Running head: COMMUNITY FAMILY HEALTH
Community Family Health Assessment Paper
Bonnie Fellhoelter and Jennifer Fisher
Grand Canyon University
NUR 313 Nursing Care of the Childbearing Family
February 16, 2011
Community Family Health Assessment
Introduction
J.K., a 34 year old, second grade teacher, is 36 weeks pregnant with her first baby. She currently lives with her husband and step-daughter in a homey two story home out in the middle of Buckeye. This paper is designed as a family health assessment of J.K. and her family, as well as, a way to educate the family about having a new infant in their household.
Developmental Stages
Developmentally J.K.’s family is a mixture of family and adolescent children and the introduction of an infant. Under Erickson’s Developmental Stages, the infant falls under the Infant stage which concerns Trust versus Mistrust. This stage “needs maximum comfort with minimal uncertainty to trust himself/herself, others, and the environment” (Erikson’s stages of development, 1990, p. 1). Their adolescent daughter is currently enrolled full time in school. According to Erikson’s Developmental Stages, she will have to deal with the Adolescent stage which deals with Identity versus Role Confusion. In this stage, the individual tries “integrating many roles (child, sibling, student, athlete, worker) into a self-image under role model and peer pressure” (Erikson’s stages of development, 1990, p. 1). With the new infant in the family J.K. will now be working with an excessively busy schedule of her husband’s, highly active daughter, and an infant. Both of the parents fall under the Young Adult stage. This stage deals with Intimacy versus isolation. According to Erikson, one “learns to make personal commitment to another as a spouse, parent, or partner” (Erikson’s stages of development, 1990, p. 1).
Individual Assessment
Health Perception/ Health Management
J.K. states that this baby boy was an accident, they had been trying for years to have a baby. They went through two rounds of in-vitro fertilization that was unsuccessful, and about a year or so after J.K. and J.B. stopped trying to have a baby, she became pregnant. Due to her and her family’s busy schedule, J.K. never took a prenatal class; however, she has been reading many different birthing books in order to become well educated about the pregnancy and how to properly manage her body during this time. She also has been talking to her mother and sister who have both been through several pregnancies in order to further comprehend what her body was going to go through and how best to care for herself during the pregnancy.
Role Relationship
Currently J.K. is a stepmother, wife, teacher, friend, and daughter. With this baby boy, she is greatly looking forward to being a mother of her own child. She is, however, nervous about being able to love her son just as much as she does her stepdaughter, and not neglect either of the children. Her husband’s daughter has lived with them since she was four years old (currently she is 13 years old). J.K. and her stepdaughter are extremely close, largely due to J.K. being there for the majority of her childhood. The step-daughter will be present at the hospital during the delivery and has stated specifically that she “wants to be there when the baby is born.” But, due to J.K.’s uncertainty of how the birth will progress, she has asked that the girl stay outside the room during delivery. J.K. also wonders how having this baby will affect her relationship with her husband; she hopes that ultimately it will make their bond grow all the stronger.
Nutrition
J.K. has never been overly concerned about choosing healthy and nutritional foods when she ate, until now. She is currently taking calcium supplements, as well as, drinking some milk to help increase her calcium intake. She does not particularly enjoy drinking milk so the calcium supplements are used as way to increase the calcium intake in her body. She is also taking prenatal vitamins on a daily basis. J.K. is also eating an increased amount of fruits and vegetables. She states that for snacks instead of eating junk food she has substituted them for slices of apples or a cup of sliced fruit or vegetables. Her protein intake has also been increased during the pregnancy. During her first trimester, her nutritional intake was not as adequate as it should have been, according to J.K. She would be a portion of the way into eating her meal, then would become full, so her intake became decreased. During the second and third trimester her appetite has been very healthy, and she is constantly eating. She has gained 40 pounds since the start of her pregnancy. Currently, she is now getting uncomfortable in her abdomen, especially when she tries to eat.
Elimination
Early in her pregnancy J.K. was regular with her eliminations. She typically has one bowel movement a day, sometimes two or three, becoming more consistent as of lately. Now as she gets closer to her due date she is experiencing polyuria. She has been getting up approximately every two hours to urinate throughout the night. During the day, she can only manage about two hours or less before J.K. has the urge to urinate; this is largely because of the increased walking she is having to do during her workday.
