Posted: January 23rd, 2023
In the event of a significant disruption of course activities because of an extraordinary environmental situation (e.g., COVID-19), this syllabus is subject to change. Any and all changes will be communicated with students in as timely a manner as the situation allows.
|Semester: Fall||Year: 2021|
|Course Prefix: NURS||Course Number: 5644|
|Course Title: Advanced Health Assessment/Differential Diagnosis|
|Course Description and Overview:
Examination of the systematic process involved in performing a holistic health assessment on individuals throughout the life span. Includes knowledge and skills necessary to gather data, interpret findings, make health diagnosis, communicate results, and empower clients.
Emphasis in this advanced course will be to individualize the history and physical exam to the presenting health concerns of the client throughout the lifespan. A review of the systematic process involved in performing a comprehensive history, physical, and psychological health assessment on individuals includes knowledge and skills necessary to gather data, interpret findings, formulate differential diagnosis, and communicate findings/plans.NURS 5644 Advanced Health Assessment/ Differential Diagnosis
Meets Core Curriculum Requirements
Faculty Contact Information:
|Name of Instructor: Rita Dellostritto, PhD, APRN, CNS, ENP, ACNP-BC, FAANP|
|Office Location: IHSI 6036|
|Phone Number: 713-794-2803; 713-826-6236 (c)|
|Office Hours: by appt|
|Email Address: [email protected]|
Name of Instructor: Rebecca Schultz, PhD, APRN, CPNP-PC
Office Location: IHSI 6026
Phone Number: 713-794-2154
Office Hours: by appt
Email Address: [email protected]
|Name of Instructor: Patrick Laird, DNP, APRN, ACNP-BC, NEA-BC
Office Location: Off Campus
Phone Number: 281-222-0619
Office Hours: by appt
Email Address: [email protected]
|Name of Instructor: Jodi Wright, DNP, APRN, AGACNP-BC, FNP-BC|
|Office Location: Off Campus|
|Phone Number: 312-933-6764|
|Office Hours: by appt|
|Email Address: [email protected]|
Goals and Outcomes:
|Upon successful completion of this course, the student will be expected to be able to:
Clinically upon successful completion of this course, the student will be expected to be able to:
a. Formulating a complete and problem-focused health history and physical examination for individuals and families across the lifespan
b. Interpreting a problem-focused health history and physical examination for individuals across the Lifespan
c. Organizing data to determine a differential list of health problems
e. Prioritizing health problems
f. Presenting relevant health data and differential list of health problems to the preceptor
Female pelvic examination, client instructions in breast self-examination, male genital and prostate examination, client instructions in testicular self-examination, Denver II screening, scoliosis screening, and health maintenance screening across the lifespan.
X-ray interpretation, EKG interpretation, and interpretation of laboratory tests.
Course Materials and Supplies:
Bickley, L.S., Szilagyi, P.G., & Hoffman, R.M. (2021). Bates’ guide to physical examination and history taking (13th ed.). Philadelphia. PA: Wolters Kluwer/Lippincott Williams and Wilkens. ISBN 9781469893419
Goolsby, M.J., & Grubbs, L. (2015). Advanced assessment: Interpreting findings and formulating differential diagnoses (4th ed.). Philadelphia, PA: F.A. Davis. ISBN-13: 978-0803668942
Fischbach, F., & Dunning, M. (2021). A manual of laboratory and diagnostic tests (10th ed.). Wolters Kluwer. ISBN-13: 978-1496377128; ISBN-10: 1496377125
The following are available online through TWU Library
Fortin, A.H., Dwamena, F.C., Frankle, R.M., & Smith, R. (2012). Smith’s patient-centered interviewing: An evidence-based model (10th ed.). Lange/McGraw Hill. Free Access TWU Library at https://accessmedicine-mhmedical-com.ezp.twu.edu/book.aspx?bookid=501
Bickley, L.S. (2017). Bates’ visual guide to physical examination [video series]: Wolters Kluwer. Online access [Free through TWU Library]. Location: https://batesvisualguide.com/multimedia.aspx?categoryID=21787#21768
Bickley, L.S., Szilagyi, P.G., & Hoffman, R.M. (2021). Bates’ pocket guide to physical examination and history taking (9th ed.). Philadelphia: Walter Kluwer. ISBN-13: 978-1975109875
Diagnostic Kits: Ophthalmoscope and Otoscope, Tuning Fork, Reflex Hammer, monofilament, tape measure, Stethoscope, Pocket Snellen visual chart, Professional Lab Coat (3/4 or full length)
Computer with a functioning web camera for online quizzes/exams. NURS 5644 Advanced Health Assessment/ Differential Diagnosis
American Academy of Family Practice: http://www.aafp.org
American College of Nurse-Midwives: http://www.acnm.org
American Academy of Pediatrics: http://www.aap.org
Centers for Disease Control and Prevention: http://www.cdc.gov
Healthy People 2030: http://www.health.gov/healthypeople
Pregnancy Web Sites: http://www.awhonn.org
Texas Board of Nursing: http://www.bne.state.tx.us
World Health Organization: http://www.who.int/en/
NOTE: Student access to the internet for current information is a course expectation. There is a computer lab with internet capability for the use of TWU students on the 4th floor.
