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NURS 6512 Week 5 Assignment 3: (Optional) Practice Assessment: Skin, Hair, and Nails Examination

NURS 6512 Week 5 Assignment 3: (Optional) Practice Assessment: Skin, Hair, and Nails Examination

Advanced practice nurses are required to have the skills and knowledge necessary to
perform many different physical assessments and health examinations. In this course,
you will demonstrate your abilities in this area by conducting various optional
examinations on a volunteer “patient.”
In preparation for the Comprehensive (Head-to-Toe) Physical Assessment due in Week
9, it is recommended that you practice conducting an assessment of the skin, hair, and
nails this week.
Note: This is an optional practice physical assessment.
To Prepare
 Arrange an appropriate time and setting with your volunteer “patient” to perform a skin,
hair, and nails examination.
 Download and review the Skin, Hair, and Nails Student Checklist and Key Points,
provided in this week’s Learning Resources, and review the Seidel's Guide to Physical
Examination online media.
Optional Lab Assignment
 Perform the skin, hair, and nails examination, covering all of the areas listed in the
checklist.

What's Coming Up in Week 5?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you examine how to properly assess the head, neck, eyes, ears, nose, and
throat in order to form accurate diagnoses as you complete your Case Study
Assignment of the Skin, Hair, Nails, and HEENT. You will once again complete a DCE
related to a Focused Exam for cough. Make sure to plan ahead with your Please plan
your time accordingly.
Week 5 Required Media
Photo Credit: [fergregory]/[iStock / Getty Images Plus]/Getty Images
Next week, you will need to view several videos and animations in the Seidel’s Guide to
Physical Examination as well as other media, as required, prior to completing your Case
Study Assignment. There are several videos of various lengths. Please plan ahead to
ensure you have time to view these videos and animations to complete your
Assignment on time.
Next Week
To go to the next week:
Week 5

Week 5: Assessment of Head, Neck, Eyes,

Ears, Nose, and Throat

Emily, age 15, is brought to your clinic complaining of chills, aches, and a sore throat.
Without any testing, consider all of the possible diagnoses. It could be a cold, the flu,
bronchitis, or even something more serious, such as meningitis or mononucleosis.
Assessing the actual cause will involve much more than simple visual inspection. Some
conditions are so subtle that they require the use of special instruments and tests in
addition to a trained eye and ear.
This week, you will explore how to assess the head, neck, eyes, ears, nose, and throat.
Whether dealing with a detached retina, sinusitis, meningitis, or even cough, advanced
practice nurses need to know the proper assessment techniques in order to form
accurate diagnoses.
Learning Objectives
Students will:
 Apply assessment skills to diagnose eye, ear, and throat conditions
 Apply concepts, theories, and principles relating to health assessment techniques and
diagnoses for the head, neck, eyes, ears, nose, and throat
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 11, “Head and Neck”
This chapter reviews the anatomy and physiology of the head and neck.
The authors also describe the procedures for conducting a physical
examination of the head and neck.

 Chapter 12, “Eyes”
In this chapter, the authors describe the anatomy and function of the eyes.
In addition, the authors explain the steps involved in conducting a physical
examination of the eyes.

 Chapter 13, “Ears, Nose, and Throat”
The authors of this chapter detail the proper procedures for conducting a
physical exam of the ears, nose, and throat. The chapter also provides

pictures and descriptions of common abnormalities in the ears, nose, and
throat.
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 15, “Earache”

NURS 6512 Week 5 Assignment 3 Optional Practice Assessment Skin, Hair, and Nails Examination

NURS 6512 Week 5 Assignment 3 Optional Practice Assessment Skin, Hair, and Nails Examination

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This chapter covers the main questions that need to be asked about the
patient’s condition prior to the physical examination as well as how these
questions lead to a focused physical examination.
Chapter 21, “Hoarseness”
This chapter focuses on the most common causes of hoarseness. It
provides strategies for evaluating the patient, both through questions and
through physical exams.
Chapter 25, “Nasal Symptoms and Sinus Congestion”

