NURS 6512 Week 7 DCE Assignment 1: Digital Clinical Experience: Assessing the Heart, Lungs, and Peripheral Vascular System
NURS 6512 Week 7 DCE Assignment 1: Digital Clinical Experience: Assessing the Heart, Lungs, and Peripheral Vascular System
In order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.
In this DCE Assignment, you will conduct a focused exam related to chest pain using the simulation too, Shadow Health. Consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.
Take a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?
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Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
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Learning Resources
Required Readings
- Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
- Chapter 14, “Chest and Lungs”
This chapter explains the physical exam process for the chest and lungs. The authors also include descriptions of common abnormalities in the chest and lungs. - Chapter 15, “Heart”
The authors of this chapter explain the structure and function of the heart. The text also describes the steps used to conduct an exam of the heart. - Chapter 16, “Blood Vessels”
This chapter describes how to properly conduct a physical examination of the blood vessels. The chapter also supplies descriptions of common heart disorders.
- Chapter 14, “Chest and Lungs”
- Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis.
- Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487) (specifically focus on pp. 480–481)
- Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487)
- Download “X-Ray Interpretation: Chest (pp. 480–487)
- Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. - Chapter 8, “Chest Pain”
- Download Chapter 8, “Chest Pain”
This chapter focuses on diagnosing the cause of chest pain and highlights the importance of first determining whether the patient is in a life-threatening condition. It includes questions that can help pinpoint the type and severity of pain and then describes how to perform a physical examination. Finally, the authors outline potential laboratory and diagnostic studies. - Chapter 11, “Cough”
- Download Chapter 11, “Cough”
A cough is a very common symptom in patients and usually indicates a minor health problem. This chapter focuses on how to determine the cause of the cough by asking questions and performing a physical exam. - Chapter 14, “Dyspnea”
- Download Chapter 14, “Dyspnea”
The focus of this chapter is dyspnea, or shortness of breath. The chapter includes strategies for determining the cause of the problem through evaluation of the patient’s history, through physical examination, and through additional laboratory and diagnostic tests. - Chapter 26, “Palpitations”
- Download Chapter 26, “Palpitations”
This chapter describes the different causes of heart palpitations and details how the specific cause in a patient can be determined. - Chapter 33, “Syncope”
- Download Chapter 33, “Syncope”
This chapter focuses on syncope, or loss of consciousness. The authors describe the difficulty of ascertaining the cause, because the patient is usually seen after the loss of consciousness has happened. The chapter includes information on potential causes and the symptoms of each.
- Bansal, M. (2020). Cardiovascular disease and COVID-19.
- Links to an external site. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(3), 247–250. https://doi.org/10.1016/j.dsx.2020.03.013
- Jolobe, O. M. (2021). Differential diagnosis of the association of gastrointestinal symptoms and ST segment elevation, in the absence of chest pain.
- Links to an external site. The American Journal of Emergency Medicine, 49, 137–141. https://doi.org/10.1016/j.ajem.2021.05.067
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as well as other support resources:
- Shadow Health. (2021). Welcome to your introduction to Shadow Health.
- Links to an external site. https://link.shadowhealth.com/Student-Orientation-Video
- Shadow Health. (n.d.). Shadow Health help desk.
- Links to an external site.Retrieved from https://support.shadowhealth.com/hc/en-us
- Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.
- Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide
- Document: DCE (Shadow Health) Documentation Template for Focused Exam: Chest Pain (Word document)
- Download DCE (Shadow Health) Documentation Template for Focused Exam: Chest Pain (Word document)
Use this template to complete your Assignment 1 for this week.
Required Media
Advanced Health Assessment and Diagnostic Reasoning
Thoughtful, reasoned questioning leads from initial complaint to diagnosis in these three scenarios.
Note: Close the viewing window after the intro segment and after each diagnosis segment to view the menu. (12m)
Assessment of the Heart, Lungs, and Peripheral Vascular System – Week 7 (28m)
- SkillStat Learning, Inc. (2019). The 6 second ECG.
- Links to an external site. Retrieved from http://www.skillstat.com/tools/ecg-simulator#/-home
This interactive website allows you to explore common cardiac rhythms. It also offers the Six Second ECG game so you can practice identifying rhythms.
Online media for Seidel’s Guide to Physical Examination
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 13 and 14 that relate to the assessment of the chest, heart, and lungs. Refer to Week 4 for access instructions on https://evolve.elsevier.com/
Optional Resources
- LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.
- Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 1, “Chest Wall, Pulmonary, and Cardiovascular Systems,” pp. 263-377)
Note: Section 2 of this chapter will be addressed in Week 10.
This section of Chapter 8 describes the anatomy of the chest wall, pulmonary, and cardiovascular systems. Section 1 also explains how to properly conduct examinations of these areas.
- Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 1, “Chest Wall, Pulmonary, and Cardiovascular Systems,” pp. 263-377)
- Johnson K, & Ghassemzadeh S. (2021, July 21). Chest pain. In StatPearls [Internet].
Links to an external site. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470557/
- Links to an external site.
-
- Links to an external site.European Journal of Preventive Cardiology, 27(3), 311–320. https://doi.org/10.1177/2047487319890973Links to an external site.Zorzi, A., Vessella, T., de Lazzari, M., Cipriani, A., Menegon, V., Sarto, G., Spagnol, R., Merlo, L., Pegoraro, C., Marra, M. P., Corrado, D., & Sarto, P. (2019). Screening young athletes for diseases at risk of sudden cardiac death: Role of stress testing for ventricular arrhythmias.
To Prepare
- Review this week’s Learning Resources and the Advanced Health Assessment and Diagnostic Reasoning media program and consider the insights they provide related to heart, lungs, and peripheral vascular system.
- Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation with the Shadow Health platform. Review the examples also provided.
- Review the DCE (Shadow Health) Documentation Template for Focused Exam: Chest Pain found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
- Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
- Review the Week 7 DCE Focused Exam: Chest Pain Rubric provided in the Assignment submission area for details on completing the Assignment in Shadow Health.
- Consider what history would be necessary to collect from the patient.
- Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
DCE Focused Exam: Chest Pain Assignment:
Complete the following in Shadow Health:
- Cardiovascular Concept Lab (Required)
- Respiratory(Recommended but not required)
- Cardiovascular (Recommended but not required)
- Episodic/Focused Note for Focused Exam (Required): Chest Pain
Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total of 80% or better (this includes your DCE and your Documentation Notes), but you must take all attempts by the Week 7 Day 7 deadline.
submission information
- Complete your Focused Exam: Cough DCE Assignment in Shadow Health via the Shadow Health link in Canvas.
- Once you complete your assignment in Shadow Health, you will need to download your lab pass and upload it to the corresponding assignment in Canvas for your faculty review.
- (Note: Please save your lab pass as “LastName_FirstName_AssignmentName”.) You can find instructions for downloading your lab pass here: https://link.shadowhealth.com/download-lab-passLinks to an external site.
- Complete your documentation using the documentation template in your resources and submit it into your Assignment submission link below.
- To submit your completed assignment, save your Assignment as WK7Assgn1+last name+first initial.
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select both files and then Submit Assignment for review.z
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Rubric
NURS_6512_Week_7_DCE_Assignment_1_Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| This criterion is linked to a Learning Outcome Student DCE score(DCE percentages will be calculated automatically by Shadow Health after the assignment is completed.)Note: DCE Score – Do not round up on the DCE score. |
|
60 pts | ||||
| This criterion is linked to a Learning Outcome Subjective Documentation in Provider Note Template: Subjective narrative documentation in Provider Note Template is detailed and organized and includes: Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS)ROS: covers all body systems that may help you formulate a list of differential diagnoses. You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe. |
|
20 pts | ||||
| This criterion is linked to a Learning Outcome Objective Documentation in Provider Notes – this is to be completed using the documentation template that is provided. Document in a systematic order starting from head-to-toe, include what you see, hear, and feel when doing your physical exam using medical terminology/jargon. Document all normal and abnormal exam findings. Do not use “WNL” or “normal”. You only need to examine the systems that are pertinent to the CC, HPI, and History. Diagnostic result – Include any pertinent labs, x-rays, or diagnostic test that would be appropriate to support the differential diagnoses mentioned. Differential Diagnoses (list a minimum of 3 differential diagnoses). Your primary or presumptive diagnosis should be at the top of the list (#1). |
|
20 pts | ||||
| Total Points: 100 | ||||||
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NURS 6512 Week 7 DCE Assignment 1: Digital Clinical Experience: Assessing the Heart, Lungs, and Peripheral Vascular System
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