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.
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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.
Traumatic brain injury (TBI) causes two injury types: primary and secondary. In infants and young children, nonaccidental TBI is an important etiology of brain injury and is commonly a repetitive insult. TBI is by far the most common cause of acquired brain injury (ABI) in children and is the most common cause of death in cases of childhood injury. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) issued validated prediction rules to identify children at very low risk of clinically important TBI, which is defined as TBI requiring neurosurgical intervention or leading to death. The range of outcomes in pediatric TBI is very broad, from full recovery to severe physical and/or intellectual disabilities. Children and adolescents who have suffered a TBI are at increased risk of social dysfunction. Studies show that these patients can have poor self-esteem, loneliness, maladjustment, reduced emotional control, and aggressive or antisocial behavior.
This book provides school personnel with information on how concussion (mild traumatic brain injury) can affect learning, mental health, and social-emotional functioning, skills in developing and leading a school-based concussion support team, tools for school-based concussion assessment, and information on a safe, gradual process of returning to the academic environment. It explains what happens to the brain at the moment of impact, terminology, prevalence rates, causes, risk factors, and issues related to underreporting of concussions. Educators will learn about developmental effects, how concussions can affect students of different ages, as well as difficulties that can result from concussions such as postconcussion syndrome and second impact syndrome. This book presents a school-based concussion team model, including the specific responsibilities of the concussion team leader (CTL), and a discussion of maintaining student privacy through regulations like the Health Insurance Portability and Accountability Act of 1996. Readers are familiarized with checklists that can be used within the school and assessment tools such as Acute Concussion Evaluation (ACE) and neuropsychological assessment. Readers are also familiarized with how physical and cognitive rest can be balanced with a return to activity during the recovery period. This book also book gives concussion team members guidance on the selection of appropriate strategies, as well as decision making during a student’s return to academics, and discusses concussion prevention information by providing guidance on how readers might train others on concussion recognition and response. Case studies are integrated throughout the chapters.
This chapter includes information related to the clinical evaluation of a concussion that a child might receive in a medical setting. It discusses guidelines for appropriate use of smartphone concussion evaluation apps. This chapter examines a brief section on the future of concussion assessment. The Acute Concussion Evaluation (ACE) can help the school concussion team obtain information regarding the injury, including the cause, severity, any amnesia, loss of consciousness (LOC), and any early signs. The computerized neurocognitive assessment typically measures player symptoms, verbal/visual memory, attention span, working memory, processing speed, response variability, nonverbal problem solving, and reaction time. Neurocognitive tests, sideline assessments, and smartphone apps can help district staff and parents determine the severity of a student’s symptoms. A neuropsychological assessment to assess cognitive functioning, memory, speed, and processing time may also be administered.
You CAN Teach Med-Surg Nursing!:The Authoritative Guide and Toolkit for the Medical–Surgical Nursing Clinical Instructor
This book gives readers all the direction and resources they need to be a confident and competent medical-surgical nursing clinical instructor. It offers insight and examples related to student evaluations, syllabus preparation, and contracts that would typically be used by an adjunct instructor. Week-to-week instruction, along with medication quizzes and student learning activities, helps ensure that students are learning new knowledge and skills on an ongoing basis. A caring plan and medication forms are included, along with medication administration guidelines. The major body systems are addressed, with comprehensive resources included on each one. The increasingly significant topics of delegation and patient teaching are also included. Each clinical week is prepared and sequenced in such as way as to provide the clinical instructor with enough material to teach without redundancy. 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 included in the book on makeup assignments. The work assigned for the makeup assignment must be written in American Psychological Association (APA) format and must be thoroughly investigated with reliable evidenced-based references. The assignment should be detailed enough to makeup for the hours missed.
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.