Assessment Tools and Diagnostic Tests in Adults and Children

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

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

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:(Am assigned option 2)
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.

Assigned

Health Issues R/T Weight: Choose one of the following:

Overweight 5-year-old black boy with overweight parents who work full-time and the boy spends his time after school with his grandmother
5-year-old Asian girl of normal weight with obese parents who is home schooled

Assignment_1_Rubric_Option_2

	Excellent	Good	Fair	Poor
In 3–4 pages, address the following: An explanation of the health issues and risks that are relevant to the child you were assigned.	Points Range: 20 (20%) – 25 (25%) The response clearly, accurately, and in detail explains the relevant health issues and risks for the assigned child.	Points Range: 19 (19%) – 24 (24%) The response accurately explains the relevant health issues and risks for the assigned child.	Points Range: 18 (18%) – 23 (23%) The response vaguely and with some inaccuracy explains the relevant health issues and risks for the assigned child.	Points Range: 0 (0%) – 17 (17%) The response is inaccurate and/or missing explanations of the relevant health issues and risks for the assigned child.
Describe additional information you would need in order to further assess his or her weight-related health.	Points Range: 20 (20%) – 25 (25%) The response clearly and accurately describes detailed additional information needed to further assess the child’s weight-related health.	Points Range: 19 (19%) – 24 (24%) The response accurately describes additional information needed to further assess the child’s weight-related health.	Points Range: 18 (18%) – 23 (23%) The response vaguely and with some inaccuracy describes additional information needed to further assess the child’s weight-related health.	Points Range: 0 (0%) – 17 (17%) The response is inaccurate and/or missing a description of additional information needed to further assess the child’s 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.	Points Range: 18 (18%) – 20 (20%) The response clearly and accurately identifies and describes in detail any risks to the child’s health. The response clearly and accurately identifies and describes in detail further information needed to gain a full understanding of the child’s health, with a detailed explanation of how to gather that information in a way that is sensitive to the child.	Points Range: 16 (16%) – 17 (17%) The response accurately identifies and describes any risks to the child’s health. The response accurately identifies and describes further information needed to gain a full understanding of the child’s health, with a clear explanation of how to gather that information in a way that is sensitive to the child.	Points Range: 14 (14%) – 14 (14%) The response vaguely and with some inaccuracy identifies and describes any risks to the child’s health. The response vaguely identifies and describes further information needed to gain a full understanding of the child’s health, with a vague explanation of how to gather that information in a way that is sensitive to the child.	Points Range: 0 (0%) – 13 (13%) The response identifies inaccurately and/or is missing descriptions of any risks to the child’s health. The response identifies inaccurately and/or is missing descriptions of further information needed to gain a full understanding of the child’s health, with an inadequate or missing explanation of how to gather that information in a way that is sensitive to the child.
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.	Points Range: 10 (10%) – 10 (10%) The response clearly and accurately lists three or more specific questions that would gather more information about the child. Specific questions are carefully worded to clearly demonstrate sensitivity to the parent(s) or caregiver(s) of the child.	Points Range: 9 (9%) – 9 (9%) The response lists three specific questions that would gather more information about the child. Specific questions are worded to demonstrate sensitivity to the parent(s) or caregiver(s) of the child.	Points Range: 8 (8%) – 8 (8%) The response lists three questions with wording that is vague and lacking specificity for gathering more information about the child. Some wording of the questions lacks sensitivity to the parent(s) or caregiver(s) of the child.	Points Range: 0 (0%) – 7 (7%) The response lists two or fewer confusing or inadequate questions, or is missing questions, for gathering more information about the child. Wording of questions provided lacks sensitivity to the parent(s) or caregiver(s) of the child.
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.	Points Range: 5 (5%) – 5 (5%) The response clearly describes two or more detailed strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.	Points Range: 4 (4%) – 4 (4%) The response describes at least two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.	Points Range: 3 (3%) – 3 (3%) The response vaguely describes two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.	Points Range: 0 (0%) – 2 (2%) The response inadequately describes one strategy or is missing strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.	Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.	Points Range: 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.	Points Range: 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	Points Range: 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.	Points Range: 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors.	Points Range: 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.	Points Range: 5 (5%) – 5 (5%) Uses correct APA format with no errors.	Points Range: 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.	Points Range: 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors.	Points Range: 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors.
Total Points: 100

Excellent

Good

Fair

Poor

In 3–4 pages, address the following:

An explanation of the health issues and risks that are relevant to the child you were assigned.

Points Range: 20 (20%) – 25 (25%)

The response clearly, accurately, and in detail explains the relevant health issues and risks for the assigned child.

Points Range: 19 (19%) – 24 (24%)

The response accurately explains the relevant health issues and risks for the assigned child.

Points Range: 18 (18%) – 23 (23%)

The response vaguely and with some inaccuracy explains the relevant health issues and risks for the assigned child.

