BScN 2304

HEALTH ASSESSMENT
THEORY MANUAL

2022-2023
  

BScN 2304 Theory Manual Winter 2023 Page 1 of 34

 WELCOME TO HEALTH ASSESSMENT

THE THEORETICAL COMPONENT OF HEALTH ASSESSMENT IS A HYBRID DESIGN, INCLUSIVE OF WEEKLY

STUDENT INDEPENDENT LEARNING AND TUTORIAL SESSIONS.

ACTIVITIES

Students are required to be self-directed in completing all activities, required readings, videos and other
components posted on the course blackboard site.

IN-CLASS SESSIONS

In-class tutorial sessions will help students apply and consolidate knowledge from the pre-assigned
weeks using activities and class discussions. Students are expected to come with pre-assigned work
completed in order to fully engage in the learning process. Preparation will include completion of weekly
work prior to each tutorial session. Work includes completing the required readings that align with the
weekly learning objectives, assigned videos, and any other assigned components.

Scheduled in-class tutorial sessions will be delivered to support collaborative and interactive learning
where the professor will act as a facilitator and students are active participants.

HEALTH ASSESSMENT LEARNING OBJECTIVES

The Health Assessment Theory manual provides students with the weekly, course learning objectives
and required readings. Students are encouraged to use these learning objectives to guide their learning
each week. Multiple resources including readings, videos and content, will aid the student in addressing
the weekly learning objectives.

Note:

 The student will engage in health promotion and illness prevention strategies relevant to each
week’s content.

 The content in the Jarvis (2019) text on “Special Considerations for Advanced Practice” is not an
expectation of this course.

REQUIRED RESOURCES

Astle, B.J., & Duggleby, W. (Eds.). (2019). Canadian fundamentals of nursing (6th ed.). Elsevier Canada.
(Available at Humber Bookstore)

Jarvis, C. (2019). Physical examination and health assessment (3rd Canadian ed.). Elsevier Canada.

BScN 2304 Theory Manual Winter 2023 Page 2 of 34

 HEALTH ASSESSMENT WEEKLY CONTENT OUTLINE
WEEK SECTION

1 Entry to Practice Expectations

Interviewing
The Complete Health History
General Survey
Culture
Growth & Development
Communication and Documentation

2 Vital Signs (Review)

Symptom and Pain Assessment
Assessment Techniques (IPPA) and the Clinical Setting
3 Thorax and Lungs

4 Heart and Neck Vessels

Peripheral Vascular System

5 Head, Face, and Neck,

Regional Lymphatic System
Eyes 
Ears
Nose, Mouth, and Throat 
6 Skin/Hair/Nails
7 Musculo-Skeletal System

9 Neurological System
Mental Health Assessment
10 Abdomen
Nutritional Assessment
11 Male and Female Genitourinary Systems, Breast & Axillae, Prostate Assessments

12 Clinical Reasoning: Putting it all together

Bedside assessment and electronic health monitoring
Critical thinking and evidence-informed assessment;
priority setting

BScN 2304 Theory Manual Winter 2023 Page 3 of 34

 WEEK ONE

ENTRY-TO-PRACTICE EXPECTATIONS, INTERVIEWING, THE COMPLETE HEALTH HISTORY, GENERAL

SURVEY, CULTURE, GROWTH AND DEVELOPMENT, COMMUNICATION & DOCUMENTATION

RESOURCES

READINGS

Canadian Nurses’ Association. (2011). Position statement: Interprofessional collaboration.

https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/5%20-
%20ps117_interprofessional_collaboration_2011_e.pdf?
Canadian Nurses Association. (2018). Position statement. Promoting cultural competence in nursing.
https://hl-prod-ca-oc-download.s3-ca-central-1.amazonaws.com/CNA/2f975e7e-4a40-45ca-863c-5ebf0a138d5e/UploadedImages/
documents/Position_Statement_Promoting_Cultural_Competence_in_Nursing.pdf

College of Nurses of Ontario. (2019) Entry-to-practice competencies for Registered Nurses.

https://www.cno.org/globalassets/docs/reg/41037-entry-to-practice-competencies-2020.pdf

College of Nurses of Ontario (CNO). (2019). Practice standard: Profesisonal Standards, Revised 2002.
https://www.cno.org/globalassets/docs/prac/41006_profstds.pdf

College of Nurses of Ontario (CNO). (2019). Practice standard: Therapeutic nurse-client relationship,
Revised 2006 (pp. 3-5) https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf

Culturally Connected. (n.d.). Introduction to cultural humility. https://www.culturallyconnected.ca/

Jarvis, C. (2019). General survey, measurement, and vital signs. In A.J. Browne, J. MacDonald- Jenkins, &
M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 153-182). Elsevier
Canada.
Jarvis, C. (2019). The interview. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.). Physical
examination & health assessment (3rd ed., pp. 46-61). Elsevier Canada.
Jarvis, C. (2019). The complete health history. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude
(Eds.). Physical examination & health assessment (3rd ed., pp. 62-77). Elsevier Canada.

Jarvis, C. (2019). The cultural and social considerations in health assessment. In A.J. Browne, J.
MacDonald-Jenkins & M. Luctkar-Flude (Eds.). Physical examination and health assessment (3rd ed.,
pp. 28-43). Elsevier Canada.

National Collaborating Centre for Aboriginal Health. (2013). An overview of Aboriginal health in Canada.
Prince George, BC: University of Northern British Columbia.
https://www.ccnsa-nccah.ca/docs/context/FS-OverviewAbororiginalHealth-EN.pdf
Stickley, T. (2011). From SOLER to SURETY for effective non-verbal communication. Nurse Education in
Practice, 11(6), 395-398.

