Ms. Brown briefly took hormone replacement therapy but stopped in 2006 when the breast mass was identified. She initiated Evista therapy as a breast cancer reduction measure, but after 6 months she stopped the medication because of the side effects. Ms. Brown reports that she is not entirely opposed to considering using Evista again. What legal and ethical issues would you consider?
Public Health Nursing
Read the “Case Example: Screening for Breast or Ovarian Cancer Risk” as found on pp. 243–244 in Stanhope & Lancaster (2012). Write a DISSERTATION which completely answers the three questions following the case study (including the secondary questions listed under each numeral). Refer to the screening resources in Course Activities to help you gain a better understanding of issues surrounding screening and other preventative services.The finished Assignment should be a minimum of a 3-page expository dissertation, excluding the title page and references. The viewpoint and purpose of this Assignment should be clearly established and sustained.
use the headings Question 1, Question 2, and Question 3 to organize your materialinclude an introductory paragraph that gives a summary of the case example and a concluding paragraph which brings your DISSERTATION to a reasonable conclusion (with no heading for either)include Stanhope & Lancaster (2012) as a reference, include Stanhope & Lancaster (2012) as a reference, properly cited within the body of your DISSERTATION.no more than 10% of the DISSERTATION should include direct quotations; synthesize the material rather than merely quoting it.HERE IS THE CASE STUDY:WHAT DO YOU THINK?: A Case Example: Screening for Breast or Ovarian Cancer RiskDuring an initial visit to the High Risk Breast and Ovarian Cancer Clinic, a 37-year-old, Ms. Brown, reports that she had found a mass during a self-breast examination in 2006. She subsequently had the mass inspected by a clinician and underwent a mammogram, which showed a suspicious finding. A breast core-biopsy was performed and the pathology report indicated that she had atypical ductal hyperplasia. Ms. Brown then had a breast lumpectomy, and the lump was benign. In 1996, she had undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. Ms. Brown briefly took hormone replacement therapy but stopped in 2006 when the breast mass was identified. She initiated Evista therapy as a breast cancer reduction measure, but after 6 months she stopped the medication because of the side effects. Ms. Brown reports that she is not entirely opposed to considering using Evista again. Her family history indicated that a paternal grandmother likely had a type of “female cancer.” This grandmother died in her middle 30s to early 40s. There were also three cousins on the paternal side of the family who had unilateral breast cancer when they were in their 30 and 40s.On the maternal side of the family, her grandmother was diagnosed with breast cancer when she was in her 40s. She is alive and doing well at age 72. One of the grandmother’s sisters had lymphoma and died in her late 60s. A maternal great-aunt who was a sister to her maternal grandfather, not maternal grandmother, died in her 70s of ovarian cancer. A sister to her maternal great-aunt (another maternal great-aunt) died in her 70s or 80s of a primary brain cancer.Reflect on these questions and see what implications they have for nursing action and for public health concerns:1.What are some possible issues that could arise if Ms. Brown has a positive test? What legal and ethical issues would you consider? What considerations would you take into account if she has a teenage daughter?
2.What effect would the client’s literacy level have on how you would handle this case?
3.If you were caring for a family with multiple family members who obtain genetic testing and some members are found to be genetic mutation carriers while others are not, what would you anticipate might occur in relation to family dynamics? What actions might you take? Consider the referrals you might make.243 244Over 180,000 new cases of breast cancer are diagnosed annually, and between 5% and 10% of them have an inherited susceptibility. It is important for the nurse to take a brief family pedigree as done above to identify inherited risk factors. If Ms. Brown were to have had a BRCA-1 or BRCA-2 mutation, many more implications for decision making would arise, including prophylactic surgery for prevention of breast and/or ovarian cancer. In addition, men with a BRCA-1 mutation are at increased risk to develop prostate cancer or colorectal cancer. Men who have the BRCA-2 mutation are at risk for male breast cancer and pancreatic cancer. For women, both BRCA-1 and BRCA-2 mutation carriers have the greatest risk for breast and ovarian cancer. It is important when interpreting genetic information to be sensitive to the many issues involved, including emotional, socioeconomic, lifestyle, and environmental issues that may affect the onset of disease (Calzone et al, 2010Please cite this article as :(“Bookshelf | Public Health Nursing : Chapter 11 Genomics in Public… (page 244),” n.d.)Please reference this article as:Bookshelf | Public Health Nursing : Chapter 11 Genomics in Public… (page 244). (n.d.). Retrieved August 2, 2015, from https://online.vitalsource.com/#/books/978-0-323-08001-9/pages/66266035
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