NURS 6512: Advanced Health Assessment and Diagnostic Reasoning

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Walden University
NURS 6512: Advanced Health Assessment and Diagnostic Reasoning
Student Support and Calendar Information
So you have all key information available to you off-line, it is highly recommended that you print
the following items for your reference:
This Syllabus, including the Course Schedule that is linked on this page as a PDF
Course Calendar
Student Support
Photo Credit: Steve Hix/Fuse/Corbis/Getty Images
Credit Hours
5 quarter hours
Walden University assigns credit hours based on the number and type of assignments that
enable students to achieve the course learning objectives. In general, each semester credit
equals about 42 hours of total student work and each quarter credit equals about 28 hours of
total student work. This time requirement represents an approximate average for undergraduate
work and the minimum expectations for graduate work. The number and kind of activities
estimated to fulfill time requirements will vary by degree level and student learning style, and by
student familiarity with the delivery method and course content.
Course Description
The physical and emotional well-being of patients and families can be complex and
multifaceted. Advanced practice nurses need to have the knowledge and ability to provide safe,
competent, and comprehensive physical health assessments. Students in this course focus on
concepts and skills to assess patients across the lifespan. They learn to use diagnostic
reasoning, advanced communication, and physical assessment skills to identify changes in
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health patterns. Students also use a systematic approach through which they focus on the
assessment of patients with acute and chronic health problems. The advanced skills of suturing,
reading 12 Lead EKGs, and interpreting X-rays will be covered. Students engage in course
assignments that emphasize risk assessment, diagnostic reasoning, and evidence-based
assessment across the lifespan.
Course Prerequisites
Pre-requisites: NURS 6501: Advanced Pathophysiology
Pre- or Co-Requisite: NURS 6521: Advanced Pharmacology
Course Outcomes
By the conclusion of this course, you should be able to:
1. Apply sound critical thinking to clinical assessment and decision making
2. Develop an effective and appropriate approach to patient assessment that takes into
consideration life circumstance and cultural, ethnic, and developmental variations
3. Elicit appropriate data from a patient using functional assessment, health history, and
physical assessment
4. Interpret patient health history and physical examination data
5. Apply diagnostic reasoning when assessing patient physiology
6. Relate assessment findings to underlying pathology or physiologic changes
7. Establish a differential diagnosis based on the assessment data
8. Evaluate options for a systematic approach to preventative and palliative care
9. Analyze evidence-based and ethical considerations in health assessment
To access the SON Alignment of Learner Outcomes for this course, please select the following
NURS 6512 Alignment Chart (PDF)
Course Materials
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Please visit the university bookstore via your Walden student portal to ensure you are obtaining
the correct version of any course texts and/or materials noted in the following section. When you
receive your materials, make sure that all required items are included.
Course Texts
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and
clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide
to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A.
Note: While only the print edition of this book is referenced here, electronic versions also
may be available and may be acceptable for use in this course.
Optional Course Text
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination
(10th ed.). New York, NY: McGraw-Hill Medical.
Note: Students are expected to procure the optional course text themselves.
Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the
course and may be found within each week and within the Course Schedule.
Course Readings List
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The Course Readings List contains all of the required Walden Library resources for this course.
Please select the following link to access the list:
NURS 6512 Course Readings List
Assigned course media elements may be found in one or more weeks of the course and are
available via a streaming media player or
Note: If the print editions of these books are referenced here, electronic versions also may
be available and may be acceptable for use in this course. If electronic versions are listed,
no print versions are available.
Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the
course and may be found within each week.
Dedicated Support for Course Media
You may use the following e-mail address and toll-free number for any questions or concerns
you have about media in the course.
Phone: 1-877-238-2963
Primary and Secondary Sources
Review the following information prior to selecting resources for assignments.
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Primary: A primary source is an original document that is the first account of what happened. A
research report is primary, and you can tell because it includes materials and methods
demonstrating how the research was done. Some creative work is also primary, such as poetry,
novels, and interviews of people who experienced something firsthand. In nursing, which is an
evidence-based discipline, we strive to use primary research that is published in scholarly, peerreviewed journals.
