DNP 810 Topic 3 DQ 2 importance of a comprehensive health

DNP 810 Topic 3 DQ 2  importance of a comprehensive health

DNP 810 Topic 3 DQ 2  importance of a comprehensive health

https://nursingmasters.blog/dnp-810-topic-3-dq-2-describe-the-importance-of-a-comprehensive-health-and-physical-assessment-that-includes-information-on-environment-and-genomic-influences/

DNP 810 Topic 3 DQ 2

Describe the importance of a comprehensive health and physical assessment that includes information on environment, and genomic influences. Frame this answer through your current role, whether as an Advanced Registered Nurse Practitioner (ARNP) with a practice, or a nurse executive overseeing nursing practice in an organization.

Topic 3 DQ 2

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

Unread
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.

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

Read
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).

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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).

Unread

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 .

Unread

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.
 CS
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 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

Name:  Discussion Rubric

• Grid View
• List View

		Excellent    90–100	Good    80–89	Fair    70–79	Poor    0–69
Main Posting:    Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.		40 (40%) – 44 (44%)    Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	35 (35%) – 39 (39%)    Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	31 (31%) – 34 (34%)    Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	0 (0%) – 30 (30%)    Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting:    Writing		6 (6%) – 6 (6%)    Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	5 (5%) – 5 (5%)    Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	4 (4%) – 4 (4%)    Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 3 (3%)    Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting:    Timely and full participation		9 (9%) – 10 (10%)    Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	8 (8%) – 8 (8%)    Meets requirements for full participation. Posts main Discussion by due date.	7 (7%) – 7 (7%)    Posts main Discussion by due date.	0 (0%) – 6 (6%)    Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response:    Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%)    Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%)    Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%)    Response is on topic and may have some depth.	0 (0%) – 6 (6%)    Response may not be on topic and lacks depth.
First Response:    Writing		6 (6%) – 6 (6%)    Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%)    Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%)    Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%)    Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response:    Timely and full participation		5 (5%) – 5 (5%)    Meets requirements for timely, full, and active participation. Posts by due date.	4 (4%) – 4 (4%)    Meets requirements for full participation. Posts by due date.	3 (3%) – 3 (3%)    Posts by due date.	0 (0%) – 2 (2%)    Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%)    Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%)    Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%)    Response is on topic and may have some depth.	0 (0%) – 6 (6%)    Response may not be on topic and lacks depth.
Second Response: Writing		6 (6%) – 6 (6%)    Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%)    Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%)    Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%)    Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation		5 (5%) – 5 (5%)    Meets requirements for timely, full, and active participation. Posts by due date.	4 (4%) – 4 (4%)    Meets requirements for full participation. Posts by due date.	3 (3%) – 3 (3%)    Posts by due date.	0 (0%) – 2 (2%)    Does not meet requirements for full participation. Does not post by due date.
Total Points: 100

Name:  Discussion Rubric

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. 

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).

 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 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

Comprehensive patient health assessment is an important first step in developing a plan to deliver the best patient care. Health assessments are a key part of a nurse’s role and responsibility. The assessment is a tool to learn about patient’s concerns, symptoms and overall health. A comprehensive health assessment usually begins with a health history, which includes information about the patient’s past medical illnesses or injuries including childhood illnesses and immunizations, hospitalizations, surgeries, allergies and chronic illnesses. It also includes patient family history, environmental and genetic factors.

Environmental exposures substantially contribute to the etiology of many common complex human diseases. Environmental exposure means chemicals such as metals and solvents, and biological agents such as toxins released from mold and bacteria, that are contaminants of the natural environment of air, water, and soil. It also encompasses lifestyle factors such as diet and physical activity. For most common diseases, such as obesity, asthma, and neurodegenerative disease, environmental exposures represent an important factor contributing to the development and progression of disease. With information about the patient’s genetic predisposition being vital for the identification of the right diagnosis, treatment, and dosage, a comprehensive health examination is not possible without considering genomic influences.

DNP prepared nurse can demonstrate a high level of awareness in the field of genomics, and may identify patients at risk of genetically determined diseases. To increase the nurse’s genomic competencies, DNP prepared nurse can provide additional educational opportunities for nurses in those areas for improved outcome.

McCormick, K. A., & Calzone, K., A. (2016). The impact of genomics on health outcomes, quality and safety. Nursing Management, 47(4), 23-26. Web.

 I concur with you that comprehensive patient health assessment is an important step to developing a plan to deliver quality healthcare services. Comprehensive patient health assessment allows healthcare providers to obtain detailed information on healthcare complication. The health assessment may consider environment and genomic in the examination process (Kubica, 2019). Environment triggers genetic variations. Therefore, people in different environment may experience genetic reactions. Comprehensive patient health assessment provides adequate information. The information helps healthcare providers to identify genetic alterations caused by environment. Comprehensive patient health assessment details environmental exposure to various health conditions (Gracia et al., 2019). DNP prepared nurses have adequate information on environmental exposure and genetic variations. Thus, DNP prepared nurses use their knowledge to educate and sensitize their patients. Additional educational opportunities for nurses increase the credibility of DNP prepared nurses in educating patients.

References

Garcia, S. F., Wortman, K., Cella, D., Wagner, L. I., Bass, M., Kircher, S., … & Penedo, F. J. (2019). Implementing electronic health record–integrated screening of patient‐reported symptoms and supportive care needs in a comprehensive cancer center. Cancer, 125(22), 4059-4068.  https://doi.org/10.1002/cncr.32172

Kubica, A. (2019). Self-reported questionnaires for a comprehensive assessment of patients after acute coronary syndrome. Medical Research Journal, 4(2), 106-109. DOI: 10.5603/MRJ.a2019.0021

An essential component of nursing is viewing patients holistically. There are multiple factors that contribute to health or illness. It is erroneous for healthcare providers to silo these factors and not take them into consideration. When completing a health and physical assessment, providers should consider environmental and genetic factors. As previously discussed, many genetic factors are complex. If the conditions are right, the disease or illness will develop, and they do not follow a Mendelian pattern of inheritance (Craig, 2008). Some chr