Question

This case study is Nursing 315, Pathophysiology for nurses: A 32-year-old woman is concerned about the possibility of being pregnant. During the initial interview, you discover that she missed her usual menstrual cycle over 3 weeks ago. You also notice that her complexion is markedly tan for this time of the year (winter season). You briefly comment on this fact, and she states, "I want to keep my summer tan. So, I keep going to the tanning salon weekly." She is here today to confirm the pregnancy with her primary care provider, and you are the nurse completing the initial interview. When asked if she has been taking a folic acid supplement, she states that she had "no concerns of pregnancy and was not aware of the need to take this medicine." After she sees her primary care provider, he gives you the plan of care. The plan is to have a maternal serum marker test drawn today and recommend that she start on 600 μg of folic acid daily. In analyzing this case, please answer the following questions: Discuss any teratogenic effect of this individual not taking a folic acid supplement. Explain what effect may occur on the developing fetus, identifying specific risks noted in this case. Explain why the primary care provider included a maternal serum marker test in the plan of care for this individual. Discuss the vulnerability of the fetus based on trimesters and teratogens and the role of the folic acid supplement. Briefly discuss the how UVA and UVB rays contribute to the process of oncogenesis in skin cells. How would you educate this individual on the risk of skin cancer related to increased exposure to UVA/UVB rays? Would you expect the primary care provider to perform a skin assessment during this visit? Why or why not?

Answer 1

Discuss any teratogenic effect of this individual not taking a folic acid supplement.

The brain and spinal cord mature starting the neural tube which is shaped by dorsal folding of the neural plate subsequently the 15th post formation day. The synthesis of this folding continues in the cranial and caudal guidelines and is generally accomplished in humans amid the 21^st to 26^th post conception time in the cranial shaft and amid the 23^rd to 28^th day in the caudal shaft, respectively. These eras therefore resemble to the serious age of cranial pole fault: anencephaly and caudal pole imperfection: spina bifida. Though, it is essential to reflect that at contemporary the so-called gestational age is designed from the primary day of the previous menstrual dated in clinical practice, then it is essential to add 14 days to the post conception stage to compute the gestational period. Thus the dangerous dated of anencephaly is amid the 35th and 40th gestational time, while spina bifida had this period among the 37th and 42nd gestational days.

Explain what effect may occur on the developing fetus, identifying specific risks noted in this case. Explain why the primary care provider included a maternal serum marker test in the plan of care for this individual.

Primary in their gravidity, all womenfolk are obtainable transmission of numerous blood markers that can designate augmented fetal danger for convinced genetic illnesses and birth flaws. Amid 15 and 21 weeks' development, a maternal serum section is selected for alpha-fetoprotein, estriol and human chorionic gonadotropin (hCG).

Discuss the vulnerability of the fetus based on trimesters and teratogens and the role of the folic acid supplement.

Dose is a grave piece of any teratogenic contact. Teratogenic effects happen only when the quantity of a go-between surpasses a convinced verge. Medicines that are usually measured harmless throughout pregnancy can have opposing effects on the embryo or fetus if the mother receipts them in amounts that are so great that they reason maternal deadliness. Chronic contact is typically of more anxiety than a solitary exposure, if the quantities are alike. The road of experience is also significant. For instance, risk is improbable from the usage of dermal managers that deficiency considerable systemic preoccupation. The teratogenicity of an experience is also prejudiced by together the motherly and fetal genotypes, which can consequence in alterations in cell compassion, placental conveyance, breakdown, receptor compulsory, or drug delivery. Some medicines are absorbed lengthily by the mother; their teratogenicity be contingent upon whether a deadly form spreads the embryo or fetus in adequate amounts to harvest adverse effects.

Briefly discuss the how UVA and UVB rays contribute to the process of oncogenesis in skin cells.

There are numerous devices and fences that defend the figure in contradiction of UVR. The stratum corneum, the farthest coating of the skin, collected of dead and flaking cells, and melanin color weaken diffusion of UV into the covering. Antioxidative enzymes cleanse and absorb sensitive oxygen types. UVR also encourages melanin fusion and re-localization inside the epidermis, which dramas a vital part in reduction of UVR persuaded injury. DNA repair schemes defend cells from UV-induced cuts. The greatest significant DNA injury repair structure intricate in editing of compensations produced by UVR is nucleotide editing reparation (NER).        

How would you educate this individual on the risk of skin cancer related to increased exposure to UVA/UVB rays? Would you expect the primary care provider to perform a skin assessment during this visit? Why or why not?

The growth of skin cancer in individuals is related with determined variations in the basal keratinocyte stem cells inclining to cancer. The reality and location of a melanocyte stem cell is unidentified. Aimed at basal keratinocytes, long-lasting exposure to sunlight or ultraviolet light consequences in little incidence opinion mutations in p53 genetic factor that are justly extensively dispersed in else usual skin unprotected to sunlight. These little frequency alterations are regularly originate in basal cells and their offspring nearby epithelial cancers, and seem to chief the membrane or other epithelium for expansion of cancer. This singularity is recognized as arena cancerization. The involvement of a skin screening test will be helpful to demonstrate or find out any early break outs on skin level and early treatment.