Scholarly, peer-reviewed journal: Scholarly journals publish papers by professional authors
and experts in the field using a peer-review process to review the work and assure quality before
publishing. The focus of a scholarly journal is to provide accurate information for scholars and
other researchers. The focus is on content rather than advertising, a direct contrast to popular
media. Scholarly journals publish both primary and secondary papers, the former usually noted
as original research and the latter as reviews and commentaries. Letters to the editor may also
be published but should be recognized as opinion pieces.
Note: When selecting articles for course assignments, you are advised (unless you are
referencing seminal information) to focus on work published within the past 5 years.
Secondary: A secondary source is one step removed from the original source. This work
interprets and often compiles other work, and it includes review articles, textbooks, fact sheets,
and commentaries about a topic. It also includes news reports of original research. Secondary
work is more prone to error and bias than primary work because it is being filtered through an
additional person or persons. Review papers can be useful to glean information about a topic
and to find other sources from the reference list, but it is the original, primary research that
should be relied on most heavily in demonstrating scholarship, depth, and validation of factual
Course Assignments
1. Participation in weekly Discussions: The exchange of ideas among colleagues engaged in
scholarly inquiry is a key aspect of learning and is a requisite activity in this course. You are
expected to participate each week by posting a response to a prompt or question in the
weekly Discussion area. Discussion topics/questions are provided in the Discussion area in
each week. In addition, you are expected to respond to your fellow students’ postings. To
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count as participation, responses need to be thoughtful; that is, they must refer to the week’s
readings, relevant issues in the news, information obtained from other sources, and/or ideas
expressed in the postings of other class members. You may ask questions or offer further
information or links about the subject. Please pay attention to grammar and spelling, as
consistently poorly written posts will receive grade penalties. In grading the required
Discussion postings, your Instructor will be using the Formative Evaluative Criteria for
Discussion Board Assignments located in the Course Information area.
Note: Unless otherwise noted, initial postings to Discussions are due on or before Day
3, and response postings are due on or before Day 6. You are required to participate in
the Discussion on at least 3 different days. It is important to adhere to the weekly time
frame to allow others ample time to respond to your posting. In addition, you are
expected to respond to questions directed toward your own initial posting in a timely
2. Assignments: The Assignments provide you with the opportunity to apply the skills and
knowledge gained through the Learning Resources. See the Assignment area of specific
weeks for detailed descriptions of the assignments. In grading the required Assignments,
your Instructor will be using rubrics located in the Course Information area.
3. Physical Health Assessment Videos: This course requires that you demonstrate proficiency
in conducting physical health assessments, including a health history and a head-to-toe
physical examination. You will demonstrate this proficiency by videotaping yourself as you
perform the assessments. You will need to have access to a video recorder to capture the
required physical health assessments on video. Additionally, you will need to obtain the
necessary equipment required to perform these physical health assessments, including a
stethoscope, an otoscope, an ophthalmoscope, a pocket eye chart, a tape measure, a reflex
hammer, and Tuning Forks ( Frequency of 500-1000Hz to be used). All of the required
equipment must be used in order to pass the video and you must pass each video with a
score >69.5% in order to pass the course. You will also need to have a volunteer to act as
your “patient” for each physical assessment. Each volunteer must sign the Video Release
Form located on the Kaltura Media Uploader page located in the course navigation menu.
The signed form must be faxed to the following toll-free number prior to recording each Video
Assignment: 888–546–7564. Note: You may use the same volunteer for each video if
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Throughout this course, you will create and submit three physical health assessment videos.
Week 3: Health History
In Week 3, you will videotape yourself collecting a “patient’s” health history. This video is due
by Day 7 of Week 4.
Week 8: Skin, Hair, and Nails and HEENT Assessment
By Day 7 of Week 8, you will create and submit a video of yourself conducting a Skin, Hair,
and Nails and HEENT assessment
Week 10: Head-To-Toe Physical Assessment
By Day 7 of Week 10, you will create and submit a video of yourself conducting a head-totoe physical exam.
