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Question 1

  1. To be culturally competent means to address a patient’s needs while observing specific cultural variations that are important to them and understanding how these affect their view of medical treatments (Purnell, 2013). As a culturally competent nurse it is important to take the patient’s culture into account while completing an assessment. It is crucial to assess their perception of the condition, how this is viewed in their culture and how said views can affect how they care for their child. Some cultures view certain conditions as punishment for example. The level of understanding from the parents also plays a major roll. The nurse must be aware of the educational level of the parents and how prepared they are to receive information and apply it when caring for their child.
  2. A nurse’s understanding that Down syndrome is disorder that occurs during cell division, involving a complete or partial extra copy of chromosome 21 while in utero is important in alleviating some the stress experienced by the new parents wondering if this was caused by them or hereditary (Perkins, 2017). This can help them obtain accurate information on the condition, what to expect and development of the child in the future. The nurse can be a source of information for the parents
  3. When faced with the adversity that your child has a health issue the first concern is how this will affect them, their development and the prognosis of this condition. As a parent I would be concerned about health implications, risks and precautions I need to have to care for my child.

Question 2

a. Helping Michelle understand the possibility of her baby’s condition can result in successful management and prevention of exacerbation periods if she were to have it. It is important to explain to her that sickle cell disease is a disorder that affects the hemoglobin portion in red blood cells that carries oxygen to cells in the body. The hemoglobin molecule seen in sickle cell is called hemoglobin S. This hemoglobin S affects the shape of the red blood cells making it look like a crescent shape. This an autosomal recessive condition which means the child inherits a copy of the gene from each parent even if the parent shows no symptoms of the condition (NIH, 2020). Although there may be few exceptions, sickle cell disease is inherited from both parents which means they would have to have the gene in order for the baby to have this as well. In contrast sickle cell trait can be present when the baby inherits the gene from one parent only which means they will carry it but not show any symptoms of the disease.

b. A test can be done to identify if the person has sickle cell disorder however it would be most reasonable to see a genetic counselor who can offer valuable information on genetic blood disorders as well as family history (CDC, 2019). Testing should be encouraged because in the future there could be complications if the child engages in competitive sports such as heat stroke and muscle breakdown stemming from rigorous training (CDC, 2019).

c. Some of the factors that can shape the conversation is recognizing Michelle’s educational level and knowledge of this condition in general. This can be a guide to how to approach the subject, how much information to provide and how to ascertain it has been understood. It is important to discuss the prevalence of this disease among African Americans and how it affects 1 in 500 in the population (Purnell, 2013). Becoming familiar with the statistics may assist Michelle in understanding this is something that affects many people like her and her husband and some people are able to lead a healthy life without major complications.

Question 3

a. A disorder of the blood in which the amount of hemoglobin is low is, particular to people of Mediterranean descent is called Thalassemia. In this disorder due to the lack of hemoglobin the red blood cell’s life is remarkably shorter in the body (CDC, 2020). It is important for the nurse to be aware of this as to differentiate what is normal in this population and not. Also, to prevent providing certain medication that can increase the possibility of a hemolytic crisis (Purnell, 2013).

b. Low hemoglobin levels prevent oxygen from reaching every part of the body preventing it from working appropriately. The condition caused by this consistent low hemoglobin level in the blood is called anemia. Anemia can have many causes some including vitamin deficiency, bone marrow abnormalities or hemolytic cause such as in Thalassemia. Anemia can cause a person to feel a variety of symptoms including, shortness of breath, tiredness, weakness, dizziness, pale skin, fast heartbeat and increased fatigue (CDC, 2020). Anemia can be addressed depending on the causative agent in order to correct it and prevent further complications. Some of the treatments include vitamin supplementation, blood transfusion or dietary supplement

Reference

Perkins, A., & Vermont Tech. (2017). The lowdown on Down syndrome : Nursing made Incredibly Easy. Retrieved from https://journals.lww.com/nursingmadeincrediblyeasy/Fulltext/2017/03000/The_lowdown_on_Down_syndrome.10.aspx

Purnell, L. D. (2013). Transcultural health care: a culturally competent approach (4th ed.). Philadelphia: F.A. Davis.

Sickle cell disease – Genetics Home Reference – NIH. (2020, May 12). Retrieved May 16, 2020, from https://ghr.nlm.nih.gov/condition/sickle-cell-disease#inheritance

What is Thalassemia? (2020, April 15). Retrieved May 16, 2020, from https://www.cdc.gov/ncbddd/thalassemia/facts.html

What You Should Know About Sickle Cell Trait. (2019, October 21). Retrieved May 16, 2020, from https://www.cdc.gov/ncbddd/sicklecell/documents/SCD factsheet_Sickle Cell Trait.pdf