DNP 810 Genetic Counseling

Grand Canyon University DNP 810 Genetic Counseling– Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University DNP 810 Genetic Counseling  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for DNP 810 Genetic Counseling     

Whether one passes or fails an academic assignment such as the Grand Canyon University NUR 550 Benchmark – Evidence-Based Practice Project: Literature Review depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for DNP 810 Genetic Counseling     

The introduction for the Grand Canyon University DNP 810 Genetic Counseling  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for DNP 810 Genetic Counseling     

After the introduction, move into the main part of the DNP 810 Genetic Counseling assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for DNP 810 Genetic Counseling     

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for DNP 810 Genetic Counseling     

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for DNP 810 Genetic Counseling

Genetic counseling refers to a patient-centered communication process that enables individuals to understand, become accustomed, and adjust to the medical and psychosocial implications of genetic contributions to illness. Genetic counselors assess a person’s risk of a genetic-related disorder, prepare the person for genetic testing, convey the results, and assist in developing the management plan for the patient’s genetic disorder (Patch & Middleton, 2018). Besides, they prepare and support patients to communicate with their relatives at risk of a genetic condition. The purpose of this paper is to discuss about a patient case that might benefit from genetic counseling.

Reason For The Genetic Counseling

A 48-year-old female client is on genetic counseling based on her family health portrait findings. According to her family medical history, the patient’s mother succumbed to Breast Cancer at 70 years after battling the disease for seven years. She was diagnosed with Breast cancer at 63 years. In addition, she has two relatives from her maternal side who were diagnosed with breast cancer, one at 58 years and the other at 60 years. Her maternal grandmother died from ovarian cancer 17 years ago. The client read in a health magazine that individuals whose close relatives have a history of breast cancer have a higher risk of developing the disorder than those with no positive family history. Therefore, genetic counseling is necessary to assess the patient’s risk for breast cancer and prepare her for predictive and diagnostic screening of the disease. 

Possible Reactions The Patient May Have To the Counseling

The client will be informed during genetic counseling that she has a high risk of developing breast cancer in her 50s based on her family history. Similarly, her siblings and children are at risk of developing the disorder. After learning about her high risk of developing breast cancer, the patient might get anxious and terrified. Consequently, she may have mixed reactions to having a genetic test due to the fear of positive results (Patch & Middleton, 2018). In addition, the patient might get drenched in sorrow when she learns that she might suffer like her mother and even have a premature death. The negative reactions can be avoided by being sensitive to the concept of the point at which the client will be most able to understand and absorb the genetic information being provided.

Health

Breast cancer is the second most common cause of cancer death in women after lung cancer. In the early stage, breast cancer mostly has no symptoms like breast pain or discomfort. Symptoms that should make one suspect breast cancer include breast skin changes, skin dimpling, changes in breast size or shape, blood-stained nipple discharge in a single duct, nipple inversion, and an axillary lump (Sauter, 2018). Breast cancer lowers the quality of life and results in various health complications, often in cases where cancer spreads to other body organs.

Prevention

Breast cancer can be prevented through lifestyle modification and eliminating modifiable risk factors for breast cancer. Obesity increases the risk of breast cancer, and thus one can lower the risk by maintaining a healthy weight through healthy dietary habits and regular physical exercises (Sauter, 2018). Reducing alcohol consumption and smoking cessation also reduces the risk of breast cancer. In addition, hormone replacement therapy (HRT) is a risk factor, and thus women with a family history of breast cancer should stop HRT.

Screening

Breast cancer is screened through mammography, which is the only available method for early detection of non-palpable breast cancer. Mammography is considered a sensitive screening method for breast cancer. It is unique based on its ability to shoe preclinical lesions like masses too small to be palpated manually (Song et al., 2019). It is important to note that traditional film mammography is progressively being replaced by digital mammography, which has the advantage of reading, filing, and transmitting mammograms electronically. Besides, studies demonstrate that digital mammography benefits females with dense breasts, like those below 50 years (Song et al., 2019). Screening is recommended in healthy women 50-74 years with no signs of breast cancer. However, it is recommended for women 40-49 years with an average risk for breast cancer.

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Diagnostics

Diagnostics for breast cancer include imaging and laboratory tests. Imaging tests include Ultrasonography and Magnetic resonance imaging (MRI). Ultrasonography of the breast is mostly used as an additional test to refine findings on mammography. For example, if a mammogram shows a lesion, the ultrasonography assists in distinguishing a fluid-filled cyst from a solid mass (He et al., 2020). Besides, mammography and ultrasound are usually more effective in detecting cancers in females with dense breasts. MRI is used to visualize better suspicious areas found in a mammogram or for females with dense breasts. The MRI helps to establish the actual size of the cancerous mass and identify any other cancers in the breast. Furthermore, a breast cancer diagnosis is based on a pathologic exam of tissue from the suspected cancerous mass (He et al., 2020). Lab tests like pathologic study of the lymph nodes are used to detect if the breast cancer has metastasized.