COMMUNICATION & DOCUMENTATION READINGS

Barry, M. (2019). Documenting and reporting. In B. Astle, W. Duggleby, P. Potter, A. Perry, & P. Stockert,
(Canadian Eds.). Canadian fundamentals of nursing. (6th ed., pp. 233-242). Elsevier Canada.
BScN 2304 Theory Manual Winter 2023 Page 4 of 34
Camera, I. (2019). Bedside assessment and electronic health recording. In A.J. Browne, J. MacDonald-
Jenkins, & M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 848).
Elsevier Canada.

College of Nurses of Ontario. (2008). Practice standard: Documentation.

https://www.cno.org/globalassets/docs/prac/41001_documentation.pdf (pp. 3-8)

College of Nurses of Ontario. (2012). Documentation—An overview. [Video].

https://www.cno.org/en/learn- about-standards-guidelines/educational-tools/learning-
modules/documentation-2010/
College of Nurses of Ontario. (2012). Documentation—Communication. [Video].
https://www.cno.org/en/learn- about-standards-guidelines/educational-tools/learning-
modules/documentation-2010/

College of Nurses of Ontario. (2012). Documentation—Accountability. [Video].

https://www.cno.org/en/learn- about-standards-guidelines/educational-tools/learning-
modules/documentation-2010/
College of Nurses of Ontario. (2012). Documentation—Security. [Video]. https://www.cno.org/en/learn-
about- standards-guidelines/educational-tools/learning-modules/documentation-2010/
Kramer, M.L. & Ryan, S.M. (2019). Nursing assessment and diagnosis. In B.J. Astle, & W. Duggleby (Eds.),

Canadian fundamentals of nursing (6th ed, pp. 187-194). Elsevier Canada.

BScN 2304 Theory Manual Winter 2023 Page 5 of 34

LEARNING OBJECTIVES

ENTRY TO PRACTICE EXPECTATIONS

1. Define ‘competency’ and ‘competent’ as per the CNO (2019) Competencies for Entry-level Registered
Nurse Practice document.
2. Describe and discuss the requirements for entry to practice in the context of completing health
assessments with clients as described through the competencies in the CNO (2019) Entry-level
Registered Nurse Practice document.
3. Discuss professional accountability as outlined by CNO (2019), Practice standard: Professional
Standards.

INTERVIEWING
1. Review and describe the nursing process as it relates to the completion of health assessment, with
clients across the lifespan.
2. List, describe, and demonstrate the five (5) tasks of the successful interview.
3. Define and describe the following terms.
- Unconditional - Clarification
Positive Regard - Facilitation - Interpretation
- Empathy - Silence - Explanation
- Active Listening - Reflection - Summary
4. Describe and discuss the process of communication, including the factors related to attending to the
physical setting.
5. Identify, discuss, and demonstrate different communication techniques that assist the client
narrative.
6. Identify and discuss the three (3) phases of the interview.
7. Differentiate and discuss when and how to use open and closed questions.
8. Identify and discuss the ten (10) Traps to interviewing.
9. Identify, describe, and demonstrate non-verbal modes of communication, including SURETY.
10. Describe developmental, cultural and social considerations as they relate to the Interview.
11. Identify, discuss, and demonstrate effective therapeutic communication skills and their use in client
assessment and care as outlined by CNO (2019), Practice standard: Therapeutic nurse-client
relationship.
12. Discuss ways the nurse would modify interviewing techniques when working with a hearing-
impaired person.
13. Discuss important points to consider when using an interpreter during an interview.

COMPLETE HEALTH HISTORY

BScN 2304 Theory Manual Winter 2023 Page 6 of 34
 1. Explain, differentiate, and demonstrate the collection of subjective and objective data.
2. List the sources of data utilized in history taking.
3. Describe the purpose and steps in taking a health history.
4. Discuss how completing a health history may differ with clients across the lifespan.
5. List, define, and apply terms associated with the mnemonic (OPQRSTUV) used for symptom/pain
assessment.

GENERAL SURVEY

1. Describe the purpose and steps in completing a General Survey.

2. Describe developmental and sociocultural considerations as they relate to the General Survey.
3. Identify the four (4) main areas of the General Survey, and discuss key aspects of each:

- Physical Appearance - Mobility

- Body Structure - Behaviour
CULTURE

1. Define and describe the following terms as they apply to health assessment and nursing care.

- Culture - Cultural safety

- Culturalism - Cultural humility
- Cultural sensitivity - Transcultural nursing
- Cultural competence - Cultural awareness
2. Discuss and apply the relevant components of the Canadian Nurses Association’s documents that
outline expectations for the delivery of culturally appropriate care of clients by nurses in the context
of completing health assessments.
3. Describe the knowledge needed to assess the health needs of the Indigenous client.
4. Describe four (4) elements required to health balance with Indigenous clients.