|Pre/Co-requisites Courses: BIOL 5333 Advanced Pathophysiology|
Because we are a “Campus with a Heart,” you are encouraged to keep yourself and others safe through the following actions:
Texas Woman’s University strives to make all learning experiences as accessible as possible. If you anticipate or experience academic barriers based on your disability (including mental health, chronic, or temporary medical conditions), please contact me via email/phone or during office hours, so that we may privately discuss options. To establish reasonable accommodations, please register with Disability Services for Students (DSS). After registration, contact me as soon as possible to discuss your accommodations so that they may be implemented in a timely fashion. DSS contact information: DSS website (www.twu.edu/dss); [email protected]; 940-898-3835; CFO Ste. 106 NURS 5644 Advanced Health Assessment/ Differential Diagnosis
TWU is committed to providing a safe learning environment free of all forms of sexual misconduct, including sexual harassment sexual assault, domestic violence, dating violence, and stalking. Federal laws (Title IX and the Violence Against Women Act) and TWU policies prohibit discrimination on the basis of sex and therefore prohibit sexual misconduct. As students, if you or someone you know is experiencing sexual harassment, relationship violence, stalking, or sexual assault, there are campus resources available to provide support and assistance. Alleged sexual misconduct can be non-confidentially reported to the Title IX Coordinator at the Report an Incident website (https://twu.edu/civility/report-an-incident/) or at (940) 898-2968. Additionally, please be aware that under Title IX of the Education Amendments of 1972, all employees are required to disclose information about such misconduct to the Title IX Office. Students who wish to speak to a confidential employee who does not have this reporting responsibility, you can contact TWU Counseling and Psychological Services at (940) 898-3801 for the Denton Campus, (214) 689-6655 for the Dallas Campus, and (713) 794-2059 for the Houston Campus.
Title IX is a federal law which requires schools that receive federal funds to provide reasonable accommodations to students who are pregnant or have pregnancy related conditions. This includes pregnancy, pre-natal doctor appointments, childbirth, false pregnancy, miscarriage, termination of pregnancy, or recovery from any of these conditions. Students who may need academic accommodations due to pregnancy related conditions should complete the Pregnancy Accommodation form (https://twu.edu/pregnancy-accommodation-form/) to coordinate academic needs.
Honesty in completing assignments is essential to the mission of the University and to the development of the personal integrity of students. In submitting graded assignments, students affirm that they have neither given nor received unauthorized assistance, and that they have abided by all other provisions of the Academic Integrity Policy and the Student Code of Conduct as found on the TWU website and in the TWU Student Handbook. Cheating, plagiarism, collusion, dual submission of a paper, or other kinds of academic dishonesty will not be tolerated and will result in appropriate sanctions that may include failing an assignment, failing the class, removal from an academic program, or being suspended or expelled. Allegations of academic dishonesty in this course may be reported to the Office of Civility and Community Standards. The specific disciplinary process for academic dishonesty is in Section 5 as part of the TWU Student Code of Conduct (http://www.twu.edu/student-handbook). For details on avoiding plagiarism, review the Library Tutorial: Avoiding Plagiarism (http://libguides.twu.edu/c.php?g=270163&p=1803990).
