Assignment 1: Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children

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

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N

Colonoscopy is an essential procedure that evaluates the colon mucosa for cancer, adenomas, and inflammation. The purpose of this paper is to outline the function of colonoscopy, the procedure followed when using colonoscopy, and the information generated. The paper will also outline the validity, reliability, sensitivity, and positive predictive values of colonoscopy.

Colonoscopy in Healthcare

Colonoscopy acts as a diagnostic, elective, and therapeutic tool within healthcare settings. It is executed using a colonoscope, a hand-held flexible tube-like tool with a high-definition camera at the tip (Sai

to et al., 2021). The colonoscope also constitutes accessory channels that help in the insertion and fluids to cleanse the colonic mucosa and the colonoscope lens. The camera project visual data on a screen that shows abnormalities and overgrowth of the colonic wall. The data also helps in evaluating, biopsy, and removal of mucosal lesions using the accessory channels.

Colonoscopy Purpose

Colonoscopy is recommended for a variety of reasons. First, it is used for screening colonoscopies to assess for colorectal cancer in patients at high risk, such as those with inflammatory bowel disease, hereditary polyposis, a family history of colorectal cancer at age 60, and surveillance after colorectal cancer resection (Saito et al., 2021). According to medical guidelines, screening should begin at the age of 45 and be repeated every ten years. Colonoscopy is an elective procedure that evaluates symptoms such as unexplained changes in bowel habits, inflammatory colitis, GI bleeding, geriatric weight loss, persistent abdominal pain, and iron deficiency anemia (Saito et al., 2021). Colonoscopy aids in the excision and ablation of lesions, the removal of foreign bodies, stenosis dilation, palliative management of known neoplasms, and the treatment of bleeding lesions.

The assessment tools aid in the diagnosis of a wide range of illnesses. A good tool should be extremely precise and reliable. Breast cancer is becoming more common in today’s world, necessitating the development of more effective and reliable screening and diagnostic technologies. The current study investigates how effective mammography tests are at detecting breast cancer.

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 required for the imaging assessment tool to produce the most accurate results. Patients are advised not to wear talcum powders prior to having a mammogram assessment because they are very likely to produce calcium artifacts, resulting in false-positive results. When collecting data for the clinical history, it is critical that the patient be open about any underlying conditions they may be experiencing. To reduce anxiety, the radiologist should also explain the implications of the test and what to expect. The patient is instructed to stand in front of the x-ray machine with their breasts on a plastic plate. The plate is firmly pressed against the breast to flatten it and allow the x-ray to penetrate (Mack & Lapane, 2019). Furthermore, the flattening is intended to achieve an even thickness and improve the test procedure’s sensitivity in detecting abnormalities in the brain. Because x-rays can be harmful to one’s health, it is best to use low-dose x-rays. The scattering of the rays must be avoided so that they do not reach other parts of the body, which is accomplished by compressing the breasts (Le & Adler, 2020).

A digital mammogram can also be obtained using a full-field digital electron system. The images from the radiological analysis are saved to the computer. Because it reduces human errors, digitalization improves diagnostic procedure accuracy. 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

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

When it comes to predictive value, or reproducibility, it is important to note that reliable tests should yield consistent results. Breast cancer screening and diagnosis can be greatly improved with the use of mammography, a test with a high rate of accuracy. It also has a low rate of false-positive results.

Clinical genetic testing is expected to become commonplace in the near future, according to many specialists. However, the World Health Organization (WHO) has stated that many of the genetic tests currently in development have “questionable predictive usefulness.”

Chronic obesity is still one of the most common health problems in this country. High rates of obesity are straining the U.S. healthcare system as a leading cause of mortality, illness and disability as well as healthcare utilization and healthcare expenses (Obesity Society, 2016). Obesity affects 39.8 percent of American adults (CDC, 2018). As of 2008, medical expenses in the United States were expected to be $147 billion a year for obesity, which is $1,429 more than the medical costs for those of normal weight (CDC, 2018).

