Multan College of Nursing, MMDC Multan.

Annual Master Plan

Advanced Health Assessment 2019-20
MSc Nursing 1st Year

Course Name Health Assessment

Course
Credit allocated Classroom: 03
Laboratory:
Clinical:
Total: 03
Placement in Curriculum: MSC Nursing YEAR I
Pre-requisite: Anatomy & Physiology
Co-requisite Course: Advance Concept in Nursing
Course Faculty: Farhan Mukhtar
Lecture Day & Timings Monday: 2:30pm – 4:30pm

Tuesday: 4:30 pm – 5:30 pm

COURSE DESCRIPTION:

An introduction to the content and skills needed to assess the basic health status of individuals of
varying ages. These skills can be applied to nursing care in a wide variety of clinical settings. This
course emphasizes history taking and physical examination skills.

COURSE OBJECTIVES:
By the completion of Year I, learners will be able to:

1. Systematically assess the health status of an individual by obtaining a complete health history
using interviewing skills appropriately.
2. Utilize proper techniques of observation and physical examination in assessing various body
systems.
3. Differentiate normal from abnormal findings.
4. Record findings in an appropriate manner.

5. Demonstrate an awareness of the need to incorporate health assessment as part of their

general practice skills.
6. Apply knowledge of growth &
development, anatomy, physiology, &psychosocial skills in assessment &analysis of data
collected.

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Teaching/Learning Strategies;

Interactive lectures, small group discussion, group presentation, case studies, simulation
exercises and role play, videotaping, demonstration, movies & lab practice.

Course Expectation;

1. Active participation in all class and clinical.

2. Pre and Post Readings
3. Completion of all assignments on due dates.
4. Students are expected to “Pass” clinical rotation satisfactorily.

Outcome:
The students are expected to perform and apply nursing health assessment with
regards to patient care, to formulate nursing diagnoses, and identify health
problems.

Suggested reading:

Nurses’ Handbook of Health Assessment, 4th ed., Lippincott, Janet R.

Weber Nursing Health Assessment – Concepts and Activities,

Margaret A. Fitzgerald Manual of Nursing Practice, Lippincott, 8th

ed., William & Wilkins

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Topical Outline
Advanced Health & Clinical Assessment

Unit 1 The Nursing Health History

Unit 2 Components of Nursing Health History
Unit 3 Physical Assessment and General Physical survey

 Skin, hair and nail assessment

- subjective and objective data focus questions,
- objective data assessment techniques
- skin inspection and palpation
- scalp inspection and palpation
- nail inspection and palpation
- teaching tips and nursing management for selected
nursing diagnoses

 Head, neck and cervical lymph node assessment

- subjective and objective data focus question
- face and neck palpation, trachea/thyroid/lymph node
palpation
- teaching tips and nursing management for selected
nursing diagnoses

 Mouth, nose and sinus assessment

- subjective and objective data focus questions
- inspection of mouth, nose and sinus
- teaching tips and nursing management for selected
nursing diagnoses

 Eye assessment
- subjective and objective data focus question
- external eyes inspection (eyelids/lashes)
- eye functioning test (visual acuity, peripheral vision
- accommodation
- extraocular movements
- response to light, abnormal eye movement)
- ophthalmic examination (red reflex, inspect optic disc,
retinal vessel, retinal background)
- teaching tips and nursing management for selected
nursing diagnoses

 Ear assessment
- subjective and objective data focus question
- inspect external ear (size, shape, lesion, discoloration)
- palpate external ear (mastoid process – tenderness,
temperature, edema)
- inspect auditory canal with otoscope (cerumen,
appearance, tenderness),
- inspect tympanic membrane with otoscope (color,
consistency, landmarks)
- assess auditory function (gross hearing ability, lateral
sound, comparison of air conduction)
- teaching tips and nursing management for selected
nursing diagnoses

