Feb 23, 2024 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
Assignment 1 Case Study Assignment Assessment Tools and Diagnostic Tests in Adults and Children
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
Assessment Tools and Diagnostic Tests in Adults and Children
Diagnosis and assessment are key in identifying a patient’s health condition. As such, advanced practice nurses need to know how to select appropriate tools for assessment and diagnosis as different tools have specific reliability and validity (Daniel et al., 2018). In addition, depending on the nature of the information needed, tools these tools can be used to great effect to reveal a patient’s status, such as nutrition which can be used in determining if a patient is at risk of a health issue.
As such, the purpose of this assignment is to explore assessment and diagnostic tests in adults. The tools of focus in the mammogram. Various aspects will be explored, including; a description of how the diagnostic test or assessment tool is used in health care, its purpose, how it is conducted, the information it gathers, and an evaluation of its reliability and validity as well as issues with predictive values, reliability, and sensitivity.
Description of the Use of Mammogram
A mammogram is one of the tools commonly used in healthcare, specifically on women. It is a screening tool applied in diagnosis and offers effective imaging in efforts to detect breast carcinoma. The idea is to carry out the test earlier to increase the chances of timeous detection of carcinoma for better prognosis hence leading to higher chances of the breast cancer patient’s survival (Le & Adler, 2020). The instrument uses an imaging technique to come up with a pictorial representation of the breast, which is then analyzed to find out the status.
In healthcare, women, especially those at least forty years of age, are required to go for mammogram tests regularly to help in the timeous detection of breast cancer, as breast cancer is a leading cause of death among women. Late detection has been connected to unfavorable outcomes since when cancer spreads to more cells in an individual’s body, then its treatment becomes more complicated.
The Purpose
The major purpose of a mammogram uses it to help in detecting any alterations in the breast tissues in order to detect cancer. Mammogram tests are capable of detecting microcalcifications even lower than one hundred micrometer diameter. Therefore, this tool is capable of detecting cancer even prior to the development of any visible lumps (Keating & Pace, 2018). Its strength is also inaccurate imaging of the breasts. In addition, mammography can also be applied in pre-operative localization in individuals who have symptoms already.
How it is Conducted
The production of accurate results when using a mammogram heavily hinges on how the test is being conducted. In addition, an accurate interpretation is also needed to arrive at accurate conclusions. One of the factors to consider for accurate results is the issue of talcum powder. The calcium powder can lead to false-positive results; therefore, the patient should not use the powder before the test.
The patient also needs to be honest and open when relaying the past medical history, such as the underlying issues (Zebari et al., 2021). In addition, for better information, the radiologists also need to inform the patient about the expectations, and when the patient indicates that they are ready, they have to be informed to stand in front of the machine with plastic used in strapping the breasts since the breasts will have to be flattened for appropriate images.
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The breast is also flattened to create a uniform thickness as well as enhance the sensitivity of the process in finding the possible possibilities. In addition, low-dose x-rays are used as higher doses could damage the cells and adversely affect the patient’s health. During the test, the breast is also compressed to help in preventing the dispersion of the rays hence focusing them on the targeted part of the body (Zebari et al., 2021). More recently, digital mammograms have also been used where the obtained data is stored in a computer storage section. Digitalization majorly focuses on eliminating human error to improve accuracy.
The Information Gathered
The instrument is applied to reveal mass distribution as the tests reveal the breast calcification region. It is impossible to identify the breast tissue micro calcifications through palpation of the breast (Gøtzsche et al., 2021). The major reason for the complexity is that they are too little for detection.
Validity and Reliability
Validity and reliability are important for instruments used in the diagnosis and assessments of various conditions. Digital mammograms have been shown to be more reliable and accurate in comparison to film-based mammograms. According to Giampietro (2020), the mammogram’s sensitivity is at least eighty-seven percent, as seven percent of the cases are usually negative.
In detecting breast cancer, a series of images are captured using the instrument to help also eliminate the false positives. In most cases, the false positives entail hormone therapy individuals as the strategy enhances breast density and hence could be confused with cancer. In addition, the instrument has an accuracy of 90.9% as they are highly predictive of negative and positive results.
Conclusion
Breast cancer is devastating and leads to loss of lives if not detected early enough and appropriate action is taken. Advance Practice Nurses need to know the importance of using mammograms for early screening for better prognosis. The mammogram is reliable and relevant in diagnosing breast cancer since it has a strong predictive value. In addition, the occurrences of false positives are usually few and hardly occur.
References
Daniel, M., Rencic, J., Durning, S. J., Holmboe, E., Santen, S. A., Lang, V., … & Gruppen, L. D. (2019). Clinical reasoning assessment methods: a scoping review and practical guidance. Academic Medicine, 94(6), 902-912. 10.1097/ACM.0000000000002618.
Giampietro, R. R., Cabral, M. V. G., Lima, S. A. M., Weber, S. A. T., & dos Santos Nunes-Nogueira, V. (2020). Accuracy and effectiveness of mammography versus mammography and tomosynthesis for population-based breast cancer screening: a systematic review and meta-analysis. Scientific reports, 10(1), 1-10. https://doi.org/10.1038/s41598-020-64802-x
Gøtzsche, P. C., Heath, I., & Visco, F. (2021). Mammography screening: truth, lies and controversy. CRC Press.
