NR509 Advanced Physical Assessment
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) NR509 Advanced Physical Assessment
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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. NR509 Advanced Physical Assessment
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. NR509 Advanced Physical Assessment
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. NR509 Advanced Physical Assessment
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) NR509 Advanced Physical Assessment
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. NR509 Advanced Physical Assessment
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 just far enough for the patient to be fully viewed but your techniques can still be seen. You do NOT need to zoom the recording device in for examination techniques. Adjust the camera angle as needed during the recording.
Consider using a tripod if using a hand-held recording device. Alternatively, have another person hold the camera steady during the recording.
Complete the assignment before the due date in case technical problems or other unforeseen events occur.
Ensure video and audio quality. Recording without quality video and/or audio will not be evaluated; the opportunity to resubmit is not guaranteed.
Kaltura Resources (Links to an external site.):?Kaltura resources?are available?under the Technology section of the Student Resource Center. Call the Help Desk for technical support and request a ticket number.?The Help Desk is available at 877-366-9388 for 24/7 support.
Completing the Physical Examination Video
Follow the examination sequence and techniques listed on the Physical Examination Grading Rubric and demonstrated in the physical examination video (Links to an external site.) in the course. Please note: You should aim to replicate the exam order and techniques seen on this video; however, you SHOULD NOT provide professional edits, power point slides and/or other transitional slides while completing this assignment.
Record the video in one continuous recording. Do not edit the video. Edited videos will not be graded.
Use a head-to-toe and anterior-posterior approach during the exam. If an examination area or technique is forgotten, add it at the end of the video before stopping the recording. There is NO deduction for completing an examination technique out of order.
The video should NOT exceed 33 minutes, including an environmental scan, verbal consents, and the entire physical examination. NR509 Advanced Physical Assessment
If the video is longer than 33 minutes, grading will stop, and the score earned in the first 33 minutes will be the final score.
Verbalize each exam step as noted on the grading rubric. Verbalize expected normal examination findings during the examination. For example, when examining the external auditory canal with the otoscope, describe what is seen. It is not necessary to differentiate between normal and abnormal findings.
Identify all cranial nerves by name and number.
Review the entire video before submission to ensure all examination techniques are visible and the audio is clear throughout. The transcript must be enabled in Kaltura prior to submission. Use the Physical Examination Grading Rubric as a self-check when to review the video before submission.
NR509 Advanced Physical Assessment
Week 8 Assessment
Reflection
Assignment
Purpose
The purpose of this activity is to deepen learning through reflective inquiry. It will allow for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals related to course outcomes, program outcomes, AACN Essentials, and NONPF competencies.
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?client?populations.
CO 2: Differentiate normal and abnormal health history and physical examination findings.
CO 4: Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual?client.
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Preparing the Assignment
Follow these guidelines when completing this assignment. Contact your course faculty if you have questions.
Describe how learning in this course helped you to meet Program Outcome 1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care). Provide at least two specific examples.
Select one of the competencies from AACN Essentials Domain 1 listed below and describe how learning in this course helped you to meet the advanced-level nursing education competency. Provide at least two specific examples.
1.1 Demonstrate an understanding of the discipline of nursing’s distinct perspective and where shared perspectives exist with other disciplines
1.1e Translate evidence from nursing science as well as other sciences into practice.
1.1f Demonstrate the application of nursing science to practice.
1.1g Integrate an understanding of nursing history in advancing nursing’s influence in health care.
1.2 Apply theory and research-based knowledge from nursing, the arts, humanities, and other sciences.
1.2f Synthesize knowledge from nursing and other disciplines to inform education, practice, and research.
1.2g Apply a systematic and defendable approach to nursing practice decisions.
1.2h Employ ethical decision making to assess, intervene, and evaluate nursing care.
1.2i Demonstrate socially responsible leadership.
1.2j Translate theories from nursing and other disciplines to practice.
1.3 Demonstrate clinical judgment founded on a broad knowledge base.
1.3d Integrate foundational and advanced specialty knowledge into clinical reasoning.
1.3e Synthesize current and emerging evidence to influence practice.
1.3f Analyze decision models from nursing and other knowledge domains to improve clinical judgment
Select one of the competencies from the NONPF Independent Practice Competency listed below and describe how learning in this course helped you to meet the competency. Provide at least two specific examples.
Functions as a licensed independent practitioner.
Demonstrates the highest level of accountability for professional practice.
Practices independently managing previously diagnosed and undiagnosed patients.
Provides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making. NR509 Advanced Physical Assessment
Educates professional and lay caregivers to provide culturally and spiritually sensitive, appropriate care
Collaborates with both professional and other caregivers to achieve optimal care outcomes.
Coordinates transitional care services in and across care settings.
Participates in the development, use, and evaluation of professional standards and evidence-based care.
Submit the assignment using correct grammar mechanics and APA style standards.
Writing is free of grammar, syntax, spelling, and punctuation errors.
A title page is included in APA format.
Document is double-spaced.
A reference page is included if references were cited. If a reference page is included, use APA format.
NR509 Advanced Physical Assessment
Week 8 Assessment
ePortfolio
Purpose
The purpose of the ePortfolio assignment is to provide the graduate nurse practitioner student an opportunity to synthesize and reflect on the process of becoming an entry-level nurse practitioner. This process will include a psychomotor, affective, and cognitive growth review throughout the program and involves professional self-assessment. In addition, the ePortfolio provides evidence of what the graduate NP student has accomplished during their graduate education and how the MSN program outcomes, AACN Essentials, and NONPF nurse practitioner competencies have been satisfied. In each course, students will upload artifacts to the ePortfolio that demonstrate achievement.
Chamberlain College of Nursing MSN Program Outcomes
Through this assignment, the student will demonstrate the ability to:?
Provide high-quality, safe, patient, centered care grounded in holistic health principles.
Create a caring environment for achieving quality health outcomes.
Engage in lifelong personal and professional growth through reflective practice and appreciation of cultural diversity.
Integrate professional values through scholarship and service in health care.
Advocate for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice. NR509 Advanced Physical Assessment
Preparing the Assignment
Follow these guidelines when completing this assignment. Contact your course faculty if you have questions.??
The ePortfolio assignment is embedded in all courses throughout the nurse practitioner program. For Week 8 in each course, you will upload selected assignments to the Course Artifacts section of the portfolio. In your capstone practicum course, you will complete the Introduction and Outcomes Analysis & Planning sections of the ePortfolio.
Course Artifacts should collectively demonstrate growth in critical thinking, new graduate nurse practitioner clinical competence, scholarly writing, and professional development that occurred during the program.
If you have not done so already, begin by setting up your ePortfolio. Use the quickguide below and view the ePortfolio tutorials in the Student Resource Center for further guidance.
ePortfolio quickguide image. Description below.
ePortfolio Quickguide Image Description
NR509 Artifacts
Use the “Organize/Manage Pages” feature to add a NR 509 page to your Course Artifacts section.
Click “Edit this Page” to name pages and add content using Rich Text Editor
Location: Right side of ePortfolio editing screen
Submit the following assignments using the File/Image Upload to the NR509 page. The file should include the submitted assignments, instructor comments, and the completed grading rubric.
iHuman case reflection activity (choose any completed case)
Head-to-toe assessment rubric (video link need not be included)
Submit the following assignment using the File/Image Upload to the NR509 page. The file should include the submitted assignment. NR509 Advanced Physical Assessment