Prognostics

The long-term prognosis depends on the stage of the breast tumor. The five-year survival rate in breast cancer depends on the cancer stage, with localized and regional breast cancer having the highest survival rate and metastasized having the lowest (Łukasiewicz et al., 2021). Poor prognosis in breast cancer is associated with factors like younger age (20s and 30s), race (Blacks), larger primary tumor, high-grade tumor, absence of estrogen and progesterone receptors, and presence of BRCA gene mutations.   

Selection of Treatment

The treatment of breast cancer includes surgery, radiation therapy, and chemotherapy. Treatment is selected based on the tumor and patient factors. However, surgery is increasingly being recommended, and it involves early referral to a plastic surgeon to remove the cancer tumor and reconstruct the breast (Łukasiewicz et al., 2021). Besides, breast-conserving surgery combined with radiation therapy has the advantage of having less-extensive surgery and maintaining the breasts.

Monitoring of Treatment Effectiveness

Patients with a history of breast cancer surgery still require mammography screening. If a person had a total mastectomy, the other breast needs annual follow-up since there is a high risk of cancer developing in the other breast. Besides, if the patient had a partial mastectomy, subcutaneous mastectomy, or lumpectomy, then the breast needs follow-up mammography (Łukasiewicz et al., 2021). The first mammogram is performed six months after surgery to offer a baseline for the new postoperative and post-radiation changes. After that, mammography can be carried out every 6-12 months for screening and follow-up.

Conclusion

A family history of breast cancer, especially among first-degree relatives, increases a person’s risk of developing the disease. Screening is recommended in females aged 40-49 years with an average risk of breast cancer and in healthy females 50-74 years. Mammography is the most recommended method for breast cancer screening, with digital mammography being beneficial in females with dense breasts. Treatment options include surgery, radiotherapy, and chemotherapy. 

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References

He, Z., Chen, Z., Tan, M., Elingarami, S., Liu, Y., Li, T., Deng, Y., He, N., Li, S., Fu, J., & Li, W. (2020). A review on methods for diagnosis of breast cancer cells and tissues. Cell proliferation, 53(7), e12822. https://doi.org/10.1111/cpr.12822

Łukasiewicz, S., Czeczelewski, M., Forma, A., Baj, J., Sitarz, R., & Stanisławek, A. (2021). Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers, 13(17), 4287. https://doi.org/10.3390/cancers13174287

Patch, C., & Middleton, A. (2018). Genetic counseling in the era of genomic medicine. British medical bulletin, 126(1), 27–36. https://doi.org/10.1093/bmb/ldy008

Sauter, E. R. (2018). Breast Cancer Prevention: Current Approaches and Future Directions. European journal of breast health, 14(2), 64–71. https://doi.org/10.5152/ejbh.2018.3978

Song, S. Y., Park, B., Hong, S., Kim, M. J., Lee, E. H., & Jun, J. K. (2019). Comparison of Digital and Screen-Film Mammography for Breast-Cancer Screening: A Systematic Review and Meta-Analysis. Journal of breast cancer, 22(2), 311–325. https://doi.org/10.4048/jbc.2019.22.e24

Sample Answer 2 for DNP 810 Genetic Counseling

Genetic counseling mainly provides an individual with information on how genetic conditions might affect them or their family members (Migliore et al., 2019).The case scenario for this discussion involves a 30-year-old male client, P.T, with a family history of Huntington’s disease (HD). His wife discovered that she was pregnant. It was pointed out to then by the family physician the need to see a genetic counselor to consider genetic testing for their unborn baby and determine whether the child had inherited the mutation and is likely to be stricken with HD in adulthood. HD is an inherited disease that causes progressive neural degeneration. HD patients normally experience behavioral and mental changes including dementia, and paranoia in addition to physical symptoms like slurred speech, difficulty walking, and jerky movements. Studies show that individuals who come from families with a genetic history of HD have a 50% of developing the disease at some point in their life (Karadag et al., 2021). However, genetic tests for HD are available for an appropriate course of action based on the results. The purpose of this paper is to evaluate the need and benefits of genetic counseling for P.T and his wife.

Need for Genetic Counseling

            Genetic testing for HD involves much more than just collecting blood test results. Many issues are normally at stake such as social, emotional, and financial issues which does not only involve the individual seeking testing, but also their immediate family members, and even extended family at large. Before initiating the process of genetic testing, the client deserves a chance to evaluate these issues keenly which is a genetic counselor (Oosterloo et al., 2020). The case of P.T and his wife is even more complex given that proceeding to carry out a genetic test on their unborn child raises several ethical concerns. For instance, they will be depriving the child of free will, as they have no idea whether the child wants to know if he or she is going to have HD later in life. On the other hand, knowing whether you carry the genetic mutation for HD earlier in life helps consider health promotion practices that will help prolong the life of the individual upon onset of the disease in addition to having a better prognosis. The genetic counselor will thus discuss such issues father with the client and his wife to promote sound decision-making concerning genetic testing for their unborn child.

