NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children

Sample Answer for NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Included After Question

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. 

 

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 

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

Many experts predict that genetic testing for disease susceptibility is well on its way to becoming a routine part of clinical care. Yet many of the genetic tests currently being developed are, in the words of the World Health Organization (WHO), of “questionable prognostic value.” 

—Leslie Pray, PhD 

Obesity remains one of the most common chronic diseases in the United States. As a leading cause of United States mortality, morbidity, disability, healthcare utilization and healthcare costs, the high prevalence of obesity continues to strain the United States healthcare system (Obesity Society, 2016).  More than one-third (39.8%) of U.S. adults have obesity (CDC, 2018). The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2018). 

According to the Centers for Disease Control and Prevention (CDC), the rate of childhood obesity has tripled in the past 30 years, with an estimated 13.7 million children and adolescents considered obese (CDC, 2018). When seeking insights about a patient’s overall health and nutritional state, body measurements can provide a valuable perspective. This is particularly important with pediatric patients. Measurements such as height and weight can provide clues to potential health problems and help predict how children will respond to illness. Nurses need to be proficient at using assessment tools, such as the Body Mass Index (BMI) and growth charts, in order to assess nutrition-related health risks and pediatric development while being sensitive to other factors that may affect these measures. Body Mass Index is also used as a predictor for measurement of adult weight and health. 

Assessments are constantly being conducted on patients, but they may not provide useful information. In order to ensure that health assessments provide relevant data, nurses should familiarize themselves with test-specific factors that may affect the validity, reliability, and value of these tools. 

This week, you will explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions. You will examine the validity and reliability of these tests and tools. You will also examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. 

Learning Objectives 

Students will: 

  • Evaluate validity and reliability of assessment tools and diagnostic tests 
  • Analyze diversity considerations in health assessments 
  • Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment 
  • Apply assessment skills to collect patient health histories 

 

Learning Resources 

 

Required Readings (click to expand/reduce)  

 

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. 

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

  • Chapter 3, “Examination Techniques and Equipment” 

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process. 

 

  • Chapter 8, “Growth and Nutrition” 

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

 

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

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

 

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

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

 

Centers for Disease Control and Prevention. (2018). Childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood 

 

This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity. 

 

 

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

 

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

 

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

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

 

 

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 

 

Document: Shadow Health Support and Orientation Resources (PDF) 

 

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) 

 

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)  

 

Taking a Health History
How do nurses gather information and assess a patient’s health? Consider the importance of conducting an in-depth health assessment interview and the strategies you might use as you watch. (16m) 

Assessment Tool, Diagnostics, Growth, Measurements, and Nutrition in Adults and Children – Week 3 (11m) 

Rubric Detail  

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

Content 

Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_1 

  Excellent   Good   Fair   Poor  
In 3–4 pages, address the following:

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

Points Range: 30 (30%) – 35 (35%)  

The response clearly, accurately, and with specific detail describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers. 

Points Range: 24 (24%) – 29 (29%)  

The response accurately describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers. 

Points Range: 18 (18%) – 23 (23%)  

The response vaguely and/or with some inaccuracy describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers. 

Points Range: 0 (0%) – 17 (17%)  

The response is inaccurate or missing descriptions of how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers. 

Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.   Points Range: 45 (45%) – 50 (50%)  

The response accurately and thoroughly evaluates the test or tool’s validity and reliability, and explains any issues with clear sensitivity, reliability, and predictive values. Student’s research is clear, accurate, and appropriate for the evaluation. 

Points Range: 39 (39%) – 44 (44%)  

The response accurately evaluates the test or tool’s validity and reliability, and explains any issues with sensitivity, reliability, and predictive values. Student’s research is somewhat clear, accurate,and appropriate for the evaluation. 

Points Range: 33 (33%) – 38 (38%)  

The response vaguely and/or with some inaccuracy evaluates the test or tool’s validity and reliability, and explains any issues with some sensitivity, reliability, and predictive values. Student’s research is vague or inaccurate for the evaluation. 

Points Range: 0 (0%) – 32 (32%)  

“The response is inaccurate and/or missing evaluations of the test or tool’s validity and reliability, with explanations of any issues missing or lacking sensitivity, reliability, and predictive values. Student’s research is missing, inaccurate, or lacking for the evaluation. 

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  

Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_1 

Rubric Detail  

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

Content 

Name: NURS_6512_Week_3_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  

Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_2 

 

A Sample Answer For the Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children

Title: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children

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

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 inflammatory bowel disease, hereditary polyposis, a family history of colorectal cancer at age <60 years, and surveillance after resection of colorectal cancer (Saito et al., 2021). Healthcare guidelines recommend starting the screening at age 45 and after every 10 years. As an elective procedure, colonoscopy evaluates symptoms like inexplicable changes in bowel habits, inflammatory colitis, GI bleeding, weight loss among the geriatrics, persistent abdominal pain, and iron deficiency anemia (Saito et al., 2021). Therapeutically, colonoscopy helps with excision and ablation of lesions, removal of foreign bodies, stenosis dilation, palliative management of known neoplasms, and handling of bleeding lesions.

Colonoscopy Performance

Generally, colonoscopy can be performed in an outpatient center or within a hospital. The process duration ranges between 30 and 60 minutes. It begins with the insertion of an IV needle in the arm for pain medicine, anesthesia, or sedatives. These help to numb pain during the procedure. Once sedated, the patient then lies on a table and the colonoscope is inserted into the colon through the anus. The scope inflates the large intestines with air for clarity as the camera sends a video image to a monitor (Saito et al., 2021). The scope is adjusted for clarity and better viewing. Once at the opening of the small intestines, the scope is withdrawn as the doctor inspects the lining of the large intestines again. The process looks for the presence of colon polyps and bowel cancer to address unexplained diarrhea, blood in the stool, and abdominal pain.

