Family Assessment and Diagnosing

• Family composition

  • A family consists of two parents and two children. John, the father, is 36 years old. Mary, a mother, is 34, and two boys named Michael and Jack are ten and nine respectively. All members are white.
• Roles of each family member.

  • Mary is viewed as a leader in the family, and her position is respected. She has a broad range of responsibilities and makes some of the most important decisions. John is the primary provider, and he is working two jobs at the moment. He is busy most of the time and rarely spends time with his children. Mary also provides for the family, but she is working part-time because of housework and has to take care of the boys. Michael is an older son and has much more responsibilities than a younger Jack and it leads to numerous conflicts.
• Do family members have any existing physical or psychological conditions that are affecting family function?

  • The fact that Mary suffers from chronic depression affects the ability of the family to function properly. The problem is that other members do not understand this condition and do not offer the support that is required. John has problems with sleep, and it complicates relationships.
• Home (physical condition) and external environment; living situation (this must include financial information). How the family support itself.

  • The home has been recently purchased, and it is in excellent condition at the moment. The neighborhood is very peaceful, and few stores are available nearby. Both parents are working on well-paying jobs and are capable of providing their children with everything necessary for their comfort and development. John does consult and is currently working at an engineering firm. Mary is a part-time account manager at the moment.
• How adequately have individual family members accomplished age-appropriate developmental tasks?

  • Every single member of the family has reached developmental tasks that are appropriate for their age. However, Michael’s social skills are not well-developed and need to be improved because he is too dependent on his parents and cannot make decisions himself.
• Do an individual family member’s developmental states create stress in the family?

  • It is imperative to note that stress is present in the family because of the difference in developmental states. Michael is a young boy that has to go to school, and it is evident that he has difficulty interacting with his family. He is too shy and worried about the opinions of others most of the time.
• What developmental stage is the family in? How well has the family achieved the task of this and previous developmental stages?

  • This family is currently in the fourth stage of development because they have school children. The family has done an outstanding job achieving previous tasks, but they are struggling with this particular phase because their children have issues with learning and parents are worried that it is their fault.
• Any family history of genetic predisposition to a disease?

  • John’s family has a history of cardiovascular diseases. His uncle has suffered from hypertension for many years and has died because of myocardial infarction. Mary’s family has a history of type-2 diabetes, and her mother currently deals with this illness.
• Immunization status of the family?

  • The family’s immunization is up-to-date.
• Any child or adolescent experiencing problems

  • Michael has several issues at school, and he struggles to pay attention to tasks most of the time. Moreover, he frequently feels exhausted and sleeps too much.
• Hospital admission of any family member and how it is handled by the other members?

  • John had to visit a hospital nearly two years ago because of appendicitis. The situation was handled well by other family members and children offered support to their father. Also, Mary notes that the information that was provided by health care professionals was vital, and they understood that they should not worry.
• What are the typical modes of family communication? It is effective? Why?

  • Consensual and pluralistic modes are preferred by the family in most cases. John and Mary think that this approach is efficient, and it has helped them to address most of the situations.
• How are decisions made in the family?

  • They like to explain their actions to their children and believe that they should learn from their experience when it is necessary. They are willing to participate in conversations when making significant decisions and consider the opinions of each member. However, disagreements are also quite common. Members of the family may not talk to each other for some time, but they are capable of reaching a consensus most of the time.
• Is there evidence of violence within the family? What forms of discipline are used?

  • There have been no instances of violence in the family according to husband and wife. An authoritative approach is preferred by the parents. Moreover, they think that it is necessary to collaborate with children when solving problems or making decisions. Also, it is believed that high standards that have been set would help them to become independent individuals in the future. However, parents should be a little less strict because children have problems with social interactions.
• How well the family deals with a crisis?

  • The family deals with tragedies and crises well according to the information provided. However, the problem is that children are too quiet sometimes, and they may be afraid to share their emotions. The situation can be quite problematic in some cases, and it may be paramount to establish an environment where the feelings and opinions of others are valued.
• What cultural and religious factors influence family health and social status?

  • It is necessary to note that factors related to culture and religion do not affect the health status of the family. They are Christians, and every single member understands that diagnoses voiced by professionals should be trusted, and it is important to follow their recommendations. Also, they do not like traditional medicine and consider it ineffective most of the time.
• What are the family goals?

  • One of the most significant goals of this family is to provide their children with the best possible education to ensure that they will have opportunities for employment and development.
• Identify any external or internal sources of support that are available?

