Hey guys, in this lesson we are going to quickly go over the two factors that have the greatest influence on growth and development- and those are genetic and environmental influences. 

Okay so these two categories are very broad but they give us a starting point for thinking about the all the different variables that work together to contribute to growth and development.  For genetics, we are primarily thinking about chromosomal diseases like Down Syndrome, Turner Syndrome, Cystic Fibrosis, Sickle Cell Anemia and Haemophilia – just to name a few. But people can also have genetic predispositions or an inherited risk for diagnoses like breast cancer and heart disease.  

For the environment- we are basically talking about any and everything that contributes towards each person’s experience of life.  So things like family, socio-economic status, culture, location, nutrition, and then also things like government policies that influence things like school lunches, occupational safety at work, maternity leave- things like that.

So you can see we are looking very big picture here- but at the same time it’s something you can apply to each and every patient interaction you have.

For your nursing assessment there are some specific things that may indicate an increased likelihood of a genetic or chromosomal abnormalities.  These are ear abnormalities- for example, patients with Down Syndrome usually have low set ears. Unusually shaped eyes – along with facial features.  Skin abnormalities, like cafe au lait spots (light brown, flat spots that are kinda like birth marks. And loose or stiff joints may also be present with chromosomal abnormalities.

When assessing environment, you want to consider assessing a patient access to outdoor spaces, access to nutritional foods, their social and family environments (are they well supported and connected?), economic stability, and really just any signs of chronic stress,  that could be affecting growth and development.

For management one of the most direct things we can do is provide genetic testing for patients who may have reason to be concerned about their inherited risk for certain diseases.  In these cases, genetic counseling is usually warranted.

Next, we should always be considering environmental influences that may impact a patient’s health and development.  Our care plans should always be made with these variables in mind.

The same is true for our patient education.  It’s no good telling a family they should go on walks together for exercise, when they don’t have access to a safe place to do this in.