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NURS 6512N 32 Week 4 Assignment 2 Digital Clinical Experience

NURS 6512N 32 Week 4 Assignment 2: Digital Clinical Experience

(DCE): Health History Assessment
A comprehensive health history is essential to providing quality care for patients across
the lifespan, as it helps to properly identify health risks, diagnose patients, and develop
individualized treatment plans. To effectively collect these heath histories, you must not
only have strong communication skills, but also the ability to quickly establish trust and
confidence with your patients. For this DCE Assignment, you begin building your
communication and assessment skills as you collect a health history from a volunteer
"patient."
Photo Credit: Sam Edwards / Caiaimage / Getty Images
To Prepare
 Review this week’s Learning Resources as well as the Taking a Health History media
program, and consider how you might incorporate these strategies. Download and
review the Student Checklist: Health History Guide and the History Subjective Data
Checklist, provided in this week's Learning Resources, to guide you through the
necessary components of the assessment.

 Access and login to Shadow Health using the link in the left-hand navigation of the
Blackboard classroom.
 Review the Shadow Health Student Orientation media program and the Useful Tips and
Tricks document provided in the week’s Learning Resources to guide you through
Shadow Health.
 Review the Week 4 DCE Health History Assessment Rubric, provided in the
Assignment submission area, for details on completing the Assignment.
DCE Health History Assessment:
Complete the following in Shadow Health:
Orientation
 DCE Orientation (15 minutes)
 Conversation Concept Lab (50 minutes)
Health History
 Health History of Tina Jones (180 minutes)
Note: Each Shadow Health Assessment may be attempted and reopened as many
times as necessary prior to the due date to achieve 80% or better, but you must take all
attempts by the Week 4 Day 7 deadline.
Submission and Grading Information
No Assignment submission due this week but will be due Day 7, Week 4.
Grading Criteria
To access your rubric:
Week 4 Assignment 2 DCE Rubric

What's Coming Up in Module 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 3, you will examine advanced health assessments using a system focused
approach.
Next week, you will specifically explore how to assess the skin, hair, and nails, as well
as how to evaluate abnormal skin findings while conducting health assessments. You
will also complete your first Lab Assignment: Differential Diagnosis for Skin Conditions
as well as complete your DCE: Health History Assessment in the simulation tool,
Shadow Health.
Week 4 Required Media
Photo Credit: [fergregory]/[iStock / Getty Images Plus]/Getty Images
Next week, you will need to view several videos and animations in Seidel’s Guide to
Physical Examination as well as other media, as required, prior to completing your Lab
Assignment. There are several videos in varied lengths. Please plan ahead to ensure
you have time to view these media programs to complete your Assignment on time.
Next Module

To go to the next module:
Module 3

Module 3: Approach to System-Focused Advanced Health Assessments
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What's Happening in This Module?
Module 3: Approach to System-Focused Advanced Health Assessments is a 7-week module that
spans Weeks 4–10. In this module, you explore advanced health assessments using a system-
focused approach. Assessments such as skin, hair, and nails as well as head, neck eyes, ears,
nose, and throat (HEENT) help you to begin considering abnormalities as you move forward in
your assessments. You continue the module by assessing the abdomen and gastrointestinal
system and move to other systems—such as heart, lungs, vascular, musculoskeletal,
neurologic—before finishing with other special examinations.
What do I have to do? When do I have to do it?

Review your Learning Resources. Days 1–7, Weeks 4, 5, 6,

7, 8, 9, and 10

DCE: Health History Assessment

Complete and submit your
DCE: Health History
Assessment by Day 7 of
Week 4.

Lab Assignment: Differential Diagnosis for Skin
Conditions

Submit your Lab
Assignment by Day 7 of
Week 4.

Case Study Assignment: Assessing the Head, Eyes, Ears,
Nose, and Throat

Submit your Case Study
Assignment by Day 6 of
Week 5.

