This article covers NURS 6512 Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System.
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NURS 6512 Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System
Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System
Cardiovascular disease (CVD) is the largest cause of death worldwide. Accounting for 800,000 deaths annually, CVD frequently goes unnoticed until it is too late. Early detection and prevention measures can save the lives of many patients who have CVD. Conducting an assessment of the heart, lungs, and peripheral vascular system is one of the first steps that can be taken to detect CVD and many more conditions that may occur in the thorax, or chest area.
This week, you will evaluate abnormal findings in the area of the chest and lungs. In addition, you will appraise health assessment techniques and diagnoses for the heart, lungs, and peripheral vascular system.
Learning Objectives- Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System
Students will:
- Evaluate abnormal cardiac and respiratory findings
- Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for the heart, lungs, and peripheral vascular system
Photo Credit: ANDRZEJ WOJCICKI/Science Photo Library/Getty Images
Learning Resources- Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System
Required Readings
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
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.
- Chapter 13, “Chest and Lungs” (pp. 260-293)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 14, “Heart” (pp. 294-331)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 15, “Blood Vessels” (pp. 332-349)This chapter describes how to properly conduct a physical examination of the blood vessels. The chapter also supplies descriptions of common heart disorders.
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.
- Chapter 8, “Chest Pain” (pp. 81–96)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” (pp. 118-147)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 through asking questions and performing a physical exam.
- Chapter 14, “Dyspnea” (pp. 159–173)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” (pp. 310-317)This chapter describes the different causes of heart palpitations and details how the specific cause in a patient can be determined.
- Chapter 33, “Syncope” (pp. 390-397)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.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
- Chapter 8, “Outpatient Charting and Communications” (pp. 173-188)
Note: Download these Adult Examination Checklists and Physical Exam Summaries to use during your practice cardiac and respiratory examination.
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Blood vessels. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. This Blood Vessels Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for cardiovascular assessment. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Cardiovascular Assessment was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for chest and lung assessment. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Chest and Lung Assessment was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Chest and lungs. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. This Chest and Lungs Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Heart. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. This Heart Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
McCabe, C., & Wiggins, J. (2010a). Differential diagnosis of respiratory disease part 1. Practice Nurse, 40(1), 35–41.Retrieved from the Walden Library databases. This article describes the warning signs of impending deterioration of the respiratory system. The authors also explain the features of common respiratory conditions.
McCabe, C., & Wiggins, J. (2010b). Differential diagnosis of respiratory diseases part 2. Practice Nurse, 40(2), 33–41. Retrieved from the Walden Library databases. The authors of this article specify how to identify the major causes of acute breathlessness. Additionally, they explain how to interpret a variety of findings from respiratory investigations.
SkillStat Learning, Inc. (2014). The 6 second ECG. 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.
University of Virginia. (n.d.). Introduction to radiology: An online interactive tutorial. Retrieved from http://www.med-ed.virginia.edu/courses/rad/index.html. This website provides an introduction to radiology and imaging. For this week, focus on cardiac radiography and chest radiology.
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Required Media
Laureate Education. (Producer). (2012). Advanced health assessment and diagnostic reasoning. Baltimore, MD: Author. Note: You will use the case studies presented in the media, Advanced Health Assessment and Diagnostic Reasoning, to complete this week’s Discussion.
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, 14, and 15 that relate to the assessment of the heart, lungs, and peripheral vascular system. Refer to Week 4 for access instructions on https://evolve.elsevier.com/.
Optional Resources
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th 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. 302–433)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.
NURS 6512 Week 7 Discussion: Assessing the Heart, Lungs, and Peripheral Vascular System
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?
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 Discussion, you will consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
To prepare:
With regard to the case study you were assigned:
- Review this week’s Learning Resources and consider the insights they provide.
- 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?
- Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject line (“Discussion – Week 6”) with “Review of Case Study” identifying the number of the case study you were assigned.
