Introduction
For the present assignment, a family research approach was chosen in which several known generations are analyzed to determine the pattern of heredity for a particular disease. The family chosen for the current analysis was the extended family of the author’s best friend, consisting of at least four known generations for which there is a history of the disease. The disease undergoing a phylogenetic study is bronchial asthma, a condition of non-infectious respiratory dysfunction in a patient whose breathing difficulties occur due to bronchospasm (Shine et al., 2019). According to the WHO, bronchial asthma affects more than 262 million patients, with a higher incidence in boys (WHO, 2021). Thus, the health care system is prepared for this threat and is well-informed about the diagnosis of the disease for patients of different ages, which is partly the motivation for choosing the disease in the current study.
The target client is a 23-year-old young man of Caucasian descent with an average build. Client A lives and works in the United States, and his area of employment includes educational services. Client A infrequently suffers from episodes of bronchospasm and shortness of breath, and each time this is due to an allergic reagent nearby. A friend stated that his bronchial asthma worsens whenever he has to deal with dust or mold or when he has to walk up the stairs or run several hundred meters. During periods of most significant exacerbation of shortness of breath, client A uses bronchodilators, including Salbutamol (Carotenuto et al., 2018). In addition, he takes antihistamines to reduce allergic reactions and eye and nasal drops to minimize symptomatic dysfunction. In other words, client A is a carrier of bronchial asthma with an allergic context, but the frequency of these attacks is low and directly related to the implementation of a preventive complex.
There are also several members of the friend’s family who suffer from this disease. This should include his younger sister, client B, a sixteen-year-old girl who experiences even less frequent asthma attacks. When B was a child, the frequency of shortness of breath and comorbidities was more frequent, but bronchial asthma no longer troubled her as she matured. It is likely that if B were placed in an irritating environment with dust and pollen from certain plants, her childhood diagnosis would worsen. On the other hand, a friend’s father was also a disease carrier and used a bronchodilator every day. In the father’s case, client C, bronchial asthma was evident, as he needed to take medication regularly for his attacks. Cat hair, building dust, and mold were inhibitors of shortness of breath and choking, so client C carried Salbutomol with him at all times, unlike his children. Finally, of the known cases of diagnosed asthma among the older generation in the friend’s family, his father’s mother, client D, and her sibling, client E, were also carriers, but what allergens caused them to have seizures is unknown. According to family records, they had frequent shortness of breath, but they hardly ever used inhalers because they were cautious about medication. In addition, they were quite elderly and overweight and had several comorbidities that made their lives difficult.
Genogram
The above narrative illustrates that bronchial asthma occurred in at least three generations. Figure 1 below shows the genogram for this family, which reflects the facts of a consistent and concurrent diagnosis of the disease in some of its members. On a broad scale, it is clear that the disease is not that common in this family, but its hereditary nature is difficult to ignore. Notably, there are no observable signs of the disease from client A’s maternal line, which is evidence of either migration of the disease through the paternal line or a lack of proper diagnosis for relatives of the friend’s mother.
Regarding the presented genogram, it is necessary to emphasize several points that simplify its work. The symbols presented are standardized: squares represent males, and circles represent females (Symbols used in genogram, n.d.). At the same time, the figures highlighted in yellow show the target disease studied in this case, namely bronchial asthma. If any, the numbers inside the figures show the age at the time of the family member’s death, and the prefix next to it reflects the leading cause of death. The red borders for some of the figures highlight an additional disease associated with a rapid decline in visual acuity. There is no precise diagnosis that can be traced to the highlighted clients, but closer to adolescence, these members began to lose vision and were forced to wear glasses or contact lenses. Notably, most of the client’s grandparents, like his father, died due to complications from alcohol addiction. Recognizing alcoholism as a psychophysiological illness, it must be said that the client appears to be susceptible to this as well (Gibbins, 2019). No other diseases of hereditary nature were present in this genogram.
In other words, target client A has an inherited predisposition to vision loss and the development of bronchial asthma; however, in reality, both of these dysfunctions are already present in him. Vision loss may continue to progress, and acuity will begin to decline even more severely, mediated by age-related changes. Meanwhile, having a distant relative (client E) with stomach cancer may be a signal for regular diagnosis, as it is known that some cancers can be linked to heredity (Blair et al., 2020). The development of alcohol dependence also makes sense for client A, leading to severe illness, cancer, and asthma exacerbation. Thus, client A is aware of the significant hereditary threats and takes appropriate preventive measures to control his or her health.
Resources
Thus, from a review of family history, four key risks were found that put client A’s health at risk: vision loss, alcoholism, bronchial asthma, and cancer. The first step in managing these conditions is recognizing their relevance and danger and viewing oneself as vulnerable to these diseases. In terms of vision problems, it is sufficient for client A to undergo vision testing with an ophthalmologist every year so that timely progress can be monitored and treatment corrected (CDC, 2020). Increased diopters of glasses and contact lenses will probably be needed to improve the individual’s quality of life. Regular screening is also necessary to track cancer threats, but such screening is not standardized in the U.S. (NCI, 2019). Consequently, it is entirely the patient’s responsibility to undergo a regular ultrasound, MRI, and biologic testing to determine the risks of infection in the early stages. In terms of alcoholism, this condition is susceptible — diagnosis itself proves difficult. In this case, a knowledgeable client A should closely monitor his behavior, assess his drinking habits, and contact a psychotherapist if he notices problems. The right thing to do is to inform a loved one about the risks and ask him or her to monitor to get an outside assessment.
Pharmaceutical intervention is necessary to treat bronchial asthma when it exacerbates. Current thinking is that medication cannot cure asthma, so supportive, relapse-relieving therapy is necessary (GINA, 2018). The client must be thoroughly trained to give himself or herself first aid, including the use and frequency of bronchodilators, antihistamines, and drops to reduce the symptomatic presentation: tears, runny nose, and sneezing. After each episode of exacerbation, the client should visit the attending physician to record a recurrence and adjust medications as needed.
Thus, client A’s health management plan should include regular screenings for early detection of cancer and vision loss and visits to the attending physician after exacerbations of asthmatic syndromes. Alcohol treatment is not required until the client demonstrates primary signs of addiction. Incorporating these practices into the treatment plan is not a financial burden, as most diagnostic procedures are covered by insurance, including through the HIPAA Act (Reed, 2019). In addition, the client lives in an American metropolitan area, which means he or she has no problem with medical accessibility. The friend expressed a personal desire to “live long and not get sick,” from which it can be inferred that he is fully interested in a physician intervention that will bring meaning to improve quality of life.
Integration of Views into NP Practice
Any treatment and postoperative recovery should be based on clinical evidence but by no means on physician authority or opaque judgments. Only evidence-based practices are essential to nursing practice, including diagnosis, laboratory tests, personal desires of the client, and family history analysis. As in this paper, Phylogenetic research is a beneficial strategy for nursing practice to assess the potential for health risks. This systematizes and summarizes the underlying problems and thus has a powerful impact on treatment and diagnostic decisions. Thus, I perceive genomics as a perfect science-based tool with which NP practice can be improved many times.
References
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Symbols used in Genogram. (n.d.). GenoPro. Web.
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