DCE: Focused Exam: Cough

Complete and submit your
DCE: Focused Exam:
Cough by Day 7 of Week
5.

Lab Assignment: Assessing the Abdomen

Submit your Lab
Assignment by Day 7 of
Week 6.

Midterm Exam Complete by Day 7 of

Week 6.

DCE: Focused Exam: Chest Pain

Complete and submit your
DCE: Focused Exam:
Chest Pain by Day 6 of

NURS 6512N 32 Week 4 Assignment 2 Digital Clinical Experience

NURS 6512N 32 Week 4 Assignment 2 Digital Clinical Experience

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Week 7.

Discussion: Assessing Musculoskeletal Pain

Post by Day 3 of Week 8
and respond to your
colleagues by Day 6 of
Week 8.

Case Study Assignment: Assessing Neurological Symptoms

Submit your Case Study
Assignment by Day 6 of
Week 9.

DCE: Comprehensive (Head-to-Toe) Physical Assessment

Complete and submit your
DCE: Comprehensive
Physical Assessment
by Day 7 of Week 9.

Lab Assignment: Assessing the Genitalia and Rectum

Submit your Lab
Assignment by Day 7 of
Week 10.

Go to the Module's Content

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

Week 10

Week 4: Assessment of the Skin, Hair, and

Nails

Something as small and simple as a mole or a discolored toenail can offer meaningful
clues about a patient’s health. Abnormalities in skin, hair, and nails can provide non-
invasive external clues to internal disorders or even prove to be disorders themselves.
Being able to evaluate such abnormalities of the skin, hair, and nails is a diagnostic
benefit for any nurse conducting health assessments.
This week, you will explore how to assess the skin, hair, and nails, as well as how to
evaluate abnormal skin findings.
Learning Objectives
Students will:

  Apply assessment skills to diagnose skin conditions

 Apply concepts, theories, and principles relating to health assessment techniques and
diagnoses for the skin, hair, and nails

Learning Resources

Required Readings (click to expand/reduce)
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 9, “Skin, Hair, and Nails”
This chapter reviews the basic anatomy and physiology of skin, hair, and
nails. The chapter also describes guidelines for proper skin, hair, and nails
assessments.
Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia,
PA: F. A. Davis.
Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company.
Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.

This section explains the procedural knowledge needed prior to
performing various dermatological procedures.
Chapter 1, “Punch Biopsy”
Chapter 2, “Skin Biopsy”

Chapter 10, “Nail Removal”
Chapter 15, “Skin Lesion Removals: Keloids, Moles, Corns, Calluses”
Chapter 16, “Skin Tag (Acrochordon) Removal”
Chapter 22, “Suture Insertion”
Chapter 24, “Suture Removal”
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 28, “Rashes and Skin Lesions”
This chapter explains the steps in an initial examination of someone with
dermatological problems, including the type of information that needs to
be gathered and assessed.
Note: Download and use the Student Checklist and the Key Points when
you conduct your assessment of the skin, hair, and nails in this Week’s
Lab Assignment.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Skin, hair, and nails: Student checklist. In Seidel's guide to
physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the
Copyright Clearance Center.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Skin, hair, and nails: Key points. In Seidel's guide to physical
examination: An interprofessional approach (9th ed.). St. Louis, MO:
Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the
Copyright Clearance Center.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.).
Philadelphia, PA: F. A. Davis.

 Chapter 2, "The Comprehensive History and Physical Exam" (Previously
read in Weeks 1 and 3)

VisualDx. (n.d.). Clinical decision support. Retrieved June 11, 2019, from
http://www.skinsight.com/info/for_professionals

This interactive website allows you to explore skin conditions according to
age, gender, and area of the body.

Clothier, A. (2014). Assessing and managing skin tears in older people.
Nurse Prescribing, 12(6), 278–282.

