Brenda Hanson
NSG/420
February 4, 2015
Beverly Eldridge
Friedman Family Assessment
A nursing assessment of a family is the basis of nursing interventions. Stanhope and Lancaster (2008) state, “By using a systematic process, family problem areas are identified and family strengths are emphasized as the building blocks for interventions and to facilitate family resiliency (p. 567). The following will discuss a family who has become more typical in this day and age. The family consists of father (RLA) 35 years old, mother (MCC) 32 years old, one son (ECC) eleven years old, one daughter (GAC) nine years old, and second daughter (MCA) six months old.
The family rents a two bedrooms, one bathroom home with a front …show more content…
yard, backyard and detached garage. There are four steps leading up to the front door and four steps leading up to the backdoor. The home is in a quite downtown older neighborhood. There is one neighbor next door to the right and no neighbor to the left. There is a high school located across the street. There is an alley way behind the back yard fence. The home has an attic and a crawl space. The home is built up off the ground. The home was built in 1912. The home has copper pipes and lead-based paint. The family had to sign a consent to acknowledge these hazards being in the home. The rent for the house is 1100/ month. The water and sewage is linked to the city. Garbage collection is once per week.
Father (RLA) and mother (MCC) met at a friend’s super bowl party four years ago. . Father (RLA) was single at the time with no children and mother (MCC) was recently divorced with two small school aged children. Both RLA and MCC have high school diplomas and trade school certificates. MCC has joint custody of the two school aged children ECC and GAC. After dating for three years RLA and MCC found out that she was pregnant. They decided to move in together and get their own place. RLA and MCC each lived with family prior to moving in together. The RLA and MCC found a house to rent and moved in before the youngest daughter was born this past July. All members of this family have been born and raised In California. Both parents are English and Irish. RLA family is the fourth generation in the United States from Ireland. MCC family is from England and Ireland. Several generations have been in the United States for many years. MCC children are a quarter Costa Rican and three fourths Caucasian. The newest baby girl MCA is English and Irish. Mother and children attend a Baptist church, while father does not attend any church.
This family is considered a multi-adult household with children. Listed as number four on the eight stage model outlined by Duvall and Hill. (Center for Parent Education, 2013). RLA and MCC come from divorced families. The family communicates well. They live in a small house so the adult conversations usually occur during the morning and day when the children are in school. RLA works the night shift 2:30pm to 11pm. RLA is the only person in the home working. The family has only one car. MCC stays home and takes care of the household duties such as getting ECC and GAC ready for school, laundry, cooking, cleaning and takes care of MCA since she is a baby. RLA said on January 31, 2015 he sleeps after work at about 3 am and wakes at about 11am each day to spend time with MCA, help out around the house and spend some time with MCC before the kids come home. ECC and GAC share the weekends with their father and stay with him from Friday’s after school till Monday mornings, when he drops them at school. This family communicates well and the children are very respectful and polite to RLA. RLA seems to be able to communicate well with the kids and they also listen well to him. RLA mother lives in the same city and so do other close family members for both RLA and MCC. When there is punishment to be handed out mostly both parents are involved. For example RLA may feel that putting the dishes away is a good punishment for telling a lie and MCC will usually agree, or offer another punishment to fit the crime so to speak. RLA and MCC will discuss the situation and agree upon a consequence for behavior. The adults believe they are raising future people for this country. They want these children to be active, mature and respectful individuals of society. ECC and GAC get good grades. Both stated they like to compete between themselves for the highest principal’s award, since they go to the same school. The children are an active part of this family. Everything seems to center around the children’s health and wellbeing overall. The value system this family has in place is very similar to those in this same ethnic background.
According to RLA (January 31, 2015) one of the biggest family stressors is the financial situation. Since RLA is the only one working, he works for the school district as a janitor, average pay is $14.00/hour. This is a family of five trying to survive on one paycheck. MCC also gets assistance from WIC and child support from ECC and GAC father. However the family cannot rely on the child support as the father doesn’t always make his payments. MCC said in January 31, 2015 that she has plans to return to the workforce when MCA is old enough to go to school. The fact that the family only has one car is also something that could potentially become a problem for them if it ever breaks down. The way this family handles the stressors that are presented to them is by having outlets. RLA states his release is hanging out and relaxing with his friends. RLA says he goes out drinking about two times a month. MCC says her stressors are relieved by the quite time she takes in the early morning hours before everyone gets up. She will go out onto the porch, she will smoke and relax while looking at the stars. Both parents in this family smoke. ECC has asthma, and uses an inhaler of Albuterol when needed. GAC is healthy. The school aged children have not been completely vaccinated due to the loose of health insurance, according to MCC, she signed a religious beliefs paper in order to allow the kids to remain in school. When the kid’s father gets health insurance they will then get up to date on their vaccinations. The baby MCA is doing well and is healthy. She is too young to be vaccinated as of right now. The family is healthy for the most part with the exception of RLA. RLA has been diagnosed with hypertension and he is overweight. MCC is healthy and active as are the kid’s. The family cooks many meals at home that consist of meat vegetables and a carb such as bread or potatoes. With most of the meals being cooked by MCC, RLA can cook and states he enjoys making breakfast the most. Occasionally the family will go to RLA mother’s house and she will cook dinner for the family. MCA was born premature at 5lbs. she has been eating and thriving well, she is up to 13lbs now and on time for growth. For physical activity the family will walk, or ride bicycles to the downtown attractions. MCC says she likes to do DVDs of exercise when the baby is asleep. The family does not have access to the internet. They will visit RLA’s mother to use her computer or go to the library down the street from their house. RLA, ECC and GAC have cell phones while MCC does not have one. The family has a landline phone. The family has basic cable. The kid’s do not play sports.