BScN 2304 Theory Manual Winter 2023 Page 7 of 34

COMMUNICATION & DOCUMENTATION

[NOTE: ADDITIONAL SOAPIE AND DAR LEARNING MATERIALS WILL BE AVAILABLE ON BLACKBOARD.]
1. Describe reasons why documentation is important.
2. Define client confidentiality. Identify the federal legislation that protects client information
confidentiality.
3. List and describe the legal guidelines for documentation (see: Barry (2019) - Table 15-1, p. 235).
4. Describe the benefits of electronic health records.
5. Describe charting by exception and how it is used.
6. Review the three (3) standard statements for the College of Nurses of Ontario (CNO, 2008) Practice
Standard on Documentation and understand the expectations for documenting health assessment
findings.
7. Review and describe communication, accountability, and security requirements for documentation
of client information as outlined in the College of Nurses of Ontario (CNO, 2012) online modules.
8. Describe the different forms of documentation.
9. Describe the purposes for use of military time when documenting health assessment information.
10. Describe and demonstrate Subjective/Objective/Assessment/Planning/Intervention/Evaluation
(SOAPIE) charting.
11. Describe and demonstrate Data/Action/Response (DAR) charting.
12. Describe and demonstrate Subjective/Background/Recommendation technique for report (SBAR).
13. Explore the Canadian Nurses Association’s five (5) main interprofessional collaboration principles
and discuss how the principles facilitate collaboration among professions, professionals, and clients
throughout the assessment process.

BScN 2304 Theory Manual Winter 2023 Page 8 of 34

WEEK TWO

VITAL SIGNS (REVIEW), SYMPTOM AND PAIN ASSESSMENT, ASSESSMENT TECHNIQUES (IPPA)

RESOURCES

READINGS

Jarvis, C. (2019). Assessment techniques and the clinical setting. In A.J. Browne, J. MacDonald- Jenkins, &
M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 141-152). Elsevier
Canada.

Jarvis, C. (2019). Pain assessment. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 182-195). Elsevier Canada.
Jarvis, C. (2019). General survey, measurement, and vital signs. In A.J. Browne, J. MacDonald- Jenkins, &
M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed.,pp. 153-182). Elsevier
Canada.

MEDIA (VIDEOS ARE AVAILABLE ON ELSEVIER)

Williamson, T. (2014). Mosby’s nursing skills Series - basic skills: Vital signs. St. Louis, MO: Elsevier.

[PLEASE NOTE THAT THESE VIDEOS GIVE IMPERIAL MEASURES (I.E. TEMPERATURE IN FAHRENHEIT RATHER
THAN CELSIUS—NOTE THAT THE EXPECTATION FOR RECORDING AND REPORTING VITAL SIGNS ARE IN THE
METRIC SYSTEM)]

LEARNING OBJECTIVES

VITAL SIGNS (REVIEW)

NOTE: FOR THE PURPOSE OF THE BSCN 2304 THEORY AND LAB, PLEASE APPLY THE VITAL SIGN RANGES FROM
JARVIS (2019).

1. Describe the appropriate client preparation for the assessment of vital signs.
2. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to
completing vital signs.
3. Review the rationale and correct techniques for the measurement of vital signs.
4. Describe the following key points related to temperature.
- Identify and describe factors that can affect temperature.
- Differentiate between the sites used to measure temperature.
- Describe the steps involved in taking a temperature.
- Identify the normal ranges of findings throughout the lifespan.

5. Describe the following key points related to heart rate.

- Describe the different ways to measure heart rate.
- Identify the importance of rate, rhythm, and strength/force when assessing a pulse.
- Identify factors that may affect heart rate.
- Identify the normal ranges of findings throughout the lifespan.

BScN 2304 Theory Manual Winter 2023 Page 9 of 34

BScN 2304 Theory Manual Winter 2023 Page 10 of 34
 6. Describe the following key points related to respiration rate.
- Identify the importance of rate, rhythm, depth, effort, and accessory muscle use when
assessing respiration.
- Identify factors that may affect respiration.
- Identify the normal ranges of findings throughout the lifespan.

7. Describe the following key points related to oxygen saturation.

- Discuss what oxygen saturation measures.
- Describe the measurement of arterial oxygen saturation.
- Identify normal ranges of findings.

8. Describe the following key points related to blood pressure.

- Describe what blood pressure measures.
- Discuss factors that affect blood pressure.
- Discuss common mistakes in blood pressure measurement.
- Identify normal ranges of findings throughout the lifespan.

SYMPTOM AND PAIN ASSESSMENT

1. Discuss developmental and gender considerations in relation to pain assessment.
2. Discuss ethnocultural differences regarding the pain experience.
3. Review the definition of pain.
4. Review the sources and types of pain.
5. Describe the components of a comprehensive pain assessment.
6. Identify and discuss the use of standardized assessment tools for pain and other symptoms (e.g.,
nausea, vomiting, diarrhea etc...).
7. Apply the mnemonic OPQRSTUV to the assessment of pain and other symptoms (e.g., nausea,
vomiting, diarrhea etc...).

ASSESSMENT TECHNIQUES AND THE CLINICAL SETTING

1. Discuss the importance of the environment when completing a physical exam.
2. Describe the physical preparation of the client when preparing for the physical exam.
3. Identify and describe routine precautions.
4. Discuss key points related to the preparation of the nurse, and the execution of the physical exam.
5. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to
completing a physical exam.
6. Define and describe the four (4) main techniques used during physical assessment.
- Inspection - Palpation
- Percussion - Auscultation

7. Describe the following key points related to inspection.

BScN 2304 Theory Manual Winter 2023 Page 11 of 34

 - Describe the importance of symmetry.
- Identify the elements required to complete correct inspection of a client.

8. Describe the following key points related to palpation.

- Identify which parts of the hand are used for the various types of palpation.
- Differentiate between light, deep, and bimanual palpation.

9. Describe the following key points related to percussion.

- Describe what percussion is assessing.
- Differentiate between direct and indirect percussion.
- Identify and describe the characteristics of percussion notes.

10. Describe the following key points related to auscultation.

- Describe the necessary conditions required to thoroughly and accurately auscultate.
- Differentiate between the diaphragm and the bell of the stethoscope and discuss what each are
used to assess.

