NR509 Complete Course Latest 2022 March (Full)

NR509 Advanced Physical Assessment

Week 1 Discussion

Social Determinants of Health

Discussion

Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced health assessment. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Course Outcomes

This discussion enables the student to meet the following course outcomes:

CO1 Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations.?

CO4?Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient.?

CO5 Conduct focused and comprehensive health histories and examinations for various patient populations.?

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

This week, you will consider assessment questions and appropriate interventions related to social determinants of health. Healthy physical, social, and economic environments strengthen the potential to achieve health and well-being. The nurse practitioner (NP) must assess all facets of clients’ health during a comprehensive health history. Identify the assigned topics?listed by the first letter of your first name. For example, if your first name begins with the letter G then your?assigned social determinant is?education access and quality.?

First Letter of Your First Name   Topic

A – E       Economic stability

F – J        Education access and quality

K – O      Health care access and quality

P – S       Neighborhood and built environment

T – Z        Social and community context

Complete the following requirements:

Application?of?Course?Knowledge

Examine the overview of your assigned social determinant of health on the HealthyPeople (Links to an external site.) website. Define the determinant.

Describe how the assigned social determinant could impact the health outcomes of a client.

Identify what information the NP could gather to assess the impact of the determinant for the client.

Discuss at least two online, national, or local resources available for at-risk clients and families for the selected determinant.

Integration of Evidence: Provide support?from?a?minimum of?one?scholarly?in-text citation?in addition to the textbook.??

Engagement in Meaningful Dialogue: Respond to a student peer and course faculty to further dialogue.?

Peer Response: Respond?substantively?to at least?one?topic-related?post?by?a?student?peer with a different topic from the initial post. A?substantive?post?adds content?or?insights?or?asks?a?question?that?will?add to the?learning?experience?and/or generate?discussion.???

Faculty Response: Respond substantively?to at least?one?question?by?course faculty. The faculty question may be directed to the student, to another student, or the entire class.????? ??

Professionalism in Communication: Present information in a logical, meaningful, and understandable sequence that is relevant to the discussion topic.??

Grammar, spelling, and/or punctuation are accurate.?

Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 10 words). The quote must add substantively to the discussion.?

Reference Citation:?Provide references with complete information as required by APA (0-1 errors). Include in-text citations included for all references AND references for all in-text citations (0 errors).? ?

Wednesday Participation Requirement: Provide?a?substantive?response to the graded?discussion?question(s) or topic(s),?posted by?the?course?faculty?(not?a?response?to a peer),?by?Wednesday,?11:59 p.m. MT?of?each week.? ?

Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic, one to a student?peer,?and one to a faculty question)?on two different days during the week.?

 

NR509 Advanced Physical Assessment

Week 2 Discussion

Client Challenges

Discussion

Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced health assessment. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Course Outcomes

This discussion enables the student to meet the following course outcomes:

CO1: Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations.?

CO4:?Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient.?

CO5: Conduct focused and comprehensive health histories and examinations for various patient populations.

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

Some clients may present specific challenges to the interview and physical examination. Nurse practitioners must be able to identify behaviors that impede the assessment and consider strategies to provide care to these clients. 

Review the assigned topics?listed by the first letter of your first name. For example, if your first name begins with the letter G then then your?assigned topic is?the approach to a flirtatious client.

The First Letter of Your First Name           Topic

A – D      Argumentative client

E – H       Flirtatious client

I – L         Talkative client

M – P     Client who displays racist or discriminatory behavior

Q – T       Adolescent client who is reluctant to answer questions

U – Z       Violent client

Complete the following requirements:

Application?of?Course?Knowledge:

Create a sample scenario based on your assigned topic. Describe potential client behaviors consistent with the concern listed. 

Discuss an appropriate and professional approach to address the behavior and communicate with the client.

Provide an example of how you would document the encounter. 

 Integration of Evidence: Provide support?from?a?minimum of?one?scholarly?in-text citation?in addition to the textbook.??

Engagement in Meaningful Dialogue: Respond to a student peer and course faculty to further dialogue.?

Peer Response: Respond?substantively?to at least?one?topic-related?post?by?a?student?peer with a different topic from the initial post. A?substantive?post?adds content?or?insights?or?asks?a?question?that?will?add to the?learning?experience?and/or generate?discussion.???