Sleep/ Rest
J.K. shares a bed with her husband in the master bedroom upstairs. Prior to her pregnancy, she typically slept anywhere from six to eight hours a night. During her first and second trimester she didn’t have any trouble sleeping. However, towards the end of this third trimester, her sleeping habits have been interrupted severely by having to get up for urinary frequency, increased lower back pain, and the baby moving around frequently. J.K. likes using the body pillows when she sleeps, it increases her comfort level.
Activity/ Exercise
J.K. does not have an exercise routine or regimen. As a second grade teacher she is constantly moving and lifting. The combination of that, her husband’s busy schedule, and her stepdaughter’s very active lifestyle, J.K. does not always have the time to set aside for a consistent workout. She does, however, have a recumbent bike available for her use at the house. J.K. started to use the recumbent bike just before she became pregnant. After becoming pregnant she decided to stop using the bike because she was unsure of how it would affect the fetus. We were able to educate her that it was perfectly fine to workout using the recumbent bike.
Cognitive/ Perceptive
J.K. has her bachelor’s degree in education; this degree has allowed her to teach at Heritage Elementary School. At Heritage, J.K. moved from teaching kindergarten last year, where she had taught for the past three, to teaching second grade at their main campus in Glendale. She originally obtained her degree in Norway. J.K. was thinking of going back to get her master’s degree before she got pregnant, however, she is planning on going back after her son is a couple years old. J.K. states that she is an auditory and visual learner. J.K. and her husband make all the major decisions for the family together; if a disagreement occurs, then they compromise. When J.K. first got married her husband, J.B., was in charge of their finances, but after he left for his second tour in Iraq she became in charge of major financial decisions. She is ecstatic to have a son of her own and to continue growing their family together. J.K. stated that she is a little nervous, not so much about having a baby but of the pain during birth. Her husband will be present with her at birth. Shortly after that, her mother is coming in March to help J.K. and J.B. with their baby.
Self Perception
J.K. is excited to have a baby of her own, especially after trying for so long and having no success until now. She is extremely close with her mother and sister and is slightly disappointed that neither one of them will be there during her son’s birth. Her mother will be arriving in Phoenix on March fourth to help J.K. and her husband. J.K. is a very social person, extremely easy going, gentle, caring, and intelligent. She does not really like to cook, but does it because it makes her husband happy. She seems very positive about being pregnant and how everything has progressed during her pregnancy. She is nervous about the pain during birth, hearing that it is the most excruciating kind of pain a woman can face. J.K. has been able to take maternal leave from work long enough to adjust to having him at home. She then will have about a month left of work to finish before her summer break begins. Her husband is also trying to get time off work to help at home.
Sexuality/ Reproduction
J.K. stated that this pregnancy was completely unplanned. She went through in-vitro fertilization (IVF) twice trying to get pregnant. Both times she went through the IVF were unsuccessful. Prior to her IVF treatment and pregnancy, J.K. was on birth control. After this birth she is unsure of whether or not she will return to taking birth control. J.K. state several times how much she was hoping to have another baby after this one, however, she does not think it will likely happen because of how hard it was to get pregnant this time. She is still sexually active and plans to be while her child is growing.
Coping Stress
Having a new infant in the household is an extremely stressful situation in their lives. Their routines will completely change to match that of the baby’s. Prior to the pregnancy, J.K. could live comfortably with the finances that were brought in to their family. Now, she is a little nervous about finances due to having the baby and the uncertainty of having a job next year (being in the education system). However, J.K. has a savings system set up for her family.
Beliefs/ Values
J.K. was raised in Norway, and grew up attending a state church. When she came to Phoenix, settling here with her husband, they tried several churches but never found one that quite felt like home or like the ones she grew up in. One of her top priorities with her son is to teach him morals and respect of others. She practices her faith at home and when J.K. visits her home in Norway, she goes to church with her immediate family.
