Renal Question #35
The nurse is caring for a 32-year old client with a new diagnosis of polycystic kidney disease. The client states, “My mother had enlarged kidneys.” Which response by the nurse best explains the condition to the client?
- “Polycystic kidney disease runs in families and is an inherited disorder that may be passed from a parent(s) to the children.”
- “It was just a draw of the dice for your diagnosis and just a coincidence.”
- “You have an autosomal dominant with a mutated copy of the PKD1 or PKD2 gene or you have autosomal recessive pattern with two altered PKHD1 genes.”
- “Your mother should have had genetic counseling prior to having children.”
The best choice is A. Either the gene is passed from a parent or both. If recessive, the parents are not affected but the children are affected. If dominant, then one or both parents will have the actual disease. If one has the condition, then there is a 50% chance of passing the condition to the children. In this situation, one out of two copies of the gene is altered for the person to develop the disease. In recessive conditions, both parents may possess the gene without having the condition but may have 25% chance of having a child with both copies, which will cause a severe form of polycystic kidney disease. Enlarged kidneys on exam may clue the health care provider (HCP) into ordering more imaging studies. It is not just coincidence to have the condition. Selection C is correct, but the language is not client centered and basis for therapeutic communication. Selection D is insensitive and judgmental since many times the condition is not diagnosed until 30 years of age, after many children are already born.