health assessment 27 – The Nursing Hub

Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and ChildrenMany 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.”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 Resources
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. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.or…
Note: You will access this article from the Walden Library databases.
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.
Note: You will access this article from the Walden Library databases.
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.
Note: You will access this article from the Walden Library databases.
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)

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”

Case Study Assignment: Assessment Tools in Adults and Children
Case Scenario: Overweight 5 year old African American boy with overweight parents who work full time and the boy spend his time after school with Grandmother.

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 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.

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