NURS 6512 Week 2 Diversity and Health Assessment Tools and Diagnostic Tests Discussions papers

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.

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In this Discussion, 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.

To prepare:

·        Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:

o   Mammogram

o   Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds) Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

o   Prostate-specific antigen (PSA) test

o   Dix-Hallpike test

o   Body-mass index (BMI) using waist circumference for adults

·        Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

·        Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?

·        Are there any controversies or issues related to any of these tests or tools?

·        Consider any ethical dilemmas that could arise by using these tests or tools. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Post 1 page paper APA format a description of how the assessment tool or diagnostic test you selected is used in health care. 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.

 Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

o   Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

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.

·        Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

o   Chapter 1, “Clinical Reasoning, Differential Diagnosis, 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.

·        Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o   Appendices A–E (pp. 225–236)

·        Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine,156(2), 162–163.
Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

·        Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–150. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.
Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

·        Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460–467.
Retrieved from the Walden Library databases.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105–113.
Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 3, “The Physical Screening Examination”

o   Chapter 17, “Principles of Diagnostic Testing”

 

o   Chapter 18, “Common Laboratory Tests”

ORDER A CUSTOMIZED, PLAGIARISM-FREE NURS 6512 Week 2 Diversity and Health Assessment Tools and Diagnostic Tests Discussions papers HERE

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

Subjective Data
CC: “I came for my annual physical exam, but do not want to be a burden to my daughter.”
History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis
PSH: S/P cholecystectomy
Drug Hx:
Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.

Review of Systems (ROS)
General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or chills.
Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty chewing or swallowing.
Neck: no pain or injury
Respiratory:
CV:
GI:
GU: no urinary hesitancy or change in urine stream
Integument: multiple bruises on his upper arms and back.
MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness
Psych: Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Objective Data
PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous.
Lungs: CTA AP&L
Cor: S1S2 without rub or gallop
Abd: benign, normoactive bowel sounds x 4
Ext: no cyanosis, clubbing or edema
Integument: multiple bruises in different stages of healing – on his upper arms and back.
Neuro: No obvious deformities, CN grossly intact II-XII

Case 2

Subjective Data
CC: “I am here for my annual physical exam and have been having vaginal discharge.”
History of Present Illness (HPI): 32-year-old pregnant lesbian – her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

Drug Hx:
Current Medications: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion
Family Hx: She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Review of Systems (ROS)
General: no fatigue, fever or chills.
Head, eyes, ears, nose & throat (HEENT):
Neck: no pain or injury
Respiratory:
CV:
GI:
GU:
Integument: multiple piercings, and tattoos. Old scars related to “cutting”.
Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Objective Data
PE: B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, ornasopharynx clear, good dentition. Piercing in her right nostril and lower lip.
Lungs: CTA AP&L
Cor: S1S2 without rub or gallop
Abd: benign, normoactive bowel sounds x 4
GU: external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adenxa intact.
Ext: no cyanosis, clubbing or edema
Integument: intact without lesions masses or rashes.
Neuro: No obvious deficits and CN grossly intact II-XII

Case 3

Subjective Data
CC: “Annual physical exam”
History of Present Illness (HPI): 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.
Drug Hx:
Current medication – denied
Allergies: no allergies to food or medications.
Family history: is very positive for diabetes, hypertension, and alcoholism.

Review of Systems (ROS)
General: no recent weight gains of losses, fatigue, fever or chills.
Head, eyes, ears, nose & throat (HEENT):
Neck:
Respiratory:
CV: no chest discomfort or palpitations
GI:
GU:
Integument: history of eczema – not active
MS/Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements
Psych:

Objective Data
PE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6

General: 23 year old male appears well developed and well nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.
HEENT: Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, ornasopharynx clear, poor dentition – multiple carries. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.
Lungs: CTA AP&L
Cor: S1S2, +II/VI holosystolic murmur; without rub or gallop
Abd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.
Ext: no cyanosis, clubbing or edema
Integument: intact without lesions masses or rashes.
Neuro: No obvious deficits and CN grossly intact II-XII

To prepare:

·        Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

·        Select one of the three case studies. Reflect on the provided patient information.

·        Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

·        Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

·        Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post a 1 page paper APA format  

1. explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected

Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers

2. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. 3. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

 Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

o   Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

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. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 1, “Clinical Reasoning, Differential Diagnosis, 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.

·        Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o   Appendices A–E (pp. 225–236)

·        Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine,156(2), 162–163. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.
Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

·        Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–150.
Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

·        Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460–467.
Retrieved from the Walden Library databases.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105–113.
Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test.

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 3, “The Physical Screening Examination”

o   Chapter 17, “Principles of Diagnostic Testing”

o   Chapter 18, “Common Laboratory Tests” Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.