Points Range: 0 (0%) – 17 (17%)

The response is inaccurate and/or missing explanations of the relevant health issues and risks for the assigned child.

Describe additional information you would need in order to further assess his or her weight-related health.

Points Range: 20 (20%) – 25 (25%)

The response clearly and accurately describes detailed additional information needed to further assess the child’s weight-related health.

Points Range: 19 (19%) – 24 (24%)

The response accurately describes additional information needed to further assess the child’s weight-related health.

Points Range: 18 (18%) – 23 (23%)

The response vaguely and with some inaccuracy describes additional information needed to further assess the child’s weight-related health.

Points Range: 0 (0%) – 17 (17%)

The response is inaccurate and/or missing a description of additional information needed to further assess the child’s 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.

Points Range: 18 (18%) – 20 (20%)

The response clearly and accurately identifies and describes in detail any risks to the child’s health. The response clearly and accurately identifies and describes in detail further information needed to gain a full understanding of the child’s health, with a detailed explanation of how to gather that information in a way that is sensitive to the child.

Points Range: 16 (16%) – 17 (17%)

The response accurately identifies and describes any risks to the child’s health. The response accurately identifies and describes further information needed to gain a full understanding of the child’s health, with a clear explanation of how to gather that information in a way that is sensitive to the child.

Points Range: 14 (14%) – 14 (14%)

The response vaguely and with some inaccuracy identifies and describes any risks to the child’s health. The response vaguely identifies and describes further information needed to gain a full understanding of the child’s health, with a vague explanation of how to gather that information in a way that is sensitive to the child.

Points Range: 0 (0%) – 13 (13%)

The response identifies inaccurately and/or is missing descriptions of any risks to the child’s health. The response identifies inaccurately and/or is missing descriptions of further information needed to gain a full understanding of the child’s health, with an inadequate or missing explanation of how to gather that information in a way that is sensitive to the child.

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.

Points Range: 10 (10%) – 10 (10%)

The response clearly and accurately lists three or more specific questions that would gather more information about the child. Specific questions are carefully worded to clearly demonstrate sensitivity to the parent(s) or caregiver(s) of the child.

Points Range: 9 (9%) – 9 (9%)

The response lists three specific questions that would gather more information about the child. Specific questions are worded to demonstrate sensitivity to the parent(s) or caregiver(s) of the child.

Points Range: 8 (8%) – 8 (8%)

The response lists three questions with wording that is vague and lacking specificity for gathering more information about the child. Some wording of the questions lacks sensitivity to the parent(s) or caregiver(s) of the child.

Points Range: 0 (0%) – 7 (7%)

The response lists two or fewer confusing or inadequate questions, or is missing questions, for gathering more information about the child. Wording of questions provided lacks sensitivity to the parent(s) or caregiver(s) of the child.

Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

Points Range: 5 (5%) – 5 (5%)

The response clearly describes two or more detailed strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

Points Range: 4 (4%) – 4 (4%)

The response describes at least two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

Points Range: 3 (3%) – 3 (3%)

The response vaguely describes two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

Points Range: 0 (0%) – 2 (2%)

The response inadequately describes one strategy or is missing strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

Points Range: 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

Points Range: 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

Points Range: 3 (3%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

Points Range: 0 (0%) – 2 (2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

Points Range: 5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

Points Range: 4 (4%) – 4 (4%)

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

Points Range: 3 (3%) – 3 (3%)

Contains several (3 or 4) grammar, spelling, and punctuation errors.

Points Range: 0 (0%) – 2 (2%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

Points Range: 5 (5%) – 5 (5%)

Uses correct APA format with no errors.

Points Range: 4 (4%) – 4 (4%)

Contains a few (1 or 2) APA format errors.

Points Range: 3 (3%) – 3 (3%)

Contains several (3 or 4) APA format errors.

Points Range: 0 (0%) – 2 (2%)

Contains many (≥ 5) APA format errors.

Total Points: 100

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Assessment Tools and Diagnostic Tests in Adults and Children

Assessment Tools

The measurement that was chosen is the body-mass index (BMI) using waist circumference. This measurement is used to examine overweight and obesity. Overweight and obesity entail the excessive accumulation of fat that is risky to an individual’s health. The prevalence of overweight and obesity is very high, and this comes with health risks like heart disease, diabetes, etc. (Chen et al., 2018).

BMI is commonly utilized to examine overweight and obesity since it is a cost-effective and simple measurement. BMI is obtained by dividing the individual’s weight by the square of their height in meter. BMI thus estimates the total body fat and the individual’s risk to develop weight-related diseases (Quadros et al., 2016). Therefore, BMI can screen weight categories likely to pose health risks. High BMI indicates high body fat while low BMI represents low body fat, where high body fat and being underweight pose health problems to an individual (Sijtsm et al., 2014).

