See page 16 and 17 of attached document. Assignment labeled Genomics part 1

 Patient Genetic and Genomics Interview and Education Part 1

 To assess a patient’s genetic risk, you must understand the relationship of genetics and genomics to health, prevention, screening, treatment, and monitoring. E This is a two-part assignment whose purpose is to help you develop your abilities to apply genetics and genomic information while providing patient care. Purpose: Use a constructed genetic pedigree from collected family history information to identify a risk profile and develop a plan of care, including patient education and referral. Before you start this project go and register for the G3C (Global Genetics and Genomics Community) learning portal https://www.genomicscases.net/en/. The site is free and has interactive cases that demonstrate how genetic and genomics link to health and illness. Throughout each patient scenario, there are links to resources and supplemental educational activities to expand upon genetic/genomic learning concepts. At the end of each patient encounter, learners are prompted to make a recommendation to their “patient” and are assessed across multiple domains such as risk assessment, family history, and patient medical history. There are 17 cases, and you can get CEs for the activities. Part 1: a. Choose one case in the https://www.genomicscases.net/en/ and complete the activity, please submit the report given at the end of the activity. b. Select a patient that you can interview virtually. Set up a time and quiet time, go over with the patient about confidentiality, and explain that no identifiable information will be used in this assignment. c. Go to the Center for Disease Control “My Family Health Portrait: A tool from the Surgeon General at https://phgkb.cdc.gov/FHH/html/index.html d. Collect a client’s personal and three-generation family health history to assess for genomic factors that impact the client’s health ( Save the created Family Health History, please, use fictitious names, but keep the rest of the information accurate). e. Identify genetic and genomic factors within collected history and that contribute to illness and/or health risk. f. Identify issues in this patient-related to each of the following: Financial/Socioeconomics, Cultural, Religious, and Lifestyle. g. Identify ethical/legal concepts related to this patient. Include concepts Genetics/Genomics Nursing Practice. 17 h. Identify the major challenge with this patient and identified possible strategies to overcome this challenge i. Report your findings in a three-page report including the three-generation Map using APA guidelines 

Grading Rubric Rating Criteria Needs Improvement 10 points Proficient 15 points Exceptional 20 points Pedigree Construction Student included most data from family members but is missing data from some individuals. Trait of interest is clearly diagramed in the pedigree. Student included 3 or more generations using standardized symbols and terminology OR the U.S. Surgeon General’s My Family Health Portrait Tool. Student included 3 or more generations using standardized symbols and terminology OR the U.S. Surgeon General’s My Family Health Portrait Tool. Pedigree Analysis Analysis of the pedigree is incomplete, inaccurate, and/or does not address relevant genomic factors that impact the client’s health. Analysis of the pedigree is complete, accurate, AND addresses relevant genomic factors that impact the client’s health. Analysis of the pedigree is comprehensive, accurate, AND addresses relevant genomic factors that impact the client’s health. Pedigree identification of health risk Identifies some risk factors but fails to make connections. Identifies partially potential health risk factors for this patient. Identifies potentially significant health risk for this patient. Pedigree identification of environmental and cultural factor as risk fa tors. Completes a risk analysis of the environmental and cultural factors but misses two or more components. Completes a risk analysis of the environmental and cultural factors but misses one component. Completes a thorough risk analysis for the identified patient based on their pedigree, culture, environmental exposure and life style.

  

1. Portfolio part II 

a) APRN protocol also known as collaborative agreement with supervising physician(s).

b.) business proposal (refer to portfolio explanation/examples found on your BB lecture section. 

There is an example of a business proposal. Use the example to create a brief business proposal with no more than two pages word or power point as your choice;

c.) Create a LinkedIn page and send me a proof of you creating the link.

The Assignment: 5 pages

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. 

Introduction to the case (1 page)

• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

BACKGROUND

This week, we examine a 31-year-old male who presents to the office with a chief complaint of insomnia. 

SUBJECTIVE

Patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but is now having difficulty both falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his job, which is a forklift operator at a local chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He states he has fallen asleep on the job due to lack of sleep from the night before. The patient’s medical record from his previous physician states that he has a history of opiate abuse, which began after he broke his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. The patient states recently he has been using alcohol to help him fall asleep, approximately four beers prior to bed.

MENTAL STATUS EXAM

The patient is alert and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight, and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future oriented.

Decision Point One

Trazodone: 50–100 mg daily at bedtime 

RESULTS OF DECISION POINT ONE

• Patient returns to clinic in 2 weeks
• Patient states medication works well but gives him an unpleasant side effect of a prolonged erection of the penis, approximately 15 minutes after waking 
• Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
• Patient denies auditory/visual hallucinations and is future oriented

Decision Point Two

Explain that priapism is a side effect of trazodone that should diminish over time. Continue dose 

RESULTS OF DECISION POINT TWO

• Patient returns to clinic in 2 weeks
• Patient states priapism has diminished over time
• Patient denies auditory/visual hallucinations and is future oriented 
• Patient states trazodone is effective at 50 mg dose but sometimes wakes up following day with next-day drowsiness
• Patient denies auditory/visual hallucinations and is future oriented

Decision Point Three

Continue dose. Explain to patient he may split the 50 mg tablet in half. The decreased dose should minimize next-day drowsiness. Follow up in 4 weeks 

Guidance to Student
Trazodone is a selective serotonin reuptake inhibitor that has a low side effect profile. It would not be prudent to prescribe sonata as it carries with it the risk of complex sleep behaviors. Hydroxyzine is an antihistamine with strong sedative properties. However, many patients complain of anticholinergic adverse effects the following morning, such as Xerostomia and Xerophthalmia.
The patient is presenting with excessive somnolence. It would be prudent to reduce the dose of trazodone by 50% and reassess in 4 weeks. 

After reviewing the Psychosocial Care of the Elderly source found in the Learning Materials in Module 3, discuss surprising facts about the psychosocial care of the aging. Did you originally consider any of these as myths, when in reality they are based on evidence? How can nurses influence attitudes among caregivers and the public about aging?