Question

You are caring for Mr. Jones, who was admitted to the hospital 4 days ago for treatment of injuries sustained in a motor vehicle accident. His diagnoses are fractured right femur, right shoulder dislocation, and closed head injury. Mr. Jones also has chronic hypertension, which has been worsened by his failure to take his medication for several days before the accident and by the stress of the accident.

Mr. Jones is 48 years old, married, and has three children ages 15, 10, and 4. He is the owner of a small, home-based plumbing company. Two other plumbers work for him. His wife does not work outside the home but does some of the office work for his company. The family lives in a small house in a relatively rural area, about 25 miles from the nearest city.

Mrs. Jones is a quiet, shy person who does not drive very much outside of her immediate area. Mr. Jones is the dominant figure, making all major decisions in both the business and the family. The family’s financial situation could be described as “just surviving month to month.” The family belongs to a small Baptist church in their community but are not active because Mr. Jones usually considers himself “on call” every weekend. Mr. Jones is a Native American and has no family in the area. Mrs. Jones is from the area and has one sister and an elderly mother living nearby.

Based on the above information, and the information from Chapter 10 in your text, describe what you think would be the impact of this illness on Mr. Jones and his family with respect to the questions that follow.

1. In his adjustment to illness, what stage do you think Mr. Jones is demonstrating? Give a rationale for your answer.

2. Based on references to Mr. Jones’ cultural background and previous behavior, how do you think Mr. Jones would behave as a patient while in the hospital? Would he be cooperative? Would he tell you if he had pain? Would he refuse treatment? (What internal and external influences might be factors?)

3. What impact would this illness have on Mr. Jones’ anxiety level?

4. What internal, external, and interpersonal stressors might be operative for Mr. Jones? List as many as possible under each category.

5. What stressors might be factors for this family? List as many as possible.

6. What is the potential impact of Mr. Jones’ illness on the family - his children, his wife, his extended family?

7. What could you, as a nurse, do to assist Mr. Jones?

Answer 1

1. Mr Jones is in the 3rd stage, of adjustment of illness called Frustration. The reason being the sentence says "

Mr. Jones also has chronic hypertension, which has been worsened by his failure to take his medication for several days before the accident and by the stress of the accident."

2. He being active in his work place, would find difficult to adjust to hospital setup. Because his activities are restricted in hospital at present. He would not want others to control his activities, because he was the boss in his home based plumbing company.But since he has closed brain injury, his chances of decision making is less.

His status of expression of pain would be less. His chances of refusal of treatment is less.

3. Since his brain damge is closed, anxiety level cannot be predicted.If he is in conscious status, he would suerly be anxious of his condition as well as his family.

4.Physical environment, Trauma and Injury, challenges and difficulties on dialy basis are some of the internal stressor Mr Jone was facing.

Prescence of illness and infection,emotional well being, overall health and fitness level are some of the external stressors Mr Jone had during his illness