Family Assessment
Health Perception/ Health Management
J.K., mother, age 34 and J.B., father, age 32, believe it is important to exercise and eat well in order to have good health. They take multivitamins. They make sure that they keep their yearly dental, eye, and medical visits, and recently, the prenatal visits. When someone gets sick they go to the doctor. The mother, J.K. seems to have the most influence concerning health related decisions. Family doesn’t have an exercise schedule, but the father does train/ gets in shape as needed for his Army duties. Mother has used a recumbent bike from time to time. The thirteen year old daughter, C.B., which is the father’s daughter by a previous marriage, does Tai Kwon Do which helps keep her in shape. They use their seatbelts when in the car and have smoke detectors in their home. They make sure they get eight hours of adequate sleep, though lately, with the pregnancy, J.K. has not been getting very much sleep. They are all non smokers and rarely drink alcohol. The family plans on giving birth at Estrella Hospital. They would like a water birth but they are not sure that will happen. J.K. plans on using an epidural. Parents want to be present for the birth and have their daughter wait in the lobby and then join them after the birth. J.K. has not had any childbirth classes.
Role/Relationship
J.B. is a recruiter for the Army. He served in Iraq for two tours. J.K. is a second grade teacher at Heritage Elementary school. Their 13 year old daughter, C.B., is from J.B.’s previous marriage and lives with her biological mother every other weekend. Daughter has been part of this couple’s lives for nine years. She and her husband do very well together when it comes to decision making. They discuss the problem and arrive at a solution together. Once baby arrives, J.K. plans on taking a six to eight week maternity leave that she hopes will run into the end of the school year. As a teacher she plans on taking the summer off as scheduled to save on daycare expenses. In the fall, she plans on using an in home day care through one of the parents of her students. They were planning on putting in a back yard landscape but have those plans on hold due to financial reasons with the upcoming baby.
Nutritional
The family is aware of the composition of a healthy diet. They try to eat lots of fruits and vegetables, milk, and protein. J.B. likes to eat egg whites for breakfast. He has removed sugar from his diet. He likes to eat chicken or beef with a steak rub at lunch, and broccoli. He allows himself salt if needed for flavoring. He will also eat an apple or orange for a snack. The family also enjoys eating roast beef sandwiches, pizza, salads. Being a dual income household allows them to have sufficient resources to obtain adequate nutrition. They try and eat meals together, but that doesn’t always happen. They like to go grocery shopping together and they decide together what their meals will be. They even prepare meals together, but usually she is the one who cooks. Friday nights they try to go out together as a family and eat pizza. They also will snack on potato chips, and candy like Twizzlers.
Elimination
The family does not use laxatives. They try to use fiber to help stimulate the bowels if they are having constipation problems. They usually have regular bowel and urinary elimination patterns. The family plans on potty training their son. Their philosophy is that they will start encouraging him when he is two years old if he looks like he is interested and ready. They won’t try and force him. They use a garbage disposal to eliminate some food waste. They have a dog and the daughter takes care of picking up the dog’s poop. There is recycling and so trash is put in the appropriate waste receptacle. There are no problems with insects or rodents.
Sleep/ Rest
The family has a good pattern of sleep and rest usually getting at least eight hours of sleep. J.K. has not been sleeping as well since being pregnant in these latter weeks, but this has not prevented her husband from sleeping through her insomnia. The daughter sleeps less during the week because of school and doing homework, and sleeps ten or more hours on the weekend. Mother plans to have baby stay in the bedroom with them, but father wants baby in its own room. At the moment, the nursery has not been prepared. They plan to use a play yard with the attached changing table. Later, they plan to use the crib that converts into a toddler bed. Usually, the doggy door allows the dog to go in and out of the house to use the bathroom. However, at night, the dog sleeps with J.B. and J.K. and wakes them up to be let out of the bedroom. Once the baby is born, the dog will sleep with the daughter and she will be responsible for letting out the dog.
Activity/ Exercise
Family doesn’t have an exercise schedule, but the father does train/ gets in shape as needed for his Army duties. Mother has used a recumbent bike from time to time. The thirteen year old daughter, C.B., which is the father’s daughter by a previous marriage, does Tai Kwon Do which helps keep her in shape. They like to go shopping together at the mall. They don’t go to church and don’t have family centered activities. There are some neighborhood parks that are available and they do plan on doing the baby swim lessons when that time comes.
Cognitive/ Perceptive
Because this couple already has been parenting a thirteen year old, they have knowledge and understanding of parenting concepts. As to having an infant, the mother has never had one before and so her understanding and knowledge is more limited. They have not been going to any child birth classes but she has done lots of reading so she knows what to expect in regards to infant care, labor and delivery management and postpartum management. She and her husband do very well together when it comes to decision making. They discuss the problem and arrive at a solution together. When it comes to bills, she pays them. There are no sensory deficits among the family members. J.B. had lasik eye surgery in September 2010 and so his vision has now been corrected. The family is future oriented. They are planning for how their lives will unfold with the new baby and his development. This family has a positive attitude and is warm and friendly.
