Family Genetic & Health History Direct Care Alternative Learning Activity
Your Name: Date:
Your Instructors Name:
Directions : Complete the information below using either a real or fictitious or adult participant. Should you choose to use an individual for this activity, please remember to maintain privacy by not including any names or personal identifying information.
Please note that the activity can be performed using distance communication modalities.
When complete, please submit the completed activity with the practicum log.
1: Family Genetic History:
Develop a family genetic history that includes, at a minimum, three generations of your chosen adults family, including grandparents, parents, and the adults generation. If the adult has any children, include them as the fourth generation. **PLEASE NOTE: This activity is to reveal the potential impact of the familys health on the adult participant. You do not need to identify anyone who is not biologically related to the adult except for a spouse or significant other.
You do not need to use symbols, but instead write brief descriptions for each person. Each description should include the following information: first name, birthdate, death date, occupation, education, primary language, and a health summary, including any medical diagnoses. An example is below.
Complete the family genetic history form below. Indicate if any information is N/A (not applicable) or unknown. Indicate any information the person did not want to disclose by noting Does not want to disclose.
Family Member
Description
Paternal grandfather
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Paternal grandmother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Father
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Fathers siblings (write a brief summary of any significant health issues)
Maternal grandfather
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Maternal grandmother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Mother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Mothers siblings (write a brief summary of any significant health issues)
Adult Participant
First and last initials:
Birthdate:
Occupation:
Education:
Primary language:
Health summary:
Adult participants siblings (write a brief summary of any significant health issues)
Adult participants spouse/significant other
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Adult participants children (write a summary for each child, up to four children)
Child #1 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #2 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #3 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #4 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
2. Health History
BIOGRAPHICAL DATA
Date:
Initials:
Age:
Date of birth:
Birthplace:
Gender:
Marital status:
Race:
Occupation:
Source of information:
Reliability of source of information:
PRESENT HEALTH HISTORY/ILLNESS
Health goals:
MEDICATIONS
Include purpose, dose, duration, frequency, and any desired or undesired effects for each medication.
Prescription medications:
Over-the-counter medications:
Herbals:
PAST HISTORY
Childhood diseases:
Immunizations:
Allergies:
Blood transfusions:
Major illnesses:
Injuries:
Hospitalizations:
Labor and deliveries:
Surgeries:
Use of alcohol:
Use of tobacco:
Use of illicit drugs:
EMOTIONAL HISTORY
Mental, emotional or psychiatric problems:
PSYCHOSOCIAL/ OCCUPATIONAL HISTORY
Occupational history:
Educational level:
Financial background:
ROLES AND RELATIONSHIPS
Significant others:
Support systems:
ETHNICITY AND CULTURE
Ethnicity and culture:
Physical and social characteristics that influence healthcare decisions:
SPIRITUALITY
Beliefs and practices influencing health decisions:
Religious and spiritual needs:
HISTORICAL REVIEW OF SYSTEMS
Skin, hair, nails:
Head, neck, related lymphatics:
Eyes:
Ears, nose, mouth, and throat:
Respiratory:
Breasts and axillae:
Cardiovascular:
Peripheral vascular:
Abdomen:
Urinary:
Reproductive:
Musculoskeletal:
Neurologic:
3. Evaluation of family genetic history
Evaluate the impact of the familys genetic history on your adult participants health. For example, if the adult participants mother and both sisters have diabetes, hypertension, or cancer, what might that mean for the adult participants future health? (1 paragraph)
4. Evaluation of health history
Evaluate your participants health history. What might this individuals current health status mean for the participants future health? Discuss some potential areas for health promotion or prevention of future illness for this individual. (1 paragraph)
5. Planning for future wellness
Discuss 1 health goal you would like to set for this individual, based on the evaluation of the family genetic history and health history, which will promote an optimal level of wellness both now and in the future. Use evidence from the data collected to describe why you feel this goal is a priority, and discuss 2-3 recommended interventions for this individual, based on the goal. (1-2 paragraphs)
Family Genetic & Health History 1
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Chamberlain College of Nursing
Family Genetic & Health History Direct Care Alternative Learning Activity
Your Name: Date:
Your Instructors Name:
Directions : Complete the information below using either a real or fictitious or adult participant. Should you choose to use an individual for this activity, please remember to maintain privacy by not including any names or personal identifying information.
