Grand Canyon University: NRS 429V
January 26, 2012
Family Health Assessment
Performing a family assessment, rather than focusing on the individual, incorporates on a broader level the environmental and social influences and determinants of health. The typical family has changed over time from what was composed of two biological parents and their children, to being as disparate as the individual. The family is the primary social environment where health promotion and prevention takes place, engrained in their values, beliefs, and practices. For this assessment, the author has chosen a nuclear family. Gordon’s eleven functional health patterns are a tool used by nurses to conduct a thorough family assessment and history, and obtain information on the areas of need for health promotion and illnesses. The systems theory as explained by Edelman and Mandle, (2006), states that a change in any person in the family will affect the entire family as a unit. (Ch. 7p. ?) The importance of a complete family assessment can be surmised by this statement: ”Families are the most central and enduring influence in children’s lives… the health and well being of children are inextricably linked to their parent’s physical and emotional and social health, social circumstances and childrearing practices”.(Edelman & Mandle, 2010, p. 174). The family chosen by this author consists of two adults; the father (31), mother (30), and their three daughters, ages 11, 4, and 15 months. Based on the functional pattern of health perception, no one smokes, everyone is current on their immunizations, and the father admitted to “social drinking”, though the mother added that he has no self control when he does drink (names, personal communication, date). Both adults exercise regularly, and the mother recently entered into a 90 day physical fitness challenge in her community. The children are enrolled in sports and dance classes and appear overall in good physical condition. In the assessment of Nutrition, Activity & Exercise, Sleep & Rest, Sexuality, and Elimination, both parents take multivitamins regularly and prescribed medications. They prefer to eat spicy foods and have meats as the center of their meals. They deny any problems in healing or dentition and state that they have excellent health and dental insurance through the father’s employer which is the State of Arizona (name, personal communication, date). The family all maintain regular health visits and yearly physical exams. An area of dysfunction exists with the father and sleep habits. He routinely has a need for sleep aids, and stated that he will have to take twice as much some nights to stay asleep. He averages about 3 to 4 hours of sleep without the use of sleep aids and has been using them for a period of 6 years. The other family members deny any problems in this area but the mother complains that the fathers need for sleeping pills has gotten worse over time and has investigated alternative therapies. The mother uses an IUD for family planning and both admit they are done having kids due to busy lifestyle, supporting the statement the mother added that she recently worked a 60 hour week. Medications the father takes are primarily related to insomnia and include Xanax, Buproprion, and two weeks started Restoril in order to try to get off the Xanax for sleep, but isn’t sure if its working or not. The mother takes Synthroid for an underactive thyroid condition brought on after having her third child four years ago. This statement made by the mother prompted more questioning as the children listed in the beginning of the interview would mean the third child would have been 15 months ago. The mother then acknowledged a fourth daughter who was the oldest, born in October 2000, who died of metastatic Ewing’s Sarcoma, of the lumbar spine, in November 2004. The mother explained that though the physicians claim for this to be not a genetic disorder, there was a maternal aunt who died at age 8 of the same disease (name, personal communication, date). The question on elimination patterns divulged a recent traumatic event in which the parents were in a car accident, and the father had to have an indwelling Foley for three weeks before urinary function returned fully. The mother having her seatbelt on had minor cuts, bruises, and an impact injury to the left forearm where a visible four inch scar is a reminder, and an impact injury to the right heel. The father, who did not have a seatbelt in place suffered extensive injuries to the brain, lungs, stomach, liver, multiple rib and other bone fractures, with the most disabling of his injuries being a fractured C1 vertebrae. As the father sat there in his neck brace, the mother told me the story of the accident, adding that he had surgery to fuse the neck from occiput to C3 last October after wearing a Halo device for five months in hopes that the fracture might heal on its own. Based on the function of cognitive patterns, the mother stated that she notices a difference in her memory and function based on her compliance with her thyroid medication regimen (name, personal communication, date). The father was sent to an inpatient rehab facility for two weeks after his injuries for speech therapy, and the mother states that is took several months before he could remember most things (name, personal communication, date). She reported that he had forgotten things such as their youngest daughter’s name. In the area of self perception and role relationship, the family agrees that the accident changed a lot. The mother was required to pick up the responsibilities that the father usually took care of which was very difficult. She had no time off available from work, and had used all of her FMLA from the birth of their last child. “It was a feeling of despair”, stated the mother (name, personal communication, date). The father stated that he felt helpless and would get angry for not being able to do things such as write a complete sentence. “The speech lady made me feel like an idiot”, he said (name, personal communication, date). When asked how they cope with the stressors presented to them, the mother said they have only been able to make it thus far with the help of “awesome friends and family” who came to their aid. The local feed store had delivered hay to their house, without having to be asked, for their animals and the two neighbors fed and watered them. The mother mentioned the use of religion and prayer for comfort and hope. In looking to the future they both have a mutual respect for the delicacy of life and plan to take advantage of every moment together. They have planned two vacations in April, and have a better savings plan for if something were to happen in the future. In assessment of the family chosen by this author, an appropriate nursing diagnosis would include Caregiver Role Strain related to the increased responsibility added due to the incapacity of the father from the accident. Wellness Nursing Diagnoses applicable are Readiness for Enhanced Family Coping, and Effective Therapeutic Regimen Management would also apply related to this family’s ability to cope with the past stressors and look forward to the future for a better life. (Weber, 2005p. 1) References
Edelman, C., & Mandle, C. L. (2010). Health Promotion Throughout the Life Span (7th ed.). [VitalSource Bookshelf]. http://dx.doi.org/9780323056625 Weber, J. R. (2005). Wellness Nursing Diagnoses. In Nurses’ handbook of health assessment (5th, ). Retrieved from http://jxzy.smu.edu.cn/jkpg/UploadFiles/file/TF_06928152357_nursing%20diagnoses%20grouped%20by%20functional%20health%20patterns.pdf
Hi Kimberly, the paper includes questions regarding the 11 Functional Health Patterns and the interview is summarized of these findings. Nursing diagnoses are stated. Continue to work citing references according to APA guidelines. Otherwise, you have a great paper.