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 Thoracic and lung assessment
- subjective and objective data focus question
- Inspection (lateral, posterior and anterior thorax – color,
intercostals spaces, chest symmetry, respiration,
shape/position of sternum, chest expansion)
- palpation (palpate the thorax – sensation, vocal/sound,
thoracic expansion)
- percussion (resonance, diaphragmatic excursion
bilaterally)
- auscultation (breath sounds, altered voice sound),
teaching tips and nursing management for selected
nursing diagnoses

 Cardiac assessment
- subjective and objective data focus question
- inspection to identify landmarks and any abnormal
pulsation
- palpation (aortic area, pulmonic area, tricuspid area,
mitral area),
- percussion – to define cardiac borders and area of
dullness
- auscultation (heart sound, rate/rhythm)
- teaching tips and nursing management for selected
nursing diagnoses

 Abdominal assessment
- subjective and objective data focus question
- inspection - skin color, venous pattern, skin integrity,
umbilicus, surface motion, symmetry, contour
- auscultation - bowel sounds, vascular sounds
- percussion - all four quadrants, liver area, spleen area
- palpation - all four quadrants – tenderness, consistency,
masses, kidneys, abdominal girth
- teaching tips and nursing management for selected
nursing diagnoses

 Genitourinary/reproductive assessment – female genitalia, male

genitalia, inguinal area, external rectal examination
- subjective and objective data focus question
- inspection
female – labia, urinary meatus, vaginal orifice, vaginal
wall

male – observe penis, discharge, skin texture, observe

glans for shape, size and lesions
- palpate - masses, tenderness, discharge, foreskin
- inspection - inguinal area
- assessment of external rectal area, peri-anal area color,
masses or discharge, sacrococcygeal area for color, hair
and texture
- teaching tips and nursing management for selected
nursing diagnoses

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 Musculo-skeletal assessment
- subjective and objective data focus question
- inspection of gait
- inspection and palpation of spine, shoulder, posterior
iliac crest
- palpation and inspection of head, neck, facial structure,
muscle development, inspect and palpate upper and
lower extremities, inspect for range of motion
- teaching tips and nursing management for selected
nursing diagnoses.

 Neurological assessment
- subjective and objective data focus question
- mental status assessment - appearance & movement,
posture, gait, motor movement, hygiene, facial
expression, speech
- observe mood - feelings, expressions, thought process,
perceptions, clarity
- cognition/level of consciousness, memory, abstract
reasoning
- ability to make sound
- ability to identify similarities, sensory perception and
coordination
- cranial nerve assessment - scent, assess vision, assess
pupils, ability to feel/touch, assess jaw jerk, assess
hearing
- sensory nerve assessment - primary sensation, cortical
and discriminatory sensation
- motor assessment – voluntary movements, deep tendon
reflexes, bicep reflex, triceps reflex, patella reflex,
achilles reflex, babinski reflex, decortication,
decerebration
- teaching tips and nursing management for selected
nursing diagnoses.

 Nutritional assessment
- subjective and objective data focus question
- general inspection - muscle mass, body fat, posture,
energy level, frame size, weight/height, mid-arm
circumference, triceps skin fold, hypoglycemia,
hyperglycemia, electrolyte imbalance
- teaching tips and nursing management for selected
nursing diagnoses.

 Prenatal/intra-partum/postpartum assessment
- Prenatal - Subjective and objective focus question, weight,
vital signs, skin color, edema of extremities, assess breast (size,
tenderness, vascularization), urine consistency, vaginal
discharge, inspect pelvic joints, gait, leg cramps), neurological
status, palpate outline of fetus, fundal height, fetal heart sound
and movement, altered nutrition, teaching tips and nursing
management for selected nursing diagnoses.

