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.
● Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom
Analysis”
This chapter introduces the diagnostic process, which includes performing an analysis
of the symptoms and then formulating and testing a hypothesis. The authors discuss
how becoming an expert clinician takes time and practice in developing clinical
judgment.
Gibbs , H., & Chapman-Novakofski, K. (2012). Exploring nutrition literacy: Attention to
assessment and the skills clients need. Health, 4 (3), 120–124.
This study explores nutrition literacy. The authors examine the level of
attention paid to health literacy among nutrition professionals and the skills
and knowledge needed to understand nutrition education.
Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-
Wommack, R. (2014). Weight status misperception as related to selected health risk
behaviors among middle school students. Journal of School Health, 84( 2), 116–123.
doi:10.1111/josh.12128
Credit Line: Weight status misperception as related to selected health risk behaviors among middle school students by Martin, B. C., Dalton, W. T.,
Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R., in Journal of School Health, Vol. 84/Issue 2. Copyright 2014 by Blackwell
Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
Noble, H., & Smith, J. (2015) Issues of validity and reliability in qualitative research .
Evidence Based Nursing, 18 (2), pp. 34–35.
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2011). History subjective data checklist. In Mosby’s guide to physical examination (7th
ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Mosby’s Guide to Physical Examination , 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R.
W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.
This History Subjective Data Checklist was published as a companion to Seidel’s Guide
to Physical Examination (8th ed.) by Ball, J. W., Dains, J. E., & Flynn, J.A. Copyright
Elsevier (2015). From https://evolve.elsevier.com
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A.
Davis.
● Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in
Week 1)
● Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as
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)
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
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?
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.
Based on your research, evaluate the test or the tool’s validity and reliability, and
explain any issues with sensitivity, reliability, and predictive values.
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.