11. Identify some common pieces of equipment used during the physical exam and discuss their uses.

- Stethoscope
- Pulse oximeter
- Otoscope
- Reflex hammer
- Sphygmomanometer
- Pen light
- Ophthalmoscope

BScN 2304 Theory Manual Winter 2023 Page 12 of 34

WEEK THREE

THORAX AND LUNGS

RESOURCES

READINGS

Jarvis, C. (2019). Thorax and lungs. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 448-492). Elsevier Canada.
MEDIA (VIDEO IS AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Chest and lungs. [Video]

LEARNING OBJECTIVES

THORAX AND LUNGS

1. Review and apply knowledge of normal function and structure of thorax and lungs to the physical
assessment of thorax and lungs.
2. Describe the appropriate client preparation for the assessment of the thorax and lungs.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
thorax and lungs.
4. Describe the health history questions and their relevance used to assess the thorax and lungs.
5. Describe and discuss the techniques and processes of examining the thorax and lungs.
- Inspection - Palpation
- Percussion - Auscultation

6. Describe and define the following terms.

- Accessory - Respiratory excursion

- Vital - Fremitus (tactile)

7. Locate and discuss the lung borders on the anterior and posterior of chest.
8. Describe the following signs and symptoms and their relationship to common health conditions

- Barking
- Friction - Hyperresonance
- Barrel - Pleural
- Hemoptysis - Dry
- Congested - Thoracic kyphosis

9. Locate and explain the use of thoracic surface landmarks in assessing the lungs and thorax.

- Angle of Louis (Sternal Angle) - Scapular

BScN 2304 Theory Manual Winter 2023 Page 13 of 34

 - Midclavicular line - Midsternal
- Midaxillary - Anterior axillary
- Vertebral - Supra-sternal notch
- Posterior axillary line
10. Discuss the expected finding and significance of a normal ratio of the anterior-posterior diameter of
the chest to the transverse diameter.

11. Discuss the associated pathological disease, expected finding and significance of the ratio of the
anterior- posterior diameter of the chest to the transverse diameter for a barrel chest.
12. Discuss the associated pathological disease, expected finding and significance of the ratio of the
anterior- posterior diameter of the chest to the transverse diameter for a thoracic kyphosis.
13. Identify and discuss the characteristics of the predominate sound percussed over healthy lung
tissue.
14. Identify and discuss the characteristics of percussion notes heard with the following associated
health conditions.
- Atelectasis - Pleural effusion
- Pneumothorax - Emphysema
- Pneumonia - Tumour
15. List five (5) factors that can cause extraneous noise during auscultation. Discuss how the nurse
examiner could resolve these factors.
16. Identify, locate and describe the three (3) normal breath sounds.
- Bronchial
- Vesicular
- Bronchovesicular
17. Identify and describe the difference between pathological and non-pathological adventitious breath
sounds.
- Crackles - Wheezes
18. Describe and compare the following respiratory states.
- Apnea - Paroxysmal - Tachypnea
- Orthopnea Nocturnal Dyspnea - Hyperpnea
- Bradypnea - Dyspnea

BScN 2304 Theory Manual Winter 2023 Page 14 of 34

BScN 2304 Theory Manual Winter 2023 Page 15 of 34
WEEK FOUR

HEART AND NECK VESSELS/ PERIPHERAL VASCULAR SYSTEM

RESOURCES

READINGS
Jarvis, C. (2019). Heart and neck vessels. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 493-538). Elsevier Canada.
Jarvis, C. (2019). Peripheral vascular system and lymphatic system. In A.J. Browne, J. MacDonald-Jenkins,
&
M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 539-565). Elsevier
Canada.
MEDIA (VIDEOS ARE AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Blood vessels [Video].

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Heart [Video].

LEARNING OBJECTIVES

HEART AND NECK VESSELS

1. Review and apply knowledge of normal function and structure of the cardiovascular system.
2. Describe appropriate client preparation for the assessment of the cardiovascular system.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
cardiovascular system.
4. Discuss appropriate health history questions for the head and neck vessels.
5. Describe and discuss the techniques and processes of examining the head and neck vessels
- Inspection - Palpation
- Percussion - Auscultation
6. Define and describe the following terms.
- Apex of the heart - Systole - Sinus arrhythmia
- Base of the heart - Apical pulse
- Point of maximal - Diastole
impulse
7. Describe a regional cardiovascular assessment in the correct order.
8. Identifies the correct landmarks and describe assessment techniques for the three areas of the
carotid arteries (inspection, auscultation, palpation).
9. Describes correct assessment of the precordium for the apical pulse (inspection, auscultation,
palpation).
10. Describes the apical pulse (noting location, size, amplitude, duration).
11. Describes correct palpation technique of the precordium (apex, left sternal border, base).
12. Identifies the correct landmarks and describes auscultation technique for the four (4) heart valve
areas.
BScN 2304 Theory Manual Winter 2023 Page 16 of 34
 13. Describe the following signs and symptoms as they relate to common cardiovascular health
conditions.
- Angina pectoris - Nocturia - Orthostatic hypotension
- Edema - Tachycardia - Bradycardia
- Palpitation - Dyspnea - Murmur
- Central cyanosis - Pallor - Pulse deficit
- Orthopnea - Clubbing
- Bruit
14. Describe the two (2) heart sounds and their relationship to the cardiac cycle. Describe intensity,
quality, location, and method of auscultation:
- S1 - S2

15. Explain and describe jugular vein assessment. Discuss implications of abnormal findings.
16. Discuss developmental considerations as they relate to physical assessment of head and neck
vessels.
PERIPHERAL VASCULAR SYSTEM

