| Course | NU 715 Telehealth to Expand Health Care Access and Delivery |
|---|---|
| Unit | Unit 2 |
| Paper type | Remote examination protocol |
| Length | About 520 words, 4 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU 715 Unit 2
Remote Examination Protocol for the Seven-Day Post-Discharge Heart Failure Video Visit: Every Component Given an Owner
Student Name
Department of Nursing, Herzing University
NU 715: Telehealth to Expand Health Care Access and Delivery
Instructor Name
January 28, 2026
Remote Examination Protocol for the Seven-Day Post-Discharge Heart Failure Video Visit: Every Component Given an Owner
Scope
Visit: the first follow-up after hospital discharge for heart failure, within seven days, by live video from the patient's home, in a composite rural Kansas health system. Participants: the nurse practitioner at the clinic; the patient at home; a family member or caregiver when available, who is asked in advance to attend. Equipment at the patient's end: the home scale, blood pressure cuff, and pulse oximeter issued at discharge, a phone or tablet with a camera, and the medication bottles. The protocol assigns every component of the usual heart failure examination to the patient, the caregiver, the clinician's observation, or an in-person follow-up, and it states what is lost. The structure follows published guidance on patient-assisted virtual examination (Benziger et al., 2021).
Before the Visit
The clinic nurse calls the day before to confirm the device works, asks that the patient weigh themselves that morning before breakfast after urinating, and asks that a caregiver be present and all medication bottles be brought to the visit. If the patient cannot manage video, the visit converts to a clinic visit or to a telephone visit with the in-person components scheduled separately.
The Components and Who Performs Them
The table assigns each component an owner and states what is lost at a distance.
| Component | Owner | How it is done | What is lost |
|---|---|---|---|
| Weight | Patient | Reads the morning weight aloud; clinician compares with discharge weight and monitoring data | Nothing, if the scale is reliable and used the same way each day |
| Blood pressure and heart rate, seated | Patient or caregiver | Home cuff after 5 minutes seated; reading shown to camera | Accuracy depends on cuff size and technique; clinician watches the technique once |
| Orthostatic blood pressure | Patient with caregiver standing by | Repeat after 1 and 3 minutes standing, holding a chair | Safety depends on the caregiver; skipped if alone |
| Oxygen saturation | Patient | Pulse oximeter on a warm finger, reading shown to camera | Reliability varies with device and circulation |
| General appearance, color, work of breathing | Clinician | Observation at rest and while talking | Subtle color changes may be missed on camera |
| Breathlessness at rest | Patient | Counts aloud from 1 in one breath; the count reached and time taken are recorded | A rough measure; a low count warrants in-person assessment |
| Jugular venous pressure | Caregiver, directed by clinician | Patient reclined at 45 degrees; caregiver holds a light across the neck and the camera close | Often not assessable on video; documented as limited |
| Peripheral edema | Caregiver | Presses firmly over the shin for 5 seconds, then camera held close; photo taken | Grading is less precise than in person |
| Lung and heart sounds | In-person follow-up | Not attempted; replaced by symptom questions on cough, orthopnea, and waking breathless | Auscultation is lost entirely |
| Medication reconciliation | Patient and caregiver | Each bottle held to the camera; compared with discharge list | None; the home view often improves this |
| Cognition and understanding | Clinician | Teach-back of daily weights and when to call | Little |
The Counting Test
Because auscultation is not possible, the protocol adds a simple measure of breathlessness. Counting aloud in one breath from 1, recording how far the patient gets and how long it takes, has been studied as a rough indicator of respiratory distress (Chorin et al., 2016). It is recorded at every video visit so that it can be compared over time; a count much lower than at discharge, or a patient who cannot reach 10, is treated as a reason for same-day in-person assessment.
When the Visit Converts to In-Person
The protocol lists findings that end the video visit and lead to same-day in-person assessment at the nearest clinic or the emergency department: oxygen saturation below 90%; new breathlessness at rest or inability to count to 10 in one breath; chest pain or fainting; weight up by over a kilogram overnight, or by two kilograms or more compared with discharge; systolic blood pressure below 90 with dizziness; or new confusion. These thresholds reflect the warning signs emphasized in heart failure guidance for patients after discharge (Heidenreich et al., 2022), adapted by the service's cardiologist.
Documentation
The note records that the visit was by video, who was present at each end, which components were performed and by whom, which could not be assessed, and the reason for any conversion to in-person care. A component recorded as limited, such as jugular venous pressure, is not recorded as normal.
What This Protocol Cannot Replace
The loss of auscultation is real, and a patient whose symptoms are unclear should have an in-person examination within a week even if the video visit is reassuring. The protocol aims to catch deterioration early and to reduce travel for stable patients, not to replace every clinic visit.