By Day 3
Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
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Submission and Grading Information
Grading Criteria
To access your rubric:
Week 7 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 7 Discussion
Assignment (Optional): Practice Assessment: Cardiac and Respiratory Examination
It is crucial to diagnose cardiac and respiratory conditions early due to the critical nature of these organs. Before a condition can be diagnosed, an examination must be conducted. Properly conducting a cardiac and respiratory examination requires detailed knowledge of the examination procedure and experience in performing this assessment.
In preparation for the Head-to-Toe Physical Assessment Video due in Week 10, it is recommended that you practice performing a cardiac and respiratory examination this week.
Note: This is an optional practice physical assessment. You do not have to capture a video of this assessment, as no submission is required.
To prepare:
- Arrange an appropriate time and setting with your volunteer “patient” to perform a cardiac and respiratory examination.
- Download and review the Cardiac and Respiratory Checklists provided in this week’s Learning Resources.
- Ensure that you have a stethoscope to perform the examination.
To complete:
- Perform the cardiac and respiratory examination. Be sure to cover all of the areas listed in the checklist and to use the equipment appropriately.
Looking Ahead: Skin, Hair, and Nails, and HEENT Physical Assessment Video
In Week 8, you will videotape yourself conducting a skin, hair, and nails, and HEENT physical assessment.
By Day 7 of Week 8
This video is due. Refer to Week 8 for additional guidance.
Week in Review
This week, you properly applied health assessment techniques and diagnoses for the heart, lungs, and peripheral vascular system. In addition, you evaluated abnormal cardiac and respiratory findings using the patient’s history and potential abnormal findings. You also recommended appropriate exams/diagnostic tests to determine causes and abnormalities.
Next week, you will explore how to accurately assess the abdomen and gastrointestinal system.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6512_Week_7_Discussion_Rubric
Outstanding Performance | Excellent Performance | Competent Performance | Proficient Performance | Room for Improvement | |
---|---|---|---|---|---|
Main Posting: Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. | Points Range: 44 (44%) – 44 (44%)Thoroughly responds to the discussion question(s)is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.supported by at least 3 current, credible sources | Points Range: 40 (40%) – 43 (43%)Responds to the discussion question(s)is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.75% of post has exceptional depth and breadthsupported by at least 3 credible references | Points Range: 35 (35%) – 39 (39%)Responds to most of the discussion question(s)is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.50% of post has exceptional depth and breadthsupported by at least 3 credible references | Points Range: 31 (31%) – 34 (34%)Responds to some of the discussion question(s)one to two criteria are not addressed or are superficially addressedis somewhat lacking reflection and critical analysis and synthesissomewhat represents knowledge gained from the course readings for the module.post is cited with fewer than 2 credible references | Points Range: 0 (0%) – 30 (30%)Does not respond to the discussion question(s)lacks depth or superficially addresses criterialacks reflection and critical analysis and synthesisdoes not represent knowledge gained from the course readings for the module.contains only 1 or no credible references |
Main Posting: Writing | Points Range: 6 (6%) – 6 (6%)Written clearly and conciselyContains no grammatical or spelling errorsFully adheres to current APA manual writing rules and style | Points Range: 5.5 (5.5%) – 5.5 (5.5%)Written clearly and conciselyMay contain one or no grammatical or spelling errorAdheres to current APA manual writing rules and style | Points Range: 5 (5%) – 5 (5%)Written conciselyMay contain one to two grammatical or spelling errorAdheres to current APA manual writing rules and style | Points Range: 4.5 (4.5%) – 4.5 (4.5%)Written somewhat conciselyMay contain more than two spelling or grammatical errorsContains some APA formatting errors | Points Range: 0 (0%) – 4 (4%)Not written clearly or conciselyContains more than two spelling or grammatical errorsDoes not adhere to current APA manual writing rules and style |
