This chapter reviews prevention, including genetic counseling. It discusses genetic testing for diagnosis as opposed to screening and the treatment for genetic disease. Methods of prevention begin with education of the public and health care professionals and identification of those at risk. Genetic counseling is the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. The malignant cells often exhibit aneuploidy as well as translocations that are found only within the tumor cells. Genetic errors that arise from specific cell lines are somatic mutations. It is suggested that there is a thorough collection of family, genetic, and medical history for children entering the adoption process. Nurses may play a variety of roles in genetic counseling that reflect their preparation, area of practice, primary functions, and setting. The chapter explains the incidence of chromosome abnormalities.

The initial recognition of the need for a genetics referral may arise when a nurse suspects a genetic contribution to disease because of personal or family medical history and/or findings from a physical assessment. Family history is a valuable and cost-effective tool that is often underutilized in clinical practice. Many common genetic conditions result from complex interactions between genetic and environmental factors. It is critical to collect information about potential environmental exposures to help inform a patient’s risk assessment. Health care professionals should become familiar about toxic environmental agents that are common in their specific geographic location. A growing number of Food and Drug Administration (FDA) approved drugs have labeling that includes pharmacogenomic information, which can be used to optimize drug dosage and prevent adverse and life-threatening drug reactions in a patient or family member.

Nurses working in the field of obstetrics must have a greater depth and breadth of genetic knowledge over any other subspecialty. In gestation, nurses should include education on the effects of teratogens, prenatal screening options, and prenatal diagnoses. After delivery, early recognition of genetic disorders is important for immediate initiation of potentially life-saving therapies. Preconception education is a critical component of health care for women of reproductive age. The Centers for Disease Control and Prevention (CDC) recommend that all women of childbearing age consume 0.4 mg of folic acid daily to prevent neural tube defects (NTDs). Counseling can still be useful in terms of optimum pregnancy management in a setting best able to cope with any anticipated problems. Complex and multifaceted maternal and fetal factors influence the consequences of drugs, radiation, and chemical and infectious agents to the developing fetus.

This chapter examines pre- and postconference expectations and activities, explores forms to be used by the professor and the students, suggests care plans and patient assignments, and describes sample concept maps and a math skills assessment. A student with no experience in health care may be shy or sheepish when it comes to hands-on care. It may be of benefit for the students to be paired in the first few weeks of clinical classes. The care plan forms can help guide the student through the nursing process. Medication forms will help the student learn about various medications. Nursing education has adopted the use of concepts maps to assist students in gathering patient information. Patient safety is the number one priority for all health care professionals. Dose calculations are a daily activity for nurses.

This chapter discusses basic review of the admission process, and describes an admission assessment exercise that allows students to assume the roles of both patient and nurse. It also describes the role of nurse in which the student learns to collect patient data and record data appropriately, and also explains the role of the electronic medication administration record (eMAR). Preconference begins with a review of the skills previously mastered: hand washing, obtaining vital signs, and performing those daily nursing activities such as taking assessments and collecting data on patients. The student is responsible for making copies of the nursing notes for the required clinical assignments. With the admission assessment exercise, the clinical instructor can discuss the correlation of the vital signs, medications, past medical history, and familial history. New designs in technology have facilitated new medication administration practices that will reduce the number of medication errors in health care facilities.

Multiple physical changes can impair the mental health of the aging individual. These changes include: acid-based imbalances, dehydration, electrolyte changes, hypothermia or hyperthermia, and hypothyroidism. This chapter reviews the most common mental health disorders affecting the elderly population and trends affecting care delivery. Moreover, chronic, unresolved pain has been associated with an increased risk of a mental health disorder such as depression, suicide, or anxiety. The aging individual may exhibit signs and symptoms of insomnia such as sleeping for short periods during the night, sleeping during times of normal social activities, arising early in the morning while others sleep, and experiencing daytime sleepiness. The chapter concludes by applying the nursing process from an interpersonal perspective to the care of an elderly patient with a mental health disorder.

This chapter examines performing effective student evaluations, evaluating a student’s strengths and weaknesses, and documenting student progress, including sample forms and templates. It also provides coaching tips and interventions for poorly performing students. As the instructor it is our fundamental responsibility to provide daily assessments on your students’ progress. Verbal feedback must be given immediately and often. Always start with the positive aspects of the students’ performance. It is our responsibility to write down our immediate thoughts and observations of each student in an objective, anecdotal format after any interaction, whether positive or negative. Sample action verbs will help to describe the students’ actions while in the clinical setting. The chapter also helps us to identify and address behaviors or patterns of behavior that require documentation and intervention. It offers some helpful tips to use when counseling students regarding their performance deficiencies.

This chapter examines final clinical evaluation, provides tools and guidance to determine whether the student has gained adequate knowledge of terms, calculations, and critical thinking, and explores instructions regarding grading. Final evaluations will be given during Week 13. Final grades will not be distributed until Week 14 to ensure that the final quiz has been added to the grade calculation total. The final grade will be based on the final evaluation, final quiz, and all assignments. Patient assignments should be given out after the quiz has been completed. The clinical evaluation tool is used to achieve a consistent means of evaluating the students’ progress in clinical. It provides a guideline for instructors to ascertain students’ deficiencies and knowledge base. The clinical evaluation criteria includes: core learning outcome, satisfactory behavior, needs improvement, and unsatisfactory behavior. The clinical instructor may use attendance as part of the students’ grades.

This chapter examines missed classes and material for makeup classes, critical thinking skills exercises, and stress-reduction techniques. Each clinical course must meet for a certain number of hours to ensure the student is meeting attendance requirements. When a student misses a clinical class, a makeup assignment should be given to meet the attendance requirement. There are several types of assignments on makeup assignments includes individual makeup assignments, group scenario makeup assignments, and library assignments. The chapter also offers some questions that may be used for individual makeup assignments or may be used to help the group discuss ethics in nursing. The challenges faced by both the senior and middle-aged adult populations: examination of cultural attitudes and concerning their own thoughts. The patient education scenarios can also be used for group discussions to further aid in the development of critical thinking skills. Stress is a necessary factor in life.

This chapter examines the musculoskeletal and integumentary systems and reviews physiological and systematic assessment of the musculoskeletal system and related nursing tools. It describes pressure ulcers, passive range of motion (PROM) and active range of motion (AROM), burn management, traction, and the effects of decreased mobility. Instructors are encouraged to discuss the costs of pressure ulcers and the reimbursement process related to health care organizations when patients develop nosocomial pressure ulcers. Pressure ulcers are also costly to the patient in terms of pain and suffering. PROM exercises are exercises that the nurse or nursing student can perform for the patient who cannot independently exercise or move an extremity. AROM exercises are an exercise therapy that the patient can perform independently. There are three phases of burn management: emergent phase, acute phase, and rehabilitation phase.