References
Benziger, C. P., Huffman, M. D., Sweis, R. N., & Stone, N. J. (2021). The telehealth ten: A guide for a patient-assisted virtual physical examination. The American Journal of Medicine, 134(1), 48-51. https://doi.org/10.1016/j.amjmed.2020.06.015
Chorin, E., Padegimas, A., Havakuk, O., Birati, E. Y., Shacham, Y., Milman, A., Topaz, G., Flint, N., Keren, G., & Rogowski, O. (2016). Assessment of respiratory distress by the Roth score. Clinical Cardiology, 39(11), 636-639. https://doi.org/10.1002/clc.22586
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., ... Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. https://doi.org/10.1161/CIR.0000000000001063
What the NU 715 Unit 2 instructions ask for
In Unit 2 you write a protocol for conducting a physical examination or assessment by telehealth for a specific visit type. Expect to define scope, describe preparation, list each exam component with who performs it, explain what cannot be assessed remotely and how to compensate, state findings that require conversion to in-person care and set documentation requirements. Many versions ask you to use published guidance on virtual examination. Check whether your section allows your own specialty. A protocol for one visit type is more useful than a general telehealth exam. Include the patient or caregiver as performers of some steps, such as checking ankle swelling, and be honest about what is lost, because conversion rules depend on that honesty.
How this NU 715 Unit 2 example is built
The protocol opens with scope in a few lines: visit type, timing, modality and setting. Preparation is described step by step, since a remote exam depends on what the patient does beforehand. The table is the core, listing each component with its performer and what distance costs. The counting test gets its own short section because it substitutes for a lost component and needs explanation. Conversion criteria are listed as findings that end the video visit, with where the patient goes next. The documentation section states what the note must record, including which components were not assessed. The final section admits that auscultation cannot be replaced and sets a rule for in-person follow-up when symptoms are unclear. Each step cites guidance or evidence.
Reading the NU 715 Unit 2 rubric
Herzing tends to grade this protocol on scope, preparation, the completeness of exam components, the handling of limits, conversion criteria, documentation and writing. Exam component points reward a full list with performers assigned. Limits are often heavily weighted, earning full marks when the protocol states what cannot be assessed and how it compensates or escalates. Conversion criteria require specific findings and destinations. Documentation points go to required elements such as modality, participants and components not done. Evidence-based thresholds strengthen several rows. A table counts toward clarity. APA 7 references should include Benziger and colleagues' guidance on the virtual physical exam and the heart failure guideline by Heidenreich and colleagues.
Common NU 715 Unit 2 mistakes, and how to avoid them
Remote exam protocols in Unit 2 most often lose points by listing exam components as if they could all be done by video. Another frequent issue is no plan for what replaces auscultation or palpation. Students often forget preparation, so the protocol assumes a scale and a charged device appear on their own. Conversion criteria are sometimes vague, such as if the patient seems worse. Caregivers are rarely given roles, though they often perform key steps. Documentation of what was not assessed is commonly missing, which creates risk. Some protocols include technology detail that belongs elsewhere. Finally, write for one visit type, because a protocol meant for every telehealth visit cannot set specific conversion thresholds.
Get a NU 715 Unit 2 example written to your instructions
Send the Unit 2 instructions and the rubric from your NU 715 classroom, plus the presentation your protocol has to cover and the setting at the patient's end. We write a custom example with each component assigned, the unobtainable ones named, documentation specified and conversion criteria set, returned in 24 to 48 hours. The first custom sample is free.
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NU 715 Unit 2 questions, answered
What if the patient is alone with a phone?
That is the ordinary case and the protocol should be built for it, with the assisted version treated as the exception. Written for somebody alone, the document has to lean on directed self-examination, a careful history and a clear conversion threshold. Say what that costs in certainty, because a protocol assuming a trained presenter at the far end describes a service most patients cannot reach.
Can I write the protocol for my own specialty?
Usually yes, and it produces better work, since you know which parts of the examination actually change management for that presentation. Follow the instructions where they name the presentation, hold the scope to one complaint, and write within the scope of practice you hold. Keep patient specifics out of the file and describe the presentation generically.
How much technology detail belongs in it?
Enough to make the examination possible and no more. Name the equipment a component depends on, whether a connected stethoscope or a camera the patient can move, and state what happens when it is unavailable. Platform features, product names and vendor comparisons belong elsewhere, because this document is about how the examination gets done.
Where can I find a free NU 715 Unit 2 sample paper?
Read the complete NU 715 Unit 2 heart failure video exam protocol here at no charge, with the component table, counting test and conversion rules. A custom protocol can be written for another visit type or specialty your section allows.
How do you do a physical exam by telehealth?
Prepare the patient beforehand, assign each component to the clinician, patient or caregiver, substitute where you can and state what cannot be assessed. This sample uses a counting test for breathlessness and converts to in-person care for set warning findings.