Feb 23, 2024 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
Assignment 1 Case Study Assignment Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N
Bodyweight and its perception play a crucial role in the mental and physical well-being of an individual. The World Health Organization (WHO) utilized the body mass index (BMI) to classify different kinds of weight statuses. A BMI of less than 18.5 is considered underweight whereas gretaer than 25 is considered overweight (Golubnitschaja et al., 2021).
The WHO reports an increasing rate of underweight among college students especially women, who have the perception that ‘thinner is better.’ This has led to an increased rate of malnutrition among these women and mental issues like depression and anxiety among others. The purpose of this paper is to elaborate on the health issues and risks which may impact the health of a 25-year-old Caucasian female college student who is underweight with anxiety and lives in a dorm with a roommate whose weight is normal.
Health Issues and Risks
Most young female adults, especially those who are in college consider a thin body image as ideal. The ‘thin is better’ perception among these women has led to increased rates of body image disturbance and disordered eating. Being underweight is very problematic as it can jeopardize the health of the individual in the long run. Underweight individuals may experience a reduction in sex hormones and the density of bone marrow leading to anemia, fatigue, and discomfort, in addition to eating disorders like binge eating disorders, bulimia nervosa, and anorexia nervosa (Kibria et al., 2019).
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Studies also show that being underweight increases the risks of cardiovascular diseases. Some studies show that underweight childbearing women like the one in the provided case study display an increased risk of preterm, birth, and infertility (Golubnitschaja et al., 2021). The patient also has anxiety and lives with a normal-weight roommate. This can contribute to body image dissatisfaction which would worsen the patient’s mental health.
Additional Information
For further assessment of the patient’s underweight status, it is crucial to know her exact BMI, hence the need to record her body weight and height. Additional, in evaluating the cause of the patient underweight, it is necessary to obtain adequate information such as the patient eating patterns both at home and when she is in college, in addition to other lifestyle habits like physical activity, and food choices among others (Lee& Kim, 2018). Given that being underweight is genetic just like obesity, it is necessary to take a complete patient history of family members who have had the same experience.
On the other hand, the female college student also has anxiety, which is probably associated with her body weight, given that her roommate is of normal body weight. As a result, it will be necessary to assess whether the patient is satisfied with her current body image and if the weight loss was intentional. This will help promote a comprehensive mental evaluation to determine whether the patient underweight is related to physical or mental causes for the development of an appropriate care plan.
Risk Assessment
The underweight female college student is at high risk of health issues such as malnutrition, anemia, depression, anxiety, and eating disorders just as mentioned above. However, given that weight-related issues are associated with high rates of emotional dysregulation, the clinician must consider gaining more information from the patient in a sensitive manner (Hong et al., 2018).
As such, it is necessary to be very considerate and use professional and respectful language when collecting sensitive information from the client. Additionally, the clinician must be neutral and nonjudgmental and show the client that they are aware of what they are going through. This way, the client will feel more comfortable, hence providing accurate and relevant information to promote the care plan.
To gain a full understanding of the client’s condition, It will be necessary to review the cause of the client being underweight, by considering life habits or genetic factors as mentioned earlier. Gaining information on the patient’s past medical history is also necessary as this will help determine whether the cause of the patient being underweight is associated with a certain medical condition.
It is also necessary to explore and discuss with the client her emotions and events associated with eating in a sensitive manner (Thomas & Warren-Findlow, 2020). Lastly, it is also crucial to discuss with the client her current activity levels to promote the development of a progressive exercise program tailored to the individual’s goals and choice.
Questions
What is your daughter’s opinion on her body image, based on how she talks about her body weight when at home?
Please describe the eating habits of your daughter when at home, in terms of how frequently she eats healthy foods, and in what quantities?
How confident is your daughter when she is around her age mates?
Mitigating Strategies
Parents or caregivers play a crucial role in promoting the health and well-being of their children. In this case, it is crucial to advise the parents to get involved in helping the patient achieve a normal body weight by offering non-judgmental support. The first way the parent can be proactive in promoting the health of their daughter is through helping her regain an understanding of what ideal body weight is and the health risks associated with being underweight. This can be achieved through organizing family sessions with a dietitian and nutritionist to help develop a healthy eating plan to help their daughter achieve and maintain normal body weight (Lyzwinski et al., 2018).
The other strategy is by boosting their child’s self-esteem to promote body image confidence. They need to motivate her to proceed with the care plan for gaining weight for her health benefits and not her physical appearance. The parents must help her take her medication and always remind her of the benefits of having an ideal body weight.
Conclusion
The provided case study demonstrates an underweight college student, who also has anxiety. The health assessment of this client will thus involve both physical and mental evaluation given the risks associated with being underweight. Given that weight-related issues are associated with emotional dysregulation, the healthcare provider must use sensitive language when collecting information from the client. Parents or caregivers must also be involved in the management of the patient’s condition to promote a positive outcome.
References
Golubnitschaja, O., Liskova, A., Koklesova, L., Samec, M., Biringer, K., Büsselberg, D., … & Kubatka, P. (2021). Caution,“normal” BMI: health risks associated with potentially masked individual underweight—EPMA Position Paper 2021. EPMA Journal, 12(3), 243-264. https://doi.org/10.1007/s13167-021-00251-4
Hong, S. A., Peltzer, K., Lwin, K. T., & Aung, L. S. (2018). The prevalence of underweight, overweight, and obesity and their related socio-demographic and lifestyle factors among adult women in Myanmar, 2015-16. PloS one, 13(3), e0194454. https://doi.org/10.1371/journal.pone.0194454
Kibria, A., Muhammed, G., Swasey, K., Hasan, M. Z., Sharmeen, A., & Day, B. (2019). Prevalence and factors associated with underweight, overweight, and obesity among women of reproductive age in India. Global health research and policy, 4(1), 1-12. https://doi.org/10.1186/s41256-019-0117-z
Lee, S. B., & Kim, J. H. (2018). Comparison of dietary behaviors and blood clinical indices in underweight, normal weight, normal weight obese and obese female college students. Korean Journal of Community Nutrition, 23(5), 431-443. https://doi.org/10.5720/kjcn.2018.23.5.431
Lyzwinski, L. N., Caffery, L., Bambling, M., & Edirippulige, S. (2018). The relationship between stress and maladaptive weight-related behaviors in college students: a review of the literature. American Journal of Health Education, 49(3), 166-178. https://doi.org/10.1080/19325037.2018.1449683
Thomas, E. V., & Warren-Findlow, J. (2020). Body image, self-esteem, and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention. Journal of American College Health, 68(6), 658-665. https://doi.org/10.1080/07448481.2019.1590370
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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 (Saito 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.”
—Doctor of Philosophy Leslie Pray
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
Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N
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 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
Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children NURS 6512N
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 wel
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