Faculty Response: Respond substantively?to at least?one?question?by?course faculty. The faculty question may be directed to the student, to another student, or to the entire class.?????

Professionalism in Communication: Present information in a logical, meaningful, and understandable sequence that is clearly relevant to the discussion topic.??

Grammar, spelling, and/or punctuation are accurate.?

Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 10 words). The quote must add substantively to the discussion.?

Reference Citation:?Provide references with complete information as required by APA (0-1 errors). Include in-text citations included for all references, AND references for all in-text citations (0 errors).?

Wednesday Participation Requirement: Provide?a?substantive?response to the graded?discussion?question(s) or topic(s),?posted by?the?course?faculty?(not?a?response?to a peer),?by?Wednesday,?11:59 p.m. MT?of?each week.?

Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic, one to a student?peer,?and one to a faculty question)?on two different days during the week.?? ?

 

NR509 Advanced Physical Assessment

Week 3 Assessment   

iHuman Virtual Patient Encounter – HEENT Assessment

Purpose

The iHuman assignments provide students with an opportunity to experience clinical scenarios that are relevant to the lesson content through virtual patient encounters. iHuman is a highly interactive and dynamic way to enhance student learning.??

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO 1: Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (POs 1, 2)

CO 2: Differentiate normal and abnormal health history and physical examination findings. (POs 1, 2)

CO 3: Document health history and physical examination findings in a logical and organized sequence.  (POs 1, 2)

CO 5: Conduct focused and comprehensive health histories and examinations for various patient populations.  (POs 1, 2)

Preparing the Assignment

Follow these guidelines when completing?each component of the?assignment.?Contact your course faculty if you have questions.?

Access?iHuman?by clicking the link provided below.? Clicking the blue bar will?launch the activity in a new browser window. You do not need to complete the case in one sitting; if you leave the case and return later, the program will begin where you left off.

All graded documentation, including the Management Plan, must be completed within the iHuman platform. Follow the iHuman Documentation Guide (Links to an external site.) as you prepare your client’s EMR.

You may use the Fillable SOAP note template (Links to an external site.) to assist with documentation and organization as you complete the case.

Complete the following components in the iHuman Virtual Patient Encounter for the assessment of the abdomen.

History: Complete a focused health history. Your score will be automatically calculated after the health history is submitted.

Physical Exam: Complete a focused physical exam. Your score will be automatically calculated after the focused physical exam is submitted.

EMR Documentation: Document within the Patient Record in iHuman using professional language. include the following components:

History of present illness

Previous medical history

Current medications

Allergies

Relevant completed screenings and preventive health

Relevant family history

Relevant social history

Focused review of systems

Focused physical exam findings

Key Findings/Most Significant Active Problem: Document Key Findings from your history and physical exam in the Assessment tab of the case. Organize Key Findings, identifying the most significant active problem (MSAP) and the relation of other key findings to the MSAP.

Problem Statement: Document a problem statement using professional language. Include the following components.

name, age

chief complaint

brief description of pertinent positive and negative subjective findings

brief description of pertinent positive and negative objective findings

Management Plan: Using the expert diagnosis provided, create a comprehensive treatment plan using professional language. Include at least one appropriate, evidence-based, scholarly source to support your decisions. Include the following components:

diagnostic tests

medications

suggested consults/referrals

client education

follow-up

Reflection: In a Microsoft Word document, respond to the self-reflection questions below. Include a title page in APA format using the title iHuman Reflection Week 5. In 2-3 paragraphs, respond substantively to all required reflection questions. Analyze your personal strengths and areas for growth.

Now that you have completed your first virtual patient encounter, it is important to self-assess your performance.  Select ONE of the following topics and discuss your achievement. Be sure to include at least ONE evidence-based improvement strategy to improve your performance in your next virtual patient encounter.

Gathering patient information (history and physical examination)

Organization and interpreting information to synthesize the problem

Identifying pertinent key findings

Developing the problem statement

Click?”Submit”?once the case is?complete. Download the iHuman Virtual Patient Encounter report.

Submit both the iHuman Virtual Patient Encounter report and your completed reflection document to the Week 3 dropbox.

 

NR509 Advanced Physical Assessment

Week 4 Assessment   

iHuman Virtual Patient Encounter – Cardiovascular Assessment

Purpose

The iHuman assignments provide students with an opportunity to experience clinical scenarios that are relevant to the lesson content through virtual patient encounters. iHuman is a highly interactive and dynamic way to enhance student learning.??