Self Perception
This family has a positive image of themselves and have a good sense of worth. They are happy with their jobs and where they are in life, especially now that they are having a baby after trying twice unsuccessfully by in-vitro fertilization to get pregnant. They are thankful to have conceived naturally once they stopped trying. They feel like their baby is a miracle. J.K. has enjoyed being pregnant and has loved that aspect of being a mother. The emotional pattern of the family is happy and positive. They feel that they contribute to society in a positive way and are good neighbors in their community. Their neighborhood is a nice middle class neighborhood that is clean and well landscaped. Their home is a two story home that is clean, comfortable, and nicely decorated. They have tile floor in the traffic patterns and kitchen. The master bedroom/ bath is upstairs.
Sexuality/ Reproductive
This couple is sexually active and is very satisfied with their reproductive patterns. They now have a son on the way. They did try twice unsuccessfully by in-vitro fertilization to get pregnant. When they stopped trying, they conceived naturally. They would probably like to have more children but they will wait and see. They have already discussed sexual topics with their daughter and are comfortable explaining those details. J.K. plans on using birth control after delivery the baby.
Coping/ Stress
There are no current stressors except for the current pregnancy that everyone has been adjusting to and will really be adjusting to once the baby arrives. During different situations the family copes in different ways. The father will not eat when he is trying to cope. He focuses on getting things in order that need attention. Sometimes he rides his bike or goes for a ride in the car. Admits he sometimes resorts to smoking. The mother likes to talk with someone or with family when she needs to cope. They also talk to one another to deal with problems. This family fits into the Family Systems Theory because individuals need one another in order to be understood as being part of a family and not be isolated from one another.
Beliefs/ Values
This family believes in God but does not go to church. They tried several churches in their area but they are not like the state churches in Norway that J.K. is used to and so she did not feel comfortable. They believe in working hard for what they earn. They value family and life.
Application of Family Theories
This family fits into the Family Systems Theory because individuals need one another in order to be understood as being part of a family and not be isolated from one another. Each one is needed to be a part of the bigger whole. The family works together as a unit and when one thing happens, such as the birth of a baby, it affects everyone in the family in regards to all of the functional health patterns (Loudermilk & Perry, 2007). This family is a dual income household and they are financially stable. J.B. is a recruiter for the Army and he served in Iraq for two tours. J.K. is a second grade teacher at Heritage Elementary school. Both of their jobs contribute to the family systems theory because if one was to lose their job, it would affect the whole family. Their 13 year old daughter, C.B., is from J.B.’s previous marriage and lives with her biological mother every other weekend. Daughter has been part of this couple’s lives for nine years. A step daughter changes the dynamics in a household because sometimes she is there and sometimes she isn’t. This change affects everyone. J.K. and her husband do very well together when it comes to decision making. They discuss the problem and arrive at a solution together. Sometimes they include their daughter. The family is able to create balance by working together. Once baby arrives, J.K. plans on taking a six to eight week maternity leave that she hopes will run into the end of the school year. As a teacher she plans on taking the summer off as scheduled to save on daycare expenses. In the fall, she plans on using an in home day care through one of the parents of her students. They were planning on putting in a back yard landscape but have those plans on hold due to financial reasons with the upcoming baby. These behaviors are understood from a circular affect. When one thing happens, such as the birth of the baby, then some family expectations like the backyard landscaping are put on hold. The baby also affects their income in respect to daycare. The family believes in maintaining their health by going to their yearly doctor’s visits. When anyone is sick, this affects the whole family and so they realize the benefit of staying healthy. This family has a positive attitude and is warm and friendly. The emotional pattern of the family is happy and positive. They feel that they contribute to society in a positive way and are good neighbors in their community. When the emotional pattern is happy and things are going well, then the family is functioning in a better way. Everyone’s emotions affect one another in a family setting. When J.K. and J.B. were trying to conceive using in-vitro fertilization, emotions in the reproductive side of their relationship were strained. After becoming pregnant their sexual relationship has improved. Again, the family as a whole is important to how it functions in a successful way.