In this chapter, the authors highlight the key questions to ask about the
patients symptoms, the key parts of the physical examination, and
potential laboratory work that might be needed to provide an accurate
diagnosis of nasal and sinus conditions.
Chapter 30, “Red Eye”

The focus of this chapter is on how to determine the cause of red eyes in
a patient, including key symptoms to consider and possible diagnoses.
Chapter 32, “Sore Throat”

A sore throat is one most common concerns patients describe. This
chapter includes questions to ask when taking the patient’s history, things
to look for while conducting the physical exam, and possible causes for
the sore throat.
Chapter 38, “Vision Loss”
This chapter highlights the causes of vision loss and how the causes of
the condition can be diagnosed.

Note: Download the six documents (Student Checklists and Key Points)
below, and use them as you practice conducting assessments of the
head, neck, eyes, ears, nose, and throat.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Head and neck: Student checklist. 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.
Ball, J. W., Dains, J. E., Flynn, J. A., & Solomon, B. S., & Stewart, R. W.
(2019). Head and neck: 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.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Eyes: Student checklist. 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.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Eyes: 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.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Ears, nose, and throat: Student checklist. 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.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Ears, nose, and throat: 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.

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.

 Chapter 71, “Visual Function Evaluation: Snellen, Illiterate E, Pictorial

This section explains the procedural knowledge needed to perform eyes,
ears, nose, and mouth procedures.
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, 3, 4, and 5)
Bedell, H. E., & Stevenson, S. B. (2013). Eye movement testing in clinical
examination. Vision Research 90, 32–37.
doi:10.1016/j.visres.2013.02.001. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0042698913000217
Rubin, G. S. (2013). Measuring reading performance. Vision Research,
90, 43–51. doi:10.1016/j.visres.2013.02.015. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0042698913000436

Harmes, K. M., Blackwood, R. A., Burrows, H. L., Cooke, J. M., Harrison,
R. V., & Passamani, P. P. (2013). Otitis media: Diagnosis and treatment.
American Family Physicians, 88(7), 435–440.

Otolaryngology Houston. (2014). Imaging of maxillary sinusitis (X-ray, CT,
and MRI). Retrieved from
http://www.ghorayeb.com/ImagingMaxillarySinusitis.html

This website provides medical images of sinusitis, including X-rays, CT
scans, and MRIs (magnetic resonance imaging).
Document: Episodic/Focused SOAP Note Exemplar (Word document)

Document: Episodic/Focused SOAP Note Template (Word document)

Document: Midterm Exam Review (Word document)
Shadow Health Support and Orientation 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: 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 Focused
Exam: Cough (Word document)
Use this template to complete your Assignment 2 for this week.

Optional Resource
Use the following resources to guide you through your Shadow Health orientation
as well as other support resources:
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s
diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.

 Chapter 7, “The Head and Neck” (pp. 178–301)

This chapter describes head and neck examinations that can be made
with general clinical resources. Also, the authors detail syndromes of
common head and neck conditions.
Required Media (click to expand/reduce)
Online media for Seidel's Guide to Physical Examination
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 10, 11, and 12 that relate to the assessment of the head,

neck, eyes, ears, nose, and throat. Refer to the Week 4 Learning Resources
area for access instructions on https://evolve.elsevier.com/.
University of Iowa Ophthalmology. (2016, December 19). Fluorescein
staining of the cornea. Retrieved from https://vimeo.com/198695974
Credit Line: University of Iowa Ophthalmology. (n.d.). Fluorescein staining of the cornea [Video file]. Retrieved from
​https://vimeo.com/198695974. The author(s) and publishers acknowledge the University of Iowa and EyeRounds.org
for permission to reproduce this copyrighted material.

Note: Approximate length of this media program is 25 seconds.

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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