Assessment Tools and Diagnostic Tests in Adults Case Study

Assessment Tools and Diagnostic Tests in Adults Case Study

Assessment Tools and Diagnostic Tests in Adults Case Study

All patients require treatments that match their conditions. Doing so reduces complications’ risks and other problems such as readmissions and mortality. As a result, careful and in-depth assessment of a patient’s condition should precede medication. In some instances, health care professionals conduct a general body assessment such as temperature or skin color and texture to determine the body’s health state. A general observation may not provide accurate details, necessitating advanced tests. Such tests should also be valid and reliable to guide advanced practice nurses appropriately. This paper discusses rapid strep testing, rapid influenza testing and Pap smear. Focus areas include the use, purpose, procedure, and the diagnostic test’s validity and reliability.

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Rapid Strep Testing

Rapid strep testing is widely used in health care settings to diagnose bacterial pharyngitis stemming from strep throat. Medically termed as group A streptococci, strep throat is characterized by irritated and swollen tonsils and the back of the throat leading to a sore throat (Centers for Disease Control and Prevention [CDC] 2021). The test’s primary purpose is to assist health care professionals to decide whether an infection requires antibiotics or other medications since antibiotics may not effectively treat viral infections. The test guides antibiotics prescription because bacterial and viral infections are indistinguishable.

The procedure is not complicated and starts with swabbing a person’s throat to collect a mucus sample. Typically, the patient should open their mouth widest while their head back. The health care professional then uses a tongue depressor to examine the inside while slightly brushing the cotton swab over the areas of interest. The cotton swab collects secretions around the throat, tonsils, and any sore areas. An analysis follows in the laboratory to determine whether the infection is bacterial or viral and appropriate medications.

Advanced practice nurses must ensure that assessment tools or diagnostic tests are valid and reliable. The consistency and diagnostic accuracy of rapid strep testing have been confirmed in clinical settings and research studies. In a study involving 291 participants, Hendi et al. (2021) found rapid strep test highly consistent since only 2% of the studied population had inconsistent results. The test’s reliability was similar to a throat culture. Hendi et al. (2021) further posited that a rapid strep test has a high sensitivity (as high as 98.9%). Other significant findings included 97.5% specificity, 94.7% positive predictive value and 99.5% negative. The results show that the test can accurately guide diagnosis and antibiotics’ prescription. However, health care professionals should consider taking a throat culture if the tests are negative but still suspect strep throat (CDC, 2021). Further tests are necessary since untreated strep throat infection can cause rheumatic fever.

Rapid Influenza Testing

Health care professionals require adequate and accurate information about infections to make informed decisions. Rapid influenza testing is a critical tool in health care settings to identify the presence of influenza A and B (CDC, 2019). Clinicians use the test’s outcome to determine whether antiviral treatment is required or further diagnostic testing is required. The test is pivotal in informing health care providers about implementing infection prevention interventions and influenza-related control measures. Based on the frequency, type, and magnitude of infections, health care professionals can determine whether there is an outbreak in the community and initiate the necessary response.

As an immunoassay to identify the type of influenza, rapid influenza testing display the infection results qualitatively (positive or negative). When conducting the rapid influenza test, the patient’s head should be tilted about 70 degrees (CDC, 2021). A swab is then inserted in the nostril while gently rotating it. The same procedure is repeated in the other nostril until resistance is felt at the nose’s turbinates. A positive result implies the detection of influenza viral antigen. However, it does not automatically indicate that the patient is contagious. A negative result implies the absence of influenza viral antigen.

Regarding validity and reliability, result outcomes vary depending on the tested population. For instance, Seki et al. (2020) confirmed the validity and reliability of the test in detecting influenza in a large Japanese population. The specificity was found high too. Seki et al. (2020) found sensitivity and specificity of the test as high as 97.1% and 89.2%, respectively. The study affirmed the reliability of the test since it facilitated accurate testing and quick intervention since 90% of the patients with influenza were tested and treated within two days. However, such outcomes are not universal. Seki et al. (2020) found that the predictive value varies depending on the level of influenza activity in the population being tested. The test is also associated with limited sensitivity occasionally.

Pap Smear Test

Health care providers need to detect illnesses early before they reach unmanageable levels. A Pap smear facilitates early cervical cancer detection to give women a higher survival chance. The test is used to examine cancerous cells in the cervix or abnormal cells likely to become cancerous (PDQ Screening and Prevention Editorial Board, 2021). Cervical cancer is a significant health concern among women considering it is the leading cause of cancer-related deaths in women (Arbyn et al., 2020). Early detection facilitates early treatment, increasing recovery chances. Early detection and interventions also reduce mortality rates and associated problems in health care settings, including high health care costs.