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Read Also: Discussion: Building a Health History NURS 6512

The number of obese children and adolescents has more than tripled in the last 30 years, according to the CDC, which estimates that 13.7 million children and adolescents are obese (CDC, 2018). Body measurements can provide important information about a patient’s general health and nutritional status. This is especially true for patients under the age of eighteen. Children’s responses to illness can be predicted using standard measurements such as height and weight. In order to assess nutritional health risks and pediatric development while being sensitive to other factors that may affect these measurements, nurses must be adept in using evaluation tools such as the Body Mass Index (BMI) and growth charts. Adult weight and health can also be gauged by calculating one’s BMI.

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)

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

Assessment Tools and Diagnostic Tests

Advanced practice nurses use a wide range of diagnostic tests and assessment tools to figure out how sick a patient is. However, these health professionals should be aware of how reliable, valid, and sensitive the tools they use are. By taking this step, the correct results of the test will be made sure of. It will also help make sure that both young people and adults are diagnosed correctly so that the wrong decisions aren’t made for either group. Mammograms are often used to find out what’s wrong. Low-energy X-rays are used by this tool to look at a person’s breasts for diagnosis and screening (Suresh et al., 2018). It is a tool that doctors and nurses use to look for breast cancer in women. The main reason why women get mammograms is so that breast cancer can be found early on. This tool works well to find breast cancer in mammals, which helps doctors figure out what’s wrong early. This tool helps doctors figure out what’s wrong with a patient and start treatment as soon as possible.

When a mammogram is being done, the patient has to stand in front of the diagnostic tool. The tool has a special X-ray that can be used to look at the breast. The doctor will then press the breast as needed between two plates that help hold the breast still for the screening. The plates push the breasts down, and then the X-ray is taken. The doctor might take more X-rays to help figure out whether or not a patient has breast cancer. This shows how the diagnostic test called a mammogram is done.

The mammogram is used to find out a lot of different things. The tool collects data about whether or not there are tumors in the breast. This information helps the doctor figure out if the patient has breast cancer or is at risk of getting it. The tool also collects information about calcium deposits, which helps the health care provider figure out if the patient has breast cancer. The tool also helps provide images that show how the patient’s breasts are doing. With this information, the patient’s condition will be correctly diagnosed, and a good treatment plan will be made to help the patient recover from breast cancer. The tool is also good for getting information about breast pain, discharge from the nipple, breast size and shape, and thickening of the breast. This kind of information is very important when trying to figure out if someone has breast cancer.

The tool for mammograms has a high rate of reliability and validity. The fact that the tool can diagnose breast cancer between 80% and 98% of the time makes it a valid and reliable diagnostic tool. Before choosing to use a diagnostic tool or test, people in the health care field find out if it is valid and reliable. A mammogram is a tool that can be used to help more people with breast cancer get treated and live (LAA, 2018). If a tool isn’t reliable, it could lead to wrong or misleading results. In the health sector, it is very important to evaluate the validity and reliability of any diagnostic tool.

When it comes to sensitivity, mammography has a high rate of about 97% among its patients (What is a mammogram, 2020).

Because of this, the tool works well to find breast cancer in women. It also means that the tool works and that doctors and nurses can use it to help women fight breast cancer. The sensitivity of mammography, on the other hand, is higher in women over 50 than in women younger than 50. But the diagnostic tool is still useful and helps doctors figure out what’s wrong with their patients.

There are no big problems with how well this diagnostic tool works. With this change, the tool will work better in health centers. The only problem with mammography is that it’s not the best way to find out if someone has breast cancer. If breast cancer is hidden by healthy breast tissue, the mammogram might not find it. This fact leads to wrong results called “false negatives” and doesn’t help women find out if they have breast cancer. The diagnostic tool can also help find signs of cancer that might not be cancer at all but just be normal breast tissue. So, the diagnostic tool is no longer reliable because it could give unreliable results.

Mammography is thought to be very accurate—about 80% of the time. The problem with this tool’s usefulness, though, is that it only has an 89 percent positive predictive value and a 90.9 percent negative predictive value (What is a mammogram, 2020). The diagnostic tool is, however, correct, and it gives results that health professionals can trust and use. Patients with cancer are easier to treat when doctors can tell ahead of time if their treatment will work. This tool has helped a lot of people live better lives. Early detection of breast cancer speeds up the treatment process and makes it easier for a person to get better. So that the health professional can make decisions based on the results of the mammogram that don’t turn out to be wrong, repeated tests are done. This move keeps mistakes from happening.