For adults with acute cough or breathlessness seen on video, the MN690 Unit 4 protocol sorts every examination element into observed, substituted or deferred, with thresholds attached. Searches like "mn 690 unit 4 assignment example", "mn690 unit 4 sample" and "mn690 unit 4 example" land here.
What a finished MN690 Unit 4 remote examination protocol looks like
Four pages in protocol format, with numbered sections and a one-page quick reference. Setup comes first: identity confirmed with two identifiers, the patient's current address and a callback number recorded before any clinical question, lighting and camera angle adjusted so the chest is visible. The examination table has three columns. Observed: respiratory rate counted over [30] seconds, speech in full sentences, accessory muscle use, lip color in natural light. Substituted: oxygen saturation from a home oximeter held to the camera, temperature from the patient's own thermometer, a family member moving the camera to show the neck and lower ribs. Deferred: auscultation, percussion and tactile fremitus. A red-flag list sets thresholds for same-day in-person care, and a failure section covers dropped connections.
How a MN690 Unit 4 example is structured
The protocol is built around a decision rather than a complete exam: whether this patient can safely stay home today. Setup precedes history because location and callback number are what make an emergency response possible if the patient deteriorates mid-visit. Observation is prescribed precisely, since vague looking produces vague notes; respiratory rate is counted, not estimated, and the patient is asked to count aloud to [20] in one breath. Substitutes carry their limits in the same row. The oximeter row cites the FDA's 2021 safety communication on reduced accuracy in darker skin pigmentation, so a borderline reading in such a patient lowers the threshold for in-person care. Deferral is not failure: auscultation is named as the element the visit gives up, and the red-flag thresholds decide when giving it up stops being acceptable. Connection loss triggers a phone call within [two] minutes.
Setup before history
Two identifiers, a current address, a callback number and a camera angle showing the chest are secured before the first clinical question.
Observation, counted
Respiratory rate over [30] seconds, a count to [20] in one breath and accessory muscle use replace any general impression of comfort.
Substitutes with their limits
Home oximetry, a personal thermometer and a family member steering the camera each appear beside what they cannot supply.
What the visit gives up
Auscultation, percussion and fremitus are named as deferred, and the protocol states plainly that the plan must account for their absence.
Red flags with numbers
Saturation below [92] percent, a rate above [24], inability to finish sentences or new confusion move the patient to same-day in-person care.
When the picture freezes
A phone call within [two] minutes, then emergency services to the confirmed address if the patient cannot be reached during a breathing assessment.
Where marks go in MN690 Unit 4
An inventory of everything a camera might show, feeding no decision, is what weaker protocols submit, and MN690 rubrics commonly reward the opposite: a protocol organized around whether the patient can stay remote. Observation left imprecise, patient appears comfortable, gives the note nothing to record. Substitutes treated as equivalent to hands-on findings overstate the exam; home devices need their limits named in the row where they are used. Red flags without numbers cannot be applied consistently by the next clinician. Protocols that begin the clinical history before confirming location and a callback number leave no route to help if the patient worsens. A missing plan for a frozen screen during a breathing assessment is among the most frequently marked omissions. Sources for thresholds should be cited, not implied.
Get a MN690 Unit 4 example written to your instructions
Name the presentation or visit type your protocol covers, the setting and any home devices patients have; upload the Unit 4 prompt and rubric too. The protocol returns with setup steps, an observed-substituted-deferred table, numeric red flags and a failure path. Free on a first custom sample; delivered in 24-48h.
MN690 Unit 4 questions, answered
Which examination elements can a video visit reliably observe?
General appearance, work of breathing, speech, skin color in good light, gait, range of motion, affect and much of a neurological screen can be observed with reasonable confidence. Anything requiring touch, sound through a stethoscope or special equipment cannot. The protocol's job is to say which category each element falls into for the presentation at hand, and what happens to the ones that cannot be observed.
How reliable are home pulse oximeters?
Useful but imperfect. Readings depend on device quality, circulation, nail polish, motion and skin pigmentation, and the FDA issued a safety communication in 2021 on reduced accuracy in people with darker skin. A protocol can still use them, provided it treats borderline values cautiously, pairs them with observed work of breathing and names the reading that triggers in-person assessment.
Should a protocol include what to do if the connection fails?
Yes, and markers tend to look for it. A dropped video during a breathing assessment leaves the clinician uncertain whether the patient is safe. The protocol names a fallback, usually an immediate phone call to the confirmed number, and a point at which emergency services are sent to the confirmed address. Without that path, the rest of the protocol has no safety floor.