1. Review and apply knowledge of normal function and structure of the peripheral vascular system.
2. Describe appropriate client preparation for the assessment of the peripheral vascular system.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
peripheral vascular system.
4. Discuss appropriate health history questions used to assess the peripheral vascular system.
5. Describe and discuss the techniques and processes of examining the peripheral vascular system.
- Inspection
- Palpation
6. Discuss appropriate health history questions used to assess the peripheral vascular system.
7. Describe the following signs and symptoms as they relate to peripheral vascular/lymphatic health
conditions.
- Arrhythmia - Thrombophlebitis
- Pitting edema Peripheral cyanosis
- Lymphedema - Lymph node enlargement
- Ischemia - Claudication
- Profile sign

BScN 2304 Theory Manual Winter 2023 Page 17 of 34

 8. Identify the location of the central and peripheral pulses.
- Brachial
- Dorsalis pedis - Carotid
- Popliteal - Femoral
- Posterior tibial
9. Identify and discuss the components of a neurovascular assessment (6 Ps).
- Pain
- Paralysis
- Pulselessness
- Paresthesia
- Pallor
- Poikilothermia

10. Describe the rating scale utilized in assessing pulse strength.

11. Describe the grading scale used for pitting edema.

BScN 2304 Theory Manual Winter 2023 Page 18 of 34

WEEK FIVE

HEAD, FACE, AND NECK/REGIONAL LYMPHATIC SYSTEM

RESOURCES

READINGS

Jarvis, C. (2019). Head, face, and neck, including regional lymphatic system. In A.J. Browne, J. MacDonald-
Jenkins, & M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 271-299).
Elsevier Canada.
Jarvis, C. (2019). Eyes. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.). Physical
examination & health assessment (3rd ed., pp. 300-349). Elsevier Canada.
Jarvis, C. (2019). Ears. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.). Physical
examination & health assessment (3rd ed., pp. 350-378). Elsevier Canada.

Jarvis, C. (2019). Nose, mouth, and throat. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 379-417). Elsevier Canada.

MEDIA (VIDEOS ARE AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Ears, nose, and throat. [Video].
Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Eyes. [Video].
Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Head and neck and lymphatic system.
[Video].

BScN 2304 Theory Manual Winter 2023 Page 19 of 34

LEARNING OBJECTIVES

HEAD AND NECK/REGIONAL LYMPHATIC SYSTEM; EYES; EARS; NOSE, MOUTH, AND THROAT
1. Review and apply knowledge of normal function and structure of head (eyes, ears, nose, mouth,
throat), face, neck, and lymphatic system to the physical assessment of head (eyes, ears, nose,
mouth, throat), neck, and regional lymphatic system.
2. Describe the appropriate client preparation for the assessment of the head (eyes, ears, nose, mouth,
throat), face, neck and lymphatic system.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
head (eyes, ears, nose, mouth, throat), face, neck, and lymphatic system.
4. Discuss appropriate health history questions for the head (eyes, ears, nose, mouth, throat), face,
neck and regional lymphatic system.
5. Outline and demonstrate the techniques and processes of examining the head (eyes, ears, nose,
mouth, throat), face, neck, and regional lymphatic system.
- Inspection
- Palpation
6. Define and describe each of the following terms.

- Accommodation - Buccal
- Cerumen - Convergence
- Edema - Fontanels (anterior & posterior)
- Moulding - Nodule
- Normocephalic - Polyp
- Pupillary light reflex - Visual acuity
7. Describe the expected findings for changes/common health conditions of the eye.

- Arcus senilis - Myopia

- Cataract - Photophobia
- Halos - Exophthalmos
- Hyperopia - Glaucoma
- Conjunctivitis - Ptosis
- Diplopia - Strabismus

8. Describe the expected findings for changes/ common health conditions of the ear.

- Conductive hearing loss - Otitis media

- Presbycusis - Vertigo
- Otalgia - Otorrhea
- Tinnitus
9. Describe the expected findings for changes / common health conditions of the mouth.

- Bruxism - Xerostomia
- Halitosis - Leukoplakia
- Caries
- Thrush
- Oral Kaposi Sarcoma
- Gingivitis
BScN 2304 Theory Manual Winter 2023 Page 20 of 34
 10. Describe the expected findings for changes/ common health problems nose.
- Deviated septum
- Rhinitis
- Epistaxis
11. Describe the expected findings for changes / common health conditions throat.
- Strep throat
- Tonsillitis
12. Describe the expected findings for changes/common health conditions head.

- Caput succedaneum - Concussion

- Hydrocephalus - Microcephalic
- Cephalhematoma - Edema
- Macrocephalic
13. Describe the expected findings for changes/common health conditions neck.

- Goiter - Hyperthyroidism
- Lymphadenopathy - Myxedema (hypothyroidism)
14. Discuss the characteristics of lymph nodes associated with cancer, acute infection, and chronic
inflammation.
15. Describe mouth examination findings for darkly pigmented clients.
16. Describe the assessment testing of visual acuity (Snellen Chart/Jaegar Chart), visual fields
(confrontation test), extraocular muscle function (corneal light reflex, diagnostics position test),
external ocular structures, anterior eyeball structures.
17. Explain the significance for the numerator and denominator for visual acuity assessment (e.g.
20/20).
18. Describe the assessment for accommodation (PERRLA).
19. Describe the hearing acuity test, whispered voice test, and identify normal findings.
20. Describe the technique used to straighten the ear canal when using the otoscope with an adult, older
adult, and infant / young child.
21. Describe the 4-point scale used to grade tonsils.