Assumptions
When first meeting J.K., there were several assumptions made about her. She was bright and very talkative when we first walked into her home, making it appear as though she was not in any discomfort. Secondly, J.B., her husband, was not present until the second interview and when talking with J.K. it appeared that her husband was not very present during the preparation of her pregnancy or throughout the pregnancy. Thirdly, she was laughing and extremely cheerful making it seem that she was very happy with no signs of worries being present. Lastly, it seems that her mother, sister, and stepdaughter will be of great help to J.K. with the new baby because of how much we talked about them.
After spending so much time with J.K, it was found that some of the assumptions made were true, while others were not. The first assumption was partially true; J.K. was comfortable when we first met. However, during the night, she gets increasingly more uncomfortable because of not being able to find a position that she can sleep in consistently. Secondly, her husband was very present throughout the pregnancy and preparing for the baby’s arrival. Meeting him during the second interview, we were able to see how much he really had been a part of this process for his wife. He had gone to several of J.K.’s doctor visits and only stopped attending them at her request. Also, he is making/preparing a nursery room for their new baby. Seeing all this activity, our second assumption is deemed false. The third assumption is mostly true; J.K. is very cheerful and ecstatic to have this new baby. She stated that the only worry she had was about the pain she would be in during labor and giving birth. J.K. was unsure of the level of pain to expect, she just always heard that it was the most painful process, but worth it in the end. The fourth assumption was largely false in that her mother, sister, and stepdaughter will be extremely active and helpful as much as possible. However, her mother and sister live in Norway and are only able to give her advice over the phone until they come to Phoenix for a visit. J.K.’s stepdaughter will be highly active in helping with the baby and has vocalized how much she wants to be there, helping as much as possible.
Validity
It would have really been nice to talk more with J.K.’s family, including her mom and sister in order to verify how they are helping her prepare for giving birth. Validity wise, it would have also been extremely beneficial to have seen her and her husband finish setting up the safety standards for having a baby in their home. J.K. and J.B. did not have very many baby supplies in the home because J.K. had not had her baby shower yet.
Diet Analysis
The 2005 Dietary Guidelines (DG) Recommendations
for Check It Out user on 2/15/11
for Check It Out user on 2/15/11
Click directly on the 
emoticon (face) for more detailed dietary information.
emoticon (face) for more detailed dietary information.| Dietary Guidelines Recommendations | Emoticon | Number of cup/ oz. Equ. Eaten | |
| Grain |  | 6.3 oz equivalent | 6 oz equivalent |
| Vegetable |  | 2.1 cup equivalent | 2.5 cup equivalent |
| Fruit |  | 2.2 cup equivalent | 2 cup equivalent |
| Milk |  | 2 cup equivalent | 3 cup equivalent |
| Meat and Beans |  | 6.5 oz equivalent | 5.5 oz equivalent |
| Dietary Guidelines Recommendations | Emoticon | Amount Eaten | Recommendation or Goal |
| Total Fat |  | 38.5% of total calories | 20% to 35% |
| Saturated Fat |  | 13.9% of total calories | less than 10% |
| Cholesterol |  | 194 mg | less than 300 mg |
| Sodium |  | 1940 mg | less than 2300 mg |
| Oils | * | * | * |
| Discretionary calories (solid fats, added sugars, and alcohol) | * | * | * |
| * Calculations for oils and discretionary calories from foods are under revision. More information about the Dietary Guidelines for Americans 2005 (To view this document you need Adobe Acrobat Reader) |
The 2005 Dietary Guidelines (DG) Recommendations
for Check It Out user on 2/16/11
for Check It Out user on 2/16/11
Click directly on the 
emoticon (face) for more detailed dietary information.
