Genetics

  Order Description   Create a three-generation genogram including physical and mental illnesses within the family history. Identify patterns and develop a plan for health promotion including patient education, screenings, and/or genetic testing. Point Allocation for Genetics Assignment 3-Generation Genogram of Family History (including physical and mental illnesses) 15 points Health Promotion Plan (including screenings, patient education, genetic testing) 20 points Spelling, format, grammar 5 points   Mr. P. is a new patient to the clinic and was asked to provide his past family medical history in order to identify patterns within the family and to develop a plan for health promotion and patient education. Mr. P is a 48-year-old white Caucasian male, born in Buffalo New York. He states he considers himself to be in good health. He is married with four healthy children and works full time in law enforcement. Mr. P. is articulate and appears to be a reliable source. FAMILY HISTORY Mr. P reports his family history as follows: Mr. P. is the oldest of three children. His mother is living, age 77 and in fair health. She is being treated for hypertension for which she takes two medications; she also takes medication for her high cholesterol, angina and anxiety. Her parents are both deceased but lived mostly healthy lives. Her mother (Maternal grandmother) passed away at the age of 93 from pneumonia, she was on no medications. Her Father (maternal grandfather) also lived to the age of 94; he died from prostrate cancer, and was on no medications. Mr. P.’s father died at age 50 from lung cancer, he was a very heavy smoker. Mr. P. was 14 when his dad passed away. His dads mother and father (paternal grandparents) also are deceased both from lung cancer at young ages. The father at age 45 and the mother at age 56 who were also known to be heavy smokers. Both maternal and paternal grandparents of Mr. P.’s were first generation born in America; the family emigrated from northern Italy. Mr. P. has one sister age 42, who is treated for high cholesterol and anxiety. He also has one brother age 45 who has HIV. Mr. P. is married with a healthy wife and four healthy children to date. GENOGRAM                       Health Promotion Plan and Education Mr. P. was educated regarding his family history and the genetic link to heart disease and lung cancer. Having family members with heart disease and cancer puts him at increased risk. Mr. P. was educated on how too much cholesterol causes plaque build up within the blood vessels and can cause stroke and or heart attach. He was given the acceptable cholesterol levels that for him should be under two hundred. He was also educated on the difference between bad cholesterol (LDL), and good cholesterol (HDL). He was also educated on the importance and the positive impact exercise has on the heart. His pla n is to exercise at minimum three times per week for forty-five minutes and maintain a healthy weight. Diet, exercise and weight management are all factors he can control. He was given dietary information including what foods to avoid i.e. high saturated fats, as well as the foods that help to break down the cholesterol. Handouts for healthy heart recipes were given with additional informational website. It was planed that he should have his cholesterol levels drawn annually and he should keep a log of his levels for his own records. It was also discussed that this healthy lifestyle will hopefully keep his blood pressure within normal range; as this is not an issue for him at present, an EKG, and CBC will be obtained as part of his plan today. When asked about anxiety he does not have any difficulty at this time. It was discussed that his mother, sister and Aunt suffer from this; he has not had any problems to date. He does admit to” getting stressed out” at times, when he feels this way his plan is: he walks, gardens or cooks something, and likes to paint. He reports feeling relaxed when he is doing these activities. Mr. P. was also educated on the risk factors of lung cancer as his father and both paternal grandparents died from this disease. The risk factors are; smoking, second hand smoke, genetics and environmental pollutants. Mr. P. is not a smoker but was exposed the first fourteen years of life that he lived with his father, so past second hand smoke, and family genetics. The plan was to remain a non-smoker and to stay away from environmental factors as much as possible. A base line chest x-ray will be obtained as a screening tool, at this visit as he has no previous x-ray and a strong family history of lung cancer. Mr. P. was also educated on the screening process for prostrate cancer. He was made aware that it is mostly found in men over age sixty-five years. The fact that his grandfather died from prostrate cancer it would be in the plan to do a PSA screen on him today and annually. Mr. P. agreed with the plan.