Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N

April 5, 2022
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Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children

Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N

Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N

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Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

The assessment tools help in the diagnosis of various health conditions. A good tool should have a high level of accuracy and reliability. The burden of breast cancer continues to increase in the current era and so better and accurate tools need to be developed to increase the screening and diagnostic accuracy. The current study explores the effectiveness of mammogram tests in detecting breast cancer.

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The Purpose of the Test

A mammogram can be termed as a screening tool specifically used for diagnostic purposes that provides enough imaging to detect breast carcinoma. If performed in its earlier stages, there is a higher chance of getting a good prognosis which in turn is beneficial for an increased chance of patient survival (Le & Adler, 2020). It is essentially an x-ray of the breast. This imaging technique uses a low x-ray dose to produce a pictorial presentation of the breast. Women are encouraged to have the test done regularly to help in the early detection of breast cancer considering that cancer is among the leading killer diseases in women (Seely & Alhassan, 2018). Late diagnosis results in poor prognosis since the cancerous cells spread to other parts of the body and so become difficult to treat. The mammogram aims to help in identifying the changes in the breast tissue. The test can detect micro-calcifications of less than 100 micrometres; therefore, it can detect the possibility of a patient having cancer before even the palpable lumps form. Furthermore, the test involves one or two views of the breast tissues and so provides an accurate visualization of the breast. Alternatively, the test is also done in symptomatic cases to help in the pre-surgical localization.

Conducting the Test

Adequate preparation is important for obtaining the most accurate results from the imaging assessment tool. Patients are advised prior to having a mammogram assessment not to wear talcum powders as they are very likely to produce calcium artefacts that will result in false-positive results. While interviewing the patient for data collation for the clinical history, it is imperative for the patient to be open about any underlying condition they might be experiencing. Also, the radiologist should let their patients understand the implication of the test and what they expect to minimize anxiety. The prepared patient is tasked to stand in front of the x-ray machine with their breasts put on a plastic plate. The plate is pressed firmly on the breast to flatten them and allow penetration of the x-ray (Mack & Lapane, 2019). Furthermore, the flattening is meant to achieve an even thickness and improve the sensitivity of the test procedure in identifying the abnormalities in the brain. X-rays can be harmful to health; therefore, it is recommended to use low-dose x-ray. The scattering of the rays must be prevented so that they don’t reach other parts of the body and this is achieved through the compression of the breasts (Le & Adler, 2020).

Alternatively, a digital mammogram may also be taken using a full-field digital electron system. The images captured from the radiological analysis are transferred to the computer. Digitalization improves the accuracy of the diagnostic procedure because it minimizes human errors. Tomosynthesis is 3-D mammography that produces many images of the breast from different angles. The variations in the calcium distribution and tissue densities are identified from the image and used to make a diagnosis.

Gathered Information

The test provides information on the mass distribution of the breast, the availability of lumps, and areas of calcification. The tiny calcium deposits in the breast cannot be detected by palpating, therefore, the tests identify the micro-calcifications in the breast tissue (Iranmakani et al., 2020).

Validity, Sensitivity, and Reliability of Mammography Sensitivity

A good test should have the ability to detect the true positives and true negatives. On the other hand, the sensitivity and specificity of the tests are affected by various factors. Therefore, there will always be cases of false positive or false negative. The mammogram test is reliable and valid because it provides comprehensive imaging of the breast and so helps in identifying even the micro-calcifications (Badu-Peprah & Adu-Sarkodie, 2018). In addition, the test is also standardized, and this reduces the variability in the results reporting.

Digital mammograms are more accurate and reliable. According to Giampietro et al. (2020), the estimated sensitivity value for the breast mammogram is 87% which is significantly high. On the other hand, about 7% of the true cases are usually

Assignment 1 Case Study Assignment Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N

Assignment 1 Case Study Assignment Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N

negative. However, the issues of false positives can be addressed by having multiple images taken so that only those people with breast cancer are reported to be having the disease. On the other hand, most of the false-positive cases are reported among the patients undergoing hormonal therapy because the procedure increases the breast densities, and this could be confused for cancer. The positive predictive value and the negative predictive value for a mammogram are 89% and 90.9% respectively (Giampietro et al., 2020). The high predictive value indicates that the test is reliable.

Conclusion

Finally, a reliable test should produce a consistent result, and this is an element of predictive value or reproducibility. Mammogram has a high predictive value and so valid and reliable test for screening and diagnosis of breast cancer. Furthermore, the test has a low level of false-positive cases reported.

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 (39.8%) of U.S. adults have obesity (CDC, 2018). 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, 2018).

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 13.7 million children and adolescents considered obese (CDC, 2018). 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.

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
  • Apply assessment skills to collect patient health histories

Learning Resources

Required Readings (click to expand/reduce)

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. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

  • Chapter 3, “Examination Techniques and Equipment”

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 8, “Growth and Nutrition”

In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.

