NURS 5644 Advanced Health Assessment/ Differential Diagnosis

NURS 5644: Advanced Health Assessment/Differential Diagnosis

SYLLABUS

In the event of significant disruptions to course activities due to extraordinary environmental circumstances (e.g., COVID-19), please note that this syllabus is subject to modifications. Any necessary changes will be promptly communicated to students.

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Semester: Fall
Year: 2021
Course Prefix: NURS
Course Number: 5644
Course Title: Advanced Health Assessment/Differential Diagnosis

Course Description and Overview:

This course delves into the systematic process essential for conducting a comprehensive and holistic health assessment on individuals spanning the entire spectrum of the lifespan. It encompasses the knowledge and skills required for data collection, interpretation of findings, health diagnosis formulation, results communication, and client empowerment.

The emphasis in this advanced course lies in tailoring the history and physical examination to match the specific health concerns presented by the client throughout their lifespan. It involves a comprehensive review of the systematic procedures associated with performing a thorough history-taking, physical examination, and psychological health assessment on individuals. This includes acquiring the knowledge and skills necessary for data gathering, findings interpretation, differential diagnosis formulation, and effective communication of findings and plans.

Meets Core Curriculum Requirements

Faculty Contact Information:

Name of Instructor: Rita Dellostritto, PhD, APRN, CNS, ENP, ACNP-BC, FAANP
Office Location: IHSI 6036
Phone Number: 713-794-2803; 713-826-6236 (c)
Office Hours: By appointment
Email Address: rdellostritto@twu.edu

Name of Instructor: Rebecca Schultz, PhD, APRN, CPNP-PC
Office Location: IHSI 6026
Phone Number: 713-794-2154
Office Hours: By appointment
Email Address: rschultz1@twu.edu

Name of Instructor: Patrick Laird, DNP, APRN, ACNP-BC, NEA-BC
Office Location: Off Campus
Phone Number: 281-222-0619
Office Hours: By appointment
Email Address: plaird@twu.edu

Name of Instructor: Jodi Wright, DNP, APRN, AGACNP-BC, FNP-BC
Office Location: Off Campus
Phone Number: 312-933-6764
Office Hours: By appointment
Email Address: jwright28@twu.edu

Goals and Outcomes:

Upon successful completion of this course, students are expected to:

1. Demonstrate proficient critical thinking and clinical decision-making skills.
2. Develop a comprehensive database, encompassing a thorough functional assessment, health history, physical examination, and appropriate diagnostic testing.
3. Conduct a risk assessment for the client, including an evaluation of lifestyle and other risk factors.
4. Recognize signs and symptoms of common emotional/cognitive health issues and understand their impact on physical assessment.
5. Perform basic laboratory tests and interpret other laboratory and diagnostic data.
6. Correlate assessment findings with underlying pathology or physiological changes.
7. Formulate a differential diagnosis based on the assessment data.
8. Synthesize knowledge of health conditions to make accurate differential diagnoses.
9. Create an effective and tailored plan of care for the client, considering life circumstances, as well as cultural, ethnic, and developmental variations.
10. Acknowledge variations in health, encompassing physiological differences, among diverse cultural, racial, ethnic, age, and gender groups, and understand how these variations influence the assessment and care plan.
11. Integrate evidence-based research into the decision-making process.

NRNP-6665 Comprehensive Integrated Psychiatric Assessment Discussion Example

Clinical Competencies:

Upon successful completion of this course, students in clinical settings should be able to:

1. Demonstrate a comprehensive and problem-focused health assessment for clients and families of all ages, ethnicities, and cultures. This includes:
a. Formulating a comprehensive and problem-focused health history and physical examination for individuals and families across the lifespan.
b. Interpreting a problem-focused health history and physical examination for individuals across the lifespan.
c. Organizing data to establish a differential list of health problems.
d. Prioritizing health problems.
e. Presenting relevant health data and the differential list of health problems to the preceptor.

2. Demonstrate clinical screening skills in:
– Female pelvic examination, providing client instructions for breast self-examination, male genital and prostate examination, instructing clients in testicular self-examination, conducting Denver II screening, scoliosis screening, and health maintenance screening across the lifespan.

3. Demonstrate clinical diagnostic skills in:
– Interpretation of X-rays, EKGs, and laboratory test results.

Course Materials and Supplies:

Textbooks:  REQUIRED TEXTBOOKS:

Bickley, L.S., Szilagyi, P.G., & Hoffman, R.M. (2021).  Bates’ guide to physical examination and history taking (13th ed.).  Philadelphia. PA: Wolters Kluwer/Lippincott Williams and Wilkens.  ISBN 9781469893419

Goolsby, M.J., & Grubbs, L. (2015).  Advanced assessment: Interpreting findings and formulating differential diagnoses (4th ed.).  Philadelphia, PA: F.A. Davis. ISBN-13:  978-0803668942

Fischbach, F., & Dunning, M. (2021).  A manual of laboratory and diagnostic tests (10th ed.).  Wolters Kluwer.  ISBN-13: 978-1496377128; ISBN-10: 1496377125

The following are available online through TWU Library

Fortin, A.H., Dwamena, F.C., Frankle, R.M., & Smith, R. (2012). Smith’s patient-centered interviewing: An evidence-based model (10th ed.).  Lange/McGraw Hill.  Free Access TWU Library at https://accessmedicine-mhmedical-com.ezp.twu.edu/book.aspx?bookid=501

