Family Genetic History Form, health and medicine homework help

Family Genetic History Form, health and medicine homework help Family Genetic History Form, health and medicine homework help Directions Refer to the examples in Chapter 4 of your textbook that discuss development of a genogram. Family Genetic History Form, health and medicine homework help Download the NR305_Family_Genetic_History_Form from Doc Sharing. You will document the adult participant’s family genetic history using this MS Word document. Complete the family genetic history using the information that the adult participant is willing to share with you. The focus of this course is on the normal healthy individual so your paper does not need to contain much medical/nursing detail. Refer to your textbook or the Internet to learn what impact the family’s health history may have on the adult participant’s personal state of wellness both now and in the future. Save the completed form by clicking on Save as and add your last name to the file name, for example, NR305_Family_Genetic_History_Form_Smith. Submit the completed form to the Family Genetic Historybasket in the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 2. Please post questions about this assignment to the weekly Q&A Forums so the entire class may view the answers. This paper does not require APA formatting, but you are expected to write clearly and use proper grammar and spelling. Developing a pictorial genogram using symbols to identify certain relationships(e.g., divorced, sibling, deceased, etc.), may provide more insight, however, drawing may be difficult to accomplish withMS Word, therefore you are not expected to use symbols, lines, or other drawing elements. Instead, describe the relationships among the various people in theadult participant’s family’s genetic history. Remember, the goal is not to learn how to draw with Word, but to gather information about the family and recognize its significance to the adult participant and that person’s health. chapter_4.docx family_genetic_history_form_1.docx family_genetic_history_guidelines_2.docx ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Chapter 4 The Complete Health History image http://evolve.elsevier.com/Jarvis/ The purpose of the health history is to collect subjective data—what the person says about himself or herself. This is different from objective data—what you observe through measurement, inspection, palpation, percussion, and auscultation. The history is combined with the objective data from the physical examination and laboratory studies to form the database. The database is used to make a judgment or a diagnosis about the health status of the individual (Fig. 4-1). image 4-1 The following health history provides a complete picture of the person’s past and present health. It describes the individual as a whole and how the person interacts with the environment. It records health strengths and coping skills. The history should recognize and affirm what the person is doing right: what he or she is doing to help stay well. For the well person, the history is used to assess his or her lifestyle, including such factors as exercise, healthy diet, substance use, risk reduction, and health promotion behaviors. For the ill person, the health history includes a detailed and chronologic record of the health problem. For everyone the health history is a screening tool for abnormal symptoms, health problems, and concerns; and it records ways of responding to the health problems. In many settings the patient fills out a printed or electronic history form or checklist. This allows the person ample time to recall and consider such items as dates of health landmarks and relevant family history. You then review and validate the written data and collect more data on lifestyle management and current health problems. Although history forms vary, most contain information in the sequence of categories listed to the right. This health history format presents a generic database for all practitioners. Those in primary care settings may use all of it, whereas those in a hospital may focus primarily on the history of present illness and the functional, or patterns of living, data. Health History Sequence 1. Biographic data 2. Reason for seeking care 3. Present health or history of present illness 4. Past history 5. Medication reconciliation 6. Family history 7. Review of systems 8. Functional assessment or activities of daily living (ADLs) The Health History—The Adult Record the date and time of day of the interview. Biographic Data Biographic data include name, address, and phone number; age and birth date; birthplace; gender; marital partner status; race; ethnic origin; and occupation (both usual and present; an illness or disability may have prompted a change in occupation). Record the person’s primary language. Try to find a language-concordant provider to collect the history or a medical interpreter fluent in the patient’s language. Evidence supports that language-concordance providers increase accuracy of communication and patient satisfaction.18 Source of History 1. Record who furnishes the information—usually the person himself or herself, although the source may be an interpreter or caseworker. Less reliable is a relative or friend. 2. Judge how reliable the informant seems and how willing he or she is to communicate. What is reliable? A reliable person always gives the same answers, even when questions are rephrased or repeated later in the interview. 