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO 1: Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (POs 1, 2)

CO 2: Differentiate normal and abnormal health history and physical examination findings. (POs 1, 2)

CO 3: Document health history and physical examination findings in a logical and organized sequence.  (POs 1, 2)

CO 5: Conduct focused and comprehensive health histories and examinations for various patient populations.  (POs 1, 2)

Preparing the Assignment

Follow these guidelines when completing?each component of the?assignment.?Contact your course faculty if you have questions.?

Access?iHuman?by clicking the link provided below.? Clicking the blue bar will?launch the activity in a new browser window. You do not need to complete the case in one sitting; if you leave the case and return later, the program will begin where you left off.

All graded documentation, including the Management Plan, must be completed within the iHuman platform. Follow the iHuman Documentation Guide (Links to an external site.) as you prepare your client’s EMR.

You may use the Fillable SOAP note template (Links to an external site.) to assist with documentation and organization as you complete the case.

Complete the following components in the iHuman Virtual Patient Encounter for the assessment of the abdomen.

History: Complete a focused health history. Your score will be automatically calculated after the health history is submitted.

Physical Exam: Complete a focused physical exam. Your score will be automatically calculated after the focused physical exam is submitted.

EMR Documentation: Document within the Patient Record in iHuman using professional language. include the following components:

history of present illness

previous medical history

current medications

allergies

relevant completed screenings and preventive health

relevant family history

relevant social history

focused review of systems

focused physical exam findings

Key Findings/Most Significant Active Problem: Document Key Findings from your history and physical exam in the Assessment tab of the case. Organize Key Findings, identifying the most significant active problem (MSAP) and the relation of other key findings to the MSAP.

Problem Statement: Document a problem statement using professional language. Include the following components.

name, age

chief complaint

brief description of pertinent positive and negative subjective findings

brief description of pertinent positive and negative objective findings

Management Plan: Using the expert diagnosis provided, create a comprehensive treatment plan using professional language. Include at least one appropriate, evidence-based, scholarly source to support your decisions. Include the following components:

diagnostic tests

medications

suggested consults/referrals

client education

follow-up

Reflection: In a Microsoft Word document, respond to the self-reflection questions below. Include a title page in APA format using the title iHuman Reflection Week 5. In 2-3 paragraphs, respond substantively to all required reflection questions. Analyze your personal strengths and areas for growth.

The HPI is a concise, clear, and chronologic description of the problems prompting the patient’s visit, including the onset of the problem, the setting in which it developed, its manifestations, and any treatments to date. The HPI in its most basic form is the story of the patient’s problem. It should reveal the patient’s responses to his or her symptoms and what effect the illness has had on the patient’s life. Always remember, the information flows spontaneously from the patient, but the task of oral and written organization is yours. Reflect on how well you constructed the HPI for this patient encounter and rate your performance using the following rating scale (0=unacceptable, 1=needs improvement, 2=average, 3=effective, 4=exceptional performer). Explain your rationale for the rating and identify at least ONE evidence-based strategy to improve your performance in the next virtual patient encounter.

 

NR509 Advanced Physical Assessment

Week 5 Assessment   

iHuman Virtual Patient Encounter Activity

Purpose

The iHuman assignments provide students with an opportunity to experience clinical scenarios that are relevant to the lesson content through virtual patient encounters. iHuman is a highly interactive and dynamic way to enhance student learning.

Course Outcomes

Through this assignment, the student will demonstrate the ability to:

CO 1: Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (POs 1, 2)

CO 2: Differentiate normal and abnormal health history and physical examination findings. (POs 1, 2)

CO 3: Document health history and physical examination findings in a logical and organized sequence. (POs 1, 2)

CO 5: Conduct focused and comprehensive health histories and examinations for various patient populations. (POs 1, 2)

Preparing the Assignment

Follow these guidelines when completing?each component of the?assignment.?Contact your course faculty if you have questions.?

Access?iHuman?by clicking the link provided below.? Clicking the blue bar will?launch the activity in a new browser window. You do not need to complete the case in one sitting; if you leave the case and return later, the program will begin where you left off.

All graded documentation, including the Management Plan, must be completed within the iHuman platform. Follow the iHuman Documentation Guide (Links to an external site.) as you prepare your client’s EMR.

