College of Nursing
RN to BS in Nursing
RN Upward Mobility Option
Nurs 385 Health Assessment and Clinical Decision
Making
COURSE PREFIX, NUMBER, TITLE, CREDIT HOURS
Nurs 385 Health Assessment, Clinical Decision Making, and Nursing Intervention - 5
Credits (3,2)
UNIVERSITY NAME
South Dakota State University
College of Nursing
ACADEMIC TERM, YEAR
Fall 2013
COURSE MEETING TIME AND LOCATION
This is an asynchronous, online course that is housed in the course management
system entitled Desire2Learn (D2L) and does not meet face-to-face at any specific
location, day, or time. Students are expected to log into the course on a weekly basis to
complete the assignments.
PROFESSOR CONTACT INFORMATION
Dr. Kay Foland, Professor
1011 11th Street
SDSU College of Nursing West River
Rapid City, SD 57701
Work Phone: (605)394-6195
Fax: (605) 394-1250
COURSE DESCRIPTION
Catalog Description
This course concentrates on the deliberative process utilized by the baccalaureate
prepared nurse. The course will build upon the assessment and intervention skills
acquired in the students' previous education and will emphasize clinical decision making
and use of research based interventions. This course includes a practicum component in
which the nursing process is applied to families and clients across the age continuum in
the home setting. The professional value of "human dignity" or respect for the inherent
worth and uniqueness of individuals and populations is the value based behavior central
to this course.
COURSE PREREQUISITES
Previous Courses/Experience
Nurs 222, Nurs 381
Technology Skills
Ability to use Desire2Learn, Internet Search Engines (Google or Foxfire), Microsoft
Word, and PowerPoint
TECHNICAL SUPPORT
Helpdesk 605-688-6776 or SDSU.supportdesk@sdstate.edu.
http://www.sdstate.edu/technology/
DISTANCE EDUCATION SUPPORT
http://distance.sdstate.edu/
DESCRIPTION OF INSTRUCTIONAL METHODS
Learning experiences in this course will include any or all of the following: lecture,
discussion, conferences, on-line assignments, presentations, examinations, projects,
readings, research, clinical, and independent study. My philosophy of teaching-learning
is that I am the facilitator of your learning. I believe that teaching and learning is a twoway street in an online environment, which means that I also learn from you.
COURSE REQUIREMENTS
Required Textbook and Other Materials
Jarvis, C. (2012). Physical examination and health assessment/health online
package (6th ed.). Philadelphia, PA: W.B. Saunders. ISBN 0721602851
(Includes on-line component, CD ROM)
Jarvis, C. (2012). Physical examination and health assessment. Student
Laboratory Manual (6th ed.). Philadelphia, PA: W.B. Saunders.
Recommended Textbooks
Kaakinen, J., Gedaly-Duff, V., Coehlo, D., & Harmon Hanson, S. (2010). Family
health care nursing: Theory, practice and research (4th ed.). Philadelphia,
PA: W.B. Saunders.
Nunnery, R. K. (2012). Advancing your Career (5th ed.). Philadelphia , PA: F. A. Davis.
(SDSU Bookstore: http://bookstore.sdstate.edu)
Supplementary Materials
Articles available through the SDSU Library. Off Campus Library Access:
http://www.sdstate.edu/library/index.cfm
Class Attendance Policy
Students can access this asynchronous, online course through Desire2Learn. If you do
not know your Username or Password login you can contact the Help Desk or go
directly to the Desire2Learn website and read the information regarding "I'm new to
D2L." and "What is my Password?". Students are expected to log in to D2L to
complete assignments by the due dates and use proper Netiquette at all times. If you
need any type of Educational Assistance, please visit Study Guides and Strategies for
volumes of information that will assist you to improve your "reading, writing, and
arithmetic" skills.
Attendance is expected for this online class. Students are expected to "log in
and "participate" a minimum of two (2) times per week for class on separate days.
Remember that just logging in is not the same as "logging in and participating".
An excused absence will be granted in case of student illness or emergency, death of an
immediate family member (spouse, parent, sibling, child, or grandparent). Other
absences will be excused when approved by university officials (see class attendance
policy, page 23, SDSU Undergraduate Bulletin). THE STUDENT IS RESPONSIBLE TO
NOTIFY THE FACULTY PERSONALLY PRIOR TO ANY SCHEDULED ABSENCE.
Desire2Learn: https://d2l.sdbor.edu/
SDSU Academic Dishonesty Policy
South Dakota State University has taken a strong and clear stand regarding Academic
Dishonesty. Consequences range from Disciplinary Probation to Expulsion. Conduct in
this class is governed by the SDSU Student Code, Chapter One of the student code