Document: Skin Conditions (Word document)

This document contains five images of different skin conditions. You will
use this information in this week’s Discussion.
Document: Comprehensive SOAP Exemplar (Word document)
Document: Comprehensive SOAP Template (Word document)
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation
as well as other support resources:
Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file].
Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkY
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from https://support.shadowhealth.com/hc/en-us
Document: Shadow Health. (2014). Useful tips and tricks (Version 2)
(PDF)
Document: Shadow Health Nursing Documentation Tutorial (Word
document)
Document: Student Acknowledgement Form (Word document)
Note: You will sign and date this form each time you complete your DCE
Assignment in Shadow Health to acknowledge your commitment to
Walden University’s Code of Conduct.

Document: DCE (Shadow Health) Documentation Template for Health
History (Word document)
Use this template to complete your Assignment 2 for this week.

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 6, “The Skin and Nails”
In this chapter, the authors provide guidelines and procedures to aid in the
diagnosis of skin and nail disorders. The chapter supplies descriptions and
pictures of common skin and nail conditions.
Ethicon, Inc. (n.d.-a). Absorbable synthetic suture material. Retrieved from
https://web.archive.org/web/20170215015223/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/a
bsorbable_suture_chart.pdf
Ethicon, Inc. (2006). Dermabond topical skin adhesive application
technique. Retrieved from
https://web.archive.org/web/20150921174121/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/d
b_application_poster.pdf
Ethicon, Inc. (2001). Ethicon needle sales types. Retrieved from
https://web.archive.org/web/20150921171922/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/n
eedle_template.pdf
Ethicon, Inc. (n.d.-b). Ethicon sutures. Retrieved from
https://web.archive.org/web/20150921202525/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/s
uture_chart_ethicon.pdf
Ethicon, Inc. (2002). How to care for your wound after it's treated with
Dermabond topical skin adhesive. Retrieved from
https://web.archive.org/web/20150926002534/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/d
b_wound_care.pdf

Ethicon, Inc. (2005). Knot tying manual. Retrieved from
https://web.archive.org/web/20160915214422/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/k
not_tying_manual.pdf
Ethicon, Inc. (n.d.-c). Wound closure manual. Retrieved from
https://web.archive.org/web/20170829043048/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/et
h

Required Media (click to expand/reduce)

Module 3 Introduction

Dr. Tara Harris reviews the overall expectations for Module 3. Consider
how you will manage your time as you review your media and Learning
Resources for your Discussions, Case Study Lab Assignments, DCE

Assignments, and your Midterm exam (12m).

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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 online resources included with the text, Seidel's Guide to Physical
Examination. Focus on the videos and animations in Chapter 8 that relate to the
assessment of the skin, hair, and nails.
Note: To access the online resources included with the text, you need to
complete the FREE online registration that is located
at https://evolve.elsevier.com/cs/product/9780323172660?role=student .
To Register to View the Content
1. Go to https://evolve.elsevier.com/cs/product/9780323172660?role=student
2. Enter the name of the textbook, Seidel's Guide to Physical Examination (name of
text without the edition number) in the Search textbox.
3. Complete the registration process.
To View the Content for this Text
1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from
the textbook will not link directly to the desired online content. Use the
online menu to navigate to the desired content.
Suturing Tutorials
The following suturing tutorials provide instruction on the basic interrupted suture,
as well as the vertical and horizontal mattress suturing techniques
Tulane Center for Advanced Medical Simulation & Team Training. (2010,
July 8). Suturing technique [Video file]. Retrieved from

Note: Approximate length of this media program is 5 minutes.
Mikheil. (2014, April 22). Basic suturing: Simple, interrupted, vertical
mattress, horizontal mattress [Video file]. Retrieved from

Note: Approximate length of this media program is 9 minutes.
Incision and Drainage of an Abscess (a common procedure in primary
care)
New England Journal of Medicine (NEJM). (2013, September 30). NEJM
abscess incision and drainage [Video file]. Retrieved from

q4–Vf2NYfUANEyObfeNm&index=8
Note: Approximate length of this media program is 10 minutes.
Dermablade Use for Shave Biopsies
Dermablade®. (2012, November 9). PersonnaBlades [Video file].
Retrieved from https://www.youtube.com/watch?v=D8u1Y18L9DQ
Note: Approximate length of this media program is 5 minutes.

