In this graded assignment, you will interview Tina Jones to conduct a comprehensive health history and collect data to assess Ms. Jones’ recent right foot injury. You will have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication;?
In this graded assignment, you will interview Tina Jones to conduct a comprehensive health history and collect data to assess Ms. Jones’ recent right foot injury. You will have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication;?create a?problem list?using evidence from the data you collected; prioritize the identified?problems?to differentiate immediate from non-immediate care; and plan how to best address the?most important concern?with further assessment, interventions, and patient education. Please note, aside from briefly assessing Tina’s foot wound, you will NOT conduct a physical examination for this assignment.
Tips and Tricks
You will earn points on the Digital Clinical Experience (DCE) score during Shadow Health activities for how well you identify and respond to opportunities to emphasize and educate your patients. Just as in real life, timing matters. For example, if your patient reveals that she is experimenting with illegal drugs and you “skip over” the chance to address the issue during the interview, you will not be able to recapture that moment to educate your patient later in the activity. Consequently, you will lose points on the Digital Clinical Experience (DCE) score.
At the end of each Physical Assessment Assignment in Shadow Health are post-activity reflection questions. Be aware that the quality of your response to each question is measured as part of the graded assignment. Please review the details on the guideline and grading rubric. In order to achieve full credit for this portion of the grading rubric, you need to respond to each reflection post question, provide analysis of your performance, use professional language, and demonstrate insight. Please reach out to your faculty with any questions.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
Adapt skills and techniques to suit the individual needs of the patient (CO4)
Differentiate normal from abnormal physical examination findings (CO2)
Summarize,?organize,?and document findings using correct professional terminology (CO3)
Reflect upon performance to gain insight and foster knowledge (CO1)
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.
Total Points Possible: 75 Points
Assignment
Step One: Complete the Shadow Health Orientation
Step Two: Complete Conversation Lab
Step Three: Complete Health History Assignment
Step Four: Document your findings on the Fillable Soap Note TemplatePreview the document or the Printable Soap NotePreview the document.
Step Five: Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.
NR509 Advanced Physical Assessment
Week 2 Assignment
Shadow Health Assessment Assignment
Introduction and Pre-brief
In this graded assignment, Tina Jones had an asthmatic episode 2 days ago. At that time, she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Tina presents with continued shortness of breath and wheezing. Be sure to ask pertinent questions during the interview about related body systems. This case study will provide the opportunity to carefully assess lung sounds during the physical examination. Be sure to appropriately document your findings using correct medical terminology.
Tips and Tricks
You will have many opportunities to interact with Tina Jones during the Shadow Health Physical Assessment Assignments in this course. Subjective information, such as details from the health history, do NOT carry forward to the next assessment encounter. Do not assume the answers to questions that you may have previously asked in another encounter. Therefore, you must ask the same history questions again, even if you already think you know how the patient may respond! To obtain data for the health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. For example, the patient denies having chest pressure, but do not assume that she does not have chest pain – you need to ask this question specifically.
When performing your physical exam, remember to proceed in an organized manner from head to toe i.e. start with the General Survey, then the HEENT exam, and continue to move down the body in a logical manner. This keeps a nice flow for the patient and examiner.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge. ?
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
Adapt skills and techniques to suit the individual needs of the patient (CO4)
Differentiate normal from abnormal physical examination findings (CO2)
Summarize,?organize,?and document findings using correct professional terminology (CO3)
Due Date
Sunday 11:59 PM MT at the end of each respective week.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.
Total Points Possible: 75 Points
Assignment
Step One: Complete Respiratory Assignment
Step Two: Document your findings on the Fillable Soap Note TemplatePreview the document or the Printable Soap NotePreview the document.
Step Three: Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.