  • The mother is willing to offer support to her children most of the time. External sources of support such as transportation are also available.
• Is there evidence of role conflict? Role overload?

  • There are no problems related to role conflict, and each member of the family understands their roles and responsibilities. It is entirely possible that Mary is too tired most of the time because she is focused on too many tasks at once.
• Does the family have an emergency plan to deal with a family crisis, disasters?

  • The family currently does not have any plans on how to deal with crises and disasters and they think that some of the problems may resolve without any intervention.

Nursing Diagnoses

• It is evident that Michael suffers from chronic low self-esteem. The problem is that a boy has problems communicating with his others and does not want to discuss such issues with his parents. Moreover, it affects his performance at school, and he is not able to build relationships with his peers.

Interventions

A registered nurse should draw attention to the strengths of the patient.

It is imperative to tell the members of the family to focus on support for the boy, and to ensure that negative comments are avoided.

The patient should be advised to participate in group activities.

Classes focused on stress management should be considered.

Rationale

The level of confidence would increase once he recognizes that he has many positive qualities. The support of close ones would be beneficial, and each member of the family should understand that they should actively participate in the process, and it would help to ensure that recovery is prompt. Low self-esteem is quite common among young people of his age, and communication with others would be helpful. Stress management techniques can be useful, and cognitive behavioral therapy has proven to be effective in such cases (Ackley, Ladwig, & Makic, 2016). He should be able to acknowledge the reasons for such behavior and recognize the need to change as an individual (Doenges, Moorhouse, & Murr, 2013).

• Mary has to deal with enormous stress overload most of the time and it affects her relationships with other members of the family. One of the most significant aspects that need to be addressed is that she is suffering from chronic depression, and it has an impact on all the areas of her life. Also, she is worried about the fact that they may have to move to another town in the future because of her husband’s work, and it leads to enormous tension.

Interventions

Stress level needs to be evaluated with an appropriate assessment tool.

A registered nurse should provide the patient with all the necessary information regarding stress management approaches and their benefits.

Mary should be encouraged to discuss this situation with her husband and children to ensure that they have an understanding of this problem and would offer their support.

The number of tasks should be reduced.

Rationale

Stress reduction would be useful because it will help to reduce the pressure and tension that is present. Monitoring would be essential in this case because it would allow identifying the primary causes of this condition and how they may be eliminated. Participation in discussions would be beneficial because the patient may be struggling because of the inability to voice her opinions and explain her emotions. Cognitive ability and the process of decision-making may be affected, and some of the issues related to work should be addressed (Potter, Perry, Stockert, & Hall, 2016). Mary has too many responsibilities at the moment, and this aspect needs to be addressed because it may lead to the development of other issues (Urden, Stacy, & Lough, 2014).

• John is suffering from sleep deprivation, and it affects his ability to go to work and perform day-to-day activities. The problem is that he has nightmares quite often, and he is too worried about the loss of his father.

Interventions

The client should be provided with opportunities to enhance his sleep, and it may be critical to alter his schedule.

It is necessary to tell the patient to avoid drinks that contain caffeine because it may complicate the process.

A discussion about the consequences of inadequate sleep is vital, and family members also should be educated on this subject matter.

Rationale

The individual should be able to get an adequate amount of rest, and it would help to restore his previous sleep patterns. Overuse of caffeinated drinks can be quite problematic in some cases, and it is one of the factors that should be eliminated. Such issues as reduced performance, increased cardiovascular risks, and hormonal problems are frequently associated with sleep deprivation, and each member of the family should understand that the patients’ health and well-being may be affected. The possibility of other causes of this condition also should not be overlooked. Overall, the focus should be on the promotion of adequate sleep (Treas & Wilkinson, 2013).

References

Ackley, B., Ladwig, G. B., & Makic, M. F. (2016). Nursing diagnosis handbook: An evidence-based guide to planning care (11th ed.). Philadelphia, PA: Elsevier Health Sciences.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2013). Nursing diagnosis manual: Planning, individualizing, and documenting client care (4th ed.). Philadelphia, PA: F. A. Davis Company.

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing (9th ed.). Philadelphia, PA: Elsevier Health Sciences.

Treas, L. S., & Wilkinson, J. M. (2013). Basic nursing: Concepts, skills, & reasoning (2nd ed.). Philadelphia, PA: F. A. Davis Company.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2014). Critical care nursing: Diagnosis and management (7th ed.). Philadelphia, PA: Elsevier Health Sciences.