You may use the Fillable SOAP note template (Links to an external site.) to assist with documentation and organization as you complete the case.

Complete the following components in the iHuman Virtual Patient Encounter for the assessment of the abdomen.

History: Complete a focused health history. Your score will be automatically calculated after the health history is submitted.

Physical Exam: Complete a focused physical exam. Your score will be automatically calculated after the focused physical exam is submitted.

EMR Documentation: Document within the Patient Record in iHuman using professional language. include the following components:

History of present illness

Previous medical history

Current medications

Allergies

Relevant completed screenings and preventive health

Relevant family history

Relevant social history

Focused review of systems

Focused physical exam findings

Key Findings/Most Significant Active Problem: Document Key Findings from your history and physical exam in the Assessment tab of the case. Organize Key Findings, identifying the most significant active problem (MSAP) and the relation of other key findings to the MSAP.

Problem Statement: Document a problem statement using professional language. Include the following components.

name, age

chief complaint

brief description of pertinent positive and negative subjective findings

brief description of pertinent positive and negative objective findings

Management Plan: Using the expert diagnosis provided, create a comprehensive treatment plan using professional language. Include at least one appropriate, evidence-based, scholarly source to support your decisions. Include the following components:

diagnostic tests

medications

suggested consults/referrals

client education

follow-up

Reflection: In a Microsoft Word document, respond to the self-reflection questions below. Include a title page in APA format using the title iHuman Reflection Week 5. In 2-3 paragraphs, respond substantively to all required reflection questions. Analyze your personal strengths and areas for growth.

The process of clinical reasoning may seem opaque and even mysterious to beginning students. Experienced clinicians often think quickly, with little overt or conscious effort. They differ widely in personal style, communication skills, clinical training, experience, and expertise. Some clinicians may find it difficult to explain the logic behind their clinical thinking. As you gain experience, your clinical reasoning will begin at the outset of the patient encounter, not at the end. Reflect on the clinical reasoning you used during this virtual patient encounter. Describe the steps taken to identify and interpret the key findings in this case.  What are some “lessons learned” within the assessment that you can apply to your professional practice as a provider?

 

NR509 Advanced Physical Assessment

Week 6 Assessment   

iHuman Virtual Patient Encounter Activity

Purpose

The iHuman assignments provide students with an opportunity to experience clinical scenarios that are relevant to the lesson content through virtual patient encounters. iHuman is a highly interactive and dynamic way to enhance student learning.

Course Outcomes

Through this assignment, the student will demonstrate the ability to:

CO 1: Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (POs 1, 2)

CO 2: Differentiate normal and abnormal health history and physical examination findings. (POs 1, 2)

CO 3: Document health history and physical examination findings in a logical and organized sequence. (POs 1, 2)

CO 5: Conduct focused and comprehensive health histories and examinations for various patient populations. (POs 1, 2)

Preparing the Assignment

Follow these guidelines when completing?each component of the?assignment.?Contact your course faculty if you have questions.

Access?iHuman?by clicking the link provided below.? Clicking the blue bar will?launch the activity in a new browser window. You do not need to complete the case in one sitting; if you leave the case and return later, the program will begin where you left off.

All graded documentation, including the Management Plan, must be completed within the iHuman platform. Follow the iHuman Documentation Guide (Links to an external site.) as you prepare your client’s EMR.

You may use the Fillable SOAP note template (Links to an external site.) to assist with documentation and organization as you complete the case.

Complete the following components in the iHuman Virtual Patient Encounter for the musculoskeletal system.

History: Complete a focused health history. Your score will be automatically calculated after the health history is submitted.

Physical Exam: Complete a focused physical exam. Your score will be automatically calculated after the focused physical exam is submitted.

EMR Documentation: Document within the Patient Record in iHuman using professional language. include the following components:

history of present illness

previous medical history

current medications

allergies

relevant completed screenings and preventive health

relevant family history

relevant social history

focused review of systems

focused physical exam findings

Key Findings/Most Significant Active Problem: Document Key Findings from your history and physical exam in the Assessment tab of the case. Organize Key Findings, identifying the most significant active problem (MSAP) and the relation of other key findings to the MSAP.

