NURS 6512 Week 3 Discussion: Assessment Tools and Diagnostic Tests in Adults and Children

Discussion: Assessment Tools and Diagnostic Tests in Adults and Children: When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture-among other factors-are also relevant. That said, gathering and communicating this information can be a delicate process.

In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To prepare for Assessment Tools and Diagnostic Tests in Adults and Children:

Review this week’s learning resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. We will also review examples of pediatric patients and their families as it relates to BMI.

This week you will be assigned one of the following DB by your instructor.

Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:

• Mammogram
• Prostate-specific antigen (PSA) test
• Body-mass index (BMI) using waist circumference for adults
• Select one of the examples on which to focus for this Discussion. What health issues and risks may be relevant to the child you selected?
• Overweight 5-year-old boy with overweight parents
• 5-year-old girl of normal weight with obese parents
• Severely underweight 12-year-old girl with underweight parents

Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

What does the literature discuss regarding the validity, reliability, and are there any issues with sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool?

Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

By Day 3 of Assessment Tools and Diagnostic Tests in Adults and Children

Post a description of how the assessment tool or diagnostic test you selected is used in health care. Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

OR

Post an explanation of the health issues and risks that are relevant to the child you selected. Describe additional information you would need in order to further assess his or her weight-related health. Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information. Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight. Assessment Tools and Diagnostic Tests in Adults and Children Discussion

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Assessment Tools and Diagnostic Tests in Adults and Children

Respond to at least two of your colleagues who selected a different tool test, or child health example than you, using one or more of the following approaches:

Critique your colleague’s evaluation of the validity and reliability of the tool or test selected.

Suggest alternative or additional tools or tests that should be considered when gathering information about specific conditions or symptoms.

Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

Suggest additional health risks or issues that could be relevant to the child.

Critique your colleagues’ questions, and suggest how the parents or caregivers might interpret these questions. Provide alternate or additional questions.

Suggest an additional strategy for gathering patient information or promoting proactivity.

Assignment: Health History Assessment Video

A comprehensive health history is essential to providing quality care for patients across the lifespan, as it helps to properly identify health risks, diagnose patients, and develop individualized treatment plans. To effectively collect these heath histories, you must not only have strong communication skills, but also the ability to quickly establish trust and confidence with your patients. For this Assignment, you begin building your communication and assessment skills as you collect a health history from a volunteer “patient.” Assessment Tools and Diagnostic Tests in Adults and Children Discussion

To prepare:

• Arrange an appropriate time and setting with your volunteer “patient” to collect a health history.Note: Your volunteer’s Video Release Form must be submitted prior to collecting the health history. Refer to the Week 1 Looking Ahead for release form details.
• Download and review the History Subjective Data Checklist provided in this week’s Learning Resources.
• Ensure that you have appropriate lighting to record yourself collecting the patient’s health history.

To complete:

• Record yourself collecting the patient’s health history, covering all of the areas listed in the checklist.

By Day 7 of Week 4

Your Assignment is due.

NURS 6512 Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children

Many experts predict that genetic testing for disease susceptibility is well on its way to becoming a routine part of clinical care. Yet many of the genetic tests currently being developed are, in the words of the World Health Organization (WHO), of “questionable prognostic value.”

– Leslie Pray, PhD

  Obesity remains one of the most common chronic diseases in the United States. As a leading cause of United States mortality, morbidity, disability, healthcare utilization and healthcare costs, the high prevalence of obesity continues to strain the United States healthcare system (Obesity Society, 2016).  More than one-third (36.5%) of U.S. adults have obesity (CDC, 2016). The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2016).

According to the Centers for Disease Control and Prevention (CDC), the rate of childhood obesity has tripled in the past 30 years, with an estimated 12.5 million children considered obese (CDC, 2012). When seeking insights about a patient’s overall health and nutritional state, body measurements can provide a valuable perspective. This is particularly important with pediatric patients. Measurements such as height and weight can provide clues to potential health problems and help predict how children will respond to illness. Nurses need to be proficient at using assessment tools such as the Body Mass Index (BMI) and growth charts in order to assess nutrition-related health risks and pediatric development while being sensitive to other factors that may affect these measures. Body Mass Index is also used as a predictor for measurement of adult weight and health. Assessment Tools and Diagnostic Tests in Adults and Children Discussion

Assessments are constantly being conducted on patients, but they may not provide useful information. In order to ensure that health assessments provide relevant data, nurses should familiarize themselves with test-specific factors that may affect the validity, reliability, and value of these tools. Assessment Tools and Diagnostic Tests in Adults and Children Discussion

This week, you will explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions. You will examine the validity and reliability of these tests and tools. You will also examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition.

Learning Objectives

Students will:

• Evaluate validity and reliability of assessment tools and diagnostic tests.
• Analyze diversity considerations in health assessments.
• Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment.
• Assess weight-related health risks for pediatric patients.
• Design effective strategies for communicating with parents or caregivers about children’s weight-related health.
• Apply concepts, theories, and principles relating to health assessment techniques and considerations related to growth, measurement, and nutrition.
• Apply assessment skills to collect patient health histories*

*The Assignment related to this Learning Objective is introduced this week and submitted in Week 4.

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Learning Resources

Required Readings

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

• • Chapter 3, “Examination Techniques and Equipment” (pp. 30-49). This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

• • Chapter 6, “Growth and Measurement” (pp. 79-94). In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth amongst the organ systems.

• • Chapter 7, “Nutrition” (pp. 95-113). This chapter focuses on how nutrition affects growth, development, and health maintenance. The authors also provide guidelines for assessing nutrient intake.

• Review of Chapter 26, “Recording Information” (pp. 616-631). This chapter provides rationale and methods for maintaining clear and accurate records. The text also explores the legal aspects of patient records.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”. This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

• Chapter 2, “The Comprehensive History and Physical Exam” (pp. 23-32)
• Appendices B-C (pp. 373-376)
• Chapter 6, “Adult Preventative Care Visits” (pp. 125-139)
• Chapter 5, “Pediatric Preventative Care Visits” (pp. 93-108)

Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine, 156(2), 162–163. Retrieved from the Walden Library databases. This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care. Annals of Internal Medicine, 156(2), 147–150.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011).History subjective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. (PDF), This History Subjective Data Checklist was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

Gibbs, H., & Chapman-Novakofski, K. (2012). Exploring nutrition literacy: Attention to assessment and the skills clients need. Health, 4(3), 120–124. Retrieved from the Walden Library databases. This study explores nutrition literacy. The authors examine the level of attention paid to health literacy among nutrition professionals, and the skills and knowledge needed to understand nutrition education.

Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R. (2014). Weight status misperception as related to selected health risk behaviors among middle school students. Journal of School Health, 84(2), 116–123. doi:10.1111/josh.12128,

Centers for Disease Control and Prevention. (2012). Childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood/. This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.

• Chapter 3, “The Physical Screening Examination”
• Chapter 17, “Principles of Diagnostic Testing”
• Chapter 18, “Common Laboratory Tests”