DNP-810 Topic 3 DQ 2 Why is it important to have a comprehensive health and physical assessment that includes information on environment and genomic influences?

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Topic 3 DQ 2

Jun 23-27, 2022

Why is it important to have a comprehensive health and physical assessment that includes information on environment and genomic influences? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.

REPLY TO DISCUSSION

Tommie Wood

Jul 8, 2022, 7:04 PM

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Comprehensive health and thorough physical assessment including environmental and genomic factors are crucial to providing individualized treatment for patients. Precision health is explained as using information from patients including lifestyle, social, economic, cultural, and environmental factors help doctoral-prepared nurses to practice in a holistic manner. (Conley, et al., 2019)In today’s changing demographics, this information is more relevant than ever. In my practice of working with vulnerable populations, the awareness of factors regarding social determinants is imperative. Knowledge of chronic illnesses and how to treat them medically is only a portion of the responsibility of an advanced practice nurse. (Conley, et al., 2019)

Nurses are at the forefront and are important in moving precision medicine to the frontline. One of the primary goals of precision medicine/health is to improve diagnosis and personalized treatment for patients. Using tools such as the My family health portrait, is a benefit in getting the conversation started. Family health history provides information on specific diseases common in families, shared genes, and environmental and behavioral factors. (MFHP, nd). This is beneficial in establishing a family history of renal disease, diabetes, hypertension, and obesity. (MFHP, nd).

Mei R. Fu, Emma Kurnat-Thoma, Angela Starkweather, Wendy A. Henderson, Ann K. Cashion, Janet K. Williams, Maria C. Katapodi, Karin Reuter-Rice, Kathleen T. Hickey, Veronica Barcelona de Mendoza, Kathleen Calzone, Yvette P.

Amanda Clark

Jun 29, 2022, 2:41 PM

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CAT: What additional questions do you have from this weeks content?

Jennifer Murillo

Jun 27, 2022, 11:45 PM

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Replies to Tommie Wood

Once genetic alterations have been made, one’s genes can induce different responses compared to other individuals. As a result, some people may develop a disease after exposure to something in the environment, while others may not. Epigenetic alterations can be elicited through environmental factors significantly augmenting the relationship between DNA and proteins (Ayorech et al., 2019). Your genes hold the basic instructions for your body to grow and function, but they are far from the only thing controlling your traits. Most traits are shaped both by a person’s genes and by environmental factors. Environmental factors include everything outside of DNA that affects your traits (Ayorech et al., 2019).

A DNP-prepared nurse can use the information to educate their patients on how genes, via their influences on morphology and physiology, create a framework within which the environment shapes an individual’s behavior. The environment can affect morphological and physiological development; behavior develops due to that patient’s shape and internal workings (Ludeke et al., 2021). In addition, genetics influence a child’s well-being by setting the limits of growth, development, and health potential that could lead to a child’s insecurity about some aspects about their self, but with the right lifestyle factors, for example, physical activity, can lead to a lavish lifestyle with a child’s well-being (Ludeke et al., 2021). Furthermore, genes can interact with other genes and the environment. Some genes may dominate and prevent others from being expressed. In other cases, specific biological influences might impact genetic expression. An example of biological influence over gene expression is a child not getting proper nutrition (Ludeke et al., 2021). In addition, the environment a child is exposed to both in utero and throughout the rest of their life can also impact how genes are expressed. For example, exposure to harmful drugs while in utero can dramatically impact later child development (Ludeke et al., 2021).

References

Ayorech, Z., Plomin, R., & von Stumm, S. (2019). Using DNA to predict educational trajectories in early adulthood. Developmental Psychology, 55(5), 1088.

Ludeke, S. G., Gensowski, M., Junge, S. Y., Kirkpatrick, R. M., John, O. P., & Andersen, S. C. (2021). Does parental education influence child educational outcomes? A developmental analysis in a full-population sample and adoptee design. Journal of Personality and Social Psychology, 120(4).

Amanda Clark

replied toJennifer Murillo

Jun 28, 2022, 5:26 PM

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Replies to Jennifer Murillo

Hi Jennifer,

I liked reading your discussion. You brought up some great points here with how the DNP prepared nurse can use this information for educational purposes and guidance .

Margaret Mbachu

replied toJennifer Murillo

Jun 28, 2022, 9:35 PM

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Replies to Jennifer Murillo

Thanks, Jennifer for your post.

Understanding the part that environment play in family health history helps practitioners to educate and understand the etiology of disease conditions.

For example, Sickle cell disease is mainly seen in Africa, and Basal cell carcinoma is mainly seen in fair skin due to sun exposure and lack of Melanin, some disease conditions are related to work that we do, like the Asbestos, and long time exposure to radiation for the radiologist and their technician. It will also assist practitioners to protect at-risk individuals and those with poor access to health care.

Carolyn Smith

replied toJennifer Murillo

Jun 29, 2022, 10:00 AM

Replies to Jennifer Murillo

Hello Jennifer,

It is true that environment can trigger genetic alternations. Therefore, some people may be exposed to certain healthcare complications due to their environment. Comprehensive health and physical assessment allows healthcare providers to obtain adequate information on diseases. Information on environment and genomic influences increase the accuracy of medical intervention. Epigenetic alterations are common genetic reactions to environmental influence (Reiter-Brennan et al., 2021). Unfortunately, limited information on the impact of environment on genetic alternations challenges nurses from handling epigenetic alterations and other

DNP-810 Topic 3 DQ 2 Why is it important to have a comprehensive health and physical assessment that includes information on environment and genomic influences

related complications. A DNP-prepared nurse uses information from a comprehensive health and physical assessment to educate their patients (Strohschein et al., 2020). Most patients have limited information on the impact of their environment on genes. As a result, most patients expose themselves to hazardous environmental conditions unknowingly. Therefore, DNP-prepared nurses become critical players in educating and sensitizing their patients.

References

Reiter-Brennan, C., Dzaye, O., Davis, D., Blaha, M., & Eckel, R. H. (2021). Comprehensive care models for cardiometabolic disease. Current Cardiology Reports, 23(3), 1-11.

Strohschein, F. J., Allison Loucks, R. N., Rana Jin, R. N., & Brandy Vanderbyl, R. N. (2020). Comprehensive Geriatric Assessment. Clinical journal of oncology nursing, 24(5), 514-525. DOI:10.1188/20.CJON.514-525

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
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