Promoting Family Health (24) Flashcards
Because a severely injured middle-aged client informed the nurse that he did not have any immediate family members, the nurse contacted extended family members. Which of the following is most representative of extended family members?
- Grandparents, aunts, and uncles
- Parents and spouse
- Children who no longer live at home
- Roommates and close family friends
1. Grandparents, aunts, and uncles
Grandparents, aunts, and uncles are considered extended family members. Parents and spouse are considered immediate family members. Children who no longer live at home are considered immediate family members. Roommates and close family friends may be considered extended family members if grandparents, aunts, and uncles do not exist.
Examine Figures 24–3 and 24–4 on pages 390–391. Based on the information in these two diagrams, which family member is at greatest risk for developing a health problem?
- Alice
- Bill
- Kim
- Mary
4. Mary
The data indicate that Mary is at the greatest risk of developing a health problem due to her stress of repeating a year of high school, many colds, drug use, and no support indicated beyond her family. Although Alice has a heart problem, she also has strong support medically and spiritually. Bill has asthma but no other risk factors are identified. Kim has back problems, is the mother of four children, and is married for the second time to an alcoholic and is also at risk, but not as great a risk as Mary.
What should a nurse instruct a client who identifies “the family” as two college roommates, a dog, and a cat when completing a family health history form?
- Include all information about blood relatives and the animals and roommates that might influence his health.
- Include only information about genetic/hereditary and environmental illnesses of blood relatives.
- Leave the area blank since the client does not live with blood relatives.
- Use the client’s own judgment in completing the area since the physical exam is more important than the history.
1. Include all information about blood relatives and the animals and roommates that might influence his health.
The health history of the client’s current living partners is critical information since many illnesses are communicable or environmental. Giving this advice, the nurse also validates that family are whoever the client says they are. History of illness data of blood relatives is also extremely valuable and should always be included, whether or not the client lives with them. Neither the history nor the physical exam is more important than the other—both are necessary for a complete plan of care.
A visual representation of family members by sex, age, health status, and lines of relationships through the generations is referred to as a _________.
genogram
To assess the impact of illness on the family as a unit, it is essential for the nurse to assess which factors? Select all that apply.
- The duration of the illness
- The meaning of the illness to the family and its significance to family systems
- The coping mechanisms used by other families with similar illnesses
- The financial impact of the illness (including factors such as insurance and ability of the ill member to work)
- The incidence of the illness in the community at large
1. The duration of the illness
2. The meaning of the illness to the family and its significance to family systems
4. The financial impact of the illness (including factors such as insurance and ability of the ill member to work)
It is essential for the nurse to determine the duration of the illness, the meaning of the illness to the family and its significance to family systems, and the financial impact of the illness in order to completely assess the impact of the illness on the family as a whole. Duration of the illness will determine the degree of disruption and adaptation required. These factors affect the members of the family in addition to the ill client. Option 3: Coping mechanisms used by other families with similar illnesses may not be relevant be- cause families vary greatly in their makeup and function patterns. Option 5: Knowing the incidence of the illness in the community at large is an important factor for the community health nurse in exploring epidemiologic issues such as prevention strategies and public health policies but is not as relevant for assisting the particular family.
An adult child brings a parent to an agency with signs and symptoms of potential fluid retention (e.g., high blood pressure, swollen feet) possibly related to excessive sodium intake. Further nursing assessment indicates inadequate food storage and preparation techniques in the home. Which would be the most appropriate nursing diagnosis?
- Readiness for Enhanced Family Coping
- Disabled Family Coping
- Impaired Parenting
- Caregiver Role Strain
- Readiness for Enhanced Family Coping
Presenting to the clinic indicates the family
is probably ready to face the health challenges caused by the previous activities. There is no evidence that the adult child or parent is experiencing disabling coping (option 2). Impaired Parenting applies when the parent is unable to care for a child rather than the reverse. Although some strain must be experienced by the child, evidence does not indicate that Caregiver Role Strain is the most important aspect of the situation.
Prior to finalizing a family-oriented nursing care plan and imple- menting interventions, it is essential for the nurse to perform which of the following?
- Meet with all family members simultaneously.
- Confirm that the family health insurance covers all family members.
- Establish a trusting relationship with the family as a group.
- Complete a thorough history and physical examination of each family member.
3. Establish a trusting relationship with the family as a group.
Establishing trust allows for effective communication and confirms that there is mutual commitment to the goals. Meetings with the family as a group should be goal oriented. A trusting relationship is important for communication as well as accepting and implementing a plan. While considering the cost of health care is important, it does not take priority over a trusting relationship with the nurse. A detailed history and examination of each family member is relevant but family members or the family as a whole will need to trust the nurse before providing the information.
Nurses often utilize systems theory to assess family units. Which example illustrates a family unit that does NOT meet the criteria of a well-functioning system?
- The family members allow input from outside the family unit.
- The family members are interdependent.
- Each member’s personal boundaries are well defined.
- The primary activities of each member focus on personal purposes.
4. The primary activities of each member focus on personal purposes.
The focus of activity on personal purposes does not promote effective family functioning. A family system that functions efficiently focuses primarily on purposes involving the total system, allows input from the outside, has personal boundaries that are well defined, and interdependent family members.
What is a primary function of a family?
- Provide everything each member wants.
- Provide an environment that supports growth of individuals.
- Ensure that the members are accepted into society.
- Ensure that family resources are not shared with the broader community.
2. Provide an environment that supports growth of individuals.
A family should provide an environment that supports the growth of the individual members. It is neither possible nor appropriate for the family to try to provide everything each member wants (option 1), nor that members are accepted into society (option 3). Although the family protects its members, a healthy family will share and use appropriate resources with the broader community (option 4).
Which family risk factor for developing a health problem is of highest priority for the nurse to address?
- Family members’ ages of 4, 13, 38, 42, and 75 place them in many different developmental stages.
- There is a history of adult-onset diabetes on the 42-year- old father’s side.
- The primary wage earner for a family of five has recently been let go from the job and lost health insurance.
- The family members are primarily sedentary and no one engages in physical exercise for more than 1 hour each week.
3. The primary wage earner for a family of five has recently been let go from the job and lost health insurance.
A family with sudden loss of income and health insurance is at the greatest risk for developing a health problem because it may no longer be able to afford preventive or therapeutic care. Having family members in many different developmental stages may cause stressors but this is not of high priority (option 1). The history of adult-onset diabetes on the 42-year-old father’s side and the sedentary lifestyle should be addressed but will not likely cause immediate health problems (options 2 and 4).