-Intra-partum – Abdominal assessment (uterine size/shape,

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 frequency/duration/intensity of contraction, monitor fetal heart
beat, peri-anal assessment (lesion, discharge, swelling),
position, effacement, dilatation, presentation, acute pain, vital
signs

- Post partum – Monitor vital signs, inspect breast (nipples,

discharge, texture, size), inspect abdomen (size, color, texture),
palpate fundus (location, consistency, height, expression of
clots), inspect extremities for edema, inspect voiding (amount,
color), inspect perineum (episiotomy/laceration, swelling, color,
lochia, odor), teaching tips and nursing management for
selected nursing diagnoses.
Unit 4 Psychosocial assessment
- Psychosocial Issues in special health setting
- Common psychiatric disorders in general health setting
- Psychosocial aspects of pain
- Psychosocial aspects of sleep and awareness
- Psychosocial aspects of aging
Unit 5 Nursing assessment based on functional health patterns
Unit 6 Assessment of family functional health patterns
Unit 7 Nursing diagnoses according to functional health patterns
- health perception management pattern
- nutritional – metabolic pattern
- elimination pattern, activity/exercise pattern
- sexuality/reproductive pattern, sleep/rest pattern
- sensory/perceptual pattern
- cognitive pattern
- role/relationship pattern
- self perception/self concept pattern
- coping stress tolerance pattern
- value/belief pattern

Unit 8 Nursing Diagnoses and Clinical Interventions

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 Annual Lecture Plan-2019-20

S.No Day Date Class Timing Topics

April-2019
1 Wednesday 03-04-2019 2:30pm-4:30pm Introduction to Course grid
2 Thursday 04-04-2019 4:30pm-5:30pm Basic concepts of Health Assessment.
3 Wednesday 10-04-2019 3:00pm- 4:00pm Basic concepts of Health Assessment.
4 Thursday 11-04-2019 4:30pm-5:30pm Health history Interviewing skills
5 Wednesday 24-04-2019 2:30pm-4:30pm Practice Interviewing
6 Thursday 25-04-2019 4:30pm-5:30pm Physical Examination& Gordon FHP
May 2019
Ramadan & Eid –Ul- Fitar
June 2019
11 Wednesday 10-06-2019 2:30pm4:30pm Assessment of thorax and lungs
12 Thursday 11-06-2019 4:30pm5:30pm Assessment of thorax and lungs Cont……..
13 Wednesday 17-06-2019 2:30pm4:30pm Assessment of thorax and lungs Cont……..
14 Thursday 18-06-2019 4:30pm5:30pm Assessment of thorax and lungs Cont……..
15 Wednesday 24-06-2019 2:30pm4:30pm Assessment of thorax and lungs Cont……..
16 25-06-2019 4:30pm- Test No. 2
5:30pm

JULY 2019
17 Monday 01-07-2019 2:30pm-4:30pm Assessment of cardiovascular system.
18 Tuesday 02-07-2019 4:30pm-5:30pm Assessment of cardiovascular system Cont
19 Monday 08-07-2019 2:30pm-4:30pm Assessment of cardiovascular system Cont
20 Tuesday 09-07-2019 4:30pm-5:30pm Assessment of cardiovascular system Cont
21 Monday 15-07-2019 2:30pm-4:30pm Assessment of cardiovascular system Cont
22 Tuesday 16-07-2019 4:30pm-5:30pm Assessment of cardiovascular system (Lab)
23 Monday 22-07-2019 2:30pm-4:30pm Test No.3
24 Tuesday 23-07-2019 4:30pm-5:30pm Discussion
25 Monday 29-07-2019 2:30pm-4:30pm Assessment of Head & Neck
26 Tuesday 30-07-2019 4:30pm-5:30pm Assessment of Head & Neck Cont
August 2019
27 Monday 05-08-2019 2:30pm-4:30pm Assessment of Nose, Mouth and Pharynx
28 Tuesday 06-08-2019 4:30pm-5:30pm Assessment of Breast & Axilla
EID-UL-AZHA 12-14 AUGUST
29 Monday 19-08-2019 4:30pm-5:30pm Assessment of Abdominal System
30 Wednesday 20-08-2019 4:30pm-5:30pm Assessment of Abdominal System Cont
31 Thursday 26-08-2019 4:30pm-5:30pm Assessment of Abdominal System cont
32 Wednesday 27-08-2019 2:30pm-4:30pm Assessment of Abdominal System cont
SEPTEMBER 2019

