NR-302 · Week 6 of 8 · Thorax, lungs and heart

NR-302 Week 6 Thorax and Heart Findings: How to Write It

The short answer

The respiratory and cardiac stage is where auscultation enters the course, and with it the hardest documentation lesson so far: a sound is only a finding when its location, timing and quality are written down, which makes anatomical landmark language the real curriculum of the week. The written work is a documented thorax and heart assessment from your own stethoscope practice. Your section may print this as NR 302 or NR302; it is the same course. Chamberlain publishes no syllabi outside Canvas. The placement here is our teaching judgment from the course's catalog arc; your section's rubric decides what your week actually asks.

NR-302 Week 6 grading scale at Chamberlain, the criterion levels this assessment is scored on, from Chamberlain Tutors
How Chamberlain grades NR-302 Week 6, visualized by Chamberlain Tutors.

What NR-302 Week 6 asks for

Lungs clear is the two-word entry that tells a chart reviewer almost nothing, and the reviewer's first question exposes why: clear where? A trained respiratory assessment listens at named sites down both sides of the chest, anterior and posterior, comparing side against side, and its documentation carries that geography: breath sounds clear to auscultation bilaterally, anterior and posterior, all lobes. The difference between the two entries is not thoroughness of writing; it is whether the writing proves an exam. The sixth stage of an assessment course brings the stethoscope into the curriculum, and its write-ups are graded on exactly that proof.

The territory divides in two. The respiratory side covers inspection of the chest's shape and breathing effort, the respiratory pattern with its rate and depth, palpation as taught at this level, and auscultation of breath sounds at the systematic sites with their expected qualities. The cardiac side covers the apical pulse with its location described against the chest's landmark lines, rate and rhythm by auscultation, the first and second heart sounds as heard, and the peripheral circulation that completes the picture: pulses graded on the taught scale, capillary refill, and any edema described by location and the assessed scale. Both sides share one grammar: landmark, method, finding, quality.

Deliverables at this stage run to the usual shapes, a documented practice assessment, a lab write-up, a scenario documentation exercise, with one addition worth expecting: the symptom layer grows teeth here, because chest and breathing complaints are the interview material this region owns. A reported breathing symptom run through its full attribute set, and a documented set of pertinent denials, cough, shortness of breath, chest discomfort, palpitations, is scored as seriously as the auscultation entries. As everywhere in this course, hearing something odd in a practice partner is described, never diagnosed, and the write-up's job is a finding the next clinician could relocate with their own stethoscope.

The NR-302 Week 6 method, step by step

Six moves for documenting what the stethoscope and the landmark lines produce.

  1. Learn the landmark lines as writing vocabulary first

    Midclavicular, midaxillary, the intercostal spaces, the named auscultation areas. Every finding this week is located against that grid, and the write-up that cannot name its location cannot document its finding.

  2. Document the respiratory pattern before the sounds

    Rate counted for the full taught interval, depth, effort, symmetry of chest movement. The pattern entries frame the auscultation and are the part most often skipped by students eager to write about sounds.

  3. Record breath sounds site by site, side against side

    The systematic sequence your text teaches, documented as performed: clear bilaterally at all assessed sites, or the deviation at its named site with its quality described in the taught vocabulary.

  4. Locate the apical pulse in landmark language

    The auscultation point described against the intercostal space and the reference line, with rate counted apically for the full interval and rhythm characterized as regular or with its irregularity described.

  5. Write the heart sounds as heard, not as memorized

    First and second sounds present and distinct at the assessed areas is a beginner's honest entry. Extra sounds are described by where and when in the cycle they occurred, without naming a suspected cause.

  6. Complete the circuit with the periphery

    Paired pulses graded on the taught scale per site per side, capillary refill with its timing, edema present or absent by location with the scale if assessed. The cardiac write-up ends at the fingertips and ankles, not at the chest.

A layout and word budget for a thorax and heart write-up

The frame below fits a documented cardiorespiratory assignment of roughly 850 to 1,050 words. It is our own guide rather than anything the university issues, and your week's rubric and assigned form outrank it wherever they disagree.

