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Genetic research is now leading to a better understanding of the genetic components of common diseases, such as cancer, diabetes, and stroke, and creating new, gene-based technologies for screening, prevention, diagnosis, and treatment of both rare and common diseases.

Nurses are on the forefront of care, and therefore will participate fully in genetic-based and genomic-based practice activities such as collecting family history, obtaining informed consent for genetic testing, and administering gene-based therapies.

This new direction in healthcare calls for all nurses to be able to effectively translate genetic and genomic information to patients with an understanding of associated ethical issues. This article will present six genetic and genomic healthcare activities involving ethical issues of importance to nurses.

Approaches nurses can use to integrate comprehensive and current knowledge in genetics and genomics into their practice to most fully meet the needs of their patients, families, and society will also be described.

The Online Journal of Issues in Nursing. By identifying the genetic factors associated with disease, it is possible to design more effective drugs; to prescribe the best treatment for each patient; to identify and monitor individuals at high risk from disease; and to avoid adverse Maintenance cdc vol 1 reactions National Human Genome Research Institute, New genomic discoveries and their applications bring great hope for a more personalized approach to treat disease.

The field of genetics, until recently, has focused on rare, single-gene diseases, such as muscular dystrophy. This evolution is creating new, gene-based technologies for the screening, prevention, diagnosis, and treatment of both rare and common diseases, such as cancer, diabetes, heart disease, and stroke.

Although these new directions raise hopes for disease prevention and treatment, they also bring challenging ethical issues to patients and healthcare providers alike See Table 1. The United States U. Department of Energy DOE recognized the potential for ethical challenges in genetic and genomic research early on.

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Ethical Challenges for Nurses: Seeds for Thought Privacy and Confidentiality Who should have access to genetic information? Who owns and controls it? How can families resolve conflicts when some members want to be tested for a genetic disorder and others do not?

Discrimination Should employers be able to require job applicants to take genetic tests as a condition of employment? How does genetic and genomic information affect members of minority communities?

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Nurses are at the forefront of patient care, and will participate fully in genetic-based and genomic-based practice activities, such as collecting family history, obtaining informed consent for genetic testing, and administering gene-based therapies.

Nurses will need to be able to effectively translate genetic and genomic information to their patients with an understanding of associated ethical issues. This new direction in healthcare calls for nurses to integrate into their scope of practice the emerging field of genetics and genomics.

The increased availability of personal genetic information also challenges nurses to understand the ethical issues associated with activities such as informed decision making, informed consent and genetic testing, genetic and genomic research testing protection, maintaining privacy and confidentiality of genetic information, preventing genetic discrimination, and strengthening genetic and genomic care around the world.

This article will provide an overview of the above six activities associated with genetic and genomic healthcare in which nurses are involved and a discussion of the ethical issues inherent in each of these activities.

Approaches nurses can use to integrate comprehensive and current knowledge regarding genetics and genomics into their practice to most fully meet the needs of their patients, families, and society will also be described.

Genetic and genomic research is creating new areas for nursing involvement in the informed, decision-making process. As Skirton et al. The implication for nurses is that they will increasingly be involved in discussing these issues with patients in all areas of healthcare during the process of obtaining consent.

Areas of informed decision making and consent in which nurses will be most involved include gathering family history and requesting medical information.

Each will be discussed in turn. Gathering Family History Nurses practicing in primary healthcare settings and specialty care, such as oncology, will continue to be involved in obtaining and reviewing patient family histories. When family history is needed for other family members, the nurse promotes confidentiality by gathering family history again from additional family members.

Requesting Medical Information Nurses in all practice settings may be involved in requesting medical information from patients and their relatives.

In these cases the nurse can explain this need and the process to the family members and facilitate their written consent for the release of their medical information.

Informed Consent and Genetic Testing The use of genetic testing from pre-conception through adulthood is expanding rapidly. Genetic testing is increasingly used across the life continuum for screening, diagnosis, and determining the best treatment of diseases.

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Obstetric and pediatric nurses have traditionally been involved in the genetic testing process with prenatal screening for genetic conditions such as spina bifida and Down syndrome, and newborn screening for genetic conditions such as phenylketonuria PKU.

Nursing involvement in genetic testing has expanded to specialties such as oncology, with genetic testing now available for hereditary breast, ovarian, and other cancers. Nurses in all practice areas will be increasingly involved in the genetic testing process, helping the patient understand the purpose and also the risks and benefits of the genetic test, as part of the informed, decision-making and consent process.

The use of genetic testing from pre-conception through adulthood is expanding rapidly. As a result of this expansion, new ethical issues are emerging related to genetic testing and informed consent.

These new issues create ethical challenges for nurses and all healthcare providers. Currently expanding areas include newborn screening and genetic testing of children.

These new ethical challenges will be described below.Search for Continuing Education Courses. Nursing; Search for Continuing Education Courses; Related Links.

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Genetic and Genomic Healthcare: Ethical Issues of Importance to Nurses