Advanced Health Assessment and Diagnostic Reasoning

Assessment Tools and Diagnostic Tests in Adults and Children

Following the assessment tools and diagnostic tests for both adults and children, the acquisition of the patient’s clinical history is critical as it provides essential information that is useful in determining the clinical record. The physician can use assessment tools or diagnostic tests to assess the client’s clinical status, considering the clinical history of the patient.

Prostate-Specific Antigen Test

Prostate-Specific Antigen, PSA denotes a marker tumor for detecting and screening prostate cancer. Commonly, PSA is present in semen, and also, some minimal amounts of PSA are present in blood circulation. Following the constituents of PSA, both the cancerous and non-cancerous tissues in the prostate produce PSA proteins. The test for PSA measures the quantity of PSA in the blood of the patient. The test results imply a reference range if the prostate-specific antigen ranges from 1 to 4, unlike a range of 4 to 10. The levels of prostate-specific antigen are elevated, indicating a gray zone. If the levels go beyond that, there is a possibility of abnormality, suggesting a malignant tissue in the prostate (Dain et al., 2018).

Prostate malignancy is typical and a common reason for cancer death. Early recognition might be an essential instrument in getting fitting and ideal treatment. Men with prostate disease may have raised degrees of PSA. Also, numerous noncancerous conditions likewise can raise the PSA level. The PSA test can recognize elevated levels of PSA in the blood; however, it doesn’t give exact indicative data about the prostate’s state. The PSA test is just one device used to screen for early indications of prostate disease. Another basic screening test, typically done besides a PSA test, is a computerized rectal test.

In this test, the primary care physician embeds a greased, gloved finger into the patient’s rectum to arrive at the prostate. By feeling or pushing on the prostate, the specialist might have the option to decide whether it has unusual irregularities or hard zones. Neither the PSA test nor the computerized rectal test gives enough data to your PCP to analyze prostate malignancy. Exceptional outcomes in these tests may lead the primary care physician to suggest a prostate biopsy. During this method, tissue samples are taken for lab assessment. An analysis of the disease depends on the biopsy results.

Validity and Reliability

The PSA test’s legitimacy has been demonstrated successfully in distinguishing malignant prostate growth and observing the impacts of disease treatment of the prostate (Ahmad et al., 2017). A PSA test may help identify prostate malignancy at a starting phase. Additionally, the dependability of the test has its constraints. Even though the PSA is a fantastic screening instrument for malignant prostate growth, a significant level isn’t 100% demonstrative of a man with prostate disease. A few impediments to the test can build the estimation of the test that are not perceived as carcinogenic, for example, prostatitis, benevolent prostatic hyperplasia, BPH, or the standard increment of PSA with age. Serum calcium and serum parathyroid hormone, PTH, may invigorate prostate development in men without clinical prostate malignant growth.

Conditions that can lower the reliability of PSA results of the test are; particular medications utilized to treat BPH, chemotherapy, and stoutness (Mayo Clinic, 2018). A raised PSA-test result practically doesn’t demonstrate that a patient has prostate cancer, nor does a low- level show that a patient doesn’t have malignant prostate growth (Chakravarthi et al., 2019). Men can have a low PSA test result and still have prostate malignancy. Because of numerous components that can change PSA levels, there are a critical number of men who are misdiagnosed as having malignant prostate growth. The PSA test is just one device used to screen for early indications of prostate malignant growth. The clinician should relate any elevated PSA results with the advanced rectal assessment (Dains et al., 2016). Ball et al. (2015) explain that PSA screening benefits far outweigh the associated harms, including false positives, unnecessary treatment, and unnecessary biopsies.

Limitations to PSA test

Some factors that limit the PSA test include PSA-raising factors, PSA-lowering factors, misleading results, ad over-diagnosis. The PSA-raising factors may be benign prostatic hyperplasia that may show positive results, which is not an indicator of prostate cancer. Similarly, PSA –lowering factors such as BPH and urinary conditions, including high chemotherapy dosage, may decrease PSA levels even in the presence of cancer. The misleading results may originate from human errors. In this case, elevated PSA levels will indicate prostate cancer, although most men with prostate cancer may show normal PSA levels. Overdiagnosis has affected most individuals, presenting with tumors resulting in particular symptoms with time.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby. Retrived from https://search.proquest.com/openview/85a131b863048630586d8756c4e777ea/1?pq-

origsite=gscholar&cbl=47659

Chakravarthi, B. V., Dedigama-Arachchige, P., Carskadon, S., Sundaram, S. K., Li, J., Wu, K. H. H., … & Chitale, D. A. (2019). Pseudogene associated recurrent gene fusion in prostate cancer. Neoplasia, 21(10), 989-1002. Retrieved from https://www.sciencedirect.com/science/article/pii/S1476558619302738

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby. Retrieved from https://www.elsevier.com/books/advanced-health-assessment-and-clinical-diagnosis-in-

primary-care/dains/978-0-323-26625-3

Mayo Clinic (2018). PSA Test. Retrieved from https://www.mayoclinic.org/tests-

Okello, T. R., Alema, N. O., & Ogwang, D. M. (2014). Prostatic specific antigen (PSA) procedures/PSA-test/about/PAC-20384731 Relationship to patients age, prostate volume, and prostate histology at St. Mary’s hospital later. East & Central African Journal of Surgery, 19(2), 87–96. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?di rect=t rue&db=a9h&AN=109133939&site=eds-live&scope=site

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