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When seeking to identify a patients health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools
My case study
Severely underweight 12-year-old girl with underweight parents – Students with the last names start with (R-W)
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 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.
- 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.
- Based on the risks you might identify 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.
Assignment (3–4 pages, not including title and reference pages):
Assignment: 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.
- 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 3, “Examination Techniques and Equipment”
- Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
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.
. In Seidel’s guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.
- Centers for Disease Control and Prevention. (2021, April 9). Childhood overweight & obesity
This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.
- 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.
- Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”
- Nyante, S. J., Benefield, T. S., Kuzmiak, C. M., Earnhardt, K., Pritchard, M., & Henderson, L. M. (2021). Population‐level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures
- . Cancer, 127(12), 2111–2121. https://doi.org/10.1002/cncr.33460
- 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.
- 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:
- Shadow Health. (2021). Welcome to your introduction to Shadow Health
- . https://link.shadowhealth.com/Student-Orientation-Video
- Shadow Health. (n.d.). Shadow Health help desk
- . Retrieved from https://support.shadowhealth.com/hc/en-us
- Shadow Health. (2021).
In 3–4 pages, address 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.
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.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
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.
Total Points: 100
Expert Answer and Explanation
Assessment of Underweight Child
The assessment of the patient involves the use of questions and screening tools to help understand the patient’s health status as well as their medical history. The results of this assessment may help inform the type of clinical intervention which suits a specific medical case. An example is a scenario where the caregiver adapts treatment if the assessment outcomes indicate that the patient is allergic to certain medications.
When assessing a client for an illness, an interventionist has to take into consideration the client’s age, and this is important because a child may not adequately be open to sharing their thoughts or concerns like adults would (Acquah et al., 2019). Accordingly, this warrants the need to modify the assessment approach when working with a non-adult client. This applies in a case where one needs to assess a 12-year old child who is dealing with weight-related health events as this study explores.
Health Issues and Risks linked to the 12-Year Old
The teenage patient in the case is severally underweight, and her parents also have this problem, and based on this information, there are possible health issues she might be having or at risk of. One of the weight-linked issues she might be experiencing is immune-based illness, and an example is the human immunodeficiency virus (HIV).
This is because autoimmune diseases can cause a decline in one’s body weight, and some such as HIV are transmittable through birth. Still, it is possible that the patient has Lupus considering that a parent can transmit the disease to their newborn during the child birth. Anemia is another medical problem that one can link to the 12-year old. Besides, the patient might be at risk of hyperthyroidism (De Leo, Lee, & Braverman, 2016). This condition is genetic, and it is probable that it could be one of the causes of the weight loss in the parents and the child.
Additional Details Needed for Further Patient Assessment
The information pertaining to the 12-year Old’s weight problem can only help a clinician make general inferences about her health. This means that they will need additional patient data to make reliable conclusions concerning the child’s health. For example, they may need to check whether the patient has a history of joint pain, and this information is pertinent when it comes to determining or ruling out the presence of lupus.
The clinician may also have to pay attention to the diarrhea or sores over the patient’s face or on their nasal areas. These signs can help them decide on whether HIV is a possible contributor to the patient’s weight issues (Tosheno et al., 2017). Furthermore, it would be important to take into consideration the patient’s feeding habits given that food play critical role in terms of helping one add weight.
Risks and Clinical Details which can help one understand the Health of the Child
The assessment of the risks is equally important and it can help provide details about the underlying issues which cause the weight loss. The details regarding the history of the substance use and abuse can be useful when seeking to determine the key clinical issue which affects the patient. This is because the sharing of the needles can expose one to the risk of contracting weight-related health issue such as HIV.
The child’s condition may also stem from dangerous sexual behaviors, and the information on whether she has been having an intimate relationship with any person can be crucial when one wants to understand the patient’s health condition. When gathering this kind of information, the provider may need to create a good relationship with the patient by asking her to state whether she is comfortable talking about certain things (Kumar et al., 2019).
Examples of the Questions to Ask
- Have you ever used alcohol, or any drug that you think altered how you think?
- Have you ever been in an intimate relationship with an adult or another teenager?
- How often do you eat your meals?
Strategies for Encouraging the Parents to be committed to the Health of their Child
Parents play critical role in helping their children to be healthy, and certain key strategies can be effective in helping encourage them to help the assigned child have good health. Helping the parents establish a meal plan can be an effective approach to encouraging the parents’ commitment to the health of the child.
Parents can encourage their child to eat certain foods which can be helpful in building the muscles and body mass (Avis et al., 2015). The other strategy is to help the parents frequently take the measurement of the child’s weight to know whether there is progress in the management of this weight.
In overview, the assessment of a child can be a challenge to the caregivers, and there is need to use a strategy that accounts for the age of the child. A child may not be comfortable answering some questions, and it is therefore important to involve the parent not only during the assessment but when managing the patient’s health as well. Thus, the involvement of the parent can improve assessment and treatment outcome.
Acquah, E., Darteh, E., Amu, H., & Adjei, D. (2019). Predictors of underweight in children under-five years in Ghana. Ghana medical journal, 53(1), 71–78. Doi: https://doi.org/10.4314/gmj.v53i1.11.
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. Doi: https://doi.org/10.2196/resprot.4147.
De Leo, S., Lee, S. Y., & Braverman, L. E. (2016). Hyperthyroidism. Lancet (London, England), 388(10047), 906–918. Doi: https://doi.org/10.1016/S0140-6736(16)00278-6.
Kumar, R., Abbas, F., Mahmood, T., & Somrongthong, R. (2019). Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan. BMJ open, 9(7), e028972. Doi: https://doi.org/10.1136/bmjopen-2019-028972.
Tosheno, D., Mehretie Adinew, Y., Thangavel, T., & Bitew Workie, S. (2017). Risk Factors of Underweight in Children Aged 6-59 Months in Ethiopia. Journal of nutrition and metabolism, 2017, 6368746. https://doi.org/10.1155/2017/6368746.
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