Reactions to Counseling

            Most clients normally ignore the relevance of genetic counseling before considering to proceed with genetic testing. For instance, P.T and his wife feel like this is the best decision for their unborn baby, and even confirm that they will continue with the pregnancy despite the results. As such, they will most probably be reluctant to consider seeing a genetic counselor, and will even respond negatively to the counselor, ignoring most of the counselor’s concerns. However, to avoid such reactions, the counselor needs to inform them why genetic counseling is actually important in their case, and how they can benefit from the counseling (Migliore et al., 2019). The counselor needs to communicate confidently to build trust with the client and make them yearn for more knowledge about genetic testing. The counselor should also be non-judgmental ad non-directive.

Genetic Counseling for Prenatal Genetic Testing for HD

In providing genetic counseling to P.T and his wife, I will inform them on several aspects of the disease and the need for testing as follows:

1. Health: It is important to know that HD is a dominantly inherited disease, meaning that children born of families with a genetic history of HD have a 50% risk of developing the disease late in life(Klyushnikov, 2020). This disease has a broader impact on the functional ability of the patient usually leading to movement, cognitive and psychiatric disorders.
2. Prevention: HD usually results from mutations on the HTT gene. One does not have the ability to change their gene or preventing the development of the disease(Karadag et al., 2021). To date, no treatment has been discovered that can help slow down or stop the progress of HD.
3. Screening: Predictive genetic testing is crucial in promoting well-being and adoption of appropriate lifestyle modifications among individuals who test positive for the HD gene(Wieringa et al., 2021). Prenatal genetic testing for the fetus can be done in two ways, either through a  biopsy at 10 to 11 weeks or through amniocentesis at 14 to 18 weeks.
4. Diagnostics: Positive screening test for aneuploidy suggests that the fetus is at high risk of developing HD in adulthood(Klyushnikov, 2020). However, a negative test result means that the fetus is at low risk of developing the disease. It is important to note that just like any others test results, genetic testing also displays possibilities of false negative and false-positive results.
5. Prognostics: HD is a progressive disorder that results in disability and death. The mean age of death for patients diagnosed with HD ranges from 51 to 577 years but can extend (Wieringa et al., 2021). The duration of the illness also varies based on several factors with a mean of about 19 years. Cardiovascular diseases and pneumonia have been reported to be the main cause of death among patients with HD.
6. Selection of treatment: Currently, the most effective medications that are being used to help manage HD symptoms are tetrabenazine (Xenazine) and deutetrabenazine (Austedo) to suppress the involuntary writhing movements (chorea) and jerking associated with the disease (Oosterloo et al., 2020). Dietary therapy is also considered among patients who are underweight and have malnutrition associated with the disease. Other treatment approaches are specific to the symptoms exhibited by the patient.
7. Monitoring of treatment effectiveness: Monitoring the effectiveness of the selected treatment is quite complex but necessary. For instance, brain imaging with PET and MRI constantly shows abnormalities in preclinical and early onset HD (Klyushnikov, 2020). Consequently, measurements of the changes in dopamine D₂receptor binding, regional brain volumes, and abnormal brain network expression can be taken over time to determine whether the patient is getting better or worse, hence promotingthe appropriate adjustment of the treatment plan.

Conclusion

            Patients in need of genetic testing must first see a genetic counselor for more information regarding the genetic disorder and the likelihood of their family member developing the disease later in life. As demonstrated in the discussion, HD disease is an inherited disease, which calls for genetic testing of family members with a genetic history of the disease. However, the client needs to undergo genetic counseling to be able to make a sound decisions on whether or not to go through with the process.

References

Karadag, Y. S., Cavdarli, B. E., & Yuksel, R. N. (2021). Huntington’s disease in Turkey: genetic counseling, clinical features, and outcome. Neurological Research, 43(5), 381-386. https://doi.org/10.1080/01616412.2020.1866355

Klyushnikov, S. A. (2020). Huntington’s disease. LO Badalyan Neurological Journal, 1(3), 139-158. https://doi.org/10.17816/2686-8997-2020-1-3-139-158

Migliore, S., Jankovic, J., & Squitieri, F. (2019). Genetic counseling in Huntington’s disease: potential new challenges on horizon?. Frontiers in neurology, 10, 453. https://doi.org/10.3389/fneur.2019.00453

Oosterloo, M., Bijlsma, E. K., Verschuuren-Bemelmans, C. C., Schouten, M. I., de Die-Smulders, C., & Roos, R. A. (2020). Predictive genetic testing in Huntington’s disease: should a neurologist be involved?. European Journal of Human Genetics, 28(9), 1205-1209. https://doi.org/10.1038/s41431-020-0633-9

Wieringa, G., Dale, M., & Eccles, F. J. (2021). The experience of a sample of individuals in the United Kingdom living in the pre‐manifest stage of Huntington’s disease: An interpretative phenomenological analysis. Journal of Genetic Counseling. https://doi.org/10.1002/jgc4.1497