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 addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. It provides Dr. Sachs’s honest and open remarks along with interspersed additions from the authors to introduce the field and its accompanying issues. In explaining his career trajectory, Dr. Sachs recalls earning his undergraduate degree in psychology and then applying to graduate programs in applied behavioral analysis. Dr. Sachs’s somewhat zigzagged trajectory in the field demonstrates the important sport and exercise psychology principle that explains the benefits of focusing on the process rather than the outcome when setting goals. Dr. Sachs added that the United States leads the way in research and writing with regard to sport and exercise psychology, while other countries may be more advanced in the application of that knowledge at the professional levels.

This chapter addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. The topic of decision making has been covered in psychology, economics, and motor learning but addressed very sparsely in sport, exercise, and performance psychology. Rational decision making requires defining the problem, identifying criteria, weighing those criteria, generating alternative solutions, and ultimately computing the optimal decision. The chapter introduces the literature on decision making and provides examples of factors that influence the choices people make. The decision to act, move, or what move to make is decided in the response selection stage, and the final stage is when one’s brain and muscles are organized to make the actual move. The key to improve the decision-making over time is to increase personal awareness of own limitations and keep learning and collecting information from reliable sources.

One of the most important findings from the original battered woman syndrome (BWS) research was the existence of a three-phase cycle of violence that could be described and measured through careful questioning of the battered woman. This chapter describes the cycle, updates it by adding information from the courtship period, and divides the third phase into several different sections where appropriate so that there may not be any loving contrition or even respites from the abuse at times during the relationship. Teaching the woman how her perception of tension and danger rises to an acute battering incident after which she experiences feelings of relief and then gets seduced back into the relationship by the batterer’s loving behavior, often similar to what she experienced during the courtship period, has been found to be helpful in breaking the cycle of violence that keeps the woman in the relationship.

This chapter aims to give the behavioral health specialist (BHS) a basic understanding of pain, knowledge about how to effectively evaluate chronic pain, and a description of effective pain management techniques. Knowledge of the biological and psychological basis of pain is important to understanding the experience of chronic pain. A biopsychosocial assessment is the foundation for providing behavioral health treatment to the chronic pain patient. Chronic pain is less responsive to treatments commonly used for acute pain such as opioid analgesia and avoiding physical activity. A multidisciplinary team approach can substantially improve outcomes in chronic pain treatment. Whatever the format of service provision, utilizing multiple interventions such as physical therapy/exercise, emotional management, pacing, and medication, rather than a single modality can substantially improve outcomes for chronic pain. Providing psychoeducation about chronic pain can be an important strategy.

This chapter provides the doctor of nursing practice (DNP)/nurse leader with knowledge of the financial, scheduling, staffing, reporting tools, and leadership commitment required to be successful in the management and retention of their workforce and the delivery of care to the patients. The DNP/nurse leader has ultimate accountability for the cost center budget for labor resources, salary and expense dollars, staff satisfaction, and the delivery of care to the patients on the unit. Accountability and teamwork are crucial to achieving best practices, engagement by frontline staff to improve patient safety and the quality of care. There is no question that nursing care and quality patient care are inseparable. Safe staffing saves lives and a growing body of evidence documents that adequate nurse staffing improves patient outcomes, resulting in shorter lengths of stay, fewer complications, and patient deaths.

Nurses with a doctor of nursing practice (DNP) degree possess the specific skills needed to address the issues and achieve the goals related to better access, reduced health disparities, balanced quality and cost, improved health literacy, enhanced practice, and sustainability of health care and health care systems. This chapter explains the DNP abilities and proficiencies on financial and business management, applying evidence-based practice (EBPs) to build systems of care, and evaluating outcomes, with specific concentration on grant writing for health care programs. Generally, contemporary operating budgets in the acute hospital, ambulatory, or community settings are based on historic operating expenses and revenues, or increasingly are zero based. This leaves the DNP with little to no margin for increases related to redesigning care delivery models, implementing quality initiatives, initiating performance improvement strategies, or creating new service lines; except, of course, to become leaner.