Question

Case Study- Read the case study scenario, answer the questions below, and explain the rationale for your answer.

Glenna, age 38, lost leg function during a motor vehicle accident at age 16. She plays basketball at the community center and teaches aerobic classes for wheelchair-bound people three times a week. She manages a medical equipment rental business since her husband died. Business is not profitable. A physician’s referral was made to the public health department for a developmental assessment.

A nurse heard angry shouting as she stepped toward the porch of the tiny house with peeling paint. The nurse stepped over a broken tread and knocked on the weather-stained door at the end of a ramp. Suddenly a large man burst through the doorway tugging on a T-shirt and muttering. The nurse glanced past the fleeing man. Three children, ages 18 months, 4 years, and 6 years old, knelt on linoleum worn through to the wood. The TV blared a cartoon. No one heard her knock as the children stared at their mother who was crying and holding her cheek. The nurse knocked a second time on the open door and introduced herself. The woman wheeled around to face the other way.

“We are busy. Please come back later,” the woman spoke over her shoulder.

“Pick up the blocks, Chica. Make sure the back door is locked, Stephano and please make a peanut butter and jelly sandwich for your brother and sister.

Not now, Jon. She tells the youngest child, who is banging a block on her wheel.”

The nurse replies, “I can make another appointment, but it will only take a few minutes to assess Jonathan now that I am here. Your physician said you are concerned about his development. If you could answer a few questions I feel sure we can help you. I can help make the sandwiches while we talk.” The nurse’s scan of the living room located a stained spoon and knife near a broken mirror on the coffee table along with a towel, toys, and a magazine. Chica’s hair was uncombed. The boys’ hair hung to his shoulders and looked unwashed.

The mother pulled her robe together over her chest and folded her arms. “You can’t help. Jon is normal but different. You will ask a 100 questions, insult me, and then say there is nothing you can do, just like the doctor did. He made us wait 45 minutes and then says he is going to call someone else. We don’t need that kind of help. Jon is a smart boy with attention problems. I need to clean up. We don’t have time to talk right now.” She raised her voice. “Chica, pass me the cigarettes, will ya? Gracias.”

Jon continued banging his mother’s chair and vocalizing. The children stared at the nurse. Chica looked afraid. Stephano looked hopeful. His dirty pajamas ended well about the ankle.

1. Should Glenna consider herself disabled or at risk? Why? And should the nurse consider Glenna’s family at risk? Why?
2. What history questions will reveal predisposing, social, or enabling risk factors?
3. What community health nursing techniques could empower Glenna and her family?
4. How can the nurse avoid insulting the mother?

Answer 1

Yes Glenna should consider herself as a disabled only then she can find the other ways to feed her family knowing her body image she can accept the reality. She is also at risk of developing several mental problems as she going through a crisis like maturational crisis (loss of body part or it's function) and death of spouse this crisis goes through a grief process which can lead a mental illness in the future time

Glenna's family is at severe risk... . Because For identifying a family at severe risk following criteria are there

1 ; having 3 preschool children's

2; disabled family member

3; less income

4 ; malnourished children's

5; low socioeconomic status etc glenns family meet these critaria for identifying family at risk

The questions which reveal the predisposing and social risk factors are as under;

Social risk factors

1;what are the available resources to meet daily needs like healthy food , job , etc

2;socioeconomic status , public safety , harassment

3; quality schooling of children etc

Questions related to predisposing risks

1; nurse raises questions related to children's behaviour like temper tantrum.. Stuborn. Nightmares bed wetting etc

The nurse can help the glenna to know about the govt schemes which provide profit to children's poor family.. Nutritional schemes mid day meals for children's

Preventions of disease by regular immunization will decrease the burden of killer diseases

She can adress the mother to work centres to get paid for the suitable work etc

The nurse will aviod insulting the mother by

Talking in normal tone

Giving smily face expressions

Calmly listening to mother

Using silence etc