What Should the Nurse Do?
Ms. Lewis, a 28-year-old female, visits the genetic counseling clinic for guidance regarding her family history of genetic conditions. She expresses concerns about the potential risk of passing on certain conditions to her future children. Ms. Lewis’s medical history is unremarkable, but her family has a history of neurogenetic disorders, specifically Huntington disease. She reports experiencing anxiety about her reproductive decisions and is seeking information on genetic testing options. Ms. Lewis’s maternal grandmother was diagnosed with Huntington disease, and her mother is currently undergoing genetic testing to determine if she carries the gene mutation. This family history has prompted Ms. Lewis to seek advice on family planning. Vital signs are within normal limits, with a blood pressure of 120/80 mm Hg, a heart rate of 76 bpm, a respiratory rate of 18 breaths per minute, and a body temperature of 98.6°F (37°C).
1
.
How does the family history of Huntington disease affect the analysis of potential genetic risks for Ms. Lewis, and what additional information or assessments might be helpful to further understand the implications for her reproductive decisions?
2
.
What interventions and strategies would you propose to support Ms. Lewis in her decision-making process regarding family planning, and how would you tailor these solutions to address her unique emotional and informational needs?
Mr. Dias, a 45-year-old male, presents at the genetics clinic concerned about his family’s history of colon cancer. He reports that his father passed away from colon cancer, and his paternal grandmother also had a history of the disease. Mr. Dias has been experiencing occasional abdominal pain, changes in bowel habits, and noticeable weight loss. Given his family history, Mr. Dias is worried about his own risk and expresses interest in genetic testing for colon cancer susceptibility. Vital signs are stable, with a blood pressure of 120/80 mm Hg, a heart rate of 78 bpm, a respiratory rate of 18 breaths per minute, and a body temperature of 98.6°F (37°C).
3
.
How might Mr. Dias's family history and symptoms influence the analysis of potential genetic risks for colon cancer, and what additional information or assessments might be needed for a comprehensive understanding of his situation?
4
.
As the nurse, what immediate actions would you initiate to address Mr. Dias’s current concerns and informational needs, and how would you collaborate with the genetic counseling team to ensure comprehensive support?
Mrs. Hernandez, a 28-year-old female, arrives at the genetics clinic seeking guidance on genetic screening and testing due to a family history of breast cancer. Her mother was diagnosed with breast cancer at the age of 40, prompting Mrs. Hernandez to proactively explore her own risk. She reports occasional breast tenderness and is concerned about the potential implications for her health. Mrs. Hernandez has no prior history of cancer. Vital signs are within normal ranges, with a blood pressure of 118/76 mm Hg, a heart rate of 82 bpm, a respiratory rate of 16 breaths per minute, and a body temperature of 98.7°F (37.1°C).
5
.
As the nurse, what immediate actions would you initiate to address Mrs. Hernandez’s current concerns and informational needs, and how would you collaborate with the genetic counseling team to ensure comprehensive support?
6
.
After implementing interventions and providing support, how would you monitor and assess Mrs. Hernandez's progress in addressing her concerns about genetic screening, and what specific outcomes would indicate successful support and understanding?
7
.
Describe how you will engage Mrs. Hernandez in a discussion about the ethical and social concerns related to genetic screening. What strategies would you employ to ensure her values and beliefs are respected throughout the decision-making process?