BScN 2304 Theory Manual Winter 2023 Page 21 of 34

WEEK SIX

SKIN, HAIR, NAILS

RESOURCES

READINGS

Government of Canada. (2019). Melanoma skin cancer.

https://www.canada.ca/en/public-health/services/chronic-diseases/cancer/melanoma-skin-
cancer.html
Government of Canada. (2019). Non melanoma skin cancer.

https://www.canada.ca/en/public-health/services/chronic-diseases/cancer/non-melanoma-
skin-cancer.html
Government of Canada. (2018). Skin Cancer.

https://www.canada.ca/en/public-health/services/sun-safety/skin-cancer.html#a2

Jarvis, C. (2019). Skin, hair, nails. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 219-270). Elsevier Canada.
MEDIA (VIDEOS ARE AVAILABLE ON ELSEVIER)
Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Skin, hair, nails. [Video]. St. Louis,
MO: Elsevier
LEARNING OBJECTIVES

SKIN, HAIR, NAILS

1. Review and apply knowledge of normal function and structure of skin, hair, and nails.
2. Describe the appropriate client preparation for the assessment of skin, hair, and nails.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
integumentary system (skin, hair, nails).
4. Discuss appropriate health history questions for the skin, hair, and nails.
5. Discuss the assessment techniques utilized when examining the skin, nails, hair and scalp.
6. Identify and describe edema and the 4-point grading scale used to assess it.
7. Define and describe the following terms and discuss how they might relate to common health
conditions.
- Senile lentigines - Excoriation - Petechiae
- Diaphoresis - Urticaria - Hematoma
- Decubitus Ulcer
8. Describe the ABCDE mnemonic used to assess abnormal skin lesions.

BScN 2304 Theory Manual Winter 2023 Page 22 of 34

 9. Discuss the use of the Braden Scale to predict pressure sore risk.
10. Discuss risks for skin cancers and health assessment findings as they relate to melanoma.
11. Discuss dehydration and how it relates to health assessment findings.
12. Explain the appearance of pallor, erythema, cyanosis, and jaundice across various skin tones.
13. Explain the relationship of the profile sign and clubbing, as they relate to health conditions.

BScN 2304 Theory Manual Winter 2023 Page 23 of 34

BScN 2304 Theory Manual Winter 2023 Page 24 of 34
WEEK SEVEN

MUSCULOSKELETAL ASSESSMENT

RESOURCES

READINGS

Jarvis, C. (2019). Musculoskeletal system. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 625-686). Elsevier Canada.
MEDIA (VIDEO IS AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Musculoskeletal system [Video].

LEARNING OBJECTIVES

MUSCULOSKELETAL SYSTEM
1. Review and apply knowledge of normal function and structure of the musculoskeletal system.
2. Describe appropriate client preparation for the assessment of the musculoskeletal system.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
musculoskeletal system.
4. Discuss appropriate health history questions for the musculoskeletal system.
5. Describe the following skeletal movements.
- Abduction - Circumduction - Eversion
- Extension - External rotation - Flexion
- Pronation - Protraction - Hyperextension
- Adduction - Dorsiflexion - Inversion
- Opposition - Internal rotation - Plantar flexion
- Supination - Retraction
6. Discuss the health assessment techniques used to assess the musculoskeletal system.
7. Describe the following health assessment terms.
- Ankyloses - Crepitation
- Hypertonicity - Lordosis
- Ataxia - Contracture
- Hypotonicity - Sciatica
- Atrophy - Flaccid
- Kyphosis - Scoliosis
8. Describe the rating scale that is used to assess muscle strength.
9. Describe the signs and symptoms of inflammation in a joint.
10. Discuss the objective and subjective data required when completing a functional assessment of an
older adult.
11. Identify and discuss the common adaptations the older adult makes when attempting the following
maneuvers.

- Walk (with shoes on) - Walk down stairs

- Climbing up/downstairs - Pick up an object from the floor
BScN 2304 Theory Manual Winter 2023 Page 25 of 34
 - Rising from sitting in a chair - Rising from lying in a bed

BScN 2304 Theory Manual Winter 2023 Page 26 of 34

WEEK NINE

NEUROLOGICAL SYSTEM, MENTAL HEALTH ASSESSMENT

RESOURCES

READINGS
Jarvis, C. (2019). Neurological system. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., pp. 687-747). Elsevier Canada.
Jarvis, C. (2019). Mental health assessment. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude
(Eds.).
Physical examination & health assessment (3rd ed., pp. 78-108). Elsevier Canada.
MoCA. (n.d.). Montreal Cognitive Assessment. http://www.mocatest.org/
MEDIA
ACTonALZ.org. (2014). ACTonALZ.org. (2014). Montreal Cognitive Assessment (MoCA): Administration
https://www.youtube.com/watch?v=XjrnsIXoSCg
Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Neurologic system: Mental status &
cranial nerves [Video]. (Available on Elsevier).

LEARNING OBJECTIVES

MENTAL HEALTH ASSESSMENT

1. Describe the appropriate client preparation for a mental health assessment.

2. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to a
mental health assessment.
3. Discuss the significance of mental health assessment.
4. Discuss the purpose of a mental health assessment and when it might be necessary to perform one.
5. Discuss the methods and components of a mental health assessment.
6. Define the following health assessment terms.

- Abstract reasoning - Cognition - Remote memory

- Affect - Perception - Thought process
- Attention - Recent memory - Mood
- Orientation - Thought content
7. Review the components of a mental status exam.