(01:10:23:10-1:10:23:04) within the SDSU Student Policy Manual. Any evidence of
cheating or dishonesty may result in an “F” for the course, according to the discretion
of the instructor. The Student Code is available on the following website: SDSU Student
Code
Make-up policy
All written assignments should be turned in on time unless an extension has been
obtained from the professor prior to the due date and time. Graded written assignments
will lose points for each day over the due date. Active participation is expected in this
online class. Assignments are to be completed by the designated date. The student is
responsible for all material covered in this online class including announcements.
In case of an excused absence on a scheduled exam day, there will be a make-up exam
at the discretion of the faculty. IT IS THE STUDENTS RESPONSIBILITY TO CONTACT
THE FACULTY FOR MAKE-UP ARRANGEMENTS WITHIN ONE DAY FOLLOWING THE
SCHEDULED EXAM. In the case of an unexcused absence on an exam day there will not
be a make-up exam. Zero will be recorded as the student’s grade.
COURSE GOALS
1. Conduct an organized and appropriate holistic assessment of individuals and one
family.
Relates to IDEA objective # 1 Gaining factual knowledge (terms, classifications,
methods, trends).
2. Examine the professional value of human dignity and relate to the practice of
nursing in the role of provider of care, designer/manager/coordinator of care,
and member of a profession.
3. Apply diagnostic reasoning and critical thinking skills to clinical decision making.
Relates to IDEA objective # 3 Learning to apply course material (to improve
thinking, problem solving, and decisions).
4. Utilize current research findings to support interventions with clients and families.
Relates to IDEA objective # 3 Learning to apply course material (to improve
thinking, problem solving, and decisions).
5. Demonstrate the nurse's role in minimizing the stressors of illness among
individuals and families.
6. Demonstrate appropriate therapeutic communication techniques when working
with families and individuals in the home setting.
Relates to IDEA objective # 2 Learning and applying fundamental principles,
generalizations, or theories.
7. Examine key areas of health promotion of the individual/family including
nutrition, exercise, health relationships, and spiritual health.
Relates to IDEA objective # 1 Gaining factual knowledge (terms, classifications,
methods, trends).
8. Demonstrate an understanding of the principles of health beliefs and lifestyle
change during implementation of an individually developed health promotion
plan.
Relates to IDEA objective #2 Learning and applying fundamental principles,
generalizations, or theories.
9. Evaluate outcomes from interventions with clients and families.
STUDENT LEARNING OUTCOMES
Module 1
1. Differentiate between the components of the nursing process (Quiz).
2. Compare and contrast the levels of nursing experience (Quiz).
3. Differentiate between diagnostic reasoning and critical thinking when using
clinical judgment skills (Quiz).
4. Determine the order of priorities when dealing with patient problems (Quiz).
5. Analyze the four types of assessment data bases collected by nurses with broadbased assessment skills (Quiz).
6. Identify the obstacles to establishing evidence-based nursing practice (Quiz).
7. Discuss the trend toward evidence-based practice in nursing (Discussion Forum).
8. Utilize available resources for evidence-based practice in nursing (Discussion
Forum).
Module 2
1. Differentiate between the terms cultural care, culturally sensitive, culturally
appropriate, and cultural competent (Quiz).
2. Compare and contrast the terms heritage consistency and heritage inconsistency
based on culture, ethnicity, spirituality, or religion and subcultures (Quiz).
3. Differentiate between the terms socialization, acculturation, assimilation,
biculturalism, and culture shock (Quiz).
4. Compare and contrast the developmental stages of the preschooler, school-age
child, adolescent, and the older adult (Quiz).
5. Perform a Heritage Assessment on a person of your choice (Heritage Assessment
Assignment).
6. Perform two Developmental Stage Assessments for two individuals in different
developmental stages (Developmental Stages Assignment).
7. Examine the terms intimate partner violence, child abuse, and elder abuse (Case
Study).
8. Examine the assessment tools used to identify different types of abuse (Abuse
Assessment Screen (AAS), AMA Elder Abuse Screen, Danger Assessment) (Case
Study).
9. Explain the aspects of assessment and history taking for suspected abuse (Case
Study).
Module 3
1. General Survey