Submitting Your Videos
All videos will be submitted through the weekly assignment submission area using the
Kaltura Media option available via the mashup tool. Refer to the Kaltura Media Uploader
page in the course navigation menu for more information about uploading media for
Note: Although you will only film and submit the health history, partial physical exam, and
head-to-toe physical exam video assessments in Weeks 4, 8, and 10, respectively, it is highly
recommended that you view each week’s media and practice performing the related health
assessment on family members and/or patients. For example, in Week 7, you study the
abdomen and gastrointestinal system. After watching the media assigned in that week’s
Learning Resources, it is recommended that you practice conducting an abdominal
1. Exams: The course contains 2 exams that have been designed to assess your
understanding of the course topics. The Midterm exam is due by Day 7 of week 6 and the
Final exam is due by Day 7 of week 11.
2. All assignments must be completed to pass the course. This includes ALL discussion
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boards, case study assignments, midterm exam, final exam, and the mandatory videos in
Week 4 (Health History), Week 8 (Skin, Hair, Nails/HEENT), and Week 10 (Head to Toe
Physical Examination).
3. If an Incomplete is granted for students registered for clinical courses the following
quarter, you will only have 5 days to complete and pass your outstanding assignments as
this course must be passed prior to starting your practicum.
Grading Criteria and Total Components of a Grade
Course grades will be based on participation (postings) and completion of assignments listed
below. All assignments must be completed in order to receive a grade for the course.
Note: All assignments must be completed to pass the course.
Grading Scale
Letter grades will be assigned as follows:
90%–100% = A
80%–89% = B
70%–79% = C
<70% = F Please see below for the policy on Incomplete (I) grades. Important Note: This course contains weighted grading. Assignments are weighted differently depending on their type. The total points achieved for each assignment will be weighted based on the percentage values noted in the Weighted Total (%) column of the table that follows. Syllabus 11/18/18, 5:00 PM… Page 9 of 17 Assignment Total Points Weighted Total (%) Discussions: Participation in Discussions* (7 @ 100 points each) (Weeks 1, 2, 3, 5, 7, 8, 9) 700 10% Video Assignments: Week 4 (100 points) Week 8 (100 points) Week 10 (100 points) All graded videos must be passed with a score of 69.5% or greater in order to pass the course. 300 20% Case Study Assignments: Week 4 (100 points) Week 6 (100 points) Week 10 (100 points) Week 11 (100 points) 400 20% Exams: Midterm (100 points) – 25% Final (100 points) – 25% 200 50% Total: 1,600 100% * Each Discussion requires that you make one initial posting and at least two response postings to colleagues. See the Formative Evaluative Criteria for Discussion Board Assignments in Course Information area for posting details. Incomplete Grade Policy Syllabus 11/18/18, 5:00 PM… Page 10 of 17 Per University policy, Incomplete grades can be granted only to students who have already met the minimum criteria for active weekly participation in a course (including weekly postings in online courses) and have completed at least 80% of other coursework. Incompletes can be awarded when, because of extenuating circumstances, a student has not met additional course requirements, including but not limited to written assignments, group projects, and research papers, as applicable. All Incomplete grades are awarded at the discretion of the course faculty. (Reproduced from Student Catalog) Students who are eligible for an Incomplete must contact the course faculty to request the grade as soon as possible. Students who do not meet the criteria listed above will not be allowed to earn an Incomplete. If the Incomplete is approved, the Faculty Member will work with the student to outline the due date(s) for remaining work. Under no circumstances will the new due dates extend beyond 50 days from the last day of the term. Faculty will then have 10 days to assess the work and post the permanent grade before the University-allotted Incomplete time limit of 60 days expires. All Incomplete grades not resolved within the time allotted will convert to permanent grades of F. Instructor Feedback Schedule The Instructor will log in to the course during the week to monitor the weekly Discussion area. Feedback will be provided via the comments in the My Grades area, the Discussion area, and/or the Announcements page. You can expect your weekly assignment grades to be posted within 1 week of a due date. Instructor feedback and explanation is provided whenever full credit is not achieved. Depending on the nature of the feedback, Instructor responses may be posted to the Discussion area or included in the My Grades area. The goal of your Instructor is to act as a discussion and learning facilitator rather than a lecturer. The Instructor will not respond to every posting by every individual, so please feel free to ask your Instructor if you would like some personal feedback on a particular assignment posting or any time you have any questions regarding your assignments or your grade.  