Keating, N. L., & Pace, L. E. (2018). Breast cancer screening in 2018: time for shared decision making. Jama, 319(17), 1814-1815. Doi: 10.1001/jama.2018.3388.
Le, T. T., & Adler, F. R. (2020). Is mammography screening beneficial: An individual-based stochastic model for breast cancer incidence and mortality. PLoS Computational Biology, 16(7), e1008036. https://doi.org/10.1371/journal.pcbi.1008036.
Zebari, D. A., Ibrahim, D. A., Zeebaree, D. Q., Mohammed, M. A., Haron, H., Zebari, N. A., … & Maskeliūnas, R. (2021). Breast cancer detection using mammogram images with improved multi-fractal dimension approach and feature fusion. Applied Sciences, 11(24), 12122. https://doi.org/10.3390/app112412122
Case Study Assignment 1: Adults and Children Assessment Tools and Diagnostic Tests
Assessment tools aid in the diagnosis of a variety of health problems. A good tool should be highly accurate and dependable. The burden of breast cancer continues to rise in the modern era, necessitating the development of more precise tools to improve screening and diagnostic accuracy.
The purpose of this study is to determine the efficacy of mammograms in detecting breast cancer.
The Test’s Purpose
A mammogram is a screening tool that is used exclusively for diagnostic purposes and provides sufficient imaging to detect breast carcinoma. When performed early in the disease’s progression, there is a greater chance of obtaining a favorable prognosis, which results in an increased chance of patient survival (Le & Adler, 2020). It is essentially a breast x-ray. This imaging technique produces a pictorial representation of the breast using a low x-ray dose.
Women are encouraged to have the test performed on a regular basis to aid in the early detection of breast cancer, as cancer is one of the leading causes of death in women (Seely & Alhassan, 2018). Late detection results in a poor prognosis, as the cancerous cells spread to other parts of the body, making treatment more difficult.
The mammogram is intended to aid in the detection of changes in the breast tissue. The test is capable of detecting microcalcifications smaller than 100 micrometres in diameter; thus, it can detect the possibility of cancer in a patient even before palpable lumps form. Additionally, because the test involves only one or two views of the breast tissues, it provides an accurate image of the breast.
Alternatively, the test is performed in symptomatic patients to aid in pre-operative localization.
Conducting the Test Appropriate preparation is critical in order to obtain the most accurate results possible from the imaging assessment tool. Patients are advised not to wear talcum powders prior to having a mammogram assessment, as they are very likely to produce calcium artifacts, resulting in false-positive results. While interviewing the patient to collect data for the clinical history, it is critical for the patient to be candid about any underlying conditions. Additionally, the radiologist should ensure that their patients understand the significance of the test and what to expect in order to alleviate anxiety.
The patient who has been prepared is instructed to stand in front of the x-ray machine with their breasts secured on a plastic plate. The plate is firmly pressed against the breasts to flatten them and allow the x-ray to penetrate (Mack & Lapane, 2019). Additionally, the flattening is intended to achieve an even thickness and increase the sensitivity of the test procedure for detecting brain abnormalities. Because x-rays can be harmful to your health, it is recommended that you use a low-dose x-ray. The scattering of the rays must be avoided in order for them to reach other parts of the body, which is accomplished by compressing the breasts (Le & Adler, 2020).
Alternatively, a full-field digital electron system may be used to obtain a digital mammogram. The computer is used to transfer the images acquired during the radiological analysis. Digitalization increases the diagnostic procedure’s accuracy by reducing human error. Tomosynthesis is a type of three-dimensional mammography that generates numerous images of the breast from various angles.
Variations in calcium distribution and tissue densities are identified and used to make a diagnosis using the image.
Information Amassed
The test reveals the breast’s mass distribution, the presence of lumps, and areas of calcification. Because palpating cannot detect the minute calcium deposits in the breast, the tests identify the microcalcifications in the breast tissue (Iranmakani et al., 2020).
Mammography Validity, Sensitivity, and Reliability Sensitivity
A valid test should be capable of detecting true positives and negatives. On the other hand, various factors affect the sensitivity and specificity of the tests. As a result, there will always be instances of false positive or negative results. Mammography is a reliable and valid test because it provides comprehensive imaging of the breast and thus aids in detecting even microcalcifications (Badu-Peprah & Adu-Sarkodie, 2018). Additionally, the test is standardized, which reduces the variability in the reporting of results.
Digital mammograms are more precise and dependable than film mammograms. According to Giampietro et al. (2020), the breast mammogram’s estimated sensitivity value is 87 percent, which is significantly higher. On the other hand, approximately 7% of true cases are typically negative.
False positives, on the other hand, can be addressed by taking multiple images to ensure that only those with breast cancer are reported to have the disease. On the other hand, the majority of false-positive cases occur in patients undergoing hormonal therapy, as the procedure increases breast density, which may be mistaken for cancer. Mammograms have a positive predictive value of 89 percent and a negative predictive value of 90.9 percent, respectively (Giampietro et al., 2020).
The test’s high predictive value indicates its reliability.
Conclusion
Finally, a reliable test should generate consistent results, which is a component of predictive value or reproducibility. Mammography has a high predictive value, making it a valid and reliable test for breast cancer screening and diagnosis. Additionally, the test has a low rate of reported false-positive results.
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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.
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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.
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 indicated for various reasons. First, it is used for screening colonoscopies to assess for colorectal cancer in patients at high risks like those with a history of inflammat
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