Reliability and Validity of Colonoscopy

Colonoscopy remains the gold standard for colon detection despite the emergence of new screening methods. It is

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children

safe and accurate since Mack et al. (2022) explain that it yields a 94% accuracy rate in both outpatient facilities and hospitals (Mack et al., 2022). Due to its high accuracy, experts recommend a baseline colonoscopy at age 50 and a repeat of the exam every 10 years. Colonoscopy is a reliable test because it reduces the risk of colorectal cancer by 72% and reduces mortality rates by 81% (Pilonis et al., 2020). With a high accuracy rate and higher positive outcomes, the procedure remains valid and reliable.

Colonoscopy reliability, sensitivity, and Positive Predictive Values

Colonoscopy is a sensitive test that correctly identifies patients with colon diseases. Kadari et al. (2022) affirm that it is more sensitive compared to barium enema x-rays and “virtual” colonoscopy in detecting colon polyps and cancer. The researchers calculated the sensitivity of the three imaging methods based on a per-patient, per-lesion, and per histology basis. According to the study, colonoscopy found 98% of lesions 10 millimeters or larger compared to only 48% for barium enema and 59% for virtual colonoscopy (Kadari et al., 2022). Further, for smaller six-to-nine millimeters lesions, colonoscopy identified 99% of the lesions compared to 35% for barium enema and 51% for virtual colonoscopy. For adenomas, colonoscopy detected 98% of 10 millimeters or larger adenomas compared to only 55% in barium enema and 64%f for CT colonography. Accurate detection of polyps is essential because it dramatically reduces the chances of developing colon cancer.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children

The tool sensitivity is further confirmed by Martín‐López et al. (2017) who estimated that the sensitivity and specificity per patient for polyp detection in asymptomatic patients is 92.5 percent and 73.2 percent for colonoscopy, but only 66.8 percent and 80.3% for CT colonoscopy. According to Issa and Noureddine (2017), colonoscopy finds and resects precancerous lesions and neoplasia across the whole large bowel. It is also a definitive examination when other screening tests are positive. The test is relatively safe because it results in less than 1/1000 perforation rate.

For the predictive values, Issa and Noureddine (2017) outline a study among 1179 patients where 889 underwent colonoscopy. The result indicates that 253 colorectal neoplasia cases were diagnosed including 219 polyps and 35 cancers. The number of advanced adenomas diagnosed was 209. The authors calculated the predictive values of the colonoscopy to be 3.9% for cancer, 12,9% for advanced adenoma, and 25% for adenoma overall. The results were a bit dismal compared to the positive predictive value of the average risk population selected by a positive fecal occult blood test (FOBT). Colonoscopy positive predictive rate after positive FOBT ranges from 7.5% to 10% for cancer, 15% to 27% for advanced adenoma and 32% and37% for adenoma (Issa & Noureddine, 2017). The study confirms that patients at risk of colon-related pathologies may benefit from fecal occult blood testing to select the best candidate for colonoscopy. Regardless, the optimal method remains the colonoscopy in all patients.

Conclusion

Colonoscopy remains a crucial tool when diagnosing colon-related pathologies. It evaluates the large intestines and the distal portion of the small intestines. The tool used consists of accessory channels, a camera, and fluid to cleanse the colonic mucosa. It helps in screening colonoscopies, for elective purposes, and therapeutic purposes like ablation of lesions and removal of foreign bodies among others. The procedure is executed in a hospital or an outpatient and it lasts for around thirty to sixty minutes. It is safe, accurate, well-tolerated, and has a higher sensitivity. The positive predictive values are slightly lower however it remains the most ideal choice when handling issues affecting the colon.

 

References

Issa, I. A., & Noureddine, M. (2017). Colorectal cancer screening: An updated review of the available options. World journal of gastroenterology, 23(28), 5086. https://doi.org/10.3748/wjg.v23.i28.5086

Kadari, M., Subhan, M., Parel, N. S., Krishna, P. V., Gupta, A., Uthayaseelan, K., … & Sunkara, N. A. B. S. (2022). CT Colonography and Colorectal Carcinoma: Current Trends and Emerging Developments. Cureus, 14(5). https://doi.org/10.7759/cureus.24916

Mack, M., Luzum, M., & Wesorick, D. H. (2022). Annals for Hospitalists-March 2022. Annals of Internal Medicine, 176(3), HO3. https://doi.org/10.7326/AWHO202203150

Martín‐López, J. E., Beltrán‐Calvo, C., Rodríguez‐López, R., & Molina‐López, T. J. C. D. (2014). Comparison of the accuracy of CT colonography and colonoscopy in the diagnosis of colorectal cancer. Colorectal Disease, 16(3), O82-O89. https://doi.org/10.1111/codi.12506

Pilonis, N. D., Bugajski, M., Wieszczy, P., Franczyk, R., Didkowska, J., Wojciechowska, U., … & Kaminski, M. F. (2020). Long-term colorectal cancer incidence and mortality after a single negative screening colonoscopy. Annals of internal medicine, 173(2), 81-91. https://doi.org/10.7326/M19-2477

Saito, Y., Oka, S., Kawamura, T., Shimoda, R., Sekiguchi, M., Tamai, N., … & Inoue, H. (2021). Colonoscopy screening and surveillance guidelines. Digestive Endoscopy, 33(4), 486-519. https://doi.org/10.1111/den.13972