Please note that the activity can be performed using distance communication modalities.
When complete, please submit the completed activity with the practicum log.
1: Family Genetic History:
Develop a family genetic history that includes, at a minimum, three generations of your chosen adults family, including grandparents, parents, and the adults generation. If the adult has any children, include them as the fourth generation. **PLEASE NOTE: This activity is to reveal the potential impact of the familys health on the adult participant. You do not need to identify anyone who is not biologically related to the adult except for a spouse or significant other.
You do not need to use symbols, but instead write brief descriptions for each person. Each description should include the following information: first name, birthdate, death date, occupation, education, primary language, and a health summary, including any medical diagnoses. An example is below.
Complete the family genetic history form below. Indicate if any information is N/A (not applicable) or unknown. Indicate any information the person did not want to disclose by noting Does not want to disclose.
Family Member
Description
Paternal grandfather
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Paternal grandmother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Father
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Fathers siblings (write a brief summary of any significant health issues)
Maternal grandfather
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Maternal grandmother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Mother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Mothers siblings (write a brief summary of any significant health issues)
Adult Participant
First and last initials:
Birthdate:
Occupation:
Education:
Primary language:
Health summary:
Adult participants siblings (write a brief summary of any significant health issues)
Adult participants spouse/significant other
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary (include cause of death if applicable):
Adult participants children (write a summary for each child, up to four children)
Child #1 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #2 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #3 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #4 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
2. Health History
BIOGRAPHICAL DATA
Date:
Initials:
Age:
Date of birth:
Birthplace:
Gender:
Marital status:
Race:
Occupation:
Source of information:
Reliability of source of information:
PRESENT HEALTH HISTORY/ILLNESS
Health goals:
MEDICATIONS
Include purpose, dose, duration, frequency, and any desired or undesired effects for each medication.
Prescription medications:
Over-the-counter medications:
Herbals:
PAST HISTORY
Childhood diseases:
Immunizations:
Allergies:
Blood transfusions:
Major illnesses:
Injuries:
Hospitalizations:
Labor and deliveries:
Surgeries:
Use of alcohol:
Use of tobacco:
Use of illicit drugs:
EMOTIONAL HISTORY
Mental, emotional or psychiatric problems:
PSYCHOSOCIAL/ OCCUPATIONAL HISTORY
Occupational history:
Educational level:
Financial background:
ROLES AND RELATIONSHIPS
Significant others:
Support systems:
ETHNICITY AND CULTURE
Ethnicity and culture:
Physical and social characteristics that influence healthcare decisions:
SPIRITUALITY
Beliefs and practices influencing health decisions:
Religious and spiritual needs:
HISTORICAL REVIEW OF SYSTEMS
Skin, hair, nails:
Head, neck, related lymphatics:
Eyes:
Ears, nose, mouth, and throat:
Respiratory:
Breasts and axillae:
Cardiovascular:
Peripheral vascular:
Abdomen:
Urinary:
Reproductive:
Musculoskeletal:
Neurologic:
3. Evaluation of family genetic history
Evaluate the impact of the familys genetic history on your adult participants health. For example, if the adult participants mother and both sisters have diabetes, hypertension, or cancer, what might that mean for the adult participants future health? (1 paragraph)
4. Evaluation of health history
Evaluate your participants health history. What might this individuals current health status mean for the participants future health? Discuss some potential areas for health promotion or prevention of future illness for this individual. (1 paragraph)
5. Planning for future wellness
Discuss 1 health goal you would like to set for this individual, based on the evaluation of the family genetic history and health history, which will promote an optimal level of wellness both now and in the future. Use evidence from the data collected to describe why you feel this goal is a priority, and discuss 2-3 recommended interventions for this individual, based on the goal. (1-2 paragraphs)
Family Genetic & Health History 1
Applied Sciences
Architecture and Design
Biology
Business & Finance
Chemistry
Computer Science
Geography
Geology
Education
Engineering
English
Environmental science
Spanish
Government
History
Human Resource Management
Information Systems
Law
Literature
Mathematics
Nursing
Physics
Political Science
Psychology
Reading
Science
Social Science
Home
Homework Answers
Blog
Archive
Tags
Reviews
Contact
twitterfacebook
Copyright © 2021 SweetStudy.com
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