SectionWhat belongs in itWord target
Regional symptom layerReported breathing and chest symptoms with full attributes, plus the pursued denials, in reporting verbs.130 to 160
Chest inspection and patternShape, symmetry, effort, rate with its counting interval, and depth, before any sound appears.130 to 160
Breath sounds by siteThe systematic sequence with laterality throughout, qualities in the taught vocabulary, deviations located precisely.170 to 210
Apical assessmentLocation in landmark language, rate for the full interval, rhythm, and the first and second sounds as heard.140 to 170
Peripheral circulationGraded pulses per site per side, refill timing, and edema status by location.120 to 150
Method and comparison noteWhat was assessed by which technique, compared against the cited expected findings, scope held.90 to 120

Evidence craft for auscultation documentation

Location is the license for every sound entry. A breath sound without a site or an apical rate without its landmark is unverifiable. The intercostal-space-and-line grammar exists so a second listener can place their stethoscope where yours was, which is the entire meaning of documented.

Counting intervals are part of the datum. A rate counted for the full taught interval is a different measurement from a shortcut estimate, and rhythm irregularities make the difference clinically material. Write the interval with the count and the habit becomes visible credit.

Grading scales must be named to mean anything. A pulse graded two means nothing until the scale is identified; the taught scale with its range makes the entry portable. The same holds for edema grading and any quality vocabulary: the textbook's terms, used as defined, cited where comparison is assigned.

Symmetry claims require both sides examined. Bilaterally is a word your exam has to earn: it asserts the sequence visited matching sites on both sides. If a site was inaccessible in the practice session, the honest entry names what was assessed and what was not, exactly as the previous weeks taught.

Five mistakes that cost points in this week's territory

  • Lungs clear, unlocated. The two-word entry proves no sequence, no sites and no comparison, and this is the week the habit is priced out of you.
  • The radial shortcut for apical work. Documenting an apical rate that was actually taken at the wrist misstates the method, and method is part of the finding.
  • Sounds named beyond scope. An unexpected sound described by site, timing and quality is correct; the same sound labeled with a suspected condition is a scope breach.
  • Ungraded pulses. Present is not a grade; the taught scale per site per side is the standard, and its absence collapses the peripheral section.
  • A soundless symptom layer. Skipping the reported cough, breathlessness and chest-discomfort questions leaves the region's interview half undone, and rubrics check the denials.

Before you submit

  • Every sound entry carries a named site and laterality
  • Rates state their counting interval; rhythm is characterized
  • The apical location is written in landmark language
  • All grades name their scales as taught in the course text
  • Deviations are described by site, timing and quality, never named diagnostically
  • The regional symptom layer includes the pursued denials

Writing up thorax and heart for NR-302?

Send the instructions and the rubric out of Canvas. A premium original draft comes back in 24 to 48 hours with every sound located and every grade on its scale, and revisions run until the grade lands.

Questions students ask about this stage

I am not confident I heard what I was supposed to hear. How do I document that?
Document what you heard with the confidence you actually have, and let the technique note carry the uncertainty. Breath sounds heard at all assessed sites, qualities difficult to distinguish at the posterior bases, is an honest entry that still demonstrates the systematic sequence, the landmark vocabulary and the comparison habit. Every clinician's first hundred auscultations sounded ambiguous; instructors know this and grade the documented process, not golden ears. What sinks write-ups is the opposite move: transcribing the textbook's expected findings as though they were heard. If your entry describes a perfect exam in perfect vocabulary during your third week with a stethoscope, the grader knows which book it came from. Keep practicing in lab, and let the write-ups tell the truth at each stage of your ear's development.
Why does the apical rate matter if I already documented a radial pulse in vitals?
Because the two measurements can legitimately disagree, and the disagreement is clinical information. The radial pulse counts beats that produced a palpable wave at the wrist; the apical count hears every beat at the source, and in irregular rhythms some beats are too weak to reach the periphery. That is why the apical method, with a full counting interval, is the standard for this region's assessment and why documenting the site and method with the rate is not pedantry. In your write-up, treat them as two distinct data points with two methods, and if your practice session captured both, recording them side by side, each labeled, shows the grader you understand why the course teaches both techniques rather than one.
My partner's assessment was completely normal. How long should the write-up really be?
As long as the systematic exam it documents, which is longer than students expect. A normal cardiorespiratory write-up still carries the inspection entries, the counted pattern, every auscultation site with laterality, the located apical point, the characterized rhythm, the heart sounds, the graded pulses at each taught site on both sides, refill and edema status, and the regional symptom layer with its denials. Written properly, normal fills every section of the frame; it simply fills them with expected findings in the taught vocabulary. The length is the point: a complete normal is the baseline every future abnormal will be measured against, and the rubric is checking whether you can produce that baseline without an abnormality to make it interesting.

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