Consistent attendance is vital to academic success and is expected of all students. Grades are determined by academic performance, and instructors may give students written notice that attendance related to specific classroom activities is required. Absences do not exempt students from academic requirements. Excessive absences, even if documented, may result in a student’s failing the course. Excused absences are within the purview of the instructor. Students must consult with instructors regarding make-up work.
Evaluation will be based on examination scores, assignments and satisfactory clinical performance.
Major Course Assignments and Examinations:
|Activities, Assignments, and Grading Policy:
TWU College of Nursing Grading Scale:
A = 100-90, B = 89-80, C = 79-70, D = 69-60, F < 60
ADVANCED PRACTICE NURSING GRADING CRITERIA:
For successful completion of this course with progression to the advanced practice tract, the student must pass both the clinical component AND exam requirements.
Students making <80% on any exam/quiz are encouraged to do an individual test review with their assigned class faculty for the purpose of identifying content areas for improvement, as well as the development of test taking skills. All individual test reviews must be done within two weeks of taking the examination. The exam/quiz will no longer be available for review after that time.
**All unit exams/quizzes must be taken on the designated dates. Failure to do so will result in having to take a new version of the examination (i.e. short answer, fill in the blank, short essay, etc) or forfeiture of the missed examination. Make up exams will be given at the discretion of the instructor.
*The student must also pass the clinical requirements with >80% in order to successfully pass the clinical component of the course. Inability to successfully complete the physical assessment component and/or obtain the required number of clinical hours constitutes a clinical failure in the course and will receive a failing grade in the course regardless of the exam average or cumulative course grade. If a student receives a clinical grade of fail (< 80%), the student is considered to have failed the course and will receive that grade as the course grade. The clinical grade includes the completion of a MINUMUM of 45 clinical hours, a combination of Skills lab and Shadow Health Computerized clinical hours.
* Appropriate dress is required which includes a lab coat over street clothes in Baylor lab & clinical days. No jeans or open toed shoes will be allowed in Baylor simulation lab or in the TWU nursing lab
Course/Assignments/Quizzes and Examinations:
ii) Be written in APA format;
iii) Include evidenced-based references if indicated (SOAP notes, presentations);
iv) Be uploaded to Canvas in Microsoft Word format with the attached grading rubric;
v) Saved as a document title Lastname_FirstInitial_Assignment name.doc
Pagers & Cellular Classroom Policy
Pagers and cellular phones must be turned off or to the silent mode during class, seminar, laboratory, and conference times. This is disruptive to class flow and failure to comply may result in the student being asked to leave class.
Tape Recording and Photography Course Policy
Anyone desiring to tape record formal presentations or informal discussions must receive permission of the person presenting the information prior to the scheduled time of the presentation. DO NOT tape record or photograph in clinical settings without clear and written protocols and permissions received in conjunction with the clinical instructor and faculty.
E-mail and Canvas are communication and teaching modalities used extensively in this course. All students are expected to access, navigate, and use these modalities on a regular basis. Failure of a student to receive messages, announcements, or assignments sent or posted via these modalities may jeopardize the student’s progress in the course and does not constitute a viable excuse for failing to meet course requirements and expectations. Teaching Modules will be placed on Canvas to enhance learning. If you have any questions about using Canvas, please contact the IT department helpline [(940) 898-3971]. Keyboard skills are necessary for clinical documentation.
Students should check the Canvas prior to each class and periodically during the week. E-mails will be sent to the University assigned e-mail account if the student plans to use another account, the student is required to up-date this information through their Portal account.
Preliminary grades are often posted on Canvas, as a convenience for students. However, these grades are not considered official; only those grades submitted to the registrar’s office at the end of the semester are official.
Disaster Course Policy
In the event of a disaster (i.e. hurricane, pandemic epidemic) affecting the Houston area and/or causing University closure, clinical practice associated with the course will be canceled and didactic content will be placed on the course Canvas site.
