Assignment Option 1: Adult Assessment Tools or Diagnostic Tests

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests

Advanced practice nurses (APNs) use various diagnostic tests and assessment tools when diagnosing adults presented with different clinical manifestations to determine an individual’s health condition. Diagnostic tests guide nurses in diagnosing a client correctly, resulting in an appropriate treatment plan. Hence, these tests and tools are significant when treating adults who are presented with various symptoms at the family clinic. Nurses must consider significant factors influencing the validity and reliability of the results when selecting diagnostic tests. This paper focuses on the prostate-specific antigen (PSA) test, including its use in healthcare, purpose, the procedure for conducting the test, information gathered by the test, and its validity and reliability.

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How is Prostate-Specific Antigen (PSA) test Used in Healthcare?

            Individuals diagnosed with prostate cancer have high PSA levels in the blood. The prostate gland’s normal and malignant cells produce prostate-specific antigens (PSA). However, significantly higher levels of PSA are produced if malignant cells are present in the prostate gland. According to Tikkinen et al. (2018), the PSA test is the recommended clinical guideline for prostate cancer screening among individuals with related symptoms. Thus, primary care providers use the PSA results to rule out prostate cancer in individuals who presented to the clinic with prostate cancer symptoms. Additionally, medical professionals order the PSA test while screening for cancer in individuals with no cancer symptoms, especially those above 50yo. Regular cancer screening reduces the risk of various cancer forms, especially among individuals at a high risk of a particular cancer form (Loomans-Kropp & Umar, 2019). Hence, the PSA test is used in the early detection and prevention of prostate cancer.

What is the Purpose of the PSA Test?

Health care providers order PSA tests when treating patients presenting prostate cancer symptoms. This test can be ordered alone or with a DRE when providing healthcare to this patient population. High levels of PSA usually indicate the presence of prostate cancer. The results of this test enable a healthcare provider to determine an individual’s healthcare problem. The PSA level usually rises in prostate cancer. However, other benign (not cancerous) might cause the PSA level to rise above the normal range. In particular, PSA rises in individuals diagnosed with prostatitis and benign prostatic hyperplasia (BPH) (Duvedi et al., 2019). These two conditions do not increase prostate cancer risk. Nonetheless, a person diagnosed with prostatitis and benign prostatic hyperplasia (BPH) can also develop prostate cancer (Duvedi et al., 2019). Additionally, a healthcare provider can order a PSA test when screening for prostate cancer in an individual with no symptoms to reduce the risk of prostate cancer. Lastly, a healthcare provider can order the PSA test when dealing with a person diagnosed with prostate cancer. In this case, the test is ordered to assess the effectiveness of the patient’s treatment plan or check if cancer has recurred.

How is the Test Conducted?

            Healthcare providers order the PSA test to measure the PSA levels in the blood, especially in patients who presented with prostate cancer symptoms. When conducting this test, a clinician draws a blood sample and sends it to a laboratory for analysis. The results are in nanograms of PSA per milliliter (ng/mL) of blood.

What Information does the PSA Gather?

            The PSA test focuses on measuring PSA levels in the blood. However, normal or abnormal PSA level cutoff points have not been established. Healthcare providers can recommend a prostate biopsy based on an individual’s PSA test results. PSA levels of 4.0 ng/mL and below were considered normal in the past decades. Nonetheless, prostate cancer was diagnosed in persons whose PSA levels were lower than 4.0 ng/mL. On the contrary, no prostate cancer was detected in individuals with higher PSA levels, ranging from 4 and 10 ng/mL.

The PSA Test’s Validity and Reliability

The PSA test enables healthcare providers to detect high PSA levels in the blood. However, this test does not give precise diagnostic details about the prostate condition. Therefore, the PSA test is unreliable since it only detects prostate cancer early signs. Additionally, this test has validity issues. The amount of PSA circulating in the blood varies significantly over time. The PSA’s test positive predictive value of less than 4.0 ng/mL is approximately 30%, indicating that the level is slightly less (Ferraro et al., 2021). Approximately one-third of men with elevated PSA levels will test positive for prostate cancer on biopsy. The predictive value decrease with an increase in the PSA level. A positive predictive value of approximately 25% was reported in individuals with PSA levels ranging from 4.0 to 10.0 ng/mL (Ferraro et al., 2021). This relatively low predictive value indicates a high likelihood of giving wrong results when used to detect prostate cancer.

Overall, the PSA test is used in healthcare facilities to detect the PSA level in individuals with prostate cancer symptoms. It is used as the primary diagnosis for prostate cancer. Additionally, the PSA test is conducted in healthy men with no prostate cancer symptoms to enhance early detection and prevention of this form of cancer. However, this test has validity and reliability issues. Additionally, its positive predictive value is relatively low and reduces as the PSA level increases.

References

Duvedi, P., Singh, H., Bedi, G. K., & Kaur, M. (2019). Role of Prostate-Specific Antigen (PSA) in Patients with Benign Prostate Hyperplasia. Journal of Clinical & Diagnostic Research, 13(5). DOI:10.7860/JCDR/2019/39748.12814.

Ferraro, S., Bussetti, M., Bassani, N., Rossi, R. S., Incarbone, G. P., Bianchi, F., … & Panteghini, M. (2021). Defining outcome-based prostate-specific antigen (PSA) thresholds for advanced prostate cancer risk prediction. Cancers, 13(14), 3381. Doi: 10.3390/cancers13143381

Loomans-Kropp, H. A., & Umar, A. (2019). Cancer prevention and screening: the next step in the era of precision medicine. NPJ precision oncology, 3(1), 1-8. Doi: 10.1038/s41698-018-0075-9

Tikkinen, K. A., Dahm, P., Lytvyn, L., Heen, A. F., Vernooij, R. W., Siemieniuk, R. A., … & Agoritsas, T. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline. Bmj, 362. Doi: https://doi.org/10.1136/bmj.k3581.

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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
The Assignment One
Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:

Students with the last name starting with A,B,C,D,E,F,G, H, I, J Please select a diagnostic tool below

Mammogram
Prostate-specific antigen (PSA) test
Body-mass index (BMI) using waist circumference for children

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 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.

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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 f

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. (2021, April 9). Childhood overweight & obesity. http://www.cdc.gov/obesity/childhood/
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. (2021, April 9). Childhood overweight & obesity. http://www.cdc.gov/obesity/childhood/
https://content.waldenu.edu/content/dam/laureate/laureate-academics/wal/ms-nurs/nurs-6512-11wk/week-3/Week_3_Dains_Chap1.pdf
https://search.proquest.com/docview/1784000673?accountid=14872
https://content.waldenu.edu/content/dam/laureate/laureate-academics/wal/ms-nurs/nurs-6512-11wk/week-3/Week%203_History%20Subjective%20Data%20Checklist.pdf

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)