NR509 Advanced Physical Assessment
Week 3 Assignment
Shadow Health Assessment Assignment
Introduction and Pre-brief
Two days after a minor, low-speed car accident in which Tina Jones was a passenger, she noticed daily bilateral headaches along with neck stiffness. She reports that it hurts to move her?neck, and she believes her neck might be swollen. She did not lose consciousness in the accident and denies changes in level of consciousness since that time. She states that she gets a headache every day that lasts approximately 1-2 hours. She occasionally takes 650 mg of over the counter Tylenol with relief of the pain. This case study will allow you the opportunity to examine the patient’s optic nerve via use of the ophthalmoscope as well as assess her visual acuity. You will need to document your findings using appropriate medical terminology. Careful assessment of documentation of EACH cranial nerve is integral to performing a comprehensive neurological assessment. Be sure to assess for foot neuropathy using the monofilament test.
Tips and Tricks
By now you are very familiar and comfortable with navigating the Shadow Health virtual learning environment. The simulated patients are similar to actual patients and can respond to over 70,000 initial and follow-up questions. Your patients will never get frustrated when you ask multiple questions and they will never get embarrassed or withhold information if you address sensitive subjects, like sexual activity.
Be sure to practice asking interview questions in Shadow Health using the talk-to-text feature and the Google Chrome browser. This will assist with reducing the time commitment for each assignment and enhance the fidelity of your patient-provider experience.
When writing up your physical examination findings, it is insufficient to simply document that the cranial nerve assessed was “intact” or “normal”. What does this mean? Document exactly what you assessed and the findings. Documentation of pertinent negative findings, which denote what you expect to find during the examination and not an abnormality, are just as important as pertinent positive, or abnormal, findings.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge. ?
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
Adapt skills and techniques to suit the individual needs of the patient (CO4)
Differentiate normal from abnormal physical examination findings (CO2)
Summarize,?organize,?and document findings using correct professional terminology (CO3)
Due Date
Sunday 11:59 PM MT at the end of each respective week.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.
Total Points Possible: 75 Points
Assignment
Step One: Complete the designated Shadow Health (SH) Assignment on the SH platform.
Step Two: Document your findings on the Fillable Soap Note TemplatePreview the document or the Printable Soap NotePreview the document.
Step Three: Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.
NR509 Advanced Physical Assessment
Week 4 Assignment
Shadow Health Assessment Assignment
Introduction and Pre-brief
This assignment provides the opportunity to conduct a focused exam on Brian Foster, who presents with recent episodes of chest pain in a non-emergency setting. Interview Mr. Foster and be sure to thoroughly assess the cardiovascular system as well as related body systems in order to compile a list of differential diagnoses. This case study offers you the opportunity to evaluate Mr. Foster’s personal and family history with heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds.
Tips and Tricks
The sounds in the Shadow Health Concept Labs and Physical Assessment Assignments are medically accurate.
Distinguishing normal from abnormal heart sounds requires practice and carefully listening for sometimes subtle and easily missed sounds. Be sure to take advantage of the Cardiovascular Concept Lab to sharpen your skills prior to beginning this assignment.
Optimize your listening experience by using headphones with your computer and listen to both normal and abnormal sounds multiple times to improve your proficiency with recognizing subtle differences.
Often patients present with a specific complaint or problem. However, during the history and physical examination, a new problem may be discovered that takes precedence during the visit. Be alert to such a situation with this case study assignment.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge. ?
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
Adapt skills and techniques to suit the individual needs of the patient (CO4)
Differentiate normal from abnormal physical examination findings (CO2)
Summarize,?organize,?and document findings using correct professional terminology (CO3)
Due Date
Sunday 11:59 PM MT at the end of each respective week.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.
Total Points Possible: 75 Points
Assignment
Step One: Complete the designated Shadow Health (SH) Assignment on the SH platform.
Step Two: Document your findings on the Fillable Soap Note TemplatePreview the document or the Printable Soap NotePreview the document.
Step Three: Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.