3. Note if the person appears well or ill; a sick patient may communicate poorly. See sample recordings at right. Sample Statements: Patient herself, who seems reliable Patient’s son, John Ramirez, who seems reliable Mrs. R. Fuentes, interpreter for Theresa Castillo, who does not speak English 50 Reason for Seeking Care* This is a brief, spontaneous statement in the person’s own words that describes the reason for the visit. Think of it as the “title” for the story to follow. It states one (possibly two) symptoms or signs and their duration. A symptom is a subjective sensation that the person feels from the disorder. A sign is an objective abnormality that you as the examiner could detect on physical examination or in laboratory reports.Family Genetic History Form, health and medicine homework help Try to record whatever the person says is the reason for seeking care, enclose it in quotation marks to indicate the person’s exact words, and record a time frame. See examples at right. Sample Statements: “Chest pain for 2 hours” “Sore throat for 3 days now and just getting worse” “Earache and fussy all night” “Need annual physical for work” “Want to start jogging and need checkup” The reason for seeking care is not a diagnostic statement. Avoid translating it into the terms of a medical diagnosis. For example, Mr. J.S. enters with shortness of breath, and you ponder writing “emphysema.” Even if he is known to have emphysema from previous visits, it is not the chronic emphysema that prompted this visit but, rather, the “increasing shortness of breath” for 4 hours. Some people try to self-diagnose based on similar signs and symptoms in their relatives or friends or on conditions they know they have. Rather than record a woman’s statement that she has “strep throat,” ask her what symptoms she has that make her think this is present, and record those symptoms. Occasionally a person may have many reasons for seeking care. After the first reason, ask, “Is there anything else we should take care of today?” The most important reason to the person may not necessarily be the one stated first. Try to focus on which is the most pressing concern by asking the person which one prompted him or her to seek help now. Present Health or History of Present Illness For the well person, this is a short statement about the general state of health: “I feel healthy right now.” “I am healthy and active.” For the ill person, this section is a chronologic record of the reason for seeking care, from the time the symptom first started until now. Isolate each reason for care identified by the person and say, for example, “Please tell me all about your headache, from the time it started until the time you came to the hospital” (Fig. 4-2). If the concern started months or years ago, record what occurred during that time and find out why the person is seeking care now. image 4-2 As the person talks, do not jump to conclusions and bias the story by adding your opinion. Collect all the data first. Although you want the person to respond in a narrative format without interruption from you, your final summary of any symptom the person has should include these eight critical characteristics: 1. Location. Be specific; ask the person to point to the location. If the problem is pain, note the precise site. “Head pain” is vague, whereas descriptions such as “pain behind the eyes,” “jaw pain,” and “occipital pain” are more precise and diagnostically significant. Is the pain localized to this site or radiating? Is the pain superficial or deep? 2. Character or Quality. This calls for specific descriptive terms such as burning, sharp, dull, aching, gnawing, throbbing, shooting, viselike. Use similes: Does blood in the stool look like sticky tar? Does blood in vomitus look like coffee grounds? 3. Quantity or Severity. Attempt to quantify the sign or symptom such as “profuse menstrual flow soaking five pads per hour.” Quantify the symptom of pain using the scale shown on the right. With pain, avoid adjectives, and ask how it affects daily activities. Then record if the person says, “I was so sick I was doubled up and couldn’t move” or “I was able to go to work, but then I came home and went to bed.” 4. Timing (Onset, Duration, Frequency). When did the symptom first appear? Give the specific date and time or state specifically how long ago the symptom started prior to arrival (PTA). “The pain started yesterday” will not mean much when you return to read the record in the future. The report must include answers to questions such as, “How long did the symptom last (duration)? Was it steady (constant) or did it come and go during that time (intermittent)? Did it resolve completely and reappear days or weeks later (cycle of remission and exacerbation)?” 51 5. Setting. Where was the person or what was the person doing when the symptom started? What brings it on? For example, “Did you notice the chest pain after shoveling snow, or did the pain start by itself?” Family Genetic History Form, health and medicine homework help 6. Aggravating or Relieving Factors. What makes the pain worse? Is it aggravated by weather, activity, food, medication, standing bent over, fatigue, time of day, or season? What relieves it (e.g., rest, medication, or ice pack)? What is the effect of any treatment? Ask, “What have you tried?” or “What seems to help?” 7. Associated Factors. Is this primary symptom associated with any others (e.g., urinary frequency and burning associated with fever and chills)? Review the body system related to this symptom now rather than waiting for the Review of Systems section later. Many clinicians review the person’s medication regimen now (including alcohol and tobacco use) because the presenting symptom may be a side effect or toxic effect of a chemical. 