The procedure involves collecting cells from the cervix for advanced analysis. During the test, a health care provider takes cells from the cervix for further assessment via a microscope for cervical cancer (Nkwabong et al., 2019). Health care professionals use a small clinical brush to remove the cells gently. Besides examining cancerous cells, the microscope assessment can be used to identify cell changes likely to cause cancer or other infections and inflammations. Since the primary focus is cervical cancer or possible development, health care professionals use the results as the basis for informed decision-making.

A Pap smear’s validity and reliability are affected by sensitivity levels. Pap test with repeat Pap testing is highly sensitive in detecting cervical cancer (PDQ Screening and Prevention Editorial Board, 2021). However, age determines the number of tests required. Younger women usually require a single test, while older women need several examinations. Else, the validity of the test would be affected. In a cross-sectional study of women screened for cervical dysplasia, Nkwabong et al. (2018) found Pap smear sensitivity to be 55.5%. The positive predictive value was 88.2%. As a result, repeated testing is necessary to enhance the accuracy of the test to avoid false positives and false negatives.

Conclusion

Accurate disease detection is crucial for proper treatment. Detection also enables health care providers to apply the necessary infection control interventions. Depending on the infection, advanced practice nurses can use various assessment tools or diagnostic tests. As discussed above, rapid strep testing, rapid influenza testing, and Pap smear help health care providers to detect different infections accurately. Outcomes guide decision making, including treatment and infection control practices.

References

Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2020). Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet Global Health, 8(2), e191-e203.https://doi.org/10.1016/S2214-109X(19)30482-6

Centers for Disease Control and Prevention. (2019). Rapid diagnostic testing for influenza: Information for clinical laboratory directors.https://www.cdc.gov/flu/professionals/diagnosis/rapidlab.html

Centers for Disease Control and Prevention. (2021). Influenza specimen collection.cdc.gov%2Fflu%2Fpdf%2Fprofessionals%2Fflu-specimen-collection-poster.pdf&usg=AOvVaw0t4XJ7Fo1y_xEgoWhX3p66

Centers for Disease Control and Prevention. (2021). Strep throat: All you need to know. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Hendi, S. B., Malik, Z. A., Khamis, A. H., & Al-Najjar, F. Y. (2021). High diagnostic accuracy of automated rapid Strep A test reduces antibiotic prescriptions for children in the United Arab Emirates. BMC Pediatrics, 21(1), 1-6.https://doi.org/10.1186/s12887-021-02516-3

Nkwabong, E., Laure BessiBadjan, I., &Sando, Z. (2019).Pap smear accuracy for the diagnosis of cervical precancerous lesions.Tropical Doctor, 49(1), 34-39.https://doi.org/10.1177%2F0049475518798532

PDQ Screening and Prevention Editorial Board.(2021). Cervical cancer screening.PDQ Cancer Information Summaries [Internet].https://www.ncbi.nlm.nih.gov/books/NBK65734/

Seki, Y., Oda, Y., & Sugaya, N. (2020).Very high sensitivity of a rapid influenza diagnostic test in adults and elderly individuals within 48 hours of the onset of illness.PloSOne, 15(5), e0231217. https://doi.org/10.1371/journal.pone.0231217

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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 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.
The Assignment:
Adult Assessment Tools or Diagnostic Tests: ALL THREE tools must be discussed and referenced please.
Rapid strep testing : One of the tools to be discussed(must discuss ALL).
Rapid Influenza testing : One of the tools to be discussed(must discuss ALL).
Pap Smear :One of the tools to be discussed for females(must discuss ALL).

Assignment (3–4 pages, not including title and reference pages):
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 formatting.

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RUBRIC
In 3–4 pages, address the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
o What is its purpose?
o How is it conducted?
o What information does it gather?
30 (30%) – 35 (35%)
The response clearly, accurately, and with specific detail describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.
45 (45%) – 50 (50%). The response accurately and thoroughly evaluates the test or tool’s validity and reliability, and explains any issues with clear sensitivity, reliability, and predictive values. Student’s research is clear, accurate, and appropriate for the evaluation.
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.
5 (5%) – 5 (5%). Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%). Uses correct grammar, spelling, and punctuation with no errors.
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.
5 (5%) – 5 (5%). Uses correct APA format with no errors.