Family Nursing Diagnosis

Family Nursing Diagnosis

Deundra Newton

NUR/405

May 14, 2016

Professor Jean Ha

Family Nursing Diagnosis

“Family, as defined and implemented in the health care system, has traditionally been based on using the legal notions of relationships such as biological/genetic blood ties, and contractual relationships such a adoption, guardianship, or marriage” (Stanhope & Lancaster, 2014, p. 601). A family is made up of two or more people who rely on one another for financial, emotional, and/or physical support to maintain a healthy lifestyle. Community health nursing is important to the dynamics of a family and in this situation the family is seen as a client. Community health nurses assist those who are a part of a vulnerable population or a high-risk group and provide resources such as education and case management. Therefore, a community health nurse is an advocate to the client and plays and essential role in the prevention and spread of illnesses and diseases.

Identifying Data

The family that was chosen and agreed to participate is African American. In this family, the male is the head of the household and brings in the primary source of income into the home for this family. The father, I.M., is 48 years of age, the mother, B.M., is 46 years of age, and the daughter of the two, I.M., is 15 years of age. The mother and father have been married for 20 years. The father, I.M., is currently the other adult that is employed. B.M. is unemployed but receives a disability check due to a previous job related injury four years ago. I.M. works at a local warehouse and makes only enough money to keep the household a float. During the marriage the family has experienced many ups and downs related to financial struggles and addiction. During the marriage infidelity has also been a factor. I.M. has stated that he cheated on his wife because she was always out in the streets and was not helping him raise their child and tend to other household needed. I.M. verbalizes that even though he has cheated in the past, he has not cheated on his wife in over 10 years. However, B.M. still holds this over his head from time to time. B.M. states the she suffers from depression related to her addiction and previous marital issues that she seems to not be able to get over. Anger, depression, infidelity, stress, and problems with coping are observed within this family structure. The daughter, I.M., also deals with a lot of stress due to the lack of family support. I.M. (daughter) struggles with her school work and has to go to tutoring often for help with her studies because he father works a lot and her mother is not always home. The neighborhood is run down and drug activity is observed at each turn. There are a few schools and one park in the immediate area. There are also some mom and pop stores that provide some necessities and grill cooked food such as hamburgers. The mother (B.M.) has a diagnosis of diabetes and hypertension and does not take her medication as prescribed. The father (I.M.) has a diagnosis of hypertension, and takes his medication as ordered. The teenage child (I.M.) is overall healthy at this present time. Because of stress related to work and caring for the family on the part of the father, drug addiction and medication non-adherence by the mother, and the lack of a strong support system for the teen, the health of the family is poor.

Environmental Data

The family lives in a two bedroom, one bathroom apartment in the southern section of the town. The living area and bedrooms are very small. There is a small playground area within the apartment complex as well. The family has one car that is mainly used by the father as his transportation to work. The daughter rides the school bus to school on a daily basis. Even though the apartment is small, it is clean and organized. The father and daughter do most of the cleaning and the mother cooks 2-3 times a week.

Family Structure and Function

Family structure is based on the way in which the family is set up and how they function on an everyday basis. This family appears to care for one another and each other’s whereabouts. The family does not spend a lot of family time together due to addiction issues with the mother and long work hours for the father. However, they do get to go out to eat dinner and see a movie from time to time as a family. The father functions as the head of the household, the mother cooks from time to time, but is in and out of the home using drugs on most days, and the daughter is a full time high school student.

Family Nursing Diagnosis and Interventions

The first diagnosis is ineffective health maintenance related to addiction. The mother is not consistent with taking her medications due to her drug addiction and extended time out of the home seeking drugs. A nursing intervention for this diagnosis would be to “assess for family patterns, economic issues, and cultural patterns that influence compliance with a given medical regimen” (Ackley & Ladwig, 2014, p. 413). The second diagnosis for this family is stress overload related to multiple stressors. Each member of this family is dealing with stress in some form. The father is stressed because he is the head of the household and is having to not only care for the couple’s child, but he also has to care for the mother on most days when she has been out on drug binges. The father also has to pay all of the bills and only makes enough money to do just that, with little extra spending money. Therefore, the father experiences a lot of stress when he has to spend extra money to ensure that other household needs are met, such as clothes and food. A nursing intervention for this diagnosis is to  “assist the client in identification of stress overload during vulnerable life events” (Ackley & Ladwig, 2014, p. 770). The last diagnosis for this family is ineffective coping related to related to situational crisis.  The couple’s teen daughter deals with stress due to the lack of a strong support system. She struggles with schoolwork because she has a hard time coping with her current family situation. An intervention for this diagnosis is to “observe for contributing factors of ineffective coping such as poor self-concept, grief, lack of problem-solving skills, lack of support, recent change in life situation, maturational or situational crisis” (Ackley & Ladwig, 2014, p. 262). To assist the family with a focus on the need for more education, I would ensure that the appropriate hotline and self-help group contact information was provided to the family. I would provide the family with written information on hypertension, diabetes, and how to cope with stress. I would assist the family in setting goals and at least once a month I would visit the family to check the progress towards the goals and if any changes are needed to the plan of care at that time. The list of resources and topic selections were chosen for this family because I feel that if these areas could be addressed and more information could be provided, the health of the family as a whole could be much better. I feel that it is important to set goals and monitor the progress of goals. If the family feels that someone has their best interest at heart and care, they are more likely to be an active participant in the plan of care. Leading health indicators by Healthy People 2020 that relate to the family and their diagnosis is substance abuse, mental health, and social determinants (Office of Disease Prevention and Health Promotion, 2014).