Advanced Health Assessment NURS 6512 Week 3 Assignment 1
Advanced health assessment on weight-related health is essential for parents and caregivers to track their children’s weight gain or loss, determine whether they are underweight or overweight, and decide on the steps to take to help the child maintain a healthy weight.
According to Song et al. (2018), children with a healthy weight seem to be fitter, healthier, able to concentrate in school and learn and are more self-confident. The weight-related health risks in children include diabetes, cardiovascular diseases, and developing stroke even in adulthood. The child that will be assessed is an eight-year-old male, overweight male.
This essay presents different concepts of an advanced health assessment, the related health issues, weight-related risks, further information, and the specific questions to ask the caregiver or the parents. The child to be for this assessment is a foster child whose foster parents have an average weight while his biological parents are overweight.
Health Issues and Risks Relevant to the Child
The child assigned is an 8-year-old overweight male. There are various health issues and related risks for this child. The Centers for Disease Control and Prevention (n.d.) notes that obese children are exposed to a higher risk of health conditions than children with a healthy weight.
Some health conditions for which this child may be at increased risk include type 2 diabetes, breathing problems including asthma and sleep Apnea, high blood pressure and high cholesterol, heart disease, joint pains, and gallstone and gallbladder disease (CDC.gov, n.d.)
Furthermore, research shows that childhood obesity is associated with weight-related stigma and bullying, psychological issues such as depression and anxiety, low self-esteem, self-reported quality of life, and obesity in adulthood (Rundle et al., 2020).
The social issues related to the obese child, including weight-related stigma and peer bullying, can significantly affect the child’s health, especially maintaining healthy weight behavior. Additionally, the child is at a higher risk for mental health issues, such as depression and anxiety, resulting from low self-confidence, bullying, and exposure to weight-related stigma.
Rundle et al. (2020) also note that obese children are likelier to be obese even in adulthood, especially if the obesity is not treated in childhood.
Additional Information to Further Assess weight-related Health
Extensive assessment is required to acquire information on the child’s weight-related health. The additional information that will be necessary to assess the child’s weight further includes height, body mass index (BMI), fat mass index, weight circumference, body habitus, and vitals (Panuganti et al., 2022).
The height and weight would be used to calculate the body mass index. The body habitus will help determine the child’s level of obesity, or whether the child is just overweight, and decide what steps can be taken to address it. Body habitus is an individual’s physical characteristics, including physique, body build, and general bearing.
It is worth noting that assessing the weight-and related health of a child should be in line with the standard screening tool for obesity, the BMI, and the child’s vitals, to ensure all the necessary information is gathered. I would also assess whether the child has obesity-related health conditions, such as diabetes and gait abnormalities.
Risks and Further Information to Gain Full Understanding of the Child Weight-related Health
Following the complete physical assessment, further information to gain a full understanding of the child’s weight-related health would be to gather an entire history of obesity in the child. History taking would help screen and understand the underlying causes of the child’s obesity (Panuganti et al., 2022).
When gathering the child’s obesity history, I would ask for nutrition patterns, previous weight loss efforts and the results, sleep patterns, physical activity, and family history. I would also assess any medications used that may be causing the weight gain and associated past medical history, including surgical history that may have contributed to weight gain or caused the child to be physically inactive. Identifying the exact possible cause of obesity will help address the issue by informing further medical and nursing management.
Specific Questions to Ask About the Child
Parents and caregivers have been allowed by law to take full responsibility for their children’s health, decision-making, and any consequences from the decisions until the child attain the legal age (Warnick et al., 2019). Thus, it is good to note that I engaged the child’s caregiver throughout the assessment, and the physical assessment was done in their presence.
There are various specific questions that the parent and guardian can be asked about the child’s weight-related health. The first question is whether the child has changes in appetite and feeding habits. The other question is whether the child demonstrates difficulties in carrying out physical activities.
Additionally, I can ask if the child has weight-related health conditions and any medications that cause weight gain. Additionally, when asking these questions, I considered the caregiver’s sensitivity and avoided using words such as overeating or being lazy.
Strategies to Encourage Parents and Caregivers to be Proactive About their child’s Weight-Related Health
According to Pudney, Himmelstein and Puhl (2018), parents and caregivers play a significant role in the weight-related health of their children. They can help reduce weight stigma that may affect the child’s healthy weight behavior, thus discouraging maintaining healthy weight maintenance and weight loss for obese children. O
n the contrary, parents and caregivers can encourage their children to seek healthy weight behaviors, maintain a healthy weight, and encourage weight loss. Thus, it is essential to encourage parents and caregivers to be proactive about their child’s weight-related health.
Strategies that can be used to encourage parents and caregivers to be proactive about their child’s weight-related health include nutrition education and teaching on the importance of physical activity. Nutrition education is essential in helping parents promote healthy eating habits in their children. More so, parents and caregivers can proactively support their children in weight-loss efforts by enhancing better nutritional habits.
