Assignment 1: Digital Clinical Experience: Assessing the Heart Lungs and Peripheral Vascular System

Assignment 1: Digital Clinical Experience: Assessing the Heart Lungs and Peripheral Vascular System

Assignment 1: Digital Clinical Experience: Assessing the Heart Lungs and Peripheral Vascular System

Assignment 1: Digital Clinical Experience:
Assessing the Heart, Lungs, and Peripheral
Vascular System

Photo Credit: [Squaredpixels]/[E+]/Getty Images

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 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.
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 and Grading Information

By Day 7 of Week 7
 Complete your Focused Exam: Chest Pain DCE Assignment in Shadow Health via the
Shadow Health link in Blackboard.
 Once you complete your Assignment in Shadow Health, you will need to download your
lab pass and upload it to the corresponding Assignment in Blackboard 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-pass
 Once you submit your Documentation Notes to Shadow Health, make sure to copy and
paste the same Documentation Notes into your Assignment submission link below.
 Download, sign, date, and submit your Student Acknowledgement Form found in the
Learning Resources for this week.
Grading Criteria

To access your rubric:
Week 7 Assignment 1 DCE Rubric

Submit Your Assignment by Day 7 of Week 7

To submit your Lab Pass:
Week 7 Lab Pass

To participate in this Assignment:
Week 7 Documentation Notes for Assignment 1

To Submit your Student Acknowledgement Form:
Submit your Week 7 Assignment 1 DCE Student Acknowledgement Form

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 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.
Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA:
F. A. Davis.

 Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487) (previously read
in Week 6; specifically focus on pp. 480–481)
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”
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”
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”
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”
This chapter describes the different causes of heart palpitations and details how
the specific cause in a patient can be determined.

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.

Note: Download the Student Checklists and Key Points to use during your
practice cardiac and respiratory examination.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Chest and lungs: 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).
Chest and lungs: 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).
Heart: 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).
Heart: 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.

Katz, J. N., Lyons, N., Wolff, L. S., Silverman, J., Emrani, P., Holt, H. L., …
Losina, E. (2011). Medical decision-making among Hispanics and non-Hispanic
Whites with chronic back and knee pain: A qualitative study. BMC
Musculoskeletal Disorders, 12(1), 78–85.

This study examines the medical decision making among Hispanics
and non-Hispanic whites. The authors also analyze the preferred
information sources used for making decisions in these populations.

Smuck, M., Kao, M., Brar, N., Martinez-Ith, A., Choi, J., & Tomkins-Lane, C. C.
(2014). Does physical activity influence the relationship between low back pain
and obesity? The Spine Journal, 14(2), 209–216.
doi:10.1016/j.spinee.2013.11.010

Shiri, R., Solovieva , S., Husgafvel-Pursiainen, K., Telama, R., Yang, X., Viikari,
J., Raitakari, O. T., & Viikari-Juntura, E. (2013). The role of obesity and physical
activity in non-specific and radiating low back pain: The Young Finns study.
Seminars in Arthritis & Rheumatism, 42(6), 640–650.
doi:10.1016/j.semarthrit.2012.09.002

McCabe, C., & Wiggins, J. (2010a). Differential diagnosis of respiratory disease
part 1. Practice Nurse, 40(1), 35–41.

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.

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.

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: 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:
Chest Pain (Word document)
Use this template to complete your Assignment 1 for this week.

Optional Resource
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.

Required Media (click to expand/reduce)

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)

Photo Credit:Provided courtesy of the Laureate International Network of Universities.

Assessment of the Heart, Lungs, and Peripheral Vascular System – Week

7 (28m)

SkillStat Learning, Inc. (2019). 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.

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/