Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.
Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.
For this Assignment, you will develop a script to be used to interview a volunteer serving in the role of patient.
• Review the Ewing (2004) questionnaire found in this week’s Learning Resources and consider the difficult questions you might have to ask when you take a patient’s health history.
• Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.
• Review the media programs related to a vaginal exam, pap test, and breast exam.
• Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a health history. (Note: You will also find the Health History Form in Chapter 7)
• Describe the components of a complete gynecologic health history. Include considerations for special populations such as LGBTQ+ individuals.
• What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments? (i.e., bone density test, Gardasil vaccine, shingles, etc.)?
• What questions would you consider in your patient’s assessment? For example
o What is your patient’s living situation?
o Do they have stairs?
o Do they live by themselves?
o Do they have a working refrigerator?
• Create your own script for building a health history and use the Health History Template for guidance (consider the type of language you would use to help your patient be more comfortable). As you create your script, consider the difficult questions you want to include in your script.
Zebrafish (Danio Rerio) are model fish due to their homology of their genome being 70% similar to humans and the fact that they are being equally exposed, if not more to BPA due to our waste that is contaminating the aquatic environment.1 Therefore, In order to understand biological, chemical and genetic structures that are effected there is a need for toxin observation and it’s costs due to exposure. Fish, wildlife and ourselves have been greatly affected by toxins found the environment. Water pollution has been suspected to be the cause of damage to the reproductive health, lifespan, embryonic and larval development of fish populations.2 In one experiment the dose amount vs. effects was tested, the low dose of BPA exposure being 5 μg/L, the intermediate dose being 10 μg/L, and the high BPA dose being 20 μg/L. The goal was to determine which of these concentrations (which are common in the environment today) would have an effect on the reproductive system. The results of the experiment showed a blocked ovulation period on the eighth day of the BPA treatment in fish on the low BPA concentration. The fish that received the intermediate(10 μg/L) BPA concentration and high concentration(20 μg/L) did not show significant changes compared to the control fish with no BPA concentration. The low concentration of BPA (5 μg/L) significantly affected estrogen receptor 1 and estrogen receptor 2a yet not the other genes involved in oocyte growth such as; estrogen receptor 2b, steroidogenic acute regulatory protein, cytochrome, and follicle stimulating hormone receptor (Fig.4). This experiments conclusion was in line with the rainbow trout’s conclusion, the lowest concentration of BPA proved to be the most harmful. This affected the D.rerio maturation and oocyte growth. In another experiment zebrafish were used to detect toxicants (including BPA) and to discover the health related effects exposure has to humans. Zebrafish are not only great to experiment on because of their genome is similar to humans but their embryo and larvae are transparent which allows observation to see if there are any malformations in early stages. Zebrafish were treated by putting BPA (powder form) mixed in with their fish food. Fish that were sexually mature (usually 3 months) were used and marked by fluorescent dye. Fish were divided into 3 groups of 8 fish resulting in a total of 24 fish treated. Each group was separated into its own aquarium and fed with food that could or could not be BPA treated, twice a day for 6 months. To test the fertility of the fish they were mated with untreated fish(Fig 9). Offspring was then cultivated and observed for mutations. Some effects of the BPA food were a decrease in size of ovaries to the point they almost disappeared. Males that were tested also showed a decrease in testes size and fertility(Fig. 10). In the initial generation which automatically resulted in survival rate being lowered, an increased rate of abnormality in offspring due to the ovaries and testes retracting. The first generation appeared normal but when getting a deeper look their reproductive tissues were deformed. In the first generation there were higher percentage of sterile males. >GET ANSWER