emoticon (face) for more detailed dietary information.| Dietary Guidelines Recommendations | Emoticon | Number of cup/ oz. Equ. Eaten | |
| Grain |  | 9.7 oz equivalent | 6 oz equivalent |
| Vegetable |  | 1.9 cup equivalent | 2.5 cup equivalent |
| Fruit |  | 3.1 cup equivalent | 2 cup equivalent |
| Milk |  | 2.9 cup equivalent | 3 cup equivalent |
| Meat and Beans |  | 3.7 oz equivalent | 5.5 oz equivalent |
| Dietary Guidelines Recommendations | Emoticon | Amount Eaten | Recommendation or Goal |
| Total Fat |  | 37.4% of total calories | 20% to 35% |
| Saturated Fat |  | 13.1% of total calories | less than 10% |
| Cholesterol |  | 236 mg | less than 300 mg |
| Sodium |  | 2533 mg | less than 2300 mg |
| Oils | * | * | * |
| Discretionary calories (solid fats, added sugars, and alcohol) | * | * | * |
| * Calculations for oils and discretionary calories from foods are under revision. More information about the Dietary Guidelines for Americans 2005 (To view this document you need Adobe Acrobat Reader) |
As women continue to grow in their pregnancy, their need for nutrient intake increases in order to adequately provide for the expectant mother and her infant. The graphs above are based off of a two day food diary from J.K. These graphs show that J.K. is meeting most of her recommendations on nutrient intake. For the ones she is not meeting, milk and meat and beans, J.K. is taking supplements for calcium. In regards to meat and bean intake, J.K. states that she usually eats more protein than the two days she recorded.
Clue Clustering
Cluster 1-Nutrition
1) take multivitamins
2) eat lots of fruits and vegetables, milk, and protein
3) J.B. likes to eat egg whites for breakfast
4) He has removed sugar from his diet
5) He likes to eat chicken or beef with a steak rub at lunch, and broccoli
6) He will also eat an apple or orange for a snack
7) eating roast beef sandwiches, pizza, salads
8) try and eat meals together
9) father will not eat when he is trying to cope
10) Friday nights they try to go out together as a family and eat pizza.
11) snack on potato chips, and candy like Twizzlers.
Cluster 2- family health & safety
1) keep their yearly dental, eye, and medical visits, and recently, the prenatal visits.
2) use their seatbelts when in the car
3) have smoke detectors in their home
4) get eight hours of adequate sleep
5) J.K. has not been getting very much sleep
6) all non smokers
7) rarely drink alcohol.
8) does not use laxatives
9) use fiber to help stimulate the bowels if they are having constipation problems
10) have regular bowel and urinary elimination patterns.
11) use a garbage disposal to eliminate some food waste
12) There is recycling
13) no problems with insects or rodents.
14) daughter sleeps less during the week because of school and doing homework, sleeps ten or more hours on the weekend
15) are no sensory deficits among the family members
16) neighborhood is a nice middle class neighborhood that is clean and well landscaped.
17) couple is sexually active and is very satisfied with their reproductive patterns
18) did try twice unsuccessfully by in-vitro fertilization to get pregnant.
19) J.K. plans on using birth control after delivery the baby.
20) father sometimes resorts to smoking
Cluster 3-exercise
1) Family doesn’t have an exercise schedule
2) father does train/ gets in shape as needed
3) used a recumbent bike from time to time
4) daughter does Tai Kwon Do which helps keep her in shape
Cluster 4-pregnancy and childcare
1) J.K. plans on using an epidural
2) J.K. has not had any childbirth classes.
3) taking a six to eight week maternity leave
4) plans on using an in home day care
5) plans on potty training their son won’t try and force him
6) plan on doing the baby swim lessons
7) have knowledge and understanding of parenting concepts.
8) has done lots of reading so she knows what to expect in regards to infant care, labor and delivery management and postpartum management.
Cluster 5-family issues
1) 13 year old daughter, C.B., is from J.B.’s previous marriage and lives with her biological mother every other weekend
2) Daughter has been part of this couple’s lives for nine years.
3) She and her husband do very well together when it comes to decision making.
4) back yard landscape but have those plans on hold due to financial reasons with the upcoming baby.
5) dual income household allows them to have sufficient resources
6) Friday nights they try to go out together as a family and eat pizza.
7) daughter takes care of picking up the dog’s poop.
8) the nursery has not been prepared
9) the dog sleeps with J.B. and J.K. and wakes them up to be let out of the bedroom.
10) go shopping together at the mall
11) don’t go to church
12) don’t have family centered activities
13) family has a positive attitude and is warm and friendly.
14) family has a positive image of themselves and have a good sense of worth
15) happy with their jobs and where they are in life
16) contribute to society in a positive way and are good neighbors in their community.
17) already discussed sexual topics with their daughter and are comfortable explaining those details.
18) no current stressors except for the current pregnancy
19) mother likes to talk with someone or with family when she needs to cope
20) believes in God
21) believe in working hard for what they earn.
22) value family and life.