Bickley, L.S. (2017).  Bates’ visual guide to physical examination [video series]: Wolters Kluwer.  Online access [Free through TWU Library]. Location:  https://batesvisualguide.com/multimedia.aspx?categoryID=21787#21768

Recommended Texts: 

Bickley, L.S., Szilagyi, P.G., & Hoffman, R.M. (2021). Bates’ pocket guide to physical examination and history taking (9th ed.).  Philadelphia: Walter Kluwer. ISBN-13:  978-1975109875

Required Supplies:

Diagnostic Kits:  Ophthalmoscope and Otoscope, Tuning Fork, Reflex Hammer, monofilament, tape measure, Stethoscope, Pocket Snellen visual chart, Professional Lab Coat (3/4 or full length)

Computer with a functioning web camera for online quizzes/exams. NURS 5644 Advanced Health Assessment/ Differential Diagnosis

Internet Resources

American Academy of Family Practice: http://www.aafp.org

American College of Nurse-Midwives: http://www.acnm.org

American Academy of Pediatrics: http://www.aap.org

Centers for Disease Control and Prevention: http://www.cdc.gov

Healthy People 2030: http://www.health.gov/healthypeople

Pregnancy Web Sites: http://www.awhonn.org

Texas Board of Nursing: http://www.bne.state.tx.us

World Health Organization: http://www.who.int/en/

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NOTE: Ensuring access to the internet for current information is an expectation for this course. A computer lab with internet access is available for TWU students on the 4th floor.

Pre/Co-requisites Courses: BIOL 5333 Advanced Pathophysiology

Policy Statements

COVID-19 Precautions

As a university committed to safety, we encourage you to take the following actions to protect yourself and others:

1. Get the COVID-19 vaccine if you haven’t already; vaccines are available at Student Health Services (SHS).
2. Wear a mask indoors, following CDC guidelines.
3. Maintain a consistent seat in face-to-face classes for the semester, as seating charts are utilized for contact tracing.
4. Adhere to recommended health protocols, including frequent hand washing and the use of hand sanitizer and sanitation supplies on campus.
5. Stay home if you are feeling unwell.
6. Complete the COVID-19 Reporting Form if you have tested positive, show symptoms, or have been exposed to a positive case. This helps in minimizing the virus’s spread on our campuses.
7. Notify your professor if COVID-19 impacts you, and for assistance with missed assignments due to COVID-19, use the Health and Academic Support Request form.
8. Refer to TWU’s COVID-19 website for the latest pandemic information and university response.
9. Be aware that TWU may adjust class formats and sizes as needed.

Disability Access Policy Statement

TWU is committed to providing accessible learning experiences. If you have a disability (including mental health, chronic, or temporary medical conditions), please contact me to discuss accommodations. To establish reasonable accommodations, register with Disability Services for Students (DSS) and then inform me to implement them promptly.

Title IX: Sexual Violence Education

TWU maintains a safe environment free of sexual misconduct. If you or someone you know experiences sexual harassment, assault, or violence, campus resources are available for support. Report incidents to the Title IX Coordinator or contact TWU Counseling and Psychological Services for confidential help.

Title IX: Pregnant and Parenting Students

Title IX mandates reasonable accommodations for pregnant students or those with pregnancy-related conditions. Complete the Pregnancy Accommodation form to coordinate academic needs.

Academic Integrity

Honesty in assignments is vital to university values. By submitting work, you affirm that it’s your own and abide by the Academic Integrity Policy and Student Code of Conduct. Plagiarism, cheating, collusion, and other dishonest practices will result in appropriate consequences.

TWU Attendance Policy

Consistent attendance is crucial for academic success. Instructors may require attendance for specific activities, and absences don’t excuse students from requirements. Excessive absences may lead to course failure.

Grading and Evaluation

Grading is based on exams, assignments, and clinical performance. Assignments, exams, and quizzes must follow guidelines:

– Submitted on Canvas with an approved cover sheet.
– Written in APA format.
– Include evidence-based references if required.
– Saved in Microsoft Word format with the attached grading rubric.
– Follow a specific naming convention.

Late submissions receive point deductions. Exams and quizzes have specific guidelines, and makeup exams are at the instructor’s discretion.

Lab Hours and Requirements

Students must complete a minimum of 45 lab hours. Requirements include up-to-date documentation of:

– RN License in Texas
– CPR certification
– Immunizations
– Drug screening and background check

Lab hours must be recorded in the Clinical Calendar weekly. Failure to do so may result in point reductions.

Optional Requirements

– Pagers and cellular phones must be silenced during class.
– Recording or photography requires prior permission.
– Proficiency in using email and Canvas is expected.

Professionalism

Students are expected to maintain professionalism in all interactions. This includes timely attendance, adherence to academic honesty policies, and appropriate behavior in class and clinical settings.

TWU Dress Code

Professional dress is expected during final practicum examinations. Guidelines include wearing a lab coat, clean white lab jackets, and appropriate grooming.

Teaching Modalities

Course content is delivered through various modalities, including internet sources, textbooks, and health assessment videos. Regular access and utilization of these resources are expected.

Important Dates

– September 6: Labor Day
– November 5: Last Day to Withdraw
– November 25-27: Thanksgiving Break

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