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NURS 6512: Advanced Health Assessment and Diagnostic Reasoning | Week 3
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.
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.
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.
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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.
NURS 6512 Week 3: assessment tools and diagnostic tests essay assignment
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:
- 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
- Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:
- 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
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.
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
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