- Appearance - Behaviour
- Cognition - Thinking
8. Describe and discuss the following health conditions.
- Delirium
- Dementia
9. Discuss the use of the Montreal Cognitive Assessment Tool (MoCA).

BScN 2304 Theory Manual Winter 2023 Page 27 of 34

NEUROLOGICAL SYSTEM
1. Review and apply knowledge of normal function and structure of the neurological system.
2. Describe appropriate client preparation for neurological assessment.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
neurological assessment.
4. Discuss appropriate health history questions for the neurological system.
5. Discuss the techniques used to assess the neurological system.
6. Define the following health assessment terms.
- Proprioception
- Reflexes
- Level of consciousness
- Stereognosis
7. Describe the following health conditions related to the neurological system.

- Hemiplegia - Peripheral neuropathy

- Spasticity - Paraplegia
- Quadriplegia - Syncope
8. Describe the following signs and symptoms related to neurological health conditions.

- Aphasia - Paralysis - Dysarthia

- Apraxia - Tremor - Hypotonia
- Astereognosis - Dysphagia - Paresthesia
- Decorticate rigidity - Ataxia - Tic
- Flaccid - Decerebrate - Nystagmu
- Hypertonia rigidity
9. Identify the function and method of testing for each of the 12 Cranial Nerves.
10. Identify and describe tests of cerebellar function.
11. Describe the method of testing for the following.
- Superficial pain
- Vibration
- Light touch
- Stereognosis

12. Identify, describe and note the normal findings of the following deep tendon reflexes.

- Biceps - Triceps
- Quadriceps - Achilles
13. Describe the following levels of consciousness.

- Alert - Coma
- Obtunded - Lethargic or somnolent
- Stupor or semi-coma - Acute confusional state/delirium

BScN 2304 Theory Manual Winter 2023 Page 28 of 34

 14. Discuss the components and grading of the Glasgow Coma Scale.

WEEK TEN

ABDOMEN, NUTRITIONAL ASSESSMENT

RESOURCES

READINGS

Jarvis, C. (2019). Nutritional assessment and nursing practice. In A.J. Browne, J. MacDonald-Jenkins, & M.
Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 196-218). Elsevier
Canada.
Jarvis, C. (2019). The abdomen. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.). Physical
examination & health assessment (3rd ed., pp. 566-606). Elsevier Canada.
Jarvis, C. (2019). General survey, measurement, and vital signs. In A.J. Browne, J. MacDonald- Jenkins, &
M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed.,pp. 153-182). Elsevier
Canada.

MEDIA (VIDEO IS AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Abdomen [Video].

LEARNING OBJECTIVES

ABDOMEN
1. Review and apply knowledge of normal function and structure of the abdomen.
2. Describe the appropriate client preparation for the assessment of the abdomen.
3. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to the
abdominal system.
4. Describe the expected changes that take place within the gastrointestinal system during pregnancy
and their impact on assessing the abdomen of a pregnant female.
5. Discuss appropriate health history questions for the abdominal system.
6. Discuss the techniques used to assess the abdomen and provide rationale for the sequence of the
exam (Inspection, Auscultation, Palpation, Percussion).
7. Define the following health assessment terms.
- Suprapubic - Scaphoid
- Protuberant - Striae
- Tympany - Borborygmus

BScN 2304 Theory Manual Winter 2023 Page 29 of 34

 8. Identify and describe the four (4) profiles that can be observed when inspecting a client’s abdomen.
9. Identify and describe normal bowel sounds noting character and frequency.
10. Identify and describe abnormal auscultation sounds including the following.
- Hyperactive bowel
- Hypoactive bowel
- Bruits

11. Identify and explain each of the percussion notes heard over the abdomen.
12. Differentiate between light and deep palpation.
13. Differentiate between involuntary rigidity and voluntary guarding.
14. Describe expected examination findings for each of the following common health conditions.
- Anorexia - Appendicitis
- Hepatomegaly - Peritonitis
- Hernia - Splenomegaly
- Hemorrhoid - Tumour
- Paralytic ileus
15. Describe the following signs and symptoms and discuss their relationship to common health
conditions.
- Ascites - Dyspepsia - Emesis
- Flatus - Constipation - Bladder distension
- Dysphagia - Hematemesis
- Melena - Diarrhea
16. Discuss screening measures that are recommended for early detection of colon/rectal cancer.
NUTRITIONAL ASSESSMENT
1. Describe developmental, cultural, and ethnic (as appropriate) considerations as they relate to a
nutritional assessment.
2. Identify appropriate health history questions related to nutritional assessment.
3. Define nutritional status and its various levels.
4. Examine the various ways to assess nutritional intake.
- The 24-Hour Recall
- The Food Frequency Questionnaire
- The Food Diary
- Direct Observation
5. Discuss commonly used anthropomorphic measures used during a nutritional assessment.
- Waist-Hip Ratio
- Waist Circumference
- Weight
- Height
6. Discuss the importance of waist circumference, and waist-to-hip ratio as it relates to increased
health risk.

BScN 2304 Theory Manual Winter 2023 Page 30 of 34

WEEK ELEVEN

MALE & FEMALE GENITOURINARY SYSTEMS, BREASTS & AXILLAE, PROSTATE ASSESSMENT

RESOURCES

READINGS

Jarvis, C. (2019). Breasts and regional lymphatic system. In A.J. Browne, J. MacDonald-Jenkins, & M.
Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., pp. 418-447). Elsevier
Canada.
Jarvis, C. (2019). Anus, rectum, and prostate. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar- Flude
(Eds.). Physical examination & health assessment (3rd ed., pp. 607-624). Elsevier Canada.
Jarvis, C. (2019). Male genitourinary system. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar- Flude
(Eds.). Physical examination & health assessment (3rd ed., pp. 748-778). Elsevier Canada.
Jarvis, C. (2019). Female genitourinary system. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar- Flude
(Eds.). Physical examination & health assessment (3rd ed., pp. 779-818). Elsevier Canada.