Main Posting: Timely and full participation | Points Range: 10 (10%) – 10 (10%)Meets requirements for timely and full participationposts main discussion by due date | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)Does not meet requirement for full participation |
First Response:Post to colleague’s main post that is reflective and justified with credible sources. | Points Range: 9 (9%) – 9 (9%)Response exhibits critical thinking and application to practice settingsresponds to questions posed by facultythe use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives | Points Range: 8.5 (8.5%) – 8.5 (8.5%)Response exhibits critical thinking and application to practice settings | Points Range: 7.5 (7.5%) – 8 (8%)Response has some depth and may exhibit critical thinking or application to practice setting | Points Range: 6.5 (6.5%) – 7 (7%)Response is on topic, may have some depth | Points Range: 0 (0%) – 6 (6%)Response may not be on topic, lacks depth |
First Response: Writing | Points Range: 6 (6%) – 6 (6%)Communication is professional and respectful to colleaguesResponse to faculty questions are fully answered if posedProvides clear, concise opinions and ideas that are supported by two or more credible sourcesResponse is effectively written in Standard Edited English | Points Range: 5.5 (5.5%) – 5.5 (5.5%)Communication is professional and respectful to colleaguesResponse to faculty questions are answered if posedProvides clear, concise opinions and ideas that are supported by two or more credible sourcesResponse is effectively written in Standard Edited English | Points Range: 5 (5%) – 5 (5%)Communication is mostly professional and respectful to colleaguesResponse to faculty questions are mostly answered if posedProvides opinions and ideas that are supported by few credible sourcesResponse is written in Standard Edited English | Points Range: 4.5 (4.5%) – 4.5 (4.5%)Responses posted in the discussion may lack effective professional communicationResponse to faculty questions are somewhat answered if posedFew or no credible sources are cited | Points Range: 0 (0%) – 4 (4%)Responses posted in the discussion lack effectiveResponse to faculty questions are missingNo credible sources are cited |
First Response: Timely and full participation | Points Range: 5 (5%) – 5 (5%)Meets requirements for timely and full participationposts by due date | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)Does not meet requirement for full participation |
Second Response: Post to colleague’s main post that is reflective and justified with credible sources. | Points Range: 9 (9%) – 9 (9%)Response exhibits critical thinking and application to practice settings * responds to questions posed by facultythe use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives | Points Range: 8.5 (8.5%) – 8.5 (8.5%)Response exhibits critical thinking and application to practice settings | Points Range: 7.5 (7.5%) – 8 (8%)Response has some depth and may exhibit critical thinking or application to practice setting | Points Range: 6.5 (6.5%) – 7 (7%)Response is on topic, may have some depth | Points Range: 0 (0%) – 6 (6%)Response may not be on topic, lacks depth |
Second Response: Writing | Points Range: 6 (6%) – 6 (6%)Communication is professional and respectful to colleaguesResponse to faculty questions are fully answered if posedProvides clear, concise opinions and ideas that are supported by two or more credible sourcesResponse is effectively written in Standard Edited English | Points Range: 5.5 (5.5%) – 5.5 (5.5%)Communication is professional and respectful to colleaguesResponse to faculty questions are answered if posedProvides clear, concise opinions and ideas that are supported by two or more credible sourcesResponse is effectively written in Standard Edited English | Points Range: 5 (5%) – 5 (5%)Communication is mostly professional and respectful to colleaguesResponse to faculty questions are mostly answered if posedProvides opinions and ideas that are supported by few credible sourcesResponse is written in Standard Edited English | Points Range: 4.5 (4.5%) – 4.5 (4.5%)Responses posted in the discussion may lack effective professional communicationResponse to faculty questions are somewhat answered if posedFew or no credible sources are cited | Points Range: 0 (0%) – 4 (4%)Responses posted in the discussion lack effectiveResponse to faculty questions are missingNo credible sources are cited |
Second Response: Timely and full participation | Points Range: 5 (5%) – 5 (5%)Meets requirements for timely and full participationPosts by due date | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)NA | Points Range: 0 (0%) – 0 (0%)Does not meet requirement for full participation |