 

  • Chapter 5, “Recording Information”  (Previously read in Week 1)

This chapter provides rationale and methods for maintaining clear and accurate records. The text also explores the legal aspects of patient records.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guide. In Seidel’s guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line:  Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Centers for Disease Control and Prevention. (2018). 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.

Chaudhry, M. A. I., & Nisar, A. (2017). Escalating health care cost due to unnecessary diagnostic testing. Mehran University Research Journal of Engineering and Technology, (3), 569.

This study explores the escalating healthcare cost due the unnecessary use of diagnostic testing. Consider the impact of health insurance coverage in each state and how nursing professionals must be cognizant when ordering diagnostics for different individuals.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

 

  • Chapter 1, “Clinical Reasoning, 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.

Gibbs , H., & Chapman-Novakofski, K. (2012). Exploring nutrition literacy: Attention to assessment and the skills clients need. Health, 4(3), 120–124.

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

Credit Line: Weight status misperception as related to selected health risk behaviors among middle school students by Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R., in Journal of School Health, Vol. 84/Issue 2. Copyright 2014 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

Noble, H., & Smith, J. (2015) Issues of validity and reliability in qualitative research . Evidence Based Nursing, 18(2), pp. 34–35.

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.

Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

 

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

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

  • Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Week 1)
  • Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file]. Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkY

Shadow Health. (n.d.). Shadow Health help desk. Retrieved from https://support.shadowhealth.com/hc/en-us

Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)

Document: Shadow Health Nursing Documentation Tutorial (Word document)

Document: Student Acknowledgement Form (Word document)

Note: You will sign and date this form each time you complete your DCE Assignment in Shadow Health to acknowledge your commitment to Walden University’s Code of Conduct.

Optional Resource

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”

Required Media (click to expand/reduce)

Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

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.

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.

Photo Credit: Getty Images/Hero Images

For this Assignment, 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. You also will review examples of pediatric patients and their families as it relates to BMI.
  • By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
  • Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
  • Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
  • If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
    • 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.

The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:

  • A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
    • What is its purpose?
    • How is it conducted?
    • What information does it gather?
  • 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.

Assignment Option 2: Child Health Case:
Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and 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.
  • 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.
By Day 6 of Week 3

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn1+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 3 Assignment 1 Option 1 Rubric

To access your rubric:

Week 3 Assignment 1 Option 2 Rubric

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 6 of Week 3

To participate in this Assignment:

Week 3 Assignment 1

Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

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 DCE Assignment, you begin building your communication and assessment skills as you collect a health history from a volunteer “patient.”

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To Prepare

  • Review this week’s Learning Resources as well as the Taking a Health History media program, and consider how you might incorporate these strategies. Download and review the Student Checklist: Health History Guide and the History Subjective Data Checklist, provided in this week’s Learning Resources, to guide you through the necessary components of the assessment.
  • Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
  • Review the Shadow Health Student Orientation media program and the Useful Tips and Tricks document provided in the week’s Learning Resources to guide you through Shadow Health.
  • Review the Week 4 DCE Health History Assessment Rubric, provided in the Assignment submission area, for details on completing the Assignment.

DCE Health History Assessment:

Complete the following in Shadow Health:

Orientation

  • DCE Orientation (15 minutes)
  • Conversation Concept Lab (50 minutes)

Health History

  • Health History of Tina Jones (180 minutes)

Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve 80% or better, but you must take all attempts by the Week 4 Day 7 deadline.

Submission and Grading Information

No Assignment submission due this week but will be due Day 7, Week 4.

Grading Criteria

To access your rubric:

Week 4 Assignment 2 DCE Rubric

What’s Coming Up in Module 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 3, you will examine advanced health assessments using a system focused approach.

Next week, you will specifically explore how to assess the skin, hair, and nails, as well as how to evaluate abnormal skin findings while conducting health assessments. You will also complete your first Lab Assignment: Differential Diagnosis for Skin Conditions as well as complete your DCE: Health History Assessment in the simulation tool, Shadow Health.

Week 4 Required Media

Photo Credit: [fergregory]/[iStock / Getty Images Plus]/Getty Images

Next week, you will need to view several videos and animations in Seidel’s Guide to Physical Examination as well as other media, as required, prior to completing your Lab Assignment. There are several videos in varied lengths. Please plan ahead to ensure you have time to view these media programs to complete your Assignment on time.

Next Module

To go to the next module:

Module 3

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Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_1
Grid View
List View
Excellent Good Fair Poor
In 3–4 pages, address the following:

A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
o What is its purpose?
o How is it conducted?
o What information does it gather?
30 (30%) – 35 (35%)
The response clearly, accurately, and with specific detail describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
24 (24%) – 29 (29%)
The response accurately describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
18 (18%) – 23 (23%)
The response vaguely and/or with some inaccuracy describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
0 (0%) – 17 (17%)
The response is inaccurate or missing descriptions of how the assessment tool or diagnostic test assigned is used in healthcare,

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