NURS 5644 Advanced Health Assessment/ Differential Diagnosis

Course Title: Advanced Health Assessment/Differential Diagnosis

Course Description and Overview:

This course delves into the systematic process of conducting a thorough health assessment for individuals across the lifespan. It equips students with the knowledge and skills required to collect pertinent data, interpret findings, establish health diagnoses, effectively communicate results, and empower clients.

In this advanced course, particular emphasis is placed on tailoring the history and physical examination to address the specific health concerns presented by the client at different life stages. The curriculum includes a comprehensive review of the systematic procedures essential for conducting an in-depth assessment, covering aspects such as gathering data, interpreting findings, formulating differential diagnoses, and communicating assessment outcomes and plans.

NURS 5644 Advanced Health Assessment/Differential Diagnosis

Goals and Outcomes:

Upon successful completion of this course, students will be expected to:

  1. Demonstrate proficient critical thinking and clinical decision-making abilities.
  2. Develop a comprehensive database, encompassing a complete functional assessment, health history, physical examination, and appropriate diagnostic testing.
  3. Conduct a risk assessment, including the evaluation of lifestyle and other contributing factors.
  4. Recognize signs and symptoms of common emotional/cognitive health problems and understand their impact on physical assessment.
  5. Perform basic laboratory tests and interpret various laboratory and diagnostic data.
  6. Relate assessment findings to underlying pathology or physiological changes.
  7. Establish a differential diagnosis based on assessment data.
  8. Synthesize knowledge of health conditions when formulating differential diagnoses.
  9. Develop an effective and culturally sensitive plan of care, considering life circumstances and variations in cultural, ethnic, and developmental factors.
  10. Recognize health variations, including physiological differences, across diverse cultural, racial, ethnic, age, and gender groups, influencing assessment and care plans.
  11. Integrate evidence-based research into decision-making processes.

NURS 5644 Advanced Health Assessment/Differential Diagnosis

Clinical Expectations:

Upon successful completion of this course, students in clinical settings will be expected to:

  1. Demonstrate a thorough and problem-focused health assessment for clients and families of all ages, ethnicities, and cultures, including: a. Formulating comprehensive health history and physical examinations for individuals and families across the lifespan. b. Interpreting problem-focused health histories and physical examinations across the lifespan. c. Organizing data to determine a differential list of health problems. d. Prioritizing health problems. e. Presenting relevant health data and a differential list of health problems to the preceptor.
  2. Demonstrate clinical screening skills, covering areas such as the 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.
  3. Demonstrate clinical diagnostic skills, including X-ray interpretation, EKG interpretation, and the interpretation of laboratory tests.

Course Materials and Supplies

Textbooks:   REQUIRED TEXTBOOKS: 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 : Wolters Kluwer.  Online access [Free through TWU Library]. Location:  https://batesvisualguide.com/multimedia.aspx?categoryID=21787#21768 Recommended Texts:  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 Required Supplies: 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

Pre/Co-requisites Courses: BIOL 5333 Advanced Pathophysiology

Evaluation:

Evaluation CriteriaWeightGrading Scale
Examination Scores50 ptsA: 100-90, B: 89-80, C: 79-70, D: 69-60, F < 60
Assignments30 pts
– Subjective Health History (Shadow Health: Tina Jones)5 pts
– Subjective Written Health History Assignment5 pts
– SOAP #1 Assignment: Focused H&P (Shadow Health & Written SOAP)5 pts
– Microscopic Exam5 pts
– SOAP #2 Assignment: Comprehensive Final Soap (Shadow Health & Written SOAP)5 pts
Weekly Exams/Quizzes (8 Total worth 5pts each)50 pts
Midterm: Check off Male/Female GU examination (Pass/Fail)Pass/Fail
Final OSCE Head-to Toe Check-off (Must score 80% or higher to pass)25 pts
Attendance (Must attend 3 in-class labs for Pass)Pass/Fail
Successful Completion 45-hour (Shadow Health & Lab)Pass/Fail
Submission of ALL required documentsPass/Fail

Grading Standards:

  • 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 track, the student must pass both the clinical component AND exam requirements.

Academic Support and Examination Policies:

Test Review Policy:

  • Students scoring below 80% on any exam/quiz are strongly encouraged to schedule an individual test review with their assigned class faculty. The purpose is to identify content areas for improvement and develop effective test-taking skills.
    • All individual test reviews must be completed within two weeks of taking the examination. After this period, the exam/quiz will no longer be available for review.

Exam/Quiz Attendance:

  • All unit exams/quizzes must be taken on the designated dates. Failure to comply will result in either taking a new version of the examination (e.g., short answer, fill in the blank, short essay) or forfeiture of the missed examination.
    • Make-up exams will be granted at the discretion of the instructor.

Clinical Component Requirements:

  • Students must achieve >80% in the clinical requirements to pass the clinical component of the course.
    • Failure to successfully complete the physical assessment component and/or obtain the required number of clinical hours constitutes a clinical failure in the course, resulting in a failing grade, regardless of the exam average or cumulative course grade.
    • A clinical grade of fail (<80%) means the student has failed the entire course. The clinical grade considers a minimum of 45 clinical hours, a combination of Skills lab and Shadow Health Computerized clinical hours.

Dress Code:

  • Appropriate dress is mandatory during Baylor lab and clinical days. This includes wearing a lab coat over street clothes. Jeans and open-toed shoes are not permitted in Baylor simulation lab or the TWU nursing lab.

Course Assignments, Quizzes, and Examinations Policies:

Course Assignments:

  1. Every assignment in the graduate program must:
    • Be uploaded to Canvas with an accompanying TWU-approved professional cover sheet in the designated assignment dropbox.
    • Assignments submitted without the TWU cover page and grading criteria/rubric will be rejected, resulting in either a score of zero or a late penalty.
    • Emailed assignments will not be accepted.
    • Unawareness of course requirements is not considered a valid rationale for missing exams, quizzes, or due dates. Please check the course schedule/calendar carefully.
  2. Assignment Format:
    • Written in APA format.
    • Include evidence-based references if indicated (SOAP notes, presentations).
    • Uploaded to Canvas in Microsoft Word format with the attached grading rubric.
    • Saved as a document titled Lastname_FirstInitial_AssignmentName.doc. (Example: SmithS_SubjHealthhx.doc)

Exams/Quizzes:

  1. Weekly exams and check-offs verify student learning, ensure retention of foundational knowledge for clinical practice, and prepare students for clinical rotations and national board exams.
  2. Plan to arrive 30 minutes early for Midterm/Final check-off exams on campus.
    • Late students will not be allotted extra time.
    • No makeup exams/quizzes are permitted.

Absenteeism and Valid Excuses:

  1. If absent from a scheduled lab or exam, follow this procedure:
    • Contact faculty/course manager before the starting time via telephone and email, leaving name, phone number, and reason for absence.
    • Valid excuses include documented student illness, serious illness or death in the student’s immediate family, official school activity, state-recognized religious holiday, or other verified absences approved by the instructor.
  2. Upon return to the University:
    • Present verbal or written documentation of the circumstances.
    • Prepare to write an examination on the first day back (if indicated) and demonstrate examination technique competencies on a date determined by the faculty.
  3. Failure to follow this procedure results in forfeiting the grade on the midterm or final examination.

Retaking of Exams/Quizzes:

  1. Not permitted under any circumstances.

Exam Administration:

  1. Exams are administered online via laptop/desktop.
  2. Bring laptops to lab for video content review during wait times for lab skills check-offs.
  3. Weekly exam/quiz requires internet camera/video capability.

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