Missing Data
Missing data that would be helpful to have for this family health assessment are lab results and specific height and weight of the family members, as well as BMI indexes. This would have given a better picture of their nutritional status. It also would have helped to know what may have been going on internally with the mother.
Inferences
Data from Cluster #1 was clustered together because it all related to nutrition. It showed the normal food choices being consumed and the risk for eating junk food. There is also the abnormal pattern where the father will sometimes not eat when he is stressed.
Data from Cluster #2 was clustered together because it all related to family health and safety. The family is aware of taking care of their health and they live in a safer neighborhood. Sleep is an area that is being affected and when the dad can’t cope, he sometimes resorts to smoking which is not good for one’s health.
Data from Cluster #3 was clustered together because it all related to exercise. Though the daughter is active in her Tae Kwon Do and the dad does some physical training when needed, the mother is not very active and because the family doesn’t have an exercise schedule, this could lead to health problems like diabetes or high blood pressure or obesity.
Data from Cluster #4 was clustered together because it all related to pregnancy and childcare. The mother is knowledgeable about labor and delivery because she has been reading a lot of books. She has been trying to prepare herself, yet since she hasn’t taken the childbirth classes, she could end up being unprepared in the long run when it come to delivery time.
Data from Cluster #5 was clustered together because it all related to family issues. The family has a good positive image of themselves and they work well together, however they don’t have family centered activities. This will be even more impacted when the baby comes and hopefully, their daughter will not feel neglected. At least she is participating in her Tae Kwon Do activities.
Analyticity Wellness/Nursing Diagnosis
Family Centered Wellness nursing diagnosis: Readiness for enhanced childbearing process.
Open-minded Outcome Criteria and Inquisite
Outcome #1: Family will continue to practice making healthy dietary choices continuing
through the pregnancy and throughout the next six months.
Nursing Intervention (Diagnostic): The nurse will verbally verify healthy nutritional intake with family as well as obtain weight measurements and BMI index.
Nursing Intervention (Community Referrals): The nurse will provide family with
community resources in order to educate and enhance knowledge of healthy dietary
choices. Community Referral is: Mayo Clinic Hospital Healthy Pregnancy. The website
is http://www.mayoclinic.com/health/pregnancy-week-by-week/MY00331. Another
referral is: Paradise Valley Hospital Maternity Services Contact: (619) 470-4200.
Outcome #2: Husband and daughter will support mother as she continues making her prenatal
visits with her doctor through the time of her delivery.
Nursing Intervention (Therapeutic): The nurse will ensure mother is provided comfort through the use of pillows and blankets as needed while at the physician’s office.
Outcome #3: Family will seek necessary knowledge of labor and delivery and newborn care by
the delivery date.
Nursing Intervention (Educational): The nurse will instruct the family on labor and delivery methods and newborn care practices by using videos and/or pamphlets.
Cognitive Maturity-Outcomes Evaluation
Outcome #1: Outcome was only partially met because though they are doing well at the moment by eating healthy foods, the time frame of six months has not elapsed and measurements have not been confirmed.
Outcome #2: Outcome was partially met since mother has been making all of her prenatal visits but has not delivered yet, so time frame has not ended.
Outcome #3: Outcome has been met because parents have been instructed on labor and delivery methods and newborn care practices before the delivery date and are ready for their newborn.
Conclusion
A large quantity of information was obtained in order to assess and evaluate this family for the Community Family Health Assessment assignment. The mother, J.K. was analyzed from the perspective of the pregnant mother and the father, J.B. was interviewed to gather information on his role in their relationship. Both of them provided information on their daughter and the dynamics within their household as they pertained to the functional health patterns. An understanding about the impact of the family on functional health patterns was obtained during this interview process. Clues were clustered and analyzed and a wellness nursing diagnosis was created with outcomes and interventions. In the future, these will need to be re-evaluated to see if the outcomes were met. This was a good learning experience for Jennifer and Bonnie as they worked with this family on their Community Family Health Assessment assignment.
References
Carpenito-Moyet, L.J. (2010) Nursing diagnosis: Application to clinical practice. 13th ed.). Philadelphia, PA : Lippincott Williams & Wilkins
Lowdermilk, D. L., & Perry, S. E. (2007). Maternity and women's health care (9th ed.).
Philadelphia: Mosby
Erikson’s development stages (1990). Patient teaching. Loose leaf library. Springhouse
corporation. Retrieved February 15, 2011 from
http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/erikson.hm
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