23 Jan 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:
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
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.
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”
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