. Describe common problems and
conditions of the neurologic system
Student Assignments
Read Bates,
Chapter 16, pp 573-594,
Chapter 17 pp 595-667
Learning Activities
Lecture and discussion
Skills Lab: Practice and
perform an examination of
the neurologic system
Know Cranial nerves
And MMSE
Document finding on lab
worksheet
Unit 9: Life Span Examinations
Unit Objectives
1. Describe the anatomy and
physiology differences of the Older Adult.
2. Identify assessment approaches and
special areas of concern when assessing
symptoms in the older adult, pregnancy
and pediatrics.
3. Define the “Sixth Vital Sign” and its
implications.
Student Assignments
Learning Activities
Read: Chapter 20, pp. 839-870
Review Chapters 18,19
Lecture and discussion
Self-study
Wissmann, J. et al
Fundamentals of Nursing
ATI text and online testing
Bates Guide to Physical Examination may be referred to in future courses. It is recommended you retain
this book.
Cfg/08
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N3421 Course Schedule: This course schedule may encounter some changes during the term.
Faculty will inform students of these changes as they become evident.
Nov 10, 2008
Nov 11, LAB
Unit 1 Health Assessment [Chap 1-4]
Perform Health History & written assignment
Nov 17
Nov 18 LAB
Unit 2 Skin, EENT, Head and Neck [chap 5-6]
* Unit 1 Paper due 11/17 (20% of grade)
November 24 –29
Thanksgiving Break
Dec 1
Dec 2 LAB
Unit 3 Thorax and Lungs
Dec 8,
Dec 9, LAB
EXAM I - Unit 4 - Heart & PV System [chap 8,14]
{Key Room @ 3:10 pm 12/8 exam}
Dec 15
Dec 16, LAB
Unit 5 Breast, Axillae, Abdomen, GI [chap 9-10]
Dec 22, 2008 – Jan 3, 2009
Christmas Break
Jan 5, 2009
Jan 6, LAB
Unit 6 Male/female genitalia, anus, rectum [chap 11-13]
TBD
Jan 12
Jan 13 LAB
EXAM II - Unit 7 Musculoskeletal [chap 15]
Jan 19
Jan 20, LAB
Unit 8 Neurological system [chap 16-17]
Jan 26
Jan 27, LAB
Unit 9 Life Span [chap. 20]
Feb 2 & 3
Feb 9, 2008
{Key Room @ 3:10 pm}
* Written Comp. Physical Assessment Paper due 1/28 (15% of grade)
TBA
FINAL EXAM 1200 -1400
EVALUATIONS/COURSE GRADES 1500-1700
All students will be assigned a Skills Lab partner for this Term. You will perform physical examinations on
each other throughout the term. Weekly Unit assignments and demonstration of assessment skills are your
responsibility. You must be prepared, display professional behavior and perform skills successfully, with
minimal prompting, to pass the course. Written lab assignments may be required weekly.
Absence from class/lab will jeopardize you and your lab partner’s ability to pass. Please be accountable to
one another.
CFG ‘08
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