NURS 6512 Week 3 Discussion 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

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.

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)

Assessment of Nutrition in Children Example Approach

Nutrition, among other things, influences children’s growth and development. The nutritional need is especially important before a child reaches the age of five, owing to the robust physical and physiological development. At this stage of development, any dietary deficiency has both short- and long-term health repercussions. The case study is about a five-year-old severely underweight child who lives with his normal-weight adopted mother and father. His weight predisposes him to several health issues and hazards, as detailed below.

An Explanation of the Health Issues and Risks Relevant to the Child

Given the consequences of malnutrition, especially during the first five years of life, adequate nutrition is paramount. Low weight for age is one of the signs of malnutrition, as demonstrated in the 5-year-old child’s case scenario. Concerning health issues and risks, the child will undergo immunological, cardiovascular, gastrointestinal, endocrine, genitourinary, and circulatory changes. 

The immune system of malnourished children is significantly compromised due to decreased immunoglobulin levels, reduced complement system, and low phagocytic activity, putting the child at risk of infections (Dipasquale et al., 2020). In the cardiovascular system, the patient is in danger of diminished cardiac output and low blood pressure, which may lead to hypoperfusion of the body’s vital organs (Dipasquale et al., 2020). 

Because of the gut’s diminished absorptive capacity, nutritional absorption is substantially reduced, exacerbating undernutrition. Furthermore, in the genitourinary system, the kidney’s capacity to excrete excess acid and water is severely diminished, and the patient is vulnerable to urinary tract infections due to inadequate immunity (Dipasquale et al., 2020). The many biochemical and physiological changes are a response to the body’s already low energy levels.

Additional Information

Obtaining a medical history from children may be challenging; consequently, in most circumstances, proxy reporting by parents is helpful. It is critical to gather information on the various causes of the child’s malnutrition, as well as vital data for the child’s diagnosis. Data on the child’s dietary intake may tell if child abuse is a likely cause of malnutrition. 

According to Burford et al. (2020), the underprivileged, such as adopted children, may encounter medical neglect in a variety of ways, one of which is a deprivation of adequate nutritious food. Asking the parents about the child’s dietary schedule, components, and capacity to acquire food is vital

Malnutrition may be caused by nutritional deprivation, but it can also be associated with other medical conditions. I would have to determine whether the child has any medical condition that causes significant wasting, such as HIV, tuberculosis, malignancies, or any other chronic disease. Laboratory testing would also provide further information to aid in determining the cause of malnutrition. 

Among the valuable laboratory data that would be required are a complete blood count or blood culture, which may indicate an infection as a cause or a consequence of malnutrition, HIV testing, and Xpert MTB/RIF for tuberculosis (Keller, 2019). Because the child is adopted, obtaining information from the parents may be challenging because they are more likely to conceal any history of the child’s mistreatment. 

As a result, emphasizing the significance of the medical history to the parents, explaining to them in clear, precise, and unadorned language, and acknowledging or speaking to them in their local language are critical in acquiring the information.