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33 Monday 02-09-2019 2:30pm-4:30pm Assessment of Abdominal System cont
34 Tuesday 03-09-2019 4:30pm-5:30pm Assessment of Abdominal System Lab
DEFENCE DAY 6 SEPTEMBER
YOM-E-ASHURA ---- 09-10 SEPTEMBER
35 Monday 16-09-2019 2:30pm-4:30pm Assessment of Nervous system
36 Tuesday 17-09-2019 4:30pm-5:30pm Assessment of Nervous system Cont
37 Monday 23-09-2019 2:30pm-4:30pm Assessment of Nervous system Cont
38 Tuesday 24-09-2019 4:30pm-5:30pm Assessment of Nervous system Cont
39 Monday 30-09-2019 2:30pm-4:30pm Assessment of Nervous system (Lab)
OCTOBER 2019
40 Tuesday 01-10-2019 4:30pm-5:30pm Test 4
41 Monday 07-10-2019 2:30pm-4:30pm Discussion
42 Tuesday 08-10-2019 4:30pm-5:30pm Assessment of the musculoskeletal system
43 Monday 14-10-2019 2:30pm-4:30pm Assessment of the musculoskeletal system Cont
44 Tuesday 15-10-2019 4:30pm-5:30pm Assessment of the musculoskeletal system Cont
45 Monday 21-10-2019 2:30pm-4:30pm Assessment of the musculoskeletal system Cont
46 Tuesday 22-10-2019 4:30pm-5:30pm Assessment of the musculoskeletal system (Lab)
47 Monday 28-10-2019 2:30pm-4:30pm Test No.5
Test Discussion
NOVEMBER 2019
48 Monday 04-11-2019 4:30pm-5:30pm Assessment of female genitalia
49 Tuesday 05-11-2019 2:30pm-4:30pm Assessment of male genitalia
50 Monday 11-11-2019 4:30pm-5:30pm Assessment of female, male genitalia (Lab)
51 Tuesday 12-11-2019 2:30pm-4:30pm Assessment of eyes and ears
52 Monday 18-11-2019 4:30pm-5:30pm Assessment of eyes and ears (Lab)
53 Tuesday 18-11-2019 2:30pm-4:30pm Test No.6
54 Monday 25-11-2019 4:30pm-5:30pm Nutritional Assessment
55 Tuesday 26-11-2019 2:30pm-4:30pm Prenatal/intra-partum/postpartum assessment

DECEMBER 2019
56 Monday 02-12-2019 2:30pm-4:30pm Prenatal/intra-partum/postpartum assessment
cont
57 Tuesday 03-12-2019 4:30pm-5:30pm Psychological Assessment
58 Monday 09-12-2019 2:30pm-4:30pm Psychological Assessment of pain
59 Tuesday 10-12-2019 4:30pm-5:30pm Psychological Assessment of sleep & awareness
60 Monday 16-12-2019 2:30pm-4:30pm Psychological Assessment of aging
61 Tuesday 17-12-2019 4:30pm-5:30pm Test No. 7
Winter vocations

Required Text Book:

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 1. Janet Weber, J Kelley. (2010). Lab Manual to accompany Health
Assessmentin Nursing 4th edition. Lippincott Williams & Wilkins Philadelphia
.New York London.

Reference Books:
2. L.S.Bickley. (Bates)Guide to Physical Examination and History taking. (10th
edition) Lippincott William.New YorkLondon.
3. J.Weber.Nurses handbook of Health Assessment (6th edition)Lippincott
William.New York London.
4. Koizer. Fundamental of Nursing.
5. Jarvis’s, Health Assessment

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