ORDER A PLAGIARISM-FREE PAPER NOW Course Procedures 1. All class Discussions take place in the weekly Discussion areas. Syllabus 11/18/18, 5:00 PM… Page 11 of 17 2. You are encouraged to post course-related questions to the Contact the Instructor area, as they may be of interest to all; however, if your question is urgent, it is often best to e-mail the Instructor. If your e-mailed question is thought to be of benefit to all, it may be responded to by the Instructor via e-mail to all or posted as an announcement. 3. Instructor feedback on content and writing issues that is thought to be of benefit to the entire class may be posted to the Contact the Instructor area; however, most personal critique will be done privately in My Grades. Be sure to check the My Grades area for comments every week, even if you received full credit. 4. Please feel free to use the Class Café to initiate and participate in conversations not directly related to the course. This is an excellent opportunity to get to know other students better. The Instructor will browse the Class Café occasionally, but generally will not respond to conversations posted there unless students have specific questions for him or her. 5. Check the e-mail account you use for official Walden University business on a regular basis. The expectation is that you are checking this e-mail account daily during the week. If you experience difficulty sending or receiving Walden e-mail, please contact the Student Support Team right away. Contact information for the Student Support Team is located in the Student Support area. 6. Review all materials in the Course Information area, as well as the materials contained under each of the weekly buttons. Please note: There are Optional Readings located within the Learning Resources section of each week in the course. You are encouraged to explore these readings as needed in order to enhance your understanding of the course content. Preferred Methods for Delivering Assignments 1. Be sure that you post to the correct Discussion area each week. Do not e-mail postings to the Instructor. For all initial Discussion postings, make sure that the first sentence of your posting reads Main Question Post. For your responses to others’ response postings, make Syllabus 11/18/18, 5:00 PM… Page 12 of 17 sure that the first sentence of your response reads Response. These actions will ensure easily identifiable subject lines for your postings and responses. 2. Assignments are submitted to the SafeAssign link and named according to the week in which the Assignment is submitted. Directions for naming each Assignment are included in each week’s Assignment area. 3. All e-mail correspondence must contain in the subject line “NURS 6512-XX-NAME” (XX is the section number) followed by a brief description of the subject. This subject line convention ensures that your e-mail will be easily identified and responded to in a timely manner. It is required that the e-mail contain a signature that matches the official name used in the course. Late Assignment Policy Students are expected to submit assignments by the due dates noted in the course. In extenuating circumstances, such as illness, the student must contact the Instructor as soon as possible to discuss the situation. In those circumstances, faculty will determine the appropriate course of action for the student. Depending on the situation, these actions may include recommendations to drop the course (if within the University drop/withdrawal period), acceptance of some or all of the overdue assignments with or without penalties, or failure to accept assignments. Assignments submitted late without prior agreement of the Instructor, outside of an emergency absence, or in violation of agreements for late submission, will receive a grade reduction for the assignment amounting up to 20%. After 5 days, the assignment will not be graded. Students should be aware that late assignments may not receive the same level of written feedback as do assignments submitted on time. Keeping Your Coursework You will have access to the course and your coursework from the course start date until 60 days after the course ends. After this time, you will no longer be able to access the course or related materials. For this reason, we strongly recommend that you retain copies of your Syllabus 11/18/18, 5:00 PM… Page 13 of 17 completed assignments and any documents you wish to keep. The University is not responsible for lost or missing coursework. Course Evaluation At or near the end of the course, you will receive an e-mail inviting you to submit an online evaluation of the course and instruction. All submitted course evaluations are confidential, and only aggregate data and comments will be shared with the Instructor and Program Director. Your feedback is vitally important to Walden University in its efforts to continuously improve programs. Students With Disabilities Students in this course who have a disability that might prevent them from fully demonstrating their abilities should contact