Question

1.         A couple has come to the clinic for genetic testing. They met and eloped without meeting the extended family. The wife found out that the husband has family members with a genetic disorder. She is pregnant and concerned that their baby will inherit this disorder. A. How should the nurse approach this? B. What options can the nurse suggest if the testing proves positive for a genetic trait? C. List some appropriate nursing diagnoses for this situation.

2.         A couple has decided to have genetic testing conducted before they try to have any children because of some family members with genetic disorders. They are both anxious and concerned about the outcome but insist this is the best decision. A. What should the nurse be aware of? B. How can the nurse best help this couple? C. What are some of the options available to this couple if the testing comes back positive for a trait they do not wish to pass on?

3.         A young couple has just found out they are pregnant with their first child. They are aware there are genetic disorders in the family but they are uncertain if they want to have any genetic testing conducted. A few family members are concerned and are encouraging the couple to undergo genetic testing. A.        What are some immediate concerns for the nurse to help this couple with? B. The couple remains adamant about no genetic testing; how should the nurse prepare to help this couple? C. What are some expected outcomes for this situation?

Answer 1

Ans.1

A)The nurse should approach with calmness. She should actively listen to her client's concern regarding the baby. Let her ventilate her fear of passing the genetic disorder to the baby. Nurse should provide reassurance to the client. Providing a glass of water and eye contact while listening gives a sign to the client that nurse is showing interest in her worry and will provide help. Nurse should then provide information regarding genetic studies and genetic testing. She should find out if the family can understand about autosomal dominant and recessive traits and if yes then she can explain them about its inheritance in next generation.

B) A positive test result of the genetic testing means that the laboratory study found a change in a particular gene.If the test results are positive for a genetic trait then the nurse can provide following options to the couple;

i) available preventive measures

ii) available treatment measures

iii) also the positive results can not be used to predict the exact course or severity of the genetic disorder.

C) Nursing diagnosis

I)Fear and anxiety related to presence of history of genetic problem.

ii) Knowledge deficit related to the investigative procedures i.e. genetic testing.

________________x__________x_________________

Ans. 2

A) The nurse should be aware that the couple is being provided with the health teaching regarding the test. She should make sure that the couple is aware about the pros and cons of the test which is to be conducted. The complications and risk benefit ratio should be well explained to them.

B) The nurse can provide reassurance to the couple. She can be helpful in decision making process by providing all the necessary information regarding specific genetic disorder, risks involved in reproduction, and available prenatal diagnostic measures/options. She can also provide genetic counseling to the couple.

C) If the results of genetic tests are positive then you can go for the available treatment options. They can take advice from the nurse counselor and ask if giving birth would create more problems and how it can be avoided.

Ans. 3

A)The knowledge deficit is the immediate concern here. The nurse needs to consent provide all the necessary information regarding genetic testing to the couple; it's benefits and risk /complications, so that the couple can make decision independently.

B) Adamant couple can be approached with a friendly approach. They should be evaluated first about their existing knowledge on genetic testing and later their false information of any should be corrected, and provided with the correct one. They are always free to make their decision whether to undergo the test or not but they do have right to have all the information to make an appropriate decision.

C) If the nurse is able to convince the couple to undergo the test this will eliminate the fear and anxiety among the family members.

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