Problem Statement: Document a problem statement using professional language. Include the following components.

name, age

chief complaint

brief description of pertinent positive and negative subjective findings

brief description of pertinent positive and negative objective findings

Management Plan: Using the expert diagnosis provided, create a comprehensive treatment plan using professional language. Include at least one appropriate, evidence-based, scholarly source to support your decisions. Include the following components:

diagnostic tests

medications

suggested consults/referrals

client education

follow-up

Reflection: In a Microsoft Word document, respond to the self-reflection questions below. Include a title page in APA format using the title iHuman Reflection Week 6. In 2-3 paragraphs, respond substantively to all required reflection questions. Analyze your personal strengths and areas for growth.

One rule is to always include “the worst-case scenario” in your differential diagnosis and make sure you have ruled out this possibility based on your findings and patient assessment. Your goal is to minimize the risk of missing unusual or infrequent conditions such as meningococcal meningitis, bacterial endocarditis, pulmonary embolus, or subdural hematoma that are particularly ominous. Reflect on your performance during this virtual patient encounter. What are the “red flags” in this case? Based on your pertinent key findings, what is “the worst-case scenario”? What lessons did you learn from this case that you can apply to your future professional practice?

Submit both the iHuman Virtual Patient Encounter report and your completed reflection document to the Week 6 dropbox.

 

NR509 Advanced Physical Assessment

Week 7 Assessment   

Physical Examination Video Evaluation

Purpose

Evaluation of clinical competence is essential to ensure quality and safety in advanced practice nursing education. The purpose of the physical examination video evaluation is to assess knowledge and understanding of a complete head-to-toe examination for entry-level clinical competency. This assignment supports the professional formation of the nurse practitioner.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO 2: Differentiate normal and abnormal health history and physical examination findings.?

CO 5: Conduct focused and comprehensive health histories and examinations for various patient populations.?

Preparing the Assignment

Follow these guidelines when completing each component of the assignment.

Create a video using the assignment guidelines. This video is for educational purposes only and will be viewed by course faculty and appointed Chamberlain officials. This video will not be posted for public viewing.

Select a volunteer participant, school-aged or older, to demonstrate the examination. If the volunteer participant is a minor, you must be the parent or guardian.

Select a private environment without background noise or distractions to conduct the examination. Demonstration of examination techniques must be conducted in the positions identified in the demonstration video with the volunteer participant sitting upright, lying down, and standing/walking. Plan accordingly.

The volunteer participant should remain clothed at all times. Auscultating over the shirt is acceptable for privacy purposes. The suggested attire for the participant is a tank top and shorts.

Use required medical equipment:

Stethoscope with bell and diaphragm

Reflex hammer

Otoscope/ophthalmoscope set

Pocket Snellen chart

Textbooks/notes/assistive materials are NOT permitted during the physical examination.

Wear nursing scrubs with or without a lab coat. Business casual dress with or without a lab coat is also acceptable. Religious head wrap/headdress may be worn.

Begin the video with a 360-degree environment scan and verbal consents:

Scan the entire examination area/room with a 360-degree view with the camera to show that textbooks/notes/assistive materials are not present (i.e., taped to a wall, on a table).

If there is a volunteer recording your video, please identify them in the environment scan. Neither the patient nor/or recording volunteer may verbally or physically coach you during the recording session. Evidence of coaching by volunteers and/or using notes/assistive materials, etc. is grounds for an Academic Integrity Violation.

Student states in front of the camera: “My name is [First and Last Name of Student] and this is my physical examination assignment for NR509.”

Volunteer participant states in front of the camera: “My name is [First and Last Name of Adult Participant] and I give my permission for this examination to be recorded and submitted to Chamberlain College of Nursing for grading purposes.”

If the volunteer is a minor, the student must state in front of the camera: “I am the parent/guardian of [First and Last Name of Minor Participant] and I give my permission for this examination to be recorded and submitted to Chamberlain College of Nursing for grading purposes”.

Technology Requirements

A video recording device with microphone is required. Select one of the following options to create your recording:

Use the Kaltura (Links to an external site.) recording tool on your computer with a microphone/webcam.

The Kaltura KMS Go app, available for Android and iOS, may also be used to record via smartphone. Refer to Kaltura resources (Links to an external site.) under the Resources tab of the course for instructions.

Camera view: The grading faculty must have a clear view of your examination techniques during the examination, including stethoscope placement on the torso. Set the recording device at a distance jus

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