Name:  Assignment Rubric

  Excellent Good Fair Poor
Summarize your interpretation of the frequency data provided in the output for respondent’s age, highest school grade completed, and family income from prior month. 32 (32%) – 35 (35%)

The response accurately and clearly explains, in detail, a summary of the frequency distributions for the variables presented.

The response accurately and clearly explains, in detail, the number of times the value occurs in the data.

The response accurately and clearly explains, in detail, the appearance of the data, the range of data values, and an explanation of extreme values in describing intervals that sufficiently provides an analysis that fully supports the categorization of each variable value.

The response includes relevant, specific, and appropriate examples that fully support the explanations provided for each of the areas described.

28 (28%) – 31 (31%)

The response accurately summarizes the frequency distributions for the variables presented.

The response accurately explains the number of times the value occurs in the data.

The response accurately explains the appearance of the data, the range of data values, and explains extreme values in describing intervals that provides an analysis which supports the categorization of each variable value.

The response includes relevant, specific, and accurate examples that support the explanations provided for each of the areas described.

25 (25%) – 27 (27%)

The response inaccurately or vaguely summarizes the frequency distributions for the variables presented.

The response inaccurately or vaguely explains the number of times the value occurs in the data.

The response inaccurately or vaguely explains the appearance of the data, the range of data values, and inaccurately or vaguely explains extreme values.

An analysis that may support the categorization of each variable value is inaccurate or vague.

The response includes inaccurate and irrelevant examples that may support the explanations provided for each of the areas described.

0 (0%) – 24 (24%)

The response inaccurately and vaguely summarizes the frequency distributions for the variables presented, or it is missing.

The response inaccurately and vaguely explains the number of times the value occurs in the data, or it is missing.

The response inaccurately and vaguely explains the appearance of the data, the range of data values, and an explanation of extreme values, or it is missing.

An analysis that does not support the categorization of each variable values is provided, or it is missing.

The response includes inaccurate and vague examples that do not support the explanations provided for each of the areas described, or it is missing.

Summarize your interpretation of the descriptive statistics provided in the output for respondent’s age, highest school grade completed, race and ethnicity, currently employed, and family income from prior month. 45 (45%) – 50 (50%)

The response accurately and clearly summarizes in detail the interpretation of the descriptive statistics provided.

The response accurately and clearly evaluates in detail each of the variables presented, including an accurate and complete description of the sample size, the mean, the median, standard deviation, and the size and spread of the data.

40 (40%) – 44 (44%)

The response accurately summarizes the interpretation of the descriptive statistics provided.

The response accurately explains evaluates each of the variables presented, including an accurate description of the sample size, the mean, the median, standard deviation, and the size and spread of the data.

35 (35%) – 39 (39%)

The response inaccurately or vaguely summarizes the interpretation of the descriptive statistics provided.

The response inaccurately or vaguely evaluates each of the variables presented, including an inaccurate or vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data.

0 (0%) – 34 (34%)

The response inaccurately and vaguely summarizes the interpretation of the descriptive statistics provided, or it is missing.

The response inaccurately and vaguely evaluates each of the variables presented, including an inaccurate and vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data, or it is missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3 (3%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 2 (2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion was provided.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 (3%) – 3 (3%)

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 (0%) – 2 (2%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%)

Uses correct APA format with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or 2) APA format errors.

3 (3%) – 3 (3%)

Contains several (3 or 4) APA format errors.

0 (0%) – 2 (2%)

Contains many (≥ 5) APA format errors.

Total Points: 100

Name:  Assignment Rubric

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