8. Patient’s Perception. Find out the meaning of the symptom by asking how it affects daily activities (Fig. 4-3). “How has this affected you? Is there anything you can’t do now that you could do before?” Also ask directly, “What do you think it means?” This is crucial because it alerts you to potential anxiety if the person thinks the symptom may be ominous. image 4-3 Pain Scale Quantify the symptom of pain by asking: “On a 10-point scale, with 10 being the most pain you can possibly imagine and 1 being mild pain you barely notice, tell me how your pain feels right now.” (See Chapter 10 for a full description.) You may find it helpful to organize this same question sequence into the mnemonic PQRSTU to help remember all the points. Note that you still need to address the patient’s perception of the problem. P: Provocative or Palliative. What brings it on? What were you doing when you first noticed it? What makes it better? Worse? Q: Quality or Quantity. How does it look, feel, sound? How intense/severe is it? R: Region or Radiation. Where is it? Does it spread anywhere? S: Severity Scale. How bad is it (on a scale of 1 to 10)? Is it getting better, worse, staying the same? T: Timing. Onset—Exactly when did it first occur? Duration—How long did it last? Frequency—How often does it occur? U: Understand Patient’s Perception of the problem. What do you think it means? Past Health Past health events are important because they may have residual effects on the current health state. The previous experience with illness may also give clues about how the person responds to illness and the significance of illness for him or her. Childhood Illnesses. Measles, mumps, rubella, chickenpox, pertussis, and strep throat. Avoid recording “usual childhood illnesses,” because an illness common in the person’s childhood (e.g., mumps) may be unusual today. Ask about serious illnesses that may have sequelae for the person in later years (e.g., rheumatic fever, scarlet fever, poliomyelitis). Accidents or Injuries. Auto accidents, fractures, penetrating wounds, head injuries (especially if associated with unconsciousness), and burns. Serious or Chronic Illnesses. Asthma, depression, diabetes, hypertension, heart disease, human immunodeficiency virus (HIV) infection, hepatitis, sickle-cell anemia, cancer, and seizure disorder. Hospitalizations. Cause, name of hospital, how the condition was treated, how long the person was hospitalized, and name of the physician. Operations. Type of surgery, date, name of the surgeon, name of the hospital, and how the person recovered. Obstetric History. Number of pregnancies (gravidity), number of deliveries in which the fetus reached full term (term), number of preterm pregnancies (preterm), number of incomplete pregnancies (miscarriages or abortions), and number of children living (living). For each complete pregnancy, note the course of pregnancy; labor and delivery; sex, weight, and condition of each infant; and postpartum course. Recorded as: Grav 3 Term 2 Preterm 1 Ab 0 Living 3 52 Immunizations. Routinely assess vaccination history and urge the recommended vaccines. Your strong recommendation increases compliance.1 Use the current Centers for Disease Control (CDC) recommendations for adults, but be aware of primary contraindications and precautions as well as the person’s lifestyle, occupation, and travel Family Genetic History Form, health and medicine homework help .1 The 2013 recommendations for adults include: influenza (annually), tetanus-diphtheria-pertussis (Td/Tdap) (once and boost every 10 years), varicella, human papilloma virus (HPV) for female and male (3 doses ages 9 to 26 years), zoster (after 60 years), measles-mumps-rubella (1 or 2 doses), pneumococcal (once and boost after 65 years), meningococcal, and hepatitis A and B. Recommendations for Tdap now include routine vaccination for those over 65 years and for repeat Tdap with each pregnancy during 27 to 36 weeks’ gestation. You can find a printable color-coded table of the 2013 adult immunization schedule at http://www.cdc.gov/vaccines/schedules/hcp/adult.html. Advise gay and bisexual men to receive HPV, hepatitis A, and hepatitis B vaccinations. If they are not in a long-term monogamous relationship, they should have annual testing for HIV, syphilis, gonorrhea, and chlamydia.2a Last Examination Date. Physical, dental, vision, hearing, electrocardiogram (ECG), chest x-ray film, mammogram, Pap test, stool occult blood, serum cholesterol. Allergies. Note both the allergen (medication, food, or contact agent such as fabric or environmental agent) and the reaction (rash, itching, runny nose, watery eyes, or more serious difficulty breathing). With a drug this symptom should not be a side effect but a true allergic reaction. Current Medications. Medication reconciliation is a comparison of a list of current medications with a previous list, which is done at every hospitalization and every clinic visit. The purpose is to reduce errors and promote patient safety. For all currently prescribed medications, note the name (generic or trade), dose, and schedule, and ask: “How often do you take it each day? What is it for? How long have you been taking it? Do you have any side effects?” and if not taking it, “What is the reason you