However, the validity and reliability of BMI measurement in regard to body fat and the risk to diseases related to weight are uncertain because BMI estimates the total body weight but does not quantify the fat distribution and thus it is difficult to link it to cardiometabolic changes. Central fat distribution is attributable to health problems in comparison to the total body fat and hence it may not demonstrate cardiometabolic risk factors effectively (Quadros et al., 2016).

Thus, weight circumference and BMI are used together to evaluate overweight/obesity and predict the risk of health conditions related to weight. The waist circumference is used to measure fat’s total distribution within the body and therefore it can effectively predict health conditions related to weight (Aranha et al., 2020). Additionally, abdominal obesity has been shown to increase the risk of cancer, diabetes, cardiovascular disease; therefore, weight circumference can effectively predict health risks allied to weight.

When used together, both waist circumference and BMI are valid and reliable measurement tools to assess overweight/obesity, along with the associated health conditions (Aranha et al., 2020).

Child Assessment and Health Issues/Risks

The child that was chosen is an “overweight child who is a 5-year-old boy with overweight parents”. Nurse practitioners (NPs) play the role of evaluating health risks allied to weight and developing appropriate interventions to address the overweight and associated health risks.

Childhood obesity is associated with many health risks, especially if the parents also have overweight problems. Some of the health risks children with obesity face include diabetes, heart disease, obstructive sleep apnea, metabolic syndrome, asthma, breathing problems, and hypertension (Fruh, 2017). Additionally, children with obesity face emotional and social problems such as discrimination, bullying by peers, social isolation, negative body image, depression, and low self-esteem (Davidson et al., 2019).

Additional Information

Additional information relevant for further assessment for this child includes the child’s eating and food intake habits; the family health history of conditions such as obesity; and the child’s activity levels, including time spent playing computer games and watching TV. Information about the child’s psychosocial and mental health will be collected to assess the impact of the overweight on the child’s social and emotional aspects (Davidson et al., 2019).

Questions

Some of the questions that would be used to examine weight problem and the associated health risks consist of:

Describe the typical foods in your household. The question is useful in evaluating the family’s feeding habits since food is a major contributing factor in obesity and overweight.
Describe the typical day for this child. How much time does he spend playing computer/phone games or watching television? This question addresses the child’s activity levels since being physically active helps to reduce weight, burns calories, and strengthens bones and muscles.
Has the child ever talked about being isolated or bullied by his peers? The question helps to establish any emotional or social challenge the child might be facing because of being overweight.

Strategies to Address the Child’s Overweight Issues

The first strategy includes encouraging the child’s family to adopt a healthy diet that consists of a high intake of fruits, vegetables, and low-calorie foods (Avis et al., 2015). The parents and the caregiver will be advised to avoid fast foods and sweetened beverages for the child. Additionally, to motivate the child to adopt healthy eating habits, the parents and caregiver will be advised to model healthy feeding habits.

The second strategy includes advising parents and the caregiver to ensure that the child is physically active and decrease time spent playing phone/computer games and watching TV. The family will also be encouraged to engage in physical activities to burn excess calories. The parents will be advised to take part in play activities such as playing soccer or cycling in order to encourage the child to be physically active (Avis et al., 2015).

References

Aranha, L. N., & Oliveira, G. M. M. (2020). Waist Circumference: A Simple Measure for Childhood Obesity? Arquivos Brasileiros de Cardiologia, 114(3), 538-539.

Avis, J. L., Cave, A. L., Donaldson, S., Ellendt, C., Holt, N. L., Jelinski, S., Martz, P., Maximova, K., Padwal, R., Wild, T. C., & Ball, G. D. (2015). Working with Parents to Prevent Childhood Obesity: Protocol for a Primary Care-Based eHealth Study. JMIR research protocols, 4(1), e35. https://doi.org/10.2196/resprot.4147

Chen, Y., Zhang, Y., & Wang, L. (2018). Low Diagnostic Accuracy of Body Mass Index-Based and Waist Circumference-Based References for Childhood Overweight and Obesity in Identifying Overfat among Chinese Children and Adolescents. BioMed research international, 2018, 4570706. https://doi.org/10.1155/2018/4570706.

Davidson, K., Vidgen, H., Denney-Wilson, E., & Daniels, L. (2019). Who is responsible for assessing children’s weight status? –a qualitative study of health professionals in regional Australia. BMC public health, 19(1), 1196.

Fruh S. M. (2017). Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. Journal of the American Association of Nurse Practitioners, 29(S1), S3–S14. https://doi.org/10.1002/2327-6924.12510.

Quadros, T. M. B. D., Gordia, A. P., Mota, J., & Silva, L. R. (2016). The utility of body mass index, waist circumference, and waist-to-height ratio as screening tools for hyperglycemia in young people. Archives of endocrinology and metabolism, 60(6), 526-531.