For assistance with Canvas and Pioneer Portal, you will find step-by-step instructions at the TWU website for distance learning. The website is: www.twu.edu/dl/orientation
Immunizations, Drug Testing, and Background Checks:
Drug testing and criminal background screening is required for all students in the TWU College of Nursing. (refer to TWU policy). Everyone should have an account in Castle Branch prior to registering for this class. Castle Branch maintains all of your information (current CPR card, RN license, proof of medical health insurance, current immunizations, HIPPA training, etc) during the time you are a student. Besides Castle Branch all immunizations must be up to date in the TWU Student Health Services in Denton.
***Students must be compliant in all areas prior to their first day of lab/clinical. Any student who attends clinical before being compliant will have to repeat those clinical hours.
You must complete the on line registration for urine drug screening (SurScan) prior to the second week of class. The agency TWU uses for drug screening is SurScan: http://www.surscan.com/nursing_students_twu.html. It is important to note that you are a graduate nursing student at TWU-Houston. All urine drug screens will be obtained as a group in this class, if contacted by SurScan to go to a particular site, inform them that your drug screen will be obtained on TWU campus. Upload a copy of your receipt for proof of registration into Canvas. All students are required to perform a urine drug screen during this semester regardless of whether you have taken this course in the past and submitted to a drug screen. NURS 5644 Advanced Health Assessment/ Differential Diagnosis
Other Course Information
Professionalism: Students are expected to maintain a respectful demeanor in the laboratory and classroom setting, and when communicating with faculty, peers, and ancillary services. Every action taken, both personally and professionally, reflects on the student’s ability to develop into a rational, critically thinking Advanced Practice Nurse. You are encouraged to review the student handbook regarding Professional Demeanor. Disrespectful demeanors are not tolerated and considered a breach in the Code of Conduct required at TWU.
Professionalism includes, but is not limited to, the following: Timely attendance to class or clinical activities, adherence to the academic honesty policies of the University and course syllabus, appropriate behavior in class and clinical activities (includes turning cell phones to silent), notifying faculty or preceptor as soon as possible with changes in preceptor agreements clinical schedules, promptness to the clinical site(s), documenting factual logs, adherence to the clinical dress policy. Any act that gives an unfair advantage to any student is considered unprofessional.
TWU Dress Code.
Professional dress is expected during final practicum examinations.
Modalities to deliver content in this course include internet sources, required textbooks, as well as health assessment videos and Shadow Health Digital Clinical Experiences (aka: virtual patient). All students are expected to access, navigate, and utilize these modalities on a frequent basis. Failure of a student to receive messages, announcements, or assignments sent or posted via these modalities may jeopardize the progress of the student in the course and does not constitute a viable excuse for failing to meet course requirements and expectations. Students are expected to check the course and course email at least once daily M-F.
September 6 – Labor Day
Nov 5 – Last Day to Withdraw
Nov 25-27 – Thanksgiving Break
Assessment and Differential Diagnostics
Introduction to Shadow Health
Foundations for Evaluating Clients
|1/17/2021 @ Midnight (MN)|
|Exam Module 1&2
1/24/2021 @ MN
2/7/2021 @ MN
Abdomen & Peripheral Vascular
2/14/2021 @ MN
Due 2/21/2021 @ MN
Practice all of the above skills
3/14/2021 @ MN
Breast and Rectal Exams
3/21/2021 @ MN
Practice all skills since last lab
Children – Infants to Adolescence
4/4/2021 @ MN
|4/5/2021||Evaluating the older Adult||Exam: 4/11-12/2021
4/11/2021 @ MN
|Pending||Female Exam||Baylor (you will sign up)|
|Pending||Male Exam||Baylor (you will sign up)|
|Due by 5/3/2021||Final Check-off||Via Zoom|
This is a preliminary schedule. It is subject to change
ALL Exams are Online. They require LockDown Browser with Monitor
Exams will Open at 0001 on the first day and Close at 2359 on the 2nd day of the Exam. NURS 5644 Advanced Health Assessment/ Differential Diagnosis
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