List the information considered in each of the four areas of a general
survey: Physical appearance, body structure, mobility, and behavior.
Describe relevant developmental considerations in relation to a general survey.
Conduct a general survey on a client of your choice and document findings
narratively.
2. Pain Assessment: The Fifth Vital Sign




Compare acute and chronic pain with acute and chronic behaviors.
Describe developmental, transcultural, and gender considerations regarding pain.
Compare available pain assessment tools.
Describe the physical changes that may occur because of poorly controlled pain.
Module 4
1. General Nutritional Assessment



Describe the unique nutritional needs for various developmental periods
throughout the life cycle.
Describe the factors that identify the need for a comprehensive nutritional
assessment for a client.
Use nutritional assessment in the provision of health care.
2. Skin, Hair, and Nails



Describe the significant differences between the skin of clients across the life
span.
Cite examples of health care implications presented by skin alterations.
Complete an assessment of the skin, hair, and nails using appropriate techniques
and documentation of findings.
3. Nose, Mouth, and Throat


Identify the anatomic landmarks of the nose, mouth, and throat.
Demonstrate physical assessment techniques for the nose, mouth, and throat
and documentation of findings.
Module 5 and 6
1. Head and Neck Assessment


Identify the significant features, structures, and landmarks of the head, neck,
and regional lymph nodes.
Demonstrate physical assessment techniques for the head, neck, and regional
lymph nodes in the neck.
2. Eye and Ear Assessment


Examine the internal and external anatomic landmarks of the eye and ear.
Demonstrate physical assessment techniques for the eye and ear, including age
specific techniques across the life span.
3. Neurologic Assessment and Mental Status Examination






Name the two parts of the nervous system.
Relate the components of the central nervous system to their function.
Differentiate among the three types of neurologic examination.
Define the behaviors that are included in an assessment of an individual's mental
system.
State the purpose of a mental status examination.
Demonstrate physical assessment techniques for the neurologic system.
Module 7 and 8
1. Thorax and Lung Assessment




Gather appropriate health history information for a client with a respiratory
disorder.
Demonstrate how to inspect, palpate, percuss, and auscultate respiratory
structures.
Describe normal assessment findings of the respiratory system
Describe the most common abnormal findings detected by physical assessment
of the respiratory system.
2. Heart and Neck Vessels



Differentiate between normal and abnormal findings during inspection and
palpation of the cardiovascular system.
Demonstrate auscultation of the precordium and describe the heart sounds
normally heard at each assessment point.
Describe the most common abnormal findings detected by physical assessment
of the precordium and neck vessels.
3. Peripheral Vascular and Lymphatic System

Demonstrate knowledge of the symptoms related to the peripheral vascular


system by obtaining a regional health history from a client.
Demonstrate palpation of peripheral arterial pulses by assessing amplitude and
symmetry and by noting any signs of arterial insufficiency.
Demonstrate palpation of the lymphatic system by identifying enlargement,
clumping, or abnormal firmness of regional lymph nodes.
Module 9
Musculoskeletal System




