1.The nurse educator has been asked by a local women’s cancer support group to speak with their daughters and granddaughters about cervical cancer. (Learning Objectives 1, 2, 3, and 4)
- What are the identified risk factors for cervical cancer? What can be done to decrease the risk for development of cervical cancer?
- What screening test should women have, and how often, for cervical cancer? Does this change with age?
- Once a woman is diagnosed with cervical cancer, what are the treatment options?
- What is the most common cancer of the reproductive tract? What can be done to decrease the risk factors for all female cancers?
2. Janet is a 67-year-old Caucasian client coming to your office today to receive her test results after being seen a week ago for complaints of pelvic and abdominal discomfort, urinary frequency and urgency, and abdominal bloating despite not eating much. You are in the room with Janet when her doctor enters the room and gives Janet the diagnosis of probable ovarian cancer. He wants to schedule surgery immediately. He leaves you and Janet to discuss the situation and come up with a decision regarding immediate surgery. Janet is stunned and has a lot of questions. (Learning Objectives 2, 3, and 6)
- Janet wants to know how she got ovarian cancer. How would you explain the etiology to Janet in terms she can understand?
- Janet wants to know what this means. Janet asks “Am I going to die from this?” What are the treatment options and prognosis for ovarian cancer to Janet?
- As the nurse caring for Janet, how can you support her and her family as they journey through this event?
1. Lauren has been a pediatric nurse at a children’s hospital for the past 7 years. Recently she began a new job as a nurse in a genetics office. One of today’s cases involves Emily and Brad Davis. Emily is a young white female who looks to be in her mid-twenties. Her husband, Brad, is a young white male. Lauren notices the young woman is pregnant, most likely sometime in her mid-trimester. (Learning Objectives 4 and 6)
Lauren introduces herself and explains that she needs to obtain a complete medical history from the couple. When the history is complete, Lauren finds the following pertinent facts:
- Emily, age 27, and Brad, age 29, have been married for 6 years.
- They have a 4-year-old daughter who was recently diagnosed with cystic fibrosis.
- Emily is currently 28 weeks pregnant.
- The couple is very worried that their unborn child may have cystic fibrosis.
- No person in either immediate family has cystic fibrosis.
- A cousin on Emily’s mom’s side of the family has cystic fibrosis.
- Brad has no known cases of cystic fibrosis in his family; however, he recalls a great uncle on his dad’s side who was ill most of his life and died at age 9.
- What type of genetic disorder does cystic fibrosis fall under? Why doesn’t Emily, Brad, or any of their siblings have this disorder? What are the odds that the Davises’ unborn child will have this disorder?
- What would you tell the Davis couple about planning for future children?
- What do you think about the history of the great uncle who died at age 9?
2. Abbie and her husband, Greg, come to your genetics center for additional testing after having had a “positive” maternal serum alfa protein test (MSAFP) at 16 weeks gestation and a “positive” triple screen test at 18 weeks gestation. Abbie is now 20 weeks pregnant. (Learning Objectives 4, 5, and 6)
- Based on the “positive” MSAFP, what genetic abnormality could the fetus have? What more would we want to know about her “positive” test result? What does the “positive” triple screen test indicate?
- What additional genetic testing is indicated for Abbie and Greg? Which tests could be definitive? What is your role as the nurse in regards to genetic counseling?
- Abbie and Greg are given the diagnosis of trisomy 21. They want to know what caused this and what it means to their baby. What ethical and legal issues does this diagnosis raise?
1. Jessica and Mike are new clients at your obstetrics office. You are asking them about the reason for their visit. Jessica says she thinks she is pregnant because she missed a period. Mike tells you Jessica is always nauseated in the morning and eats all the time the rest of the day. They have not been using birth control and have wanted to have children since they got married last summer. Jessica says her clothes are feeling tighter and her breasts seem tender. Mike says he has noticed that Jessica has been frequently getting up to go to the bathroom at night. (Learning Objectives 1 and 3)
- What subjective symptoms have led Jessica and Mike to presume she is pregnant? What other conditions could be the cause of Jessica’s symptoms? How can a pregnancy be confirmed as probable? Diagnosed as positive?
- What are the nutritional needs of Jessica and her baby?
2. Beth (age 18) is experiencing her first pregnancy and is now 24 weeks gestation. She tells you that she is “amazed by the changes that have happened to my body already.” Beth wants to understand what additional changes are going to occur to her “besides just getting a really huge belly.” Additionally, Beth relates to you that she is in her senior year of high school, is no longer involved with the baby’s father, and lives at home with her mother and 12-year-old brother. (Learning Objectives 2 and 4)
- What general body adaptations will Beth experience throughout the remainder of her pregnancy?
- What psychosocial adaptations may Beth experience as a result of being a teenage, single mother living at home?
ANSWER EVERY QUESTION UNDER THE CASE STUDY, ANSWERS CAN BE SHORT 5-7 SENTENCES.
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