Growth and development - Hereditary and environmental influences: Nursing

Hereditary and environmental factors influence a person's development. Even before conception.

Hereditary factors refer to the genetic determination of traits like eye color or the inheritance of disorders like cystic fibrosis.

On the other hand, environmental factors refer to external influences, found where people live work and play as they can impact how genes are expressed.

Often, the impact on a person's development is multifactorial, meaning it results from a combination of hereditary and environmental factors.

The hereditary material that determines a person's development is contained in their chromosomes tightly packed into each chromosome is DNA, which is organized into genes that carry a person's unique genetic code.

During fertilization, each parent donates half their chromosomes to create a fertilized ovum called a zygote which contains a total of 46 chromosomes organized into 23 pairs.

These chromosome pairs are numbered from 1 to 22 with the 23rd pair, the sex chromosomes labeled as X or Y. Now, if chromosomes are altered, the person's development can be negatively affected.

These chromosomal alterations can involve changes in the structure of a chromosome and can involve deletions, duplications, translocations and inversions.

A deletion is when part of the DNA is missing like with crete a Shah syndrome where the short arm of chromosome five is missing.

If there's extra genetic material in a chromosome, it's called duplication. Like when there's an extra copy of some of the genes found in the long arm of chromosome seven resulting in developmental delay, behavioral problems and other anomalies.

Another structural alteration is translocation where part of a chromosome moves to another chromosome. An example is the Philadelphia chromosome, which is chromosome 22 with a bit of chromosome nine on it resulting in a type of leukemia.

Lastly, an inversion which is where part of a chromosome is rearranged. In reverse order.

Inversions often result in spontaneous abortions or infertility. There are also chromosomal alterations that involve changes in the number of chromosomes.

Monosomy can happen if one of the chromosomes in a pair is missing. Trisomy is when an extra chromosome is added to a pair.

An example is trisomy 21 where there are three copies of the 21st chromosome resulting in down syndrome. A trisomy can happen with sex chromosomes too.

So in Klinefelter syndrome, there's an extra X chromosome or X XY where the affected person is genetically male, but hypogonadism or underdeveloped genitals, testosterone deficiency and infertility are also present as far as environmental influences go.

These can involve terrains which are harmful agents that can alter the environment in such a way that a defect occurs. Tarados can be infectious like rubella, varicella and toxoplasmosis medications like folic acid antagonists, lithium and anti hyperlipidemic agents.

Substances like alcohol, tobacco and illicit drugs as well as herbicides, lead or mercury. Now, genetic counseling can provide parents with support through information advocacy and referrals for specialty services.

The counseling can occur before during or after pregnancy before pregnancy. Preconception screening involves an evaluation of family history by evaluating medical records using photographs or by constructing a genogram which can help identify inheritance patterns in family members.

After conception, prenatal testing typically involves identifying fetal abnormalities through diagnostics like maternal blood tests, ultrasonography, amniocentesis or chorionic villus sampling.

If a baby is born with a defect, then postnatal testing can include physical examination and imaging and blood tests can detect inherited disorders like sickle cell disease or cystic fibrosis.

Chromosomal analysis can also be done where the number of chromosomes can be counted and examined for structural abnormalities.

As the nurse, your interventions will focus on identifying factors that indicate the need for genetic counseling while gathering your patient's medical history.

You can note if their occupation increases the risk of exposure to teratogenic agents or if they're being treated with medications that are teratogenic, you'll also check if they're at risk of contracting an infection that can be harmful during pregnancy and ensure they are up to date on their immunizations.

In addition, you can provide counseling about lifestyle modifications that can impact inheritance like diet, smoking or alcohol use.

Other interventions include taking a detailed family history and constructing a three generation genogram to identify any genetic risk factors that would warrant professional genetic counseling.

Finally, if your patient's genetic testing reveals abnormal results, you can support them by providing education resources and emotional support as needed.

All right, as a quick recap, hereditary and environmental influences can affect a person's development. Even before conception development can be negatively affected by changes in the structure or number of chromosomes or exposure to teratogens.

Nursing considerations are focused on identifying factors that indicate the need for genetic counseling.