Furthermore, educating the parent on the importance of physical activity is another way to encourage the patent or caregiver to be proactively involved in the weight-related health of their child. By understanding the importance of physical activity, parents can create an environment whereby their children are physically active, thus helping them lose weight and maintain a healthy weight.
In summary, advanced health assessment of children with obesity is essential in tracking the related health issues and risks. Assessment should include physical assessment and history taking. The parent or caregivers of the child should be actively engaged in assessing their child, and the nurse should consider the parent’s or care provider’s sensitivity. It is vital to encourage parents and caregivers to be proactive in their child’s weight-related health.
Panuganti K.K, Nguyen M, Kshirsagar R. K. & Doerr, C. (2022) Obesity (Nursing) StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK568702/
Pudney, E. V., Himmelstein, M. S., & Puhl, R. M. (2019). The role of weight stigma in parental weight talk. Pediatric Obesity, 14(10), e12534. https://doi.org/10.1111/ijpo.12534
Rundle, A. G., Factor-Litvak, P., Suglia, S. F., Susser, E. S., Kezios, K. L., Lovasi, G. S., Conh, B. A.,& Link, B. G. (2020). Tracking of obesity in childhood into adulthood: effects on body mass index and fat mass index at age 50. Childhood Obesity, 16(3), 226-233. https://doi.org/10.1089/chi.2019.0185
Song, M., Lee, C. S., Lyons, K. S., Stoyles, S., & Winters-Stone, K. M. (2018). Assessing the feasibility of parent participation in a commercial weight loss program to improve child body mass index and weight-related health behaviors. SAGE Open Medicine, 6, 2050312118801220. https://doi.org/10.1177/2050312118801220
The Centers for Disease Control and Prevention. (n.d.). Overweight and Obesity. Consequences of Obesity in Childhood. https://www.cdc.gov/obesity/index.html
Warnick, J. L., Stromberg, S. E., Krietsch, K. M., & Janicke, D. M. (2019). Family functioning mediates the relationship between child behavior problems and parent feeding practices in youth with overweight or obesity. Translational Behavioral Medicine, 9(3), 431–439. https://doi.org/10.1093/tbm/ibz050
NURS 6512 Week 3: Assessment of Nutrition in Children Instructions
WEEK 3: AT A GLANCE
ASSESSMENT OF NUTRITION IN 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.
- 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
- Week 3: Assignment 1
CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN 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.
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.
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
- 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.
BY DAY 6 OF WEEK 3
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Assignment (3–4 pages, not including title and reference pages): Make sure you stay on what the assignment ask you to do CHILD RISK HEALTH CONCERNS according to the specific case each one has own peculiarities according to the child relation with the family.
Case 1: Acklin, Alvarez, Amama, Basco, Black, Bolivard, Brown & Colyer
4 year old overweight female with normal weight parents who are living with elderly grandparents in their home
Case 2: Curry, Fobanjong, Garcia, Green, Hutcheson, Iskander, Jean & Johnson
- 10 year old severely underweight male in 3nd grade who lives with her normal weight mom on the weekends and her underweight father during the week.
Case 3: Jordan, Moore, Parfait, Pina, Queija, Raymond & Russell
- 5 year old severely underweight male who lives with his normal weight adopted mother and father.
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 immunoglobin 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.
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.
Burford, A., Alexander, R., & Lilly, C. (2020). Malnutrition and medical neglect. Journal of Child & Adolescent Trauma, 13(3), 305–316. https://doi.org/10.1007/s40653-019-00282-0
Dipasquale, V., Cucinotta, U., & Romano, C. (2020). Acute malnutrition in children: Pathophysiology, clinical effects and treatment. Nutrients, 12(8), 2413. https://doi.org/10.3390/nu12082413
Keller, U. (2019). Nutritional laboratory markers in malnutrition. Journal of Clinical Medicine, 8(6), 775. https://doi.org/10.3390/jcm8060775
- Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach(10th 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). Student checklist: Health history guideDownload 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 & obesityLinks to an external site..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.
- 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 proceduresLinks to an external site..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 HealthLinks to an external site.. https://link.shadowhealth.com/Student-Orientation-Video
- Shadow Health. (n.d.). Shadow Health help deskLinks to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us
- Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide
- Document: Shadow Health Nursing Documentation TutorialDownload Shadow Health Nursing Documentation Tutorial(Word document)
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)
- LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination(11th ed.). New York, NY: McGraw Hill Medical.
- Chapter 3, “The Screening Physical Examination”
- Chapter 17, “Principles of Diagnostic Testing”
- Chapter 18, “Common Laboratory Tests”
|This criterion is linked to a Learning Outcome In 3–4 pages, address the following: An explanation of the health issues and risks that are relevant to the child you were assigned.||
|This criterion is linked to a Learning Outcome Describe additional information you would need in order to further assess his or her weight-related health.||
|This criterion is linked to a Learning Outcome 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.||
|This criterion is linked to a Learning Outcome 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.||
|This criterion is linked to a Learning Outcome Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.||
|This criterion is linked to a Learning Outcome 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.||
|This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation||
|This criterion is linked to a Learning Outcome 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|