Outline health history questions useful in eliciting information about
musculoskeletal complaints.
Identify appropriate modifications of a musculoskeletal physical assessment for a
pediatric and elderly patient.
Describe techniques used to inspect and palpate musculoskeletal structures, test
range of motion, evaluate muscle strength, and estimate muscle mass.
Demonstrate physical assessment techniques for the musculoskeletal system.
EVALUATION PROCEDURES
Evaluation Policy
Students will be evaluated by the academic and professional judgment of the individual
faculty member(s) assigned to teach this course, based on requirements and
performance standards approved by the College of Nursing. You must receive a "C" in
this course in order to proceed in the nursing major. University policy for filing
delinquent slips for "C" grades at midterm will be followed. Students will receive
periodic feedback throughout the course. Procedures specific to this course are found in
the syllabus.
Grades for all components of the course will be assigned on the following basis:
Section I: Health Assessment
50 %
Quizzes/Module Assignments/Discussion Forums
30 %
Performance and Comprehensive On-line Exam (Expert Proctor-Advanced Practice
20 %
NP or Physician)
Section II: Family
40 %
A. Family Assessment and Plan of Care
20 %
B. Pre/Post Family Home Visit Summaries
20 %
C. Discussion & Participation
Section III: Accountability
10 %
NOTE: BOTH SECTION I and PART II MUST BE PASSED WITH A MINIMUM
"C" GRADE TO SUCCESSFULLY COMPLETE THIS COURSE.
Assignments turned in late may be lowered one letter grade per day late.
See Total Points for a detailed list of the points assigned to each assignment.
Discussion Participation
Participation in the Discussion Forum will be graded based on overall student
participation that:
1. Reflects own preparation and learning.
2. Contributes to the learning of others.
3. Demonstrates clarity, relevance, precision, and timeliness.
All postings in the Discussion Forum are worth 10 points and will be graded using
the Discussion Forum Grading Rubric.
Evaluation Criteria: Accountability
Accountability -10 % of the final grade will be evaluated for student accountability as
indicated:
1) Completing assignments and agency contracts in a timely fashion and selecting a
family that has been cleared with the instructor and is appropriate for the course
requirements.
2) Completing and mailing the family consent to the instructor after the first visit as an
important record.
3) Taking the initiative to orient oneself to the course and read through all course
materials.
4) Working cooperatively with a family based agency or health provider, informing
them of your course related activities in the setting or with your employer in the work
setting.
5) Preparing theoretically and mentally for weekly on-line classes,
6) Demonstrating evidence of critical thinking in class and practicum assignments,
7) Demonstrating both a professional attitude behavior, while involved with field
experiences,
8) Is accountable to the practicum instructor and agency through initiating ongoing
communication when concerns or questions arise.
9) Is accountable for assignments completed throughout the course and at course end
in a timely manner in this paced course.
Performance Standards
This course will be evaluated using the College of Nursing, Undergraduate Department
Grading Scale.
A = 92 to 100%
B = 84 to 91%
C = 76 to 83%
D = 68 to 75%
F = Below 68%
and the following qualitative behavioral standards set by the faculty team for
evaluation:
"A" Exceptional
Written assignments and presentations show originality of thought in stating and
developing a central theme/idea. Ideas are clear, logical and thought
provoking, reflecting superior critical thinking skills. Material is carefully
constructed and organized in sentences and paragraphs. Positive qualities of
writing excellence are demonstrated throughout, i.e. careful choice of effective
words and phrases, the absence of spelling and grammatical errors. References,
when applicable, are strategically incorporated strongly reinforcing the central
theme/idea. The logical development and firm support of the content reflects
thorough understanding/application of family nursing and communication.
Professionalism and accountability are consistently demonstrated.
"B" Superior
Written assignments and presentations have a clearly individual insight or tone and
clearly state a purpose, with logical development. Ideas are clear with some
positive qualities of writing excellence and verbal deliver, comparatively free from
errors in the use of English. Reference selection, when applicable, does not
strongly reinforce the main purpose to the paper. Imaginative competence is
evidenced, but presentation lacks the reinforcing qualities of mechanics and style
which characterize “A” work. Mastery of family nursing and
communication
concepts is reflected by a moderate understanding/application. Professionalism
and accountability are usually manifested.
"C" Average
The average written assignment and presentation has a strong central idea and is
organized clearly enough to convey its purpose. Serious error in the use of English
is avoided. Reference selection, if applicable, is weak. The assignment lacks the
vigor of critical thinking and expression which merit a higher rating. Minimal
understanding/application of family nursing and communication concepts is
evident. Professionalism and accountability are occasionally evidenced.
"D" Unsatisfactory
Written assignment and presentations contain serious errors in the use of
grammar, spelling, and punctuation and fails to present a central idea or logical
thought development. The conception and expression of ideas are
incorrect/ineffective. References, when applicable, are inadequately
incorporated/analyzed. Understanding/application of family nursing and
communication concepts, as well as nursing concepts is lacking throughout.
Professionalism and accountability are rarely portrayed.
AMERICAN DISABILITIES ACT STATEMENT
This course acknowledges the importance of ADA requirements. Any student who feels
s/he may need an accommodation based on the impact of a disability should contact
Nancy Hartenoff-Crooks, Coordinator of Disability Services (605-688-4504 or Fax, 605688-4987) to privately discuss your specific needs. The Office of Disability Services is
located in room 065, the Student Union.
For more information please see SDSU's Office of Disability Services.
TENTATIVE COURSE OUTLINE/SCHEDULE
A detailed Calendar is linked on the Homepage.
FREEDOM IN LEARNING
Under Board of Regents and University policy student academic performance may be
evaluated solely on an academic basis, not on opinions or conduct in matters unrelated
to academic standards. Students should be free to take reasoned exception to the data
or views offered in any course of study and to reserve judgment about matters of
opinion, but they are responsible for learning the content of any course of study for
which they are enrolled. Students who believe that an academic evaluation reflects
prejudiced or capricious consideration of student opinions or conduct unrelated to
academic standards should first contact the instructor of the course to initiate a review
of the evaluation. If the student remains unsatisfied, the student may contact the
department head and/or dean of the college which offers the class to initiate a review
of the evaluation.
Copyright: All distance education materials may be copyrighted.
BLOOD-BOURN PATHOGENS
Students of the College of Nursing must be aware that the College of nursing has a
policy and procedure for students who are infected with a blood borne pathogen such
as Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus and other
infectious diseases. The student may review this policy at the office of any department
head. All students who have been diagnosed with a blood-borne pathogen should
inform the clinical instructor in person. This is medical information and will be kept
confidential while informing only those "who need to know." This information is needed
to protect the health of patients, the public, and to remain in compliance with the
clinical facilities that you may attend.
UNIVERSITY CALENDAR
Important dates such as drop/add, withdrawal, and official holidays