stopped taking it?” A person could take furosemide from one bottle and Lasix from another prescriber and not know that it is the same medication. Ask about nonprescription and over-the-counter (OTC) drugs. The average U.S. home medicine cabinet holds 24 OTC medications, and 40% of Americans take at least one OTC medicine every 2 days.12b Specifically ask about aspirin (because many people do not consider it a medication even though they take it every day) and other medications: vitamins, birth control pills, antacids, cold remedies, acetaminophen. Be aware that acetaminophen is a component in many OTC pain and cold medications. It has close to 25 trade names, including Tylenol. Serious liver damage may ensue if a person unknowingly doubles or triples the maximum daily acetaminophen intake. For any pain reliever (e.g., acetaminophen, ibuprofen [Advil, Motrin]) ask how many milligrams the person takes. Ask about herbal medications. Although not regulated by the Food and Drug Administration (FDA), they are popular because consumer advertising promises weight loss, improved memory, or relief from insomnia or depression. Many are considered safe, but some interact with prescribed medications. For example, St. John’s wort is often taken for depression, but because it enters the CYP 450 enzyme metabolism, it has many herb-drug interactions.12 Inquire about substances (alcohol, tobacco, street drugs) here or later in Personal Habits (see p. 57). Family History In the age of genomics an accurate family history highlights diseases and conditions for which a particular patient may be at increased risk. A person who learns that he or she may be vulnerable for a certain condition may seek early screening and periodic surveillance. A person with significant coronary heart disease history (e.g., a cardiac event in a first-degree male relative < 55 years or female relative < 65 years) may be influenced to adopt a healthy lifestyle when possible to mitigate that risk. The most fruitful way to compile a complete family history is to send home a detailed questionnaire before the health care/hospital encounter because the information takes time to compile and often comes from multiple family members. Family Genetic History Form, health and medicine homework help Then you can use the health visit to complete the pedigree. A pedigree or genogram is a graphic family tree that uses symbols to depict the gender, relationship, and age of immediate blood relatives in at least three generations such as parents, grandparents, and siblings (Fig. 4-4). The health of close 53family members such as spouse or partner and children is equally important to highlight the patient’s prolonged contact with any communicable disease or environmental hazard such as tobacco smoke, or to flag the effect of a family member’s illness on this person. image 4-4 Genogram or family tree. (American Society of Human Genetics, 2004.) Record the medical condition of each relative and other significant health data such as age and cause of death, twinning, tobacco use, and heavy alcohol use. When reviewing the 54family history data, ask specifically about coronary heart disease, high blood pressure, stroke, diabetes, obesity, blood disorders, breast/ovarian cancer, colon cancer, sickle-cell anemia, arthritis, allergies, alcohol or drug addiction, mental illness, suicide, seizure disorder, kidney disease, and tuberculosis (TB). Family History Tools in Electronic and Print Format U.S. Surgeon General (My Family Health Portrait): www.hhs.gov/familyhistory/ Utah Health Family Tree: www.health.utah.gov/genomics American Medical Association: www.ama-assn.org/ama/pub/category/2380.html image Culture and Genetics Add several questions to the complete health history when the person is a new immigrant: • Biographical data—When did the person enter the United States and from what country. If a refugee, under which conditions did he or she come? Was there harrassment or torture? Many immigrants have significant health care needs (e.g., diabetes, accidents on the job, muscle pain) but are in the country without documentation. Unless your facility ensures anonymity, they are reluctant to furnish biographic data for fear of deportation. • The older adult may have come to this country after World War II and may be a Holocaust survivor—Questions regarding family and past history may evoke painful memories and must be asked carefully. • Spiritual resources/religion—Assess whether certain procedures, such as administering blood to a Jehovah’s Witness or drawing large amounts of blood from a Chinese patient, are prohibited. • Past health—Which immunizations were given in the homeland (e.g., was the person given Bacillus Calmette-Guérin [BCG])? This vaccine is used in many countries to prevent TB; it is not administered in the United States. If the person has had BCG, he or she will have a positive tuberculin test; further diagnostic procedures must be done, including a sputum test and chest xray film. • Health perception—How does the person describe health and illness, and what does he or she see as the problem that he or she is now experiencing? • Nutritional—Which foods and food combinations are taboo? Review of Systems The purposes of this section are (1) to evaluate the past and present health state of each body system, (2) to double-check in case any significant data were omitted in the Present Illness section, and (3) to evaluate health promotion practices. The … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10