Government of Canada. (2019, May 21). Health concerns: Cancer.

https://www.canada.ca/en/health-canada/services/health-concerns/diseases-conditions/
cancer.html
MEDIA (VIDEOS ARE AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Breasts and axillae [Video].
Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Female genitalia and rectum. [Video].
Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Male genitalia, rectum, and prostate
[Video].

LEARNING OBJECTIVES

GENITOURINARY SYSTEM
1. Review and apply knowledge of normal function and structure of genitourinary system to the
physical assessment of genitourinary system.
2. Describe the appropriate client preparation for the assessment of the genitourinary system.
3. Describe pregnancy, developmental, cultural, and ethnic (as appropriate) considerations as they
relate to the physical assessment of the genitourinary system.

4. Discuss appropriate health history questions for the genitourinary system.

5. Describe and discuss the techniques and processes of examining the genitourinary system.
- Inspection
- Palpation

BScN 2304 Theory Manual Winter 2023 Page 31 of 34

 6. Describe the following signs and symptoms as they relate to common genitourinary health
conditions.
- Amenorrhea - Incontinence - Cryptorchidism
- Hemorrhoid - Cystitis - Oliguria
- Cystocele - Menorrhagia - Dysmenorrhea
- Rectocele - Dysuria - Polyuria
- Fibroid - Urinary hesitancy - Fissure
- Urinary frequency - Hematuria

7. Discuss the appropriate communication strategies to implement when obtaining a sexual health
history.
8. Describe the method of performing monthly self-examination of the testes.
9. Discuss normal assessment findings of male genitalia.
10. Describe the abnormal findings during inspection of the penis.
11. Identify risk factors and discuss screening measures for the early detection of prostate cancer.
12. Discuss the health assessment data that may be found when inspecting the female genitalia.
13. Outline the changes that occur during the life span of the female during menarche and menopause.
14. Explain the Papanicolaou test (PAP test).

BREASTS AND AXILLAE

1. Review and apply knowledge of normal function and structure breasts and axillae to the physical
examination of breasts and axillae.
2. Describe the appropriate client preparation for the assessment of the breasts and axillae.
3. Describe pregnancy, developmental, cultural, and ethnic (as appropriate) considerations as they
relate to the physical assessment of the breasts and axillae.
4. Describe appropriate health history questions for breasts and axillae.
5. Describe and discuss the techniques and processes of examining the breasts and axillae.
- Inspection - Palpation
6. Describe the following signs and symptoms as they relate to common health conditions of the
breast and axillae.
- BRCA1 - BRA2
- Galactorrhea - Mastalgia
- Peau d’orange
7. Describe expected examination findings for each of the following common health conditions.
- Benign breast disease - Fibroadenoma
- Mastitis - Paget’s Disease
8. Describe the components of the breast exam including relevant landmarks.
- Examination by the nurse - Examination by the client

BScN 2304 Theory Manual Winter 2023 Page 32 of 34

9. Discuss and differentiate between female and male examination techniques and expected
assessment findings.
10. List and describe the ten (10) characteristics to note when assessing a breast lump.
11. List and describe the modifiable and unmodifiable risk factors that increase the risk of breast
cancers.
12. Identify and discuss the Best Practice Breast Cancer Risk Assessment and Screening
Recommendations for early detection of breast cancer.

BScN 2304 Theory Manual Winter 2023 Page 33 of 34

WEEK TWELVE

CLINICAL REASONING: PUTTING IT ALL TOGETHER, BEDSIDE ASSESSMENT AND ELECTRONIC HEALTH
MONITORING, CRITICAL THINKING AND EVIDENCE-INFORMED ASSESSMENT; PRIORITY SETTING

RESOURCES

PRE-PREPARATION

Review content from past courses that taught developmental theories (across the lifespan), anatomy and
physiology/pathophysiology, chronic health issues, and pharmacotherapeutics [relevant to the content
for this module]. Review pre-preparation videos provided on Blackboard site.

READINGS

Jarvis, C. (2019). Critical thinking and evidence-informed assessment; Priority setting. In A.J. Browne, J.
MacDonald-Jenkins, & M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed.,
chapter 1, pp. 1-18). Elsevier Canada.
Jarvis, C. (2019). Putting it all together. In A.J. Browne, J. MacDonald-Jenkins, & M. Luctkar-Flude (Eds.).
Physical examination & health assessment (3rd ed., chapter 28, pp. 819-840). Elsevier Canada.

Jarvis, C. (2019). Bedside assessment and electronic health monitoring. In A.J. Browne, J. MacDonald-
Jenkins, & M. Luctkar-Flude (Eds.). Physical examination & health assessment (3rd ed., chapter 29,
pp. 841-849). Elsevier Canada.
MEDIA (VIDEO IS AVAILABLE ON ELSEVIER)

Robinson, B. (Producer) & Harman, G. (Producer/Director). (2014). Putting it all together [Video].

LEARNING OBJECTIVES
1. Discuss the four (4) types of data collection.
2. Discuss how the nurse determines the order of priority of a person’s problems.
3. Outline and discuss the process of completing a systematic head to toe assessment of a client.

BScN 2304 Theory Manual Winter 2023 Page 34 of 34