Blended Family History and Nursing Diagnoses

Family History and Brief Health Characteristics

The interviewed family is a blended family, where the parents are married not for the first time, and their children come from previous marriages. The mother and father are 35 and 42 respectively, and the children are 8 and 10 (a boy and a girl). The mother is of Jewish descent, while the father is of a Hispanic origin. The roles in this family are distributed rather equally. Both parents have a job, although the father has a slightly tighter schedule than the mother does, so he seems to be the primary provider of the family.

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The mother works part-time, spending more time with their children. The boy, aged 8, is exhibiting symptoms of autism. Although the child was never diagnosed, it is reasonable to assume the family might experience problems in this area. Moreover, the father has a genetic heart condition. Similarly to his father, he has experienced heart palpitations and an abnormal rhythm at a young age. The mother does not have any inherited conditions.

The physical condition of their home is above expectations. The family lives in a two-story house that is regularly cleaned and is overall in a satisfactory condition. Their living situation is tied to a mortgage on the house that is going to be paid off in approximately 15 years. Despite the mortgage payments, the family is well provided, as the father owns his own business that is rather lucrative, while the mother is working part-time in a private school in their neighborhood. The mother’s salary is smaller than her husband is, but they can still afford all the necessary things, as well as going on vacation with their children once a year.

The mother and father are quite accomplished in their respective fields. The members of the family efficiently perform the age-appropriate developmental tasks, save for the boy who has difficulties socializing, with a possible autism diagnosis. The parents, having remarried, are both in the same developmental stage. After their previous unsuccessful attempts to establish a family, they focus on the task of creating a supportive and loving atmosphere for their children.

The only factor that might be stressful for the family is the boy’s overly isolated nature. Being an owner of his own business, the father is under pressure as well. The family is in the fourth developmental stage, as their children are 8 and 10. The developmental tasks at this point include promoting academic accomplishments and striving to become a part of the community with school-aged children (The family life cycle, n.d., p. 11).

The socializing difficulties with their son hinder the achievements of these tasks, although overall the family has dealt with the developmental tasks pertaining to the other stages rather well. The parents got married when their children were 2 and 4, so they have lived through the third stage (Family with Preschoolers) together, while they went through the previous stages separately. The tasks of the third stage were quite challenging for the family, as it required a huge amount of attention and strength, as well as dealing with the lack of privacy at home. The parents coped with the tasks quite well, even though certain aspects were very challenging at first.

Additional difficulties can be explained by the fact that this particular family is of a blended type, where children experienced difficulties adjusting to a new parent.

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Genetic predisposition to disease was revealed on the father’s side, as he has an inherited heart condition. At 25 years old, he already experienced palpitations and abnormal heart rhythm. His father and his grandfather had similar problems.

The family’s immunization status is up to date. Vaccines necessary for children aged 7-18 were administered, as well as all vaccines for the previous stages of development. The problems experienced by the children come down to the boy’s difficulties regarding socializing and fitting into the school community, as well as his tendency to isolate. The girl, aged 10, has mild dermatitis that resurfaces from time to time, with the causes related to allergies and other factors.

The most serious hospital admission that occurred in the family was related to the father’s congenital heart disease. He experiences palpitations, difficulty breathing, and other symptoms, which led to hospitalization. His wife and the children handled the matter rather well at first but the man’s child, the daughter, had difficulties afterward. She admitted that she was in shock at first, with it later transforming into permanent anxiety. The girl felt she was constantly scared of the possibility of her father’s unexpected death.

The typical modes of family communication are of a pluralistic nature. The parents offer their children a possibility of learning on their own, making mistakes, and drawing the necessary conclusions. An open conversation is very valued in a pluralistic family (Cuncic, n.d., par. 3). Conflict resolution pattern is productive, as it is based on an open conversation.

The family is working on an open conversation regarding decision-making. They strive to make decisions based on mutual agreements and open discussions. Although both mother and father are dominant figures, they go to great lengths to reach a compromise. Their efforts are explained by the fact that both of them have unsuccessful marriages behind them, which led to them drawing the necessary conclusions.

There is no evidence of violence in the family. The forms of discipline employed include withdrawal of privileges, letting the child see the consequences of their actions. These methods are considered very effective in dealing with children aged 6-12 (Psychosocial Pediatrics Committee, 2004, p. 39). The parents discipline their children by withdrawing their computer game and TV privileges, as well as by restricting their possibilities of meeting their friends.

The family is average in dealing with a crisis. As the father is under pressure at work, it often leads to him being short-tempered. In case there is a crisis, it can prove to be a serious obstacle. Luckily, the mother can neutralize the tension and lead the conversation towards reaching a compromise. However, the family does not have any emergency plans to deal with disasters or crises of a more serious nature. There is no evidence of role overload in the family. However, there is a slight role conflict in the case of the mother, who works in a private school, albeit part-time, and tries to combine her role as a mother and a high school teacher.

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Among cultural and religious factors that influence the family health and social status are certain cultural traditions from both the mother’s and the father’s side. Jewish religious traditions coupled with the Catholic religion are a combination that entails certain difficulties regarding the family’s social status. Jewish and Catholic traditions are rather problematic to put together, which is an obstacle for the family to fit into their community.

The family goals include creating a supportive and loving atmosphere for the upbringing of their children. The latter is to get a good education and graduate college with bright prospects. The parents focus their efforts on the mentioned goals, as their children are a priority.

Regarding internal sources of support, it is necessary to emphasize the family’s strong coping ability. The members of the family seem to support each other efficiently, openly discuss their conflicts and overall problems. The mother is of a kind nature and is supportive of her husband’s work, as well as attentive to the needs and problems of their children. External sources of support include a family therapist that helps guide their actions towards creating a supportive and loving atmosphere.

Nursing Diagnoses and a Brief Care Plan

The first nursing diagnosis pertains to the domain of Role and Relationships, i.e. impaired social interaction (The complete list of NANDA nursing diagnosis, n.d., p. 4). It concerns the boy and his problems in socializing. The second nursing diagnosis regards the father’s stressful job and pertains to the domain of Self-Perception, i.e. stress overload. The third nursing diagnosis is related to the daughter’s anxiety after her father’s hospitalization, i.e. coping and stress tolerance.

The suggested nursing care plan encapsulates all three aspects in a comprehensive way. As the son in the interviewed family experiences problems socializing, he is isolated and cannot adapt to his environment. It is suggested that the nurse discusses the issue with the parents and proposes that they take extra interest in what the child is interested in, and try to introduce him to social groups that share the interests.

The father’s stressful job has a negative impact on his self-perception. It is recommended that the father seek relaxation methods or hobbies that might relieve his stress. The daughter’s anxiety has a negative impact on her well-being. The latter can be addressed by carefully explaining the nature of her father’s problem and the actual risks involved. Perhaps it would be a good idea to seek the help of a family therapist.


Cuncic, A. (n.d.). Types of communication patterns in families. Web.

Psychosocial Pediatric Committee. (2004). Effective discipline for children. Paediatric Child Health 9(1): 37-41.

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The complete list of NANDA nursing diagnosis for 2012-2014, with 16 new diagnoses. (n.d.). Web.

The family life cycle. (n.d.). Web.

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