NR509 Advanced Physical Assessment
Week 5 Assignment
Shadow Health Assessment Assignment
Introduction and Pre-brief
Mrs. Esther Park is a 78-year-old woman who comes to the clinic complaining of abdominal pain. She reports that the pain isn’t severe, but that her daughter was concerned and brought her in. It is very important to determine whether or not the situation is an emergency and the underlying cause of Esther’s discomfort. Be sure to inquire about a variety of psychosocial factors related to the GI system, including her diet, toilet habits, immunizations, recent travel, etc. This case study will offer you the opportunity to take a complete surgical, reproductive, and current sexual history. During her physical examination, take particular note as to where Mrs. Park verbalizes pain during palpation so that you may synthesize verbal and non-verbal cues. Be sure to apply the supportive information learned in this week’s concept lab to your critical thinking process in this case study.
Tips and Tricks
Evaluation of the elderly patient with abdominal pain can be difficult, time-consuming, and fraught with potential missteps. Abdominal pain is the most common emergency department complaint and the fourth most common complaint among elderly patients. The physiologic, pharmacologic, and psychosocial aspects of elderly patients make an evaluation of their abdominal pain different than in the general population.
As a clinician, you must develop an index of suspicion which is defined as awareness and concern for potentially serious underlying and unseen injuries or illness. Having a well-developed index of suspicion for abnormality will help to differentiate diagnoses.
To optimize your assessment experience and sharpen your skills, be sure to explore the Abdominal Concept Lab prior to beginning the assignment.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge. ?
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
Adapt skills and techniques to suit the individual needs of the patient (CO4)
Differentiate normal from abnormal physical examination findings (CO2)
Summarize,?organize,?and document findings using correct professional terminology (CO3)
Due Date
Sunday 11:59 PM MT at the end of each respective week.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.
Total Points Possible: 75 Points
Assignment
Step One: Complete the designated Shadow Health (SH) Assignment on the SH platform.
Step Two: Document your findings on the Fillable Soap Note TemplatePreview the document or the Printable Soap NotePreview the document.
Step Three: Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.
NR509 Advanced Physical Assessment
Week 6 Assignment
Shadow Health Assessment Assignment
Introduction and Pre-brief
Daniel “Danny” Rivera is an 8-year-old boy brought to the clinic by a family member for a cough. It is important for you to determine whether or not Danny is in distress, explore the underlying cause of his cough, and look for related symptoms in other body systems. Ask about a variety of psychosocial factors related to home life, such as second-hand smoke exposure. Be sure to observe non-verbal cues as Danny presents with intermittent coughing and visible breathing difficulty. This case study will challenge you to differentiate his presenting symptoms and carefully listen as you auscultate his lungs. You will have the opportunity to also physically examine his eyes, ears, nose, and throat and document your findings using appropriate professional medical terminology. Apply the supportive information learned in the respiratory concept lab to your critical thinking process in this case study.?
Tips and Tricks
Upon physical exam, be sure to note clues to specific conditions and pathology. For example, “cobblestoning” is pathognomonic for Allergic Rhinitis. Conversely, understand that an erythemic tympanic membrane is not necessarily pathognomonic for Otitis Media.
You will utilize specific assessment tools with your clinical practice. Be sure you know how to apply and interpret the Centor assessment criteria. The Centor criteria are a set of criteria which may be used to identify the likelihood of a bacterial infection in patients complaining of a sore throat.?
Most cough suppressant preparations are marketed as mixtures of dextromethorphan or codeine with antihistamines, decongestants, expectorants, and/or antipyretics. Some nonprescription preparations substitute diphenhydramine or eucalyptus oil in place of codeine or dextromethorphan. Prescription medications may substitute other narcotic agents (hydrocodone or hydromorphone) for codeine and may be more addictive than codeine.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge. ?
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
Adapt skills and techniques to suit the individual needs of the patient (CO4)
Differentiate normal from abnormal physical examination findings (CO2)
Summarize,?organize,?and document findings using correct professional terminology (CO3)
Due Date
Sunday 11:59 PM MT at the end of each respective week.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.
Total Points Possible: 75 Points
Assignment
Step One: Complete Respiratory Assignment
Step Two: Document your findings on the Fillable Soap Note TemplatePreview the document or the Printable Soap NotePreview the document.
Step Three: Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.
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