Three nursing diagnosis that pertain to this family as stated by the Healthy People 2020 are, as follows (a) environmental health, eliminate elevated blood lead levels in all children (b) determinants of health, increase the proportion of smoke free homes , (c) Maternal, Infant, and Child Health, Reduce the rate of infant deaths from sudden infant death syndrome(SIDS).
Some interventions to perform for (a) environmental health eliminating elevated blood lead levels in all children, ensure lead safe practices during renovations, repair and painting of pre 1978 homes, provide families with education materials needed to protect their children, offer screenings to all children living in these types of older communities that have home older than 1978. Some interventions to perform for (b) increase the proportion of smoke free homes, offer cessation programs educating the family on the negative effects it can have on young children, education on ways to stop smoking and ways to create a smoke free environment, possibly send fliers to the high school discussing the dangers of smoking and effects of second hand smoke. The primary nursing diagnosis I would focus on for this family is a smoke free environment and home life. Especially since ECC has asthma and the baby is still not clear of the age when sudden infant death syndrome can occur. I also would use this as it seems to be healthy for the family as a whole. Helping the parents to a cessation program such as American Red …show more content…
Cross will not only benefit their own individual health but the overall health of the family.
Resource list to help this family, would include smoking cessation programs through the local American Red Cross. Pamphlets and educational materials on how to prevent Sudden Infant Death Syndrome and reduce exposure to lead based paints. Local referrals to clinics to get blood levels checked for the lead based paint. This family could use some education on these items affecting their health.
In conclusion helping this family to stop smoking would present to be the biggest and most effective way of improving overall health for all members. Interestingly enough both parents stopped smoking while MCC was pregnant with MCA. However three months after settling in with the new baby both parents area smoking again.
Assignment Grading Criteria
Friedman Family Assessment
Week Three
Complete a family assessment using the Friedman Family Assessment model from Appendix E of Public Health Nursing.
Include three family nursing diagnoses, and then choose one as a priority family nursing diagnosis.
Include the following information:
Identifying data
Developmental stage and history of family
Environmental data
Family structure
Family functions
Family stress and coping
Family composition form
Identify family values that may be different than your own values, and how this could affect the intervention.
Any potential solutions and actions to arrive at a consensus for the best interest of the patient or family (advocacy)
Create a concept map identifying three possible community health nursing interventions (as indicated by the Friedman Family Assessment) to address the priority family nursing diagnosis. Identify opportunities for community health nursing interventions to influence the issues in a positive way that involves nursing role in working with families. Make sure to balance legal and ethical considerations with any potential solution or actions.
Provide a resource list to address the family’s needs
Content
9 points possible
Points available
Points earned
Developmental state and history of the family
1
Environmental data
1
Family structure, composition, and functions
1.5
Family stress and coping
1.5
Three family nursing diagnoses including one priority family nursing diagnosis
1
Nursing interventions
3
Format
2 points possible
Points available
Points earned
Follows rules of grammar, usage, and punctuation
Has a structure that is clear, logical, and easy to follow
Consistent with APA guidelines for formatting and citation of outside works
2
Total
11
References
Center for Parent Education. (2013). family Development Theory. Retrieved from http://parenteducation.unt.edu
Healthy People 20200. (2012). Healthy People 2020 Objectives. Retrieved from http://healthypeople2020.gov
Stanhope, M., & Lancaster, J. (2008). Public Health Nursing (7th ed.). Maryland, MO: Elsevier.
Stanhope, M., & Lancaster, J. (2012). Public Health Nursing (8th ed.). Maryland, MO: Elsevier.
RLA Family Member Head of Household, personal identifying information omitted due to privacy reasons.
MCC Family Member Head of Household, personal identifying information omitted due to privacy reasons.