the director of disability services at or at 1- 800-925-3368, ext. 312-1205 and +1-612-925-3368 or for international toll-free numbers as soon as possible to initiate disability verification and discuss accommodations that may be necessary to ensure full participation in the successful completion of course requirements. Classroom Participation In accordance with U.S. Department of Education guidance regarding class participation, Walden University requires that all students submit at least one of their required Week 1 assignments (which includes posting to the Discussion Board) within each course(s) during the first 7 calendar days of class. For courses with two-week units, posting to the Discussion Board by Day 7 meets this requirement. The first calendar day of class is the official start date of the course as posted on your myWalden academic page. Assignments submitted prior to the official start date will not count toward your participation. Financial Aid cannot be released without class participation as defined above. Syllabus 11/18/18, 5:00 PM… Page 14 of 17 Students who are taking their first class with Walden and do not submit at least one of their required Week 1 assignments (or at least one Discussion post) by the end of the 7th day will be administratively withdrawn from the university. Students who have already taken and successfully completed at least one or more class(es) with Walden, and who do not participate within the first 7 days, will be dropped from that class. If you have any questions about your assignments, or you are unable to complete your assignments, please contact your Faculty Member. Checklist The weekly course checklist below outlines the assignments due for the course. For full assignment details and directions, refer to each week of the course. All assignments are due by 11:59 p.m. Mountain Time (MT) on the day assigned (which is 1:59 a.m. Eastern Time (ET) the next day). The time stamp in the classroom will reflect Eastern Time (ET), regardless of your time zone. As long as your submission time stamp is no later than 1:59 a.m. Eastern Time (ET), you have submitted on time. To view the Course Calendar: Course Calendar To View a Printable Course Schedule For full assignment details and directions, refer to each week of the course. Click on the NURS 6512 Course Schedule (PDF) link to access the Course Schedule. Document: NURS 6512 Course Schedule (PDF) Syllabus 11/18/18, 5:00 PM… Page 15 of 17 Checklist Module Assignment Title Week 1 Building a Comprehensive Health History Learning Resources Reading Optional Discussion Building a Health History Looking Ahead Physical Health Assessment Videos Week 2 Functional Assessments and Cultural and Diversity Awareness in Health Assessment Learning Resources Reading Optional Discussion Diversity and Health Assessments Week 3 Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children Learning Resources Reading Optional Discussion Assessment Tools and Diagnostic Tests in Adults and Children Assignment Health History Assessment Video Week 4 Assessment of the Skin, Hair, and Nails Learning Resources Reading Media Optional Assignment 1 Differential Diagnosis for Skin Conditions Assignment 2 Health History Assessment Video Assignment 3 (Optional)Practice Assessment: Skin, Hair, and Nails Examination Week 5 Assessment of Head, Neck, Eyes, Ears, Nose, and Throat Learning Resources Reading Media Optional Discussion Assessing the Ears, Nose, and Throat Week 6 Assessment of the Abdomen and Gastrointestinal System Learning Resources Reading Media Syllabus 11/18/18, 5:00 PM… Page 16 of 17 Optional Assignment 1 Assessing the Abdomen and Gastrointestinal System Exam Midterm Exam Assignment 2 (Optional)Practice Assessment: Abdominal Examination Week 7 Assessment of the Heart, Lungs, and Peripheral Vascular System Learning Resources Reading Media Optional Discussion Assessing the Heart, Lungs, and Peripheral Vascular System Assignment (Optional) Practice Assessment: Cardiac and Respiratory Examination Week 8 Assessment of the Musculoskeletal System Learning Resources Reading Media Optional Discussion Assessing Muscoskeletal Pain Assignment 1 Assessing the Skin, Hair, Nails, and HEENT Assignment 2 (Optional) Practice Assessment: Musculoskeletal Examination Week 9 Assessment of Cognition and the Neurologic System Learning Resources Reading Media Optional Discussion Assessing Neurological Symptoms Assignment (Optional) Practice Assessment: Neurological Examination Looking Ahead Head-to-Toe Physical Assessment Video Week 10 Special Examinations—Breast, Genital, Prostate, and Rectal Learning Resources Reading Media Optional Assignment 1 Assessing the Genitalia and Rectum Assignment 2 Head-to-Toe Physical Assessment Video Week 11 The Ethics Behind Assessment Syllabus 11/18/18, 5:00 PM… Page 17 of 17 Learning Resources Reading Assignment Ethical Concerns Exam Final Exam Bibliography The bibliography contains the references for all learning materials in the course. For your convenience, a link has been provided to download and save the bibliography. To access the Bibliography: Document: NURS 6512 Bibliography (PDF)

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